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WorksheetsRhythms
Total questions: 25
Worksheet time: 19mins
A client is admitted to the emergency department reporting chest pain and shortness of breath. The nurse notes an irregular rhythm on the bedside electrocardiograph monitor. The nurse counts 9 RR intervals on the client’s 6-second rhythm tracing. The nurse correctly identifies the client’s heart rate as...
100 bpm
90 bpm.
80 bpm
70 bpm.
A client is undergoing preoperative teaching before his cardiac surgery and the nurse is aware that a temporary pacemaker will be placed later that day. What is the nurse's responsibility in the care of the client's pacemaker?
Monitoring for pacemaker malfunction or battery failure
Determining when it is appropriate to remove the pacemaker
Making necessary changes to the pacemaker settings
Selecting alternatives to future pacemaker use
The nurse is proving discharge instructions for a client with a new arrhythmia. Which statement should the nurse include?
Your family and friends may want to take a CPR class.
It is not necessary to learn how to take your own pulse.
If you miss a dose of your antiarrhythmic medication, double up on the next dose.
Do not be concerned if you experience symptoms of lightheadedness and dizziness.
The client has just been diagnosed with a arrhythmia. The client asks the nurse to explain normal sinus rhythm. What would the nurse explain is the characteristic of normal sinus rhythm?
Heart rate between 60 and 150 beats/minute.
Impulse travels to the atrioventricular (AV) node in 0.15 to 0.5 second.
The ventricles depolarize in 0.5 second or less.
The sinoatrial (SA) node initiates the impulse.
A client reports light-headedness, chest pain, and shortness of breath. They physician orders tests to ascertain what is causing the client’s problems. Which test is used to identify cardiac rhythms?
electrocardiogram
electroencephalogram
echocardiogram
electrocautery
A client has been diagnosed with atrial fibrillation and has been prescribed warfarin therapy. What should the nurse prioritize when providing health education to the client?
The need to have regular blood levels drawn
The importance of taking the medication 1 hour before or 2 hours after a meal
The need to sit upright for 30 minutes after taking the medication
The importance of adequate fluid intake
A nurse is caring for a client who's experiencing sinus bradycardia with a pulse rate of 40 beats/minute. The client's blood pressure is 80/50 mm Hg and the client reports dizziness. Which medication does the nurse anticipate administering to treat bradycardia?
Atropine
Dobutamine
Amiodarone
Lidocaine
The nurse documents that a client is having a normal sinus rhythm. What characteristics of this rhythm has the nurse assessed?
Heart rate between 60 and 150 beats per minute.
Impulse travels to the atrioventricular (AV) node in 0.15 to 0.5 seconds.
The ventricles depolarize in 0.5 seconds or less.
The sinoatrial (SA) node initiates the impulse.
The nurse analyzes a 6-second electrocardiogram (ECG) tracing. The P waves and QRS complexes are regular. The PR interval is 0.18 seconds long, and the QRS complexes are 0.08 seconds long. The heart rate is calculated at 70 bpm. The nurse correctly identifies this rhythm as
normal sinus rhythm.
sinus tachycardia.
junctional tachycardia.
first-degree atrioventricular block
A nurse provides evening care for a client wearing a continuous telemetry monitor. While the nurse is giving the client a back rub, the client ’s monitor alarm sounds and the nurse notes a flat line on the bedside monitor system. What is the nurse’s first response?
Assess the client and monitor leads.
Administer a pericardial thump.
Call for assistance and begin CPR.
Call a code and obtain the crash cart.
The nursing student asks the nurse how to tell the difference between ventricular tachycardia and ventricular fibrillation on an electrocardiogram strip. What is the best response?
"Ventricular fibrillation is irregular with undulating waves and no QRS complex.
"The QRS complex in ventricular fibrillation is always narrow, while in ventricular tachycardia the QRS is of normal width."
"The P-R interval will be prolonged in ventricular fibrillation, while in ventricular tachycardia the P-R interval is normal."
"The two look very much alike; it is difficult to tell the difference."
A nurse provides morning care for a client in the intensive care unit (ICU). Suddenly, the bedside monitor shows ventricular fibrillation and the client becomes unresponsive. After calling for assistance, what action should the nurse take next?
Begin cardiopulmonary resuscitation
Prepare for endotracheal intubation
Provide electrical cardioversion
Administer intravenous epinephrine
A client tells the nurse “my heart is skipping beats again; I’m having palpitations.” After completing a physical assessment, the nurse concludes the client is experiencing occasional premature atrial complexes (PACs). The nurse should instruct the client to
avoid caffeinated beverages.
request sublingual nitroglycerin.
apply supplemental oxygen.
lie down and elevate the feet.
lie down and elevate the feet.
The nurse witnesses a client experiencing ventricular fibrillation. What is the nurse's priority action?
defibrillation
cardioversion
IV bolus of atropine
IV bolus of dobutamine
The nurse is caring for a client who is being discharged after insertion of a permanent pacemaker. The client, an avid tennis player, is scheduled to play in a tournament in 1 week. What is the best advice the nurse can give related to this activity?
"You will need to cancel this activity; you must restrict arm movement above your head for 2 weeks."
"You may resume all normal activity in 1 week; if you are used to playing tennis, you may proceed with this activity."
"You should avoid tennis; basketball or football would be a good substitute."
"Cancel your tennis tournament and wait until fall, then try hockey; skating is much easier on pacemakers."
The staff educator is teaching a class in arrhythmias. What statement is correct for defibrillation?
The staff educator is teaching a class in arrhythmias. What statement is correct for defibrillation?
It is a scheduled procedure 1 to 10 days in advance.
The client is sedated before the procedure.
It is used to eliminate ventricular arrhythmias.
It uses less electrical energy than cardioversion.
The nurse cares for a client with a dysrhythmia and understands that the P wave on an electrocardiogram (ECG) represents which phase of the cardiac cycle?
Atrial depolarization
Early ventricular repolarization
Ventricular depolarization
Ventricular repolarization
A client is diagnosed with a dysrhythmia at a rate slower than 60 beats/minute with a regular interval between 0.12 and 0.20 seconds. What type of dysrhythmia does the client have?
sinus bradycardia
atrial bradycardia
heart block
none
none
A patient with hypertension has a newly diagnosed atrial fibrillation. What medication does the nurse anticipate administering to prevent the complication of atrial thrombi?
Adenosine
Amiodarone
Warfarin
Atropine
After performing an ECG on an adult client, the nurse reports that the PR interval reflects normal sinus rhythm. What is the PR interval for a normal sinus rhythm?
0.05 and 0.1 seconds.
0.12 and 0.2 seconds.
0.15 and 0.3 seconds.
0.25 and 0.4 seconds.
The nurse reads an athletic client's electrocardiogram. What finding will be consistent with a sinus bradycardia?
PR interval of 0.24 seconds.
Heart rate of 42 beats per minute (bpm).
QR interval of 0.25 seconds.
P-to-QR ratio of 1:2.
P-to-QR ratio of 1:2.
Which of the following medication classifications is more likely to be expected when the nurse is caring for a client with atrial fibrillation?
Diuretic
Anticoagulant
Antihypertensive
Potassium supplement
The nurse is assessing vital signs in a patient with a permanent pacemaker. What should the nurse document about the pacemaker?
Date and time of insertion
Location of the generator
Model number
Pacer rate
The nurse is caring for a client who is displaying a third-degree AV block on the EKG monitor. What is the priority nursing intervention for the client?
assessing blood pressure and heart rate frequently
identifying a code-level status
heart block
maintaining intravenous fluids
alerting the healthcare provider of the third-degree
The nurse knows that what PR interval presents a first-degree heart block?
0.24 seconds
0.14 seconds
0.16 seconds
0.18 seconds
