Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025), Exams of Nursing

Download Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) and more Exams Nursing in PDF only on Docsity! Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) You are the nurse working on the telemetry unit and you have finally gotten to sit down to work on some charting. Suddenly the heart monitors at the station start beeping. Patient in room 18 is showing this rhythm on the monitor. The medical team advances together into the room and finds them unconscious. What is priority action by the nurse? A) Prepare to administer adenosine to the patient B) Begin chest compressions C) Prepare for defibrillation D) Check for a pulse - Correct Answer ✅Answer: D. A pulse would be assessed for first. Then the patient will be defibrillized and chest compressions will begin immediately. The nurse sees the following rhythm on the monitor. Which of the following lab values does the nurse identify as being most likely to have caused this dysrhythmia? a) K 3.0 b) Ca 10.5 Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) c) Hgb 9 d) Magnesium 2.1 - Correct Answer ✅Answer: C. Anemia can contribute to sinus tachycardia. The patient who has recently been experiencing runs of ventricular tachycardia suddenly loses consciousness. The patient is defibrillated, and the rate returns as the following. What should the nurse do first? A) Begin compressions B) Shock the client again immediately C) Prepare for intubation D) Administer adenosine - Correct Answer ✅Answer: A. Following defibrillation, CPR is immediately initiated if a perfusable rhythm is not initiated. The client may need to be shocked again, but chest compressions must begin first. Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) must be on hand. An ekg monitor should be in the room to monitor the effectiveness of the medication. The nurse has just administered adenosine via IV push and sees the following rhythm on the monitor. What is the nurse's priority intervention? a) Apply conductive gel and defibrillate the patient b) Document the findings and continue to monitor c) Administer another mg of the medication d) Begin chest compressions - Correct Answer ✅Answer: B. This finding would be expected upon administration of adenosine. The rhythm should then begin again in some other rhythm, hopefully normal sinus rhythm. It would be important to document the exact time of this change and continue to monitor the change back to NSR. If this change does not occur, or if another rhythm is produced, appropriate action would then be taken based on the result. Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) You, the nurse, note the following rhythm on the EKG monitor for a patient named billy. What is the first thing the nurse should do? a) Check for a pulse b) Tell Billy to try to poop c) Prepare to defibrillate billy d) Prepare to administer Amiodorone - Correct Answer ✅Answer: B. With SVT (Supraventricular tachycardia), the first thing to do would be to instruct the pt. to perform the Valsalva maneuver by bearing down. A group of nursing students are discussing atrial flutter. These students recognize that which of the following are seen with atrial flutter? Select all that apply: 1) Ventricular rate of 220-300 bpm. 2) Regular rhythm 3) Saw-tooth pattern 4) Measurable PR interval 5) Long QRS interval - Correct Answer ✅Answer(s): 2, 3 Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) The ATRIAL rate is 220-300 bpm. Ventricular is about 75- 150. The rhythm is regular, with the P wave appearing as little flutter or a "saw tooth pattern". The PR interval is not measurable r/t this saw-tooth P wave. The QRS is normal. A nursing student is aware that which of the following is the treatment for unstable atrial flutter? 1) Adenosine (Adenocard) 6 mg rapid IVP. 2) Cardioversion with adjacent Heparin therapy 3) Defibrillation STAT followed by CPR. 4) Altemose 3 mg IVP over 1-2 seconds. - Correct Answer ✅Answer: 2) Cardioversion is used if the patient is unstable. Anticoagulants are used if the arrhythmia has stuck around for 48 hr +. Adenosine may be used with a narrow QRS and regular RR interval. I made up Altemose. Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) 1) Atropine 2) Defibrillation 3) Amiodarone 4) Adenosine - Correct Answer ✅Answer: 3) This is describing ventricular tachycardia (QRS is a giveaway), and the treatment for a stable patient is Amiodarone or cardioversion. If the patient were unstable, we'd go ahead and defibrillate. The nurse in the intensive care unit (ICU) hears an alarm sound in the patient's room. Arriving in the room, the patient is unresponsive, without a pulse, and a flat line on the monitor. What is the first action by the nurse? a) Administer atropine 0.5 mg b) Administer epinephrine c) Defibrillate with 360 joules Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) d) Begin cardiopulmonary resuscitation (CPR) - Correct Answer ✅Answer: d) We cannot defibrillate asystole. A A group of nursing students are studying AV blocks and ask their instructor, "what causes a first-degree block?" The nursing instructor responds that which of the following can cause a first-degree block: Select all that apply 1) Diarrhea 2) Chronic constipation 3) Diltiazem 4) Digoxin 5) Metoprolol - Correct Answer ✅Answer(s): 2, 3, 4, 5 Diarrhea will not stimulate a vagal response, but vomiting can. Chronic constipation will cause a consistent vagal response. Digoxin, beta blockers, and calcium channel Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) blockers can all contribute to first degree blocks. Relate this to bradycardia. A 26-year-old client with atrial fibrillation that has not responded to medication therapy has arrived at the hospital for an elective cardioversion. Which of the following patient statements most concerns the nurse? 1) "I can't wait to stop taking this Coumadin. I've been on this crap for weeks now." 2) "I'm starving. I haven't eaten anything in 3 hours." 3) "I feel really short of breath, can I lie down?" 4) "I haven't taken my Digoxin since 9 o'clock last night. Is that okay?" - Correct Answer ✅Answer: 3 Patients with atrial fibrillation are at incredibly high risk for clots, even with anticoagulation therapy. Shortness of breath could indicate a PE, and this should be immediately investigated by the nurse. The patient should be NPO for at least 4 hr. prior to the procedure related to anesthesia use, but this is not as urgent of a Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) A - Correct Answer ✅A client's electrocardiogram strip shows atrial and ventricular rates of 80 complexes per minute. The PR interval is 0.14 second, and the QRS complex measures 0.08 second. The nurse interprets this rhythm is: A) Normal sinus rhythm B) Sinus bradycardia C) Sinus tachycardia D) Sinus dysrhythmia D Ventricular tachycardia is a life-threatening dysrhythmia that results from an irritable ectopic focus that takes over as the pacemaker for the heart. The low cardiac output that results can lead quickly to cerebral and myocardial ischemia. Client's frequently experience a feeling of impending death. Ventricular tachycardia is treated with Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) antidysrhythmic medications or magnesium sulfate, cardioversion (client awake), or defibrillation (loss of consciousness), Ventricular tachycardia can deteriorate into ventricular defibrillation at any time. - Correct Answer ✅A client has frequent bursts of ventricular tachycardia on the cardiac monitor. A nurse is most concerned with this dysrhythmia because: A) It is uncomfortable for the client, giving a sense of impending doom. B) It produces a high cardiac output that quickly leads to cerebral and myocardial ischemia. C) It is almost impossible to convert to a normal sinus rhythm. D) It can develop into ventricular fibrillation at any time. BCD Amiodarone causes prolongation of the QT interval, which can precipitate dysrhythmia. Antidysrhythmic medications cause changes in cardiac rhythm and rate; Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) therefore monitoring of heart rate and rhythm is needed.Electrolyte depletion, specifically potassium and magnesium, may predispose to further dysrhythmia. Although it is always important to monitor vital signs and urine output, these assessments are not specific to amiodarone. - Correct Answer ✅The nurse administers amiodarone (Cordarone) to a client with ventricular tachycardia. Which monitoring by the nurse is necessary with this drug? Select all that apply. a. Respiratory rate b. QT interval c. Heart rate and rhythm d. Magnesium level e. Urine output B The effects of metoprolol are to decrease heart rate, blood pressure, and myocardial oxygen demand. ST Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) Answer ✅The nurse is caring for a client on a telemetry unit with a regular heart rhythm and rate of 60; a P wave precedes each QRS complex, and the PR interval is 0.24 second. Additional vital signs are as follows: blood pressure 118/68, respiratory rate 16, and temperature 98.8° F. The following medications are available on the medication record. What action should the nurse take? a. Administer atropine. b. Administer digoxin. c. Administer clonidine. d. Continue to monitor. A This client has a stable, asymptomatic dysrhythmia, which usually requires no treatment; this client can be managed by a nurse with less cardiac dysrhythmia training. - Correct Answer ✅You are the charge nurse on the telemetry unit and are responsible for making client Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) assignments. Which client would be appropriate to assign to the float RN from the medical-surgical unit? a. The 64-year-old admitted for weakness who has a first- degree heart block with a heart rate of 58 beats/min b. The 71-year-old admitted for heart failure who is short of breath and has a heart rate of 120 to 130 beats/min c. The 88-year-old admitted with an elevated troponin level who is hypotensive with a heart rate of 96 beats/min d. The 92-year-old admitted with chest pain who has premature ventricular complexes and a heart rate of 102 beats/min C - Correct Answer ✅A client with atrial fibrillation with rapid ventricular response has received medication to slow the ventricular rate. The pulse is now 88. For which additional therapy does the nurse plan? a. Synchronized cardioversion Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) b. Electrophysiology studies (EPS) c. Anticoagulation d. Radiofrequency ablation therapy B The nurse needs to assess the client to determine stability before proceeding with further interventions. If the client has a pulse and is relatively stable, elective cardioversion or antidysrhythmic medications may be prescribed. - Correct Answer ✅The nurse is caring for a client with unstable angina whose cardiac monitor shows ventricular tachycardia. Which action is appropriate to implement first? a. Defibrillate the client at 200 J. b. Check the client for a pulse. c. Cardiovert the client at 50 J. d. Give the client IV lidocaine. Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) c. A P wave precedes every QRS complex. d. The ST segment is elevated. ABE The Valsalva maneuver stimulates the vagus nerve, causing bradycardia. Inferior wall MI is a cause of bradycardia and heart blocks. Calcium channel blockers such as diltiazem may cause bradycardia. - Correct Answer ✅The nurse is caring for a client who has developed a bradycardia. Which possible causes should the nurse investigate? Select all that apply a. Bearing down for a bowel movement b. Possible inferior wall myocardial infarction (MI) c. Client stating that he just had a cup of coffee d. Client becoming emotional when visitors arrived e. Diltiazem (Cardizem) administered an hour ago Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) D Sinus rhythm presents with heart rates from 60 to 100 beats/min; by definition, the bradydysrhythmia has resolved. - Correct Answer ✅How does the nurse recognize that atropine has produced a positive outcome for the client with bradycardia? a. Client states he is dizzy and weak. b. The nurse notes dyspnea. c. The client has a heart rate of 42. d. The monitor shows sinus rhythm. BCD - Correct Answer ✅The nurse teaches a client with new-onset atrial fibrillation that risk factors for this dysrhythmia may include which? Select all that apply. a. Use of beta-adrenergic blockers b. Excessive alcohol use Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) c. Advancing age d. High blood pressure e. Palpitations C - Correct Answer ✅What teaching does the nurse include for a client with atrial fibrillation who has a new prescription for warfarin? a. It is important to consume a diet high in green leafy vegetables. b. You should take aspirin or ibuprofen for headache. c. Report nosebleeds to your provider immediately. d. Avoid caffeinated beverages. A Defibrillation interrupts the heart rhythm and allows normal pacemaker cells to take over: in asystole, there is no rhythm to interrupt; therefore this intervention is not Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) a. Normal sinus rhythm b. Sinus bradycardia c. Sinus rhythm with first-degree atrioventricular (AV) block d. Sinus rhythm with premature ventricular contractions D - Correct Answer ✅The nurse is teaching the client with a new permanent pacemaker. Which statement by the client indicates the need for further discharge education? a. "I will be able to shower again soon." b. "I need to take my pulse every day." c. "I might trigger airport security metal detectors." d. "I no longer need my heart pills."' B - Correct Answer ✅The nurse is caring for a client with unstable angina whose cardiac monitor shows ventricular Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) tachycardia. Which action is appropriate to implement first? a. Defibrillate using 200 J. b. Check the client for a pulse. c. Cardiovert the client at 50 J. d. Administer IV ibutilide (Corvert). B - Correct Answer ✅The nurse obtains a 6-second rhythm strip and charts the following analysis: atrial rate 70, regular; ventricular rate 40, regular; QRS 0.04 sec; no relationship between P waves and QRS complexes; atria and ventricles beating independently of each other. Which of the following would be a correct interpretation of this rhythm strip? a. Sinus dysrhythmias b. Third-degree heart block c. Wenckebach phenomenon Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) d. Premature ventricular contractions C After pacemaker insertion, it is important for the patient to limit activity of the involved arm to minimize pacemaker lead displacement. The nonpressure dressing is kept dry until removed, usually 24 hours postoperative. It is important for the nurse to observe signs of infection by assessing for any redness, swelling, or discharge from the incision site. - Correct Answer ✅The nurse is caring for a patient who is 24 hours postpacemaker insertion. Which of the following nursing interventions is most appropriate at this time? a. Reinforcing the pressure dressing as needed b. Encouraging range-of-motion exercises of the involved arm c. Assessing the incision for any redness, swelling, or discharge Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) d. β-Adrenergic blockers and dopamine C VT is associated with a rate of 150 to 250 beats/min; the P wave is not normally visible. P wave inversion and a normal QRS complex are not associated with VT. Rate and rhythm are not measurable in ventricular fibrillation. - Correct Answer ✅Which of the following ECG characteristics is consistent with a diagnosis of ventricular tachycardia (VT)? a. Unmeasurable rate and rhythm b. Rate 150 beats/min; inverted P wave c. Rate 200 beats/min; P wave not visible d. Rate 125 beats/min; normal QRS complex 3 - Correct Answer ✅One hour after administering IV furosemide (Lasix) to a client with heart failure, a short burst of ventricular tachycardia appears on the cardiac Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) monitor. Which of the following electrolyte imbalances should the nurse suspect? 1.Hypocalcemia 2.Hypermagnesemia 3.Hypokalemia 4.Hypernatremia A The P wave represents the depolarization of the atria. The P-R interval represents depolarization of the atria, atrioventricular (AV) node, bundle of His, bundle branches, and the Purkinje fibers. The QRS represents ventricular depolarization. The Q wave is the first negative deflection following the P wave and should be narrow and short. - Correct Answer ✅To determine whether there is a delay in impulse conduction through the atria, the nurse will measure the duration of the patient's Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) a.P wave. b.Q wave. c.P-R interval. d.QRS complex. D - Correct Answer ✅The nurse needs to quickly estimate the heart rate for a patient with a regular heart rhythm. Which method will be best to use? a.Count the number of large squares in the R-R interval and divide by 300. b.Print a 1-minute electrocardiogram (ECG) strip and count the number of QRS complexes. c.Calculate the number of small squares between one QRS complex and the next and divide into 1500. d.Use the 3-second markers to count the number of QRS complexes in 6 seconds and multiply by 10. Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) D The burst of sustained ventricular tachycardia indicates that the patient has significant ventricular irritability, and antidysrhythmic medication administration is needed to prevent further episodes. The nurse should notify the health care provider after the medication is started. Defibrillation is not indicated given that the patient is currently in a sinus rhythm. Documentation and continued monitoring are not adequate responses to this situation. - Correct Answer ✅A patient who was admitted with a myocardial infarction experiences a 45- second episode of ventricular tachycardia, then converts to sinus rhythm with a heart rate of 98 beats/minute. Which of the following actions should the nurse take next? a.Immediately notify the health care provider. b.Document the rhythm and continue to monitor the patient. Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) c.Perform synchronized cardioversion per agency dysrhythmia protocol. d.Prepare to give IV amiodarone (Cordarone) per agency dysrhythmia protocol. A Atropine will increase the heart rate and conduction through the AV node. Because the medication increases electrical conduction, not cardiac contractility, the quality of the peripheral pulses is not used to evaluate the drug effectiveness. The patient does not have premature atrial or ventricular contractions. - Correct Answer ✅After the nurse gives 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.Increase in strength of peripheral pulses c.Decrease in premature atrial contractions Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) d.Decrease in premature ventricular contractions D The patient is instructed to avoid lifting the arm on the pacemaker side above the shoulder to avoid displacing the pacemaker leads. The patient should notify airport security about the presence of a pacemaker before going through the metal detector, but there is no need to notify the airlines when making a reservation. Microwave oven use does not affect the pacemaker. The insertion procedure involves minor surgery that will have a short recovery period. - Correct Answer ✅After providing a patient with discharge instructions on the management of a new permanent pacemaker, the nurse knows that teaching has been effective when the patient states a."I will avoid cooking with a microwave oven or being near one in use." b."It will be 1 month before I can take a bath or return to my usual activities." Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) b.Refer the student to a cardiologist for further diagnostic testing. c.Tell the student to stop playing immediately if any dyspnea occurs. d.Obtain more detailed information about the student's family health history. D Because the normal QRS interval is 0.04 to 0.10 seconds, the patient's QRS interval of 0.14 seconds indicates that the conduction through the ventricular conduction system is prolonged. The P-R interval and Q-T interval are within normal range, and ST segment should be isoelectric (flat). - Correct Answer ✅When analyzing the rhythm of a patient's electrocardiogram (ECG), the nurse will need to investigate further upon finding a(n) a.isoelectric ST segment. b.P-R interval of 0.18 second. Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) c.Q-T interval of 0.38 second. d.QRS interval of 0.14 second. C Because this patient has dyspnea and chest pain in association with the new rhythm, the nurse's initial actions should be to address the patient's airway, breathing, and circulation (ABC) by starting with oxygen administration. The other actions also are important and should be implemented rapidly. - Correct Answer ✅A patient who is on the progressive care unit develops atrial flutter, rate 150, with associated dyspnea and chest pain. Which action that is included in the hospital dysrhythmia protocol should the nurse do first? a.Obtain a 12-lead electrocardiogram (ECG). b.Notify the health care provider of the change in rhythm. c.Give supplemental O2 at 2 to 3 L/min via nasal cannula. Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) d.Assess the patient's vital signs including oxygen saturation. B The patient's clinical manifestations indicate pulseless electrical activity and the nurse should immediately start CPR. The other actions would not be of benefit to this patient. - Correct Answer ✅A patient whose heart monitor shows sinus tachycardia, rate 132, is apneic and has no palpable pulses. What is the first action that the nurse should take? a.Perform synchronized cardioversion. b.Start cardiopulmonary resuscitation (CPR). c.Administer atropine per agency dysrhythmia protocol. d.Provide supplemental oxygen via non-rebreather mask. D Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) such as heparin, enoxaparin, or warfarin. Sotalol, atropine, and lidocaine are not appropriate for this complication. - Correct Answer ✅A nurse evaluates prescriptions for a client with chronic atrial fibrillation. Which medication should the nurse expect to find on this client's medication administration record to prevent a common complication of this condition? a. Sotalol (Betapace) b. Warfarin (Coumadin) c. Atropine (Sal-Tropine) d. Lidocaine (Xylocaine) B In temporary pacing, the wires are threaded onto the epicardial surface of the heart and exit through the chest wall. The pacemaker spike should be followed immediately by a QRS complex. Pacing spikes seen without subsequent QRS complexes imply loss of capture. If there is no capture, then there is no ventricular Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) depolarization and contraction. The nurse should assess for cardiac output via vital signs and level of consciousness. The other interventions would not determine if the client is tolerating the loss of capture. - Correct Answer ✅A nurse cares for a client with an intravenous temporary pacemaker for bradycardia. The nurse observes the presence of a pacing spike but no QRS complex on the client's electrocardiogram. Which action should the nurse take next? a. Administer intravenous diltiazem (Cardizem). b. Assess vital signs and level of consciousness. c. Administer sublingual nitroglycerin. d. Assess capillary refill and temperature. D To avoid injury, the rescuer commands that all personnel clear contact with the client or the bed and ensures their compliance before delivery of the shock. A precordial thump can be delivered when no defibrillator is available. Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) Defibrillation is done in asynchronous mode. Equipment should not be tested before a client is defibrillated because this is an emergency procedure; equipment should be checked on a routine basis. Epinephrine should be administered after defibrillation. - Correct Answer ✅A nurse prepares to defibrillate a client who is in ventricular fibrillation. Which priority intervention should the nurse perform prior to defibrillating this client? a. Make sure the defibrillator is set to the synchronous mode. b. Administer 1 mg of intravenous epinephrine. c. Test the equipment by delivering a smaller shock at 100 joules. d. Ensure that everyone is clear of contact with the client and the bed. C Clients who use cocaine or illicit inhalants are particularly at risk for potentially fatal dysrhythmias. The other Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) drug. The apical pulse should be taken with a stethoscope so that there will be no mistake about what the heart rate actually is. - Correct Answer ✅A client with atrial fibrillation is receiving digoxin (Lanoxin). It is MOST important for the nurse to? a. Record an EKG strip after administration b. Monitor blood pressure every 4 hours c. Maintain accurate intake and output records d. Measure apical pulse prior to administration 3. easiest intervention should be first, if client doesn't respond then should could have another nurse go check - Correct Answer ✅The telemetry nurse is unable to read the telemetry monitor at the nurse's station. Which intervention should the telemetry nurse implement first? 1. Go to the client's room to check the client. 2. Instruct the primary nurse to assess the client. Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) 3. Contact the client on the client call system. 4. Request the nursing assistant to take the crash cart to the client's room. 3. activate team arrival and code care being brought - Correct Answer ✅The client shows ventricular fibrillation on the telemetry at the nurse's station. Which action should the telemetry nurse implement first? 1. Administer epinephrine IVP. 2. Prepare to defibrillate the client. 3. Call a STAT code. 4. Start cardiopulmonary resuscitation. 1. Drug of choice for dysrhythmias - Correct Answer ✅The client is experiencing multifocal premature ventricular contractions. Which antidysrhythmic medication would the nurse expect the health-care provider to order Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) for this client? 1. Lidocaine. 2. Atropine. 3. Digoxin. 4. Adenosine. 3. Patient is symptomatic, prepare for pacemaker - Correct Answer ✅The client is exhibiting sinus bradycardia, is complaining of syncope and weakness, and has a BP of 98/60. Which collaborative treatment should the nurse anticipate being implemented? 1. Administer a thrombolytic medication. 2. Assess the client's cardiovascular status. 3. Prepare for insertion of a pacemaker. 4. Obtain a permit for synchronized cardioversion. Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) 1. Prepare to insert a pacemaker. 2. Administer atropine, an antidysrhythmic. 3. Obtain a STAT electrocardiogram (ECG). 4. Notify the health-care provider. 1,3,4,5 - Correct Answer ✅The client is in ventricular fibrillation. Which interventions should the nurse implement? Select all that apply. 1. Start cardiopulmonary resuscitation. 2. Prepare to administer the antidysrhythmic adenosine IVP. 3. Prepare to defibrillate the client. 4. Bring the crash cart to the bedside. 5. Prepare to administer the antidysrhythmic amiodarone IVP. 4. there is no set treatment for tachycardia, determine cause-most likely pain in this case - Correct Answer Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) ✅The client who is one (1) day postoperative coronary artery bypass surgery is exhibiting sinus tachycardia. Which intervention should the nurse implement? 1. Assess the apical heart rate for one (1) full minute. 2. Notify the client's cardiac surgeon. 3. Prepare the client for synchronized cardioversion. 4. Determine if the client is having pain. 1. this describes normal sinus rhythm - Correct Answer ✅The client's telemetry reading shows a P wave before each QRS complex and the rate is 78. Which action should the nurse implement? 1. Document this as normal sinus rhythm. 2. Request a 12-lead electrocardiogram. 3. Prepare to administer the cardiotonic digoxin PO. 4. Assess the client's cardiac enzymes. Dysrhythmia NCLEX Questions and Answers with Rationales (Latest Update 2025) 2 - Correct Answer ✅Which client problem has priority for the client with a cardiac dysrhythmia? 1. Alteration in comfort. 2. Decreased cardiac output. 3. Impaired gas exchange. 4. Activity intolerance.