CV Quiz 1 combined

The EXG pattern of a patient with a regular HR reveals 20 small squares between each R-R interval. What is the patients heart rate? _____BPM

1500 / 20 = 75bpm

The patient with a regular HR has four QRS complexes between every 3-sec marker on the ECG paper. Calculate the Patients Heart rate. ____ BPM

4}(beats per 3 sec) + 4 = 8X 10 = 80 bpm

Which rhythm pattern finding is indicative of PVCs? A. A QRS complex >.12 sec followed by a P wave B. Continuous wide QRS complexes with a ventricular rate of 160 bpm C. P waves hidden in QRS complexes with regular rhythm of 120bpm D. Saw-toothed P waves with no measurable PR interval and an irregular rhythm

A. A QRS complex >.12 sec followed by a P wave

What describes refractoriness? A. Abnormal electrical impulses B. Period in which heart tissue cannot be stimulated C. Areas of the heart do not repolarize at the same rate because of depressed conduction D. Sodium migrates rapidly into the cell so it is positive compared to the outside of the cell

B. Period in which heart tissue cannot be stimulated

What accurately describes ECG monitoring? a. Depolarization of the cells in the ventricles produces the T was on the ECG, b. B. An abnormal cardiac impulse that arises in the atria, ventricles, or AV junction can creat a premature beat that is know as an artifact c. Lead placement for V1 includes one lead each for right arm right leg left arm and left leg with the fifth lead on the fourth intercostal space to the right of the sternal border d. If the SA node fails to discharge an impulse or discharges very slowly, a secondary pacemaker in the AV node is able to dischare at a rate of 30-40 times per minute.

C. The V1 leads are placed toward each limb and centrally at the fourth intercostal space to the right of the sternal border.

The patients PR interval comprises six small boxes on the ECG graph. What does the nurse determine that this indicated? A. A normal finding B. A problem with ventricular depolarization C. A disturbance in the repolarization of the atria D. A problem with conduction from the SA node to the Ventricular cells

D. A problem with conduction from the SA node to the Ventricular cells

A patient with an acute MI has sinus tachycardia of 126 bpm. the nurse recognizes that ift this dysrhyythmia is not treated the patient is likely to experience. a. hypertension b. escape rhythms C. Ventricular tachycardia D. An increase in infarct size

D. An increase in infarct size

The patient is brought to the emergency department with acute coronary syndrome ACS. What changes should the nurse expect to see on the ECG if only myocardial injury has occurred? A. Absent P wave B. A wide Q wave C. Inverted T wave D. ST segment elevation

D. ST segment elevation

What action is included in the nurses responsibilities in preparing to administer defibrillation? a. Applying gel pads to the patients chest b. Setting the defibrillator to deliver 50 joules c. Setting the defibrillator to a synchronized mode d. Sedating the patient with midazolam (versed) before defibrillation

a. Applying gel pads to the patients chest

A patient on the cardiac telemetry unit goes into ventricular fibrillation and is unresponsive. Following initiation of the emergency call system (code blue), what is the next priority for the nurse in caring for this patient? a. Begin CPR b. Get the crash cart c. Administer amiodarone IV d. Defibrillate with 360 joules

a. Begin CPR

A patients rhythm strip indicates a normal HR and rhythm with normal P waves and QRS complexes but eh PR interval is .26 second. What is the most appropriate action by the nurse? a. Continue to assess the patient. b. Administer atropine per protocol c. Prepare the patient for synchronized cardioversion d. Prepare the patient for placement of temporary pacemaker

a. Continue to assess the patient.

A patient with no history of heart disease has a rhythm strio that shows an occasional distorted P wave followed by normal AV and Ventricular conduction. What should the nurse question the patient about? a. The use of caffeine b. The use of sedatives c. Any aerobic training d. Holding of breath during exertion

a. The use of caffeine

A patient with a sinus node dysfunction has a permanent pacemaker inserted. Before discharge, what should the nurse include when teaching the patient? a. Avoid cooking with microwave ovens. b. Avoid standing near antitheft devices in doorways c. Use mild analgesics to control the chest spasms caused by the pacing current d. Start lifting the arm above the shoulder right away to prevent a "frozen shoulder"

b. Avoid standing near antitheft devices in doorways

While providing discharge instructions to the patient who has had an implantable cardioverter-defibrillator (ICD) inserted, the nurse teaches the patient that if the ICD fires, he or she should do what? a. Lie down b. Call the cardiologist c. Push the reset button on the pulse generator d. Immediately take his or her antidysrhythmic medication

b. Call the cardiologist

In the patient with a dysrhythmia which assessment indicates decreased CO? a. HTN and bradycardia b. Chest pain and dec mentation c. Abdominal distention and hepatomegaly d. Bounding pulses and ventricular heave

b. Chest pain and dec mentation

Which rhythm abnormaly has an increased risk of ventricular tachycardia and ventricular fibrillation? a. PAC b. PVC on the T wave c. Premature ventricular contraction d. PVC couplet

b. PVC on the T wave

A patient with an acute myocardial infarction MI develops the following ECG pattern : Atrial rate of 82 and regular; ventricular rate of 46 and regular; p was and QRS complex are normal but there is no relationship between the P wave and the QRS complex. What dysrhythmia does the nurse identify this as and what treatment is expected? a. Sinus bradycardia treated with atropine b. Third-degree heart block treated with a pacemaker c. Atrial fibrillation treated with electrical cardio version d. Type 1 second degree AV block treated with observation

b. Third-degree heart block treated with a pacemaker

In the patient experiencing ventricular fibrillation (VF) what is the rationale for using cardiac defibrillation? a. Enhance repolarization and relaxation of ventricular myocardial cells b. Provide an electrical impulse that stimulates normal myocardial contractions c. Depolarize the cells of the myocardium to allow the SA node to resume pacemaker function d. Deliver an electrical impulse to the heart at the time of ventricular contraction to convert the heart to a sinus rhythm

c. Depolarize the cells of the myocardium to allow the SA node to resume pacemaker function

The nurse is evaluation the tele ECG rhythm strip. How should the nurse document the distorted P wave causing an irregular rhythm? a. A flutter b. Sinus bradycardia c. Premature Atrial contraction (PAC) d. Paroxysmal supraventricular tachycardia (PSVT)

c. Premature Atrial contraction (PAC)

A patient with a acute MI is having multifocal PVS and ventricular couplets. He is alert and has a BO of 118/78 mm Hg with an irregular pulse of 86 bpm. What is the priority nursing action at this time? a. Continue to assess the patient b. Ask the patient to perform Valsalva maneuver c. Prepare to administer ant dysrhythmic drugs per protocol d. Be prepared to administer cardiopulmonary resuscitation (CPR)

c. Prepare to administer ant dysrhythmic drugs per protocol

A patient with chest pain that is unrelieved by nitroglycerin is admitted to the coronary care unit for observation and diagnosis. While the pateitn has continuous ECG monitoring, what finding would most concern the nurse? a. Occasionall PVCs b. An inverted T wave c. ST segment elevation d. A PR interval of .18 seconds

c. ST segment elevation

The use of catheter ablation therapy to "burn: areas of the cardiac conduction system is indicated for the treatment a. Sinus arrest b. Heart blocks c. Tachydysrhythmias d. Premature ventricular tachycardia

c. Tachydysrhythmias

What accurately describes the PR interval (select all that apply)? a. .16 sec b. <.12 sec c. .06-.12 sec d. .12-.2 sec e. Time of depolarization and repolarization of the ventricles f. Measured from beginning of the P wave to beginning of QRS complex

d. .12-.2 sec f. Measured from beginning of the P wave to beginning of QRS complex

What describes the SA nodes ability to discharge an electrical impuse spontaneously? a. Excitability b. Contractility c. Conductivity d. Automaticity

d. Automaticity

The nurse plans close monitoring for the patient during electrophysiologic testing because this test.. a. Requires the use of dyes that irritate the myocardium b. Causes myocardial ischemia, resulting in dysrhythmias c. Involves the use of anticoagulants to prevent thrombus and embolism d. Inducese dysrhythmia that may require cardioversion or defibrillation to correct

d. Inducese dysrhythmia that may require cardioversion or defibrillation to correct

A 54-year-old patient who has no structural heart disease has an episode of syncope. An upright tilt table test is performed to rule out neurocardiogenic syncope. The nurse explains to the patient that if neurocardiogenic syncope is the problem, the patient will experience what? a. No change in HR or BP b. Palpitations and dizziness c. Tachydysrhythmias and chest pain d. Marked bradycardia and hypotension

d. Marked bradycardia and hypotension

After defibrillation the ACLS nurse says that the patient has pulseless electrical activity. What is most important for the nurse to understand about this rhythm? A the heart rate is 40 to 60 BPM Hypoxemia and hypervolemia are common with PEA There is dissociated activity of the ventricles and atrium There is electrical activity with no mechanical response

d. There is electrical activity with no mechanical response

What should the nurse reading the monitor strip call the rhythm with a regular PR interval but a blocked QRS complex? A Asystole Arrial fib First-degree AV block Type 2 second degree AV block

d. Type 2 second degree AV block