1. A client has a Permanent Pacemaker

1. A client has a Permanent Pacemaker inserted for treatment of Chronic Atrial Fibrillation with slow ventricular response. The nurse would teach the client based on the fact that the Pacemaker will a. prevent or minimize ventricular irritability. b. discharge if ventricular fibrillation occurs. c. cause the atria to repolarize after the T wave. d. initiate a ventricular contraction when needed 2. According to ACLS protocol, first line treatment for Ventricular Tachycardia with no palpable pulse is a. defibrillation. b. synchronized cardioversion. c. lidocaine 1 mg/kg IV push. d. amiodarone IV push. 3. When defibrillating a client, it is important to a. check to see that the synchronizer switch is turned on. b. pre-medicate with Versed so the procedure is less uncomfortable. c. charge the defibrillator using the button on the defibrillator or the paddles. d. position the paddles gently on the chest wall over the conductive material. 4. A client with a large myocardial infarction has been having frequent premature ventricular contractions (PVCs) on his cardiac monitor. The pattern that the nurse recognizes as the most characteristic of PVCs is a. an irregular rhythm. b. an inverted T wave. c. a wide, distorted QRS complex. d. an increasingly long PR interval. 5. When a client experiences a cardiac dysrhythmia, the most important factor in determining the urgency for intervention is a. the unusual size of amplitude in the dysrhythmia. b. the client’s immediate response to the dysrhythmia. c. the relationship of the dysrhythmia to the admitting diagnosis. d. whether the dysrhythmia is a new finding for the client. 6. A client arrives in the Emergency Department complaining of palpitations, shortness of breath, and dizziness. The EKG reveals sinus tachycardia. What is the most probable cause of the dizziness? a. An over stimulation of the parasympathetic nervous system b. An increase in cardiac output related to the increased heart rate c. A decrease in ventricular filling time d. A increase in orthostatic blood pressure 7. Eight hours after coronary artery bypass surgery, the client is nauseated, restless, and weak. The nurse checks the client’s cardiac monitor and notes Tall Peaked T-Waves. The nurse suspects that the client is most likely experiencing symptoms of a. hypermagnesemia. b. hypomagnesemia. c. hyperkalemia. d. hypokalemia. 8. Your client has had an extensive myocardial infarction. Their clinical course was complicated by cardiogenic shock. Which invasive device could be used to help improve the cardiac output? a. Swan-Ganz/pulmonary artery flow-directed catheter b. Central line for central venous pressure monitoring c. Intra-aortic balloon pump d. Temporary transvenous pacemaker 9. Which intervention would best increase contractility of the heart? a. Starting the client on lanoxin (Digoxin) b. Initiating a nitroglycerine (Tridil) drip c. Administering verapamil (Calan) d. Administering diltiazem (Cardizem)

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