NR 341 COMPLEX ADULT HEALTH
EXAM 2 - UNIT 3 + 4 WITH 100%
CORRECT ANSWERS 2025/2026
Pacemakers correct answers >> Permanent and temporary.
stimulate contractions.
Atria = P-wave stimulation (spike right before)
Ventricle = QRS stimulation (spike right before)
Dual Pacemaker correct answers >> Better than single
pacemaker b/c CARDIAC OUTPUT IS INCREASED AND MINICS
HEART MUCH CLOSER than a single one.
Will see P-wave and QRS complexes for each paced beat (A-V
paced).
Transcutaneous Pacemaker (external) correct answers >>
Temporary, noninvasive.
Need to give enough sedation and pain meds.
Attached to D-fib and put in pacer mode to shock heart.
Permanent Pacemaker (internal) correct answers >> Invasive
and need informed concent for Dr.
Need to explain risks and complications.
Clean chest and make sure it's sterile.
,Complications of internal pacemakers correct answers >>
Malfunctions, leads can get displaces, battery can die,
pneumothorax, can irritate phrenic nerve/stimulation (hiccups).
A - paced EKG correct answers >> Pacing stimulus directed
to heart and a pacer spike is seen on EKG strip. Vertical line
followed by a P-wave (atrail pacing)
V - paced EKG correct answers >> Pacing stimulus directed
to heart and a pacer spike is seen on EKG strip. Vertical line
followed by a QRS complex (ventricular pacing).
Each pacemaker spike needs to be followed by a... correct
answers >> complex (p-wave or QRS)
Failure to Capture correct answers >> Electrical charge to
myocardium is insufficient to produce atrial or ventricular
contraction.
What can failure to capture result in? correct answers >>
Serious bradycardia or asystole.
What causes failure to capture w/ pacemakers? correct
answers >> Pacer lead damage, battery failure, dislodgement of
electrode, electrical charge set too low, fibrosis od electrode tip.
What to do if see EKG of pacemaker with no complex? correct
answers >> Assess first and then notify Dr. Means electrical
charge is not strong enough to cause contraction.
, Pacemaker Placement correct answers >> PLaced in the OR
or Cath Lab.
24 hr stay.
Left arm should not be lifted more than 90 degrees (no greater
than shoulder level).
Pacemaker patient education correct answers >> Monitor
incision site, Monitor/check HR 1x/day, always carry pacemaker ID
card, NO MRIs (contraindicated bc of magnet), can't have security
wand waved over them (notify security), can't walk through metal
detector.
Notify Dr. if chest pain, palpitations, hiccups, SOB, dizziness.
Cardioversion correct answers >> Indicated for fast rhythms
w/ a pulse.
Elective procedure - need to have consent, have crash cart ready,
enough sedation and pain medication (can have skin burns)
Prior to a cardioversion procedure... correct answers >>
Echocardiogram needs to be done to r/o risk of blood clot
dislodgement (placed on anticoagulants)
Internal Cardioversion correct answers >> *AICD* -
pacemaker w/ ability to shock.
Pacing capabilities - A paced, V paced, or both.
What meds are people with an AICD on? correct answers >>
Amiodarone (antiarrythmic)
EXAM 2 - UNIT 3 + 4 WITH 100%
CORRECT ANSWERS 2025/2026
Pacemakers correct answers >> Permanent and temporary.
stimulate contractions.
Atria = P-wave stimulation (spike right before)
Ventricle = QRS stimulation (spike right before)
Dual Pacemaker correct answers >> Better than single
pacemaker b/c CARDIAC OUTPUT IS INCREASED AND MINICS
HEART MUCH CLOSER than a single one.
Will see P-wave and QRS complexes for each paced beat (A-V
paced).
Transcutaneous Pacemaker (external) correct answers >>
Temporary, noninvasive.
Need to give enough sedation and pain meds.
Attached to D-fib and put in pacer mode to shock heart.
Permanent Pacemaker (internal) correct answers >> Invasive
and need informed concent for Dr.
Need to explain risks and complications.
Clean chest and make sure it's sterile.
,Complications of internal pacemakers correct answers >>
Malfunctions, leads can get displaces, battery can die,
pneumothorax, can irritate phrenic nerve/stimulation (hiccups).
A - paced EKG correct answers >> Pacing stimulus directed
to heart and a pacer spike is seen on EKG strip. Vertical line
followed by a P-wave (atrail pacing)
V - paced EKG correct answers >> Pacing stimulus directed
to heart and a pacer spike is seen on EKG strip. Vertical line
followed by a QRS complex (ventricular pacing).
Each pacemaker spike needs to be followed by a... correct
answers >> complex (p-wave or QRS)
Failure to Capture correct answers >> Electrical charge to
myocardium is insufficient to produce atrial or ventricular
contraction.
What can failure to capture result in? correct answers >>
Serious bradycardia or asystole.
What causes failure to capture w/ pacemakers? correct
answers >> Pacer lead damage, battery failure, dislodgement of
electrode, electrical charge set too low, fibrosis od electrode tip.
What to do if see EKG of pacemaker with no complex? correct
answers >> Assess first and then notify Dr. Means electrical
charge is not strong enough to cause contraction.
, Pacemaker Placement correct answers >> PLaced in the OR
or Cath Lab.
24 hr stay.
Left arm should not be lifted more than 90 degrees (no greater
than shoulder level).
Pacemaker patient education correct answers >> Monitor
incision site, Monitor/check HR 1x/day, always carry pacemaker ID
card, NO MRIs (contraindicated bc of magnet), can't have security
wand waved over them (notify security), can't walk through metal
detector.
Notify Dr. if chest pain, palpitations, hiccups, SOB, dizziness.
Cardioversion correct answers >> Indicated for fast rhythms
w/ a pulse.
Elective procedure - need to have consent, have crash cart ready,
enough sedation and pain medication (can have skin burns)
Prior to a cardioversion procedure... correct answers >>
Echocardiogram needs to be done to r/o risk of blood clot
dislodgement (placed on anticoagulants)
Internal Cardioversion correct answers >> *AICD* -
pacemaker w/ ability to shock.
Pacing capabilities - A paced, V paced, or both.
What meds are people with an AICD on? correct answers >>
Amiodarone (antiarrythmic)
