ATI LPN
Timby's Introductory Medical-Surgical Nursing Thirteenth, North American Edition
Chapter 26 Questions
Question 1 of 5
The nurse is preparing to defibrillate a client with no breathing or pulse. Which nursing action precedes the nurse pressing the discharge button?
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.
Question 2 of 5
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.
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.
Question 3 of 5
The nurse is caring for a client with an arrhythmia. While assessing the data in the history of the chart, the nurse anticipates the cause of the arrhythmia to be which of the following?
Correct Answer: B
Rationale: The nurse realizes that the most common cause of arrhythmias is ischemic heart disease. When the heart does not obtain sufficient blood to meet demands, the heart works harder to circulate body fluids and becomes inefficient in the process. Problems with the peripheral vessels, narrowing of the aorta and plaque build-up in the vessels may be a component of the disease process but not the best answer.
Question 4 of 5
The client has just been admitted with bradycardia and scheduled for the insertion of a pacemaker. The nurse notifies the physician that the client's heart rate has dropped into the 40 beats/minute range. The physician orders a temporary pacemaker. The nurse knows that there are different types of temporary pacemakers. What types of temporary pacemakers are there? Select all that apply.
Correct Answer: B,C,D
Rationale: The three types of temporary pacemakers are transcutaneous, transvenous, and transthoracic. Transatrial and transabdominal are not types of temporary pacemakers.
Question 5 of 5
Which of the following does the nurse recognize as the therapeutic goal of radiofrequency catheter ablation for a client with cardiac arrhythmias?
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.