EXAM 4, DYSRHYTHMIAS
UPDATED ACTUAL QUESTIONS WITH CORRECT
ANSWERS
Question 1.
A. Tachycardia
*Increased sympathetic activity results in an increased heart rate (tachycardia), increased contractility,
increased venous tone, and increased arteriolar tone (elevated blood pressure).
*Sympathetic stimulation also causes bronchodilation (not bradypnea) and possibly hyperglycemia.
ANSWER
In the failing heart, arterial pressure falls, stimulating the baroreceptor reflex to increase
sympathetic nervous system activity. The nurse understands increased sympathetic activity
will produce which response?
A. Tachycardia
B. Bradypnea
C. Hypotension
D. Hypoglycemia
Question 2.
Atrrial fibrillation with controlled rate
1) Rhythm: Irregular
2) Rate: ventricular is 70
3) P wave: fibrillatory waves "wavy junk"
4) PRI: N/A
5) QRS: 0.12
ANSWER
Interpret this rhythm
,Question 3.
Atrial tachycardia
*paroxysmal atrial tach where pt goes in and out of it for unknown reason
*HR 150-250
ANSWER
Name this rhythm
Question 4.
Atrial dysrhytmias
ANSWER
What type of dysrythmia: -originates in artial tissue
-caused by "irritability/ectopic firing"
-atrial depolarization path altered
-P wave changes!
Question 5.
Decrease HR w meds like diltiazem (calcium channel blocker), beta blockers, or digoxin *then after
acute symptoms under control, turn attention to converting the rhythm (not always possible)
ANSWER
If pt presents to the ED with SOB, lightheaded, HR of 160 with Afib what is the quickest way to
restore CO?
,Question 6.
d. Ventricular and atrial depolarizations are initiated from different sites.
Normal rhythm shows one P wave preceding each QRS complex, indicating that all depolarization is
initiated at the SA node. QRS complexes without a P wave indicate a different source of initiation of
depolarization
ANSWER
A nurse assesses a clients ECG tracing and observes that not all QRS complexes are preceded
by a P wave. How should the nurse interpret this observation?
a. Pt has hyperkalemia causing irregular QRS complexes.
b. Ventricular tachycardia is overriding the normal atrial rhythm.
c. Pts chest leads are not making sufficient contact with the skin.
d. Ventricular and atrial depolarizations are initiated from different sites.
Question 7.
b.Client who is dismissed after coronary artery bypass surgery
*Atrial fibrillation occurs commonly in clients with cardiac disease and is a common occurrence after
coronary artery bypass graft (CABG) surgery. The other conditions do not place a client at higher risk
for atrial fibrillation.
ANSWER
The nurse is assessing clients at a community clinic. Which client does the nurse assess most
carefully for atrial fibrillation?
a.Middle-aged client who takes an aspirin daily
b.Client who is dismissed after coronary artery bypass surgery
c.Older adult client after a carotid endarterectomy
d.Client with chronic obstructive pulmonary disease
, Question 8.
Normal sinus rhythm with one PAC at the third complex
1) Rhythm: regular (underlying)
2) Rate: 72
3) P wave: sinus (underlying), abnormal (premature)
4) PRI: 0.14-0.16
5) QRS: 0.04-0.08
ANSWER
Interpret this rhythm
Question 9.
C) The ventricles are taking too long to depolarize
*normal QRS is <0.12
ANSWER
The nurse notes that the patient's QRS complex is measured at 0.14 seconds, and the ST
segment is normal. What does this mean?
A) The atria are taking too long to depolarize
B) The patient is having a myocardial infarction
C) The ventricles are taking too long to depolarize
D) this is a normal finding
Question 10.
-give for pts with irregular rhythms like Afib, pulseless Vtach, & Vfib
-monitor for adverse effects:
-bradycardia
-hypotension
-AV blocks (prolonged PRI)
-prolonged QT interval
-pulmonary toxicity & fibrosis (long term pulmonary function tests)
-proarrythmic
-long half life
ANSWER
What are nursing implications for Amiodarone
UPDATED ACTUAL QUESTIONS WITH CORRECT
ANSWERS
Question 1.
A. Tachycardia
*Increased sympathetic activity results in an increased heart rate (tachycardia), increased contractility,
increased venous tone, and increased arteriolar tone (elevated blood pressure).
*Sympathetic stimulation also causes bronchodilation (not bradypnea) and possibly hyperglycemia.
ANSWER
In the failing heart, arterial pressure falls, stimulating the baroreceptor reflex to increase
sympathetic nervous system activity. The nurse understands increased sympathetic activity
will produce which response?
A. Tachycardia
B. Bradypnea
C. Hypotension
D. Hypoglycemia
Question 2.
Atrrial fibrillation with controlled rate
1) Rhythm: Irregular
2) Rate: ventricular is 70
3) P wave: fibrillatory waves "wavy junk"
4) PRI: N/A
5) QRS: 0.12
ANSWER
Interpret this rhythm
,Question 3.
Atrial tachycardia
*paroxysmal atrial tach where pt goes in and out of it for unknown reason
*HR 150-250
ANSWER
Name this rhythm
Question 4.
Atrial dysrhytmias
ANSWER
What type of dysrythmia: -originates in artial tissue
-caused by "irritability/ectopic firing"
-atrial depolarization path altered
-P wave changes!
Question 5.
Decrease HR w meds like diltiazem (calcium channel blocker), beta blockers, or digoxin *then after
acute symptoms under control, turn attention to converting the rhythm (not always possible)
ANSWER
If pt presents to the ED with SOB, lightheaded, HR of 160 with Afib what is the quickest way to
restore CO?
,Question 6.
d. Ventricular and atrial depolarizations are initiated from different sites.
Normal rhythm shows one P wave preceding each QRS complex, indicating that all depolarization is
initiated at the SA node. QRS complexes without a P wave indicate a different source of initiation of
depolarization
ANSWER
A nurse assesses a clients ECG tracing and observes that not all QRS complexes are preceded
by a P wave. How should the nurse interpret this observation?
a. Pt has hyperkalemia causing irregular QRS complexes.
b. Ventricular tachycardia is overriding the normal atrial rhythm.
c. Pts chest leads are not making sufficient contact with the skin.
d. Ventricular and atrial depolarizations are initiated from different sites.
Question 7.
b.Client who is dismissed after coronary artery bypass surgery
*Atrial fibrillation occurs commonly in clients with cardiac disease and is a common occurrence after
coronary artery bypass graft (CABG) surgery. The other conditions do not place a client at higher risk
for atrial fibrillation.
ANSWER
The nurse is assessing clients at a community clinic. Which client does the nurse assess most
carefully for atrial fibrillation?
a.Middle-aged client who takes an aspirin daily
b.Client who is dismissed after coronary artery bypass surgery
c.Older adult client after a carotid endarterectomy
d.Client with chronic obstructive pulmonary disease
, Question 8.
Normal sinus rhythm with one PAC at the third complex
1) Rhythm: regular (underlying)
2) Rate: 72
3) P wave: sinus (underlying), abnormal (premature)
4) PRI: 0.14-0.16
5) QRS: 0.04-0.08
ANSWER
Interpret this rhythm
Question 9.
C) The ventricles are taking too long to depolarize
*normal QRS is <0.12
ANSWER
The nurse notes that the patient's QRS complex is measured at 0.14 seconds, and the ST
segment is normal. What does this mean?
A) The atria are taking too long to depolarize
B) The patient is having a myocardial infarction
C) The ventricles are taking too long to depolarize
D) this is a normal finding
Question 10.
-give for pts with irregular rhythms like Afib, pulseless Vtach, & Vfib
-monitor for adverse effects:
-bradycardia
-hypotension
-AV blocks (prolonged PRI)
-prolonged QT interval
-pulmonary toxicity & fibrosis (long term pulmonary function tests)
-proarrythmic
-long half life
ANSWER
What are nursing implications for Amiodarone
