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NURS MISC Chapter 25 Nursing Care of Patients With Cardiac Dysrhythmia WITH FULL ANSWERS A, Exams of Nursing

NURS MISC Chapter 25 Nursing Care of Patients With Cardiac Dysrhythmia WITH FULL ANSWERS AND RATIONALE 2023NURS MISC Chapter 25 Nursing Care of Patients With Cardiac Dysrhythmia WITH FULL ANSWERS AND RATIONALE 2023 NURS MISC Chapter 25 Nursing Care of Patients With Cardiac Dysrhythmia WITH FULL ANSWERS AND RATIONALE 2023NURS MISC Chapter 25 Nursing Care of Patients With Cardiac Dysrhythmia WITH FULL ANSWERS AND RATIONALE 2023 NURS MISC Chapter 25 Nursing Care of Patients With Cardiac Dysrhythmia WITH FULL ANSWERS AND RATIONALE 2023NURS MISC Chapter 25

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Nurs Misc Chapter
25 Nursing Care of
Patients With
Cardiac
Dysrhythmia
Chapter 25. Nursing Care of Patients With Cardiac Dysrhythmias
MULTIPLE CHOICE
1. After reviewing an electrocardiogram, the nurse determines that an electrical impulse
originated in a patient’s sinoatrial node. What did the nurse see on this tracing?
1. An upright T wave
2. An inverted T wave
3. A positive P wave before a QRS complex
4. A negative P wave before a QRS complex
ANS: 3
Chapter: Chapter 25. Nursing Care of Patients With Cardiac Dysrhythmias
Objective: 1. Describe how electrical activity flows through the heart.
Page: 437
Heading: Cardiac Conduction System
Integrated Process: Clinical Problem-Solving Process (Nursing Process)
Client Need: PHYSBasic Care and Comfort
Cognitive Level: Application (Applying)
Concept: Perfusion
Difficulty: Moderate
Feedback
1
This wave does not indicate that the electrical impulse originated in the
sinoatrial (SA) node.
2
This wave does not indicate that the electrical impulse originated in the SA
node.
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Download NURS MISC Chapter 25 Nursing Care of Patients With Cardiac Dysrhythmia WITH FULL ANSWERS A and more Exams Nursing in PDF only on Docsity!

25 Nursing Care of

Patients With

Cardiac

Dysrhythmia

Chapter 25. Nursing Care of Patients With Cardiac Dysrhythmias

MULTIPLE CHOICE

  1. After reviewing an electrocardiogram, the nurse determines that an electrical impulse originated in a patient’s sinoatrial node. What did the nurse see on this tracing?
  2. An upright T wave
  3. An inverted T wave
  4. A positive P wave before a QRS complex
  5. A negative P wave before a QRS complex ANS: 3 Chapter: Chapter 25. Nursing Care of Patients With Cardiac Dysrhythmias Objective: 1. Describe how electrical activity flows through the heart. Page: 437 Heading: Cardiac Conduction System Integrated Process: Clinical Problem-Solving Process (Nursing Process) Client Need: PHYS—Basic Care and Comfort Cognitive Level: Application (Applying) Concept: Perfusion Difficulty: Moderate Feedback (^1) This wave does not indicate that the electrical impulse originated in the sinoatrial (SA) node. (^2) This wave does not indicate that the electrical impulse originated in the SA node.

25 Nursing Care of

Patients With

Cardiac

Dysrhythmia

(^3) A positive P wave before a QRS complex indicates that an electrical impulse originated in the SA node. (^4) This wave does not indicate that the electrical impulse originated in the SA node.

PTS: 1 CON: Perfusion

  1. The nurse is reinforcing teaching for a patient who has a pacemaker. Which measure should the nurse include when explaining how the pulse should be monitored?
  2. Take radial pulse for 1 minute.
  3. Take apical pulse for 1 minute.
  4. Take jugular pulse for 30 seconds.
  5. Take brachial pulse for 30 seconds.

ANS: 1 Chapter: Chapter 25. Nursing Care of Patients With Cardiac Dysrhythmias Objective: 6. Plan nursing care for patients with an implanted device. Page: 451 Heading: Nursing Care of Patients With Pacemakers Integrated Process: Clinical Problem-Solving Process (Nursing Process) Client Need: PHYS—Reduction of Risk Potential Cognitive Level: Application (Applying)

25 Nursing Care of

Patients With

Cardiac

Dysrhythmia

Difficulty: Moderate Feedback (^1) When the rhythm reads asystole, CPR is started immediately. (^2) When the rhythm reads asystole, CPR is started immediately. (^3) When the rhythm reads asystole, CPR is started immediately. (^4) When the rhythm reads asystole, CPR is started immediately.

PTS: 1 CON: Perfusion

  1. The nurse is caring for a patient receiving warfarin (Coumadin). Which finding would be of most concern to the nurse?
  2. The patient reports blood in the urine.
  3. The patient reports nausea.
  4. The patient’s apical heart rate is 72 beats/min.
  5. The patient has a dry cough.

ANS: 1 Chapter: Chapter 25. Nursing Care of Patients With Cardiac Dysrhythmias Objective: 3. Explain current medical treatments for cardiac arrhythmias. Page: 447 Heading: Medications Used in Treatment of Arrhythmias (Table 25.2)

25 Nursing Care of

Patients With

Cardiac

Dysrhythmia

Integrated Process: Clinical Problem-Solving Process (Nursing Process) Client Need: PHYS—Pharmacological Therapies Cognitive Level: Application (Applying) Concept: Safety Difficulty: Moderate Feedback (^1) Hematuria indicates the patient may be receiving too much Coumadin. (^2) Nausea is not a priority. (^3) The heart rate is normal. (^4) Dry cough is not the most concerning effect.

PTS: 1 CON: Safety

  1. A patient is diagnosed with ventricular fibrillation. For which emergency intervention should the nurse anticipate preparing?
  2. Defibrillation
  3. Endotracheal intubation
  4. Synchronized cardioversion
  5. Cardiopulmonary resuscitation

ANS: 1 Chapter: Chapter 25. Nursing Care of Patients With Cardiac Dysrhythmias Objective: 5. Plan nursing care for patients with an arrhythmia. Page: 450 Heading: Therapeutic Measures Integrated Process: Clinical Problem-Solving Process (Nursing Process) Client Need: PHYS—Physiological Adaptation Cognitive Level: Application (Applying)

25 Nursing Care of

Patients With

Cardiac

Dysrhythmia

Chapter: Chapter 25. Nursing Care of Patients With Cardiac Dysrhythmias Objective: 2. List the six steps used for arrhythmia interpretation. Page: 447 Heading: Atrial Fibrillation Rules Integrated Process: Clinical Problem-Solving Process (Nursing Process) Client Need: PHYS—Reduction of Risk Potential Cognitive Level: Analysis (Analyzing) Concept: Perfusion Difficulty: Moderate Feedback (^1) This describes atrial fibrillation. (^2) This describes atrial fibrillation. (^3) This describes atrial fibrillation. (^4) This describes atrial fibrillation.

PTS: 1 CON: Perfusion

  1. The nurse is reinforcing teaching for a patient with premature ventricular contractions (PVCs) and is being discharged. Which lifestyle recommendation should be the most important for the nurse to include?
  2. “It is important for you to drink decaffeinated beverages.”
  3. “You should increase the amount of exercise you do each day.”
  4. “It is important for you to reduce the amount of fat in your diet.”
  5. “Weight gain and fluid retention are likely causing your abnormal heart rhythm.”

ANS: 1 Chapter: Chapter 25. Nursing Care of Patients With Cardiac Dysrhythmias Objective: 5. Plan nursing care for patients with an arrhythmia.

25 Nursing Care of

Patients With

Cardiac

Dysrhythmia

Page: 448 Heading: Therapeutic Measures Integrated Process: Teaching/Learning Client Need: Health Promotion and Maintenance Cognitive Level: Application (Applying) Concept: Perfusion Difficulty: Moderate Feedback (^1) The ingestion of caffeine is a common cause of PVCs. The patient should be instructed to avoid caffeine. (^2) Exercise, dietary fat, body weight, and fluid level are not identified as causes for PVCs. (^3) Exercise, dietary fat, body weight, and fluid level are not identified as causes for PVCs. (^4) Exercise, dietary fat, body weight, and fluid level are not identified as causes for PVCs.

PTS: 1 CON: Perfusion

  1. The nurse is caring for a patient who develops sinus tachycardia. What action should the nurse take?

25 Nursing Care of

Patients With

Cardiac

Dysrhythmia

  1. “I may move my arm freely.”
  2. “I may resume normal activity in 1 week.”
  3. “Grounded microwave ovens may be safely used.”

ANS: 4 Chapter: Chapter 25. Nursing Care of Patients With Cardiac Dysrhythmias Objective: 6. Plan nursing care for patients with an implanted device. Page: 451 Heading: Cardiac Pacemakers Integrated Process: Teaching/Learning Client Need: PHYS—Basic Care and Comfort Cognitive Level: Evaluation (Evaluating) Concept: Perfusion Difficulty: Moderate Feedback (^1) The patient is going to have activity, limb movement, and weight-lifting restrictions after the insertion of a pacemaker. (^2) The patient is going to have activity, limb movement, and weight-lifting restrictions after the insertion of a pacemaker. (^3) The patient is going to have activity, limb movement, and weight-lifting restrictions after the insertion of a pacemaker.

25 Nursing Care of

Patients With

Cardiac

Dysrhythmia

(^4) Grounded microwave ovens may be safely used around pacemakers, which are now encased for protection.

PTS: 1 CON: Perfusion

  1. The nurse is caring for a patient in respiratory acidosis who also had a myocardial infarction (MI). For which rhythm should the nurse assess?
  2. Ventricular fibrillation
  3. Atrial fibrillation
  4. Ventricular tachycardia
  5. Atrial flutter

ANS: 3 Chapter: Chapter 25. Nursing Care of Patients With Cardiac Dysrhythmias Objective: 5. Plan nursing care for patients with an arrhythmia. Page: 445 Heading: Etiology Integrated Process: Clinical Problem-Solving Process (Nursing Process) Client Need: PHYS—Reduction of Risk Potential Cognitive Level: Analysis (Analyzing) Concept: Perfusion Difficulty: Moderate Feedback (^1) Patients with respiratory acidosis and an MI are at risk for ventricular tachycardia. (^2) Patients with respiratory acidosis and an MI are at risk for ventricular tachycardia.

25 Nursing Care of

Patients With

Cardiac

Dysrhythmia

Concept: Perfusion Difficulty: Moderate Feedback (^1) Headache, confusion, and tingling extremities are not manifestations of PVCs. (^2) Headache, confusion, and tingling extremities are not manifestations of PVCs. (^3) Lightheadedness is a manifestation of PVCs. (^4) Headache, confusion, and tingling extremities are not manifestations of PVCs.

PTS: 1 CON: Perfusion

  1. The nurse is caring for a group of patients. Which patient is at risk for developing premature atrial contractions (PACs)?
  2. A 40-year-old smoker who takes digoxin (Lanoxin)
  3. A 50-year-old who occasionally drinks alcohol who takes atenolol (Tenormin)
  4. A 60-year-old with sinus tachycardia who takes diltiazem (Cardizem)
  5. A 70-year-old with atrial flutter who metoprolol succinate (Lopressor)

ANS: 1 Chapter: Chapter 25. Nursing Care of Patients With Cardiac Dysrhythmias Objective: 5. Plan nursing care for patients with an arrhythmia. Page: 445 Heading: Etiology Integrated Process: Clinical Problem-Solving Process (Nursing Process) Client Need: PHYS—Reduction of Risk Potential Cognitive Level: Analysis (Analyzing) Concept: Perfusion Difficulty: Moderate Feedback

25 Nursing Care of

Patients With

Cardiac

Dysrhythmia

(^1) Smoking and digoxin (Lanoxin) places a patient at risk for PACs. (^2) This patient is not at risk for PACs. (^3) This patient is not at risk for PACs. (^4) This patient is not at risk for PACs.

PTS: 1 CON: Perfusion

  1. The nurse observes two PACs in 1 minute on a patient’s cardiac monitor. The patient is asymptomatic. What action is required by the nurse?
  2. Administer digoxin (Lanoxin).
  3. Notify the physician.
  4. Continue monitoring the patient.
  5. Take vital signs every 15 minutes.

ANS: 3 Chapter: Chapter 25. Nursing Care of Patients With Cardiac Dysrhythmias Objective: 5. Plan nursing care for patients with an arrhythmia Page: 445 Heading: Premature Atrial Contractions Integrated Process: Clinical Problem-Solving Process (Nursing Process) Client Need: PHYS—Physiological Adaptation

25 Nursing Care of

Patients With

Cardiac

Dysrhythmia

Concept: Perfusion Difficulty: Moderate Feedback (^1) This medication is not the reversal agent for Coumadin. (^2) This medication is not the reversal agent for Coumadin. (^3) Vitamin K is the reversal agent for Coumadin. (^4) This medication is not the reversal agent for Coumadin.

PTS: 1 CON: Perfusion

  1. The nurse is reading a cardiac monitor of a patient and observes a regular rhythm, a flutter of P waves with a sawtooth pattern, QRS interval 0.08 second, and an atrial rate of 300 beats/min. The nurse recognizes this as which arrhythmia?
  2. Atrial fibrillation
  3. Atrial flutter
  4. Sinus tachycardia
  5. Ventricular tachycardia

ANS: 2 Chapter: Chapter 25. Nursing Care of Patients With Cardiac Dysrhythmias Objective: 5. Plan nursing care for patients with arrhythmia.

25 Nursing Care of

Patients With

Cardiac

Dysrhythmia

Page: 445 Heading: Atrial Flutter Rules Integrated Process: Clinical Problem-Solving Process (Nursing Process) Client Need: PHYS—Reduction of Risk Potential Cognitive Level: Analysis (Analyzing) Concept: Perfusion Difficulty: Moderate Feedback (^1) This describes atrial flutter. (^2) This describes atrial flutter. (^3) This describes atrial flutter. (^4) This describes atrial flutter.

PTS: 1 CON: Perfusion

  1. The nurse is preparing to administer digoxin (Lanoxin). The nurse assesses the apical pulse and notes a rate of 54 beats/min. Which action should the nurse take?
  2. Notify the health care provider (HCP).
  3. Prepare to administer atropine sulfate.
  4. Administer the medication.
  5. Withhold the medication.

ANS: 1 Chapter: Chapter 25. Nursing Care of Patients With Cardiac Dysrhythmias Objective: 5. Plan nursing care for patients with an arrhythmia. Page: 452 Heading: Medications Used in Treatment of Arrhythmias (Table 25.2) Integrated Process: Clinical Problem-Solving Process (Nursing Process)

25 Nursing Care of

Patients With

Cardiac

Dysrhythmia

ANS: 3

Chapter: Chapter 25. Nursing Care of Patients With Cardiac Dysrhythmias Objective: 5. Plan nursing care for patients with an arrhythmia. Page: 439 Heading: ST Segment Integrated Process: Clinical Problem-Solving Process (Nursing Process) Client Need: PHYS—Basic Care and Comfort Cognitive Level: Application (Applying) Concept: Perfusion Difficulty: Moderate Feedback (^1) Reviewing the ECG recordings in the patient’s chart is wasting valuable time. (^2) Auscultating chest sounds and other physical assessment parameters is wasting time. (^3) The nurse should alert the supervising RN and patient’s physician immediately as the ST segment depression indicates cardiac ischemia. The patient requires prompt treatment to prevent complications. (^4) Continuing to monitor the cardiac tracing could lead to a potentially lethal situation.

PTS: 1 CON: Perfusion

  1. The nurse is caring for a group of patients on the telemetry unit. Which patient should the nurse see first?
  2. A patient with sinus bradycardia with a heart rate of 58 beats/min
  3. A patient with sinus tachycardia with a heart rate of 104 beats/min
  4. A patient with premature atrial contractions who is asymptomatic
  5. A patient with atrial fibrillation reporting dyspnea

25 Nursing Care of

Patients With

Cardiac

Dysrhythmia

ANS: 4

Chapter: Chapter 25. Nursing Care of Patients With Cardiac Dysrhythmias Objective: 5. Plan nursing care for patients with an arrhythmia. Page: 439 Heading: Signs and Symptoms Integrated Process: Clinical Problem-Solving Process (Nursing Process) Client Need: SECE—Coordinated Care Cognitive Level: Analysis (Analyzing) Concept: Perfusion Difficulty: Moderate Feedback (^1) There is nothing indicating this patient is unstable. (^2) There is nothing indicating this patient is unstable. (^3) There is nothing indicating this patient is unstable. (^4) This patient is reporting dyspnea and should be seen first.

PTS: 1 CON: Perfusion

  1. The nurse is conducting a community health screening. Which individual should the nurse recognize as being the highest risk for atrial fibrillation?