Nursing 354 Cardiac Arrhythmias
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1. A nurse is assessing a patient with a cardiac rhythm of atrial fibrillation.
Which ECG finding is most characteristic of atrial fibrillation?
A. Regular rhythm with wide QRS complexes
B. Sawtooth flutter waves
C. Irregularly irregular rhythm with no distinct P waves
D. Regular rhythm with prolonged PR intervals
Answer: C. Irregularly irregular rhythm with no distinct P waves
Rationale: Atrial fibrillation is characterized by chaotic atrial activity, absent
distinct P waves, and an irregularly irregular ventricular rhythm.
2. Which cardiac arrhythmia is associated with a "sawtooth" appearance on
the ECG?
A. Atrial fibrillation
B. Atrial flutter
,C. Ventricular fibrillation
D. Sinus tachycardia
Answer: B. Atrial flutter
Rationale: Atrial flutter typically produces characteristic sawtooth flutter waves,
especially visible in the inferior ECG leads.
3. A patient has a heart rate of 48 beats/minute with regular rhythm and
normal P waves preceding each QRS complex. Which rhythm does the nurse
recognize?
A. Junctional rhythm
B. Atrial fibrillation
C. Sinus bradycardia
D. Ventricular tachycardia
Answer: C. Sinus bradycardia
Rationale: Sinus bradycardia originates in the sinoatrial node and has a rate
below 60 beats/minute while maintaining normal P waves and a regular
rhythm.
4. Which patient with sinus bradycardia requires the most immediate nursing
intervention?
A. Patient with a heart rate of 56 beats/minute who is sleeping
B. Patient with a heart rate of 52 beats/minute who exercises regularly
C. Patient with a heart rate of 58 beats/minute and no symptoms
D. Patient with a heart rate of 42 beats/minute, hypotension, and altered
mental status
Answer: D. Patient with a heart rate of 42 beats/minute, hypotension, and
altered mental status
,Rationale: Symptomatic bradycardia with hypotension and altered mental
status indicates inadequate cardiac output and requires immediate intervention.
5. Which ECG characteristic is expected with premature ventricular
contractions (PVCs)?
A. Narrow QRS complex preceded by a normal P wave
B. Wide, abnormal QRS complex occurring earlier than expected
C. Sawtooth P waves
D. Prolonged PR interval with dropped beats
Answer: B. Wide, abnormal QRS complex occurring earlier than expected
Rationale: PVCs originate in the ventricles and produce premature, wide, and
abnormal QRS complexes that are generally not preceded by normal P waves.
6. Which finding in a patient with frequent PVCs should concern the nurse
most?
A. Occasional single PVCs
B. PVCs occurring after caffeine intake
C. PVCs occurring in runs of three or more
D. One PVC occurring during sleep
Answer: C. PVCs occurring in runs of three or more
Rationale: Three or more consecutive ventricular beats constitute ventricular
tachycardia and can progress to more serious ventricular dysrhythmias.
7. A patient develops ventricular tachycardia but has a pulse and is
hemodynamically stable. Which treatment may be prescribed?
A. Immediate defibrillation
B. An antiarrhythmic medication such as amiodarone
, C. Oral beta blocker only
D. Carotid massage
Answer: B. An antiarrhythmic medication such as amiodarone
Rationale: Stable ventricular tachycardia with a pulse may be treated with an IV
antiarrhythmic such as amiodarone according to the clinical situation and
protocol.
8. A patient is unresponsive and pulseless. The ECG shows chaotic,
disorganized electrical activity without identifiable QRS complexes. Which
rhythm is present?
A. Atrial flutter
B. Sinus arrest
C. Ventricular tachycardia with a pulse
D. Ventricular fibrillation
Answer: D. Ventricular fibrillation
Rationale: Ventricular fibrillation produces chaotic ventricular electrical activity
and results in no effective cardiac output, making it a cardiac arrest rhythm
requiring immediate resuscitation and defibrillation.
9. What is the priority intervention for a patient in ventricular fibrillation?
A. Administer oral amiodarone
B. Obtain a 12-lead ECG
C. Begin CPR and provide immediate unsynchronized defibrillation
D. Administer atropine
Answer: C. Begin CPR and provide immediate unsynchronized defibrillation
Rationale: Ventricular fibrillation is a shockable cardiac arrest rhythm. High-
quality CPR and rapid defibrillation are priorities.
Practice Exam Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A Instant Download
1. A nurse is assessing a patient with a cardiac rhythm of atrial fibrillation.
Which ECG finding is most characteristic of atrial fibrillation?
A. Regular rhythm with wide QRS complexes
B. Sawtooth flutter waves
C. Irregularly irregular rhythm with no distinct P waves
D. Regular rhythm with prolonged PR intervals
Answer: C. Irregularly irregular rhythm with no distinct P waves
Rationale: Atrial fibrillation is characterized by chaotic atrial activity, absent
distinct P waves, and an irregularly irregular ventricular rhythm.
2. Which cardiac arrhythmia is associated with a "sawtooth" appearance on
the ECG?
A. Atrial fibrillation
B. Atrial flutter
,C. Ventricular fibrillation
D. Sinus tachycardia
Answer: B. Atrial flutter
Rationale: Atrial flutter typically produces characteristic sawtooth flutter waves,
especially visible in the inferior ECG leads.
3. A patient has a heart rate of 48 beats/minute with regular rhythm and
normal P waves preceding each QRS complex. Which rhythm does the nurse
recognize?
A. Junctional rhythm
B. Atrial fibrillation
C. Sinus bradycardia
D. Ventricular tachycardia
Answer: C. Sinus bradycardia
Rationale: Sinus bradycardia originates in the sinoatrial node and has a rate
below 60 beats/minute while maintaining normal P waves and a regular
rhythm.
4. Which patient with sinus bradycardia requires the most immediate nursing
intervention?
A. Patient with a heart rate of 56 beats/minute who is sleeping
B. Patient with a heart rate of 52 beats/minute who exercises regularly
C. Patient with a heart rate of 58 beats/minute and no symptoms
D. Patient with a heart rate of 42 beats/minute, hypotension, and altered
mental status
Answer: D. Patient with a heart rate of 42 beats/minute, hypotension, and
altered mental status
,Rationale: Symptomatic bradycardia with hypotension and altered mental
status indicates inadequate cardiac output and requires immediate intervention.
5. Which ECG characteristic is expected with premature ventricular
contractions (PVCs)?
A. Narrow QRS complex preceded by a normal P wave
B. Wide, abnormal QRS complex occurring earlier than expected
C. Sawtooth P waves
D. Prolonged PR interval with dropped beats
Answer: B. Wide, abnormal QRS complex occurring earlier than expected
Rationale: PVCs originate in the ventricles and produce premature, wide, and
abnormal QRS complexes that are generally not preceded by normal P waves.
6. Which finding in a patient with frequent PVCs should concern the nurse
most?
A. Occasional single PVCs
B. PVCs occurring after caffeine intake
C. PVCs occurring in runs of three or more
D. One PVC occurring during sleep
Answer: C. PVCs occurring in runs of three or more
Rationale: Three or more consecutive ventricular beats constitute ventricular
tachycardia and can progress to more serious ventricular dysrhythmias.
7. A patient develops ventricular tachycardia but has a pulse and is
hemodynamically stable. Which treatment may be prescribed?
A. Immediate defibrillation
B. An antiarrhythmic medication such as amiodarone
, C. Oral beta blocker only
D. Carotid massage
Answer: B. An antiarrhythmic medication such as amiodarone
Rationale: Stable ventricular tachycardia with a pulse may be treated with an IV
antiarrhythmic such as amiodarone according to the clinical situation and
protocol.
8. A patient is unresponsive and pulseless. The ECG shows chaotic,
disorganized electrical activity without identifiable QRS complexes. Which
rhythm is present?
A. Atrial flutter
B. Sinus arrest
C. Ventricular tachycardia with a pulse
D. Ventricular fibrillation
Answer: D. Ventricular fibrillation
Rationale: Ventricular fibrillation produces chaotic ventricular electrical activity
and results in no effective cardiac output, making it a cardiac arrest rhythm
requiring immediate resuscitation and defibrillation.
9. What is the priority intervention for a patient in ventricular fibrillation?
A. Administer oral amiodarone
B. Obtain a 12-lead ECG
C. Begin CPR and provide immediate unsynchronized defibrillation
D. Administer atropine
Answer: C. Begin CPR and provide immediate unsynchronized defibrillation
Rationale: Ventricular fibrillation is a shockable cardiac arrest rhythm. High-
quality CPR and rapid defibrillation are priorities.
