Dysrhythmias Practice VERIFIED Questions & DETAILED
CORRECT ANSWERS with Rationales & Diagrams NEWEST
2025/26 UPDATED.
Rationale: 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?
A. Heparin
B. Atropine
C. Dobutamine
D. Magnesium sulfate - --ANSWERS---Answer: A
Rationale: 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. - --ANSWERS---Answer: D
Rationale: 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
C. The 88-year-old admitted with an elevated troponin level who
is hypotensive with a heart rate of 96 beats/min
D. The 92-year-old admitted with chest pain who has premature
ventricular complexes and a heart rate of 102 beats/min - --
ANSWERS---Answer: A
Rationale: This client has a stable, asymptomatic dysrhythmia,
which usually requires no treatment; this client can be managed
by a nurse with less cardiac dysrhythmia training.
, A client with atrial fibrillation with rapid ventricular response
has received medication to slow the ventricular rate. The pulse is
now 88. For which additional therapy does the nurse plan?
A. Synchronized cardioversion
B. Electrophysiology studies (EPS)
C. Anticoagulation
D. Radiofrequency ablation therapy - --ANSWERS---Answer: C
Rationale: Because of the risk for thromboembolism,
anticoagulation is necessary.
A client admitted after using crack cocaine develops ventricular
fibrillation. After determining unresponsiveness, which action
should the nurse take next?
A. Defibrillate at 200
B. Establish IV access.
C. Place an oral airway and ventilate.
D. Start cardiopulmonary resuscitation (CPR). - --ANSWERS---
Answer: A
Rationale: Defibrillating is of priority before any other
resuscitative measures according to Advanced Cardiac Life
Support protocols.
Which information would cause the nurse to withhold digoxin in
the client with atrial fibrillation and heart failure?
A. The client has sinus tachycardia with a rate of 102.
B. The cardiac monitor shows atrial fibrillation with a heart rate
of 98.
C. The client has a creatinine level of 1.0 mg/dl.
D. The digoxin level is 2.8 mg/dl. - --ANSWERS---Answer: D
CORRECT ANSWERS with Rationales & Diagrams NEWEST
2025/26 UPDATED.
Rationale: 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?
A. Heparin
B. Atropine
C. Dobutamine
D. Magnesium sulfate - --ANSWERS---Answer: A
Rationale: 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. - --ANSWERS---Answer: D
Rationale: 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
C. The 88-year-old admitted with an elevated troponin level who
is hypotensive with a heart rate of 96 beats/min
D. The 92-year-old admitted with chest pain who has premature
ventricular complexes and a heart rate of 102 beats/min - --
ANSWERS---Answer: A
Rationale: This client has a stable, asymptomatic dysrhythmia,
which usually requires no treatment; this client can be managed
by a nurse with less cardiac dysrhythmia training.
, A client with atrial fibrillation with rapid ventricular response
has received medication to slow the ventricular rate. The pulse is
now 88. For which additional therapy does the nurse plan?
A. Synchronized cardioversion
B. Electrophysiology studies (EPS)
C. Anticoagulation
D. Radiofrequency ablation therapy - --ANSWERS---Answer: C
Rationale: Because of the risk for thromboembolism,
anticoagulation is necessary.
A client admitted after using crack cocaine develops ventricular
fibrillation. After determining unresponsiveness, which action
should the nurse take next?
A. Defibrillate at 200
B. Establish IV access.
C. Place an oral airway and ventilate.
D. Start cardiopulmonary resuscitation (CPR). - --ANSWERS---
Answer: A
Rationale: Defibrillating is of priority before any other
resuscitative measures according to Advanced Cardiac Life
Support protocols.
Which information would cause the nurse to withhold digoxin in
the client with atrial fibrillation and heart failure?
A. The client has sinus tachycardia with a rate of 102.
B. The cardiac monitor shows atrial fibrillation with a heart rate
of 98.
C. The client has a creatinine level of 1.0 mg/dl.
D. The digoxin level is 2.8 mg/dl. - --ANSWERS---Answer: D
