Nokea
The licensed practical nurse is monitoring the waveform pattern on the cardiac monitor of the client admitted following a myocardial infarction. The nurse notes that every other beat includes a premature ventricular contraction (PVC). The nurse notes which of the following in the permanent record?
- A. Bigeminy
- B. Couplets
- C. Multifocal PVCs
- D. R-on-T phenomenon
Correct Answer: A
Rationale: The nurse is correct to note bigeminy on the permanent record when every other beat is a PVC. Couplets are two PVCs in a row. Multifocal PVCs originate from more than one location. R-on-T phenomenon occurs when the R wave falls on the T wave.
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Which of the following medications does the nurse anticipate administering to a client preparing for cardioversion?
- A. Atropine
- B. Digoxin
- C. Enalapril
- D. Diazepam
Correct Answer: D
Rationale: Prior to cardioversion, cardiac medications are held, and the client is sedated with a medication such as diazepam.
The nurse and student nurse are observing a cardioversion procedure. The nurse is correct to tell the student that electrical current will be initiated at which time?
- A. During stimulation of the SA node
- B. During repolarization of the heart
- C. During ventricular depolarization
- D. During the contraction phase
Correct Answer: C
Rationale: The electrical current is initiated at the R wave when ventricular depolarization occurs. The electrical current completely depolarizes the entire myocardium with the goal of restoring the normal pacemaker 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.
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.
The nurse is preparing to defibrillate a client with no breathing or pulse. Which nursing action precedes the nurse pressing the discharge button?
- A. Placing gel on the chest
- B. Checking the ECG rhythm
- C. Shouting, 'All clear'
- D. Stating, 'Charging'
Correct Answer: C
Rationale: Preceding pressing the discharge button, the nurse shouts 'All clear' to ensure that no one is in contact with the client. The other options are correct but not the nursing action immediately preceding.