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Cardiac Dysrhythmias and Pacemaker Care

Total questions: 19

Worksheet time: 11mins

Name
Class
Date
1.

James has been diagnosed with atrial fibrillation and is prescribed warfarin. During a follow-up visit, the nurse reviews important information about the medication. Which statement by James indicates a need for further teaching?

a)

“I will have my INR checked regularly.”

b)

“I can eat as many green leafy vegetables as I want.”

c)

“I will report any signs of bleeding to my provider.”

d)

“I will take the medication at the same time each day.”

2.

The nurse reviews the following ECG strip: Rhythm: Regular; Atrial rate: 300 bpm; Ventricular rate: 75 bpm; P waves: Saw-tooth pattern. Which dysrhythmia does this represent?

a)

Atrial flutter

b)

Atrial fibrillation

c)

Ventricular tachycardia

d)

Junctional rhythm

3.

A patient with supraventricular tachycardia (SVT) suddenly becomes unstable with hypotension and chest pain. What is the priority intervention?

a)

Perform vagal maneuvers

b)

Apply oxygen via nasal cannula

c)

Prepare for synchronized cardioversion

d)

Administer adenosine IV push

4.

Which ECG finding is most characteristic of ventricular fibrillation?

a)

Regular rhythm with widened QRS

b)

Saw-tooth flutter waves

c)

P waves preceding each QRS

d)

Chaotic, irregular waveforms with no identifiable QRS

5.

The nurse is caring for a patient with a new pacemaker. Which statement requires immediate intervention?

a)

“I will avoid lifting my arm above my shoulder for several weeks.”

b)

“I will check my pulse daily.”

c)

“I will report any dizziness or syncope.”

d)

“I will keep my cell phone in my shirt pocket.”

6.

A patient presents with chest pain unrelieved by rest or nitroglycerin. Which finding differentiates an MI from unstable angina?

a)

Pain radiating to the left arm

b)

Associated nausea and diaphoresis

c)

ST-segment elevation on ECG

d)

Pain lasting more than 20 minutes

7.

Which cardiac biomarker is most specific for myocardial infarction?

a)

CK-MB

b)

Troponin I

c)

Myoglobin

d)

BNP

8.

Mia, a patient with STEMI, is scheduled for PCI. What is the nurse’s priority action before the procedure?

a)

Start a beta-blocker

b)

Check for allergies to contrast dye

c)

Administer aspirin

d)

Obtain informed consent

9.

Which medication should the nurse anticipate for a patient with ACS to prevent platelet aggregation?

a)

Furosemide

b)

Clopidogrel

c)

Digoxin

d)

Heparin

10.

A patient with MI develops crackles and dyspnea. Which complication is most likely?

a)

Left ventricular failure

b)

Pericarditis

c)

Right ventricular failure

d)

Cardiogenic shock

11.

Charlotte, a patient with chest pain, has an ECG showing ST depression and T-wave inversion. What is the most likely diagnosis?

a)

STEMI

b)

NSTEMI

c)

Prinzmetal’s angina

d)

Ventricular tachycardia

12.

The nurse is teaching about nitroglycerin use. Which statement indicates correct understanding?

a)

I will store the tablets in a pill organizer.

b)

I should swallow the tablet whole.

c)

I can take up to three doses, five minutes apart, if pain persists.

d)

I will take nitroglycerin every day to prevent chest pain.

13.

Ava, a patient who recently experienced a myocardial infarction (MI), is prescribed a beta-blocker. During her follow-up assessment, which finding requires immediate intervention?

a)

Heart rate of 58 bpm

b)

Blood pressure of 100/60 mmHg

c)

Mild fatigue

d)

Wheezing and shortness of breath

14.

Sophia, a nurse in the cardiac unit, is caring for a patient who is currently undergoing thrombolytic therapy for an acute myocardial infarction. What is the most important assessment Sophia should perform during this therapy?

a)

Check for evidence of internal or external bleeding

b)

Administer subcutaneous heparin routinely

c)

Limit the patient’s mobility completely

d)

Encourage high-protein diet immediately

15.

Henry, a patient with acute coronary syndrome, asks his nurse why morphine is being administered to him. What is the best explanation?

a)

It decreases pain and cardiac workload

b)

It helps reduce anxiety only

c)

It increases oxygen supply to the heart

d)

It prevents blood clot formation

16.

Using the word bank provided, label the following parts of the heart.

17.

Which chamber forces blood to the lungs?

18.

You observe elevated ST segments while performing an exercise stress test on a patient. You should identify these findings as what?

a)

Expected EKG changes as a result of running

b)

Expected EKG changes due to hypokalemia

c)

Signs of pulmonary embolism

d)

Signs of acute myocardial injury

19.

Which of the following best describes this strip?

a)

Tachycardia

b)

Normal Sinus Rhythm

c)

Bradycardia

d)

Asystole