Dysrhythmias
1. What accurately describes electrocardiographic (ECG) monitoring?
a. Depolarization of the cells in the ventricles produces the T wave on the
ECG.
b. An abnormal cardiac impulse that arises in the atria, ventricles, or
atrioventricular (AV) junction can create a premature beat that is known as
“an artifact.”
c. Lead placement for V1 includes 1 lead each for right arm, right leg, left
arm, and left leg with the fifth lead on the fourth intercostal space to the
right of the sternal border.
d. If the sinoatrial (SA) node fails to discharge an impulse or discharges very
slowly, a secondary pacemaker in the AV node is able to discharge at a rate
of 30 to 40 times per minute.
2. What accurately describes the PR interval (select all that apply)?
a. 0.16 seconds
b. < 0.12 seconds
c. 0.06 to 0.12 seconds
d. 0.12 to 0.20 seconds
e. Time of depolarization and repolarization of ventricles
f. Measured from beginning of P wave to beginning of QRS complex
3. A patient with a regular heart rate (HR) has 4 QRS complexes between
every 3-second marker on the ECG paper. Calculate the patient’s HR.
_______bpm
4. The ECG pattern of a patient with a regular HR reveals 20 small squares
between each
R-R interval. What is the patient’s HR? _______bpm
5. What describes the SA node’s ability to discharge an electrical impulse
spontaneously?
a. Excitability
b. Contractility
c. Conductivity
d. Automaticity
, 6. What describes the refractory phase?
a. Abnormal electrical impulses
b. Period in which heart tissue cannot be stimulated
c. Areas of the heart do not repolarize at the same rate because of
depressed conduction
d. Sodium migrates rapidly into the cell, so it is positive compared to the
outside of the cell
7. The patient’s PR interval comprises 6 small boxes on the ECG graph. What
does the nurse determine that this indicates?
a. A normal finding
b. A problem with ventricular depolarization
c. A disturbance in the repolarization of the atria
d. A problem with conduction from the SA node to the ventricular cells
8. The nurse plans close monitoring for the patient during electrophysiologic
study (EPS) because this study
a. requires the use of dyes that irritate the myocardium.
b. causes myocardial ischemia, resulting in dysrhythmias.
c. involves the use of anticoagulants to prevent thrombus and embolism.
d. induces dysrhythmias that may require cardioversion or defibrillation to
correct.
9. What should the nurse reading the monitor strip call a rhythm with a
regular PR interval but a blocked QRS complex?
a. Asystole
b. Atrial fibrillation
c. First-degree AV block
d. Type II second-degree AV block
10. After defibrillation, the advanced cardiac life support (ACLS) nurse says
that the patient has pulseless electrical activity (PEA). What is most
important for the nurse to understand about this rhythm?
a. The HR is 40 to 60 bpm.
b. Hypoxemia and hypervolemia are common with PEA.
c. There is dissociated activity of the ventricle and atrium.
d. There is electrical activity with no mechanical response.
11. The nurse is evaluating the telemetry ECG rhythm strip. How should the
nurse document the distorted P wave causing an irregular rhythm?
1. What accurately describes electrocardiographic (ECG) monitoring?
a. Depolarization of the cells in the ventricles produces the T wave on the
ECG.
b. An abnormal cardiac impulse that arises in the atria, ventricles, or
atrioventricular (AV) junction can create a premature beat that is known as
“an artifact.”
c. Lead placement for V1 includes 1 lead each for right arm, right leg, left
arm, and left leg with the fifth lead on the fourth intercostal space to the
right of the sternal border.
d. If the sinoatrial (SA) node fails to discharge an impulse or discharges very
slowly, a secondary pacemaker in the AV node is able to discharge at a rate
of 30 to 40 times per minute.
2. What accurately describes the PR interval (select all that apply)?
a. 0.16 seconds
b. < 0.12 seconds
c. 0.06 to 0.12 seconds
d. 0.12 to 0.20 seconds
e. Time of depolarization and repolarization of ventricles
f. Measured from beginning of P wave to beginning of QRS complex
3. A patient with a regular heart rate (HR) has 4 QRS complexes between
every 3-second marker on the ECG paper. Calculate the patient’s HR.
_______bpm
4. The ECG pattern of a patient with a regular HR reveals 20 small squares
between each
R-R interval. What is the patient’s HR? _______bpm
5. What describes the SA node’s ability to discharge an electrical impulse
spontaneously?
a. Excitability
b. Contractility
c. Conductivity
d. Automaticity
, 6. What describes the refractory phase?
a. Abnormal electrical impulses
b. Period in which heart tissue cannot be stimulated
c. Areas of the heart do not repolarize at the same rate because of
depressed conduction
d. Sodium migrates rapidly into the cell, so it is positive compared to the
outside of the cell
7. The patient’s PR interval comprises 6 small boxes on the ECG graph. What
does the nurse determine that this indicates?
a. A normal finding
b. A problem with ventricular depolarization
c. A disturbance in the repolarization of the atria
d. A problem with conduction from the SA node to the ventricular cells
8. The nurse plans close monitoring for the patient during electrophysiologic
study (EPS) because this study
a. requires the use of dyes that irritate the myocardium.
b. causes myocardial ischemia, resulting in dysrhythmias.
c. involves the use of anticoagulants to prevent thrombus and embolism.
d. induces dysrhythmias that may require cardioversion or defibrillation to
correct.
9. What should the nurse reading the monitor strip call a rhythm with a
regular PR interval but a blocked QRS complex?
a. Asystole
b. Atrial fibrillation
c. First-degree AV block
d. Type II second-degree AV block
10. After defibrillation, the advanced cardiac life support (ACLS) nurse says
that the patient has pulseless electrical activity (PEA). What is most
important for the nurse to understand about this rhythm?
a. The HR is 40 to 60 bpm.
b. Hypoxemia and hypervolemia are common with PEA.
c. There is dissociated activity of the ventricle and atrium.
d. There is electrical activity with no mechanical response.
11. The nurse is evaluating the telemetry ECG rhythm strip. How should the
nurse document the distorted P wave causing an irregular rhythm?
