DYSRHYTHMIAS (NCLEX) EXAM 1 2025
QUESTIONS AND ANSWERS
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
A client has frequent bursts of ventricular tachycardia on the cardiac monitor. 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 myocardial 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.
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,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 dysrhythmia.
Antidysrhythmic medications cause changes in cardiac rhythm and rate; therefore 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.
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.
The nurse is caring for a client with atrial fibrillation. In addition to an antidysrhythmic, what
medication does the nurse plan to administer?
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, 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).
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: blood pressure 118/68, respiratory rate 16, and temperature 98.8° F. The
following medications are available on the medication record. What action should the nurse
take?
a. Administer atropine.
b. Administer digoxin.
c. Administer clonidine.
d. Continue to monitor. - ANS D
The client is displaying sinus rhythm with first-degree atrioventicular heart block; this is usually
asymptomatic and does not require treatment. Atropine is used in emergency treatment of
symptomatic bradycardia. This client has normal vital signs. Digoxin is used in the treatment of
atrial fibrillation, which is, by definition, an irregular rhythm. Clonidine is used in the treatment
of hypertension; a side effect is bradycardia.
You are the charge nurse on the telemetry unit and are responsible for making client
assignments. Which client would be appropriate to assign to the float RN from the medical-
surgical unit?
a. The 64-year-old admitted for weakness who has a first-degree heart block with a heart rate
of 58 beats/min
b. The 71-year-old admitted for heart failure who is short of breath and has a heart rate of 120
to 130 beats/min
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QUESTIONS AND ANSWERS
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
A client has frequent bursts of ventricular tachycardia on the cardiac monitor. 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 myocardial 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.
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,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 dysrhythmia.
Antidysrhythmic medications cause changes in cardiac rhythm and rate; therefore 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.
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.
The nurse is caring for a client with atrial fibrillation. In addition to an antidysrhythmic, what
medication does the nurse plan to administer?
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, 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).
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: blood pressure 118/68, respiratory rate 16, and temperature 98.8° F. The
following medications are available on the medication record. What action should the nurse
take?
a. Administer atropine.
b. Administer digoxin.
c. Administer clonidine.
d. Continue to monitor. - ANS D
The client is displaying sinus rhythm with first-degree atrioventicular heart block; this is usually
asymptomatic and does not require treatment. Atropine is used in emergency treatment of
symptomatic bradycardia. This client has normal vital signs. Digoxin is used in the treatment of
atrial fibrillation, which is, by definition, an irregular rhythm. Clonidine is used in the treatment
of hypertension; a side effect is bradycardia.
You are the charge nurse on the telemetry unit and are responsible for making client
assignments. Which client would be appropriate to assign to the float RN from the medical-
surgical unit?
a. The 64-year-old admitted for weakness who has a first-degree heart block with a heart rate
of 58 beats/min
b. The 71-year-old admitted for heart failure who is short of breath and has a heart rate of 120
to 130 beats/min
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