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152 Cards in this Set
- Front
- Back
- 3rd side (hint)
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A patient has been scheduled for cardiovascular CT with contrast. To prepare this patient for the test, what action should the nurse perform? A) Keep the patient NPO for at least six hours prior to the test. B) Establish peripheral IV access. C.) Limit the patient's activity for two hours before the test. D) Patient to perform incentive spirometry. |
B) Establish peripheral IV access.
Rationale: An IV is necessary if contrast is to be used to enhance the images of the CT. The patient does not need to fast or limit his activity. Incentive spirometry is not relevant to this diagnostic test |
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The student nurse is preparing a teaching plan for a patient being discharged s/p MI. What should the student include in the teaching plan? Select all that apply. A) the need for careful monitoring for cardiac symptoms. B) the need for carefully regulated exercise. C) the need for dietary modifications. D) the need for early resumption of pre-pre-diagnosis activity. E) the need for increased fluid intake. |
Answers= A, B, C
Rationale: Dietary modifications, exercise, weight loss, & careful monitoring are important strategies for maintaining 3 major CVD risk factors: hyperlipidemia, hypertension and diabetes. There's no need to increase fluid intake and activity should be slowly and deliberately increased |
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A critical care nurse is caring for a patient with hemodynamic monitoring system in place. For what complications should the nurse assess? Select all that apply.
A) pneumothorax B) infection C) atelectasis D) bronchospasm E) air embolism |
Answers = A, B, E |
During insertion of hemodynamic catheter pneumothorax can occur. There is a risk for air embolism during medication or fluid administration, blood draws, and anytime that the system is open to air. Infection is a risk because catheters are inserted directly into venous circulation. |
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The patient has a hemocystine level order. What aspects of this test should guide the nurses care? select all that apply.
A) A 12 hour fast is necessary before drawing the blood sample. B) Recent inactivity can depress homocysteine levels. C) Genetic factors can elevate homocysteine levels. D) A diet low in folic acid elevates homocysteine levels. E) An EKG should be performed immediately before drawing a sample. |
Answers= A, C, D |
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When hemodynamic monitoring is ordered for a patient, a catheter is inserted into the appropriate blood vessel or heart chamber. When assessing a patient who is such a device in place, the nurse should check which of the following components? Select all that apply.
A) a transducer B) a flush system C) a leveler D) a pressure bag E) an oscillator |
Answer = A, B, D |
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When hemodynamic monitoring is ordered for a patient, a catheter is inserted into the appropriate blood vessel or heart chamber. When assessing a patient who is such a device in place, the nurse should check which of the following components? Select all that apply.
A) a transducer B) a flush system C) a leveler D) a pressure bag E) an oscillator |
Answer = A, B, D |
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The nurse is relating the deficits in a patient synchronization of the atrial and ventricular events to his diagnosis. What are the physiologic characteristics of the nodal and purkinjie cells that provide the synchronization? Select all that apply.
A) connectivity B) excitability C) automaticity D) conductivity E) independence |
Answer = B, C, D |
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When hemodynamic monitoring is ordered for a patient, a catheter is inserted into the appropriate blood vessel or heart chamber. When assessing a patient who is such a device in place, the nurse should check which of the following components? Select all that apply.
A) a transducer B) a flush system C) a leveler D) a pressure bag E) an oscillator |
Answer = A, B, D |
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The nurse is relating the deficits in a patient synchronization of the atrial and ventricular events to his diagnosis. What are the physiologic characteristics of the nodal and purkinjie cells that provide the synchronization? Select all that apply.
A) connectivity B) excitability C) automaticity D) conductivity E) independence |
Answer = B, C, D |
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The nurse is calculating a cardiac patients pulse pressure. If the patient's blood pressure is 122/76 what is the patient's pulse pressure?
A) 46 mmHg B) 99 mmHg C) 198 mmHg D) 76 mmHg |
A.) 46 mmHg |
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The physician has placed a Central venous pressure (CVP) monitoring line in and acutely ill patient so right ventricular function and venous blood return can be closely monitored. The result shows decreased CVP. What does this indicate?
A) possible hypovolemia B) possible MI C) left-sided heart failure D) aortic valve regurgitation |
A) possible hypovolemia |
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When hemodynamic monitoring is ordered for a patient, a catheter is inserted into the appropriate blood vessel or heart chamber. When assessing a patient who is such a device in place, the nurse should check which of the following components? Select all that apply.
A) a transducer B) a flush system C) a leveler D) a pressure bag E) an oscillator |
Answer = A, B, D |
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The nurse is relating the deficits in a patient synchronization of the atrial and ventricular events to his diagnosis. What are the physiologic characteristics of the nodal and purkinjie cells that provide the synchronization? Select all that apply.
A) connectivity B) excitability C) automaticity D) conductivity E) independence |
Answer = B, C, D |
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The nurse is calculating a cardiac patients pulse pressure. If the patient's blood pressure is 122/76 what is the patient's pulse pressure?
A) 46 mmHg B) 99 mmHg C) 198 mmHg D) 76 mmHg |
A.) 46 mmHg |
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The physician has placed a Central venous pressure (CVP) monitoring line in and acutely ill patient so right ventricular function and venous blood return can be closely monitored. The result shows decreased CVP. What does this indicate?
A) possible hypovolemia B) possible MI C) left-sided heart failure D) aortic valve regurgitation |
A) possible hypovolemia |
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While auscultating a patient's heart sounds, the nurse hears an extra heart sound immediately after the second heart sound (S2). An audible S3 would be considered an expected finding in what patient?
A) an older adult B) 20-year-old patient C) a patient who has undergone valve replacement D) a patient who takes a beta adrenergic blockers |
B) 20-year-old patient
Rationale: S3 represents a normal finding in children and adults up to 35 or 40 years of age. In these cases it's called a physiologic S3. |
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The nurse is caring for a patient with a history of heart disease. What factor should the nurse identify as possibly contributing to a decrease in cardiac output?
A) A change in position from standing to sitting B) a heart rate of 54 bpm C) pulse ox reading of 94% D) increased preload related to ambulation |
B) a heart rate of 54 bpm
Rationale: CO = SV x HR *An increase in preload would cause an increase in stroke volume (not decrease) & increased SV = increased CO. * going from standing to sitting would INCREASE cardiac output and not decrease |
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When hemodynamic monitoring is ordered for a patient, a catheter is inserted into the appropriate blood vessel or heart chamber. When assessing a patient who is such a device in place, the nurse should check which of the following components? Select all that apply.
A) a transducer B) a flush system C) a leveler D) a pressure bag E) an oscillator |
Answer = A, B, D |
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The nurse is relating the deficits in a patient synchronization of the atrial and ventricular events to his diagnosis. What are the physiologic characteristics of the nodal and purkinjie cells that provide the synchronization? Select all that apply.
A) connectivity B) excitability C) automaticity D) conductivity E) independence |
Answer = B, C, D |
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The nurse is calculating a cardiac patients pulse pressure. If the patient's blood pressure is 122/76 what is the patient's pulse pressure?
A) 46 mmHg B) 99 mmHg C) 198 mmHg D) 76 mmHg |
A.) 46 mmHg |
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The physician has placed a Central venous pressure (CVP) monitoring line in and acutely ill patient so right ventricular function and venous blood return can be closely monitored. The result shows decreased CVP. What does this indicate?
A) possible hypovolemia B) possible MI C) left-sided heart failure D) aortic valve regurgitation |
A) possible hypovolemia |
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While auscultating a patient's heart sounds, the nurse hears an extra heart sound immediately after the second heart sound (S2). An audible S3 would be considered an expected finding in what patient?
A) an older adult B) 20-year-old patient C) a patient who has undergone valve replacement D) a patient who takes a beta adrenergic blockers |
B) 20-year-old patient
Rationale: S3 represents a normal finding in children and adults up to 35 or 40 years of age. In these cases it's called a physiologic S3. |
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The nurse is caring for a patient with a history of heart disease. What factor should the nurse identify as possibly contributing to a decrease in cardiac output?
A) A change in position from standing to sitting B) a heart rate of 54 bpm C) pulse ox reading of 94% D) increased preload related to ambulation |
B) a heart rate of 54 bpm
Rationale: CO = SV x HR *An increase in preload would cause an increase in stroke volume (not decrease) & increased SV = increased CO. * going from standing to sitting would INCREASE cardiac output and not decrease |
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A resident of a long-term care facility has complained to the nurse of chest pain. What aspect of the resident's pain would be most suggestive of angina as the cause? A) The pain is worse when the resident inhales deeply. B) The pain occurs immediately following physical exertion. C) The pain is worse when the resident coughs. D) The pain is more severe when the resident moves his upper body. |
B) The pain occurs immediately following physical exercise
Rationale: narrowed coronary arteries impedes blood flow when oxygen demand rises the body is unable to increase blood flow myocardial ischemia occurs causing the pain associated with angina |
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A Critical care nurse is caring for a patient with a pulmonary artery pressure monitoring system. The nurse is aware that pulmonary artery pressure monitoring is used to assess left ventricular function. What is an additional function of pulmonary artery pressure monitoring systems?
A) to assess the patient's response to fluid and drug administration. B) To obtain specimens for ABG measurement. C) To dislodge pulmonary emboli. D) To diagnose the etiology of COPD |
B) To obtain specimens for ABG measurement
Rationale: pulmonary artery pressure monitoring is used to assess left ventricular function (cardiac output), to diagnose the etiology of shock, to evaluate a patient's response to medical intervention (fluid administration and vasoactive medications). |
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Cardiac Conduction System:
The electrical signal travels through the heart starting at the SA Node and then traveling in what order? |
SA Node >> AV Node >> Bundle of HIS >> Purkinjie Fibers |
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A Critical care nurse is caring for a patient with a pulmonary artery pressure monitoring system. The nurse is aware that pulmonary artery pressure monitoring is used to assess left ventricular function. What is an additional function of pulmonary artery pressure monitoring systems?
A) to assess the patient's response to fluid and drug administration. B) To obtain specimens for ABG measurement. C) To dislodge pulmonary emboli. D) To diagnose the etiology of COPD |
B) To obtain specimens for ABG measurement
Rationale: pulmonary artery pressure monitoring is used to assess left ventricular function (cardiac output), to diagnose the etiology of shock, to evaluate a patient's response to medical intervention (fluid administration and vasoactive medications). |
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Cardiac Conduction System:
The electrical signal travels through the heart starting at the SA Node and then traveling in what order? |
SA Node >> AV Node >> Bundle of HIS >> Purkinjie Fibers |
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The nurse working on a cardiac care unit is caring for a patient who stroke volume has increased. The nurse is aware that the afterload influences the patient stroke volume. The nurse recognizes that afterload is increased when there is what?
A) arterial vasoconstriction B) Venous vasoconstriction C) arterial vasodilation D) Venous vasodilation |
A) arterial vasoconstriction
Rationale: after load = the pressure that the left ventricle must overcome in order to pump blood out of the heart and into the arteries. If the arteries CONSTRICT (become smaller) than this pressure (the after load) INCREASES |
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The nurse is preparing a patient for a scheduled transesophageal electrocardiography (TEE). What action should the nurse perform?
A.) Instruct the patient to drink 1 L of water before the test. B) Administer IV benzodiazepines and opioids. C) Inform the patient that she will remain on bed rest following the procedure. D) Inform the patient that an Access line will be initiated in her femoral artery. |
C) Inform the patient that she will remain on bed rest following the procedure.
Rationale: during the recovery period, the patient remains on bed rest with the head of the bed elevated to 45°. The patient should not drink water, they must be NPO for 6 hours prior to the procedure. The Patient would be sedated but not be heavily sedated, and opioids are not necessary. Also the patient will have a peripheral IV inserted (usually in one arm) preprocedure. |
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The critical care nurse is caring for a patient who has had an MI. The nurse should expect to assist with establishing what hemodynamic monitoring system to assess the patients left ventricular function?
A) Central venous pressure (CVP) monitoring B) pulmonary artery pressure monitoring (PAMP) C) systemic arterial pressure monitoring (SAPM) D) arterial blood gases (ABGs) |
B) pulmonary artery pressure monitoring (PAMP)
Rationale: *PAPM = assessment of left ventricular function * CVP = assessment right ventricular function SAPM= continual assessment of blood pressure ABGs = pH and O2/CO2 in the blood |
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After the insertion of an intra-arterial pressure monitoring catheter what assessment should the nurse prioritize in the plan of care?
A) Fluctuations of core body temperature. B) Signs and symptoms of esophageal varices. C) Signs and symptoms of compartment syndrome. D) And perfusion distal to the insertion site. |
D) And perfusion distal to the insertion site
Rationale: this is an important assessment because intra arterial pressure catheters are placed directly into an artery and can block bloodflow distal to the insertion site (causing ischemia of tissue and loss of limb). |
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The nurse caring for a patient who with a central venous pressure (CVP) monitoring system in place. What intervention should be included in the care plan of a patient with CVP?
A) Apply an antibiotic ointment to the insertion site twice daily. B) Change the site dressing when it becomes visibly soiled. C) Performed passive ROM exercises to prevent venous stasis. D) Aspirate blood from the device once daily to test pH. |
B) Change the site dressing when it becomes visibly soiled.
* gauze dressing should be changed every two days; transparent dressings are changed at least every 7 days and whenever dressings become damp, loosened, or visibly soiled. * antibiotic ointments are contraindicated |
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The nurse caring for a patient who with a central venous pressure (CVP) monitoring system in place. What intervention should be included in the care plan of a patient with CVP?
A) Apply an antibiotic ointment to the insertion site twice daily. B) Change the site dressing when it becomes visibly soiled. C) Performed passive ROM exercises to prevent venous stasis. D) Aspirate blood from the device once daily to test pH. |
B) Change the site dressing when it becomes visibly soiled.
* gauze dressing should be changed every two days; transparent dressings are changed at least every 7 days and whenever dressings become damp, loosened, or visibly soiled. * antibiotic ointments are contraindicated |
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A brain B-type natriuretic peptide (BNP) sample has been drawn from an older adult patient who is been experiencing vital fatigue and shortness of breath. This test will allow the care team to investigate the possibility of what diagnosis?
A) pleurisy B) heart failure C) valve dysfunction D) cardiomyopathy |
B) heart failure
*BNP is a test for left ventricular damage that was caused by the expansion of the ventricular walls from increased pressure, making it a helpful diagnostic, monitoring, and prognostic tool for heart failure. |
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A lipid profile has been ordered for patient who is been experiencing cardiac symptoms. When should a lipid profile be drawn in order to maximize the accuracy of the results?
A) as close to the end of the day as possible. B) After a meal high in fat. C) After a 12 hour fast. D) 30 minutes after a normal meal. |
C) After a 12 hour fast. * although cholesterol medications are taken at night due to the manufacture of cholesterol taking place at night, a lipid profile should be taken on an empty stomach after a 12 hour fast |
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The physician has ordered a highly-sensitive C-reactive protein (hs–CRP) drawn on a patient. The results of this test will allow the nurse to evaluate the role of what process that is implicated in the development of atherosclerosis?
A) immunosuppression B) inflammation C) infection D) hemostasis |
B) inflammation
*high-sensitivity CRP is a protein produced by the liver in response to systemic inflammation. Inflammation that is thought to play a role in the development and progression of atherosclerosis. |
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The physician has ordered a highly-sensitive C-reactive protein (hs–CRP) drawn on a patient. The results of this test will allow the nurse to evaluate the role of what process that is implicated in the development of atherosclerosis?
A) immunosuppression B) inflammation C) infection D) hemostasis |
B) inflammation
*high-sensitivity CRP is a protein produced by the liver in response to systemic inflammation. Inflammation that is thought to play a role in the development and progression of atherosclerosis. |
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A patient is scheduled for a transthoracic echocardiography. What should the nurse teach the patient in anticipation of this diagnostic procedure?
A) The test is noninvasive, and nothing will be inserted into the patient's body. B) The patient's pain will be aggressively managed during this procedure. C) The test will provide a detailed profile of the hearts electrical activity. D) The patient will remain on bed rest for 1 to 2 hours after the test. |
A) The test is noninvasive, and nothing will be inserted into the patient's body
* |
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A patient is being admitted to the cardiac care unit for an EP study what goal should guide the planning and execution of the patient's care?
A) ablation of the area causing the dysrhythmia. B) Freeze hypersensitive cells. C) Diagnose the dysrhythmia. D) Determine the nursing plan of care. |
C) Diagnose the dysrhythmia |
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A patient is being admitted to the cardiac care unit for an EP study what goal should guide the planning and execution of the patient's care?
A) ablation of the area causing the dysrhythmia. B) Freeze hypersensitive cells. C) Diagnose the dysrhythmia. D) Determine the nursing plan of care. |
C) Diagnose the dysrhythmia |
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During a CPR class, asked about the difference between cardioversion and defibrillation. What would the instructors best response be?
A) Cardioversion is done on a beating heart; defibrillation is not. B) The difference is the timing of the delivery of the electric current. C) Defibrillation is synchronized with the electrical activity of the heart, but cardioversion is not. D) Cardioversion is always attempted before defibrillation because it has fewer risks. |
B) the difference is the timing of the delivery of the electric current |
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A patient is being admitted to the cardiac care unit for an EP study what goal should guide the planning and execution of the patient's care?
A) ablation of the area causing the dysrhythmia. B) Freeze hypersensitive cells. C) Diagnose the dysrhythmia. D) Determine the nursing plan of care. |
C) Diagnose the dysrhythmia |
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During a CPR class, asked about the difference between cardioversion and defibrillation. What would the instructors best response be?
A) Cardioversion is done on a beating heart; defibrillation is not. B) The difference is the timing of the delivery of the electric current. C) Defibrillation is synchronized with the electrical activity of the heart, but cardioversion is not. D) Cardioversion is always attempted before defibrillation because it has fewer risks. |
B) the difference is the timing of the delivery of the electric current |
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The patient calls his cardiologist office and talks to the nurse. He is concerned because he feels he is being defibrillated too often. The nurse tells the patient to come to the office to be evaluated because the nurse knows that the most frequent complication of ICD therapy is what?
A) infection B) failure to capture C) premature batteries depletion D) over sensing of dysrhythmias |
D) over sensing of dysrhythmias |
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A patient is being admitted to the cardiac care unit for an EP study what goal should guide the planning and execution of the patient's care?
A) ablation of the area causing the dysrhythmia. B) Freeze hypersensitive cells. C) Diagnose the dysrhythmia. D) Determine the nursing plan of care. |
C) Diagnose the dysrhythmia |
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During a CPR class, asked about the difference between cardioversion and defibrillation. What would the instructors best response be?
A) Cardioversion is done on a beating heart; defibrillation is not. B) The difference is the timing of the delivery of the electric current. C) Defibrillation is synchronized with the electrical activity of the heart, but cardioversion is not. D) Cardioversion is always attempted before defibrillation because it has fewer risks. |
B) the difference is the timing of the delivery of the electric current |
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The patient calls his cardiologist office and talks to the nurse. He is concerned because he feels he is being defibrillated too often. The nurse tells the patient to come to the office to be evaluated because the nurse knows that the most frequent complication of ICD therapy is what?
A) infection B) failure to capture C) premature batteries depletion D) over sensing of dysrhythmias |
D) over sensing of dysrhythmias
*Inappropriate delivery of ICD therapy, is usually due to over sensing of atrial and sinus tachycardia with a rapid ventricular rate response this is the most frequent complication of ICD. Infections, failure to capture, and premature battery failure are less common complications. |
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The nurses caring for a patient who is in the recovery room following the implantation of an ICD. The patient has developed ventricular tachycardia (VT). What should the nurse assess and document?
A) ECG to compare time of onset of VT and onset of the devices shock. B) ECG so physician can see what type of dysrhythmia the patient has. C) the Patient's LOC at the time of the dysrhythmia. D) the Patient's activity at the time of the dysrhythmia. |
A) ECG to compare time of onset of VT and onset of the devices shock |
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A patient is being admitted to the cardiac care unit for an EP study what goal should guide the planning and execution of the patient's care?
A) ablation of the area causing the dysrhythmia. B) Freeze hypersensitive cells. C) Diagnose the dysrhythmia. D) Determine the nursing plan of care. |
C) Diagnose the dysrhythmia |
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During a CPR class, asked about the difference between cardioversion and defibrillation. What would the instructors best response be?
A) Cardioversion is done on a beating heart; defibrillation is not. B) The difference is the timing of the delivery of the electric current. C) Defibrillation is synchronized with the electrical activity of the heart, but cardioversion is not. D) Cardioversion is always attempted before defibrillation because it has fewer risks. |
B) the difference is the timing of the delivery of the electric current |
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The patient calls his cardiologist office and talks to the nurse. He is concerned because he feels he is being defibrillated too often. The nurse tells the patient to come to the office to be evaluated because the nurse knows that the most frequent complication of ICD therapy is what?
A) infection B) failure to capture C) premature batteries depletion D) over sensing of dysrhythmias |
D) over sensing of dysrhythmias
*Inappropriate delivery of ICD therapy, is usually due to over sensing of atrial and sinus tachycardia with a rapid ventricular rate response this is the most frequent complication of ICD. Infections, failure to capture, and premature battery failure are less common complications. |
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The nurses caring for a patient who is in the recovery room following the implantation of an ICD. The patient has developed ventricular tachycardia (VT). What should the nurse assess and document?
A) ECG to compare time of onset of VT and onset of the devices shock. B) ECG so physician can see what type of dysrhythmia the patient has. C) the Patient's LOC at the time of the dysrhythmia. D) the Patient's activity at the time of the dysrhythmia. |
A) ECG to compare time of onset of VT and onset of the devices shock |
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The nurses caring for a patient who has had a biventricular pacemaker implanted. When planning the patient's care, the nurse should recognize that the goal of this intervention is:
A) resynchronization B) defibrillation C) angioplasty D) ablation |
A) resynchronization |
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A patient is being admitted to the cardiac care unit for an EP study what goal should guide the planning and execution of the patient's care?
A) ablation of the area causing the dysrhythmia. B) Freeze hypersensitive cells. C) Diagnose the dysrhythmia. D) Determine the nursing plan of care. |
C) Diagnose the dysrhythmia |
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During a CPR class, asked about the difference between cardioversion and defibrillation. What would the instructors best response be?
A) Cardioversion is done on a beating heart; defibrillation is not. B) The difference is the timing of the delivery of the electric current. C) Defibrillation is synchronized with the electrical activity of the heart, but cardioversion is not. D) Cardioversion is always attempted before defibrillation because it has fewer risks. |
B) the difference is the timing of the delivery of the electric current |
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The patient calls his cardiologist office and talks to the nurse. He is concerned because he feels he is being defibrillated too often. The nurse tells the patient to come to the office to be evaluated because the nurse knows that the most frequent complication of ICD therapy is what?
A) infection B) failure to capture C) premature batteries depletion D) over sensing of dysrhythmias |
D) over sensing of dysrhythmias
*Inappropriate delivery of ICD therapy, is usually due to over sensing of atrial and sinus tachycardia with a rapid ventricular rate response this is the most frequent complication of ICD. Infections, failure to capture, and premature battery failure are less common complications. |
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The nurses caring for a patient who is in the recovery room following the implantation of an ICD. The patient has developed ventricular tachycardia (VT). What should the nurse assess and document?
A) ECG to compare time of onset of VT and onset of the devices shock. B) ECG so physician can see what type of dysrhythmia the patient has. C) the Patient's LOC at the time of the dysrhythmia. D) the Patient's activity at the time of the dysrhythmia. |
A) ECG to compare time of onset of VT and onset of the devices shock |
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The nurses caring for a patient who has had a biventricular pacemaker implanted. When planning the patient's care, the nurse should recognize that the goal of this intervention is:
A) resynchronization B) defibrillation C) angioplasty D) ablation |
A) resynchronization |
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Following cardiac resuscitation, a patient has been placed in a state of mild hypothermia before being transferred to the CICU. The nurses assessment reveals that the patient is experiencing neuromuscular paralysis. How should the nurse best respond?
A) administer hypertonic IV solution. B) Administer a bolus of warmed normal saline. C) Reassess the patient in 15 minutes. D) Document this as an expected assessment finding. |
D) Document this as an expected assessment finding
*The nurse caring for a patient with hypothermia (passive or induced) needs to monitor for appropriate level of cooling, sedation, and neuromuscular paralysis to prevent seizures, myoclonus, and shivering. Neuromuscular paralysis is an expected finding and does not necessitate further intervention. |
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A patient is being admitted to the cardiac care unit for an EP study what goal should guide the planning and execution of the patient's care?
A) ablation of the area causing the dysrhythmia. B) Freeze hypersensitive cells. C) Diagnose the dysrhythmia. D) Determine the nursing plan of care. |
C) Diagnose the dysrhythmia |
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During a CPR class, asked about the difference between cardioversion and defibrillation. What would the instructors best response be?
A) Cardioversion is done on a beating heart; defibrillation is not. B) The difference is the timing of the delivery of the electric current. C) Defibrillation is synchronized with the electrical activity of the heart, but cardioversion is not. D) Cardioversion is always attempted before defibrillation because it has fewer risks. |
B) the difference is the timing of the delivery of the electric current |
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The patient calls his cardiologist office and talks to the nurse. He is concerned because he feels he is being defibrillated too often. The nurse tells the patient to come to the office to be evaluated because the nurse knows that the most frequent complication of ICD therapy is what?
A) infection B) failure to capture C) premature batteries depletion D) over sensing of dysrhythmias |
D) over sensing of dysrhythmias
*Inappropriate delivery of ICD therapy, is usually due to over sensing of atrial and sinus tachycardia with a rapid ventricular rate response this is the most frequent complication of ICD. Infections, failure to capture, and premature battery failure are less common complications. |
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The nurses caring for a patient who is in the recovery room following the implantation of an ICD. The patient has developed ventricular tachycardia (VT). What should the nurse assess and document?
A) ECG to compare time of onset of VT and onset of the devices shock. B) ECG so physician can see what type of dysrhythmia the patient has. C) the Patient's LOC at the time of the dysrhythmia. D) the Patient's activity at the time of the dysrhythmia. |
A) ECG to compare time of onset of VT and onset of the devices shock |
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The nurses caring for a patient who has had a biventricular pacemaker implanted. When planning the patient's care, the nurse should recognize that the goal of this intervention is:
A) resynchronization B) defibrillation C) angioplasty D) ablation |
A) resynchronization |
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Following cardiac resuscitation, a patient has been placed in a state of mild hypothermia before being transferred to the CICU. The nurses assessment reveals that the patient is experiencing neuromuscular paralysis. How should the nurse best respond?
A) administer hypertonic IV solution. B) Administer a bolus of warmed normal saline. C) Reassess the patient in 15 minutes. D) Document this as an expected assessment finding. |
D) Document this as an expected assessment finding
*The nurse caring for a patient with hypothermia (passive or induced) needs to monitor for appropriate level of cooling, sedation, and neuromuscular paralysis to prevent seizures, myoclonus, and shivering. Neuromuscular paralysis is an expected finding and does not necessitate further intervention. |
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The nurses caring for a patient who has had a dysrhythmic event. The nurse is aware of the need to assess for signs of diminished cardiac output. What change in status may signal to the nurse a decrease in cardiac output?
A) Increased blood pressure. B) founding peripheral pulses. C) Changes and LOC D) skin flushing |
C) changes in LOC
* A change in the patient's LOC may indicate poor perfusion to the brain which could be caused by decreased cardiac output it. |
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A patient is being admitted to the cardiac care unit for an EP study what goal should guide the planning and execution of the patient's care?
A) ablation of the area causing the dysrhythmia. B) Freeze hypersensitive cells. C) Diagnose the dysrhythmia. D) Determine the nursing plan of care. |
C) Diagnose the dysrhythmia |
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During a CPR class, asked about the difference between cardioversion and defibrillation. What would the instructors best response be?
A) Cardioversion is done on a beating heart; defibrillation is not. B) The difference is the timing of the delivery of the electric current. C) Defibrillation is synchronized with the electrical activity of the heart, but cardioversion is not. D) Cardioversion is always attempted before defibrillation because it has fewer risks. |
B) the difference is the timing of the delivery of the electric current |
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The patient calls his cardiologist office and talks to the nurse. He is concerned because he feels he is being defibrillated too often. The nurse tells the patient to come to the office to be evaluated because the nurse knows that the most frequent complication of ICD therapy is what?
A) infection B) failure to capture C) premature batteries depletion D) over sensing of dysrhythmias |
D) over sensing of dysrhythmias
*Inappropriate delivery of ICD therapy, is usually due to over sensing of atrial and sinus tachycardia with a rapid ventricular rate response this is the most frequent complication of ICD. Infections, failure to capture, and premature battery failure are less common complications. |
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The nurses caring for a patient who is in the recovery room following the implantation of an ICD. The patient has developed ventricular tachycardia (VT). What should the nurse assess and document?
A) ECG to compare time of onset of VT and onset of the devices shock. B) ECG so physician can see what type of dysrhythmia the patient has. C) the Patient's LOC at the time of the dysrhythmia. D) the Patient's activity at the time of the dysrhythmia. |
A) ECG to compare time of onset of VT and onset of the devices shock |
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The nurses caring for a patient who has had a biventricular pacemaker implanted. When planning the patient's care, the nurse should recognize that the goal of this intervention is:
A) resynchronization B) defibrillation C) angioplasty D) ablation |
A) resynchronization |
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Following cardiac resuscitation, a patient has been placed in a state of mild hypothermia before being transferred to the CICU. The nurses assessment reveals that the patient is experiencing neuromuscular paralysis. How should the nurse best respond?
A) administer hypertonic IV solution. B) Administer a bolus of warmed normal saline. C) Reassess the patient in 15 minutes. D) Document this as an expected assessment finding. |
D) Document this as an expected assessment finding
*The nurse caring for a patient with hypothermia (passive or induced) needs to monitor for appropriate level of cooling, sedation, and neuromuscular paralysis to prevent seizures, myoclonus, and shivering. Neuromuscular paralysis is an expected finding and does not necessitate further intervention. |
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The nurses caring for a patient who has had a dysrhythmic event. The nurse is aware of the need to assess for signs of diminished cardiac output. What change in status may signal to the nurse a decrease in cardiac output?
A) Increased blood pressure. B) founding peripheral pulses. C) Changes and LOC D) skin flushing |
C) changes in LOC
* A change in the patient's LOC may indicate poor perfusion to the brain which could be caused by decreased cardiac output it. |
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The nurses caring for a patient whose sudden onset of sinus bradycardia is not responding adequately to atropine. What might be the treatment of choice for this patient?
A) implanted pacemaker B) transcutaneous pacemaker C) ICD D) asynchronous defibrillator |
B) transcutaneous pacemaker
Rationale: The patient has SUDDENLY developed bradycardia = acute situation. * If a patient suddenly developed bradycardia, is symptomatic but has a pulse, and is unresponsive to atropine, emergency pacing may be started with transcutaneous pacing, which most defibrillators are now equipped to perform. And implanted pacemaker is not a time appropriate option for an acute problem. |
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A patient is being admitted to the cardiac care unit for an EP study what goal should guide the planning and execution of the patient's care?
A) ablation of the area causing the dysrhythmia. B) Freeze hypersensitive cells. C) Diagnose the dysrhythmia. D) Determine the nursing plan of care. |
C) Diagnose the dysrhythmia |
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During a CPR class, asked about the difference between cardioversion and defibrillation. What would the instructors best response be?
A) Cardioversion is done on a beating heart; defibrillation is not. B) The difference is the timing of the delivery of the electric current. C) Defibrillation is synchronized with the electrical activity of the heart, but cardioversion is not. D) Cardioversion is always attempted before defibrillation because it has fewer risks. |
B) the difference is the timing of the delivery of the electric current |
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The patient calls his cardiologist office and talks to the nurse. He is concerned because he feels he is being defibrillated too often. The nurse tells the patient to come to the office to be evaluated because the nurse knows that the most frequent complication of ICD therapy is what?
A) infection B) failure to capture C) premature batteries depletion D) over sensing of dysrhythmias |
D) over sensing of dysrhythmias
*Inappropriate delivery of ICD therapy, is usually due to over sensing of atrial and sinus tachycardia with a rapid ventricular rate response this is the most frequent complication of ICD. Infections, failure to capture, and premature battery failure are less common complications. |
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The nurses caring for a patient who is in the recovery room following the implantation of an ICD. The patient has developed ventricular tachycardia (VT). What should the nurse assess and document?
A) ECG to compare time of onset of VT and onset of the devices shock. B) ECG so physician can see what type of dysrhythmia the patient has. C) the Patient's LOC at the time of the dysrhythmia. D) the Patient's activity at the time of the dysrhythmia. |
A) ECG to compare time of onset of VT and onset of the devices shock |
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The nurses caring for a patient who has had a biventricular pacemaker implanted. When planning the patient's care, the nurse should recognize that the goal of this intervention is:
A) resynchronization B) defibrillation C) angioplasty D) ablation |
A) resynchronization |
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Following cardiac resuscitation, a patient has been placed in a state of mild hypothermia before being transferred to the CICU. The nurses assessment reveals that the patient is experiencing neuromuscular paralysis. How should the nurse best respond?
A) administer hypertonic IV solution. B) Administer a bolus of warmed normal saline. C) Reassess the patient in 15 minutes. D) Document this as an expected assessment finding. |
D) Document this as an expected assessment finding
*The nurse caring for a patient with hypothermia (passive or induced) needs to monitor for appropriate level of cooling, sedation, and neuromuscular paralysis to prevent seizures, myoclonus, and shivering. Neuromuscular paralysis is an expected finding and does not necessitate further intervention. |
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The nurses caring for a patient who has had a dysrhythmic event. The nurse is aware of the need to assess for signs of diminished cardiac output. What change in status may signal to the nurse a decrease in cardiac output?
A) Increased blood pressure. B) founding peripheral pulses. C) Changes and LOC D) skin flushing |
C) changes in LOC
* A change in the patient's LOC may indicate poor perfusion to the brain which could be caused by decreased cardiac output it. |
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The nurses caring for a patient whose sudden onset of sinus bradycardia is not responding adequately to atropine. What might be the treatment of choice for this patient?
A) implanted pacemaker B) transcutaneous pacemaker C) ICD D) asynchronous defibrillator |
B) transcutaneous pacemaker
Rationale: The patient has SUDDENLY developed bradycardia = acute situation. * If a patient suddenly developed bradycardia, is symptomatic but has a pulse, and is unresponsive to atropine, emergency pacing may be started with transcutaneous pacing, which most defibrillators are now equipped to perform. And implanted pacemaker is not a time appropriate option for an acute problem. |
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A patient is undergoing preoperative teaching before his cardiac surgery; the nurse is aware that a temporary pacemaker will be placed later that day. What is the nurses responsibility in the care of the patients pacemaker?
A) Monitoring for pacemaker malfunction or battery failure. B) Determining when it is appropriate to remove the pacemaker. C) Making necessary changes to the pacemaker settings. D) Selecting alternatives to future pacemaker use. |
A) Monitoring for pacemaker malfunction or battery failure. |
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A patient has undergone diagnostic testing and received a diagnosis of sinus bradycardia should be able to sign us know dysfunction. When planning this patient's care, what nursing diagnosis is most appropriate?
A) acute pain B) risk for unilateral neglect C) risk for activity intolerance D) risk for fluid volume excess |
C) risk for activity intolerance |
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A patient is being admitted to the cardiac care unit for an EP study what goal should guide the planning and execution of the patient's care?
A) ablation of the area causing the dysrhythmia. B) Freeze hypersensitive cells. C) Diagnose the dysrhythmia. D) Determine the nursing plan of care. |
C) Diagnose the dysrhythmia |
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A patient scheduled for catheter ablation therapy. When describing this procedure to the patient's family, the nurse should address which aspect of the treatment?
A) Resetting of the heart's contractility B) destruction of specific cardiac cells C) correction of structural cardiac abnormalities D) clearance of partial included coronary artery is |
B) destruction of specific cardiac cells |
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During a CPR class, asked about the difference between cardioversion and defibrillation. What would the instructors best response be?
A) Cardioversion is done on a beating heart; defibrillation is not. B) The difference is the timing of the delivery of the electric current. C) Defibrillation is synchronized with the electrical activity of the heart, but cardioversion is not. D) Cardioversion is always attempted before defibrillation because it has fewer risks. |
B) the difference is the timing of the delivery of the electric current |
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The patient calls his cardiologist office and talks to the nurse. He is concerned because he feels he is being defibrillated too often. The nurse tells the patient to come to the office to be evaluated because the nurse knows that the most frequent complication of ICD therapy is what?
A) infection B) failure to capture C) premature batteries depletion D) over sensing of dysrhythmias |
D) over sensing of dysrhythmias
*Inappropriate delivery of ICD therapy, is usually due to over sensing of atrial and sinus tachycardia with a rapid ventricular rate response this is the most frequent complication of ICD. Infections, failure to capture, and premature battery failure are less common complications. |
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The nurses caring for a patient who is in the recovery room following the implantation of an ICD. The patient has developed ventricular tachycardia (VT). What should the nurse assess and document?
A) ECG to compare time of onset of VT and onset of the devices shock. B) ECG so physician can see what type of dysrhythmia the patient has. C) the Patient's LOC at the time of the dysrhythmia. D) the Patient's activity at the time of the dysrhythmia. |
A) ECG to compare time of onset of VT and onset of the devices shock |
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The nurses caring for a patient who has had a biventricular pacemaker implanted. When planning the patient's care, the nurse should recognize that the goal of this intervention is:
A) resynchronization B) defibrillation C) angioplasty D) ablation |
A) resynchronization |
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Following cardiac resuscitation, a patient has been placed in a state of mild hypothermia before being transferred to the CICU. The nurses assessment reveals that the patient is experiencing neuromuscular paralysis. How should the nurse best respond?
A) administer hypertonic IV solution. B) Administer a bolus of warmed normal saline. C) Reassess the patient in 15 minutes. D) Document this as an expected assessment finding. |
D) Document this as an expected assessment finding
*The nurse caring for a patient with hypothermia (passive or induced) needs to monitor for appropriate level of cooling, sedation, and neuromuscular paralysis to prevent seizures, myoclonus, and shivering. Neuromuscular paralysis is an expected finding and does not necessitate further intervention. |
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The nurses caring for a patient who has had a dysrhythmic event. The nurse is aware of the need to assess for signs of diminished cardiac output. What change in status may signal to the nurse a decrease in cardiac output?
A) Increased blood pressure. B) founding peripheral pulses. C) Changes and LOC D) skin flushing |
C) changes in LOC
* A change in the patient's LOC may indicate poor perfusion to the brain which could be caused by decreased cardiac output it. |
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The nurses caring for a patient whose sudden onset of sinus bradycardia is not responding adequately to atropine. What might be the treatment of choice for this patient?
A) implanted pacemaker B) transcutaneous pacemaker C) ICD D) asynchronous defibrillator |
B) transcutaneous pacemaker
Rationale: The patient has SUDDENLY developed bradycardia = acute situation. * If a patient suddenly developed bradycardia, is symptomatic but has a pulse, and is unresponsive to atropine, emergency pacing may be started with transcutaneous pacing, which most defibrillators are now equipped to perform. And implanted pacemaker is not a time appropriate option for an acute problem. |
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A patient is undergoing preoperative teaching before his cardiac surgery; the nurse is aware that a temporary pacemaker will be placed later that day. What is the nurses responsibility in the care of the patients pacemaker?
A) Monitoring for pacemaker malfunction or battery failure. B) Determining when it is appropriate to remove the pacemaker. C) Making necessary changes to the pacemaker settings. D) Selecting alternatives to future pacemaker use. |
A) Monitoring for pacemaker malfunction or battery failure. |
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A patient has undergone diagnostic testing and received a diagnosis of sinus bradycardia should be able to sign us know dysfunction. When planning this patient's care, what nursing diagnosis is most appropriate?
A) acute pain B) risk for unilateral neglect C) risk for activity intolerance D) risk for fluid volume excess |
C) risk for activity intolerance |
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A patient is being admitted to the cardiac care unit for an EP study what goal should guide the planning and execution of the patient's care?
A) ablation of the area causing the dysrhythmia. B) Freeze hypersensitive cells. C) Diagnose the dysrhythmia. D) Determine the nursing plan of care. |
C) Diagnose the dysrhythmia |
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A patient scheduled for catheter ablation therapy. When describing this procedure to the patient's family, the nurse should address which aspect of the treatment?
A) Resetting of the heart's contractility B) destruction of specific cardiac cells C) correction of structural cardiac abnormalities D) clearance of partial included coronary artery is |
B) destruction of specific cardiac cells |
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The nurses caring for a patient on telemetry. The patient's ECG shows a shortened PR interval, slurring of the initial QRS deflection, and prolonged QRS duration. What does this ECG show?
A) sinus bradycardia B) myocardial infarction C) lupus like syndrome D) Wolff-Parkinson-White syndrome |
D) Wolff-Parkinson-White syndrome |
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During a CPR class, asked about the difference between cardioversion and defibrillation. What would the instructors best response be?
A) Cardioversion is done on a beating heart; defibrillation is not. B) The difference is the timing of the delivery of the electric current. C) Defibrillation is synchronized with the electrical activity of the heart, but cardioversion is not. D) Cardioversion is always attempted before defibrillation because it has fewer risks. |
B) the difference is the timing of the delivery of the electric current |
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The patient calls his cardiologist office and talks to the nurse. He is concerned because he feels he is being defibrillated too often. The nurse tells the patient to come to the office to be evaluated because the nurse knows that the most frequent complication of ICD therapy is what?
A) infection B) failure to capture C) premature batteries depletion D) over sensing of dysrhythmias |
D) over sensing of dysrhythmias
*Inappropriate delivery of ICD therapy, is usually due to over sensing of atrial and sinus tachycardia with a rapid ventricular rate response this is the most frequent complication of ICD. Infections, failure to capture, and premature battery failure are less common complications. |
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The nurses caring for a patient who is in the recovery room following the implantation of an ICD. The patient has developed ventricular tachycardia (VT). What should the nurse assess and document?
A) ECG to compare time of onset of VT and onset of the devices shock. B) ECG so physician can see what type of dysrhythmia the patient has. C) the Patient's LOC at the time of the dysrhythmia. D) the Patient's activity at the time of the dysrhythmia. |
A) ECG to compare time of onset of VT and onset of the devices shock |
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The nurses caring for a patient who has had a biventricular pacemaker implanted. When planning the patient's care, the nurse should recognize that the goal of this intervention is:
A) resynchronization B) defibrillation C) angioplasty D) ablation |
A) resynchronization |
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Following cardiac resuscitation, a patient has been placed in a state of mild hypothermia before being transferred to the CICU. The nurses assessment reveals that the patient is experiencing neuromuscular paralysis. How should the nurse best respond?
A) administer hypertonic IV solution. B) Administer a bolus of warmed normal saline. C) Reassess the patient in 15 minutes. D) Document this as an expected assessment finding. |
D) Document this as an expected assessment finding
*The nurse caring for a patient with hypothermia (passive or induced) needs to monitor for appropriate level of cooling, sedation, and neuromuscular paralysis to prevent seizures, myoclonus, and shivering. Neuromuscular paralysis is an expected finding and does not necessitate further intervention. |
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The nurses caring for a patient who has had a dysrhythmic event. The nurse is aware of the need to assess for signs of diminished cardiac output. What change in status may signal to the nurse a decrease in cardiac output?
A) Increased blood pressure. B) founding peripheral pulses. C) Changes and LOC D) skin flushing |
C) changes in LOC
* A change in the patient's LOC may indicate poor perfusion to the brain which could be caused by decreased cardiac output it. |
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The nurses caring for a patient whose sudden onset of sinus bradycardia is not responding adequately to atropine. What might be the treatment of choice for this patient?
A) implanted pacemaker B) transcutaneous pacemaker C) ICD D) asynchronous defibrillator |
B) transcutaneous pacemaker
Rationale: The patient has SUDDENLY developed bradycardia = acute situation. * If a patient suddenly developed bradycardia, is symptomatic but has a pulse, and is unresponsive to atropine, emergency pacing may be started with transcutaneous pacing, which most defibrillators are now equipped to perform. And implanted pacemaker is not a time appropriate option for an acute problem. |
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A patient is undergoing preoperative teaching before his cardiac surgery; the nurse is aware that a temporary pacemaker will be placed later that day. What is the nurses responsibility in the care of the patients pacemaker?
A) Monitoring for pacemaker malfunction or battery failure. B) Determining when it is appropriate to remove the pacemaker. C) Making necessary changes to the pacemaker settings. D) Selecting alternatives to future pacemaker use. |
A) Monitoring for pacemaker malfunction or battery failure. |
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A patient has undergone diagnostic testing and received a diagnosis of sinus bradycardia should be able to sign us know dysfunction. When planning this patient's care, what nursing diagnosis is most appropriate?
A) acute pain B) risk for unilateral neglect C) risk for activity intolerance D) risk for fluid volume excess |
C) risk for activity intolerance |
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The nurses caring for a patient with refractory atrial fibrillation who underwent the maze procedure several months ago. The nurse reviews the result of the patient's most recent cardiac imaging, which notes the presence of scarring on the atria. How should the nurse best respond to this finding?
A) recognize that the procedure was unsuccessful. B) Recognize this as a therapeutic goal of the procedure. C) Talk with the care team in preparation for repeating the menus procedure. D) Prepare the patient for pacemaker implantation. |
B) Recognize this as a therapeutic goal of the procedure |
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The nurses caring for a patient with refractory atrial fibrillation who underwent the maze procedure several months ago. The nurse reviews the result of the patient's most recent cardiac imaging, which notes the presence of scarring on the atria. How should the nurse best respond to this finding?
A) recognize that the procedure was unsuccessful. B) Recognize this as a therapeutic goal of the procedure. C) Talk with the care team in preparation for repeating the menus procedure. D) Prepare the patient for pacemaker implantation. |
B) Recognize this as a therapeutic goal of the procedure |
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A new nurse asks her preceptor to explain depolarization. What would be the best answer for the preceptor to give?
A) depolarization is the mechanical contraction of the heart muscles. B) Depolarization is the electrical stimulation of the heart muscles. C) Depolarization is the electrical relaxation of the heart muscles. D) Depolarization is the mechanical relaxation of the heart muscles. |
B) Depolarization is the electrical stimulation of the heart muscles.
*electrical stimulation of the heart is called DEpolarization, the mechanical contraction is called systole. Electrical relaxation is called REpolarization, and mechanical relaxation is called diastole. |
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The nurses caring for a patient who is just undergone catheter ablation therapy. The nurse in the step-down unit should prioritize which assessment?
A) Cardiac monitoring B) monitoring the implanted device signal C) pain assessment D) monitoring the patient's LOC |
A) Cardiac monitoring
*Following catheter ablation therapy the patient would be closely monitored to ensure that dysrhythmia does not reemerge. This is the priority over monitoring of LOC and pain, although these are also valid and important assessments. Ablation does not involve the implantation of the device. |
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A patient is brought to the ED and determined to be experiencing symptomatic sinus bradycardia. The nurse caring for this patient is aware that the medication of choice for treatment of this dysrhythmia is the administration of atropine. What guidelines will be nurse follow when administering atropine?
A) administer atropine 0.5 mg as an IV bolus every 3 to 5 minutes for a maximum of 3 mg. b) Administer atropine as a continuous infusion until symptoms resolve. C) Administer atropine as a continuous infusion to a maximum of 30 mg and 24 hours. D) Administer atropine 1 mg sublingually. |
A) administer atropine 0.5 mg as an IV bolus every 3 to 5 minutes for a maximum of 3 mg. |
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The nurses caring for a patient who is just undergone catheter ablation therapy. The nurse in the step-down unit should prioritize which assessment?
A) Cardiac monitoring B) monitoring the implanted device signal C) pain assessment D) monitoring the patient's LOC |
A) Cardiac monitoring
*Following catheter ablation therapy the patient would be closely monitored to ensure that dysrhythmia does not reemerge. This is the priority over monitoring of LOC and pain, although these are also valid and important assessments. Ablation does not involve the implantation of the device. |
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A patient is brought to the ED and determined to be experiencing symptomatic sinus bradycardia. The nurse caring for this patient is aware that the medication of choice for treatment of this dysrhythmia is the administration of atropine. What guidelines will be nurse follow when administering atropine?
A) administer atropine 0.5 mg as an IV bolus every 3 to 5 minutes for a maximum of 3 mg. b) Administer atropine as a continuous infusion until symptoms resolve. C) Administer atropine as a continuous infusion to a maximum of 30 mg and 24 hours. D) Administer atropine 1 mg sublingually. |
A) administer atropine 0.5 mg as an IV bolus every 3 to 5 minutes for a maximum of 3 mg. |
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The nurse is planning discharge teaching for a patient with a newly inserted permanent pacemaker. What is the priority teaching point for this patient?
A) start lifting arm above the shoulder right away to prevent chest wall adhesion. B) Avoid cooking with a microwave oven. C.) Avoid exposure to high voltage electrical generators D) Avoid walking through store and library antitheft devices. |
C.) Avoid exposure to high voltage electrical generators
*High output electrical generators can reprogram pacemakers and should be avoided. Recent pacemaker technology allows the patient to safely use most household electric appliances and devices including microwave ovens. The affected arm should not be raised above the shoulder for one week following placement of the pacemaker. Antitheft alarms maybe triggered so patient should be taught to walk through them quickly and avoid standing in or near these devices. These alarms generally do not interfere with pacemaker function. |
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During a patient's care conference the team is discussing whether a patient is a candidate for cardiac conduction surgery. What would be the most important criterion for the patient to have the surgery?
A) angina not responsive to other treatments. B) Decreased activity tolerance related to decreased CO. C) Atrial and ventricular tachycardia that is not responsive to other treatments. D) Ventricular fibrillation not responsive to other treatments. |
C) Atrial and ventricular tachycardia that is not responsive to other treatments.
Cardiac conduction surgery is considered in patients who do not respond to medication and antitachycardia pacing. Angina, reduced activity tolerance, and ventricular fibrillation are not criteria. |
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The nurses caring for a patient who just had an implantable cardioverter defibrillator (ICD) placed. What is the priority area for the nurses assessment?
A) Assessing the patient's activity level. B) Facilitating transthoracic echocardiography. C) vigilant monitoring of the patients ECG. D) Close monitoring of the patients peripheral perfusion. |
C) vigilant monitoring of the patients ECG. |
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The nurses caring for a patient who just had an implantable cardioverter defibrillator (ICD) placed. What is the priority area for the nurses assessment?
A) Assessing the patient's activity level. B) Facilitating transthoracic echocardiography. C) vigilant monitoring of the patients ECG. D) Close monitoring of the patients peripheral perfusion. |
C) vigilant monitoring of the patients ECG. |
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An adult patient with third-degree AV block is admitted to the cardiac care unit and placed on continuous cardiac monitoring. What rhythm characteristic with the ECG most likely show?
A) PP interval and RR interval are irregular. B) PP interval is equal to RR interval. C) Fewer QRS complexes than P waves. D) PR interval is constant. |
C) Fewer QRS complexes than P waves.
* In third-degree AV block, - NO atrial impulse is conducted through the AV node into the ventricles. - As a result, there are impulses stimulating the atria and impulses stimulating the ventricles. - Therefore there are more P waves than QRS complexes due to the difference in natural pacemaker nodal rates of the heart. The other listed ECG changes are not consistent with this diagnosis. |
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The nurses caring for a patient who just had an implantable cardioverter defibrillator (ICD) placed. What is the priority area for the nurses assessment?
A) Assessing the patient's activity level. B) Facilitating transthoracic echocardiography. C) vigilant monitoring of the patients ECG. D) Close monitoring of the patients peripheral perfusion. |
C) vigilant monitoring of the patients ECG. |
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An adult patient with third-degree AV block is admitted to the cardiac care unit and placed on continuous cardiac monitoring. What rhythm characteristic with the ECG most likely show?
A) PP interval and RR interval are irregular. B) PP interval is equal to RR interval. C) Fewer QRS complexes than P waves. D) PR interval is constant. |
C) Fewer QRS complexes than P waves.
* In third-degree AV block, - NO atrial impulse is conducted through the AV node into the ventricles. - As a result, there are impulses stimulating the atria and impulses stimulating the ventricles. - Therefore there are more P waves than QRS complexes due to the difference in natural pacemaker nodal rates of the heart. The other listed ECG changes are not consistent with this diagnosis. |
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A patient has returned to the cardiac care unit after having a permanent pacemaker implantation. For which potential complication should the nurse most closely assess this patient?
A) Chest pain B) bleeding at the implantation site C) malignant hyperthermia D) bradycardia |
B) bleeding at the implantation site
*Bleeding, hematoma, local infections, perforation of the myocardium, and tachycardia are complications of pacemaker implantation. The nurse should monitor for chest pain and bradycardia, but bleeding is the more common immediate complication. Malignant hypothermia is unlikely because it's a response to anesthesia administration. |
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The nurses caring for a patient who just had an implantable cardioverter defibrillator (ICD) placed. What is the priority area for the nurses assessment?
A) Assessing the patient's activity level. B) Facilitating transthoracic echocardiography. C) vigilant monitoring of the patients ECG. D) Close monitoring of the patients peripheral perfusion. |
C) vigilant monitoring of the patients ECG. |
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An adult patient with third-degree AV block is admitted to the cardiac care unit and placed on continuous cardiac monitoring. What rhythm characteristic with the ECG most likely show?
A) PP interval and RR interval are irregular. B) PP interval is equal to RR interval. C) Fewer QRS complexes than P waves. D) PR interval is constant. |
C) Fewer QRS complexes than P waves.
* In third-degree AV block, - NO atrial impulse is conducted through the AV node into the ventricles. - As a result, there are impulses stimulating the atria and impulses stimulating the ventricles. - Therefore there are more P waves than QRS complexes due to the difference in natural pacemaker nodal rates of the heart. The other listed ECG changes are not consistent with this diagnosis. |
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A patient has returned to the cardiac care unit after having a permanent pacemaker implantation. For which potential complication should the nurse most closely assess this patient?
A) Chest pain B) bleeding at the implantation site C) malignant hyperthermia D) bradycardia |
B) bleeding at the implantation site
*Bleeding, hematoma, local infections, perforation of the myocardium, and tachycardia are complications of pacemaker implantation. The nurse should monitor for chest pain and bradycardia, but bleeding is the more common immediate complication. Malignant hypothermia is unlikely because it's a response to anesthesia administration. |
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The nurses caring for a patient who has had an ECG. The nurse notes that leads I, II, and III differ from one another on the cardiac rhythm strip. How should the nurse best respond?
A) recognize that the view of the electrical current changes in relation to the lead placement. B) Recognize that the electrophysiological conduction of the heart differs with the lead placement. C) Inform the technician that the ECG equipment has malfunctioned. D) Inform the physician that the patient is experiencing a new onset of dysrhythmia. |
A) recognize that the view of the electrical current changes in relation to the lead placement.
*Each lead offers a different reference point to view the electrical activity of the heart. The lead displays the configuration of electrical activity of the heart. Differences between these are not necessarily attributable to equipment malfunction or Dysrhythmia. |
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The nurses caring for a patient who just had an implantable cardioverter defibrillator (ICD) placed. What is the priority area for the nurses assessment?
A) Assessing the patient's activity level. B) Facilitating transthoracic echocardiography. C) vigilant monitoring of the patients ECG. D) Close monitoring of the patients peripheral perfusion. |
C) vigilant monitoring of the patients ECG. |
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An adult patient with third-degree AV block is admitted to the cardiac care unit and placed on continuous cardiac monitoring. What rhythm characteristic with the ECG most likely show?
A) PP interval and RR interval are irregular. B) PP interval is equal to RR interval. C) Fewer QRS complexes than P waves. D) PR interval is constant. |
C) Fewer QRS complexes than P waves.
* In third-degree AV block, - NO atrial impulse is conducted through the AV node into the ventricles. - As a result, there are impulses stimulating the atria and impulses stimulating the ventricles. - Therefore there are more P waves than QRS complexes due to the difference in natural pacemaker nodal rates of the heart. The other listed ECG changes are not consistent with this diagnosis. |
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A patient has returned to the cardiac care unit after having a permanent pacemaker implantation. For which potential complication should the nurse most closely assess this patient?
A) Chest pain B) bleeding at the implantation site C) malignant hyperthermia D) bradycardia |
B) bleeding at the implantation site
*Bleeding, hematoma, local infections, perforation of the myocardium, and tachycardia are complications of pacemaker implantation. The nurse should monitor for chest pain and bradycardia, but bleeding is the more common immediate complication. Malignant hypothermia is unlikely because it's a response to anesthesia administration. |
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The nurses caring for a patient who has had an ECG. The nurse notes that leads I, II, and III differ from one another on the cardiac rhythm strip. How should the nurse best respond?
A) recognize that the view of the electrical current changes in relation to the lead placement. B) Recognize that the electrophysiological conduction of the heart differs with the lead placement. C) Inform the technician that the ECG equipment has malfunctioned. D) Inform the physician that the patient is experiencing a new onset of dysrhythmia. |
A) recognize that the view of the electrical current changes in relation to the lead placement.
*Each lead offers a different reference point to view the electrical activity of the heart. The lead displays the configuration of electrical activity of the heart. Differences between these are not necessarily attributable to equipment malfunction or Dysrhythmia. |
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The nurse is analyzing a rhythm strip. What component of the ECG corresponds to the resting state of the patient's heart?
A) P wave B) T wave C) U wave D) QRS complex |
B) T wave |
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The nursing educator is presenting a case study of an adult patient who has abnormal ventricular depolarization. This pathologic change would be most evident and what component of the ECG?
A) P wave B) T wave C) QRS complex D) U wave |
C) QRS complex
*P wave = atrial DEpolarization *QRS = ventricular DEpolarization T= ventricular REpolarization |
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The nurse is writing a plan of care for a patient with a cardiac dysrhythmia. What would be the most appropriate goal for the patient?
A) maintain a resting heart rate below 70 bpm. B) Maintain adequate control of chest pain. C) Maintain adequate cardiac output. D) Maintain normal cardiac structure.
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C) Maintain adequate cardiac output.
*The patient safety, the most appropriate goal is to maintain cardiac output to prevent worsening complications. A resting rate of less than 70 bpm is not appropriate for every patient. Just pain is more closely associated with acute coronary syndrome and then with dysrhythmias. Nursing actions cannot normally influence the physical structure of the heart. |
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The nurse is caring for an adult patient who has gone into ventricular fibrillation. When assisting with defibrilation of the patient, what must the nurse do?
A) Maintain firm contact between paddles and the patient's skin. B) Apply a layer of water as a conducting agent. C) Call "clear" before discharging the defibrillator. D) Ensure the defibrillator is in sink mode. |
A) Maintain firm contact between paddles and the patient's skin. |
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A patient who is a candidate for an implantable cardioverter defibrillator (ICD) asks the nurse about the purpose of this device. What would the nurse's best response be?
A) to detect and treat dysrhythmia such as ventricular fibrillation and ventricular tachycardia. B) To detect and treat bradycardia, which is an excessively slow heart rate. C) To detect and treat atrial fibrillation, in which your heart beats too quickly and inefficiently. D) To shock your heart if you have a heart attack at home. |
A) to detect and treat dysrhythmia such as ventricular fibrillation and ventricular tachycardia
* ICD is a device that detects and terminates life-threatening episodes of ventricular tachycardia and ventricular defibrillation. It does not treat atrial fibrillation, MI, or bradycardia |
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A nurses caring for a patient who is exhibiting ventricular tachycardia (VT). Because the patient is pulseless, the nurse should prepare for what intervention?
A) defibrillation B) ECG monitoring C) implantation of a cardio defibrillator D) angioplasty |
A) defibrillation |
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A nurses caring for a patient who is exhibiting ventricular tachycardia (VT). Because the patient is pulseless, the nurse should prepare for what intervention?
A) defibrillation B) ECG monitoring C) implantation of a cardio defibrillator D) angioplasty |
A) defibrillation
*any type of ventricular fibrillation (pulseless or with pulse) is treated with immediate defibrillation. |
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The patient converts from normal sinus rhythm at 80 bpm to atrial fibrillation with the ventricular response at 166 BPM. Blood pressure is 162/74. Respiratory rate is 20 breaths per minute with normal chest expansion and clear lungs bilaterally. IV heparin and cardizem are given. The nurse caring for the patient understands that the main goal of treatment is what?
A) decrease SA node conduction B) control ventricular heart rate C) improve oxygenation D) maintain anticoagulation |
B) control ventricular heart rate
*Treatment for atrial fibrillation is to terminate the rhythm OR to control ventricular rate. This is a priority because it directly affects cardiac output. A rapid ventricular response reduces the time for ventricular filling, resulting in a smaller stroke volume. Control of rhythm of the initial treatment of choice, followed by anticoagulation with heparin and Coumadin |
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The nurse and the other members of the team are caring for a patient who converted to ventricular fibrillation (VF). The patient was defibrillated unsuccessfully and the patient remains in VF. According to national standards, the nurse should anticipate the administration of what medication?
A) epinephrine 1 mg IV push B) lidocaine 100 mg IV push C) Amiodarone 30 mg IV push D) sodium bicarb 1 amp IV push |
A) epinephrine 1 mg IV push
*Epinephrine should be administered ASAP after the first unsuccessful defibrillation and then every 3 to 5 minutes. Antiarrhythmic medications such as Amiodarone and lidocaine are given if ventricular dysrhythmia persist |
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And ECG has been ordered for a newly admitted patient. What should the nurse do prior to electrode placement?
A) clean skin with a providone-iodine solution. B) Ensure that the area for electric placement is dry. C) Apply tincture of benzoin to the electrode sites and wait for it to become tacky. D) Gently abrade the skin by rubbing the electrode sites with gauze or cloth. |
D) Gently abrade the skin by rubbing the electrode sites with gauze or cloth
*And ECG is obtained by slightly abrading the skin with a clean dry gauze pad and placing electrodes on the body at specific areas. The abrading of skin will enhance signal transmission. Disinfecting the skin is unnecessary and conduction gel is used. |
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And ECG has been ordered for a newly admitted patient. What should the nurse do prior to electrode placement?
A) clean skin with a providone-iodine solution. B) Ensure that the area for electric placement is dry. C) Apply tincture of benzoin to the electrode sites and wait for it to become tacky. D) Gently abrade the skin by rubbing the electrode sites with gauze or cloth. |
D) Gently abrade the skin by rubbing the electrode sites with gauze or cloth
*And ECG is obtained by slightly abrading the skin with a clean dry gauze pad and placing electrodes on the body at specific areas. The abrading of skin will enhance signal transmission. Disinfecting the skin is unnecessary and conduction gel is used. |
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An ED nurse is caring for a patient who has gone into cardiac arrest. During external defibrillation, what action should the nurse perform?
A) place gel pads over the apex and posterior chest for better conduction. B) Ensure no one is touching the patient at the time the shock is delivered. C) Continue to ventilate the patient via endotracheal tube during the procedure. D) Allow at least 3 minutes between shocks.
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B) Ensure no one is touching the patient at the time the shock is delivered.
*In external defibrillation, both paddles are placed on the front of the chest. The nurse must observe to safety measures: 1) maintain good contact between the pads or paddles & the pt's skin to prevent leaking.2) Ensure that no one is in contact with the patient or with anything that is touching the pt when the defibrillator is discharged (to minimize the chance of electrical current being conducted to anyone other than the patient). Ventilation should be stopped during defibrillation. |
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The nurse is providing care to a patient who has just undergone an EP study. The patient states that she is nervous about "things going wrong" during the procedure. What is the nurses best response?
A) this is basically a risk-free procedure. B) Thousands of patients undergo EP every year. C) Remember that this is a step that will bring you closer to enjoying good health. D) The whole team will be monitoring you very closely for the entire procedure. |
D) The whole team will be monitoring you very closely for the entire procedure
*Patients who are to undergo an EP study maybe anxious about the procedure and it's outcome. A detailed discussion involving the patient, the family, and the electrophysiologist usually occurs to ensure that the pt can give informed consent and to reduce anxiety about the procedure. *It inaccurate to state that EP is a "risk-free procedure" and stating that does not necessarily relieve the patient anxiety. Characterizing EP as a step towards good health does not directly address the patient's anxiety. |
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The educator is teaching a CPR class. Which of the following aspects of defibrillation should the educator stress to the class?
A) Apply the paddles directly to the patient's skin. B) Use a conducting medium between the paddles in the skin. C) Always use a petroleum based gel between the paddles and the skin. D) Any available liquid can be used between the paddles and the skin. |
B) Use a conducting medium between the paddles and the skin.
*use multifunction conductor pads or paddles with the conducting medium between the paddles and the skin. The conducting medium is available as a sheet, gel, or paste. Do not use gels or pastes with poor electrical conductivity. |
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The nurse is caring for a patient who has CVP monitoring in place. The nurses most recent assessment reveals that the CVP is 7 mmHg. What is the nurse is most appropriate action?
A) Arrange for continuous cardiac monitoring and reposition the patient. B) Remove the CVP catheter and apply an occlusive dressing. C) Assess the patient for fluid overload and inform the physician. D) Raise the head of the patient's bed and have the patient perform deep breathing exercise if possible. |
C) Assess the patient for fluid overload and inform the physician.
*A normal CVP is 2 to 6. Many problems can cause elevated CVP, but the most common is due to hypervolemia. HIGH PRESSURE = HIGH VOLUME Assessing the patient and informing the physician are the most prudent actions. Repositioning the patient is ineffective and removing the device is inappropriate and out of our scope of practice. |
Normal CVP = 2 - 6 mmHg |
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The critical care nurses caring for a patient with the pulmonary artery catheter in place. What does his catheter measure that is particularly important critically ill patients?
A) pulmonary artery systolic pressure B) right ventricular afterload C) pulmonary artery pressure D) left ventricular preload |
D) left ventricular preload
* monitoring of the pulmonary artery diastolic and pulmonary artery wedge pressures is particularly important critically ill patients because it's used to evaluate left ventricular filling pressures also known as the left ventricular preload. This device does not directly measure the other listed aspects of cardiac function. |
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A patient's declining cardiac status has been attributed to decreased cardiac action potential. Interventions will be aimed at restoring what aspect of cardiac physiology?
A)The cycle of depolarization and repolarization. B) The time it takes from the firing of the SA node the contraction of the ventricles. C) The time between the contraction of the atria and the contraction of the ventricles. D) The cycle of firing of the AV node and the contraction of the myocardium. |
A)The cycle of depolarization and repolarization
*An exchange of ions creates a positively charged intracellular space and a negatively charged extracellular space that characterizes the period known as depolarization. Once stabilization is complete, the exchange of ions reverts to its resting state; this period is known as repolarization. The repeated cycle of depolarization and repolarization is called the cardiac action potential. |
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The nurse is caring for a patient who is undergoing an exercise stress test. Prior to reaching the target heart rate, the patient developed chest pain. What is the nurse is most appropriate response?
A) administer sublingual nitroglycerin to allow the patient to finish the test. B) Initiate cardiopulmonary resuscitation. C) Administer analgesia and slow the test. D) Stop the test and monitor the patient closely. |
D) Stop the test and monitor the patient closely.
* signs of myocardial ischemia would necessitate stopping the test. CPR would only be necessary if signs of cardiac or respiratory arrest were evident. |
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The nurse is caring for a patient admitted with unstable angina. The laboratory results for the initial troponin I is elevated. The nurse should recognize what implication of this assessment finding?
A) this is only an accurate indicator of myocardial damage when it reaches its peak in 24 hours. B) Because the patient has a history of unstable angina this is a poor indicator of myocardial injury. C) This is an accurate indicator of myocardial injury. D) This result indicates muscle injury, but does not specify the source. |
C) This is an accurate indicator of myocardial injury.
*Troponin I is specific to cardiac muscle, it is elevated within hours of the myocardial injury occurring. Even with a diagnosis of unstable angina, this is an accurate indicator of myocardial injury. |
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The nurse is caring for an 82-year-old patient. The nurse knows that changes in cardiac structure and function occur in older adults. What is a normal change expected in the aging heart of an older adult?
A) Decreased left ventricular ejection time. B) Decreased connective tissue in the SA & AV nodes and the bundle branches. C) Thinning and flaccidity of the cardiac values. D) Widening of the aorta. |
D) Widening of the aorta.
*Changes in cardiac structure and function are clearly observable in the aging heart. Aging results in - decreased elasticity and widening of the aorta - thickening and rigidity of the cardiac valves - INCREASED connective tissue in the SA and AV node and bundle branches - INCREASED left ventricular ejection time (prolonging systole) |
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A resident of a long-term care facility has complained of chest pain. What aspect of the residents pain would The most suggestive of angina is the cause?
A) The pain is worse when the resident inhales deeply. B) The pain occurs immediately following physical exertion. C) The pain is worse when the resident coughs. D) The pain is most severe when the resident moves his upper body. |
B) The pain occurs immediately following physical exertion
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