Chapter 36: Nursing Management: Dysrhythmias

Chapter 36: Nursing Management: Dysrhythmias

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE
1. To determine whether there is a delay in impulse conduction through the atria, the nurse
will measure the length of the patient’s
a. P wave.
b. PR interval.
c. QT interval.
d. QRS complex.
ANS: A
The P wave represents the depolarization of the atria. The P-R interval represents
depolarization of the atria, atrioventricular (AV) node, bundle of His, bundle branches,
and the Purkinje fibers. The QRS represents ventricular depolarization. The Q-T interval
represents depolarization and repolarization of the entire conduction system.
DIF: Cognitive Level: Comprehension REF: 822
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
2. The nurse needs to estimate quickly the heart rate for a patient with a regular heart
rhythm. Which method will be best to use?
a. Print a 1-minute electrocardiogram (ECG) strip and count the number of QRS
complexes.
b. Count the number of large squares in the R-R interval and divide by 300.
c. Use the 3-second markers to count the number of QRS complexes in 6 seconds and
multiply by 10.
d. Calculate the number of small squares between one QRS complex and the next and
divide into 1500.
ANS: C
This is the quickest way to determine the ventricular rate for a patient with a regular
rhythm. All the other methods are accurate, but take longer.
DIF: Cognitive Level: Application REF: 819-821
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
3. A patient has a junctional escape rhythm on the monitor. The nurse will expect the patient
to have a heart rate of how many beats/minute?
a. 15 to 20
b. 20 to 40
c. 40 to 60
d. 60 to 100
Test Bank 36-2
ANS: C
If the sinoatrial (SA) node fails to discharge, the atrioventricular (AV) node will
automatically discharge at the normal rate of 40 to 60. The slower rates are typical of the
bundle of His and the Purkinje system and may be seen with failure of both the SA and
AV node to discharge. The normal SA node rate is 60 to 100 beats/minute.
DIF: Cognitive Level: Comprehension REF: 822 | 823
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
4. The nurse obtains a monitor strip on a patient who has had a myocardial infarction and
makes the following analysis: P wave not apparent, ventricular rate 162, R-R interval
regular, P-R interval not measurable, and QRS complex wide and distorted, QRS
duration 0.18 second. The nurse interprets the patient’s cardiac rhythm as
a. atrial fibrillation.
b. sinus tachycardia.
c. ventricular fibrillation.
d. ventricular tachycardia.
ANS: D
The absence of P waves, wide QRS, rate >150, and the regularity of the rhythm indicate
ventricular tachycardia. Atrial fibrillation is grossly irregular, has a narrow QRS
configuration, and has fibrillatory atrial activity. Sinus tachycardia has P waves.
Ventricular fibrillation is irregular and does not have a consistent QRS duration.
DIF: Cognitive Level: Application REF: 830-831
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity