Complex Med Surg

Front 1

The nurse is caring for a client who has premature ventricular contractions. What sign or symptom is observed in this client?

Back 1

Fluttering

Front 2

Which is not a likely origination point for cardiac arrhythmias?

Back 2

Bundle of his

Front 3

The nurse is caring for a client with atrial fibrillation. What procedure would be recommended if drug therapies did not control the arrhythmia?

Back 3

Elective cardioversion

Front 4

After evaluating a client for hypertension, a health care provider orders atenolol, 50mg P.O. Daily. Which therapeutic effect should atenolol have in treating hypertension?

Back 4

Decreased cardiac output and decreased systolic and diastolic blood pressure

Front 5

Which ECG waveform characterizes conduction of an electrical impulse through the left ventricle?

Back 5

QRS complex

Front 6

A client arriving at the emergency department with ventricular arrhythmias. What should the nurse place in the room for treatment?

Back 6

A defibrillator

Front 7

The nurse is placing electrodes for a 12 lead electrocardiogram (ECG). The nurse would be correct in placing an electrode on which area for V1?

Back 7

Right side of sternum, 4th intercostal space

Front 8

Which electrocardiogram (ECG) characteristic is usually seen when a client’s serum potassium level is low?

Back 8

U wave

Front 9

Which electrocardiogram (ECG) characteristic is usually seen when a client’s serum potassium level is high?

Back 9

Peaked T wave

Front 10

Which ECG characteristic reflects the time from ventricular depolarization to repolarization?

Back 10

QT interval

Front 11

What are the parts of the cardiac complex on a EKG strip?

Back 11

P wave

P-R interval

T wave

Front 12

What post implantation instructions must be provided to the client with a permanent pacemaker?

Back 12

Avoid sources of electrical interference

Front 13

A patient has had an implantable cardioverter defibrillator inserted. What should the nurse be sure to include in the education of this patient prior to discharge?

Back 13

Avoid magnetic fields such as metal detection booths

Call for emergency assistance if feeling dizzy

Record events that trigger a shock sensation

Front 14

A client reports light headedness, chest pain and shortness of breath. The physician orders tests to ascertain what is causing the client’s problems. Which test is used to identify cardiac rhythms?

Back 14

Electrocardiogram

Front 15

The nurse knows that electrocardiogram characteristics of atrial fibrillation include what?

Back 15

Atrial rate of 300 to 400

Front 16

The registered nurse reviewed the patient’s vital signs and noted a consistent pattern of heart rate recordings between 48 and 58 bpm over a 24 hour period of time. What medication will cause bradycardia?

Back 16

Atenolol

Front 17

A demand mode pacemaker is what type of pacemaker?

Back 17

Self activated

Front 18

The nurse is caring for a client who has a suspected dysthymia. What most appropriate intervention should the nurse use to help detect dysthymias?

Back 18

Monitor cardiac rhythm continuously

Front 19

A client with atrial fibrillation, who does not respond to conventional treatment measures and who is not a candidate for cardioversion, would have what procedure recommended?

Back 19

Maze procedure

Front 20

During electrical cardioversion, the defibrillator is set to synchronize with the electrocardiogram (ECG) so that the electrical impulse discharges during?

Back 20

Ventricular depolarization

Front 21

After performing a ECG on an adult client, the nurse reports that the PR interval reflects normal sinus rhythm. What is the PR interval for a normal sinus rhythm?

Back 21

0.12 and 0.2 seconds

Front 22

A woman with a history of atrial fibrillation and hypertension. The nurse should presume that this patient will likely be taking which medication?

Back 22

Warfarin (Coumadin)

Front 23

The nurse is preparing to administer adenosine for a patient diagnosed with atrial flutter. How should the nurse administer this medication?

Back 23

The dose is administered rapid IV push

Front 24

The nurse is analyzing a rhythm strip. What does the nurse look at to identify ventricular depolarization?

Back 24

T wave

Front 25

What potential complication should the nurse assess for most closely in a postoperative patient immediately following permanent pacemaker implantation?

Back 25

Bleeding at the implantation site

Front 26

A client with frequent premature ventricular contractions is prescribed amiodarone. The nurse will withhold the medication until the completion of which diagnostic test?

Back 26

Pulmonary function

Front 27

The staff educator is teaching a CPR class. What is an important aspect of defibrillating that the educator stresses to their class?

Back 27

Use a conducting medium between the multifunction paddles and the skin

Front 28

The nurse is working on a monitored unit assessing the cardiac monitor rhythms. Which waveform pattern needs attention first?

Back 28

Ventricular fibrillation

Front 29

What is the drug of choice for a stable client with ventricular tachycardia?

Back 29

Amiodarone

Front 30

What does a catheter ablation do to treat recurrent atrial arrhythmias?

Back 30

Destroys the specific cardiac cells that are causing the patients arrhythmias

Front 31

The nurse is attempting to determine the ventricular rate and rhythm of a patient’s telemetry strip. What should the nurse examine to determine this part of the analysis?

Back 31

RR interval

Front 32

A nurse is caring for a client who has been admitted to have a cardioverter defibrillators are used in which clients?

Back 32

Clients with recurrent life threatening tachydysrhythmias

Front 33

The nurse is providing discharge instructions to a client after a permanent pacemaker insertion. Which safety precaution will the nurse communicate to the client?

Back 33

Avoid undergoing magnetic resonance imaging (MRI)

Front 34

When the nurse observes that the client’s heart rate increases during inspiration and decreases during expiration, the nurse reports that the client is demonstrating?

Back 34

Sinus dysthymia

Front 35

A patient is 2 days postoperative after having a permanent pacemaker inserted. The nurse observes that the patient is having continuous hiccups as the patient states, “I thought this was normal “. What does the nurse understand is occurring with this patient?

Back 35

Lead wire dislodgement

Front 36

Which rhythm is also termed a ventricular escape rhythm?

Back 36

Idioventricular rhythm

Front 37

What term is used to describe a tachycardia characterized by abrupt onset, abrupt cessation, and a QRS of normal duration?

Back 37

Paroxysmal atrial tachycardia

Front 38

Normal SA node HR

Back 38

60 - 100 bpm

Front 39

Normal PR Interval

Back 39

0.12 - 0.20

Front 40

Normal QRS

Back 40

0.8-0.12

Front 41

Normal QT

Back 41

Less than 0.40 sec is good

Front 42

Correct order of waves on ECG

Back 42

P wave-QRS-T wave

All upright on lead 2

Front 43

P wave represents what on ECG?

Back 43

Atrial depolarization (contraction)

Front 44

PR Interval represents what on ECG?

Back 44

Atrial depolarization and some repolarization

Front 45

QRS represents what on ECG?

Back 45

Ventricular Depolarization (contraction)

Front 46

QT Interval represents what on ECG?

Back 46

Ventricular depolarization and some depolarization

Front 47

ST elevation is on ECG represents what?

Back 47

Stemi

Front 48

Does not have ST elevation on ECG represents?

Back 48

Non Stemi

Front 49

Normal Potassium level

Back 49

3.5 to 5

Front 50

Hyperkalemia shows up on ECG as what?

Back 50

Peaked T wave

Front 51

Most common on ECG with hypokalemia?

Back 51

U wave

Front 52

ST elevation on ECG represents?

Back 52

Acute injury

Person in process of MI

Front 53

ST depression on ECG represents?

Back 53

Less damage or heart has recovered

Front 54

T wave inversion represents on ECG?

Back 54

Eschemia (lack of blood supply)

Front 55

T wave inversion represents on ECG?

Back 55

Eschemia (lack of blood supply)

Front 56

After MI and that part of heart is dead, not repairable is called?

Back 56

Infarction

Front 57

What is it called when HR is greater than 100?

Back 57

Tachycardia

Front 58

What is it called when HR is less than 60bpm?

Back 58

Bradycardia

Front 59

Conditions that cause Hypokalemia?

Back 59

Taking lasix

Excess vomiting

NG Tube

Front 60

Causes of Hyperkalemia

Back 60

Potassium sparing diuretics

Renal failure patient

Over eating foods with potassium

Front 61

Foods high in potassium

Back 61

Bananas

Tomatoes

Potatoes

OJ

Front 62

Treatment for Ventricular Fibrillation?

Back 62

Defib

Front 63

What is the treatment for a patient in Ventricular Tachycardia asymptomatic with pulse?

Back 63

O2, IV, Heart monitor

Front 64

What is the treatment for patient in V Tach, symptomatic with pulse?

Back 64

O2, IV, heart monitor

Synchronized cardioversion

Front 65

What is treatment for patient in V Tach with No pulse?

Back 65

Defib

Front 66

A nurse is?

Back 66

Coordinator, evaluator, assessor, motivator

Front 67

What a nurse is Not?

Back 67

Self confessor

Dominator

Front 68

How to treat Hyperkalemia?

Back 68

Can use lasix

Polystyrene Sodium

Front 69

In A Fib what pulse is considered RVR (rapid ventricular response)

Back 69

Greater than 100

Front 70

What do you think of when it’s A fib? Main problem?

Back 70

Blood clots

Front 71

What is a common diagnosis in a patient with A fib?

Back 71

CHF

Front 72

Aspirin and plavix are what drugs?

Back 72

Anti platelet

Front 73

Eliquis, Coumadin (warfarin), lovenox, heparin are considered what?

Back 73

Anti coagulants

Front 74

TPA, Alteplase, Reteplase

Are examples of what type of drug?

Back 74

Thrombolytic, fibrinolytic

(Breaks up blood clots)

Front 75

Right Side Heart Failure s/sx?

Back 75

DJV (distended jugular veins)

Edema

Weight gain

Ascites

Front 76

Left side heart failure s/sx?

Back 76

C- cough

H- hemoptysis

O- orthopnea

P- pulmonary congestion (crackles/rales) pink frothy sputum

Front 77

What do you do for asystole?

Back 77

CPR-Epinephrine-vasopressin-ET tube

Front 78

What do wide deep Q waves mean on a ECG?

Back 78

Old infarction

Front 79

What does hypercalcemia look like on ECG?

Back 79

Shortened QT wave

Front 80

What does hypocalcemia look like on a ECG?

Back 80

Prolonged QT interval

Front 81

Normal path of electrical conduction through the heart?

Back 81

SA Node - AV Node - Bundle of His - Rt/Lt Bundle branches - purkinjie fibers