Nokea
The nurse needs to estimate quickly the heart rate for a patient with a regular heart rhythm. Which of the following methods is 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 100.
- 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.
Correct Answer: C
Rationale: 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.
You may also like to solve these questions
The nurse is caring for a patient who has been experiencing dizziness and shortness of breath for several days. During cardiac monitoring in the emergency department (ED), the nurse obtains the following electrocardiographic tracing. Which of the following cardiac rhythms should the nurse identify?
- A. Sinus rhythm with premature ventricular contractions (PVCs)
- B. Junctional escape rhythm
- C. Third-degree atrioventricular (AV) block
- D. Sinus rhythm with premature atrial contractions (PACs)
Correct Answer: C
Rationale: The inconsistency between the atrial and ventricular rates and the variable P-R interval indicate that the rhythm is third-degree AV block. Sinus rhythm with PACs or PVCs will have a normal rate and consistent P-R intervals with occasional PACs or PVCs. A junctional escape rhythm will not have P waves.
When analyzing the waveforms of a patient's electrocardiogram (ECG), the nurse will need to investigate further upon assessing which of the following findings?
- A. T wave of 0.16 second
- B. P-R interval of 0.18 second
- C. Q-T interval of 0.34 second
- D. QRS interval of 0.14 second
Correct Answer: D
Rationale: Because the normal QRS interval is 0.04-0.10 seconds, the patient's QRS interval of 0.14 seconds indicates that the conduction through the ventricular conduction system is prolonged. The P-R interval, Q-T interval, and T-wave interval are within the normal range.
The nurse administers IV atropine to a patient with symptomatic type 1, second-degree atrioventricular (AV) block. Which of the following findings indicate that the medication has been effective?
- A. Increase in the patient's heart rate
- B. Decrease in premature contractions
- C. Increase in peripheral pulse volume
- D. Decrease in ventricular ectopic beats
Correct Answer: A
Rationale: Atropine will increase the heart rate and conduction through the AV node. Because the medication increases electrical conduction, not cardiac contractility, the quality of the peripheral pulses is not used to evaluate the drug effectiveness. The patient does not have ventricular ectopy or premature contractions.
The nurse has received change-of-shift report about the following patients on the telemetry unit. Which of the following patients should the nurse see first?
- A. A patient with atrial fibrillation, rate 88, who has a new order for warfarin
- B. A patient with type 1 second-degree atrioventricular (AV) block, rate 60, who is dizzy when ambulating
- C. A patient who is in a sinus rhythm, rate 98, after having electrical cardioversion 2 hours ago
- D. A patient whose implantable cardioverter-defibrillator (ICD) fired three times today who has a dose of amiodarone due
Correct Answer: D
Rationale: The frequent firing of the ICD indicates that the patient's ventricles are very irritable, and the priority is to assess the patient and administer the amiodarone. The other patients may be seen after the amiodarone is administered.
The nurse is caring for a patient who is on the telemetry unit and develops atrial flutter, rate 150, with associated dyspnea and diaphoresis, with an oxygen saturation of 94%. Which of the following actions that are included in the hospital dysrhythmia protocol should the nurse take first?
- A. Obtain a 12-lead electrocardiogram (ECG).
- B. Give O2 via nasal cannula at 3-4 L/minute.
- C. Take the patient's blood pressure and respiratory rate.
- D. Notify the health care provider of the change in rhythm.
Correct Answer: B
Rationale: Since this patient has dyspnea in association with the new rhythm, the nurse's initial actions should be to ensure a patent airway and oxygen administration. The other actions also are important and should be implemented rapidly.