Dysrhythmias Practice Exam
Questions and Answers
You are the nurse working on the telemetry unit and you have finally gotten to sit down to work on
some charting. Suddenly the heart monitors at the station start beeping. Patient in room 18 is showing
this rhythm on the monitor. The medical team advances together into the room and finds them
unconscious. What is priority action by the nurse?
A) Prepare to administer adenosine to the patient
B) Begin chest compressions
C) Prepare for defibrillation
D) Check for a pulse - Correct Answers: Answer: D
A pulse would be assessed for first. Then the patient will be defibrillized and chest compressions will
begin immediately.
The patient who has recently been experiencing runs of ventricular tachycardia suddenly loses
consciousness. The patient is defibrillated, and the rate returns as the following. What should the nurse
do first?
A) Begin compressions
B) Shock the client again immediately
C) Prepare for intubation
D) Administer adenosine - Correct Answers: Answer: A
Following defibrillation, CPR is immediately initiated if a perfusable rhythm is not initiated. The client
may need to be shocked again, but chest compressions must begin first.
The patient with a history of hypertension and diabetes has the following rhythm strip. The patient's
vitals are as follows: BP 145/89, HR 90, SpO2 95%, RR 19. Which of the following does the nurse expect
to do at this time?
a) Prepare the client for cardioversion STAT
b) Begin administering anticoagulants
,c) Grab the crash cart for administration of adenosine
d) Teach the client about possibility of pacemaker installation - Correct Answers: Answer: B
Atrial flutter places the client at high risk for development of clot formation in the atria. Because the
client is stable at this time, cardioversion or adenosine would not be performed at this time. Before
cardioversion can occur in a patient, anticoagulant therapy should be begun at least 48 hours
beforehand if possible.
The nurse is preparing to administer adenosine to the patient with the following rhythm which is
symptomatic. What should the nurse plan on having in the patient room? Select All That Apply:
a) Physician
b) Crash cart
c) IV pump
d) EKG monitor
e) Lidocaine - Correct Answers: Answer: A, B, and D
Adenosine is administered as a very quick IV push. The physician must be present in the room and the
crash cart must be on hand. An ekg monitor should be in the room to monitor the effectiveness of the
medication.
The nurse has just administered adenosine via IV push and sees the following rhythm on the monitor.
What is the nurse's priority intervention?
a) Apply conductive gel and defibrillate the patient
b) Document the findings and continue to monitor
c) Administer another mg of the medication
d) Begin chest compressions - Correct Answers: Answer: B
This finding would be expected upon administration of adenosine. The rhythm should then begin again
in some other rhythm, hopefully normal sinus rhythm. It would be important to document the exact
time of this change and continue to monitor the change back to NSR. If this change does not occur, or if
another rhythm is produced, appropriate action would then be taken based on the result.
, A group of nursing students are discussing atrial flutter. These students recognize that which of the
following are seen with atrial flutter? Select all that apply:
1) Ventricular rate of 220-300 bpm.
2) Regular rhythm
3) Saw-tooth pattern
4) Measurable PR interval
5) Long QRS interval - Correct Answers: Answer(s): 2, 3
The ATRIAL rate is 250-400 bpm. Ventricular is about 75-150. The rhythm is regular, with the P wave
appearing as little flutter or a "saw tooth pattern". The PR interval is not measurable r/t this saw-tooth P
wave. The QRS is normal.
A nursing student is aware that which of the following is the treatment for unstable atrial flutter?
1) Adenosine (Adenocard) 6 mg rapid IVP.
2) Cardioversion with adjacent Heparin therapy
3) Defibrillation STAT followed by CPR.
4) Altemose 3 mg IVP over 1-2 seconds. - Correct Answers: Answer: 2
Cardioversion is used if the patient is unstable. Anticoagulants are used if the arrhythmia has stuck
around for 48 hr +. Adenosine may be used with a narrow QRS and regular RR interval
A nurse working on a CVT unit receives report from day shift. After receiving report, which patient
should the nurse see first?
1) A 23-year-old professional tennis player with a HR of 47 bpm.
2) A 69-year-old male with atrial fibrillation who has new onset confusion.
3) A 72-year-old female with atrial flutter who reports feeling unusually tired today and yesterday.
4) A 33-year-old female with sinus tachycardia who is asking for her at-home Metoprolol. - Correct
Answers: Answer: 2
Patients with a-fib are at risk for pulmonary and systemic emboli, and new onset of confusion may
indicate a stroke in this patient. Patients with atrial flutter may feel more tired some days than others.
Questions and Answers
You are the nurse working on the telemetry unit and you have finally gotten to sit down to work on
some charting. Suddenly the heart monitors at the station start beeping. Patient in room 18 is showing
this rhythm on the monitor. The medical team advances together into the room and finds them
unconscious. What is priority action by the nurse?
A) Prepare to administer adenosine to the patient
B) Begin chest compressions
C) Prepare for defibrillation
D) Check for a pulse - Correct Answers: Answer: D
A pulse would be assessed for first. Then the patient will be defibrillized and chest compressions will
begin immediately.
The patient who has recently been experiencing runs of ventricular tachycardia suddenly loses
consciousness. The patient is defibrillated, and the rate returns as the following. What should the nurse
do first?
A) Begin compressions
B) Shock the client again immediately
C) Prepare for intubation
D) Administer adenosine - Correct Answers: Answer: A
Following defibrillation, CPR is immediately initiated if a perfusable rhythm is not initiated. The client
may need to be shocked again, but chest compressions must begin first.
The patient with a history of hypertension and diabetes has the following rhythm strip. The patient's
vitals are as follows: BP 145/89, HR 90, SpO2 95%, RR 19. Which of the following does the nurse expect
to do at this time?
a) Prepare the client for cardioversion STAT
b) Begin administering anticoagulants
,c) Grab the crash cart for administration of adenosine
d) Teach the client about possibility of pacemaker installation - Correct Answers: Answer: B
Atrial flutter places the client at high risk for development of clot formation in the atria. Because the
client is stable at this time, cardioversion or adenosine would not be performed at this time. Before
cardioversion can occur in a patient, anticoagulant therapy should be begun at least 48 hours
beforehand if possible.
The nurse is preparing to administer adenosine to the patient with the following rhythm which is
symptomatic. What should the nurse plan on having in the patient room? Select All That Apply:
a) Physician
b) Crash cart
c) IV pump
d) EKG monitor
e) Lidocaine - Correct Answers: Answer: A, B, and D
Adenosine is administered as a very quick IV push. The physician must be present in the room and the
crash cart must be on hand. An ekg monitor should be in the room to monitor the effectiveness of the
medication.
The nurse has just administered adenosine via IV push and sees the following rhythm on the monitor.
What is the nurse's priority intervention?
a) Apply conductive gel and defibrillate the patient
b) Document the findings and continue to monitor
c) Administer another mg of the medication
d) Begin chest compressions - Correct Answers: Answer: B
This finding would be expected upon administration of adenosine. The rhythm should then begin again
in some other rhythm, hopefully normal sinus rhythm. It would be important to document the exact
time of this change and continue to monitor the change back to NSR. If this change does not occur, or if
another rhythm is produced, appropriate action would then be taken based on the result.
, A group of nursing students are discussing atrial flutter. These students recognize that which of the
following are seen with atrial flutter? Select all that apply:
1) Ventricular rate of 220-300 bpm.
2) Regular rhythm
3) Saw-tooth pattern
4) Measurable PR interval
5) Long QRS interval - Correct Answers: Answer(s): 2, 3
The ATRIAL rate is 250-400 bpm. Ventricular is about 75-150. The rhythm is regular, with the P wave
appearing as little flutter or a "saw tooth pattern". The PR interval is not measurable r/t this saw-tooth P
wave. The QRS is normal.
A nursing student is aware that which of the following is the treatment for unstable atrial flutter?
1) Adenosine (Adenocard) 6 mg rapid IVP.
2) Cardioversion with adjacent Heparin therapy
3) Defibrillation STAT followed by CPR.
4) Altemose 3 mg IVP over 1-2 seconds. - Correct Answers: Answer: 2
Cardioversion is used if the patient is unstable. Anticoagulants are used if the arrhythmia has stuck
around for 48 hr +. Adenosine may be used with a narrow QRS and regular RR interval
A nurse working on a CVT unit receives report from day shift. After receiving report, which patient
should the nurse see first?
1) A 23-year-old professional tennis player with a HR of 47 bpm.
2) A 69-year-old male with atrial fibrillation who has new onset confusion.
3) A 72-year-old female with atrial flutter who reports feeling unusually tired today and yesterday.
4) A 33-year-old female with sinus tachycardia who is asking for her at-home Metoprolol. - Correct
Answers: Answer: 2
Patients with a-fib are at risk for pulmonary and systemic emboli, and new onset of confusion may
indicate a stroke in this patient. Patients with atrial flutter may feel more tired some days than others.
