Nokea
The client has just been diagnosed with a arrhythmia. The client asks the nurse to explain normal sinus rhythm. What would the nurse explain is the characteristic of normal sinus rhythm?
- A. Heart rate between 60 and 150 beats/minute.
- B. Impulse travels to the atrioventricular (AV) node in 0.15 to 0.5 second.
- C. The ventricles depolarize in 0.5 second or less.
- D. The sinoatrial (SA) node initiates the impulse.
Correct Answer: D
Rationale: The characteristics of normal sinus rhythm are heart rate between 60 and 100 beats/minute, the SA node initiates the impulse, the impulse travels to the AV node in 0.12 to 0.2 second, the ventricles depolarize in 0.12 seconds or less, and each impulse occurs regularly.
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Elective cardioversion is similar to defibrillation except that the electrical stimulation waits to discharge until an R wave appears. What does this prevent?
- A. Disrupting the heart during the critical period of atrial repolarization
- B. Disrupting the heart during the critical period of ventricular repolarization
- C. Disrupting the heart during the critical period of ventricular depolarization
- D. Disrupting the heart during the critical period of atrial depolarization
Correct Answer: B
Rationale: It is similar to defibrillation. One difference is that the machine that delivers the electrical stimulation waits to discharge until it senses the appearance of an R wave. By doing so, the machine prevents disrupting the heart during the critical period of ventricular repolarization.
The nurse is providing instruction to a group of new nurses orienting on the unit, highlighting the benefits of the implantable cardioverter defibrillator (ICD). While pointing at a diagram of the heart, at which location would the nurse identify the placement of the electrical lead?
- A. On the right atrium near the SA node
- B. In the right ventricle near the septum
- C. At the left atrium on the anterior wall
- D. On the left ventricle on the posterior wall
Correct Answer: B
Rationale: The nurse is correct to explain that an ICD consists of a generator with a battery and one or two electrical leads that resemble a wire. The generator is placed under the skin, and the lead wire is inserted transvenously through the subclavian or cephalic vein to the apex or septum of the right ventricle. The other options are incorrect.
The nursing student is taking a pre-nursing pharmacology class. Today, the nursing student is learning about antiarrhythmic drugs. What drug is a potassium channel blocker?
- A. Amiodarone
- B. Lidocaine
- C. Flecainide
- D. Isoproterenol
Correct Answer: A
Rationale: Potassium channel blockers include amiodarone and bretylium tosylate. Lidocaine and flecainide are sodium channel blockers. Isoproterenol is a beta-blocker.
Which of the following does the nurse recognize as the therapeutic goal of radiofrequency catheter ablation for a client with cardiac arrhythmias?
- A. Reperfusion of ischemic heart tissue
- B. Dilation of arterial blood vessels
- C. Destruction of errant tissue
- D. Stimulation of the impulse center
Correct Answer: C
Rationale: The therapeutic goal of radiofrequency catheter ablation is to destroy errant tissue, in hopes of allowing impulse conduction to travel over appropriate pathways. The goal does not include dilation of blood vessels or reperfusion of heart tissue. There is no stimulation of the heart.
The licensed practical nurse is setting up the room for a client arriving at the emergency department with ventricular arrhythmias. The nurse is most correct to place which of the following in the room for treatment?
- A. A suction machine
- B. A defibrillator
- C. Cardioversion equipment
- D. An ECG machine
Correct Answer: B
Rationale: The nurse is most correct to place a defibrillator close to the client room if not in the room. The nurse realizes that clients with ventricular arrhythmias are at a high risk for fatal heart arrhythmia and death. A suction machine is used to remove respiratory secretions. Cardioversion is used in a planned setting for atrial arrhythmias. An ECG machine records tracings of the heart for diagnostic purposes. Most clients with history of cardiac disorders have an ECG completed.