Dysrhythmias NCLEX Practice Questions Graded A+
The nurse should suspect that the older adult client experiencing syncope, generalized weakness, and
dyspnea may be experiencing Mobitz I second-degree AV block, Mobitz II second-degree AV block, or
third-degree AV block. These dysrhythmias can lead to decreased cardiac output, causing symptoms
such as syncope (fainting), generalized weakness, and dyspnea (shortness of breath). First-degree AV
block and sinus arrhythmia do not typically cause these clinical manifestations.
Torsades de pointes is correctly identified by the nurse as a type of ventricular tachycardia. It is
associated with long-QT syndrome, which prolongs the QT segment on the ECG. Ventricular fibrillation is
characterized by chaotic, rapid depolarization of the ventricles, resulting in ineffective pumping of the
heart. Junctional dysrhythmias originate from the AV node, and atrioventricular conduction blocks refer
to defects in the transmission of the sinus impulse through the AV node.
The nurse is caring for a pediatric client diagnosed with an atrial dysrhythmia. Assessment findings
reveal rapid pulse with frequent episodes of palpitations and decreased blood pressure. Which diagnosis
should the nurse anticipate?
Sick sinus syndrome
Premature atrial contractions
Wolff-Parkinson-White syndrome
,Wandering atrial pacemaker ✔️Wolff-Parkinson-White syndrome
The client's assessment findings support the diagnosis of Wolff-Parkinson-White syndrome. The client's
assessment findings do not support the other diagnoses.
The nurse is assessing a client admitted with a suspected stroke. Which dysrhythmia would support this
diagnosis?
Junctional escape rhythm
Mobitz II second-degree block
Torsade de pointes
Atrial fibrillation ✔️Atrial fibrillation
Atrial fibrillation is characterized by disorganized atrial activity without discrete atrial contractions,
increasing the risk for formation of thromboemboli and stroke. Mobitz II second-degree block, junctional
escape rhythm, and torsades de pointes are dysrhythmias that do not support this client's diagnosis.
, The nurse is caring for a client with a first-degree AV block. Which clinical manifestation and history
finding support this diagnosis?
Rapid, weak pulse with low blood pressure and a history of rheumatic heart disease
Irregular pulse with decreased blood pressure and a history of chronic use of digoxin
Normal pulse with normal blood pressure with no identified risk factors in healthy individuals
Rapid pulse, low blood pressure, decreased urinary output, and a history of thyrotoxicosis ✔️Normal
pulse with normal blood pressure with no identified risk factors in healthy individuals
Clients with first-degree AV block will have a normal pulse and normal blood pressure. First-degree AV
block is a benign conduction delay that generally poses no threat, has no symptoms, and requires no
treatment. Impulse conduction through the AV node is slowed, but all atrial impulses are conducted to
the ventricles. Irregular pulse with decreased blood pressure is a clinical manifestation of second-degree
and third-degree heart blocks. A rapid, weak pulse with low blood pressure is a clinical manifestation of
ventricular tachycardia. Rapid pulse, low blood pressure, and decreased urinary output is a clinical
manifestation of atrial flutter.
The nurse should suspect that the older adult client experiencing syncope, generalized weakness, and
dyspnea may be experiencing Mobitz I second-degree AV block, Mobitz II second-degree AV block, or
third-degree AV block. These dysrhythmias can lead to decreased cardiac output, causing symptoms
such as syncope (fainting), generalized weakness, and dyspnea (shortness of breath). First-degree AV
block and sinus arrhythmia do not typically cause these clinical manifestations.
Torsades de pointes is correctly identified by the nurse as a type of ventricular tachycardia. It is
associated with long-QT syndrome, which prolongs the QT segment on the ECG. Ventricular fibrillation is
characterized by chaotic, rapid depolarization of the ventricles, resulting in ineffective pumping of the
heart. Junctional dysrhythmias originate from the AV node, and atrioventricular conduction blocks refer
to defects in the transmission of the sinus impulse through the AV node.
The nurse is caring for a pediatric client diagnosed with an atrial dysrhythmia. Assessment findings
reveal rapid pulse with frequent episodes of palpitations and decreased blood pressure. Which diagnosis
should the nurse anticipate?
Sick sinus syndrome
Premature atrial contractions
Wolff-Parkinson-White syndrome
,Wandering atrial pacemaker ✔️Wolff-Parkinson-White syndrome
The client's assessment findings support the diagnosis of Wolff-Parkinson-White syndrome. The client's
assessment findings do not support the other diagnoses.
The nurse is assessing a client admitted with a suspected stroke. Which dysrhythmia would support this
diagnosis?
Junctional escape rhythm
Mobitz II second-degree block
Torsade de pointes
Atrial fibrillation ✔️Atrial fibrillation
Atrial fibrillation is characterized by disorganized atrial activity without discrete atrial contractions,
increasing the risk for formation of thromboemboli and stroke. Mobitz II second-degree block, junctional
escape rhythm, and torsades de pointes are dysrhythmias that do not support this client's diagnosis.
, The nurse is caring for a client with a first-degree AV block. Which clinical manifestation and history
finding support this diagnosis?
Rapid, weak pulse with low blood pressure and a history of rheumatic heart disease
Irregular pulse with decreased blood pressure and a history of chronic use of digoxin
Normal pulse with normal blood pressure with no identified risk factors in healthy individuals
Rapid pulse, low blood pressure, decreased urinary output, and a history of thyrotoxicosis ✔️Normal
pulse with normal blood pressure with no identified risk factors in healthy individuals
Clients with first-degree AV block will have a normal pulse and normal blood pressure. First-degree AV
block is a benign conduction delay that generally poses no threat, has no symptoms, and requires no
treatment. Impulse conduction through the AV node is slowed, but all atrial impulses are conducted to
the ventricles. Irregular pulse with decreased blood pressure is a clinical manifestation of second-degree
and third-degree heart blocks. A rapid, weak pulse with low blood pressure is a clinical manifestation of
ventricular tachycardia. Rapid pulse, low blood pressure, and decreased urinary output is a clinical
manifestation of atrial flutter.
