ATI LPN
Timby's Introductory Medical-Surgical Nursing Thirteenth, North American Edition
Chapter 26 : Caring for Clients With Cardiac Arrhythmias Questions
Question 1 of 5
The nurse is caring for a client with atrial fibrillation. What procedure would be recommended if drug therapies did not control the arrhythmia?
Correct Answer: D
Rationale: Atrial fibrillation is treated with elective cardioversion or digitalis if the ventricular rate is not too slow. Defibrillation is used for a ventricular problem. Maze procedures are used for clients who are not candidates for cardio diversion; these procedures use scar-forming techniques to eliminate rapid firing of ectopic pacemaker sites, thus restoring the normal conduction pathways in the atria. A Maze procedure might be considered for this client only after determining ineligibility for cardiodiversion. Pacemakers are implanted for bradycardia.
Question 2 of 5
Elective cardioversion is similar to defibrillation except that the electrical stimulation waits to discharge until an R wave appears. What does this prevent?
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.
Question 3 of 5
The nurse enters the client's room and finds the client pulseless and unresponsive. What would be the treatment of choice for this client?
Correct Answer: C
Rationale: Defibrillation is used during pulseless ventricular tachycardia and ventricular fibrillation.
Question 4 of 5
The client has returned to the floor with a transthoracic pacemaker ready to be connected. The nurse knows that a transthoracic pacemaker is a temporary pacemaker used in what situation?
Correct Answer: A
Rationale: The leads of a transthoracic pacemaker are inserted during open heart surgery. They extend from the chest incision. If the client requires cardiac pacing during postoperative recovery, the leads are connected to a temporary pacing unit.
Question 5 of 5
The nurse is caring for clients on a telemetry unit. Which nursing consideration best represents concerns of altered rhythmic patterns of the heart?
Correct Answer: D
Rationale: The best representation of a nursing concern related to a cardiac arrhythmia is the inability of the heart to fill the chambers and eject blood flow efficiently. Lack of an efficient method to circulate blood and bodily fluids produces a variety of complications such as tissue ischemia, pulmonary edema, hypotension, decreased urine output, and impaired level of consciousness. The other options can occur with arrhythmias, but the cause stemming from the altered pattern is the best answer.