Cardiac Dysrhythmias Test Bank Questions

Cardiac Dysrhythmias Test Bank Questions The nurse assesses a client's ECG tracing and observes that not all QRS complexes are preceded by a P wave. How should the nurse interpret this observation? A. The client has ...

Cardiac Dysrhythmias Test Bank Questions The nurse assesses a client's ECG tracing and observes that not all QRS complexes are preceded by a P wave. How should the nurse interpret this observation? A. The client has hyperkalemia causing irregular QRS complexes. B. Ventricular tachycardia is overriding the normal atrial rhythm. C. The client's chest leads are not making sufficient contact with the skin. D. Ventricular and atrial depolarizations are initiated from different sites. - ✔✔D. Ventricular and atrial depolarizations are initiated from different sites. Rationale: Normal rhythm shows one P wave preceding each QRS complex, indicating that all depolarizatoin is initiated at the SA node. QRS complexes without a P wave indicate a different source of initiation of depolarization. This finding on an ECG tracing is not an indication of hyperkalemia, ventricular tachycardia, or disconnection of leads. A nurse cares for a client who has a heart rate averaging 56 beats/min with no adverse symptoms. Which activity modification should the nurse suggest to avoid further slowing of the heart rate? A. Make certain that your bath water is warm. B. Avoid straining while having a bowel movement. C. Limit your intake of caffeinated drinks to one a day. D. Avoid strenuous exercise such as running. - ✔✔B. Avoid straining while having a bowel movement. Rationale: Bearing down strenuously during a bowel movement is one type of Valsalva maneuver, which stimulates the vagus nerve and results in slowing of the heart rate. Such a result is not desirable in a person who has bradycardia. The other instructions are not appropriate for this condition. A nurse is assessing clients on a med-surg unit. Which client should the nurse identify as being at greatest risk for atrial fibrillation? A. A 45-year-old who takes an aspirin daily. B. a 50-year-old who is post coronary artery bypass surgery. C. A 78-year-old who had a carotid endarterectomy. D. An 80-year-old with COPD. - ✔✔B. a 50-year-old who is post coronary artery bypass surgery. Rationale: Atrial fibrillation occurs commonly in clients with cardiac disease and is a common occurrence after coronary artery bypass graft surgery. The other conditions do not place these clients at higher risk for atrial fibrillation. A nurse assesses a client with atrial fibrillation. Which manifestation should alert the nurse to the possibility of a serious complication from this condition? A. Sinus tachycardia B. Speech Alterations C. Fatigue D. Dyspnea with activity - ✔✔B. Speech Alterations Rationale: Clients with atrial fibrillation are at risk for embolic stroke. Evidence of embolic events includes changes in mentation, speech, sensory function, and motor function. Clients with atrial fibrillation often have a rapid ventricular response as a result. Fatigue is a nonspecific complaint. Clients with atrial fibrillation often have dyspnea as a result of the decreased cardiac output caused by the rhythm disturbance. A nurse evaluates prescriptions for a client with chronic atrial fibrillation. Which medication should the nurse expect to find on this client's medication administration record to prevent a common complication of this condition? A. Solatol (Betapace) B. Warfarin (Coumadin) C. Atropine (Sal-Tropine) D. Lidocaine (Xylocaine) - ✔✔B. Warfarin (Coumadin) Rationale: A-fib puts clients at risk for developing emboli. Clients at risk for developing emboli are treated with anticoagulants, such as heparin, enoxaparin, or warfarin. Sotalol, atropine, and lidocaine are not appropriate for this complication. A nurse administers prescribed adenosine (Adenocard) to a client. Which response should the nurse assess for as the expected therapeutic response. A. Decreased intraocular pressure B. Increased heart rate C. Short period of asystole D. Hypertensive crisis - ✔✔C. Short period of asystole Rationale: Clients usually respond to adenosine with a short period of asystole, bradycardia, hypotension, dyspnea, and chest pain A nurse cares for a client with an intravenous temporary pacemaker for bradycardia. The nurse observes the presence of a pacing spike but no QRS complex on the client's ECG. Which action should the nurse take next? A. Administer intravenous diltiazem (Cardizem). B. Assess vital signs and LOC. C. Administer sublingual nitroglycerin D. Assess capillary refil and temperature - ✔✔B. Assess vital signs and LOC. Rationale: In temporary pacing, the wires are threaded into the epicardial surface of the heart and exit through the chest wall. The pacemaker spike should be followed immediately by a QRS complex. Pacing spikes seen without subsequent QRS complexes imply loss of capture. The nurse shpuld assess for cardiac output via vital signs and LOC. The other interventions would not determine if the client is tolerating the loss of capture.