Advanced Med-Surg Cardiac
Arrhythmias Exam Prep – Questions &
Rationales 2018
A nurse is assessing an electrocardiogram rhythm strip. The P waves and QRS complexes are regular. The
PR interval is 0.16 second, and QRS complexes measure 0.06 second. The overall heart rate is 64 beats
per minute. The nurse assesses the cardiac rhythm as:
A) Normal sinus rhythm
B) Sinus bradycardia
C) Sick sinus syndrome
D) First-degree heart block - ANSWER ✔✨---A) Normal sinus rhythm
Rationale: measurements are normal, measuring 0.12 to 0.20 second and 0.4 to 0.10 second,
respectively.
A nurse notices frequent artifact on the ECG monitor for a client whose leads are connected by cable to
a console at the bedside. The nurse examines the client to determine the cause. Which of the following
items is unlikely to be responsible for the artifact?
A) Frequent movement of the client
B) Tightly secured cable connections
C) Leads applied over hairy areas
D) Leads applied to the limbs - ANSWER ✔✨---B) Tightly secured cable connections
, Rationale: Motion artifact, or "noise," can be caused by frequent client movement, electrode placement
on limbs, and insufficient adhesion to the skin, such as placing electrodes over hairy areas of the skin
A nurse is watching the cardiac monitor and notices that the rhythm suddenly changes. There are no P
waves, the QRS complexes are wide, and the ventricular rate is regular but over 100. The nurse
determines that the client is experiencing:
A) Premature ventricular contractions
B) Ventricular tachycardia
C) Ventricular fibrillation
D) Sinus tachycardia - ANSWER ✔✨---B) Ventricular tachycardia
Rationale: Ventricular tachycardia is characterized by the absence of P waves, wide QRS complexes
(usually greater than 0.14 second), and a rate between 100 and 250 impulses per minute. The rhythm is
usually regular.
A nurse is viewing the cardiac monitor in a client's room and notes that the client has just gone into
ventricular tachycardia. The client is awake and alert and has good skin color. The nurse would prepare
to do which of the following?
A) Immediately defibrillate
B) Prepare for pacemaker insertion
C) Administer amiodarone (Cordarone) intravenously
D) Administer epinephrine (Adrenaline) intravenously - ANSWER ✔✨---C) Administer amiodarone
(Cordarone) intravenously
Rationale: First-line treatment of ventricular tachycardia in a client who is hemodynamically stable is the
use of anti-dysrhythmics such as amiodarone (Cordarone), lidocaine (Xylocaine), and procainamide
(Pronestyl).
A nurse is caring for a client with unstable ventricular tachycardia. The nurse instructs the client to do
which of the following, if prescribed, during an episode of ventricular tachycardia?
A) Breathe deeply, regularly, and easily
Arrhythmias Exam Prep – Questions &
Rationales 2018
A nurse is assessing an electrocardiogram rhythm strip. The P waves and QRS complexes are regular. The
PR interval is 0.16 second, and QRS complexes measure 0.06 second. The overall heart rate is 64 beats
per minute. The nurse assesses the cardiac rhythm as:
A) Normal sinus rhythm
B) Sinus bradycardia
C) Sick sinus syndrome
D) First-degree heart block - ANSWER ✔✨---A) Normal sinus rhythm
Rationale: measurements are normal, measuring 0.12 to 0.20 second and 0.4 to 0.10 second,
respectively.
A nurse notices frequent artifact on the ECG monitor for a client whose leads are connected by cable to
a console at the bedside. The nurse examines the client to determine the cause. Which of the following
items is unlikely to be responsible for the artifact?
A) Frequent movement of the client
B) Tightly secured cable connections
C) Leads applied over hairy areas
D) Leads applied to the limbs - ANSWER ✔✨---B) Tightly secured cable connections
, Rationale: Motion artifact, or "noise," can be caused by frequent client movement, electrode placement
on limbs, and insufficient adhesion to the skin, such as placing electrodes over hairy areas of the skin
A nurse is watching the cardiac monitor and notices that the rhythm suddenly changes. There are no P
waves, the QRS complexes are wide, and the ventricular rate is regular but over 100. The nurse
determines that the client is experiencing:
A) Premature ventricular contractions
B) Ventricular tachycardia
C) Ventricular fibrillation
D) Sinus tachycardia - ANSWER ✔✨---B) Ventricular tachycardia
Rationale: Ventricular tachycardia is characterized by the absence of P waves, wide QRS complexes
(usually greater than 0.14 second), and a rate between 100 and 250 impulses per minute. The rhythm is
usually regular.
A nurse is viewing the cardiac monitor in a client's room and notes that the client has just gone into
ventricular tachycardia. The client is awake and alert and has good skin color. The nurse would prepare
to do which of the following?
A) Immediately defibrillate
B) Prepare for pacemaker insertion
C) Administer amiodarone (Cordarone) intravenously
D) Administer epinephrine (Adrenaline) intravenously - ANSWER ✔✨---C) Administer amiodarone
(Cordarone) intravenously
Rationale: First-line treatment of ventricular tachycardia in a client who is hemodynamically stable is the
use of anti-dysrhythmics such as amiodarone (Cordarone), lidocaine (Xylocaine), and procainamide
(Pronestyl).
A nurse is caring for a client with unstable ventricular tachycardia. The nurse instructs the client to do
which of the following, if prescribed, during an episode of ventricular tachycardia?
A) Breathe deeply, regularly, and easily
