Introduction Critical Care Nursing 7th Edition By Sole Klein
Introduction Critical Care Nursing 7th Edition By Sole Klein
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Chapter 07: Dysrhythmia Interpretation and Management
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
MULTIPLE CHOICE
| a. | the fastest pacemaker cell in the heart. |
| b. | the only pacemaker cell in the heart. |
| c. | the only cell that does not affect the cardiac cycle. |
| d. | located in the left side of the heart. |
ANS: A
The cardiac cycle begins with an impulse that is generated from a small concentrated area of pacemaker cells high in the right atria called the sinoatrial node (sinus node or SA node). The SA node has the fastest rate of discharge and thus is the dominant pacemaker of the heart. The AV node has pacemaker properties and can discharge an impulse if the SA node fails. The ventricles have pacemaker capabilities if the sinus node or the AV node ceases to generate impulses.
DIF: Cognitive Level: Remember/Knowledge REF: p. 90
OBJ: Explain the relationships between electrical and mechanical events in the heart.
TOP: Nursing Process Step: N/A
MSC: NCLEX Client Needs Category: Physiological Integrity
| a. | pace the heart if the ventricles fail. |
| b. | slow the impulse arriving from the SA node. |
| c. | send the impulse to the SA node. |
| d. | allow for ventricular filling during systole. |
ANS: B
The impulse from the SA node quickly reaches the atrioventricular (AV) node located in the area called the AV junction, between the atria and the ventricles. Here the impulse is slowed to allow time for ventricular filling during relaxation or ventricular diastole. The AV node has pacemaker properties and can discharge an impulse if the SA node (not the ventricle) fails. The electrical impulse is then rapidly conducted through the bundle of His to the ventricles (not the SA node) via the left and right bundle branches.
DIF: Cognitive Level: Remember/Knowledge REF: p. 90
OBJ: Explain the relationships between electrical and mechanical events in the heart.
TOP: Nursing Process Step: N/A
MSC: NCLEX Client Needs Category: Physiological Integrity
| a. | 40 to 60 beats per minute. |
| b. | 60 to 100 beats per minute. |
| c. | 20 to 40 beats per minute. |
| d. | more than100 beats per minute. |
ANS: B
The sinus node reaches threshold at a rate of 60 to 100 times per minute. Because this is the fastest pacemaker in the heart, the SA node is the dominant pacemaker of the heart. The AV node has an inherent rate of 40 to 60 beats per minute and the His-Purkinje system can fire at a rate of 20 to 40 beats per minute. Sinus tachycardia results when the SA node fires faster than 100 beats per minute.
DIF: Cognitive Level: Remember/Knowledge REF: p. 90
OBJ: Explain the relationships between electrical and mechanical events in the heart.
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
| a. | negative. |
| b. | upside down. |
| c. | upright. |
| d. | equally positive and negative. |
ANS: C
When an electrical signal is aimed directly at the positive electrode, an upright inflection is visualized. If the impulse is going away from the positive electrode, a negative deflection is seen; and if the signal is perpendicular to the imaginary line between the positive and negative poles of the lead, the tracing is equiphasic, with equally positive and negative deflection.
DIF: Cognitive Level: Understand/Comprehension REF: p. 92
OBJ: Explain the relationships between electrical and mechanical events in the heart.
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
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