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A year ago
A patient has a normal cardiac rhythm and a heart rate of 72 beats/minute. The nurse determines that the P-R interval is 0.24 seconds. The most appropriate intervention by the nurse would be to
 
  a. notify the health care provider immediately.
  b. give atropine per agency dysrhythmia protocol.
  c. prepare the patient for temporary pacemaker insertion.
  d. document the finding and continue to monitor the patient.

Question 2

The nurse notes that a patient's cardiac 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

Question 3

The nurse obtains a rhythm strip on a patient who has had a myocardial infarction and makes the following analysis:
 
  no visible P waves, P-R interval not measurable, ventricular rate 162, R-R interval regular, and QRS complex wide and distorted, QRS duration 0.18 second. The nurse interprets the patient's cardiac rhythm as
  a. atrial flutter.
  b. sinus tachycardia.
  c. ventricular fibrillation.
  d. ventricular tachycardia.

Question 4

A patient has a junctional escape rhythm on the monitor. The nurse will expect the patient to have a heart rate of _____ beats/minute.
 
  a. 15 to 20
  b. 20 to 40
  c. 40 to 60
  d. 60 to 100
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wrote...
A year ago
The answer to question 1

ANS: D
First-degree atrioventricular (AV) 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.

The answer to question 2

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 (PVCs) are multifocal or that the R-on-T phenomenon is occurring.

The answer to question 3

ANS: D
The absence of P waves, wide QRS, rate >150 beats/minute, 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.

The answer to question 4

ANS: C
If the sinoatrial (SA) node fails to discharge, the atrioventricular (AV) node will automatically discharge at the normal rate of 40 to 60 beats/minute. The slower rates are typical of the bundle of His and the Purkinje system and may be seen with failure of both the SA and AV node to discharge. The normal SA node rate is 60 to 100 beats/minute.
wrote...
A year ago
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wrote...
A year ago
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