STUVIA 2024/2025
Nclex Style EKG Practice
A and B
The consistency of the RR interval indicates regular rhythm. A normal P wave before each complex
indicates the impulse originated in the SA node. The number of complexes in a 6 second strip is
multiplied by 10 to approximate the heart rate; normal sinus rhythm is 60 to 100. Elevation of the ST
segment is a sign of cardiac ischemia and is unrelated to the rhythm. The QRS duration should be
less than 0.12 second; the PR interval should be 0.12 to 0.20 second. - ✔✔What criteria should the
nurse use to determine normal sinus rhythm for a client on a cardiac monitor? Check all that apply.
A. The RR intervals are relatively consistent
B. One P wave precedes each QRS complex
C. Four to eight complexes occur in a 6 second strip
D. The ST segment is higher than the PR interval
E. The QRS complex ranges from 0.12 to 0.20 second
A.
Carotid sinus massage is one of the maneuvers used for vagal stimulation to decrease a rapid heart
%
rate and possibly terminate a tachydysrhythmia. The others include inducing the gag reflex and
asking the client to strain or bear down. Medication therapy often is needed as an adjunct to keep the
rate down or maintain the normal rhythm. - ✔✔A client with rapid rate atrial fibrillation asks a nurse
why the physician is going to perform carotid massage. The nurse responds that this procedure may
stimulate the:
A. Vagus nerve to slow the heart rate
B. Vagus nerve to increase the heart rate; over driving the rhythm
C. Diaphragmatic nerve to slow the heart rate
D. Diaphragmatic nerve to overdrive the rhythm
A.
Premature ventricular contractions can cause hemodynamic compromise. The shortened ventricular
filling time with the ectopic beats leads to decreased stroke volume and, if frequent enough, to
decreased cardiac output. The client may be asymptomatic or may feel palpitations. PVCs can be
caused by cardiac disorders or by any number of physiological stressors, such as infection, illness,
surgery, or trauma, and by the intake of caffeine, alcohol, or nicotine. - ✔✔A client is having frequent
premature ventricular contractions. A nurse would place priority on assessment of which of the
following items?
A. Blood pressure and peripheral perfusion
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, STUVIA 2024/2025
B. Sensation of palpitations
C. Causative factors such as caffeine
D. Precipitating factors such as infection
A.
The client with uncontrolled atrial fibrillation with a ventricular rate more than 150 beats a minute is at
risk for low cardiac output because of loss of atrial kick. The nurse assesses the client for palpitations,
chest pain or discomfort, hypotension, pulse deficit, fatigue, weakness, dizziness, syncope, shortness
of breath, and distended neck veins. - ✔✔A client has developed atrial fibrillation, which a ventricular
rate of 150 beats per minute. A nurse assesses the client for:
A. Hypotension and dizziness
B. Nausea and vomiting
C. Hypertension and headache
D. Flat neck veins
A. Normal Sinus Rhythm
measurements are normal, measuring 0.12 to 0.20 second and 0.4 to 0.10 second, respectively. -
✔✔A nurse is assessing an electrocardiogram rhythm strip. The P waves and QRS complexes are
regular. The PR interval is 0.16 second, and QRS complexes measure 0.06 second. The overall heart
%
rate is 64 beats per minute. The nurse assesses the cardiac rhythm as:
A. Normal Sinus Rhythm
B. Sinus Bradycardia
C. Sick Sinus Syndrome
D. First-degree heart block
B.
Atrial fibrillation is characterized by a loss of P waves; an undulating, wavy baseline; QRS duration
that is often within normal limits; and an irregular ventricular rate, which can range from 60 to 100
beats per minute (when controlled with medications) to 100 to 160 beats per minute (when
uncontrolled). - ✔✔A nurse is watching the cardiac monitor, and a client's rhythm suddenly changes.
There are no P waves; instead there are wavy lines. The QRS complexes measure 0.08 second, but
they are irregular, with a rate of 120 beats a minute. The nurse interprets this rhythm as:
A. Sinus tachycardia
B. Atrial fibrillation
C. Ventricular tachycardia
D. Ventricular fibrillation
B.
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Nclex Style EKG Practice
A and B
The consistency of the RR interval indicates regular rhythm. A normal P wave before each complex
indicates the impulse originated in the SA node. The number of complexes in a 6 second strip is
multiplied by 10 to approximate the heart rate; normal sinus rhythm is 60 to 100. Elevation of the ST
segment is a sign of cardiac ischemia and is unrelated to the rhythm. The QRS duration should be
less than 0.12 second; the PR interval should be 0.12 to 0.20 second. - ✔✔What criteria should the
nurse use to determine normal sinus rhythm for a client on a cardiac monitor? Check all that apply.
A. The RR intervals are relatively consistent
B. One P wave precedes each QRS complex
C. Four to eight complexes occur in a 6 second strip
D. The ST segment is higher than the PR interval
E. The QRS complex ranges from 0.12 to 0.20 second
A.
Carotid sinus massage is one of the maneuvers used for vagal stimulation to decrease a rapid heart
%
rate and possibly terminate a tachydysrhythmia. The others include inducing the gag reflex and
asking the client to strain or bear down. Medication therapy often is needed as an adjunct to keep the
rate down or maintain the normal rhythm. - ✔✔A client with rapid rate atrial fibrillation asks a nurse
why the physician is going to perform carotid massage. The nurse responds that this procedure may
stimulate the:
A. Vagus nerve to slow the heart rate
B. Vagus nerve to increase the heart rate; over driving the rhythm
C. Diaphragmatic nerve to slow the heart rate
D. Diaphragmatic nerve to overdrive the rhythm
A.
Premature ventricular contractions can cause hemodynamic compromise. The shortened ventricular
filling time with the ectopic beats leads to decreased stroke volume and, if frequent enough, to
decreased cardiac output. The client may be asymptomatic or may feel palpitations. PVCs can be
caused by cardiac disorders or by any number of physiological stressors, such as infection, illness,
surgery, or trauma, and by the intake of caffeine, alcohol, or nicotine. - ✔✔A client is having frequent
premature ventricular contractions. A nurse would place priority on assessment of which of the
following items?
A. Blood pressure and peripheral perfusion
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, STUVIA 2024/2025
B. Sensation of palpitations
C. Causative factors such as caffeine
D. Precipitating factors such as infection
A.
The client with uncontrolled atrial fibrillation with a ventricular rate more than 150 beats a minute is at
risk for low cardiac output because of loss of atrial kick. The nurse assesses the client for palpitations,
chest pain or discomfort, hypotension, pulse deficit, fatigue, weakness, dizziness, syncope, shortness
of breath, and distended neck veins. - ✔✔A client has developed atrial fibrillation, which a ventricular
rate of 150 beats per minute. A nurse assesses the client for:
A. Hypotension and dizziness
B. Nausea and vomiting
C. Hypertension and headache
D. Flat neck veins
A. Normal Sinus Rhythm
measurements are normal, measuring 0.12 to 0.20 second and 0.4 to 0.10 second, respectively. -
✔✔A nurse is assessing an electrocardiogram rhythm strip. The P waves and QRS complexes are
regular. The PR interval is 0.16 second, and QRS complexes measure 0.06 second. The overall heart
%
rate is 64 beats per minute. The nurse assesses the cardiac rhythm as:
A. Normal Sinus Rhythm
B. Sinus Bradycardia
C. Sick Sinus Syndrome
D. First-degree heart block
B.
Atrial fibrillation is characterized by a loss of P waves; an undulating, wavy baseline; QRS duration
that is often within normal limits; and an irregular ventricular rate, which can range from 60 to 100
beats per minute (when controlled with medications) to 100 to 160 beats per minute (when
uncontrolled). - ✔✔A nurse is watching the cardiac monitor, and a client's rhythm suddenly changes.
There are no P waves; instead there are wavy lines. The QRS complexes measure 0.08 second, but
they are irregular, with a rate of 120 beats a minute. The nurse interprets this rhythm as:
A. Sinus tachycardia
B. Atrial fibrillation
C. Ventricular tachycardia
D. Ventricular fibrillation
B.
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