Exam 1: Dysrhythmias (NCLEX)
1. A client's electrocardiogram strip shows atri- A
al and ventricular rates of 80 complexes per
minute. The PR interval is 0.14 second, and
the QRS complex measures 0.08 second. The
nurse interprets this rhythm is:
A) Normal sinus rhythm
B) Sinus bradycardia
C) Sinus tachycardia
D) Sinus dysrhythmia
2. A client has frequent bursts of ventricular D
tachycardia on the cardiac monitor. A nurse Ventricular tachycardia is a life-threat-
is most concerned with this dysrhythmia be- ening dysrhythmia that results from an
cause: irritable ectopic focus that takes over
as the pacemaker for the heart. The
A) It is uncomfortable for the client, giving a low cardiac output that results can lead
sense of impending doom. quickly to cerebral and myocardial is-
B) It produces a high cardiac output that chemia. Client's frequently experience a
quickly leads to cerebral and myocardial is- feeling of impending death. Ventricular
chemia. tachycardia is treated with antidysrhyth-
C) It is almost impossible to convert to a nor- mic medications or magnesium sulfate,
mal sinus rhythm. cardioversion (client awake), or defibril-
D) It can develop into ventricular fibrillation at lation (loss of consciousness), Ventricu-
any time. lar tachycardia can deteriorate into ven-
tricular defibrillation at any time.
3. The nurse administers amiodarone (Cor- BCD
darone) to a client with ventricular tachycar- Amiodarone causes prolongation of the
dia. Which monitoring by the nurse is neces- QT interval, which can precipitate dys-
sary with this drug? Select all that apply. rhythmia. Antidysrhythmic medications
cause changes in cardiac rhythm and
, Exam 1: Dysrhythmias (NCLEX)
a. Respiratory rate rate; therefore monitoring of heart rate
b. QT interval and rhythm is needed.Electrolyte deple-
c. Heart rate and rhythm tion, specifically potassium and magne-
d. Magnesium level sium, may predispose to further dys-
e. Urine output rhythmia. Although it is always impor-
tant to monitor vital signs and urine out-
put, these assessments are not specific
to amiodarone.
4. The nurse is caring for a client with acute B
coronary syndrome (ACS) and atrial fibrilla- The ettects of metoprolol are to de-
tion who has a new prescription for metopro- crease heart rate, blood pressure, and
lol (Lopressor). Which monitoring is essential myocardial oxygen demand. ST seg-
when administering the medication? ment elevation is consistent with MI; it
does not address monitoring of meto-
a. ST segment prolol. Elevation in troponin is consis-
b. Heart rate tent with a diagnosis of MI but does not
c. Troponin address needed monitoring for meto-
d. Myoglobin prolol. Elevation in myoglobin is consis-
tent with myocardial injury in ACS but
does not address needed monitoring
related to metoprolol.
5. The nurse is caring for a client with atrial A
fibrillation. In addition to an antidysrhythmic, Clients with atrial fibrillation are prone
what medication does the nurse plan to ad- to blood pooling in the atrium, clotting,
minister? then embolizing. Heparin is used to pre-
vent thrombus development in the atri-
a. Heparin um and the consequence of emboliza-
b. Atropine tion (i.e., stroke).
c. Dobutamine
d. Magnesium sulfate
, Exam 1: Dysrhythmias (NCLEX)
6. The nurse is caring for a client on a telemetry D
unit with a regular heart rhythm and rate of The client is displaying sinus rhythm
60; a P wave precedes each QRS complex, and with first-degree atrioventicular heart
the PR interval is 0.24 second. Additional vital block; this is usually asymptomatic and
signs are as follows: blood pressure 118/68, does not require treatment. Atropine is
respiratory rate 16, and temperature 98.8° F. used in emergency treatment of symp-
The following medications are available on tomatic bradycardia. This client has nor-
the medication record. What action should mal vital signs. Digoxin is used in the
the nurse take? treatment of atrial fibrillation, which is,
by definition, an irregular rhythm. Cloni-
a. Administer atropine. dine is used in the treatment of hyper-
b. Administer digoxin. tension; a side ettect is bradycardia.
c. Administer clonidine.
d. Continue to monitor.
7. You are the charge nurse on the telemetry A
unit and are responsible for making client as- This client has a stable, asymptomatic
signments. Which client would be appropri- dysrhythmia, which usually requires no
ate to assign to the float RN from the med- treatment; this client can be managed
ical-surgical unit? by a nurse with less cardiac dysrhythmia
training.
a. The 64-year-old admitted for weakness
who has a first-degree heart block with a
heart rate of 58 beats/min
b. The 71-year-old admitted for heart failure
who is short of breath and has a heart rate of
120 to 130 beats/min
c. The 88-year-old admitted with an elevated
troponin level who is hypotensive with a heart
rate of 96 beats/min
d. The 92-year-old admitted with chest pain
1. A client's electrocardiogram strip shows atri- A
al and ventricular rates of 80 complexes per
minute. The PR interval is 0.14 second, and
the QRS complex measures 0.08 second. The
nurse interprets this rhythm is:
A) Normal sinus rhythm
B) Sinus bradycardia
C) Sinus tachycardia
D) Sinus dysrhythmia
2. A client has frequent bursts of ventricular D
tachycardia on the cardiac monitor. A nurse Ventricular tachycardia is a life-threat-
is most concerned with this dysrhythmia be- ening dysrhythmia that results from an
cause: irritable ectopic focus that takes over
as the pacemaker for the heart. The
A) It is uncomfortable for the client, giving a low cardiac output that results can lead
sense of impending doom. quickly to cerebral and myocardial is-
B) It produces a high cardiac output that chemia. Client's frequently experience a
quickly leads to cerebral and myocardial is- feeling of impending death. Ventricular
chemia. tachycardia is treated with antidysrhyth-
C) It is almost impossible to convert to a nor- mic medications or magnesium sulfate,
mal sinus rhythm. cardioversion (client awake), or defibril-
D) It can develop into ventricular fibrillation at lation (loss of consciousness), Ventricu-
any time. lar tachycardia can deteriorate into ven-
tricular defibrillation at any time.
3. The nurse administers amiodarone (Cor- BCD
darone) to a client with ventricular tachycar- Amiodarone causes prolongation of the
dia. Which monitoring by the nurse is neces- QT interval, which can precipitate dys-
sary with this drug? Select all that apply. rhythmia. Antidysrhythmic medications
cause changes in cardiac rhythm and
, Exam 1: Dysrhythmias (NCLEX)
a. Respiratory rate rate; therefore monitoring of heart rate
b. QT interval and rhythm is needed.Electrolyte deple-
c. Heart rate and rhythm tion, specifically potassium and magne-
d. Magnesium level sium, may predispose to further dys-
e. Urine output rhythmia. Although it is always impor-
tant to monitor vital signs and urine out-
put, these assessments are not specific
to amiodarone.
4. The nurse is caring for a client with acute B
coronary syndrome (ACS) and atrial fibrilla- The ettects of metoprolol are to de-
tion who has a new prescription for metopro- crease heart rate, blood pressure, and
lol (Lopressor). Which monitoring is essential myocardial oxygen demand. ST seg-
when administering the medication? ment elevation is consistent with MI; it
does not address monitoring of meto-
a. ST segment prolol. Elevation in troponin is consis-
b. Heart rate tent with a diagnosis of MI but does not
c. Troponin address needed monitoring for meto-
d. Myoglobin prolol. Elevation in myoglobin is consis-
tent with myocardial injury in ACS but
does not address needed monitoring
related to metoprolol.
5. The nurse is caring for a client with atrial A
fibrillation. In addition to an antidysrhythmic, Clients with atrial fibrillation are prone
what medication does the nurse plan to ad- to blood pooling in the atrium, clotting,
minister? then embolizing. Heparin is used to pre-
vent thrombus development in the atri-
a. Heparin um and the consequence of emboliza-
b. Atropine tion (i.e., stroke).
c. Dobutamine
d. Magnesium sulfate
, Exam 1: Dysrhythmias (NCLEX)
6. The nurse is caring for a client on a telemetry D
unit with a regular heart rhythm and rate of The client is displaying sinus rhythm
60; a P wave precedes each QRS complex, and with first-degree atrioventicular heart
the PR interval is 0.24 second. Additional vital block; this is usually asymptomatic and
signs are as follows: blood pressure 118/68, does not require treatment. Atropine is
respiratory rate 16, and temperature 98.8° F. used in emergency treatment of symp-
The following medications are available on tomatic bradycardia. This client has nor-
the medication record. What action should mal vital signs. Digoxin is used in the
the nurse take? treatment of atrial fibrillation, which is,
by definition, an irregular rhythm. Cloni-
a. Administer atropine. dine is used in the treatment of hyper-
b. Administer digoxin. tension; a side ettect is bradycardia.
c. Administer clonidine.
d. Continue to monitor.
7. You are the charge nurse on the telemetry A
unit and are responsible for making client as- This client has a stable, asymptomatic
signments. Which client would be appropri- dysrhythmia, which usually requires no
ate to assign to the float RN from the med- treatment; this client can be managed
ical-surgical unit? by a nurse with less cardiac dysrhythmia
training.
a. The 64-year-old admitted for weakness
who has a first-degree heart block with a
heart rate of 58 beats/min
b. The 71-year-old admitted for heart failure
who is short of breath and has a heart rate of
120 to 130 beats/min
c. The 88-year-old admitted with an elevated
troponin level who is hypotensive with a heart
rate of 96 beats/min
d. The 92-year-old admitted with chest pain
