Dysrhythmias Practice/Lewis Dysrhythmias
Questions Dysrhythmias NCLEX Practice
Questions and answers Newest 100% PASS
You are the nurse working on the telemetry unit and you have finally gotten to sit down to work
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
on some charting. Suddenly the heart monitors at the station start beeping. Patient in room 18 is
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
showing this rhythm on the monitor. The medical team advances together into the room and
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
finds them unconscious. What is priority action by the nurse?
II! II! II! II! II! II! II! II! II! II!
A) Prepare to administer adenosine to the patient
II! II! II! II! II! II! II!
B) Begin chest compressions
II! II! II!
C) Prepare for defibrillation
II! II! II!
D) Check for a pulse - Correct Answers Answer: D
II! II! II! II! II! II! II! II! II! II! II! II! II!
A pulse would be assessed for first. Then the patient will be defibrillized and chest compressions
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
will begin immediately.
II! II! II!
II! The patient who has recently been experiencing runs of ventricular tachycardia suddenly loses
II! II! II! II! II! II! II! II! II! II! II! II!
II! consciousness. The patient is defibrillated, and the rate returns as the following. What should the II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! nurse do first? II! II!
A) Begin compressions
II! II!
B) Shock the client again immediately
II! II! II! II! II!
C) Prepare for intubation
II! II! II!
D) Administer adenosine - Correct Answers Answer: A
II! II! II! II! II! II! II! II! II! II! II!
Following defibrillation, CPR is immediately initiated if a perfusable rhythm is not initiated. The
II! II! II! II! II! II! II! II! II! II! II! II! II!
client may need to be shocked again, but chest compressions must begin first.
II! II! II! II! II! II! II! II! II! II! II! II! II!
,II! The patient with a history of hypertension and diabetes has the following rhythm strip. The
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! patient's vitals are as follows: BP 145/89, HR 90, SpO2 95%, RR 19. Which of the following does
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! the nurse expect to do at this time?
II! II! II! II! II! II! II!
a) Prepare the client for cardioversion STAT
II! II! II! II! II! II!
b) Begin administering anticoagulants
II! II! II!
c) Grab the crash cart for administration of adenosine
II! II! II! II! II! II! II! II!
d) Teach the client about possibility of pacemaker installation - Correct Answers Answer: B
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
Atrial flutter places the client at high risk for development of clot formation in the atria. Because
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
the client is stable at this time, cardioversion or adenosine would not be performed at this time.
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
Before cardioversion can occur in a patient, anticoagulant therapy should be begun at least 48
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
hours beforehand if possible.
II! II! II! II!
II! The nurse is preparing to administer adenosine to the patient with the following rhythm which is
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! symptomatic. What should the nurse plan on having in the patient room? Select All That Apply: II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
a) Physician
II!
b) Crash cart
II! II!
c) IV pump
II! II!
d) EKG monitor
II! II!
e) Lidocaine - Correct Answers Answer: A, B, and D
II! II! II! II! II! II! II! II! II! II! II! II! II!
Adenosine is administered as a very quick IV push. The physician must be present in the room and
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
the crash cart must be on hand. An ekg monitor should be in the room to monitor the
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
effectiveness of the medication.
II! II! II! II!
II! The nurse has just administered adenosine via IV push and sees the following rhythm on the
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! monitor. What is the nurse's priority intervention? II! II! II! II! II! II!
a) Apply conductive gel and defibrillate the patient
II! II! II! II! II! II! II!
b) Document the findings and continue to monitor
II! II! II! II! II! II! II!
,c) Administer another mg of the medication
II! II! II! II! II! II!
d) Begin chest compressions - Correct Answers Answer: B
II! II! II! II! II! II! II! II! II! II! II! II!
This finding would be expected upon administration of adenosine. The rhythm should then begin
II! II! II! II! II! II! II! II! II! II! II! II! II!
again in some other rhythm, hopefully normal sinus rhythm. It would be important to document
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
the exact time of this change and continue to monitor the change back to NSR. If this change does
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
not occur, or if another rhythm is produced, appropriate action would then be taken based on the
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
result.
II!
II! A group of nursing students are discussing atrial flutter. These students recognize that which of
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! the following are seen with atrial flutter? Select all that apply:
II! II! II! II! II! II! II! II! II! II!
1) Ventricular rate of 220-300 bpm.
II! II! II! II! II!
2) Regular rhythm
II! II!
3) Saw-tooth pattern
II! II!
4) Measurable PR interval
II! II! II! II!
5) Long QRS interval - Correct Answers Answer(s): 2, 3
II! II! II! II! II! II! II! II! II! II! II! II! II!
The ATRIAL rate is 250-400 bpm. Ventricular is about 75-150. The rhythm is regular, with the P
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
wave appearing as little flutter or a "saw tooth pattern". The PR interval is not measurable r/t this
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
saw-tooth P wave. The QRS is normal.
II! II! II! II! II! II! II!
II! A nursing student is aware that which of the following is the treatment for unstable atrial flutter?
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
1) Adenosine (Adenocard) 6 mg rapid IVP.
II! II! II! II! II! II!
2) Cardioversion with adjacent Heparin therapy
II! II! II! II! II!
3) Defibrillation STAT followed by CPR.
II! II! II! II! II!
4) Altemose 3 mg IVP over 1-2 seconds. - Correct Answers Answer: 2
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
, Cardioversion is used if the patient is unstable. Anticoagulants are used if the arrhythmia has II! II! II! II! II! II! II! II! II! II! II! II! II! II!
stuck around for 48 hr +. Adenosine may be used with a narrow QRS and regular RR interval
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! A nurse working on a CVT unit receives report from day shift. After receiving report, which patient
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! should the nurse see first?II! II! II! II!
1) A 23-year-old professional tennis player with a HR of 47 bpm.
II! II! II! II! II! II! II! II! II! II! II!
2) A 69-year-old male with atrial fibrillation who has new onset confusion.
II! II! II! II! II! II! II! II! II! II! II!
3) A 72-year-old female with atrial flutter who reports feeling unusually tired today and yesterday.
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
4) A 33-year-old female with sinus tachycardia who is asking for her at-home Metoprolol. -
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
Correct Answers Answer: 2
II! II! II! II! II! II! II!
Patients with a-fib are at risk for pulmonary and systemic emboli, and new onset of confusion may
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
indicate a stroke in this patient. Patients with atrial flutter may feel more tired some days than
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
others.
II!
II! A nurse on a CVT unit views the monitor and sees the patient in room 452 has just begun having
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! occasional PVCs. Which action should the nurse take first? II! II! II! II! II! II! II! II!
1) Check on the patient
II! II! II! II!
2) Check last magnesium and potassium levels
II! II! II! II! II! II!
3) Document the occurrence and watch for further PVCs
II! II! II! II! II! II! II! II!
4) Contact the physician - Correct Answers Answer: 1
II! II! II! II! II! II! II! II! II! II! II! II!
Although electrolytes are likely the culprit, the nurse first needs to first assess the patient. Then,
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
the nurse should look in the patient's chart and evaluate or request an order for electrolyte
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
levels. This may eventually need to be documented, but the nurse can be held liable for neglect if
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
he/she does not assess the patient first. The physician may or may not need to be contacted.
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
Questions Dysrhythmias NCLEX Practice
Questions and answers Newest 100% PASS
You are the nurse working on the telemetry unit and you have finally gotten to sit down to work
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
on some charting. Suddenly the heart monitors at the station start beeping. Patient in room 18 is
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
showing this rhythm on the monitor. The medical team advances together into the room and
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
finds them unconscious. What is priority action by the nurse?
II! II! II! II! II! II! II! II! II! II!
A) Prepare to administer adenosine to the patient
II! II! II! II! II! II! II!
B) Begin chest compressions
II! II! II!
C) Prepare for defibrillation
II! II! II!
D) Check for a pulse - Correct Answers Answer: D
II! II! II! II! II! II! II! II! II! II! II! II! II!
A pulse would be assessed for first. Then the patient will be defibrillized and chest compressions
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
will begin immediately.
II! II! II!
II! The patient who has recently been experiencing runs of ventricular tachycardia suddenly loses
II! II! II! II! II! II! II! II! II! II! II! II!
II! consciousness. The patient is defibrillated, and the rate returns as the following. What should the II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! nurse do first? II! II!
A) Begin compressions
II! II!
B) Shock the client again immediately
II! II! II! II! II!
C) Prepare for intubation
II! II! II!
D) Administer adenosine - Correct Answers Answer: A
II! II! II! II! II! II! II! II! II! II! II!
Following defibrillation, CPR is immediately initiated if a perfusable rhythm is not initiated. The
II! II! II! II! II! II! II! II! II! II! II! II! II!
client may need to be shocked again, but chest compressions must begin first.
II! II! II! II! II! II! II! II! II! II! II! II! II!
,II! The patient with a history of hypertension and diabetes has the following rhythm strip. The
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! patient's vitals are as follows: BP 145/89, HR 90, SpO2 95%, RR 19. Which of the following does
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! the nurse expect to do at this time?
II! II! II! II! II! II! II!
a) Prepare the client for cardioversion STAT
II! II! II! II! II! II!
b) Begin administering anticoagulants
II! II! II!
c) Grab the crash cart for administration of adenosine
II! II! II! II! II! II! II! II!
d) Teach the client about possibility of pacemaker installation - Correct Answers Answer: B
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
Atrial flutter places the client at high risk for development of clot formation in the atria. Because
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
the client is stable at this time, cardioversion or adenosine would not be performed at this time.
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
Before cardioversion can occur in a patient, anticoagulant therapy should be begun at least 48
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
hours beforehand if possible.
II! II! II! II!
II! The nurse is preparing to administer adenosine to the patient with the following rhythm which is
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! symptomatic. What should the nurse plan on having in the patient room? Select All That Apply: II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
a) Physician
II!
b) Crash cart
II! II!
c) IV pump
II! II!
d) EKG monitor
II! II!
e) Lidocaine - Correct Answers Answer: A, B, and D
II! II! II! II! II! II! II! II! II! II! II! II! II!
Adenosine is administered as a very quick IV push. The physician must be present in the room and
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
the crash cart must be on hand. An ekg monitor should be in the room to monitor the
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
effectiveness of the medication.
II! II! II! II!
II! The nurse has just administered adenosine via IV push and sees the following rhythm on the
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! monitor. What is the nurse's priority intervention? II! II! II! II! II! II!
a) Apply conductive gel and defibrillate the patient
II! II! II! II! II! II! II!
b) Document the findings and continue to monitor
II! II! II! II! II! II! II!
,c) Administer another mg of the medication
II! II! II! II! II! II!
d) Begin chest compressions - Correct Answers Answer: B
II! II! II! II! II! II! II! II! II! II! II! II!
This finding would be expected upon administration of adenosine. The rhythm should then begin
II! II! II! II! II! II! II! II! II! II! II! II! II!
again in some other rhythm, hopefully normal sinus rhythm. It would be important to document
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
the exact time of this change and continue to monitor the change back to NSR. If this change does
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
not occur, or if another rhythm is produced, appropriate action would then be taken based on the
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
result.
II!
II! A group of nursing students are discussing atrial flutter. These students recognize that which of
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! the following are seen with atrial flutter? Select all that apply:
II! II! II! II! II! II! II! II! II! II!
1) Ventricular rate of 220-300 bpm.
II! II! II! II! II!
2) Regular rhythm
II! II!
3) Saw-tooth pattern
II! II!
4) Measurable PR interval
II! II! II! II!
5) Long QRS interval - Correct Answers Answer(s): 2, 3
II! II! II! II! II! II! II! II! II! II! II! II! II!
The ATRIAL rate is 250-400 bpm. Ventricular is about 75-150. The rhythm is regular, with the P
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
wave appearing as little flutter or a "saw tooth pattern". The PR interval is not measurable r/t this
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
saw-tooth P wave. The QRS is normal.
II! II! II! II! II! II! II!
II! A nursing student is aware that which of the following is the treatment for unstable atrial flutter?
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
1) Adenosine (Adenocard) 6 mg rapid IVP.
II! II! II! II! II! II!
2) Cardioversion with adjacent Heparin therapy
II! II! II! II! II!
3) Defibrillation STAT followed by CPR.
II! II! II! II! II!
4) Altemose 3 mg IVP over 1-2 seconds. - Correct Answers Answer: 2
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
, Cardioversion is used if the patient is unstable. Anticoagulants are used if the arrhythmia has II! II! II! II! II! II! II! II! II! II! II! II! II! II!
stuck around for 48 hr +. Adenosine may be used with a narrow QRS and regular RR interval
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! A nurse working on a CVT unit receives report from day shift. After receiving report, which patient
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! should the nurse see first?II! II! II! II!
1) A 23-year-old professional tennis player with a HR of 47 bpm.
II! II! II! II! II! II! II! II! II! II! II!
2) A 69-year-old male with atrial fibrillation who has new onset confusion.
II! II! II! II! II! II! II! II! II! II! II!
3) A 72-year-old female with atrial flutter who reports feeling unusually tired today and yesterday.
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
4) A 33-year-old female with sinus tachycardia who is asking for her at-home Metoprolol. -
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
Correct Answers Answer: 2
II! II! II! II! II! II! II!
Patients with a-fib are at risk for pulmonary and systemic emboli, and new onset of confusion may
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
indicate a stroke in this patient. Patients with atrial flutter may feel more tired some days than
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
others.
II!
II! A nurse on a CVT unit views the monitor and sees the patient in room 452 has just begun having
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! occasional PVCs. Which action should the nurse take first? II! II! II! II! II! II! II! II!
1) Check on the patient
II! II! II! II!
2) Check last magnesium and potassium levels
II! II! II! II! II! II!
3) Document the occurrence and watch for further PVCs
II! II! II! II! II! II! II! II!
4) Contact the physician - Correct Answers Answer: 1
II! II! II! II! II! II! II! II! II! II! II! II!
Although electrolytes are likely the culprit, the nurse first needs to first assess the patient. Then,
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
the nurse should look in the patient's chart and evaluate or request an order for electrolyte
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
levels. This may eventually need to be documented, but the nurse can be held liable for neglect if
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
he/she does not assess the patient first. The physician may or may not need to be contacted.
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
