Nur 2212 Unit 4 Exam Study Guide Questions & Answers: Latest Updated
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1. The nurse obtains a rhythm strip on a patient who has had a myocardial
infarction and makes
the following analysis: no visible P waves, PR interval not measurable, ventric-
ular rate of 162,
R-R interval regular, and QRS complex wide and distorted, and QRS duration of
0.18 second.
The nurse interprets the patient's cardiac rhythm as
a. atrial flutter. c. ventricular fibrillation.
b. sinus tachycardia. d. ventricular tachycardia.: ANS: D
The absence of P waves, wide QRS, rate greater than 150 beats/min, and the regularity of the
rhythm indicate ventricular tachycardia. Atrial flutter is usually regular, has a narrow QRS
configuration, and has flutter waves present representing atrial activity. Sinus tachycardia has
P waves. Ventricular fibrillation is irregular and does not have a consistent QRS duration
2. The nurse notes that a patient's heart monitor shows that every other beat is
earlier than
expected, has no visible P wave, and has a QRS complex that is wide and bizarre
in shape.
How will the nurse document the rhythm?
a. Ventricular couplets
b. Ventricular bigeminy
c. Ventricular R-on-T phenomenon
d. Multifocal premature ventricular contractions: ANS: B
Ventricular bigeminy describes a rhythm in which every other QRS complex is wide and
bizarre looking. Pairs of wide QRS complexes are described as ventricular couplets. There is
no indication that the premature ventricular contractions are multifocal or that the R-on-T
phenomenon is occurring.
3. A patient has a sinus rhythm and a heart rate of 72 beats/min. The nurse
determines that the
PR interval is 0.24 seconds. The most appropriate intervention by the nurse
would be to
a. notify the health care provider immediately.
, Nur 2212 Unit 4 Exam Study Guide Questions & Answers: Latest Updated
Guide Solution
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b. document the finding and monitor the patient.
c. give atropine per agency dysrhythmia protocol.
d. prepare the patient for temporary pacemaker insertion.: ANS: B
First-degree atrioventricular block is asymptomatic and requires ongoing monitoring because
it may progress to more serious forms of heart block. The rate is normal, so there is no
indication that atropine is needed. Immediate notification of the health care provider about an
asymptomatic rhythm is not necessary.
4. A patient who was admitted with a myocardial infarction experiences a
45-second episode of
ventricular tachycardia, then converts to sinus rhythm with a heart rate of 98
beats/min. Which
action should the nurse take next?
a. Immediately notify the health care provider.
b. Document the rhythm and continue to monitor the patient.
c. Prepare to give IV amiodarone per agency dysrhythmia protocol.
d. Perform synchronized cardioversion per agency dysrhythmia protocol.: ANS:
C
The burst of sustained ventricular tachycardia indicates that the patient has significant
ventricular irritability, and antidysrhythmic medication administration is needed to prevent
further episodes. The nurse should notify the health care provider after the medication is
started. Cardioversion is not indicated given that the patient has returned to a sinus rhythm.
Documentation and continued monitoring are not adequate responses to this situation
5. After the nurse gives IV atropine to a patient with symptomatic type 1,
second-degree
atrioventricular (AV) block, which finding indicates that the drug has been
effective?
a. Increase in the patient's heart rate
b. Increase in strength of peripheral pulses
c. Decrease in premature atrial contractions
d. Decrease in premature ventricular contractions: ANS: A
Atropine will increase the heart rate and conduction through the AV node. Because the drug
, Nur 2212 Unit 4 Exam Study Guide Questions & Answers: Latest Updated
Guide Solution
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increases electrical conduction, not cardiac contractility, the quality of the peripheral pulses is
not used to evaluate the drug effectiveness. The patient does not have premature atrial or
ventricular contractions.
6. A patient with dilated cardiomyopathy has new onset atrial fibrillation that
has been
unresponsive to drug therapy for several days. Teaching for this patient would
include
information about
a. anticoagulant therapy. c. emergency cardioversion.
b. permanent pacemakers. d. IV adenosine (Adenocard).: ANS: A
Atrial fibrillation therapy that has persisted for more than 48 hours requires anticoagulant
treatment for 3 weeks before attempting cardioversion. This is done to prevent embolization
of clots from the atria. Cardioversion may be done after several weeks of anticoagulation
therapy. Adenosine is not used to treat atrial fibrillation. Pacemakers are routinely used for
patients with bradydysrhythmias. Information does not indicate that the patient has a slow
heart rate.
7. Which information will the nurse include when teaching a patient who is
scheduled for a
radiofrequency catheter ablation for treatment of atrial flutter?
a. The procedure prevents or minimizes the risk for sudden cardiac death.
b. The procedure uses cold therapy to stop the formation of the flutter waves.
c. The procedure uses electrical energy to destroy areas of the conduction
system.
d. The procedure stimulates the growth of new conduction pathways between
the
atria.: ANS: C
Radiofrequency catheter ablation therapy uses electrical energy to "burn" or ablate areas of
the conduction system as definitive treatment of atrial flutter (i.e., restore normal sinus
rhythm) and tachydysrhythmias. All other statements regarding the procedure are incorrect.
8. The nurse knows that discharge teaching about the management of a new
permanent
, Nur 2212 Unit 4 Exam Study Guide Questions & Answers: Latest Updated
Guide Solution
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pacemaker has been most effective when the patient states
a. "It will be several weeks before I can return to my usual activities."
b. "I will avoid cooking with a microwave oven or being near one in use."
c. "I will notify the airlines when I make a reservation that I have a pacemaker."
d. "I won't lift the arm on the pacemaker side until I see the health care
provider.": ANS: D
The patient is instructed to avoid lifting the arm on the pacemaker side above the shoulder to
avoid displacing the pacemaker leads. The patient should notify airport security about the
presence of a pacemaker before going through the metal detector, but there is no need to
notify the airlines when making a reservation. Microwave oven use does not affect the
pacemaker. The insertion procedure involves minor surgery that will have a short recovery
period.
9. Which intervention by a new nurse who is caring for a patient who has just
had an implantable
cardioverter-defibrillator (ICD) inserted indicates a need for more teaching
about the care of
patients with ICDs?
a. The nurse administers amiodarone (Cordarone) to the patient.
b. The nurse helps the patient fill out the application for obtaining a Medic Alert
device.
c. The nurse encourages the patient to do active range of motion exercises for
all
extremities.
d. The nurse teaches the patient that sexual activity can be resumed when the
incision
is healed.: ANS: C
The patient should avoid moving the arm on the ICD insertion site until healing has occurred
to prevent displacement of the ICD leads. The other actions by the new nurse are appropriate
for this patient.
10. Which action should the nurse perform when preparing a patient with
supraventricular
Guide Solution
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1. The nurse obtains a rhythm strip on a patient who has had a myocardial
infarction and makes
the following analysis: no visible P waves, PR interval not measurable, ventric-
ular rate of 162,
R-R interval regular, and QRS complex wide and distorted, and QRS duration of
0.18 second.
The nurse interprets the patient's cardiac rhythm as
a. atrial flutter. c. ventricular fibrillation.
b. sinus tachycardia. d. ventricular tachycardia.: ANS: D
The absence of P waves, wide QRS, rate greater than 150 beats/min, and the regularity of the
rhythm indicate ventricular tachycardia. Atrial flutter is usually regular, has a narrow QRS
configuration, and has flutter waves present representing atrial activity. Sinus tachycardia has
P waves. Ventricular fibrillation is irregular and does not have a consistent QRS duration
2. The nurse notes that a patient's heart monitor shows that every other beat is
earlier than
expected, has no visible P wave, and has a QRS complex that is wide and bizarre
in shape.
How will the nurse document the rhythm?
a. Ventricular couplets
b. Ventricular bigeminy
c. Ventricular R-on-T phenomenon
d. Multifocal premature ventricular contractions: ANS: B
Ventricular bigeminy describes a rhythm in which every other QRS complex is wide and
bizarre looking. Pairs of wide QRS complexes are described as ventricular couplets. There is
no indication that the premature ventricular contractions are multifocal or that the R-on-T
phenomenon is occurring.
3. A patient has a sinus rhythm and a heart rate of 72 beats/min. The nurse
determines that the
PR interval is 0.24 seconds. The most appropriate intervention by the nurse
would be to
a. notify the health care provider immediately.
, Nur 2212 Unit 4 Exam Study Guide Questions & Answers: Latest Updated
Guide Solution
Study online at https://quizlet.com/_hph6nd
b. document the finding and monitor the patient.
c. give atropine per agency dysrhythmia protocol.
d. prepare the patient for temporary pacemaker insertion.: ANS: B
First-degree atrioventricular block is asymptomatic and requires ongoing monitoring because
it may progress to more serious forms of heart block. The rate is normal, so there is no
indication that atropine is needed. Immediate notification of the health care provider about an
asymptomatic rhythm is not necessary.
4. A patient who was admitted with a myocardial infarction experiences a
45-second episode of
ventricular tachycardia, then converts to sinus rhythm with a heart rate of 98
beats/min. Which
action should the nurse take next?
a. Immediately notify the health care provider.
b. Document the rhythm and continue to monitor the patient.
c. Prepare to give IV amiodarone per agency dysrhythmia protocol.
d. Perform synchronized cardioversion per agency dysrhythmia protocol.: ANS:
C
The burst of sustained ventricular tachycardia indicates that the patient has significant
ventricular irritability, and antidysrhythmic medication administration is needed to prevent
further episodes. The nurse should notify the health care provider after the medication is
started. Cardioversion is not indicated given that the patient has returned to a sinus rhythm.
Documentation and continued monitoring are not adequate responses to this situation
5. After the nurse gives IV atropine to a patient with symptomatic type 1,
second-degree
atrioventricular (AV) block, which finding indicates that the drug has been
effective?
a. Increase in the patient's heart rate
b. Increase in strength of peripheral pulses
c. Decrease in premature atrial contractions
d. Decrease in premature ventricular contractions: ANS: A
Atropine will increase the heart rate and conduction through the AV node. Because the drug
, Nur 2212 Unit 4 Exam Study Guide Questions & Answers: Latest Updated
Guide Solution
Study online at https://quizlet.com/_hph6nd
increases electrical conduction, not cardiac contractility, the quality of the peripheral pulses is
not used to evaluate the drug effectiveness. The patient does not have premature atrial or
ventricular contractions.
6. A patient with dilated cardiomyopathy has new onset atrial fibrillation that
has been
unresponsive to drug therapy for several days. Teaching for this patient would
include
information about
a. anticoagulant therapy. c. emergency cardioversion.
b. permanent pacemakers. d. IV adenosine (Adenocard).: ANS: A
Atrial fibrillation therapy that has persisted for more than 48 hours requires anticoagulant
treatment for 3 weeks before attempting cardioversion. This is done to prevent embolization
of clots from the atria. Cardioversion may be done after several weeks of anticoagulation
therapy. Adenosine is not used to treat atrial fibrillation. Pacemakers are routinely used for
patients with bradydysrhythmias. Information does not indicate that the patient has a slow
heart rate.
7. Which information will the nurse include when teaching a patient who is
scheduled for a
radiofrequency catheter ablation for treatment of atrial flutter?
a. The procedure prevents or minimizes the risk for sudden cardiac death.
b. The procedure uses cold therapy to stop the formation of the flutter waves.
c. The procedure uses electrical energy to destroy areas of the conduction
system.
d. The procedure stimulates the growth of new conduction pathways between
the
atria.: ANS: C
Radiofrequency catheter ablation therapy uses electrical energy to "burn" or ablate areas of
the conduction system as definitive treatment of atrial flutter (i.e., restore normal sinus
rhythm) and tachydysrhythmias. All other statements regarding the procedure are incorrect.
8. The nurse knows that discharge teaching about the management of a new
permanent
, Nur 2212 Unit 4 Exam Study Guide Questions & Answers: Latest Updated
Guide Solution
Study online at https://quizlet.com/_hph6nd
pacemaker has been most effective when the patient states
a. "It will be several weeks before I can return to my usual activities."
b. "I will avoid cooking with a microwave oven or being near one in use."
c. "I will notify the airlines when I make a reservation that I have a pacemaker."
d. "I won't lift the arm on the pacemaker side until I see the health care
provider.": ANS: D
The patient is instructed to avoid lifting the arm on the pacemaker side above the shoulder to
avoid displacing the pacemaker leads. The patient should notify airport security about the
presence of a pacemaker before going through the metal detector, but there is no need to
notify the airlines when making a reservation. Microwave oven use does not affect the
pacemaker. The insertion procedure involves minor surgery that will have a short recovery
period.
9. Which intervention by a new nurse who is caring for a patient who has just
had an implantable
cardioverter-defibrillator (ICD) inserted indicates a need for more teaching
about the care of
patients with ICDs?
a. The nurse administers amiodarone (Cordarone) to the patient.
b. The nurse helps the patient fill out the application for obtaining a Medic Alert
device.
c. The nurse encourages the patient to do active range of motion exercises for
all
extremities.
d. The nurse teaches the patient that sexual activity can be resumed when the
incision
is healed.: ANS: C
The patient should avoid moving the arm on the ICD insertion site until healing has occurred
to prevent displacement of the ICD leads. The other actions by the new nurse are appropriate
for this patient.
10. Which action should the nurse perform when preparing a patient with
supraventricular
