NSG 456 Exam 1

A QRS complex should measure no more than? A. 0.20 seconds B. 0.12 seconds C. 0.08 seconds D. 0.04 seconds

B. 0.12 seconds

The process that causes a heart cell to contract is known as? A. Repolarization B. Polarization C. Depolarization

C. Depolarization

8. What medication below is NOT a treatment for Sinus Tachycardia? A. Verapamil B. Metoprolol C. Antipyretics D. Dopamine

D. Dopamine (increases HR and BP)

Sinus tachycardia originates from what part of the electrical conduction system? A. Bundle of His B. Bundle Branches C. AV Node D. SA Node

D. SA Node

True or False: The SA node is located in the Left atrium. False True

True

What area of the heart is responsible for the delay of conduction between the artrium and ventricles? A. AV node B. Bundle of His C. Bachmann's Bundle D. Right bundle branch

A. AV node

What part of the heart's electrical system is known as the "gatekeeper"? A. AV node B. Gap Junction C. Tetany D. SA node

A. AV node

You're assessing a patient who is post-opt from a chest tube insertion. On assessment, you note there is 50 cc of serosanguinous fluid in the drainage chamber, fluctuation of water in the water seal chamber when the patient breathes in and out, and bubbling in the suction control chamber. Which of the following is the most appropriate nursing intervention? A. Document your findings as normal. B. Assess for an air leak due to bubbling noted in the suction chamber. C. Notify the physician about the drainage. D. Milk the tubing to ensure patency of the tubes.

A. Document your findings as normal.

What are possible causes of Sinus Tachycardia? Select all that apply: A. Exercise B. Atropine C. Pain D. Sick Sinus Syndrome E. Cardiogenic shock F. Hypothyroidism

A. Exercise B. Atropine C. Pain E. Cardiogenic shock

What two factors are used to calculate cardiac output? Select all that apply: A. Heart rate B. Blood pressure C. Stroke volume D. Mean arterial pressure

A. Heart rate C. Stroke volume

A patient is receiving mechanical ventilation with PEEP. The patient had developed a tension pneumothorax. Select ALL the signs and symptoms that can present with this condition: A. Hypotension B. Jugular Venous Distention C. Bradycardia D. Tracheal deviation E. Hyperemia F. Tachypnea

A. Hypotension B. Jugular Venous Distention D. Tracheal deviation F. Tachypnea

A patient is recovering from a pneumothorax and has a chest tube present. Which of the following is an appropriate finding when assessing the chest tube drainage system? A. Intermittent bubbling may be noted in the water seal chamber. B. 200 cc of drainage per hour is expected during recovery of a pneumothorax. C. The chest tube is positioned at the patient's chest level to facilitate drainage. D. All of these options are appropriate findings.

A. Intermittent bubbling may be noted in the water seal chamber.

When heart muscle cells are in the resting state they have what type of charge? A. Negative B. Positive C. Neutral D. Depolarized

A. Negative

You're analyzing a patient's ECG reading. What should be found in the rhythm for it to be considered Sinus Bradycardia (select all that apply): A. One p wave present in front of every QRS complex B. Atrial rate 60 and ventricular rate of 60 C. Regular atrial and ventricular rate D. Atrial rate 40 and ventricular rate of 40 E. Regular atrial rate and irregular ventricular rate F. PR interval 0.14 seconds G. PR interval 0.36 seconds H. QRS interval 0.08 seconds I. QRS interval 0.16 seconds

A. One p wave present in front of every QRS complex B. Atrial rate 60 and ventricular rate of 60 C. Regular atrial and ventricular rate F. PR interval 0.14 seconds H. QRS interval 0.08 seconds

You're analyzing an ECG strip. In order for the rhythm to be identified as Sinus Tachycardia, what must be present in the rhythm? (Select all that apply): A. One p wave present in front of every QRS complex B. Atrial rate >100 bpm C. Ventricular rate >100 bpm D. Regular atrial rate and irregular ventricular rate E. Regular atrial and ventricular rate F. Atrial rate <60 bpm G. QRS complex <0.12 seconds H. PR interval 0.12-0.20 seconds I. PR interval >0.20 seconds

A. One p wave present in front of every QRS complex B. Atrial rate >100 bpm C. Ventricular rate >100 bpm E. Regular atrial and ventricular rate G. QRS complex <0.12 seconds H. PR interval 0.12-0.20 seconds

Select all the characteristics a normal p-wave should have? (SATA) A. One p-wave should accompany a QRS complex. B. They should measure more than 0.36 seconds in duration. C. P-waves should be flat. D. P-waves should be round and upright. E. Multiple p-waves can accompany a QRS complex.

A. One p-wave should accompany a QRS complex. D. P-waves should be round and upright.

Which part of the PQRST complex represents atrial depolarization? A. P-wave B. QRS complex C. T-wave D. ST segment

A. P-wave

What area of the heart forms the QRS part on an EKG? A. Purkinje fibers B. Left and right bundles C. AV node D. SA node

A. Purkinje fibers

When a heart muscle cell goes back into its negatively charged state, or in other words, when it relaxes this is known as? A. Repolarization B. Polarization C. Depolarization

A. Repolarization

What area of the heart's electrical conduction is known as the "pacemaker" of the heart? A. SA node B. AV node C. Purknije Fibers D. Bundle of His

A. SA node

What is the correct sequence of electrical conduction of the heart? A. SA node, internodal pathways, AV node, Bundle of His, Right and Left Bundle Branch, Purkinje fibers B. AV node, internodal pathways, SA node, Bundle of His, Right and Left Bundle Branch, Purkinje fibers C. SA node, internodal pathways, AV node, Purkinje Fibers, Right and Left Bundle Branch, Bundle of His D. None of the options are correct

A. SA node, internodal pathways, AV node, Bundle of His, Right and Left Bundle Branch, Purkinje fibers

The patient reports symptoms of chest pain, has cool and clammy skin, dyspnea, and feels like they may faint. The nurse give them atropine per the providers protocol. The atropine was ineffective for treating the bradycardia. The patient is still symptomatic with a rate 35 bpm. What other options could be considered for the patient? Select all that apply: A. Transcutaneous pacing B. Amiodarone Infusion C. Dopamine Infusion D. Epinephrine Infusion

A. Transcutaneous pacing C. Dopamine Infusion D. Epinephrine Infusion

What conditions below can result in an increased cardiac afterload? Select all that apply: A. Vasoconstriction B. Aortic stenosis C. Vasodilation D. Dehydration E. Pulmonary Hypertension

A. Vasoconstriction B. Aortic stenosis E. Pulmonary Hypertension

What is hypoxia? A. insufficient oxygen at the tissue level B. Low oxygen in the blood C. Decreased respiratory drive D. Low oxygen intake through the lungs

A. insufficient oxygen at the tissue level

Which statement below best describes why Sinus Tachycardia could lead to decreased cardiac output? A. "The atrial kick is decreased leading to inadequate atria emptying." B. "The ventricles don't have enough time to fill completely so less blood is pumped out of the heart." C. "The rapid firing of the SA node leads to rapid atrial contraction and causes blood to pool in the atria." D. "The ventricles are unable to properly contract and push blood forward so less blood is pumped out of the heart."

B. "The ventricles don't have enough time to fill completely so less blood is pumped out of the heart."

Which statement is CORRECT about a tension pneumothorax? A. This condition happens when an opening to the intrapleural space creates a two-way valve which causes pressure to build up in the space leading to shifting of the mediastinum. B. A tension pneumothorax is a medical emergency and is treated with needle decompression. C. Tracheal deviation is an early sign of a tension pneumothorax D. An open pneumothorax is the only cause of a tension pneumothorax.

B. A tension pneumothorax is a medical emergency and is treated with needle decompression.

What area of the heart forms the PR segment on the EKG? A. Purkinje fibers B. AV node and Right and Left Bundles C. Apex of heart D. Bundle of His

B. AV node and Right and Left Bundles

Which medication below should not be used for the treatment of sinus bradycardia in a patient with a transplanted heart? A. Isoproterenol B. Atropine C. Epinephrine D. Glucagon

B. Atropine

Your patient is experiencing Sinus Tachycardia with a rate of 160 bpm. Which findings below demonstrate the patient is experiencing a decrease in cardiac output? Select all that apply: A. Blood pressure 220/120 mmHg B. Blood pressure70/42 mmHg C. Crackles throughout the lung fields D. Decreased capillary refill time E. Cool extremities

B. Blood pressure70/42 mmHg C. Crackles throughout the lung fields E. Cool extremities

Once electrical signals pass through the Bundle of His, they next travel to? A. AV node B. Bundle branches C. SA node D. Purkinje Fibers

B. Bundle branches

A patient has a blood pressure of 220/140. The physician prescribes a vasodilator. This medication will? A. Decrease the patient's blood pressure and increase cardiac afterload B. Decrease the patient's blood pressure and decrease cardiac afterload C. Decrease the patient's blood pressure and increase cardiac preload D. Increase the patient's blood pressure but decrease cardiac output.

B. Decrease the patient's blood pressure and decrease cardiac afterload

Select the characteristics of the AV node: (select all that apply) A. It is known as the pacemaker. B. It causes a delay in electrical signal transfer so the atria can fully empty into the ventricles. C. It's known as the gatekeeper. D. It fires and sends impulses to cause atrial depolarization of the right and left atria. E. It's found in the lower part of the right atrium just above the tricuspid valve. F. It's found in the upper part the right atrium.

B. It causes a delay in electrical signal transfer so the atria can fully empty into the ventricles. C. It's known as the gatekeeper. E. It's found in the lower part of the right atrium just above the tricuspid valve.

While helping a patient with a chest tube reposition in the bed, the chest tube becomes dislodged. What is your immediate nursing intervention? A. Stay with the patient and monitor their vital signs while another nurse notifies the physician. B. Place a sterile dressing over the site and tape it on three sides and notify the physician. C. Attempt to re-insert the tube. D. Keep the site open to air and notify the physician.

B. Place a sterile dressing over the site and tape it on three sides and notify the physician.

Stroke volume plays an important part in cardiac output. Select all the factors below that influence stroke volume: A. Heart rate B. Preload C. Contractility D. Afterload E. Blood pressure

B. Preload C. Contractility D. Afterload

Your patient develops Sinus Tachycardia with a heart rate of 136 bpm. The patient is post-op from hip surgery. The patient reports chest pain that is worst with each breath in and has shortness of breath. These findings can correlate with what serious condition? A. Cardiogenic shock B. Pulmonary embolism C. Sick Sinus Syndrome D. Hypovolemic shock

B. Pulmonary embolism

Which part of the PQRST complex represents ventricular depolarization? A. P-wave B. QRS complex C. T-wave D. ST segment

B. QRS complex

Sinus bradycardia originates in what part of the electrical conduction system? A. AV node B. SA node C. Bundle Branches D. Bundle of His

B. SA node

Which statement below best describes the term cardiac preload? A. The pressure the ventricles stretch at the end of systole. B. The amount the ventricles stretch at the end of diastole. C. The pressure the ventricles must work against to pump blood out of the heart. D. The strength of the myocardial cells to shorten with each beat.

B. The amount the ventricles stretch at the end of diastole.

A patient with a chest tube has no fluctuation of water in the water seal chamber. What could be the cause of this? A. This is an expected finding. B. The lung may have re-expanded or there is a kink in the system. C. The system is broken and needs to be replaced. D. There is an air leak in the tubing.

B. The lung may have re-expanded or there is a kink in the system.

A patient has a chest tube for treatment of a pneumothorax in the left lung. Which finding during your assessment requires immediate nursing intervention? A. The water seal chamber has intermittent bubbling. B. The patient has slight tracheal deviation to the right side. C. The water seal chamber fluctuates while the patient inhales and exhales. D. The patient complains of tenderness at the chest tube insertion site.

B. The patient has slight tracheal deviation to the right side.

A patient with hypovolemic shock is given IV fluids. IV fluids will help _________ cardiac output by: A. decrease; decreasing preload B. increase, increasing preload C. increase, decreasing afterload D. decrease, increasing contractility

B. increase, increasing preload

A normal PR interval should measure between? A. 0.04-0.12 seconds B. 0.20-0.36 seconds C. 0.12-0.20 seconds D. 0.35-0.40 seconds

C. 0.12-0.20 seconds

The nurse is assessing an ECG strip and counts 30 LARGE squares. How many seconds of time did the nurse count? A. 30 seconds B. 10 seconds C. 6 seconds D. 60 seconds

C. 6 seconds (0.2 seconds for big square)

The SA node fires at a rate of? A. 80-90 bpm B. 40-60 bpm C. 60-100 bpm D. 60-80 bpm

C. 60-100 bpm

You obtain an ECG on a patient and the rhythm is sinus bradycardia with a rate of 52 bpm. Your NEXT nursing action is to? A. Prepare to administer Atropine IV push B. Set-up for transcutaneous pacing C. Assess the patient D. Call a rapid response

C. Assess the patient

What is hypoxemia? A. Low oxygen in the lungs B. Decreased CO2 output C. Low oxygen in the blood D. Decreased respiratory rate

C. Low oxygen in the blood

Which treatments below would decrease cardiac preload? Select all that apply: A. IV fluid bolus B. Norepinephrine C. Nitroglycerin D. Furosemide

C. Nitroglycerin D. Furosemide

The nurse is assessing an ECG strip and begins measuring at the beginning of the p-wave to the beginning of the QRS complex. What is the nurse measuring? A. P-wave B. ST segment C. PR interval D. PR segment

C. PR interval

Which of the following is NOT a treatment for symptomatic sinus bradycardia? A. Dopamine B. Atropine C. Synchronized cardioversion D. Transcutaneous pacing

C. Synchronized cardioversion

Which part of PQRST complex represents ventricular repolarization? A. QRS complex B. ST segment C. T-wave D. P-wave

C. T-wave

You're providing care to a 55-year-old male. You note on the bedside monitor the patient has a heart rate of 116 bpm. You obtain an ECG and discover the patient rhythm is Sinus Tachycardia. You assess probable causes of this rhythm. Which finding below could be a cause of this patient's heart rhythm? A. Digoxin therapy B. Pain rating of 2 on 1-10 scale C. Temperature 103.6'F D. Blood glucose of 86 mg/dL

C. Temperature 103.6'F

Which of the following is a LATE sign of the development of a tension pneumothorax?* A. Hypotension B. Tachycardia C. Tracheal deviation D. Dyspnea

C. Tracheal deviation

On an EKG/ECG strip each small square represents how many seconds of time? A. 0.20 second B. 0.02 seconds C. 0.12 seconds D. 0.04 seconds

D. 0.04 seconds

You are providing care to a patient with a chest tube. On assessment of the drainage system, you note continuous bubbling in the water seal chamber and oscillation. Which of the following is the CORRECT nursing intervention for this type of finding? A. Reposition the patient because the tubing is kinked. B. Continue to monitor the drainage system. C. Increase the suction to the drainage system until the bubbling stops. D. Check the drainage system for an air leak.

D. Check the drainage system for an air leak.

Your patient is experiencing extreme fatigue, hypotension, palpations, and shortness of breath. You obtain an ECG and discover a rhythm of sinus bradycardia with a rate of 40 bpm. What finding below could be causing this condition? A. Potassium level of 3.9 meq/L B. Lisinopril 10 mg BID PO C. Blood glucose 84 D. Digoxin 0.125 mg PO daily

D. Digoxin 0.125 mg PO daily (dig slows down HR)

The patient in room 2569 calls on the call light to tell you something is wrong with his chest tube. When you arrive to the room you note that the drainage system has fallen on its side and is leaking drainage onto the floor from a crack in the system. What is your next PRIORITY? A. Place the patient in supine position and clamp the tubing. B. Notify the physician immediately. C. Disconnect the drainage system and get a new one. D. Disconnect the tubing from the drainage system and insert the tubing 1 inch into a bottle of sterile water and obtain a new system.

D. Disconnect the tubing from the drainage system and insert the tubing 1 inch into a bottle of sterile water and obtain a new system.

Select the statement below that best describes cardiac afterload: A. It's the volume amount that fills the ventricles at the end of diastole. B. It's the volume the ventricles must work against to pump blood out of the body. C. It's the amount of blood the left ventricle pumps per beat. D. It's the pressure the ventricles must work against to open the semilunar valves so blood can be pumped out of the heart.

D. It's the pressure the ventricles must work against to open the semilunar valves so blood can be pumped out of the heart.

On an EKG the P-wave represents what area of the heart? A. Left bundle branch B. AV node C. Bachmann's Bundle D. SA node

D. SA node

Which part of the electrical conduction system is located in the upper part of the right atrium and is responsible for atrial depolarization? A. AV node B. Bundle of His C. Purkinje Fibers D. SA node

D. SA node

___________ is the amount of blood pumped by the left ventricle with each beat. A. Cardiac output B. Preload C. Afterload D. Stroke volume

D. Stroke volume

True or False: Depolarization of the heart muscle is when the muscle contracts and repolarization is when the heart muscle rests. True False

True

True or False: Pulmonary and systemic vascular resistance both play a role with influencing cardiac afterload. True False

True