Detailed Answer Key
RN 231 Quiz I
1. A nurse is reviewing the EKG strip of a client who has prolonged vomiting. Which of the following abnormalities on
the client's EKG should the nurse interpret as a sign of hypokalemia?
A. Abnormally prominent U wave
Rationale: Although U waves are rare, their presence can be associated with hypokalemia, hypertension
and heart disease. For a client who has hypokalemia, the nurse should monitor the EKG strip for
a flattened T wave, prolonged PR interval, prominent U wave, or ST depression.
B. Elevated ST segment
Rationale: The nurse should identify ST depression as an indication of hypokalemia.
C. Wide QRS
Rationale: The nurse should identify a widened QRS as an indication of hyperkalemia.
D. Inverted P wave
Rationale: Inverted P waves are associated with junctional rhythms.
2. Interpret the following ECG rhythm strip. Spell out your answer, abbreviations not acceptable.
Third degree heart block
3. Interpret the following ECG rhythm strip. See waveform below. Spell out your answer, abbreviations not acceptable.
Created on:10/29/2020 Page 1
, Detailed Answer Key
RN 231 Quiz I
Junctional tachycardia
4. Interpret the following ECG rhythm strip. Spell out your answer, abbreviations not acceptable.
Torsades de Pointes
5. A client is being treated for a myocardial infarction that occured less than six hours ago. The cardiologist suspects
100% occlusion of the RCA. The nurse is likely to find that the client's 12-lead ECG on admission exhibits which
findings?
A. SVT, ST depression in inferior leads, shortened P waves.
B. Atrial fibrillation, T wave inversion in anterior leads, irregular P-R intervals.
C. Sinus bradycardia, Q waves and ST elevation in inferior leads, QRS lengthening.
D. Ventricular tachycardia, flattened T waves, P-R interval elongated and regular.
6. A nurse is caring for a client who has pericarditis and reports feeling a new onset of palpitations and shortness of
breath. Which of the following assessments should indicate to the nurse that the client may have developed atrial
fibrillation?
Created on:10/29/2020 Page 2
, Detailed Answer Key
RN 231 Quiz I
A. Different blood pressures in the upper limbs.
Rationale: The client who has atherosclerosis and peripheral artery disease may have different blood
pressures of more than 10 mm Hg in the upper extremities because of blockages. However,
there is no expected discrepancy between the blood pressure in the right and left arms
associated with atrial fibrillation.
B. Different apical and radial pulses.
Rationale: Atrial fibrillation is rapid, disorganized electrical activity of the heart in which the atrium
depolarizes too quickly and sends erratic impulses to the ventricles. The presence of a pulse
deficit between the apical and radial pulses is an indication of atrial fibrillation. The nurse should
assess further by obtaining an ECG or telemetry reading.
C. Differences between oral and axillary temperatures.
Rationale: There is often a difference between oral and axillary temperatures with axillary temperatures
being 0.5º C (0.9ºF) lower than oral. However, no expected discrepancy between the oral and
axillary temperatures is associated with atrial fibrillation.
D. Differences in upper and lower lung sounds.
Rationale: The nurse should expect to hear bronchovesicular breath sounds when auscultating over the
bronchioles that are located laterally to the sternum in the upper fields and vesicular sounds in
the lung periphery. However, there is no expected discrepancy between the anterior and
posterior lung sounds associated with atrial fibrillation.
7. A nurse is caring for a client who has atrial fibrillation and receives digoxin daily. Before administering this
medication, which of the following actions should the nurse take?
A. Offer the client a light snack.
Rationale: The client can take the medication with or without food, although giving it immediately after food
can delay absorption slightly.
B. Measure the client's blood pressure.
Rationale: It is not necessary to measure blood pressure immediately before dosing, but the nurse should
monitor the client's blood pressure routinely.
C. Measure the client's apical pulse.
Rationale: Digoxin decreases the heart rate, so the nurse should count the apical pulse for at least 1 min
before administering. The nurse should hold the medication and notify the provider if the client's
heart rate is below 60/min or if a change in heart rhythm is detected.
D. Weigh the client.
Rationale: It is not necessary to weigh the client immediately before dosing, but the nurse should monitor
the client's weight routinely.
Created on:10/29/2020 Page 3
RN 231 Quiz I
1. A nurse is reviewing the EKG strip of a client who has prolonged vomiting. Which of the following abnormalities on
the client's EKG should the nurse interpret as a sign of hypokalemia?
A. Abnormally prominent U wave
Rationale: Although U waves are rare, their presence can be associated with hypokalemia, hypertension
and heart disease. For a client who has hypokalemia, the nurse should monitor the EKG strip for
a flattened T wave, prolonged PR interval, prominent U wave, or ST depression.
B. Elevated ST segment
Rationale: The nurse should identify ST depression as an indication of hypokalemia.
C. Wide QRS
Rationale: The nurse should identify a widened QRS as an indication of hyperkalemia.
D. Inverted P wave
Rationale: Inverted P waves are associated with junctional rhythms.
2. Interpret the following ECG rhythm strip. Spell out your answer, abbreviations not acceptable.
Third degree heart block
3. Interpret the following ECG rhythm strip. See waveform below. Spell out your answer, abbreviations not acceptable.
Created on:10/29/2020 Page 1
, Detailed Answer Key
RN 231 Quiz I
Junctional tachycardia
4. Interpret the following ECG rhythm strip. Spell out your answer, abbreviations not acceptable.
Torsades de Pointes
5. A client is being treated for a myocardial infarction that occured less than six hours ago. The cardiologist suspects
100% occlusion of the RCA. The nurse is likely to find that the client's 12-lead ECG on admission exhibits which
findings?
A. SVT, ST depression in inferior leads, shortened P waves.
B. Atrial fibrillation, T wave inversion in anterior leads, irregular P-R intervals.
C. Sinus bradycardia, Q waves and ST elevation in inferior leads, QRS lengthening.
D. Ventricular tachycardia, flattened T waves, P-R interval elongated and regular.
6. A nurse is caring for a client who has pericarditis and reports feeling a new onset of palpitations and shortness of
breath. Which of the following assessments should indicate to the nurse that the client may have developed atrial
fibrillation?
Created on:10/29/2020 Page 2
, Detailed Answer Key
RN 231 Quiz I
A. Different blood pressures in the upper limbs.
Rationale: The client who has atherosclerosis and peripheral artery disease may have different blood
pressures of more than 10 mm Hg in the upper extremities because of blockages. However,
there is no expected discrepancy between the blood pressure in the right and left arms
associated with atrial fibrillation.
B. Different apical and radial pulses.
Rationale: Atrial fibrillation is rapid, disorganized electrical activity of the heart in which the atrium
depolarizes too quickly and sends erratic impulses to the ventricles. The presence of a pulse
deficit between the apical and radial pulses is an indication of atrial fibrillation. The nurse should
assess further by obtaining an ECG or telemetry reading.
C. Differences between oral and axillary temperatures.
Rationale: There is often a difference between oral and axillary temperatures with axillary temperatures
being 0.5º C (0.9ºF) lower than oral. However, no expected discrepancy between the oral and
axillary temperatures is associated with atrial fibrillation.
D. Differences in upper and lower lung sounds.
Rationale: The nurse should expect to hear bronchovesicular breath sounds when auscultating over the
bronchioles that are located laterally to the sternum in the upper fields and vesicular sounds in
the lung periphery. However, there is no expected discrepancy between the anterior and
posterior lung sounds associated with atrial fibrillation.
7. A nurse is caring for a client who has atrial fibrillation and receives digoxin daily. Before administering this
medication, which of the following actions should the nurse take?
A. Offer the client a light snack.
Rationale: The client can take the medication with or without food, although giving it immediately after food
can delay absorption slightly.
B. Measure the client's blood pressure.
Rationale: It is not necessary to measure blood pressure immediately before dosing, but the nurse should
monitor the client's blood pressure routinely.
C. Measure the client's apical pulse.
Rationale: Digoxin decreases the heart rate, so the nurse should count the apical pulse for at least 1 min
before administering. The nurse should hold the medication and notify the provider if the client's
heart rate is below 60/min or if a change in heart rhythm is detected.
D. Weigh the client.
Rationale: It is not necessary to weigh the client immediately before dosing, but the nurse should monitor
the client's weight routinely.
Created on:10/29/2020 Page 3
