Chapter 26--Arrhythmias: Nursing Management

Chapter 26--Arrhythmias: Nursing Management MULTIPLE CHOICE 1. A client is experiencing an alteration in heart rate. The nurse realizes this client is experiencing a disorder of which part of the heart? 1. Atrio ...

Chapter 26--Arrhythmias: Nursing Management MULTIPLE CHOICE 1. A client is experiencing an alteration in heart rate. The nurse realizes this client is experiencing a disorder of which part of the heart? 1. Atrioventricular node 2. Bundle branches 3. Purkinje fibers 4. Sinoatrial node PTS: 1 DIF: Analyze REF: Anatomy and Physiology 2. A client is suspected of having cardiac damage. The nurse realizes that which of the following diagnostic tests is most commonly used to help diagnose this client’s possible cardiac damage or disease? 1. 12-lead electrocardiogram 2. Arterial blood gases 3. Cardiac angiogram 4. Cardiac enzymes PTS: 1 DIF: Analyze REF: ECG Monitoring 3. The nurse is analyzing a client’s electrocardiogram tracing. Which of the following complexes is not normally seen on an electrocardiogram tracing? 1. P wave 2. QRS complex 3. T wave 4. U wave PTS: 1 DIF: Analyze REF: The Normal ECG Complex; Figure 26-1 Conduction System of the Heart 4. The nurse is analyzing a client’s electrocardiogram tracing and realizes that each small square on the paper is equal to: 1. 0.04 second. 2. 0.12 second. 3. 0.20 second. 4. 0.40 second. PTS: 1 DIF: Analyze REF: Calculating Heart Rate 5. The nurse is reading an ECG rhythm strip and notes that there are nine QRS complexes in a 6-second strip. The heart rate is: 1. 36. 2. 54. 3. 81. 4. 90. PTS: 1 DIF: Apply REF: Calculating Heart Rate 6. The nurse notes that on a client’s electrocardiogram tracing, there is one P wave for every QRS complex and a delay in the impulse transmission at the AV node. This regular rhythm is identified as: 1. first-degree AV block. 2. second-degree AV block type I. 3. second-degree AV block type II. 4. complete heart block. PTS: 1 DIF: Analyze REF: First-Degree Heart Block 7. A client is unresponsive and has no pulse. The nurse notes that the electrocardiogram tracing shows continuous large and bizarre QRS complexes measured greater than 0.12 each. This rhythm is identified as: 1. premature ventricular complexes. 2. torsades de pointes. 3. ventricular fibrillation. 4. ventricular tachycardia. PTS: 1 DIF: Analyze REF: Ventricular Tachycardia 8. An elderly client is demonstrating a change in heart rate that occurs with respirations. When planning care for the client, the nurse knows that treatment may include: 1. Oxygen therapy 2. Analgesics 3. Antibiotics 4. Pacemaker insertion PTS: 1 DIF: Apply REF: Sinus Arrhythmia 9. A client’s electrocardiogram tracing shows a sawtooth pattern with F waves. The nurse realizes this client is demonstrating: 1. atrial flutter. 2. atrial fibrillation. 3. premature atrial contractions. 4. atrial tachycardia. PTS: 1 DIF: Analyze REF: Atrial Arrhythmias 10. The electrocardiogram tracing for a client shows premature junctional complexes. Which of the following should the nurse do to assist this client? 1. Administer oxygen 2. Increase intravenous fluids 3. Check on the serum digoxin level 4. Assist the client to a side-lying position PTS: 1 DIF: Apply REF: Premature Junctional Complexes 11. Which of the following should the nurse instruct a client who has been diagnosed with an arrhythmia? 1. Exercise level 2. Avoidance of calorie-dense foods 3. How to take his own pulse 4. Reasons why fatigue is expected PTS: 1 DIF: Apply REF: Table 26-2 Nursing Management for the Patient with Arrhythmias 12. A client is diagnosed with supraventricular tachycardia. The nurse should prepare to administer which of the following medications? 1. Procainamide 2. Amiodarone 3. Verapamil 4. Adenosine PTS: 1 DIF: Apply REF: Pharmacology 13. A client is recovering from insertion of a pacemaker to pace the activity of the ventricles. At which point on the electrocardiogram tracing will the nurse assess pacer spikes? 1. Before the QRS complex 2. Before the P wave 3. After the QRS complex 4. After the P wave . PTS: 1 DIF: Apply REF: Permanent Pacing; Pacemaker Malfunction MULTIPLE RESPONSE 1. A client with a heart rate of 40 who is experiencing shortness of breath and nausea is diagnosed with second-degree AV block type II. Which of the following will be included in this client’s treatment? (Select all that apply.) 1. Administer digoxin 2. Administer antiemetic 3. Administer atropine sulfate 4. Insert external pacemaker 5. Decrease intravenous fluids 6. Lower the head of the bed PTS: 1 DIF: Apply REF: Second-Degree AV Block Type II 2. A client’s electrocardiogram rhythm strip is a straight line. Which of the following should the nurse do to help this client? (Select all that apply.) 1. Assess for loose leads. 2. Assess for power to the monitor. 3. Assess the strip for possible fine ventricular fibrillation. 4. Begin cardiopulmonary resuscitation once verified the client has no pulse. 5. Raise the head of the bed. 6. Stop intravenous fluid infusion. PTS: 1 DIF: Apply REF: Asystole 3. The nurse is assessing a client who is diagnosed with pulseless electrical activity. Which of the following will the nurse include in this assessment? (Select all that apply.) 1. Hypovolemia 2. Hypoxia 3. Hypothermia 4. Tamponade 5. Thrombosis 6. Throat pain PTS: 1 DIF: Apply REF: Pulseless Electrical Activity 4. Which of the following should be implemented to ensure the safe use of a defibrillator? (Select all that apply.) 1. Do not place over monitoring electrodes. 2. Do not place over an implanted pacemaker. 3. Place the paddles at ½ inch from the implanted pacemaker site. 4. Apply transdermal medication to the chest before using the paddles. 5. Insert an oral airway before using the paddles. 6. Have another person hold the client’s airway open while using the paddles. . PTS: 1 DIF: Apply REF: Red Flag: Safe Use of Defibrillator Pads 5. Which of the following interventions would be appropriate for a client recovering from a pacemaker insertion? (Select all that apply.) 1. Monitor vital signs every 15 minutes until stable. 2. Assess for chest pain. 3. Restrict movement of affected extremity. 4. Monitor electrocardiogram every 8 hours. 5. Begin intravenous fluid infusion at 150 mL/hr. 6. Reinforce dressing with excessive bleeding. PTS: 1 DIF: Apply REF: Box 26-4 Interventions for Patient with Pacemaker Insertion