A nurse is assessing an electrocardiogram rhythm strip. The P waves and QRS complexes are regular. The PR interval is 0.16 second, and QRS complexes measure 0.06 second. The overall heart rate is 64 beats per minute. The nurse assesses the cardiac rhythm as: A. Normal sinus rhythm B. Sinus bradycardia C.… Read More »
A nurse notes that a client with sinus rhythm has a premature ventricular contraction that falls on the T wave of the preceding beat. The client’s rhythm suddenly changes to one with no P waves or definable QRS complexes. Instead, there are coarse wavy lines of varying amplitude. The nurse assesses this rhythm to be:… Read More »
While caring for a client who has sustained an MI, the nurse notes eight PVCs in one minute on the cardiac monitor. The client is receiving an IV infusion of D5W and oxygen at 2 L/minute. The nurse’s first course of action should be to: A. Increase the IV infusion rate. B. Notify the physician… Read More »
The adaptations of a client with complete heart block would most likely include: A. Nausea and vertigo B. Flushing and slurred speech C. Cephalalgia and blurred vision D. Syncope and slow ventricular rate Correct Answer: D. Syncope and slow ventricular rate In complete atrioventricular block, the ventricles take over… Read More »
A client with a bundle branch block is on a cardiac monitor. The nurse should expect to observe: A. Sagging ST segments. B. Absence of P wave configurations. C. Inverted T waves following each QRS complex. D. Widening of QRS complexes to 0.12 second or greater. Correct… Read More »
When ventricular fibrillation occurs in a CCU, the first person reaching the client should: A. Administer oxygen. B. Defibrillate the client. C. Initiate CPR. D. Administer sodium bicarbonate intravenously. Correct Answer: B. Defibrillate the client Ventricular fibrillation is a death-producing dysrhythmia and, once identified, must be terminated… Read More »
What criteria should the nurse use to determine normal sinus rhythm for a client on a cardiac monitor? Select all that apply. A. The RR intervals are relatively consistent. B. One P wave precedes each QRS complex. C. Four to eight complexes occur in a 6-second strip. D. The ST segment is… Read More »
When auscultating the apical pulse of a client who has atrial fibrillation, the nurse would expect to hear a rhythm that is characterized by: A. The presence of occasional coupled beats. B. Long pauses in an otherwise regular rhythm. C. A continuous and totally unpredictable irregularity. D. Slow but strong and… Read More »
Atherosclerosis impedes coronary blood flow by which of the following mechanisms? A. Plaques obstruct the vein. B. Plaques obstruct the artery. C. Blood clots form outside the vessel wall. D. Hardened vessels dilate to allow blood to flow through. Correct Answer: B. Plaques obstruct the artery Atherosclerosis… Read More »
A paradoxical pulse occurs in a client who had a coronary artery bypass graft (CABG) surgery two (2) days ago. Which of the following surgical complications should the nurse suspect? A. Left-sided heart failure B. Aortic regurgitation C. Complete heart block D. Pericardial tamponade Correct Answer: D.… Read More »