Fy2016 - RN Annual Rhythm Examination - BLS Providers (Please Provide You First And Last Name Only; No Initials. )

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  • 1/21 Questions

    The telemetry technicians notifies you of your patients rhythm changing from Normal Sinus in the 80's to Sinus Tachycardia in the 150's. Your initial nursing action is to....

    • Assess the patient, recent medications and other causes
    • Call 7911 - this is a lethal rhythm
    • Remove the telemetry monitor to avoid the disruptive calls from telemetry
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About This Quiz

This quiz, designed for BLS providers in FY2016, assesses the ability to identify cardiac rhythms, distinguishing lethal from non-lethal types, and appropriate responses to cardiac emergencies. It focuses on practical skills like electrode placement and rhythm interpretation crucial for patient care.

Fy2016 - RN Annual Rhythm Examination - BLS Providers (Please Provide You First And Last Name Only; No Initials. ) - Quiz

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  • 2. 

    After assessing your patients you then call telemetry for a recent report. The telemetry technician notifies you your patient has had no changes and is in Normal Sinus Rhythm. When you go into the patients room you find him unconscious and pulseless. This patient is experiencing Pulseless Electrical Activity and your immediate nursing action is to...

    • Call telemetry to confirm their reading.

    • Initiate CPR and call a Dr. Heart

    • Attempt to awaken patient with a sternal rub or ammonia capsule

    • Write up the telemetry technition for providing you with false information

    Correct Answer
    A. Initiate CPR and call a Dr. Heart
    Explanation
    Pulseless electrical activity also called electrical-mechanical disassociation - will produce an electrical rhythm on the monitor; however, the heart has ceased to mechanically contract to produce a pulse / BP. PEA / EMD is a lethal rhythm. Urgent CPR is the treatment of choice.

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  • 3. 

    I pledge to demonstrate the core values of the American Nurses Association Code of Ethics by upholding the standards of honesty and integrity. By answering yes, you certify that you are the person taking this test.

    • Yes

    • No

    Correct Answer
    A. Yes
    Explanation
    The given correct answer is "Yes" because by selecting "Yes", the individual is confirming that they pledge to demonstrate the core values of the American Nurses Association Code of Ethics by upholding the standards of honesty and integrity. Additionally, they are certifying that they are the person taking the test.

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  • 4. 
    Identify the lethal rhythm.  - ProProfs

    Identify the lethal rhythm. 

    • Pulseless electrical activity

    • Torsades de pointe

    • Asystole

    • Sinus bradycardia

    Correct Answer
    A. Asystole
    Explanation
    Asystole is cardiac standstill with no cardiac output and no ventricular depolarization.

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  • 5. 
    Identify the cardiac rhythm as being lethal or non-lethal. - ProProfs

    Identify the cardiac rhythm as being lethal or non-lethal.

    • Non - lethal

    • Lethal

    Correct Answer
    A. Non - lethal
    Explanation
    Rhythm = Sinus bradycardia with first degree AV heart block. This is s stable rhythm.

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  • 6. 

    False alarms can lead to rhythm misinterpretation. The following are way to decrease/troubleshoot false alarms. Check all that apply.

    • Prepare skin prior to placement of electrodes

    • Ensure lead placement is correct

    • Use surgical scrub on entire chest

    • Place leads in the appropriate sites

    Correct Answer(s)
    A. Prepare skin prior to placement of electrodes
    A. Ensure lead placement is correct
    A. Place leads in the appropriate sites
    Explanation
    Troubleshooting false alarms makes for a safer / quieter environment for all.

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  • 7. 

    Your patient is taking warfarin (coumadin) for treatment of Atrial Fibrillation. His rhythm on the cardiac monitor reads Atrial Fibrillation, Heart Rate 85. Your initial nursing action is to...

    • Notify MD

    • Call a Rapid Response

    • Instruct patient to vagal down and prepare for mechanical or chemical cardioversion

    • Check vital signs including & apical pulse; continue to monitor

    Correct Answer
    A. Check vital signs including & apical pulse; continue to monitor
    Explanation
    The goals for chronic A-fib include controlled heart rate and therapeutic anticoagulation. HR of 85 is considered controlled.

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  • 8. 

    After admitting a patient and placing them on telemetry you interpret the rhythm as atrial fibrillation.  Your intial nurisng actions are to [CHECK ALL THAT APPLY]

    • Initiate CPR

    • Call a Rapid Response

    • Check the patient including vital signs

    • Determine if this is an existing condition or not

    Correct Answer(s)
    A. Check the patient including vital signs
    A. Determine if this is an existing condition or not
    Explanation
    Atrial fibrillation is the most common dysrhythmia seen. The atria do not contract as evidenced by the wavy baseline and no P wave. Random signals get thru the AV node resulting in normal ventricular contraction. If conversion to SR is not attainable the next best goal is rate control and therapeutic anti-coagulation levels.

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  • 9. 

    Causes for sinus tachycardia include [CHECK ALL THAT APPLY]

    • Medications like cocaine, albuterol, epinephrine

    • Smoking

    • Anxiety

    • Pain

    Correct Answer(s)
    A. Medications like cocaine, albuterol, epinephrine
    A. Smoking
    A. Anxiety
    A. Pain
    Explanation
    Sinus tachycardia refers to a faster than normal heart rate originating from the sinus node in the heart. This can be caused by various factors, including medications such as cocaine, albuterol, and epinephrine, which can stimulate the heart and increase its rate. Smoking can also contribute to sinus tachycardia due to the nicotine and other chemicals affecting the cardiovascular system. Anxiety and pain can both trigger a stress response in the body, leading to an increased heart rate. Therefore, all of the listed options can cause sinus tachycardia.

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  • 10. 

    Telemetry calls and tells you Mr. Smith's leads are off and the battery needs to be changed. What do you do? Check all that apply:

    • Place the leads on cleaned skin

    • Change the battery

    • Assess to determine if additional hair needs to be clipped or cut from the area where leads should be placed.

    • Put the leads on the easy to reach spots on the chest - lead placement is irrelevant

    Correct Answer(s)
    A. Place the leads on cleaned skin
    A. Change the battery
    A. Assess to determine if additional hair needs to be clipped or cut from the area where leads should be placed.
    Explanation
    Proper skin preparation (clipping hair/cleaning w/alcohol/skin prep) and lead placement is important for proper transmission of rhythms. Changing the battery allow for transmission.

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  • 11. 
    Identify the rhythm strip. - ProProfs

    Identify the rhythm strip.

    • PEA (pulseless electrical activity)

    • Sinus tachycardia

    • Ventricular tachycardia

    • Torsades de pointe

    Correct Answer
    A. Torsades de pointe
    Explanation
    Torsades de Pointes is an uncommon variant of ventricular tachycardia that can be the result of lengthening the QT interval. Torsades refers to the repeating continuum of upward then downward pointing ventricular complexes.

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  • 12. 

    You notify the MD that the patient has a rhythm change; s/he asks if the patient is symptomatic; what does symptomatic mean? Check all that apply.

    • Decreased Blood Pressure

    • Altered Mental Status

    • Increased Appetite

    • Chest Pain

    • Diaphoretic

    Correct Answer(s)
    A. Decreased Blood Pressure
    A. Altered Mental Status
    A. Chest Pain
    A. Diaphoretic
    Explanation
    All the above (except increase appetite) are signs of an unstable patient. Knowing the clinical signs of an unstable patient allows you to “CLEARLY" communicate to the medical team the gravity of the situation. When notifying them the MD, request that s/he come to the pt's bedside ASAP or call a RRT.

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  • 13. 
    Identify the cardiac rhythm. - ProProfs

    Identify the cardiac rhythm.

    • Normal Sinus Rhythm

    • Atrial Fibrillation

    • Atrial Flutter

    • Sinus Bradycardia

    Correct Answer
    A. Atrial Fibrillation
    Explanation
    Atrial fibrillation is the most common dysrhythmia seen. the atria do not contract as evidenced by the wavey baseline and no P wave. random signals get thru the AV node resulting in normal ventricular contraction. if conversion to SR is not attainable the next best goal is rate control and therapeautic anti-coagulation levels.

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  • 14. 
    Identify the rhythm strip.  - ProProfs

    Identify the rhythm strip. 

    • Ventricular tachycardia

    • Ventricular fibrillation

    Correct Answer
    A. Ventricular tachycardia
    Explanation
    VT is a lethal rhythm; however, because it is so regular, the heart may continue a 'normal' cardiac cycle resulting in a pulse / BP. YOU WON"T KNOW UNTIL YOU CHECK THE PT! If the patient is conscious w/ this rhythm - check VS, have him vagal - CALL MD, ASAP. If the patient is unconscious w/ this rhythm: call for help, start CPR, place on AED, ASAP.

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  • 15. 

    Causes for sinus bradycardia include [CHECK ALL THAT APPLY]

    • Medications like beta blockers

    • Well conditioned heart (like an athlete)

    • As a result of a vasovagal response - from vomiting or coughing

    • Smoking

    Correct Answer(s)
    A. Medications like beta blockers
    A. Well conditioned heart (like an athlete)
    A. As a result of a vasovagal response - from vomiting or coughing
    Explanation
    Knowing the causes of bradycardia allows for appropriate patient care. Decreasing the heart rate w/ medications decreases the myocardial workload and oxygen demand. Brady rhythms are OK as long as the patient isn't symptomatic.

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  • 16. 

    What are the signs and symptoms of hypoxia?  Check all that apply.

    • Altered Mental Status

    • Decreased O2 Level

    • Cyanosis

    • Tachycardia

    Correct Answer(s)
    A. Altered Mental Status
    A. Decreased O2 Level
    A. Cyanosis
    A. Tachycardia
    Explanation
    All the above are signs of hypoxia - knowing these will enable you to better manage the care for this patient as well communicate the patient's condition to the medical team.

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  • 17. 

    When should the nurse obtain an apical pulse and NOT rely upon the vital sign machine for heart rate. Check all that apply.

    • Irregular Heart Rhythm

    • Normal Sinus Rhythm

    • Atrial Fibrillation

    • Prior to administration of cardiac medications

    Correct Answer(s)
    A. Irregular Heart Rhythm
    A. Atrial Fibrillation
    A. Prior to administration of cardiac medications
    Explanation
    Apical pulses are indicated for irregular rhythms, including A-fib or prior to the administration of cardiac meds like Digoxin or beta blockers. VS machines may not provide an accurate HR reading b/c not all cardiac impulses in an irregular rhythm may be perfused peripherally.

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  • 18. 

    List appropriate interventions for a patient who is hypoxic. Check all that apply.

    • Sit in upright position

    • Place patient in prone position

    • Call respiratory to administer hand held nebulizer if ordered PRN or due soon

    • Cough and Deep Breath

    • Ascultate bilateral breath sounds

    Correct Answer(s)
    A. Sit in upright position
    A. Call respiratory to administer hand held nebulizer if ordered PRN or due soon
    A. Cough and Deep Breath
    A. Ascultate bilateral breath sounds
    Explanation
    ressoving hypoxia by sitting the patient in high fowlers, opening constricted airways, opening collapsed alveoli and being proacive for early signes of heart failure / pulmonary edema / pneumonia - will help the patient the paitnet towards a more speedy recovery.

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  • 19. 
    You see this rhythm on the screen. Your response is - [CHECK ALL THAT APPLY] - ProProfs

    You see this rhythm on the screen. Your response is - [CHECK ALL THAT APPLY]

    • Check the patient ASAP, this looks like the lethal rhythm Torsades de Pointe

    • Wait for Telemetry to call and tell you what to do

    • Anticipate CPR / using the AED / caling a Dr. Heart

    • VOCERA the primary nurse to check the patient - it's probably just artifact

    Correct Answer(s)
    A. Check the patient ASAP, this looks like the lethal rhythm Torsades de Pointe
    A. Anticipate CPR / using the AED / caling a Dr. Heart
    Explanation
    assume the worst - this is torsades de pointe until proven otherwise. it is a lethal rhythm - follow BLS / ACLS protocols - call for help - start CPR - attach AED - early defibrillation is the best treament for survival

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  • 20. 
    Identify the lethal rhythm. - ProProfs

    Identify the lethal rhythm.

    • Ventricular tachycardia

    • Ventricular fibrillation

    • PEA (pulseless electrical activity)

    • Torsades de pointe

    Correct Answer
    A. PEA (pulseless electrical activity)
    Explanation
    Pulseless electrical activity (PEA) is a clinical condition characterized by unresponsiveness and lack of palpable pulse in the presence of organized cardiac electrical activity. Pulseless electrical activity has previously been referred to as electromechanical dissociation (EMD).

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Quiz Review Timeline (Updated): Feb 1, 2023 +

Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

  • Current Version
  • Feb 01, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Dec 01, 2015
    Quiz Created by
    Milly
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