NUR 398 DYSRHYTHMIAS EXAM QUESTIONS AND
DETAILED ANSWERS
The nurse is caring for a patient with atrial fibrillation. In addition to an
antidysrhythmic, what medication does the nurse plan to administer?
Rivaroxaban
2
Atropine
3
Dobutamine
4
Magnesium sulfate - ANSWER_1
The loss of coordinated atrial contractions in atrial fibrillation can lead to pooling
of blood resulting in thrombus formation. The patient is at high risk for pulmonary
embolism! Thrombi may form within the right atrium and then move through the
right ventricle to the lungs . In addition, the patient is at risk for systemic emboli,
particularly an embolic stroke, which may cause severe neurologic impairment or
death. Rivaroxaban or other anticoagulants are used to prevent thrombus
development in the atrium and the consequence of embolization (i.e., stroke).
Atropine is used to treat bradycardia and heart blocks; atrial fibrillation, unless
controlled with medication, is typically rapid. Dobutamine is an inotropic agent
used to improve cardiac output; it may cause tachycardia, thereby worsening atrial
fibrillation. Although electrolyte levels are monitored in patients with dysrhythmia,
magnesium sulfate is not used unless depletion is noted.
The nurse is caring for a patient on a telemetry unit with a regular heart rhythm and
rate of 60 beats/min; a P wave precedes each QRS complex, and the PR interval is
0.24 second. Additional vital signs are as follows: blood pressure 118/68,
respiratory rate 16, and temperature 98.8° F. All of these medications are available
on the medication record. What action does the nurse take?
1
Administer digoxin
2
, NUR 398 DYSRHYTHMIAS SOLVED EXAM (ACTUAL
LATEST 2024) WITH DETAILED ANSWERS
Administer atropine
3
Continue to monitor
4
Administer clonidine - ANSWER_3
The patient is displaying normal sinus rhythm. Atropine is used in emergency
treatment of symptomatic bradycardia. This patient has normal vital signs. Digoxin
is used in the treatment of atrial fibrillation, which is, by definition, an irregular
rhythm. Clonidine is used in the treatment of hypertension; a side effect is
bradycardia.
When caring for a patient with heart disease, which action may lead to serious
bradydysrhythmias?
1
Oropharyngeal suctioning
2
Insertion of a Foley catheter
3
Hip flexion greater than 90 degrees
4
Walking on a treadmill at a moderate pace - ANSWER_1
Anything that causes the patient to perform the Valsalva maneuver (e.g., bear
down, gag, or vomit) leads to vagal stimulation. Unintended vagal stimulation can
result in serious bradydysrhythmias and should be avoided. Oropharyngeal
suctioning causes the patient to gag and possibly vomit. Insertion of a Foley
catheter, hip flexion, and moderate walking on a treadmill do not induce the
Valsalva maneuver.
1
, NUR 398 DYSRHYTHMIAS EXAM QUESTIONS AND
DETAILED ANSWERS
A college student presents to the campus clinic reporting palpitations. Frequent
premature atrial contractions are identified on the electrocardiogram (ECG). What
does the nurse include in teaching this patient? Select all that apply.
Smoking cessation
2
Limited physical exertion
3
Decreased consumption of caffeinated beverages
4
Improvement of hydration with increased water intake
5
Referral to the counseling center for stress management - ANSWER_1,3,5
Stress is a cause of atrial irritability leading to premature atrial contractions. More
effective ways of stress management may be explored at the counseling center.
Nicotine and caffeine also increase the incidence of premature atrial contractions
and should be avoided or reduced. Increasing water intake will not alleviate the
problem. Limiting physical exertion is not indicated.
Which complications are associated with carotid sinus massage therapy? Select all
that apply. 1
Bradycardia
2
Cerebral damage
3
Ventricular fibrillation
4
Premature atrial complexes
5
, NUR 398 DYSRHYTHMIAS SOLVED EXAM (ACTUAL
LATEST 2024) WITH DETAILED ANSWERS
Premature ventricular complexes - ANSWER_1,2,3
A patient with atrial fibrillation with rapid ventricular response has received
medication to slow the ventricular rate. The pulse is now 88 beats/min. For which
additional therapy does the nurse plan?
1
Anticoagulation
2
Synchronized cardioversion
3
Electrophysiology studies (EPS)
4
Radiofrequency ablation therapy - ANSWER_1
Because of the risk for thromboembolism caused by atrial fibrillation,
anticoagulation is necessary. The patient has stabilized; cardioversion is not needed
at this time. EPS is indicated for recurring, symptomatic dysrhythmia. Ablation
therapy is ordered for recurring and symptomatic atrial fibrillation.
A patient is admitted to the intensive care unit with an acute pulmonary embolism.
What dysrhythmia would most likely contribute to this condition?
1
Atrial fibrillation
2
Sinus bradycardia
3
Ventricular tachycardia
4
1
DETAILED ANSWERS
The nurse is caring for a patient with atrial fibrillation. In addition to an
antidysrhythmic, what medication does the nurse plan to administer?
Rivaroxaban
2
Atropine
3
Dobutamine
4
Magnesium sulfate - ANSWER_1
The loss of coordinated atrial contractions in atrial fibrillation can lead to pooling
of blood resulting in thrombus formation. The patient is at high risk for pulmonary
embolism! Thrombi may form within the right atrium and then move through the
right ventricle to the lungs . In addition, the patient is at risk for systemic emboli,
particularly an embolic stroke, which may cause severe neurologic impairment or
death. Rivaroxaban or other anticoagulants are used to prevent thrombus
development in the atrium and the consequence of embolization (i.e., stroke).
Atropine is used to treat bradycardia and heart blocks; atrial fibrillation, unless
controlled with medication, is typically rapid. Dobutamine is an inotropic agent
used to improve cardiac output; it may cause tachycardia, thereby worsening atrial
fibrillation. Although electrolyte levels are monitored in patients with dysrhythmia,
magnesium sulfate is not used unless depletion is noted.
The nurse is caring for a patient on a telemetry unit with a regular heart rhythm and
rate of 60 beats/min; a P wave precedes each QRS complex, and the PR interval is
0.24 second. Additional vital signs are as follows: blood pressure 118/68,
respiratory rate 16, and temperature 98.8° F. All of these medications are available
on the medication record. What action does the nurse take?
1
Administer digoxin
2
, NUR 398 DYSRHYTHMIAS SOLVED EXAM (ACTUAL
LATEST 2024) WITH DETAILED ANSWERS
Administer atropine
3
Continue to monitor
4
Administer clonidine - ANSWER_3
The patient is displaying normal sinus rhythm. Atropine is used in emergency
treatment of symptomatic bradycardia. This patient has normal vital signs. Digoxin
is used in the treatment of atrial fibrillation, which is, by definition, an irregular
rhythm. Clonidine is used in the treatment of hypertension; a side effect is
bradycardia.
When caring for a patient with heart disease, which action may lead to serious
bradydysrhythmias?
1
Oropharyngeal suctioning
2
Insertion of a Foley catheter
3
Hip flexion greater than 90 degrees
4
Walking on a treadmill at a moderate pace - ANSWER_1
Anything that causes the patient to perform the Valsalva maneuver (e.g., bear
down, gag, or vomit) leads to vagal stimulation. Unintended vagal stimulation can
result in serious bradydysrhythmias and should be avoided. Oropharyngeal
suctioning causes the patient to gag and possibly vomit. Insertion of a Foley
catheter, hip flexion, and moderate walking on a treadmill do not induce the
Valsalva maneuver.
1
, NUR 398 DYSRHYTHMIAS EXAM QUESTIONS AND
DETAILED ANSWERS
A college student presents to the campus clinic reporting palpitations. Frequent
premature atrial contractions are identified on the electrocardiogram (ECG). What
does the nurse include in teaching this patient? Select all that apply.
Smoking cessation
2
Limited physical exertion
3
Decreased consumption of caffeinated beverages
4
Improvement of hydration with increased water intake
5
Referral to the counseling center for stress management - ANSWER_1,3,5
Stress is a cause of atrial irritability leading to premature atrial contractions. More
effective ways of stress management may be explored at the counseling center.
Nicotine and caffeine also increase the incidence of premature atrial contractions
and should be avoided or reduced. Increasing water intake will not alleviate the
problem. Limiting physical exertion is not indicated.
Which complications are associated with carotid sinus massage therapy? Select all
that apply. 1
Bradycardia
2
Cerebral damage
3
Ventricular fibrillation
4
Premature atrial complexes
5
, NUR 398 DYSRHYTHMIAS SOLVED EXAM (ACTUAL
LATEST 2024) WITH DETAILED ANSWERS
Premature ventricular complexes - ANSWER_1,2,3
A patient with atrial fibrillation with rapid ventricular response has received
medication to slow the ventricular rate. The pulse is now 88 beats/min. For which
additional therapy does the nurse plan?
1
Anticoagulation
2
Synchronized cardioversion
3
Electrophysiology studies (EPS)
4
Radiofrequency ablation therapy - ANSWER_1
Because of the risk for thromboembolism caused by atrial fibrillation,
anticoagulation is necessary. The patient has stabilized; cardioversion is not needed
at this time. EPS is indicated for recurring, symptomatic dysrhythmia. Ablation
therapy is ordered for recurring and symptomatic atrial fibrillation.
A patient is admitted to the intensive care unit with an acute pulmonary embolism.
What dysrhythmia would most likely contribute to this condition?
1
Atrial fibrillation
2
Sinus bradycardia
3
Ventricular tachycardia
4
1
