Dysrhythmias Practice Questions Guaranteed Success
1. You are the nurse on the telemetry unit and finally get a moment to work on charting when suddenly
the heart monitors start beeping. Patient in room 18 is showing a concerning rhythm on the monitor.
The medical team rushes into the room and finds the patient unconscious. What is the nurse's priority
action?
- Check for a pulse
Explanation: Assessing for a pulse is the first step in managing an unconscious patient with a concerning
rhythm. Based on the findings, appropriate interventions such as defibrillation and chest compressions
will follow.
2. A patient who has recently experienced runs of ventricular tachycardia suddenly loses consciousness.
After defibrillation, the patient's heart rate returns. What should the nurse do first?
- Begin compressions
Explanation: After defibrillation, CPR (chest compressions) should be immediately initiated if the patient
does not have a perfusable rhythm. This action takes precedence before considering further
interventions like additional shocks or medications.
,3. A patient with a history of hypertension and diabetes displays a specific rhythm strip. The patient's
vital signs include BP 145/89, HR 90, SpO2 95%, RR 19. What action does the nurse anticipate at this
time?
- Begin administering anticoagulants
Explanation: Given the patient's rhythm and clinical condition, anticoagulation therapy would be
appropriate to manage potential risks associated with the rhythm and underlying conditions.
These answers summarize the prioritized actions and appropriate responses based on the presented
scenarios in a telemetry unit setting.
Atrial flutter places the client at high risk for development of clot formation in the atria. Because the
client is stable at this time, cardioversion or adenosine would not be performed at this time. Before
cardioversion can occur in a patient, anticoagulant therapy should be begun at least 48 hours
beforehand if possible.
The nurse is preparing to administer adenosine to the patient with the following rhythm which is
symptomatic. What should the nurse plan on having in the patient room? Select All That Apply:
a) Physician
b) Crash cart
c) IV pump
,d) EKG monitor
e) Lidocaine ✔️Answer: A, B, and D
Adenosine is administered as a very quick IV push. The physician must be present in the room and the
crash cart must be on hand. An ekg monitor should be in the room to monitor the effectiveness of the
medication.
The nurse has just administered adenosine via IV push and sees the following rhythm on the monitor.
What is the nurse's priority intervention?
a) Apply conductive gel and defibrillate the patient
b) Document the findings and continue to monitor
c) Administer another mg of the medication
d) Begin chest compressions ✔️Answer: B
This finding would be expected upon administration of adenosine. The rhythm should then begin again
in some other rhythm, hopefully normal sinus rhythm. It would be important to document the exact
time of this change and continue to monitor the change back to NSR. If this change does not occur, or if
another rhythm is produced, appropriate action would then be taken based on the result.
, A group of nursing students are discussing atrial flutter. These students recognize that which of the
following are seen with atrial flutter? Select all that apply:
1) Ventricular rate of 220-300 bpm.
2) Regular rhythm
3) Saw-tooth pattern
4) Measurable PR interval
5) Long QRS interval ✔️Answer(s): 2, 3
The ATRIAL rate is 250-400 bpm. Ventricular is about 75-150. The rhythm is regular, with the P wave
appearing as little flutter or a "saw tooth pattern". The PR interval is not measurable r/t this saw-tooth P
wave. The QRS is normal.
A nursing student is aware that which of the following is the treatment for unstable atrial flutter?
1) Adenosine (Adenocard) 6 mg rapid IVP.
2) Cardioversion with adjacent Heparin therapy
3) Defibrillation STAT followed by CPR.
4) Altemose 3 mg IVP over 1-2 seconds. ✔️Answer: 2
1. You are the nurse on the telemetry unit and finally get a moment to work on charting when suddenly
the heart monitors start beeping. Patient in room 18 is showing a concerning rhythm on the monitor.
The medical team rushes into the room and finds the patient unconscious. What is the nurse's priority
action?
- Check for a pulse
Explanation: Assessing for a pulse is the first step in managing an unconscious patient with a concerning
rhythm. Based on the findings, appropriate interventions such as defibrillation and chest compressions
will follow.
2. A patient who has recently experienced runs of ventricular tachycardia suddenly loses consciousness.
After defibrillation, the patient's heart rate returns. What should the nurse do first?
- Begin compressions
Explanation: After defibrillation, CPR (chest compressions) should be immediately initiated if the patient
does not have a perfusable rhythm. This action takes precedence before considering further
interventions like additional shocks or medications.
,3. A patient with a history of hypertension and diabetes displays a specific rhythm strip. The patient's
vital signs include BP 145/89, HR 90, SpO2 95%, RR 19. What action does the nurse anticipate at this
time?
- Begin administering anticoagulants
Explanation: Given the patient's rhythm and clinical condition, anticoagulation therapy would be
appropriate to manage potential risks associated with the rhythm and underlying conditions.
These answers summarize the prioritized actions and appropriate responses based on the presented
scenarios in a telemetry unit setting.
Atrial flutter places the client at high risk for development of clot formation in the atria. Because the
client is stable at this time, cardioversion or adenosine would not be performed at this time. Before
cardioversion can occur in a patient, anticoagulant therapy should be begun at least 48 hours
beforehand if possible.
The nurse is preparing to administer adenosine to the patient with the following rhythm which is
symptomatic. What should the nurse plan on having in the patient room? Select All That Apply:
a) Physician
b) Crash cart
c) IV pump
,d) EKG monitor
e) Lidocaine ✔️Answer: A, B, and D
Adenosine is administered as a very quick IV push. The physician must be present in the room and the
crash cart must be on hand. An ekg monitor should be in the room to monitor the effectiveness of the
medication.
The nurse has just administered adenosine via IV push and sees the following rhythm on the monitor.
What is the nurse's priority intervention?
a) Apply conductive gel and defibrillate the patient
b) Document the findings and continue to monitor
c) Administer another mg of the medication
d) Begin chest compressions ✔️Answer: B
This finding would be expected upon administration of adenosine. The rhythm should then begin again
in some other rhythm, hopefully normal sinus rhythm. It would be important to document the exact
time of this change and continue to monitor the change back to NSR. If this change does not occur, or if
another rhythm is produced, appropriate action would then be taken based on the result.
, A group of nursing students are discussing atrial flutter. These students recognize that which of the
following are seen with atrial flutter? Select all that apply:
1) Ventricular rate of 220-300 bpm.
2) Regular rhythm
3) Saw-tooth pattern
4) Measurable PR interval
5) Long QRS interval ✔️Answer(s): 2, 3
The ATRIAL rate is 250-400 bpm. Ventricular is about 75-150. The rhythm is regular, with the P wave
appearing as little flutter or a "saw tooth pattern". The PR interval is not measurable r/t this saw-tooth P
wave. The QRS is normal.
A nursing student is aware that which of the following is the treatment for unstable atrial flutter?
1) Adenosine (Adenocard) 6 mg rapid IVP.
2) Cardioversion with adjacent Heparin therapy
3) Defibrillation STAT followed by CPR.
4) Altemose 3 mg IVP over 1-2 seconds. ✔️Answer: 2
