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Med/Surg Cardiovascular Exam|129 Q’s and A’s|100% Scores!!!
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Med/Surg Cardiovascular Exam|129 Q’s andA’s|100% Scores!!!
Which of the EKG findings is most likely indicative of Acute Myocardial
Infarction (AMI) in a patient presenting with acute chest pain?
A. Wide and bizarre QRS complexes in the EKG
B. ST segment changes (STEMI or NSTEMI) in the EKG
C. A saw-toothed pattern in the EKG saw-toothed pattern in the EKG
D. Flat line in the EKG - -B. ST segment changes (STEMI or NSTEMI) in the
EKG
-To determine whether there is a delay in impulse conduction through the
atria, the nurse will measure the length of the patient's:
A. P wave
B. PR interval
C. QT interval
D. QRS complex - -A. P wave
The P wave represents the depolarization of the atria. The P-R interval
represents depolarization of the atria, atrioventricular (AV) node, bundle of
His, bundle branches, and the Purkinje fibers. The QRS represents ventricular
depolarization. The Q-T interval represents depolarization and repolarization
of the entire conduction system.
-The nurse needs to estimate quickly the heart rate for a patient with a
regular heart rhythm. Which method will be best to use?
A. Print a 1-minute electrocardiogram (ECG) strip and count the number of
QRS complexes.
B. Count the number of large squares in the R-R interval and divide by 300.
C. Use the 3-second markers to count the number of QRS complexes in
6seconds and multiply by 10.
D. Calculate the number of small squares between one QRS complex and the
next and divide into 1500. - -C. Use the 3-second markers to count the
number of QRS complexes in 6seconds and multiply by 10.
This is the quickest way to determine the ventricular rate for a patient with a
regular rhythm. All the other methods are accurate, but take longer.
-The nurse obtains a monitor strip on a patient who has had a myocardial
infarction and makes the following analysis: P wave not apparent, ventricular
rate 162, R-R interval regular, P-R interval not measurable, and QRS complex
wide and distorted, QRS duration 0.18 second. The nurse interprets the
patient's cardiac rhythm as:
A. Atrial fibrillation
B. Sinus tachycardia
,C. Ventricular fibrillation
D. Ventricular tachycardia - -D. Ventricular tachycardia
The absence of P waves, wide QRS, rate >150, and the regularity of the
rhythm indicate ventricular tachycardia. Atrial fibrillation is grossly irregular,
has a narrow QRS configuration, and has fibrillatory atrial activity. Sinus
tachycardia has P waves. Ventricular fibrillation is irregular and does not
have a consistent QRS duration. The absence of P waves, wide QRS, rate
>150, and the regularity of the rhythm indicate ventricular tachycardia.
Atrial fibrillation is grossly irregular, has a narrow QRS configuration, and has
fibrillatory atrial activity. Sinus tachycardia has P waves. Ventricular
fibrillation is irregular and does not have a consistent QRS duration.
-The nurse is admitting a patient who has chest pain. Which assessment
data suggest that the pain is caused by an Acute Myocardial Infarction (AMI)?
A. The pain is relieved after the patient takes nitroglycerin
B. The pain is reproducible when the patient raises the left arm
C. The pain increases with deep breathing
D. The pain lasted longer than 30 minutes - -D. The pain lasted longer than
30 minutes
-Which of the following is the most common diagnostic tool used in patients
with HF?
A. Serum Troponin level
B. ABG
C. Echocardiogram
D. Coronary Angiography - -C. Echocardiogram
-Question 70..07 pts
After reviewing a patient's history, vital signs, physical assessment, and
laboratory data, which of the following information is most important for the
nurse to communicate to the healthcare provider?
A. Hyperglycemia
B. Elevated troponin
C. T wave on EKG
D. HR 110 bpm - -B. Elevated troponin
-Which of the following is the worst complication of Acute Coronary
Syndrome (ACS)?
A. Sinus tachycardia
B. Hypertension
C. Sudden cardiac death
D. Angina - -C. Sudden cardiac death
, -A patient who has chronic heart failure tells the nurse, "I was fine when I
went to bed, but I woke up in the middle of the night feeling like I was
suffocating! The nurse will document this assessment finding as:
A. Orthopnea
B. Paroxysmal nocturnal dyspnea
C. Asthma attack
D. Acute bilateral pleural effusion - -B. Paroxysmal nocturnal dyspnea
-A 19-year-old has a mandatory electrocardiogram (ECG) before
participating on a college swim team and is found to have sinus bradycardia,
rate 52. BP is 114/54, and the student denies any health problems. What
action by the nurse is appropriate?
A. Allow the student to participate on the swim team.
B. Refer the student to a cardiologist for further assessment.
C. Obtain more detailed information about the student's health history.
D. Tell the student to stop swimming immediately if any dyspnea occurs. - -
A. Allow the student to participate on the swim team.
-When analyzing the waveforms of a patient's electrocardiogram (ECG), the
nurse will need to investigate further upon finding a:
A. T wave of 0.16 second
B. P-R interval of 0.18 second
C. Q-T interval of 0.34 second
D. QRS interval of 0.14 second - -D. QRS interval of 0.14 second
Because the normal QRS interval is <0.12 seconds, the patient's QRS
interval of 0.14 seconds indicates that the conduction through the ventricular
conduction system is prolonged. The P-R interval, Q-T interval, and T wave
interval are within the normal range.
-Which assessment finding in a patient admitted with Acute Decompensated
Heart Failure (ADHF) requires the most immediate action by the nurse?
A. Weight gain of 1-2 lbs. over 2 weeks
B. HR of 106 bpm
C. O2 saturation of 88%
D. Urine output of 60 ml over 2 hours - -C. O2 saturation of 88%
-Which of the following is a most fatal dysrhythmia?
A. Ventricular fibrillation
B. Sinus tachycardia
C. Atrial flutter
D. Sinus bradycardia - -A. Ventricular fibrillation
-A patient whose cardiac monitor shows sinus tachycardia, rate 102, is
apneic and no pulses are palpable by the nurse. What is the first action that
the nurse should take?
, A. Give 100% oxygen per non-rebreather mask
B. Defibrillate
C. Administer atropine per hospital protocol
D. Start CPR - -D. Start CPR
The patient's clinical manifestations indicate pulseless electrical activity and
the nurse should immediately start CPR. The other actions would not be of
benefit to this patient.
-When developing a health teaching plan for a 60-year-old man with the
following risk factors for coronary artery disease (CAD), the nurse should
focus on the
A. family history of coronary artery disease.
B. increased risk associated with the patient's male sex.
C. high incidence of cardiovascular disease in older people.
D. elevation of the patient's serum low density lipoprotein (LDL) level. - -D.
elevation of the patient's serum low density lipoprotein (LDL) level.
Serum LDL is the only modifiable risk factor.
-Which information given by a patient admitted with stable angina will help
the nurse confirm this diagnosis?
A. The patient rates the pain at a level 3 to 5 (0 to 10 scale).
B. The patient states that the pain "wakes me up at night."
C. The patient says that the frequency of the pain has increased over the last
few weeks.
D. The patient states that the pain is resolved after taking one sublingual
nitroglycerin tablet. - -weeks.
D. The patient states that the pain is resolved after taking one sublingual
nitroglycerin tablet.
Chronic stable angina refers to chest pain that occurs intermittently over
long period of time with similar pattern of onset, duration, and intensity of
symptoms. The pain of chronic stable angina usually lasts only for a few
minutes before subsiding with rest, calming down, or use of sublingual
nitroglycerin (NTG)
-After the nurse has finished teaching a patient about use of sublingual
nitroglycerin (Nitrostat), which patient statement indicates that the teaching
has been EFFECTIVE?
A. "I can expect indigestion as a side effect of nitroglycerin."
B. "I can only take the nitroglycerin if I start to have chest pain."
C. "I will call an ambulance if I still have pain 5 minutes after taking the
nitroglycerin."
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