NCLEX cardiovascular questions Disrhythmias and hemodynamics

Which of the following ECG characteristics is consistent with a diagnosis of ventricular tachycardia (VT)?

Rate 200 beats/min; P wave not visible

Auscultation of a patient's heart reveals the presence of a murmur. This assessment finding is a result of

Turbulent blood flow across a heart valve.

The nursing student is seeking assistance in hearing the patients abnormal heart sounds. What should the nurse tell the student to do for more effective assessment?

Use the bell code of the stethoscope with the patient leaning forward.

For which of the following dysrhythmias is defibrillation primarily indicated?

Ventricular fibrillation

The nurse is watching the cardiac monitor, and a patient's rhythm suddenly changes. There are no P waves. Instead there are fine, wavy lines between the QRS complexes. The QRS complexes measure 0.08 sec (narrow), but they occur irregularly with a rate of 120 beats/min. The nurse correctly interprets that this rhythm is which of the following?

Ventricular tachycardia

The ECG monitor of a patient in the cardiac care unit following an MI indicates ventricular bigeminy with a rate of 50 beats per minute. The nurse would anticipate:

assessing the pt's response to the dysrhythmia.

The QRS complex on an ECG represents

depolarization from the AV node throughout the ventricles.

When assessing the cardiovascular system of a 79 year old pt, you might expect to find

difficulty in isolating the apical pulse.

A nurse is caring for a client recovering from a radical mastectomy. The nurse understands the specific goal for making a fist and releasing it on the affected side is to?

reduce transient edema.

The U wave on an ECG, if seen represents

repolarization of the Perkinje fibers or may be associated with hypokalemia.

The T wave on an ECG represents

repolarization of the ventricles.

Increases in which blood studies are diagnostic for acute coronary syndrome (ACS) select all that apply

Copeptin, cardiac troponin T (cTnT)

Which method is used to evaluate the ECG responses to normal activity over a period of 1-2 days?

Holter monitoring

A patient is scheduled for exercise nuclear imaging testing. The nurse explains to the patient that this test involves

IV administration of a radioisotope at the maximum heart rate during exercise to identify the hearts response to physical stress.

Which of the following instructions given to a patient who is about to undergo Holter monitoring is most appropriate?

"You will need to keep a diary of all your activities and symptoms."

Which of the following cardiovascular effects of aging should the nurse anticipate when providing care for older adults?

A) Arterial stiffening B) Increased blood pressure D) Decreased maximal heart rate E) Increased recovery time from activity

The nurse is caring for a patient who is 24 hours postpacemaker insertion. Which of the following nursing interventions is most appropriate at this time?

Assessing the incision for any redness, swelling, or discharge

When computing a heart rate from the ECG tracing, the nurse counts 15 of the small blocks between the R waves of a patient whose rhythm is regular. From these data, the nurse calculates the patient's heart rate to be which of the following?

100 Beats/min

A patient in asystole is likely to receive which of the following drug treatments?

Atropine and epinephrine

A patient with severe blockage in his right coronary artery. Which cardiac structure is most likely to be affected by this?

AV node.

When caring for a patient after cardiac catherization with coronary angiography, which finding should be of most concern to the nurse?

Absence of pulses distal to the catheter insertion site

A nurse is caring for an older adult with PVD and a venous ulcer on the right ankle. Which of the following assessment findings should the nurse expect to observe in the affected extremity?

Ankle swelling

A nurse is caring for a patient immediately following a transesophageal echocardiogram (TEE). Which of the following assessments are appropriate for this patient

Assess for return of gag reflex.Monitor vital signs and oxygen saturation.

The nurse is providing care for a patient who has decreased cardiac output related to heart failure. The nurse recognizes that cardiac output is

Calculated by multiplying the patient's stroke volume by the heart rate.

Which finding is associated with blue color around the lips and conjunctiva?

Central cyanosis

What sounds can be auscultated in a patient with cardiac valve problems? (Select all that apply)

Heart murmurs, third heart sound S3, fourth heart sound S4

The nurse is admitting a patient who is scheduled to undergo a cardiac catheterization. Which of the following allergies is most important for the nurse to assess before this procedure?

Iodine

The blood pressure of a 71-year-old patient admitted with pneumonia is 160/70 mm Hg. Which of the following is an age-related change that contributes to this finding?

Loss of elasticity in arterial vessels

Priority decision: The nurse caring for a patient immediately following a transesophageal echocardiogram (TEE) should consider which action to be highest priority?

Maintain NPO status until gag reflex has returned

Which of the following nursing responsibilities are priorities when caring for a pt returning from a cardiac catheterization?

Monitoring vital signs and ECG, and checking catheter insertion site and distal pulses.

While assessing the cardiovascular status of a patient, the nurse performs auscultation. Which of the following practices should the nurse implement into the assessment during auscultation?

Palpate the radial pulse while auscultating the apical pulse.

A patient has sought care following a syncopal episode of unknown etiology. Which of the following nursing actions should the nurse prioritize in the patient's subsequent diagnostic workup?

Preparing to assist with a head-up tilt-test

The nurse is monitoring the ECG of a pt admitted with ACS. Which of the following ECG characteristics would be most suggestive of ischemia?

Sinus rhythm with a depressed ST segment.

When collecting subjective data related to the cardiovascular system, what information should be obtained by the patient?

Smoking history, religious preference, and number of pillows used to sleep at night.

Which of the following patient teaching points should a nurse include when providing discharge instructions to a pt with a new permanent pacemaker and the caregiver:

Take and record a daily pulse rate, Obtain and wear a medical alert bracelet, avoid lifting the arm on the side with the pacemaker above the shoulder.

Which of the following statements best describes the electrical activity of the heart represented by measuring the PR interval on the ECG?

The length of time for the electrical impulse to travel from the SA node to the Purkinje fibers.

The nurse obtains a 6-second rhythm strip and charts the following analysis: atrial rate 70, regular; ventricular rate 40, regular; QRS 0.04 sec; no relationship between P waves and QRS complexes; atria and ventricles beating independently of each other. Which of the following would be a correct interpretation of this rhythm strip?

Third-degree heart block

A 59-year-old man has presented to the emergency department with chest pain. Which of the following components of his subsequent blood work is most clearly indicative of a myocardial infarction (MI)?

Troponin

A P-wave on an ECG represents an impulse

arising at the SA node and depolarizing the atria.

When a person's blood pressure rises, the homeostatic mechanism to compensate for an elevation involves stimulation of:

baroreceptors that inhibit the sympathetic nervous system, causing vasodilation.

A client has been admitted with a diagnosis of septic shock secondary to an untreated foot wound. The nurse should suspect that the client may be developing DIC if which of the following findings are present:

bleeding at the venipuncture site, petechiae on chest and arms, and abdominal distension.

When assessing a pt, you note a pulse deficit of 23 beats. This finding may be caused by

dysrhythmias.

The portion of the vascular system responsible for hemostasis is the:

endothelial layers of the arteries.

The auscultatory area in the left midclavicular line at the base of the 5th ICS is the

mitral area.

A patient admitted with ACS has continuous ECG monitoring. An examination of the rhythm strip reveals the following characteristics: atrial rate-74 and regular; ventricular rate-62 and irregular; normal P wave; PR interval- lengthens progressively until a P wave is not conducted; QRS- normal. The priority nursing intervention would involve:

observing for symptoms of hypotension or angina.

The nurse prepares a pt for synchronized cardioversion knowing that cardioversion DIFFERS from defibrillation in that:

patients should be sedated if cardioversion is done on a non-emergency basis.

A patient with a tricuspid valve disorder will have impaired blood flow between:

right atrium and right ventricle.

Important teaching for the patient scheduled for a radiofrequency catheter ablation procedure includes explaining that

the procedure will destroy areas of the conduction system that are causing rapid heart rhythms.

If the Purkinje system is damaged, the conduction of the electrical impulse is impaired through the:

ventricles.