ECG UWORLD DRILLS

1. The nurse is monitoring a client following a radiofrequency catheter ablation. The nurse notes that the P waves are
not associated with the QRS complexes on the cardiac monitor. Which intervention is most appropriate at this time?

a. Call a code and begin chest compression

b. Call the rapid response team and prepare for cardioversion
c. Document the findings in the chart and continue to monitor
d. Notify the cardiologist and prepare for temporary pacing

2. A client with a permanent pacemaker with continuous telemetry calls the nurse and reports feeling lightheaded and
dizzy. The client’s blood pressure is 74/55 mmHg. What is the nurse’s priority action?

a. Administer atropine 0.5 mg IV

b. Administer dopamine 5 mcg/kg/min IV
c. Initiate transcutaneous pacing
d. Notify the HCP

3. A client in the emergency department is admitted with a diagnosis of rule out myocardial infarction. Which
laboratory test should the nurse monitor to determine if the client has had an MI?
a. D-dimer test
b. Low-density lipoprotein
c. Myoglobin
d. Troponin

4. The nurse is caring for a client who experienced an anterior wall myocardial infarction 24 hours ago. The nurse
recognizes the rhythm on the cardiac monitor as which rhythm?

a. Premature ventricular contractions

b. Sinus tachycardia
c. Ventricular fibrillation
d. Ventricular tachycardia

5. A client has just returned from the cardiac catheterization laboratory for a permanent pacemaker placement. How
should the nurse document the rhythm in the client’s cardiac monitor?

a. Atrial paced rhythm

b. Atrioventricular paced rhythm
c. Biventricular paced rhythm
d. Ventricular paced rhythm
6. A 45-year-old client with atrial fibrillation has been prescribed diltiazem. Which client outcome would best indicate
that the medication has had its intended effect?
a. Atrial fibrillation is converted to sinus rhythm
b. Blood pressure is 126/78 mm Hg
c. No signs or symptoms of stroke
d. Ventricular rate decreased from 158/min to 88/min

7. A client is admitted to the cardiac care unit with atrial fibrillation. Vital signs are shown in the exhibit. Which
prescription should the nurse perform first?
Vital signs
Temperature 98.2 F (36.8 C)
Blood pressure 120/80 mmHg
Heart rate 140/min, irregular
Respirations 18/min
SpO2 98%

a. Administer diltiazem 20 mg IVP

b. Administer rivaroxaban 20 mg PO
c. Draw blood for a thyroid function test
d. Send the client for echocardiogram

8. The house supervisor has notified the charge nurse on the intensive care unit that a bed is needed for an admission
from the emergency department. All ICU beds are currently full. Which client should the charge nurse consider as
most appropriate for transfer out of the ICU?

a.

b.

c.

d.

9. The telemetry nurse reports the cardiac monitor rhythm of 4 clients to the medical unit nurse assigned in care for
them. The nurse should assess the client with which rhythm first?
a. Atrial fibrillation with a pulse of 76/min in a client prescribed rivaroxaban
b. Bradycardia in a client with a demand pacemaker set at 70/min
c. First-degree atrioventricular block in a client prescribed atenolol
d. Sinus tachycardia in a client with gastroenteritis and dehydration

10. The nurse should plan to teach which client about the need for prophylactic antibiotics prior to dental procedure?
a. Client who had a large anterior wall myocardial infarction with subsequent heart failure
b. Client who had mitral valvuloplasty repair
c. Client with a mechanical aortic valve replacement
d. Client with mitral valve prolapse with regurgitation

11. A client with an implantable cardioverter defibrillator develops ventricular tachycardia with a pulse while admitted to
the medical-surgical unit. The ICD fires multiple times without successfully stopping the VT, causing the client to
become confused and difficult to rouse. Which action by the nurse is appropriate?
a. Attempt to stimulate a vagal response by having the client cough
b. Deactivate the client’s implantable cardioverter defibrillator with an external magnet
c. Obtain a STAT 12-lead ECG to verify cardiac rhythm
d. Prepare for synchronized cardioversion with external defibrillator
12. A nurse on the telemetry unit observes the following rhythm on the monitor of a client admitted with coronary artery
disease. What action should the nurse take first?

a. Administer atropine 0.5 mg IVP

b. Measure the client’s vital signs
c. Move the client back to bed from chair
d. Obtain a temporary pacemaker

13. The nurse is monitoring a client following a radiofrequency catheter ablation. The nurse notes that the P waves are
not associated with the QRS complexes on the cardiac monitor. Which intervention is most appropriate at this time?

a. Call a code and begin chest compression

b. Call the rapid response team and prepare for cardioversion
c. Document the findings in the chart and continue to monitor
d. Notify the cardiologist and prepare for temporary pacing

14. A nurse receives an electrocardiogram of a client with type 2 diabetes, heart failure, and hypothyroidism. Based on
the findings, which of the following medications should the nurse suspect as the most likely cause?

a. Captopril
b. Carvedilol
c. Glimepiride
d. Levothyroxine

15. The nurse working in the intensive care unit hears an alarm coming from a client room. On entering the room, the
nurse sees the rhythm displayed in the exhibit on the monitor. The nurse recognizes it as which rhythm?

a. Asystole
b. Atrial fibrillation
c. Ventricular fibrillation
d. Ventricular tachycardia

16. The nurse is reviewing the medication record of a client with atrial fibrillation. Which of the following should the
nurse monitor before giving these medications? Select all that apply.
Medication administration record
Allergies None
Medications Time
Prednisone 20 mg by mouth, daily 0900
Metoprolol 50 mg by mouth, daily 0900
Digoxin 0.5 mg by mouth, daily 1300
Enoxaparin 40 mg subcutaneously, every 12 hours 0900 and 2100

a. Digoxin level
b. Glucose
c. INR
d. Platelet count
e. Serum potassium
17. The nurse is preparing to perform cardioversion in a client in supraventricular tachycardia shown in the exhibit that
has been unresponsive to drug therapy. The client has become hemodynamically unstable. Which step is most
important in performing cardioversion?

a. Charge the defibrillator

b. Push the synchronize button
c. Sedate the client
d. Select energy level

18. The nurse is reviewing the telemetry strips of assigned clients. The rhythm strip displayed in the exhibit is given to
the nurse by the technician. The nurse recognizes it as which rhythm?

a. Atrial fibrillation
b. First-degree atrioventricular block
c. Sinus bradycardia
d. Sinus rhythm

19. A nurse in the intensive care unit is interpreting a client’s cardiac rhythm. Which rhythm should the nurse
document?

a. Atrial flutter
b. Ventricular bigeminy
c. Ventricular paced rhythm
d. Ventricular tachycardia

20. The nurse is caring for a client with end-stage heart failure. The rhythm shown in the exhibit is seen on the cardiac
monitor, and the nurse finds the client unresponsive with no palpable pulse. What is the correct interpretation of this
rhythm?

a. Asystole
b. Complete heart block
c. Disconnect lead wire
d. Pulseless electrical activity

“Everything you’ve ever wanted is on the other side of fear” – George Addair