Exam 1: Dysrhythmias (NCLEX) Verified Solutions
A client's electrocardiogram strip indicates atrial and ventricular rates of 80 complexes per minute. The
PR interval measures 0.14 second, and the QRS complex duration is 0.08 second. The nurse interprets
this rhythm as:
A) Normal sinus rhythm
This interpretation is correct because the heart rate is within the normal range (60-100 beats per
minute), the PR interval is normal (0.12-0.20 seconds), and the QRS complex duration is within normal
limits (0.06-0.10 seconds).
Regarding ventricular tachycardia, a nurse is most concerned because:
D) It can develop into ventricular fibrillation at any time.
Ventricular tachycardia is a serious dysrhythmia characterized by rapid, regular heartbeats originating in
the ventricles. It can lead to decreased cardiac output, potentially causing cerebral and myocardial
ischemia. Ventricular tachycardia is concerning because it can deteriorate into ventricular fibrillation, a
life-threatening rhythm where the heart ceases to effectively pump blood.
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 ✔️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 ✔️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?
a. Heparin
b. Atropine
c. Dobutamine
d. Magnesium sulfate ✔️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 client's electrocardiogram strip indicates atrial and ventricular rates of 80 complexes per minute. The
PR interval measures 0.14 second, and the QRS complex duration is 0.08 second. The nurse interprets
this rhythm as:
A) Normal sinus rhythm
This interpretation is correct because the heart rate is within the normal range (60-100 beats per
minute), the PR interval is normal (0.12-0.20 seconds), and the QRS complex duration is within normal
limits (0.06-0.10 seconds).
Regarding ventricular tachycardia, a nurse is most concerned because:
D) It can develop into ventricular fibrillation at any time.
Ventricular tachycardia is a serious dysrhythmia characterized by rapid, regular heartbeats originating in
the ventricles. It can lead to decreased cardiac output, potentially causing cerebral and myocardial
ischemia. Ventricular tachycardia is concerning because it can deteriorate into ventricular fibrillation, a
life-threatening rhythm where the heart ceases to effectively pump blood.
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 ✔️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 ✔️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?
a. Heparin
b. Atropine
c. Dobutamine
d. Magnesium sulfate ✔️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?
