Nursing 3000 Exam questions and
answers graded A+
When computing a heart rate from the ECG tracing, the nurse counts 15 of the small blocks between
the R waves of a client whose rhythm is regular. From these data, which of the following rates
should the nurse calculate as the client's heart rate? - ANS✅✅A: 60 beats/minute
B: 75 beats/minute
C: 100 beats/minute A
D: 150 beats/minute
A: C- Since each small block on the ECG paper represents 0.04 seconds, 1 500 of these blocks
represents 1 minute. By dividing the number of small blocks (15 in this case) into 1 500, the nurse
can calculate the heart rate in a client whose rhythm is regular (in this case, 100).
Which of the following statements best describes the electrical activity of the heart represented by
measuring the PR interval on the ECG? - ANS✅✅A: The length of time it takes to depolarize the
atrium
B: The length of time it takes for the atria to depolarize and repolarize
C: The length of time for the electrical impulse to travel from the SA node to the Purkinje fibres
D: The length of time it takes for the electrical impulse to travel from the SA node to the AV node
A: C - The electrical impulse in the heart must travel from the SA node through the AV node and into
the Purkinje fibres in order for synchronous atrial and ventricular contraction to occur. The P wave
represents atrial contraction and the R wave is part of the QRS complex that represents ventricular
contraction. Therefore, when measuring the time from the beginning of the P wave to the beginning
of the QRS (PR interval), the nurse is identifying the length of time it takes for the electrical impulse
to travel from the SA node to the Purkinje fibres.
The nurse obtains a 6-second rhythm strip and charts the following analysis: atrial rate 70, regular;
ventricular rate 40, regular; QRS 0.04 second; no relationship between P waves and QRS complexes;
atria and ventricles beating independently of each other. Which of the following descriptions is a
correct interpretation of this rhythm strip? - ANS✅✅Sinus dysrhythmias
Third-degree heart block
Wenckebach phenomenon
Premature ventricular contractions
,A: B - Third-degree heart block represents a loss of communication between the atrium and
ventricles. This is depicted on the rhythm strip as no relationship between the P waves, representing
atrial contraction, and QRS complexes, representing ventricular contraction. The atria are beating
totally on their own at 70 beats/minute, whereas the ventricles are pacing themselves at 40
beats/minute.
The nurse is caring for a client who is 24 hours postpacemaker insertion. Which of the following
nursing interventions is most appropriate at this time? - ANS✅✅Reinforcing the pressure dressing
as needed
Encouraging range-of-motion exercises of the involved arm
Assessing the incision for any redness, swelling, or discharge
Applying wet-to-dry dressings every 4 hours to the insertion site
A: C - After pacemaker insertion, it is important for the client to limit activity of the involved arm to
minimize pacemaker lead displacement. The nonpressure dressing is kept dry until removed, usually
24 hours postoperatively. It is important for the nurse to observe for signs of infection by assessing
for any redness, swelling, or discharge from the incision site.
The nurse is watching the cardiac monitor, and a client's rhythm suddenly changes. There are no P
waves. Instead there are fine, wavy lines between the QRS complexes. The QRS complexes measure
0.08 second (narrow), but they occur irregularly with a rate of 120 beats/minute. Which of the
following rhythms should the nurse identify from this data? - ANS✅✅Sinus tachycardia
Atrial fibrillation
Ventricular fibrillation
Ventricular tachycardia
A: B - Atrial fibrillation is represented on the cardiac monitor by irregular R-R intervals and small
fibrillatory (f) waves. There are no normal P waves because the atria are not truly contracting, just
fibrillating.
A client has sought care following a syncopal episode of unknown etiology. Which of the following
nursing actions should the nurse prioritize in the client's subsequent diagnostic workup? -
ANS✅✅Preparing to assist with a head-upright tilt-table test
Assessing the client's knowledge of pacemakers
Preparing an intravenous dose of a β-adrenergic blocker
Teaching the client about the role of antiplatelet aggregators
, A: A - A head-upright tilt-table test is a common component of the diagnostic workup following
episodes of syncope. IV α-blockers are not indicated, and addressing pacemakers is premature and
inappropriate at this stage of diagnosis. Client education surrounding antiplatelet aggregators is not
directly relevant to the client's syncope.
For which of the following dysrhythmias is defibrillation primarily indicated? - ANS✅✅Ventricular
fibrilla tion
Third-degree AV block
Uncontrolled atrial fibrillation
Ventricular tachycardia with a pulse
A: A - Defibrillation is always indicated in the treatment of ventricular fibrillation. Drug treatments
are normally used in the treatment of uncontrolled atrial fibrillation and for ventricular tachycardia
with a pulse (if the client is stable). Otherwise, synchronized cardioversion is used (as long as the
client has a pulse). Pacemakers are the treatment of choice for third-degree heart block.
The nurse is caring for a client in asystole. Which of the following drug treatments is the client most
likely to receive? - ANS✅✅Atropine and epinephrine
Lidocaine and amiodarone
Digoxin and procainamide
α-Adrenergic blockers and dopamine
A: A - Normally the client in asystole cannot be successfully resuscitated. However, administration of
atropine and epinephrine may prompt the return of depolarization and ventricular contraction.
The nurse is caring for a client with ventricular tachycardia. Which of the following ECG
characteristics is consistent with a diagnosis of ventricular tachycardia (VT)? -
ANS✅✅Unmeasurable rate and rhythm
Rate 150 beats/minute; inverted P wave
Rate 200 beats/minute; P wave not visible
Rate 125 beats/minute; normal QRS complex
A: C - Ventricular tachycardia (VT) is associated with a rate of 150-250 beats/minute; the P wave is
not normally visible. P wave inversion and a normal QRS complex are not associated with VT. Rate
and rhythm are not measurable in ventricular fibrillation.
answers graded A+
When computing a heart rate from the ECG tracing, the nurse counts 15 of the small blocks between
the R waves of a client whose rhythm is regular. From these data, which of the following rates
should the nurse calculate as the client's heart rate? - ANS✅✅A: 60 beats/minute
B: 75 beats/minute
C: 100 beats/minute A
D: 150 beats/minute
A: C- Since each small block on the ECG paper represents 0.04 seconds, 1 500 of these blocks
represents 1 minute. By dividing the number of small blocks (15 in this case) into 1 500, the nurse
can calculate the heart rate in a client whose rhythm is regular (in this case, 100).
Which of the following statements best describes the electrical activity of the heart represented by
measuring the PR interval on the ECG? - ANS✅✅A: The length of time it takes to depolarize the
atrium
B: The length of time it takes for the atria to depolarize and repolarize
C: The length of time for the electrical impulse to travel from the SA node to the Purkinje fibres
D: The length of time it takes for the electrical impulse to travel from the SA node to the AV node
A: C - The electrical impulse in the heart must travel from the SA node through the AV node and into
the Purkinje fibres in order for synchronous atrial and ventricular contraction to occur. The P wave
represents atrial contraction and the R wave is part of the QRS complex that represents ventricular
contraction. Therefore, when measuring the time from the beginning of the P wave to the beginning
of the QRS (PR interval), the nurse is identifying the length of time it takes for the electrical impulse
to travel from the SA node to the Purkinje fibres.
The nurse obtains a 6-second rhythm strip and charts the following analysis: atrial rate 70, regular;
ventricular rate 40, regular; QRS 0.04 second; no relationship between P waves and QRS complexes;
atria and ventricles beating independently of each other. Which of the following descriptions is a
correct interpretation of this rhythm strip? - ANS✅✅Sinus dysrhythmias
Third-degree heart block
Wenckebach phenomenon
Premature ventricular contractions
,A: B - Third-degree heart block represents a loss of communication between the atrium and
ventricles. This is depicted on the rhythm strip as no relationship between the P waves, representing
atrial contraction, and QRS complexes, representing ventricular contraction. The atria are beating
totally on their own at 70 beats/minute, whereas the ventricles are pacing themselves at 40
beats/minute.
The nurse is caring for a client who is 24 hours postpacemaker insertion. Which of the following
nursing interventions is most appropriate at this time? - ANS✅✅Reinforcing the pressure dressing
as needed
Encouraging range-of-motion exercises of the involved arm
Assessing the incision for any redness, swelling, or discharge
Applying wet-to-dry dressings every 4 hours to the insertion site
A: C - After pacemaker insertion, it is important for the client to limit activity of the involved arm to
minimize pacemaker lead displacement. The nonpressure dressing is kept dry until removed, usually
24 hours postoperatively. It is important for the nurse to observe for signs of infection by assessing
for any redness, swelling, or discharge from the incision site.
The nurse is watching the cardiac monitor, and a client's rhythm suddenly changes. There are no P
waves. Instead there are fine, wavy lines between the QRS complexes. The QRS complexes measure
0.08 second (narrow), but they occur irregularly with a rate of 120 beats/minute. Which of the
following rhythms should the nurse identify from this data? - ANS✅✅Sinus tachycardia
Atrial fibrillation
Ventricular fibrillation
Ventricular tachycardia
A: B - Atrial fibrillation is represented on the cardiac monitor by irregular R-R intervals and small
fibrillatory (f) waves. There are no normal P waves because the atria are not truly contracting, just
fibrillating.
A client has sought care following a syncopal episode of unknown etiology. Which of the following
nursing actions should the nurse prioritize in the client's subsequent diagnostic workup? -
ANS✅✅Preparing to assist with a head-upright tilt-table test
Assessing the client's knowledge of pacemakers
Preparing an intravenous dose of a β-adrenergic blocker
Teaching the client about the role of antiplatelet aggregators
, A: A - A head-upright tilt-table test is a common component of the diagnostic workup following
episodes of syncope. IV α-blockers are not indicated, and addressing pacemakers is premature and
inappropriate at this stage of diagnosis. Client education surrounding antiplatelet aggregators is not
directly relevant to the client's syncope.
For which of the following dysrhythmias is defibrillation primarily indicated? - ANS✅✅Ventricular
fibrilla tion
Third-degree AV block
Uncontrolled atrial fibrillation
Ventricular tachycardia with a pulse
A: A - Defibrillation is always indicated in the treatment of ventricular fibrillation. Drug treatments
are normally used in the treatment of uncontrolled atrial fibrillation and for ventricular tachycardia
with a pulse (if the client is stable). Otherwise, synchronized cardioversion is used (as long as the
client has a pulse). Pacemakers are the treatment of choice for third-degree heart block.
The nurse is caring for a client in asystole. Which of the following drug treatments is the client most
likely to receive? - ANS✅✅Atropine and epinephrine
Lidocaine and amiodarone
Digoxin and procainamide
α-Adrenergic blockers and dopamine
A: A - Normally the client in asystole cannot be successfully resuscitated. However, administration of
atropine and epinephrine may prompt the return of depolarization and ventricular contraction.
The nurse is caring for a client with ventricular tachycardia. Which of the following ECG
characteristics is consistent with a diagnosis of ventricular tachycardia (VT)? -
ANS✅✅Unmeasurable rate and rhythm
Rate 150 beats/minute; inverted P wave
Rate 200 beats/minute; P wave not visible
Rate 125 beats/minute; normal QRS complex
A: C - Ventricular tachycardia (VT) is associated with a rate of 150-250 beats/minute; the P wave is
not normally visible. P wave inversion and a normal QRS complex are not associated with VT. Rate
and rhythm are not measurable in ventricular fibrillation.
