In atrial flutter, flutter waves form a sawtooth pattern between the QRS complexes.
Correct Answer
True
True. In atrial flutter the atria fire rapidly and regularly, producing sawtooth flutter waves in place of P waves, and the ventricles respond at a fixed ratio.
Category: Dysrhythmia Basics
Question 2
Sustained ventricular tachycardia produces narrow QRS complexes on the ECG.
Correct Answer
False
False. Ventricular tachycardia originates in the ventricles, outside the normal conduction pathway, so impulses spread slowly cell to cell and produce wide QRS complexes. Sustained ventricular tachycardia can cause hemodynamic compromise and requires advanced cardiac life support.
Category: Dysrhythmia Basics
Question 3
Ventricular fibrillation causes cardiac arrest because the ventricles quiver instead of pumping blood.
Correct Answer
True
True. In ventricular fibrillation chaotic impulses make the ventricles quiver without effective contraction, so there is no cardiac output. It is a medical emergency treated with advanced cardiac life support.
Category: Dysrhythmia Basics
Question 4
Tachycardia lengthens ventricular filling time, which increases stroke volume.
Correct Answer
False
False. A fast heart rate shortens ventricular filling time, which lowers stroke volume and cardiac output while raising the heart's workload. Prolonged tachycardia can even lead to cardiomyopathy.
Category: Dysrhythmia Basics
Question 5
Immediate-release quinidine sulfate and extended-release quinidine gluconate cannot be substituted for each other.
Correct Answer
True
True. The two quinidine salts are separate products with different release patterns and are not interchangeable, so the nurse confirms the exact product ordered and does not substitute one for the other.
Category: Class I Sodium Blockers
Question 6
Lidocaine with epinephrine can be used in place of plain IV lidocaine to treat a ventricular dysrhythmia.
Correct Answer
False
False. Lidocaine with epinephrine is a local anesthetic product and must never be used as an antidysrhythmic; a death has been reported when it was given in place of the IV form. Only plain lidocaine made for IV use is given for ventricular dysrhythmias.
Category: Class I Sodium Blockers
Question 7
Esmolol has a very short half-life, which makes its IV infusion easy to titrate.
Correct Answer
True
True. Esmolol is a beta-1 selective blocker given by continuous IV infusion, and its very short half-life lets the dose be adjusted quickly and its effects fade soon after the infusion stops. It is used for short-term control of tachycardia, such as during and after surgery.
Category: Class II Beta Blockers
Question 8
Metoprolol succinate is the immediate-release form of metoprolol.
Correct Answer
False
False. Metoprolol succinate is the extended-release tablet, while metoprolol tartrate is the immediate-release tablet; an IV form also exists. Confusing the forms can cause dosing errors, so the nurse checks the salt on every order.
Category: Class II Beta Blockers
Question 9
Because amiodarone leaves the body very slowly, its adverse effects can persist for months after the drug is stopped.
Correct Answer
True
True. Amiodarone has a very long half-life and builds up in body tissues, so toxicity monitoring continues for several months after it is discontinued.
Category: Class III Potassium Blockers
Question 10
Sotalol is a pure potassium channel blocker with no beta-blocking effects.
Correct Answer
False
False. Sotalol blocks potassium channels and also blocks beta receptors, which is why its name ends in -lol like other beta blockers. Its beta-blocking effects can cause bradycardia, hypotension and fatigue, so it is used cautiously in clients with asthma or heart failure.
Category: Class III Potassium Blockers
Question 11
Dofetilide is excreted by the kidneys, so creatinine clearance is calculated before the drug is started.
Correct Answer
True
True. Dofetilide is renally excreted, and severe renal impairment is a contraindication, so kidney function guides whether and how it is used. Potassium and magnesium are also checked and replaced first.
Category: Class III Potassium Blockers
Question 12
Ibutilide is taken as a daily oral tablet to maintain sinus rhythm over the long term.
Correct Answer
False
False. Ibutilide is given only IV, for short-term use, to convert recent-onset atrial fibrillation or flutter to sinus rhythm. It has no role in chronic maintenance therapy.
Category: Class III Potassium Blockers
Question 13
Dronedarone is contraindicated in permanent atrial fibrillation that cannot be converted to sinus rhythm.
Correct Answer
True
True. A boxed warning states that dronedarone increases the risk of death, stroke and heart failure hospitalization in permanent atrial fibrillation. It is also contraindicated in symptomatic heart failure with recent decompensation and in pregnancy.
Category: Class III Potassium Blockers
Question 14
All extended-release oral diltiazem generic products are bioequivalent and can be freely interchanged.
Correct Answer
False
False. Many oral diltiazem generics are not bioequivalent to one another, so switching products can change the drug's effect. The nurse takes an exact medication history and avoids mixing up products.
Category: Class IV Calcium Blockers
Question 15
Atropine may fail to raise the heart rate of a heart transplant recipient because the transplanted heart lacks vagal innervation.
Correct Answer
True
True. Atropine works by blocking vagal input to the heart, and a transplanted heart has no vagal nerve supply, so the drug may not correct bradycardia. The nurse checks transplant status before giving it.
Category: Unclassified Antidysrhythmics
Question 16
Atropine relieves urinary retention in a client with benign prostatic hyperplasia.
Correct Answer
False
False. Atropine's anticholinergic action can cause complete urinary retention, and the risk is highest in a client with benign prostatic hyperplasia, so it is used with caution in clients who already have trouble emptying the bladder. Clients report difficulty urinating along with dry mouth and constipation.
Category: Unclassified Antidysrhythmics
Question 17
Adenosine is contraindicated in a client with second- or third-degree AV block who has no pacemaker.
Correct Answer
True
True. Adenosine slows AV node conduction, so it can worsen existing heart block. It is also avoided in bradycardia when no pacemaker is present.
Category: Unclassified Antidysrhythmics
Question 18
Adenosine should be injected slowly to prevent a brief pause in the heart rhythm.
Correct Answer
False
False. Adenosine is given as a rapid IV bolus through the port closest to the heart and followed at once by a rapid saline flush, because it is cleared within seconds. A brief pause on the monitor after the bolus is an expected effect.
Category: Unclassified Antidysrhythmics
Question 19
Digoxin can be useful for a client who has both heart failure with reduced ejection fraction and atrial fibrillation.
Correct Answer
True
True. Digoxin is used for rate control in atrial fibrillation and for heart failure with reduced ejection fraction, so it can serve clients with both conditions when many other antidysrhythmics are contraindicated.
Category: Unclassified Antidysrhythmics
Question 20
The Vaughan Williams system groups antidysrhythmic drugs by their chemical structure.
Correct Answer
False
False. The Vaughan Williams system groups antidysrhythmics by primary mechanism: class I sodium channel blockers, class II beta blockers, class III potassium channel blockers and class IV calcium channel blockers. It is imperfect because many drugs have more than one mechanism.
Category: Dysrhythmia Basics