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3 CE Test Hours

Atrial Fibrillation

Updated Management Guidelines and Nursing Implications

Contrada, Emily

AJN The American Journal of Nursing: May 2015 - Volume 115 - Issue 5 - p 39,49
doi: 10.1097/01.NAJ.0000465029.12847.41
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GENERAL PURPOSE:

To provide information about the latest guideline for the management of atrial fibrillation, issued jointly in 2014 by the American Heart Association, the American College of Cardiology, and the Heart Rhythm Society.

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LEARNING OBJECTIVES:

After reading this article and taking this test, you will be able to

  • recognize the assessment findings indicative of and risk factors for atrial fibrillation.
  • identify components of the latest guideline for treatment of atrial fibrillation.
  1. How does atrial fibrillation rank as a common chronic cardiac dysrhythmia?
    1. first
    2. second
    3. third
  2. Nearly what percentage of cases of atrial fibrillation occur in people over 65 years of age?
    1. 65%
    2. 75%
    3. 85%
  3. Results from the Framingham Heart Study indicate that one's lifetime risk of developing atrial fibrillation is
    1. 1 in 4.
    2. 1 in 5.
    3. 1 in 6.
  4. In atrial fibrillation, multiple atrial cells
    1. cease electrical activity.
    2. behave as individual pacemakers.
    3. increase blood flow to the left ventricle.
  5. Of the following, which is the most common complication of atrial fibrillation?
    1. hemodynamic compromise
    2. torsade de pointes
    3. heart failure
  6. Data from the Centers for Medicare and Medicaid Services demonstrate that, among beneficiaries with atrial fibrillation, the most common comorbidity is
    1. hypertension.
    2. cardiomyopathy.
    3. chronic kidney disease.
  7. A common symptom of atrial fibrillation is
    1. chest pain.
    2. insomnia.
    3. fatigue.
  8. Assessment findings typically include a pulse that is
    1. slow.
    2. irregular.
    3. bounding.
  9. On an electrocardiogram, atrial fibrillation appears as
    1. an erratic baseline.
    2. inverted P waves.
    3. a wide QRS complex.
  10. In both the CHADS2 and the CHA2DS2-VASc stroke risk stratification tools, the D stands for
    1. dyspnea.
    2. diastolic pressure.
    3. diabetes.
  11. Patients with atrial fibrillation who have mechanical heart valves or hemodynamically significant mitral stenosis should be treated with which of the following anticoagulants?
    1. warfarin
    2. apixaban
    3. rivaroxaban
  12. With which of the following drugs has monotherapy been found ineffective for preventing stroke in patients with atrial fibrillation?
    1. clopidogrel
    2. dabigatran
    3. aspirin
  13. For patients who are asymptomatic and show no signs of heart failure, the 2014 American Heart Association/American College of Cardiology/Heart Rhythm Society guideline recommends a resting heart rate of less than
    1. 110 bpm.
    2. 120 bpm.
    3. 130 bpm.
  14. In the Atrial Fibrillation Follow-Up Investigation of Rhythm Management study, which of the following drug classifications was found most effective in achieving heart rate control?
    1. ?-blockers
    2. cardiac glycosides
    3. calcium channel blockers
  15. According to a recent meta-analysis, which of the following drugs was found most effective for maintaining normal sinus rhythm once atrial fibrillation was converted?
    1. flecainide
    2. amiodarone
    3. propafenone
  16. In the same meta-analysis, which of the following drugs for maintaining normal sinus rhythm after cardioversion was found to have the lowest rate of adverse events?
    1. dronedarone
    2. dofetilide
    3. sotalol
  17. If cardioversion results in normal sinus rhythm but atrial fibrillation recurs, the new guideline recommends which of the following treatment modalities?
    1. use of a biphasic defibrillator
    2. an antiarrhythmic medication
    3. lowering the defibrillation threshold
  18. In a study of patients undergoing the most recent Cox maze procedure, up to what percentage were free from atrial fibrillation at 6 months’ follow-up?
    1. 63%
    2. 74%
    3. 87%
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