Nokea
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.
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A client presents to the emergency department via ambulance with a heart rate of 210 beats/minute and a sawtooth waveform pattern per cardiac monitor. The nurse is most correct to alert the medical team of the presence of a client with which disorder?
- A. Asystole
- B. Premature ventricular contraction
- C. Atrial flutter
- D. Ventricular fibrillation
Correct Answer: C
Rationale: Atrial flutter is a disorder in which a single atrial impulse outside the SA node causes the atria to contract at an exceedingly rapid rate. The atrioventricular (AV) node conducts only some impulses to the ventricle, resulting in a ventricular rate slower than the atrial rate, thus forming a sawtooth pattern on the heart monitor. Asystole is the absence of cardiac function and can indicate death. Premature ventricular contraction indicates an early electric impulse and does not necessarily produce an exceedingly rapid heart rate. Ventricular fibrillation is the inefficient quivering of the ventricles and indicative of a dying heart.
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.
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 nurse reports to the cardiac nurse practitioner that the client is consistently exhibiting a normal sinus rhythm. What characteristic(s) has the nurse noted to determine the rhythm is normal? Select all that apply.
- A. Heart rate 106 beats/minute
- B. Upright P wave before each QRS complex
- C. Each impulse occurs regularly.
- D. Impulse travels to the SA node from the AV node.
- E. Wave ends with a T wave
- F. Ventricles depolarize in the QRS complex.
Correct Answer: B,C,E,F
Rationale: Characteristics of normal sinus rhythm include a regular impulse originating in the SA node and with impulses continuing to the AV node. There is a P wave initially with depolarization at the QRS complex and ending with a T wave. Normal heart rate is between 60 to 100 beats/minute.
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.