NUR 453 Exam 1 UPDATED ACTUAL
QUESTIONS AND CORRECT ANSWERS
Which leads look at the inferior wall of the heart? - CORRECT ANSWERS Leads 2, 3,
and AVF
Which leads look at the lateral aspect of the heart? - CORRECT ANSWERS Leads 1,
AVL, V5, and V6
Which leads look at the interventricular septum? - CORRECT ANSWERS Leads V1 and
V2
Which leads look at the anterior wall of the heart? - CORRECT ANSWERS Leads V3 and
V4
Assessment of a patient in sinus bradycardia - CORRECT ANSWERS Bradycardia + no
symptoms + no hypoTN = just monitor (no interventions)
Bradycardia + symptoms (ex: syncope, hypoxemia, etc) but no hypoTN = give Atropine 0.5 mg
IV
Bradycardia + symptoms + HypoTN (<70/40) = shock with Pacemaker! Call for help and give
O2 while waiting
Causes of sinus bradycardia - CORRECT ANSWERS Pain meds
Beta Blockers
Anemia
Exercise
Digoxin
Causes of sinus tachycardia - CORRECT ANSWERS Fever
Pain
,Anxiety
Caffeine
Cocaine
Dehydration
PAC (Premature Atrial Contraction) - CORRECT ANSWERS Cardiac cell becomes
irritable and fires an impulse before the next sinus impulse is produced.
Caused by stress, fatigue, anxiety, caffeine, nicotine, infections
Remove substances and it is usually self-limiting
Atrial flutter - CORRECT ANSWERS No P wave
Sawtooth pattern
R to R is normal or fast
Normal QRS
Caused by pericarditis, hypoxia, and COPD
Treatment of Atrial Flutter - CORRECT ANSWERS Aflutter + HR > 100 + symptoms
(palpitations, SOB, dizziness, fatigue) = CCB & Digoxin to slow heart down
Aflutter + HR > 150 + BP 80/40 = Synchronized Cardioversion on R wave (unstable)
Atrial Fibrillation - CORRECT ANSWERS No P wave
Most common dysrhythmia
Caused by ischemia, heart disease, age > 75
AFib Treatment - CORRECT ANSWERS Unstable/New onset: Cardioversion
Stable: rate or rhythm control (CCB or BB)
Risk of clot (can lead to stroke, give anticoagulants)
, Junctional Rhythm - CORRECT ANSWERS The SA node is nonfunctional
P waves are absent
Heart is paced by the AV node at 40-60 beats/min
Occurs with hypoxemia and Digoxin toxicity
PVC - CORRECT ANSWERS Increased irritability of ventricles
No P wave
QRS wide & bizarre
Frequently occur in repetition
Can be asymptomatic or cause palpitations and decreased peripheral pulses
Caused by hypoxemia, hypokalemia, and hypomagnesemia
Ventricular Tachycardia - CORRECT ANSWERS Very rapid heartbeat that begins with the
ventricles
3 or more PVCs in a row
> 140 - 250 BPM
Regular R to R rhythm
Wide & bizarre QRS
Unresponsive, pulseness, apneic
PVC Treatment - CORRECT ANSWERS Treat the cause (give K+ but NOT IV PUSH)
Pulse = cardiovert
No pulse = give CPR
VTach treatment - CORRECT ANSWERS Stable = amiodarone
Unstable w/pulse = cardiovert
Unstable w/o pulse = defibrillate
QUESTIONS AND CORRECT ANSWERS
Which leads look at the inferior wall of the heart? - CORRECT ANSWERS Leads 2, 3,
and AVF
Which leads look at the lateral aspect of the heart? - CORRECT ANSWERS Leads 1,
AVL, V5, and V6
Which leads look at the interventricular septum? - CORRECT ANSWERS Leads V1 and
V2
Which leads look at the anterior wall of the heart? - CORRECT ANSWERS Leads V3 and
V4
Assessment of a patient in sinus bradycardia - CORRECT ANSWERS Bradycardia + no
symptoms + no hypoTN = just monitor (no interventions)
Bradycardia + symptoms (ex: syncope, hypoxemia, etc) but no hypoTN = give Atropine 0.5 mg
IV
Bradycardia + symptoms + HypoTN (<70/40) = shock with Pacemaker! Call for help and give
O2 while waiting
Causes of sinus bradycardia - CORRECT ANSWERS Pain meds
Beta Blockers
Anemia
Exercise
Digoxin
Causes of sinus tachycardia - CORRECT ANSWERS Fever
Pain
,Anxiety
Caffeine
Cocaine
Dehydration
PAC (Premature Atrial Contraction) - CORRECT ANSWERS Cardiac cell becomes
irritable and fires an impulse before the next sinus impulse is produced.
Caused by stress, fatigue, anxiety, caffeine, nicotine, infections
Remove substances and it is usually self-limiting
Atrial flutter - CORRECT ANSWERS No P wave
Sawtooth pattern
R to R is normal or fast
Normal QRS
Caused by pericarditis, hypoxia, and COPD
Treatment of Atrial Flutter - CORRECT ANSWERS Aflutter + HR > 100 + symptoms
(palpitations, SOB, dizziness, fatigue) = CCB & Digoxin to slow heart down
Aflutter + HR > 150 + BP 80/40 = Synchronized Cardioversion on R wave (unstable)
Atrial Fibrillation - CORRECT ANSWERS No P wave
Most common dysrhythmia
Caused by ischemia, heart disease, age > 75
AFib Treatment - CORRECT ANSWERS Unstable/New onset: Cardioversion
Stable: rate or rhythm control (CCB or BB)
Risk of clot (can lead to stroke, give anticoagulants)
, Junctional Rhythm - CORRECT ANSWERS The SA node is nonfunctional
P waves are absent
Heart is paced by the AV node at 40-60 beats/min
Occurs with hypoxemia and Digoxin toxicity
PVC - CORRECT ANSWERS Increased irritability of ventricles
No P wave
QRS wide & bizarre
Frequently occur in repetition
Can be asymptomatic or cause palpitations and decreased peripheral pulses
Caused by hypoxemia, hypokalemia, and hypomagnesemia
Ventricular Tachycardia - CORRECT ANSWERS Very rapid heartbeat that begins with the
ventricles
3 or more PVCs in a row
> 140 - 250 BPM
Regular R to R rhythm
Wide & bizarre QRS
Unresponsive, pulseness, apneic
PVC Treatment - CORRECT ANSWERS Treat the cause (give K+ but NOT IV PUSH)
Pulse = cardiovert
No pulse = give CPR
VTach treatment - CORRECT ANSWERS Stable = amiodarone
Unstable w/pulse = cardiovert
Unstable w/o pulse = defibrillate
