Exam 1: Dysrhythmias (NCLEX)
1. A client's electrocardiogram strip shows atrial and ventricular rates of 80
complexes per minute. The PR interval is 0.14 second, and the QRS complex
measures 0.08 second. The nurse interprets this rhythm is:
A) Normal sinus rhythm
B) Sinus bradycardia
C) Sinus tachycardia
D) Sinus dysrhythmia Ans: A
2. A client has frequent bursts of ventricular tachycardia on the cardiac mon- itor. A
nurse is most concerned with this dysrhythmia because:
A) It is uncomfortable for the client, giving a sense of impending doom.
B) It produces a high cardiac output that quickly leads to cerebral and myocar- dial
ischemia.
C) It is almost impossible to convert to a normal sinus rhythm.
D) It can develop into ventricular fibrillation at any time. Ans: D
Ventricular tachycardia is a life-threatening dysrhythmia that results from an irritable ectopic
focus that takes over as the pacemaker for the heart. The low cardiac output that results can
lead quickly to cerebral and myocardial ischemia. Client's frequently experience a feeling of
impending death. Ventricular tachycardia is treated with antidysrhythmic medications or
magnesium sulfate, cardioversion (client awake), or defibrillation (loss of consciousness),
Ventricular tachycardia can deteriorate into ventricular defibrillation at any time.
3. The nurse administers amiodarone (Cordarone) to a client with ventricular
tachycardia. Which monitoring by the nurse is necessary with this drug? Select all
,that apply.
a. Respiratory rate
b. QT interval
c. Heart rate and rhythm
d. Magnesium level
e. Urine output Ans: BCD
Amiodarone causes prolongation of the QT interval, which can precipitate dysrhyth- mia.
Antidysrhythmic medications cause changes in cardiac rhythm and rate; there- fore
monitoring of heart rate and rhythm is needed.Electrolyte depletion, specifically potassium
and magnesium, may predispose to further dysrhythmia. Although it is always important to
monitor vital signs and urine output, these assessments are not specific to amiodarone.
, 4. The nurse is caring for a client with acute coronary syndrome (ACS) and atrial
fibrillation who has a new prescription for metoprolol (Lopressor).Which monitoring
is essential when administering the medication?
a. ST segment
b. Heart rate
c. Troponin
d. Myoglobin Ans: B
The effects of metoprolol are to decrease heart rate, blood pressure, and myocardial oxygen
demand. ST segment elevation is consistent with MI; it does not address monitoring of
metoprolol. Elevation in troponin is consistent with a diagnosis of MI but does not address
needed monitoring for metoprolol. Elevation in myoglobin is consistent with myocardial
injury in ACS but does not address needed monitoring related to metoprolol.
5. The nurse is caring for a client with atrial fibrillation. In addition to an
antidysrhythmic, what medication does the nurse plan to administer?
a. Heparin
b. Atropine
c. Dobutamine
d. Magnesium sulfate Ans: A
Clients with atrial fibrillation are prone to blood pooling in the atrium, clotting, then
embolizing. Heparin is used to prevent thrombus development in the atrium and the
consequence of embolization (i.e., stroke).
6. The nurse is caring for a client on a telemetry unit with a regular heart rhythm
and rate of 60; a P wave precedes each QRS complex, and the PR interval is 0.24
second. Additional vital signs are as follows Ans: blood pressure 118/68, respiratory
1. A client's electrocardiogram strip shows atrial and ventricular rates of 80
complexes per minute. The PR interval is 0.14 second, and the QRS complex
measures 0.08 second. The nurse interprets this rhythm is:
A) Normal sinus rhythm
B) Sinus bradycardia
C) Sinus tachycardia
D) Sinus dysrhythmia Ans: A
2. A client has frequent bursts of ventricular tachycardia on the cardiac mon- itor. A
nurse is most concerned with this dysrhythmia because:
A) It is uncomfortable for the client, giving a sense of impending doom.
B) It produces a high cardiac output that quickly leads to cerebral and myocar- dial
ischemia.
C) It is almost impossible to convert to a normal sinus rhythm.
D) It can develop into ventricular fibrillation at any time. Ans: D
Ventricular tachycardia is a life-threatening dysrhythmia that results from an irritable ectopic
focus that takes over as the pacemaker for the heart. The low cardiac output that results can
lead quickly to cerebral and myocardial ischemia. Client's frequently experience a feeling of
impending death. Ventricular tachycardia is treated with antidysrhythmic medications or
magnesium sulfate, cardioversion (client awake), or defibrillation (loss of consciousness),
Ventricular tachycardia can deteriorate into ventricular defibrillation at any time.
3. The nurse administers amiodarone (Cordarone) to a client with ventricular
tachycardia. Which monitoring by the nurse is necessary with this drug? Select all
,that apply.
a. Respiratory rate
b. QT interval
c. Heart rate and rhythm
d. Magnesium level
e. Urine output Ans: BCD
Amiodarone causes prolongation of the QT interval, which can precipitate dysrhyth- mia.
Antidysrhythmic medications cause changes in cardiac rhythm and rate; there- fore
monitoring of heart rate and rhythm is needed.Electrolyte depletion, specifically potassium
and magnesium, may predispose to further dysrhythmia. Although it is always important to
monitor vital signs and urine output, these assessments are not specific to amiodarone.
, 4. The nurse is caring for a client with acute coronary syndrome (ACS) and atrial
fibrillation who has a new prescription for metoprolol (Lopressor).Which monitoring
is essential when administering the medication?
a. ST segment
b. Heart rate
c. Troponin
d. Myoglobin Ans: B
The effects of metoprolol are to decrease heart rate, blood pressure, and myocardial oxygen
demand. ST segment elevation is consistent with MI; it does not address monitoring of
metoprolol. Elevation in troponin is consistent with a diagnosis of MI but does not address
needed monitoring for metoprolol. Elevation in myoglobin is consistent with myocardial
injury in ACS but does not address needed monitoring related to metoprolol.
5. The nurse is caring for a client with atrial fibrillation. In addition to an
antidysrhythmic, what medication does the nurse plan to administer?
a. Heparin
b. Atropine
c. Dobutamine
d. Magnesium sulfate Ans: A
Clients with atrial fibrillation are prone to blood pooling in the atrium, clotting, then
embolizing. Heparin is used to prevent thrombus development in the atrium and the
consequence of embolization (i.e., stroke).
6. The nurse is caring for a client on a telemetry unit with a regular heart rhythm
and rate of 60; a P wave precedes each QRS complex, and the PR interval is 0.24
second. Additional vital signs are as follows Ans: blood pressure 118/68, respiratory
