Test Bank For Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan.

Test Bank For Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan. A heart rate can be determined by multiplying the QRS complexes in a 6-second strip by 10. The heart rate is 90. This method of calculating the heart rate is the most common method used because it is quick and can be used when the heart rate is irregular. PTS: 1 DIF: Apply REF: Calculating Heart Rate 6.The nurse notes that on a clients electrocardiogram tracing, there is one P wave for every QRS complex and a delay in the impulse transmission at the AV node. This regular rhythm is identified as: 1. first-degree AV block. 2. second-degree AV block type I. 3. second-degree AV block type II. 4. complete heart block. ANS: 1 First-degree atrioventricular (AV) block occurs when there is a delay in the impulse transmission at the AV node. This delay occurs with every impulse and can be seen on every beat on the recorded rhythm strip. Second-degree and complete heart block have differences with the P wave and the associated QRS complexes. PTS: 1 DIF: Analyze REF: First-Degree Heart Block 7.A client is unresponsive and has no pulse. The nurse notes that the electrocardiogram tracing shows continuous large and bizarre QRS complexes measured greater than 0.12 each. This rhythm is identified as: 1. premature ventricular complexes. 2. torsades de pointes. 3. ventricular fibrillation. 4. ventricular tachycardia. ANS: 4 Ventricular tachycardia occurs when the patient experiences sustained consecutive premature ventricular complexes. Torsades de pointes is characterized by a wide-to-narrow pattern of the QRS complexes. Ventricular fibrillation shows a coarse wavy baseline. PTS: 1 DIF: Analyze REF: Ventricular Tachycardia 8.An elderly client is demonstrating a change in heart rate that occurs with respirations. When planning care for the client, the nurse knows that treatment may include: 1. Oxygen therapy 2. Analgesics 3. Antibiotics 4. Pacemaker insertion ANS: 4 A change in heart rate that occurs with respirations defines a sinus arrhythmia. If the client becomes symptomatic during periods of bradycardia, treatment will include atropine sulfate or pacemaker insertion. Treatment for sinus arrhythmia might include oxygen if the client is symptomatic. Treatment for this arrhythmia does not include analgesics or antibiotics. PTS:1DIF:ApplyREF:Sinus Arrhythmia 9.A clients electrocardiogram tracing shows a sawtooth pattern with F waves. The nurse realizes this client is demonstrating: 1. atrial flutter. 2. atrial fibrillation. 3. premature atrial contractions. 4. atrial tachycardia. ANS: 1 Atrial flutter is characterized by F waves that occur in a characteristic sawtooth pattern. Atrial fibrillation is characterized by coarse waves with the baseline between the QRS complexes as being rough and uneven. Premature atrial contractions occur when an electrical impulse is generated in an area of the atria outside of the SA node. Atrial tachycardia is three or more premature atrial contractions. Neither premature atrial contractions or atrial tachycardia have an F wave on the tracing. PTS:1DIF:AnalyzeREF:Atrial Arrhythmias 10.The electrocardiogram tracing for a client shows premature junctional complexes. Which of the following should the nurse do to assist this client? 1. Administer oxygen 2. Increase intravenous fluids 3. Check on the serum digoxin level 4. Assist the client to a side-lying position ANS: 3 The most common cause of premature junctional complexes is digitalis toxicity. The nurse should check on the clients serum digoxin level. Oxygen, intravenous fluids, or position changes will not help treat this rhythm. PTS: 1 DIF: Apply REF: Premature Junctional Complexes 11.Which of the following should the nurse instruct a client who has been diagnosed with an arrhythmia? 1. Exercise level 2. Avoidance of calorie-dense foods 3. How to take his own pulse 4. Reasons why fatigue is expected ANS: 3 Instructions for a client diagnosed with an arrhythmia include symptom management, how to take own pulse, and substances to avoid the onset of an arrhythmia. The nurse may or may not instruct on exercise level. The client does not need to avoid calorie-dense foods. Fatigue is a symptom that should be reported to a health care provider. PTS:1DIF:Apply REF:Table 26-2 Nursing Management for the Patient with Arrhythmias