35: Dysrhythmias Question and
Answer 16th September 2024
1. To determine whether there is a delay in impulse
conduction through the atria, the nurse will measure the
duration of the patient's
a. P wave.
b. Q wave.
c. P-R interval.
d. QRS complex. - correct answer A
The P wave represents the depolarization of the atria. The
P-R interval represents depolarization of the atria,
atrioventricular (AV) node, bundle of His, bundle
branches, and the Purkinje fibers. The QRS represents
ventricular depolarization. The Q wave is the first
negative deflection following the P wave and should be
narrow and short.
DIF: Cognitive Level: Understand (comprehension) REF:
791
TOP: Nursing Process: Assessment MSC:
Physiological Integrity
,35: Dysrhythmias Question and
Answer 16th September 2024
2. 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. Calculate the number of small squares between one
QRS complex and the next and divide into 1500.
d. Use the 3-second markers to count the number of QRS
complexes in 6 seconds and multiply by 10. - correct
answer D
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.
DIF: Cognitive Level: Apply (application) REF: 789-790
TOP: Nursing Process: Assessment MSC:
Physiological Integrity
,35: Dysrhythmias Question and
Answer 16th September 2024
3. A patient has a junctional escape rhythm on the
monitor. The nurse will expect the patient to have a heart
rate of _____ beats/minute.
a. 15 to 20
b. 20 to 40
c. 40 to 60
d. 60 to 100 - correct answer 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 the 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/minute.
DIF: Cognitive Level: Understand (comprehension) REF:
797
TOP: Nursing Process: Assessment MSC:
Physiological Integrity
4. The nurse obtains a rhythm strip on a patient who has
had a myocardial infarction and makes the following
, 35: Dysrhythmias Question and
Answer 16th September 2024
analysis: no visible P waves, P-R interval not measurable,
ventricular rate 162, R-R interval regular, and QRS
complex wide and distorted, QRS duration 0.18 second.
The nurse interprets the patient's cardiac rhythm as
a. atrial flutter.
b. sinus tachycardia.
c. ventricular fibrillation.
d. ventricular tachycardia. - correct answer D
The absence of P waves, wide QRS, rate >150
beats/minute, 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) REF: 794
TOP: Nursing Process: Assessment MSC:
Physiological Integrity
5. The nurse notes that a patient's cardiac monitor shows
that every other beat is earlier than expected, has no
Answer 16th September 2024
1. To determine whether there is a delay in impulse
conduction through the atria, the nurse will measure the
duration of the patient's
a. P wave.
b. Q wave.
c. P-R interval.
d. QRS complex. - correct answer A
The P wave represents the depolarization of the atria. The
P-R interval represents depolarization of the atria,
atrioventricular (AV) node, bundle of His, bundle
branches, and the Purkinje fibers. The QRS represents
ventricular depolarization. The Q wave is the first
negative deflection following the P wave and should be
narrow and short.
DIF: Cognitive Level: Understand (comprehension) REF:
791
TOP: Nursing Process: Assessment MSC:
Physiological Integrity
,35: Dysrhythmias Question and
Answer 16th September 2024
2. 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. Calculate the number of small squares between one
QRS complex and the next and divide into 1500.
d. Use the 3-second markers to count the number of QRS
complexes in 6 seconds and multiply by 10. - correct
answer D
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.
DIF: Cognitive Level: Apply (application) REF: 789-790
TOP: Nursing Process: Assessment MSC:
Physiological Integrity
,35: Dysrhythmias Question and
Answer 16th September 2024
3. A patient has a junctional escape rhythm on the
monitor. The nurse will expect the patient to have a heart
rate of _____ beats/minute.
a. 15 to 20
b. 20 to 40
c. 40 to 60
d. 60 to 100 - correct answer 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 the 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/minute.
DIF: Cognitive Level: Understand (comprehension) REF:
797
TOP: Nursing Process: Assessment MSC:
Physiological Integrity
4. The nurse obtains a rhythm strip on a patient who has
had a myocardial infarction and makes the following
, 35: Dysrhythmias Question and
Answer 16th September 2024
analysis: no visible P waves, P-R interval not measurable,
ventricular rate 162, R-R interval regular, and QRS
complex wide and distorted, QRS duration 0.18 second.
The nurse interprets the patient's cardiac rhythm as
a. atrial flutter.
b. sinus tachycardia.
c. ventricular fibrillation.
d. ventricular tachycardia. - correct answer D
The absence of P waves, wide QRS, rate >150
beats/minute, 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) REF: 794
TOP: Nursing Process: Assessment MSC:
Physiological Integrity
5. The nurse notes that a patient's cardiac monitor shows
that every other beat is earlier than expected, has no
