Easy ECG in 1, 2, 3
=1.To determine whether there is a delay in impulse conduction through the atria, the nurse will measure the length of the patient’s _____________
a. P wave.
b. PR interval.
c. QT interval.
d. QRS complex.
=2. The nurse needs to estimate quickly the heart rate for a patient with a regular heart rhythm. Which method will be 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 300.
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.
= 3. The nurse obtains a monitor strip on a patient who has had a myocardial infarction and makes the following analysis: P wave not apparent, ventricular rate 162, R-R interval regular, P-R interval not measurable, and QRS complex wide and distorted, QRS duration 0.18 second. The nurse interprets the patient’s cardiac rhythm as
a. atrial fibrillation.
b. sinus tachycardia.
c. ventricular fibrillation.
d. ventricular tachycardia.
4. The nurse notes that a patient’s cardiac monitor shows that every other beat is earlier than expected, has no P wave, and has a QRS complex with a wide and bizarre shape. How will the nurse document the rhythm?
a. Ventricular couplets
b. Ventricular bigeminy
c. Ventricular R-on-T phenomenon
-d. Ventricular multifocal contractions
5 A patient has a normal cardiac rhythm and a heart rate of 72 beats/minute, except that the PR interval is 0.24 seconds. The appropriate intervention by the nurse is to
a. notify the patient’s health care provider immediately.
b. administer atropine per agency bradycardia protocol.
c. prepare the patient for temporary pacemaker insertion.
d. document the finding and continue to monitor the patient.
6 A patient who was admitted with a myocardial infarction experiences a 50-second episode of ventricular tachycardia, then converts to sinus rhythm with a heart rate of 98 beats/minute. Which action should the nurse take next?
a. Notify the health care provider.
b. Perform synchronized cardioversion.
c. Administer the PRN IV lidocaine (Xylocaine).
d. Document the rhythm and monitor the patient.
7.After the nurse administers IV atropine to a patient with symptomatic type 1, second-degree atrioventricular (AV) block, which finding indicates 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
8. A patient with cardiomyopathy has atrial fibrillation unresponsive to drug therapy for several days. The nurse anticipates that the patient may need teaching about
a. electrical cardioversion.
b. IV adenosine (Adenocard).
c. anticoagulant therapy with warfarin (Coumadin).
d. insertion of an implantable cardioverter-defibrillator (ICD).
9. A 19-year-old has a mandatory electrocardiogram (ECG) before participating on a college swim team and is found to have sinus bradycardia, rate 52. BP is 114/54, and the student denies any health problems. What action by the nurse is appropriate?
a. Allow the student to participate on the swim team.
b. Refer the student to a cardiologist for further assessment.
c. Obtain more detailed information about the student’s health history.
d. Tell the student to stop swimming immediately if any dyspnea occurs.
10. When analyzing the waveforms of a patient’s electrocardiogram (ECG), the nurse will need to investigate further upon finding a
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.
11. A patient develops sinus bradycardia at a rate of 32 beats/minute, has a BP of 80/36 mm Hg, and is complaining of feeling faint. Which action should the nurse take?
a. Continue to monitor the rhythm and BP.
b. Apply the transcutaneous pacemaker (TCP).
c. Have the patient perform the Valsalva maneuver.
d. Give the scheduled dose of diltiazem (Cardizem).
12. A patient whose cardiac monitor shows sinus tachycardia, rate 102, is apneic and no pulses are palpable by the nurse. What is the first action that the nurse should take?
a. Start CPR.
b. Defibrillate.
c. Administer atropine per hospital protocol.
d. Give 100% oxygen per non-rebreather mask.
13. A patient experiences dizziness and shortness of breath for several days. During cardiac monitoring in the emergency department (ED), the nurse obtains an electrocardiographic (ECG) tracing. The nurse interprets this cardiac rhythm as
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).
14. A patient who is complaining of a “racing” heart and nervousness comes to the emergency department. The nurse places the patient on a cardiac monitor and obtains the electrocardiographic (ECG) tracing. Which action should the nurse take next?
a. Get ready to perform electrical cardioversion.
b. Have the patient perform the Valsalva maneuver.
c. Obtain the patient’s blood pressure and oxygen saturation.
d. Prepare to give beta-blocker medication to slow the heart rate.
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