Dysrhythmias Lewis: Medical-Surgical
Nursing 10th Edition Complete Exam
Study Guide 2026 | 130+ Questions &
Answers with Detailed Explanations |
Guaranteed Pass Exam Prep
Description
This complete exam study guide contains 130+ carefully structured
questions and answers designed to help students master the most
important exam topics and achieve outstanding results. Each question is
accompanied by a clear and detailed explanation, making it easier to
understand key concepts and strengthen exam preparation.
The guide is organized in a simple and student-friendly format,
allowing learners to review essential material quickly while practicing
realistic exam-style questions. By working through these 130+ Q&A,
students can reinforce their knowledge, identify important topics, and
improve their confidence before taking the exam.
This resource is ideal for final exam revision, self-testing, and
comprehensive exam preparation, making it a valuable tool for
students who want a reliable study guide and a higher chance of
passing their exam successfully.
To determine whether there is a delay in impulse conduction through the ventricles, the
nurse will measure the duration of the patient's
a. P wave. c. PR interval.
b. Q wave. d. QRS complex. -answer ANS: D
The QRS complex represents ventricular depolarization. The P wave represents the
depolarization of the atria. The PR interval represents depolarization of the atria,
,atrioventricular node, a bundle of His, bundle branches, and the Purkinje fibers. The Q
wave is the first negative deflection following the P wave and should be narrow and
short.
Cognitive Level: Understand (comprehension)Chapter
The nurse needs to quickly estimate the heart rate for a patient with a regular heart
rhythm. Which method will be best to use?
a. Count the number of large squares in the R-R interval and divide by 300.
b. Print a 1-minute electrocardiogram (ECG) strip and count the number of QRS
complexes.
c. Use the 3-second markers to count the number of QRS complexes in 6 seconds and
multiply by 10.
d. Calculate the number of small squares between one QRS complex and the next and
divide into 1500. -answer ANS: C
This is the quickest way to determine the ventricular rate for a patient with a regular
rhythm. All the other methods are accurate but take longer.
Cognitive Level: Analyze (analysis)
A patient has a junctional escape rhythm on the monitor. The nurse will expect the
patient to have a heart rate of _____ beats/min.
a. 15 to 20 c. 40 to 60
b. 20 to 40 d. 60 to 100 -answer ANS: C
If the sinoatrial (SA) node fails to discharge, the atrioventricular (AV) node will
automatically discharge at the normal rate of 40 to 60 beats/minute. The slower rates
are typical of the bundle of His and Purkinje system and may be seen with failure of
both the SA and AV node to discharge. The normal SA node rate is 60 to 100
beats/min.
The nurse obtains a rhythm strip on a patient who has had a myocardial infarction and
makes the following analysis: no visible P waves, PR interval not measurable,
ventricular rate of 162, R-R interval regular, and QRS complex wide and distorted, and
QRS duration of 0.18 second. The nurse interprets the patient's cardiac rhythm as
a. atrial flutter. c. ventricular fibrillation.
b. sinus tachycardia. d. ventricular tachycardia. -answer ANS: D
The absence of P waves, wide QRS, rate greater than 150 beats/min, and the regularity
of the rhythm indicate ventricular tachycardia. Atrial flutter is usually regular, has a
narrow QRS configuration, and has flutter waves present representing atrial activity.
Sinus tachycardia has P waves. Ventricular fibrillation is irregular and does not have a
consistent QRS duration.
DIF: Cognitive Level: Apply (application)
The nurse notes that a patient's heart monitor shows that every other beat is earlier than
expected, has no visible P wave, and has a QRS complex that is wide and bizarre in
shape. How will the nurse document the rhythm?
a. Ventricular couplets
, b. Ventricular bigeminy
c. Ventricular R-on-T phenomenon
d. Multifocal premature ventricular contractions -answer ANS: B
Ventricular bigeminy describes a rhythm in which every other QRS complex is wide and
bizarre looking. Pairs of wide QRS complexes are described as ventricular couplets.
There is no indication that the premature ventricular contractions are multifocal or that
the R-on-T phenomenon is occurring.
DIF: Cognitive Level: Apply (application)
A patient has a sinus rhythm and a heart rate of 72 beats/min. The nurse determines
that the PR interval is 0.24 seconds. The most appropriate intervention by the nurse
would be to
a. notify the a provider immediately.
b. document the finding and monitor the patient.
c. give atropine per agency dysrhythmia protocol.
d. prepare the patient for temporary pacemaker insertion. -answer ANS: B
First-degree atrioventricular block is asymptomatic and requires ongoing monitoring
because it may progress to more serious forms of heart block. The rate is normal, so
there is no indication that atropine is needed. Immediate notification of the health care
provider about an asymptomatic rhythm is not necessary.
DIF: Cognitive Level: Apply (application)
A patient who was admitted with a myocardial infarction experiences a 45-second
episode of ventricular tachycardia, then converts to sinus rhythm with a heart rate of 98
beats/min. Which action should the nurse take next?
a. Immediately notify the health care provider.
b. Document the rhythm and continue to monitor the patient.
c. Prepare to give IV amiodarone per agency dysrhythmia protocol.
d. Perform synchronized cardioversion per agency dysrhythmia protocol. -answer ANS:
C
The burst of sustained ventricular tachycardia indicates that the patient has significant
ventricular irritability, and antidysrhythmic medication administration is needed to
prevent further episodes. The nurse should notify the health care provider after the
medication is started. Cardioversion is not indicated given that the patient has returned
to a sinus rhythm. Documentation and continued monitoring are not adequate
responses to this situation.
DIF: Cognitive Level: Analyze (analysis)
After the nurse gives IV atropine to a patient with symptomatic type 1, second-degree
atrioventricular (AV) block, which finding indicates that the drug has been effective?
a. Increase in the patient's heart rate
b. Increase in strength of peripheral pulses
c. Decrease in premature atrial contractions
Nursing 10th Edition Complete Exam
Study Guide 2026 | 130+ Questions &
Answers with Detailed Explanations |
Guaranteed Pass Exam Prep
Description
This complete exam study guide contains 130+ carefully structured
questions and answers designed to help students master the most
important exam topics and achieve outstanding results. Each question is
accompanied by a clear and detailed explanation, making it easier to
understand key concepts and strengthen exam preparation.
The guide is organized in a simple and student-friendly format,
allowing learners to review essential material quickly while practicing
realistic exam-style questions. By working through these 130+ Q&A,
students can reinforce their knowledge, identify important topics, and
improve their confidence before taking the exam.
This resource is ideal for final exam revision, self-testing, and
comprehensive exam preparation, making it a valuable tool for
students who want a reliable study guide and a higher chance of
passing their exam successfully.
To determine whether there is a delay in impulse conduction through the ventricles, the
nurse will measure the duration of the patient's
a. P wave. c. PR interval.
b. Q wave. d. QRS complex. -answer ANS: D
The QRS complex represents ventricular depolarization. The P wave represents the
depolarization of the atria. The PR interval represents depolarization of the atria,
,atrioventricular node, a bundle of His, bundle branches, and the Purkinje fibers. The Q
wave is the first negative deflection following the P wave and should be narrow and
short.
Cognitive Level: Understand (comprehension)Chapter
The nurse needs to quickly estimate the heart rate for a patient with a regular heart
rhythm. Which method will be best to use?
a. Count the number of large squares in the R-R interval and divide by 300.
b. Print a 1-minute electrocardiogram (ECG) strip and count the number of QRS
complexes.
c. Use the 3-second markers to count the number of QRS complexes in 6 seconds and
multiply by 10.
d. Calculate the number of small squares between one QRS complex and the next and
divide into 1500. -answer ANS: C
This is the quickest way to determine the ventricular rate for a patient with a regular
rhythm. All the other methods are accurate but take longer.
Cognitive Level: Analyze (analysis)
A patient has a junctional escape rhythm on the monitor. The nurse will expect the
patient to have a heart rate of _____ beats/min.
a. 15 to 20 c. 40 to 60
b. 20 to 40 d. 60 to 100 -answer ANS: C
If the sinoatrial (SA) node fails to discharge, the atrioventricular (AV) node will
automatically discharge at the normal rate of 40 to 60 beats/minute. The slower rates
are typical of the bundle of His and Purkinje system and may be seen with failure of
both the SA and AV node to discharge. The normal SA node rate is 60 to 100
beats/min.
The nurse obtains a rhythm strip on a patient who has had a myocardial infarction and
makes the following analysis: no visible P waves, PR interval not measurable,
ventricular rate of 162, R-R interval regular, and QRS complex wide and distorted, and
QRS duration of 0.18 second. The nurse interprets the patient's cardiac rhythm as
a. atrial flutter. c. ventricular fibrillation.
b. sinus tachycardia. d. ventricular tachycardia. -answer ANS: D
The absence of P waves, wide QRS, rate greater than 150 beats/min, and the regularity
of the rhythm indicate ventricular tachycardia. Atrial flutter is usually regular, has a
narrow QRS configuration, and has flutter waves present representing atrial activity.
Sinus tachycardia has P waves. Ventricular fibrillation is irregular and does not have a
consistent QRS duration.
DIF: Cognitive Level: Apply (application)
The nurse notes that a patient's heart monitor shows that every other beat is earlier than
expected, has no visible P wave, and has a QRS complex that is wide and bizarre in
shape. How will the nurse document the rhythm?
a. Ventricular couplets
, b. Ventricular bigeminy
c. Ventricular R-on-T phenomenon
d. Multifocal premature ventricular contractions -answer ANS: B
Ventricular bigeminy describes a rhythm in which every other QRS complex is wide and
bizarre looking. Pairs of wide QRS complexes are described as ventricular couplets.
There is no indication that the premature ventricular contractions are multifocal or that
the R-on-T phenomenon is occurring.
DIF: Cognitive Level: Apply (application)
A patient has a sinus rhythm and a heart rate of 72 beats/min. The nurse determines
that the PR interval is 0.24 seconds. The most appropriate intervention by the nurse
would be to
a. notify the a provider immediately.
b. document the finding and monitor the patient.
c. give atropine per agency dysrhythmia protocol.
d. prepare the patient for temporary pacemaker insertion. -answer ANS: B
First-degree atrioventricular block is asymptomatic and requires ongoing monitoring
because it may progress to more serious forms of heart block. The rate is normal, so
there is no indication that atropine is needed. Immediate notification of the health care
provider about an asymptomatic rhythm is not necessary.
DIF: Cognitive Level: Apply (application)
A patient who was admitted with a myocardial infarction experiences a 45-second
episode of ventricular tachycardia, then converts to sinus rhythm with a heart rate of 98
beats/min. Which action should the nurse take next?
a. Immediately notify the health care provider.
b. Document the rhythm and continue to monitor the patient.
c. Prepare to give IV amiodarone per agency dysrhythmia protocol.
d. Perform synchronized cardioversion per agency dysrhythmia protocol. -answer ANS:
C
The burst of sustained ventricular tachycardia indicates that the patient has significant
ventricular irritability, and antidysrhythmic medication administration is needed to
prevent further episodes. The nurse should notify the health care provider after the
medication is started. Cardioversion is not indicated given that the patient has returned
to a sinus rhythm. Documentation and continued monitoring are not adequate
responses to this situation.
DIF: Cognitive Level: Analyze (analysis)
After the nurse gives IV atropine to a patient with symptomatic type 1, second-degree
atrioventricular (AV) block, which finding indicates that the drug has been effective?
a. Increase in the patient's heart rate
b. Increase in strength of peripheral pulses
c. Decrease in premature atrial contractions
