Advanced Cardiac Dysrhythmia & Telemetry
Nursing Mastery: ECG Interpretation (P Wave, PR
Interval, QRS, QT), AV Blocks (First-Degree, Mobitz
I & II), Atrial Fibrillation & Atrial Flutter, Ventricular
Tachycardia & Ventricular Fibrillation, Sinus
Bradycardia & Tachycardia, PVCs & Bigeminy,
Cardioversion vs. Defibrillation, Pacemakers & ICD
Management, Atropine & Antiarrhythmic Therapy,
Anticoagulation (Warfarin), Hemodynamic Stability,
CPR & Emergency Response, and Clinical
Prioritization Exam Questions Verified and
Complete with A+ Graded Rationales Latest
Updated 2026
The nurse is working on a telemetry unit, caring for a client who develops dizziness and a
second-degree heart block, Mobitz Type 1. What will be the initial nursing intervention?
A. Prepare to client for cardioversion.
B. Administer an IV bolus of atropine.
C. Send the client to the cardiac catheterization laboratory.
D. Review the client's medication record.
B. Administer an IV bolus of atropine
Atropine 0.5 mg given rapidly as an intravenous bolus every 3 to 5 minutes to a maximum total
dose of 3.0 mg is the medication of choice in treating symptomatic second-degree heart block.
The client may need to be sent to the cardiac catheterization lab for a temporary pacemaker,
but atropine should be tried first. Cardioversion is used to treat a fast heart rate. Reviewing the
medication record will not help the client initially.
A nurse is teaching the client about the causes of fast heart rates. What client statement
indicates the client requires more teaching?
,A. "I will cut back on my smoking and drinking alcohol."
B. "If I take my metoprolol daily, I will be able to control my heart rate."
C. "I will drink coffee with only two of my meals."
D. "I will take my levothyroxine daily."
C. "I will drink coffee with only two of my meals."
Stimulation of the sympathetic nervous system with caffeinated beverages, smoking, and
drinking alcohol increases heart rate.The client is still drinking caffeine with two meals,
increasing the risk for a fast heart rate. Taking medications such as metoprolol and
levothyroxine will help the client maintain a normal heart rate by decreasing stimulation of the
sympathetic nervous system.
The nurse is proving discharge instructions for a client with a new arrhythmia. Which statement
should the nurse include?
A. It is not necessary to learn how to take your own pulse.
B. If you miss a dose of your antiarrhythmia medication, double up on the next dose.
C. Your family and friends may want to take a CPR class.
D. Do not be concerned if you experience symptoms of lightheadedness and dizziness.
C. Your family and friends may want to take a CPR class.
Having friends and family learn to perform CPR will help the client manage the arrhythmia.
Monitoring pulse rate at home also helps the client manage the condition. Antiarrhythmic
medication should be taken on time. Lightheadedness and dizziness should be reported to the
provider.
A client reports light-headedness, chest pain, and shortness of breath. They physician orders
tests to ascertain what is causing the client's problems. Which test is used to identify cardiac
rhythms?
A. electrocautery
,B. electrocardiogram
C. echocardiogram
D. electroencephalogram
B. electrocardiogram
An electrocardiogram is used to identify normal and abnormal cardiac rhythms.
The nurse is caring for a client with second-degree atrioventricular block, Type I with
symptomatic bradycardia. What is the most likely medication the nurse will administer?
A. diltazem
B. atropine sulfate
C. atenolol
D. nadolol
B. atropine sulfate
Atropine blocks acetylcholine at parasympathetic neuroeffector sites and blocks vagal
stimulation. The client will be treated with an anticholinergic that blocks the effects of the vagal
nerve. Atenolol and nadolol are beta blockers that are used for chest pain, myocardial
infarction, and hypertension. Diltazem is a calcium channel blocker used to treat angina or slow
the heart rate.
To evaluate a client's atrial depolarization, the nurse observes which part of the
electrocardiogram waveform?
A. T wave
B. QRS complex
C. P wave
D. PR interval
, C. P wave
The P wave depicts atrial depolarization, or spread of the electrical impulse from the sinoatrial
node through the atria. The PR interval represents spread of the impulse through the interatrial
and internodal fibers, atrioventricular node, bundle of His, and Purkinje fibers. The QRS complex
represents ventricular depolarization. The T wave depicts the relative refractory period,
representing ventricular repolarization.
The nursing student asks the nurse to describe the difference between sinus rhythm and sinus
bradycardia on the electrocardiogram strip. What is the nurse's best reply?
A. "The P-R interval will be prolonged in sinus bradycardia."
B. "The only difference is the heart rate."
C. "The QRS complex will be smaller in sinus bradycardia."
D. "The P waves will be shaped differently."
B. "The only difference is the heart rate."
All characteristics of sinus bradycardia are the same as those of normal sinus rhythm except for
the rate, which will be below 60 in sinus bradycardia. The P waves will be shaped differently in
other dysrhythmias. The QRS is the same voltage for sinus rhythms. The P-R interval is
prolonged in aterioventricular blocks.
The nursing student asks the nurse how to tell the difference between ventricular tachycardia
and ventricular fibrillation on an electrocardiogram strip. What is the best response?
A. "The P-R interval will be prolonged in ventricular fibrillation, while in ventricular tachycardia
the P-R interval is normal."
B. "The two look very much alike; it is difficult to tell the difference."
C. "Ventricular fibrillation is irregular with undulating waves and no QRS complex. Ventricular
tachycardia is usually regular and fast, with wide QRS complexes."
D. "The QRS complex in ventricular fibrillation is always narrow, while in ventricular tachycardia
the QRS is of normal width."
Nursing Mastery: ECG Interpretation (P Wave, PR
Interval, QRS, QT), AV Blocks (First-Degree, Mobitz
I & II), Atrial Fibrillation & Atrial Flutter, Ventricular
Tachycardia & Ventricular Fibrillation, Sinus
Bradycardia & Tachycardia, PVCs & Bigeminy,
Cardioversion vs. Defibrillation, Pacemakers & ICD
Management, Atropine & Antiarrhythmic Therapy,
Anticoagulation (Warfarin), Hemodynamic Stability,
CPR & Emergency Response, and Clinical
Prioritization Exam Questions Verified and
Complete with A+ Graded Rationales Latest
Updated 2026
The nurse is working on a telemetry unit, caring for a client who develops dizziness and a
second-degree heart block, Mobitz Type 1. What will be the initial nursing intervention?
A. Prepare to client for cardioversion.
B. Administer an IV bolus of atropine.
C. Send the client to the cardiac catheterization laboratory.
D. Review the client's medication record.
B. Administer an IV bolus of atropine
Atropine 0.5 mg given rapidly as an intravenous bolus every 3 to 5 minutes to a maximum total
dose of 3.0 mg is the medication of choice in treating symptomatic second-degree heart block.
The client may need to be sent to the cardiac catheterization lab for a temporary pacemaker,
but atropine should be tried first. Cardioversion is used to treat a fast heart rate. Reviewing the
medication record will not help the client initially.
A nurse is teaching the client about the causes of fast heart rates. What client statement
indicates the client requires more teaching?
,A. "I will cut back on my smoking and drinking alcohol."
B. "If I take my metoprolol daily, I will be able to control my heart rate."
C. "I will drink coffee with only two of my meals."
D. "I will take my levothyroxine daily."
C. "I will drink coffee with only two of my meals."
Stimulation of the sympathetic nervous system with caffeinated beverages, smoking, and
drinking alcohol increases heart rate.The client is still drinking caffeine with two meals,
increasing the risk for a fast heart rate. Taking medications such as metoprolol and
levothyroxine will help the client maintain a normal heart rate by decreasing stimulation of the
sympathetic nervous system.
The nurse is proving discharge instructions for a client with a new arrhythmia. Which statement
should the nurse include?
A. It is not necessary to learn how to take your own pulse.
B. If you miss a dose of your antiarrhythmia medication, double up on the next dose.
C. Your family and friends may want to take a CPR class.
D. Do not be concerned if you experience symptoms of lightheadedness and dizziness.
C. Your family and friends may want to take a CPR class.
Having friends and family learn to perform CPR will help the client manage the arrhythmia.
Monitoring pulse rate at home also helps the client manage the condition. Antiarrhythmic
medication should be taken on time. Lightheadedness and dizziness should be reported to the
provider.
A client reports light-headedness, chest pain, and shortness of breath. They physician orders
tests to ascertain what is causing the client's problems. Which test is used to identify cardiac
rhythms?
A. electrocautery
,B. electrocardiogram
C. echocardiogram
D. electroencephalogram
B. electrocardiogram
An electrocardiogram is used to identify normal and abnormal cardiac rhythms.
The nurse is caring for a client with second-degree atrioventricular block, Type I with
symptomatic bradycardia. What is the most likely medication the nurse will administer?
A. diltazem
B. atropine sulfate
C. atenolol
D. nadolol
B. atropine sulfate
Atropine blocks acetylcholine at parasympathetic neuroeffector sites and blocks vagal
stimulation. The client will be treated with an anticholinergic that blocks the effects of the vagal
nerve. Atenolol and nadolol are beta blockers that are used for chest pain, myocardial
infarction, and hypertension. Diltazem is a calcium channel blocker used to treat angina or slow
the heart rate.
To evaluate a client's atrial depolarization, the nurse observes which part of the
electrocardiogram waveform?
A. T wave
B. QRS complex
C. P wave
D. PR interval
, C. P wave
The P wave depicts atrial depolarization, or spread of the electrical impulse from the sinoatrial
node through the atria. The PR interval represents spread of the impulse through the interatrial
and internodal fibers, atrioventricular node, bundle of His, and Purkinje fibers. The QRS complex
represents ventricular depolarization. The T wave depicts the relative refractory period,
representing ventricular repolarization.
The nursing student asks the nurse to describe the difference between sinus rhythm and sinus
bradycardia on the electrocardiogram strip. What is the nurse's best reply?
A. "The P-R interval will be prolonged in sinus bradycardia."
B. "The only difference is the heart rate."
C. "The QRS complex will be smaller in sinus bradycardia."
D. "The P waves will be shaped differently."
B. "The only difference is the heart rate."
All characteristics of sinus bradycardia are the same as those of normal sinus rhythm except for
the rate, which will be below 60 in sinus bradycardia. The P waves will be shaped differently in
other dysrhythmias. The QRS is the same voltage for sinus rhythms. The P-R interval is
prolonged in aterioventricular blocks.
The nursing student asks the nurse how to tell the difference between ventricular tachycardia
and ventricular fibrillation on an electrocardiogram strip. What is the best response?
A. "The P-R interval will be prolonged in ventricular fibrillation, while in ventricular tachycardia
the P-R interval is normal."
B. "The two look very much alike; it is difficult to tell the difference."
C. "Ventricular fibrillation is irregular with undulating waves and no QRS complex. Ventricular
tachycardia is usually regular and fast, with wide QRS complexes."
D. "The QRS complex in ventricular fibrillation is always narrow, while in ventricular tachycardia
the QRS is of normal width."
