Cardiac Dysrhythmia Disorders Practice Questions Chapter Thirty Five 2026.docx

Cardiac
Dysrhythmia
Disorders
Practice
Questions
Chapter Thirty
Five 2026

, Cardiac Dysrhythmia Disorders Practice Questions Chapter Thirty Five 2026

1. To determine whether there is a delay in impulse conduction through the atria, the nurse will
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measure the duration of the patient's k k k k k




a. P wave. k k




b. Q wave. k k




c. P-R interval.
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d. QRS complex. - correct answerA
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The P wave represents the depolarization of the atria. The P-R interval represents
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depolarization of the atria, atrioventricular (AV) node, bundle of His, bundle branches, and the k k k k k k k k k k k k k k




Purkinje fibers. The QRS represents ventricular depolarization. The Q wave is the first k k k k k k k k k k k k k




negative deflection following the P wave and should be narrow and short. k k k k k k k k k k k




DIF: Cognitive Level: Understand (comprehension) REF: 791
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TOP: Nursing Process: Assessment MSC: k k k k




Physiological Integrity k




2. The nurse needs to quickly estimate the heart rate for a patient with a regular heart rhythm.
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Which method will be best to use? k k k k k k




a. Count the number of large squares in the R-R interval and divide by 300.
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b. Print a 1-minute electrocardiogram (ECG) strip and count the number of QRS complexes.
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c. Calculate the number of small squares between one QRS complex and the next and divide
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into 1500. k




d. Use the 3-second markers to count the number of QRS complexes in 6 seconds and
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multiply by 10. - correct answerD k k k k k




This is the quickest way to determine the ventricular rate for a patient with a regular rhythm. All
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the other methods are accurate, but take longer.
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DIF: Cognitive Level: Apply (application) REF: 789-790
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TOP: Nursing Process: Assessment MSC: k k k k




Physiological Integrity k




3. A patient has a junctional escape rhythm on the monitor. The nurse will expect the patient to
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have a heart rate of _____ beats/minute. k k k k k k




a. 15 to 20 k k k k




b. 20 to 40 k k k k




c. 40 to 60
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d. 60 to 100 - correct answerC
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If the sinoatrial (SA) node fails to discharge, the atrioventricular (AV) node will automatically
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discharge at the normal rate of 40 to 60 beats/minute. The slower rates are typical of the k k k k k k k k k k k k k k k k k




bundle of His and the Purkinje system and may be seen with failure of both the SA and AV node
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to discharge. The normal SA node rate is 60 to 100 beats/minute.
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DIF: Cognitive Level: Understand (comprehension) REF: 797
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TOP: Nursing Process: Assessment MSC: k k k k

,Physiological Integrity k




4. The nurse obtains a rhythm strip on a patient who has had a myocardial infarction and
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makes the following analysis: no visible P waves, P-R interval not measurable, ventricular
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rate 162, R-R interval regular, and QRS complex wide and distorted, QRS duration 0.18
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second. The nurse interprets the patient's cardiac rhythm as k k k k k k k k




a. atrial flutter.
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b. sinus tachycardia.
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c. ventricular fibrillation.
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d. ventricular tachycardia. - correct answerD
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The absence of P waves, wide QRS, rate >150 beats/minute, and the regularity of the rhythm
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indicate ventricular tachycardia. Atrial flutter is usually regular, has a narrow QRS
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configuration, and has flutter waves present representing atrial activity. Sinus tachycardia k k k k k k k k k k k




has P waves. Ventricular fibrillation is irregular and does not have a consistent QRS duration.
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DIF: Cognitive Level: Apply (application) REF: 794
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TOP: Nursing Process: Assessment MSC: k k k k




Physiological Integrity k




5. The nurse notes that a patient's cardiac monitor shows that every other beat is earlier than
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expected, has no visible P wave, and has a QRS complex that is wide and bizarre in shape.
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How will the nurse document the rhythm?
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a. Ventricular couplets
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b. Ventricular bigeminy
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c. Ventricular R-on-T phenomenon
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d. Multifocal premature ventricular contractions - correct answerB
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Ventricular bigeminy describes a rhythm in which every other QRS complex is wide and k k k k k k k k k k k k k k




bizarre looking. Pairs of wide QRS complexes are described as ventricular couplets. There is
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no indication that the premature ventricular contractions (PVCs) are multifocal or that the R-
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on-T phenomenon is occurring. k k k




DIF: Cognitive Level: Apply (application) REF: 799
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TOP: Nursing Process: Assessment MSC: k k k k




Physiological Integrity k




6. A patient has a normal cardiac rhythm and a heart rate of 72 beats/minute. The nurse
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determines that the P-R interval is 0.24 seconds. The most appropriate intervention by the k k k k k k k k k k k k k k




nurse would be to k k k




a. notify the health care provider immediately.
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b. give atropine per agency dysrhythmia protocol.
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c. prepare the patient for temporary pacemaker insertion.
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d. document the finding and continue to monitor the patient. - correct answerD
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, First-degree atrioventricular (AV) block is asymptomatic and requires ongoing monitoring k k k k k k k k k k




because it may progress to more serious forms of heart block. The rate is normal, so there is no
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indication that atropine is needed. Immediate notification of the health care provider about an
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asymptomatic rhythm is not necessary. k k k k




DIF: Cognitive Level: Apply (application) REF: 798
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TOP: Nursing Process: Implementation MSC:
k k k k




Physiological Integrity k




7. A patient who was admitted with a myocardial infarction experiences a 45-second episode
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of ventricular tachycardia, then converts to sinus rhythm with a heart rate of 98 beats/minute.
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Which of the following actions should the nurse take next?
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a. Immediately notify the health care provider.
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b. Document the rhythm and continue to monitor the patient.
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c. Perform synchronized cardioversion per agency dysrhythmia protocol.
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d. Prepare to give IV amiodarone (Cordarone) per agency dysrhythmia protocol. - correct
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answerD
The burst of sustained ventricular tachycardia indicates that the patient has significant
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ventricular irritability, and antidysrhythmic medication administration is needed to prevent
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further episodes. The nurse should notify the health care provider after the medication is
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started. Defibrillation is not indicated given that the patient is currently in a sinus rhythm.
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Documentation and continued monitoring are not adequate responses to this situation. k k k k k k k k k k




DIF: Cognitive Level: Apply (application) REF: 799
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TOP: Nursing Process: Implementation MSC:
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Physiological Integrity k




8. After the nurse gives IV atropine to a patient with symptomatic type 1, second-degree
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atrioventricular (AV) block, which finding indicates that the medication has been effective? k k k k k k k k k k k




a. Increase in the patient's heart rate
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b. Increase in strength of peripheral pulses
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c. Decrease in premature atrial contractions
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d. Decrease in premature ventricular contractions - correct answerA
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Atropine will increase the heart rate and conduction through the AV node. Because the
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medication increases electrical conduction, not cardiac contractility, the quality of the
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peripheral pulses is not used to evaluate the drug effectiveness. The patient does not have
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premature atrial or ventricular contractions. k k k k




DIF: Cognitive Level: Apply (application) REF: 798
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TOP: Nursing Process: Evaluation MSC:
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Physiological Integrity k