Comprehensive Study Guide for Relias Medical Surgical
Telemetry: Essential Resource for Mastering Medical-Surgical
Nursing Concepts, Advanced Telemetry Monitoring Protocols,
Evidence-Based Practice Guidelines, Patient Assessment
Frameworks, Critical Care Techniques, and Interactive Learning
Activities to Enhance Clinical Competence and Improve Patient
Safety Outcomes
Question 1:
What is the primary purpose of telemetry monitoring in a clinical setting?
A) To improve patient mobility
B) To monitor vital signs remotely
C) To provide nutritional support
D) To administer medications
CORRECT ANSWER: B) To monitor vital signs remotely
Rationale: Telemetry monitoring allows for the continuous observation of a patient's
vital signs and cardiac rhythms, enabling timely interventions in case of emergencies.
Question 2:
Which lead configuration is most commonly used for monitoring cardiac rhythms?
A) Lead I
B) Lead II
C) Lead III
D) Precordial leads
CORRECT ANSWER: B) Lead II
Rationale: Lead II is frequently used in telemetry because it provides the clearest view
of the heart’s electrical activity, making it easier to identify arrhythmias.
Question 3:
A patient in telemetry develops a sudden change in heart rate from normal sinus
rhythm to ventricular tachycardia. What should the nurse's first action be?
A) Prepare for defibrillation
B) Call a code blue
C) Assess the patient's symptoms
D) Administer beta-blockers
,CORRECT ANSWER: C) Assess the patient's symptoms
Rationale: The first action should always be to assess the patient to determine
hemodynamic stability and symptoms before taking further action.
Question 4:
Which of the following medications is commonly used to manage atrial fibrillation?
A) Amiodarone
B) Digoxin
C) Warfarin
D) All of the above
CORRECT ANSWER: D) All of the above
Rationale: Amiodarone and Digoxin are used to control heart rate and rhythm, while
Warfarin is used for anticoagulation to prevent stroke in patients with atrial fibrillation.
Question 5:
What complication can occur from prolonged telemetry monitoring?
A) Malnutrition
B) Skin irritation
C) Anxiety
D) Pulmonary embolism
CORRECT ANSWER: B) Skin irritation
Rationale: Prolonged use of electrodes for telemetry monitoring can lead to skin
irritation or contact dermatitis due to adhesive materials.
Question 6:
Which of the following is a sign of hypokalemia on a cardiac monitor?
A) Tall, peaked T waves
B) Flat T waves
C) Wide QRS complexes
D) Shortened QT interval
CORRECT ANSWER: B) Flat T waves
Rationale: Hypokalemia typically presents with flattened T waves and potentially the
presence of U waves.
Question 7:
What does the PR interval represent in an electrocardiogram (ECG)?
,A) Ventricular depolarization
B) Atrial depolarization and conduction through the AV node
C) Atrial repolarization
D) Ventricular repolarization
CORRECT ANSWER: B) Atrial depolarization and conduction through the AV node
Rationale: The PR interval reflects the time taken for electrical impulses to travel from
the atria through the AV node to the ventricles.
Question 8:
When should telemetry monitoring be discontinued for a patient?
A) When the patient is stable for 24 hours
B) Upon physician order
C) When the patient is discharged
D) All of the above
CORRECT ANSWER: D) All of the above
Rationale: Discontinuation may be based on physician orders, patient stability, or
discharge plans.
Question 9:
A patient with chest pain shows ST segment elevation. What does this finding
suggest?
A) Hyperkalemia
B) Myocardial infarction
C) Angina
D) Pericarditis
CORRECT ANSWER: B) Myocardial infarction
Rationale: ST segment elevation is often indicative of an ongoing myocardial infarction.
Question 10:
Which of the following is NOT a common cause of sinus bradycardia?
A) Hypothyroidism
B) Increased vagal tone
C) Hyperkalemia
D) Myocardial ischemia
CORRECT ANSWER: C) Hyperkalemia
Rationale: While hyperkalemia can affect heart rhythm, it is not typically associated
with sinus bradycardia.
, Question 11:
What does a QT interval greater than 440 ms in adult males indicate?
A) Normal heart rhythm
B) Risk for torsades de pointes
C) Bradycardia
D) Tachycardia
CORRECT ANSWER: B) Risk for torsades de pointes
Rationale: A prolonged QT interval can lead to torsades de pointes, a potentially life-
threatening arrhythmia.
Question 12:
Which assessment finding is consistent with left-sided heart failure?
A) Peripheral edema
B) Jugular venous distention
C) Pulmonary crackles
D) Ascites
CORRECT ANSWER: C) Pulmonary crackles
Rationale: Pulmonary crackles indicate fluid accumulation in the lungs, characteristic
of left-sided heart failure.
Question 13:
Which of the following patients is at highest risk for developing a deep vein
thrombosis (DVT)?
A) A postoperative patient mobilizing within hours
B) A patient on bed rest for a prolonged period
C) A patient who is up and walking daily
D) A patient receiving anticoagulants regularly
CORRECT ANSWER: B) A patient on bed rest for a prolonged period
Rationale: Prolonged immobility is a major risk factor for DVT.
Question 14:
What action should a nurse take if a telemetry reading indicates a “flat line”?
A) Turn off the telemetry
B) Check the patient for pulse and responsiveness
C) Call the physician immediately
D) Document the reading
Telemetry: Essential Resource for Mastering Medical-Surgical
Nursing Concepts, Advanced Telemetry Monitoring Protocols,
Evidence-Based Practice Guidelines, Patient Assessment
Frameworks, Critical Care Techniques, and Interactive Learning
Activities to Enhance Clinical Competence and Improve Patient
Safety Outcomes
Question 1:
What is the primary purpose of telemetry monitoring in a clinical setting?
A) To improve patient mobility
B) To monitor vital signs remotely
C) To provide nutritional support
D) To administer medications
CORRECT ANSWER: B) To monitor vital signs remotely
Rationale: Telemetry monitoring allows for the continuous observation of a patient's
vital signs and cardiac rhythms, enabling timely interventions in case of emergencies.
Question 2:
Which lead configuration is most commonly used for monitoring cardiac rhythms?
A) Lead I
B) Lead II
C) Lead III
D) Precordial leads
CORRECT ANSWER: B) Lead II
Rationale: Lead II is frequently used in telemetry because it provides the clearest view
of the heart’s electrical activity, making it easier to identify arrhythmias.
Question 3:
A patient in telemetry develops a sudden change in heart rate from normal sinus
rhythm to ventricular tachycardia. What should the nurse's first action be?
A) Prepare for defibrillation
B) Call a code blue
C) Assess the patient's symptoms
D) Administer beta-blockers
,CORRECT ANSWER: C) Assess the patient's symptoms
Rationale: The first action should always be to assess the patient to determine
hemodynamic stability and symptoms before taking further action.
Question 4:
Which of the following medications is commonly used to manage atrial fibrillation?
A) Amiodarone
B) Digoxin
C) Warfarin
D) All of the above
CORRECT ANSWER: D) All of the above
Rationale: Amiodarone and Digoxin are used to control heart rate and rhythm, while
Warfarin is used for anticoagulation to prevent stroke in patients with atrial fibrillation.
Question 5:
What complication can occur from prolonged telemetry monitoring?
A) Malnutrition
B) Skin irritation
C) Anxiety
D) Pulmonary embolism
CORRECT ANSWER: B) Skin irritation
Rationale: Prolonged use of electrodes for telemetry monitoring can lead to skin
irritation or contact dermatitis due to adhesive materials.
Question 6:
Which of the following is a sign of hypokalemia on a cardiac monitor?
A) Tall, peaked T waves
B) Flat T waves
C) Wide QRS complexes
D) Shortened QT interval
CORRECT ANSWER: B) Flat T waves
Rationale: Hypokalemia typically presents with flattened T waves and potentially the
presence of U waves.
Question 7:
What does the PR interval represent in an electrocardiogram (ECG)?
,A) Ventricular depolarization
B) Atrial depolarization and conduction through the AV node
C) Atrial repolarization
D) Ventricular repolarization
CORRECT ANSWER: B) Atrial depolarization and conduction through the AV node
Rationale: The PR interval reflects the time taken for electrical impulses to travel from
the atria through the AV node to the ventricles.
Question 8:
When should telemetry monitoring be discontinued for a patient?
A) When the patient is stable for 24 hours
B) Upon physician order
C) When the patient is discharged
D) All of the above
CORRECT ANSWER: D) All of the above
Rationale: Discontinuation may be based on physician orders, patient stability, or
discharge plans.
Question 9:
A patient with chest pain shows ST segment elevation. What does this finding
suggest?
A) Hyperkalemia
B) Myocardial infarction
C) Angina
D) Pericarditis
CORRECT ANSWER: B) Myocardial infarction
Rationale: ST segment elevation is often indicative of an ongoing myocardial infarction.
Question 10:
Which of the following is NOT a common cause of sinus bradycardia?
A) Hypothyroidism
B) Increased vagal tone
C) Hyperkalemia
D) Myocardial ischemia
CORRECT ANSWER: C) Hyperkalemia
Rationale: While hyperkalemia can affect heart rhythm, it is not typically associated
with sinus bradycardia.
, Question 11:
What does a QT interval greater than 440 ms in adult males indicate?
A) Normal heart rhythm
B) Risk for torsades de pointes
C) Bradycardia
D) Tachycardia
CORRECT ANSWER: B) Risk for torsades de pointes
Rationale: A prolonged QT interval can lead to torsades de pointes, a potentially life-
threatening arrhythmia.
Question 12:
Which assessment finding is consistent with left-sided heart failure?
A) Peripheral edema
B) Jugular venous distention
C) Pulmonary crackles
D) Ascites
CORRECT ANSWER: C) Pulmonary crackles
Rationale: Pulmonary crackles indicate fluid accumulation in the lungs, characteristic
of left-sided heart failure.
Question 13:
Which of the following patients is at highest risk for developing a deep vein
thrombosis (DVT)?
A) A postoperative patient mobilizing within hours
B) A patient on bed rest for a prolonged period
C) A patient who is up and walking daily
D) A patient receiving anticoagulants regularly
CORRECT ANSWER: B) A patient on bed rest for a prolonged period
Rationale: Prolonged immobility is a major risk factor for DVT.
Question 14:
What action should a nurse take if a telemetry reading indicates a “flat line”?
A) Turn off the telemetry
B) Check the patient for pulse and responsiveness
C) Call the physician immediately
D) Document the reading
