ATI LPN
Lewis's Medical Surgical Nursing in Canada, 5th Edition
Chapter 38 Questions
Question 1 of 5
The nurse is caring for a patient who has a normal cardiac rhythm and a heart rate of 72 beats/minute, except that the P-R interval is 0.24 seconds. Which of the following actions should the nurse implement?
Correct Answer: D
Rationale: First-degree atrioventricular (AV) block is asymptomatic and requires ongoing monitoring because it may progress to more serious forms of heart block. The rate is normal, so there is no indication that atropine is needed. Immediate notification of the health care provider about an asymptomatic rhythm is not necessary.
Question 2 of 5
Which of the following actions should the nurse take when preparing for cardioversion of a patient with supraventricular tachycardia who is alert and has a blood pressure of 110/66 mm Hg?
Correct Answer: D
Rationale: When a patient has a nonemergency cardioversion, sedation is used just before the procedure. The synchronizer switch is turned on for cardioversion. The initial level of joules for cardioversion is low (e.g., 50). CPR is not indicated for this patient.
Question 3 of 5
The nurse is interpreting an ECG strip to determine whether there is a delay in impulse conduction above the ventricles. Which of the following components of an ECG strip should the nurse measure?
Correct Answer: B
Rationale: The P-R interval represents depolarization of the atria, atrioventricular (AV) node, bundle of His, bundle branches, and the Purkinje fibres. The QRS represents ventricular depolarization. The Q-T interval represents depolarization and repolarization of the entire conduction system.
Question 4 of 5
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?
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.
Question 5 of 5
A young adult patient arrives at the student health centre at the end of the quarter complaining that, 'My heart is skipping beats.' An electrocardiogram (ECG) shows occasional premature ventricular contractions (PVCs). What of the following actions should the nurse take first?
Correct Answer: D
Rationale: In a patient with a normal heart, occasional PVCs are a benign finding. The timing of the PVCs suggests stress or caffeine as possible etiologic factors. It is unlikely that the patient has coronary artery disease, and this should not be the first question the nurse asks. The patient is hemodynamically stable, so there is no indication that the patient needs to be seen in the ED or that oxygen needs to be administered.