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Det her er en gratis smagsprøve på 15 spørgsmål om hjerterytmer og hvad man gør ved hver enkelt. Den dækker de dødelige hjertestoprytmer, stødbar over for ikke-stødbar, synkroniseret kardiovertering over for defibrillering, AV-blokkene og atrial fibrillation, og den blander multiple choice, vælg alle der passer og udfyld det tomme felt. Svar på alle 15 spørgsmål, se så din score og læs forklaringen til hvert spørgsmål.
A monitored patient suddenly shows a chaotic waveform with no identifiable QRS complexes, and is unresponsive with no pulse. What should the nurse do first?
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1. A monitored patient suddenly shows a chaotic waveform with no identifiable QRS complexes, and is unresponsive with no pulse. What should the nurse do first?
- A. Give amiodarone through the existing IV
- B. Start CPR and call for the defibrillator
- C. Deliver a synchronized cardioversion
- D. Document the rhythm change and wait for the provider
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Svar: B. Start CPR and call for the defibrillator
Ventricular fibrillation is a lethal rhythm and the only two things that reverse it are early CPR and early defibrillation, so compressions start at once and continue until the pads are on and the machine is charged. If a defibrillator is already at the bedside in a witnessed arrest, the shock goes first, and drugs come later in the algorithm.
2. Complete the sentence.
In cardiac arrest, the two rhythms that a shock can treat are _____.
Muligheder for felt 1: asystole and pulseless electrical activity, ventricular fibrillation and pulseless ventricular tachycardia, atrial fibrillation and atrial flutter, sinus bradycardia and first degree AV block
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Svar: ventricular fibrillation and pulseless ventricular tachycardia
Defibrillation works by stopping all electrical activity at once so the heart's own pacemaker can restart an organized rhythm, which only helps when the problem is disorganized ventricular activity. Asystole and pulseless electrical activity are non-shockable and get CPR, epinephrine and a search for the cause instead.
3. The monitor shows a flat line and the patient has no pulse. Which action is correct?
- A. Defibrillate as soon as the machine is charged
- B. Perform synchronized cardioversion
- C. Confirm the flat line in a second lead, continue CPR and give epinephrine
- D. Give adenosine by rapid IV push
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Svar: C. Confirm the flat line in a second lead, continue CPR and give epinephrine
Asystole is not shockable, so the work is high quality CPR, epinephrine and a hunt for a reversible cause. Checking another lead matters because a loose electrode, a disconnected cable or very fine ventricular fibrillation can all look like a flat line in one view.
4. During a code, compressions are paused for a rhythm check and the monitor shows a narrow, organized rhythm at about 70. What should the team do next?
- A. Deliver an unsynchronized shock
- B. Check for a pulse, and resume compressions at once if there is none
- C. Stop the code, since an organized rhythm means circulation is back
- D. Give adenosine to slow the rhythm down
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Svar: B. Check for a pulse, and resume compressions at once if there is none
An organized rhythm on the screen only proves that the conduction system is firing, so return of circulation is confirmed by a pulse and nothing else. No pulse with an organized rhythm is pulseless electrical activity, which is non-shockable and gets immediate compressions, epinephrine and a search for the cause such as blood loss or a tension pneumothorax.
5. Which of the following are reversible causes to look for in pulseless electrical activity?
Vælg alle, der passer.
- A. Hypovolemia
- B. Hypoxia
- C. Cardiac tamponade
- D. Hypertension
- E. Hyperglycemia
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Svar: A. Hypovolemia, B. Hypoxia, C. Cardiac tamponade
Pulseless electrical activity is treated by finding and fixing the cause, which resuscitation courses group as the Hs and Ts: hypovolemia, hypoxia, acidosis, low or high potassium, hypothermia, tension pneumothorax, tamponade, toxins and thrombosis in the lungs or the coronary arteries. High blood pressure and high glucose are not on that list and neither one takes away a pulse on its own.
6. Which patient needs synchronized cardioversion rather than defibrillation?
- A. A patient in ventricular fibrillation
- B. A patient in pulseless ventricular tachycardia
- C. A patient in atrial fibrillation at 180 who is hypotensive and confused
- D. A patient in asystole
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Svar: C. A patient in atrial fibrillation at 180 who is hypotensive and confused
Synchronized cardioversion times the shock to the R wave and is used for unstable tachycardias that still have a pulse, such as fast atrial fibrillation, atrial flutter and monomorphic ventricular tachycardia with a pulse. Defibrillation is unsynchronized and is used when there is no pulse, and the energy setting for either one comes from your device and your unit protocol.
7. Which findings mark a tachycardia as unstable and push the team toward immediate synchronized cardioversion?
Vælg alle, der passer.
- A. Hypotension with cool, clammy skin
- B. New confusion or a falling level of consciousness
- C. Ischemic chest pain or acute pulmonary edema
- D. A heart rate of 104 with a normal blood pressure
- E. Mild palpitations with no other symptoms
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Svar: A. Hypotension with cool, clammy skin, B. New confusion or a falling level of consciousness, C. Ischemic chest pain or acute pulmonary edema
Unstable means the fast rate is already causing poor perfusion, and the classic signs are hypotension or shock, altered mental status, ischemic chest discomfort and acute heart failure. A stable patient gets time for vagal maneuvers, drugs and a 12 lead first, so the number on the monitor never decides the plan by itself.
8. A patient in sinus bradycardia at 38 is dizzy, pale and hypotensive. Which drug is given first?
- A. Adenosine
- B. Atropine
- C. Amiodarone
- D. Magnesium sulfate
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Svar: B. Atropine
Atropine blocks the vagal slowing of the sinus and AV nodes, so it is the first drug for symptomatic bradycardia while pacing is being set up. If atropine does not work, the next steps are transcutaneous pacing or an infusion such as dopamine or epinephrine, with the exact doses taken from your current protocol.
9. A strip shows P waves and QRS complexes marching along at their own separate rates. The ventricular rate is 32 and the blood pressure is 78/40. What should the nurse prepare for?
- A. Defibrillation
- B. Transcutaneous pacing
- C. A rapid adenosine push
- D. Vagal maneuvers
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Svar: B. Transcutaneous pacing
P waves and QRS complexes with no relationship to each other describe third degree, or complete, heart block, where the atria and the ventricles beat independently. A slow escape rhythm with poor perfusion needs pacing, transcutaneous first and then transvenous or permanent, since atropine often fails when the block sits below the AV node.
10. On a rhythm strip the PR interval gets a little longer with each beat until one QRS is dropped, then the pattern starts over. Which rhythm is this?
- A. First degree AV block
- B. Second degree AV block type I, also called Wenckebach
- C. Second degree AV block type II
- D. Third degree AV block
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Svar: B. Second degree AV block type I, also called Wenckebach
A PR interval that stretches until a beat drops is the signature of Wenckebach, which usually sits in the AV node and is often tolerated well enough to just monitor. Type II drops beats with no PR lengthening at all and is far more dangerous, because it can slip into complete block and usually needs pacing.
11. A patient with a regular narrow QRS tachycardia at 190 is alert and comfortable with a blood pressure of 118/70. What is usually tried first?
- A. A vagal maneuver such as bearing down
- B. Immediate defibrillation
- C. Immediate synchronized cardioversion
- D. An atropine push
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Svar: A. A vagal maneuver such as bearing down
In stable supraventricular tachycardia the vagal maneuver comes first because it costs nothing and sometimes breaks the rhythm, and adenosine by rapid push with an immediate flush is the usual next step. Cardioversion is held back for patients who turn unstable, and atropine would only drive the rate higher.
12. Complete the sentence.
For torsades de pointes in a patient who still has a pulse, the drug given is intravenous _____.
Muligheder for felt 1: magnesium sulfate, adenosine, atropine, furosemide
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Svar: magnesium sulfate
Torsades de pointes is a polymorphic ventricular tachycardia that twists around the baseline and grows out of a long QT, often from low magnesium or low potassium or from QT prolonging drugs. Magnesium is the treatment while there is a pulse, and if the pulse is lost the rhythm is defibrillated like any other pulseless ventricular rhythm.
13. Which of the following are standard parts of managing ongoing atrial fibrillation?
Vælg alle, der passer.
- A. Controlling the ventricular rate, often with a beta blocker or diltiazem
- B. Assessing stroke risk and starting anticoagulation when it is indicated
- C. Considering rhythm control with an antiarrhythmic or a planned cardioversion
- D. Scheduling a routine defibrillation every few months
- E. Holding all treatment for as long as the patient feels well
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Svar: A. Controlling the ventricular rate, often with a beta blocker or diltiazem, B. Assessing stroke risk and starting anticoagulation when it is indicated, C. Considering rhythm control with an antiarrhythmic or a planned cardioversion
Atrial fibrillation care stands on three legs: rate control, rhythm control and anticoagulation chosen from a stroke risk score rather than from how the patient feels. The fibrillating atria let blood pool and clot, which is why someone with no symptoms can still have a stroke, and defibrillation is never scheduled maintenance.
14. Complete the sentence.
When atrial fibrillation has lasted longer than _____ hours, or the duration is unknown, guidelines call for several weeks of anticoagulation, or a transesophageal echo to rule out a clot, before an elective cardioversion.
Muligheder for felt 1: 12, 24, 48, 72
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Svar: 48
Clot can form in the fibrillating left atrium within about two days, and converting to sinus rhythm may push it loose and cause a stroke. Anticoagulation also continues for at least four weeks after a successful cardioversion, and longer when the patient's stroke risk score calls for it.
15. A post-op patient is in sinus tachycardia at 128, with a temperature of 102 F and pain rated 8 out of 10. What should the nurse do?
- A. Treat the causes, including the pain, the fever and any fluid loss
- B. Give adenosine to slow the rate
- C. Prepare for synchronized cardioversion
- D. Hold all fluids until the rate comes down
Vis svar og forklaring
Svar: A. Treat the causes, including the pain, the fever and any fluid loss
Sinus tachycardia is usually the heart responding correctly to something else, such as pain, fever, anxiety, bleeding, dehydration or low oxygen. The rate settles once the cause is treated, and forcing it down first can strip a patient of the compensation they are relying on.
Hvad rytmespørgsmål faktisk kræver af dig
Rytmegenkendelse bliver testet to forskellige steder, og de spørger om forskellige ting. En dysrytmieksamen på sygeplejestudiet vil som regel have dig til at navngive rytmen ud fra en strimmel og derefter sige, hvad den betyder for patienten. Et certificeringskursus som ACLS bekymrer sig langt mindre om navnet og langt mere om den gren, du tager derefter: er der puls, er patienten stabil, er rytmen stødbar, hvad gives først.
Spørgsmålene i denne smagsprøve ligger på den anden side. De tager udgangspunkt i en rytme, du allerede har identificeret, og spørger hvad sygeplejersken gør ved den. Den opdeling betyder noget, når du læser, for du kan være fremragende til at navngive rytmer og alligevel gå i stå ved sengekanten, og du kan også kunne algoritmen udenad og misse den rytme, der udløser den.
Pas på med de detaljer, der ikke er universelle. Lægemiddeldoser, jouleindstillinger, om din afdeling har stående ordinationer, og hvor langt en sygeplejerske må gå, før en læge kommer, fastsættes alt sammen af din institutions protokol og af de aktuelle genoplivningsretningslinjer, som revideres med få års mellemrum. Det, der ligger fast, er det, der testes her: hvilke rytmer der er dødelige, hvilke hjertestoprytmer et stød kan rette op på, hvornår et stød er synkroniseret og hvornår det ikke er, og hvad der overhovedet forårsager hver rytme. Lær det, og læs så de præcise tal i din egen protokol og i dit kursus' aktuelle håndbog.
Sådan bruger du smagsprøven
Tag alle 15 spørgsmål i ét stræk uden noter, cirka 60 til 90 sekunder per spørgsmål. Læs derefter forklaringen til hvert spørgsmål, også dem du svarede rigtigt på, for på et rytmespørgsmål falder det rigtige svar af den forkerte grund fra hinanden, så snart scenariet ændrer sig en smule.
Et forkert svar peger på et emne, ikke bare på ét faktum. Hvis du missede spørgsmålet om asystole og spørgsmålet om pulseless electrical activity, så repeter hele den ikke-stødbare side af hjertestopalgoritmen i stedet for at lære to svar udenad. Gik AV-blok-spørgsmålene skidt, så gå tilbage og sorter førstegrads, begge typer andengrads og tredjegrads efter hvad der sker med PR-intervallet og med de udeblevne slag, for det er det eneste, der adskiller dem på en strimmel.
Kombiner den med strimmeltræning. Genkendelse og handling er adskilte færdigheder, så træn rigtige strimler et andet sted: tæl frekvensen, tjek om rytmen er regelmæssig, kig efter en P-tak foran hvert QRS, mål PR og QRS, og sig så rytmen højt, før du kigger på svaret. De to søsterquizzer, der er linket til herunder, dækker den side.
Sådan bygger StudyPDF fulde øveprøver ud fra dit eget materiale
Femten spørgsmål kan vise dig, hvor du vakler. De kan ikke gøre dig klar alene, og en generisk spørgsmålsbank aner ikke, hvilke rytmer din underviser træner, eller hvilken protokol din afdeling følger.
StudyPDF arbejder ud fra dit materiale i stedet. Du uploader dine forelæsningsnoter om hjertet, dit rytmehæfte, dit lærebogskapitel eller håndbogen fra dit kursus, og Bo, studieagenten, bygger fulde øveprøver ud fra præcis de sider. Hvert spørgsmål bygger på dit materiale, og hver forklaring henviser til hvor svaret kommer fra, så du kan tjekke kilden når noget ser forkert ud. Du kan lave nye prøver så tit du vil, holde en enkelt på ét område som AV-blokke eller hjertestoprytmer, og følge med i hvilke begreber du bliver ved med at ramme forkert.
Du behøver ikke en fil for at komme i gang. Har du intet at uploade, så nævn et emne i stedet, for eksempel ventrikulære rytmer eller behandling af atrial fibrillation, så bygger Bo øveprøven ud fra det. Gratis at komme i gang.
Skrevet af StudyPDF-teamet. Sidst opdateret 2026-08-19.