Module E Practice Questions

The most common valvuloplasty procedure is a ________________________.

commissurotomy

A nurse is completing discharge teaching with a client who is s/p surgical placement of a mechanical heart valve. Which of the following statements by the client indicates understanding of the teaching? A) "I will have my prothrombin time checked on a regular basis." B) "I will talk to my dentist about no longer needing antibiotics before dental exam." C) "i will continue to limit my intake of foods containing potassium." D) "I will be glad to get back to my exercise routine right away."

A) "I will have my prothrombin time checked on a regular basis"

A nurse on a medical-surgical unit is caring for a client who reports pain in the jaw, back, and shoulder, and shortness of breath and nausea. Which of the following actions should the nurse take? A) obtain an EKG. B) administer enteric coated acetaminophen C) administer ibuprofen. D) maintain oxygenation

A) Obtain an EKG the nurse should obtain an EKG to detect heart rhythm abnormalities within 10 minutes of the client's reported discomfort.

A nurse is caring for a client who develops a ventricular fibrillation rhythm. The client is unresponsive, pulseless, and apneic. Which of the following actions is the nurse's priority? A) defibrillation B) airway management C) epinephrine administration D) amiodarone administration

A) defibrillation the greatest risk to the client is death from lack of cardiac output. ventricular fibrillation is a lethal rhythm so defibrillation is essential to resolve ventricular fibrillation promptly and convert the rhythm to restore cardiac ouput.

A nurse is monitoring a client who is on telemetry. Which of the following findings on the ECG strip should the nurse recognize as normal sinus rhythm? A) the P wave falls before the QRS complex. B) the T wave is in the inverted position. C) the P-R interval measures 0.22 seconds D) the QRS duration is 0.20 seconds

A) the P wave falls before the QRS complex. The nurse should recognize that in normal sinus rhythm the P wave, representing atrial depolarization, falls before the QRS wave.

A nurse is assessing a client who infective endocarditis. Which of the following findings should be priority for the nurse to report to the provider? A) splinter hemorrhages to the nails. B) dyspnea. C) fever. D) clusters of petechiae in the mouth.

B) Dyspnea the client who has infective endocarditis and develops dyspnea, tachycardia, or a cough might be developing HF or experiencing pulmonary emboli.

A nurse in an urgent care center is assessing a client who reports a sudden onset of irregular palpitations, fatigue, and dizziness. The nurse finds a rapid and irregular heart rate with a significant pulse deficit. which of the following dysrhythmias should the nurse expect to find on the ECG? A) first degree AV block. B) atrial fibrillation C) sinus bradycardia D) sinus tachycardia

B) atrial fibrillation a-fib causes a disorganized twitching of the atrial muscle. The rate is irregular with no visible P waves.

A nurse is caring for a client who has pericarditis and reports feeling a new onset of palpitations and shortness of breath. Which of the following assessments should indicate to the nurse that the client may have developed atrial fibrillation? A) different BP in the upper limbs. B) different apical and radial pulses. C) differences between oral and axillary temperatures D) differences in upper and lower lungs sounds.

B) different apical and radial pulses. the presence of a pulse deficit between the apical and radial pulses is an indication of atrial fibrillation. the nurse should assess further by obtaining an ECG or telemetry reading.

a nurse is caring for a client who has infective endocarditis. Which of the following manifestations is the priority for the nurse to monitor for? A) anorexia. B) dyspnea. C) fever. D) malaise.

B) dyspnea. when using ABC approach, the nurse determines the priority manifestation to monitor for is dyspnea. - dyspnea can be an indication of left sided HF.

A nurse is completing the admission assessment of a client who has a history of mitral valve insufficiency. Which of the following is an expected finding? A) hoarseness B) petechiae C) crackles in the lung bases D) headache

C) crackles in the lung bases.

the P wave represents atrial depolarization and atrial repolarization. TRUE OR FALSE

FALSE; the P waves represents atrial depolarization (left and right atrium)

Pericarditis is commonly referred to as a valve disorder. TRUE OR FALSE.

FALSE; It is referred to as a disease of the heart.

atrial flutter is a rhythm commonly described as "irregularly irregular" TRUE OR FALSE.

FALSE; atrial flutter is a considered to have a regular rhythm.

cardioversion should be synchronized with the T wave. TRUE OR FALSE.

FALSE; should be synchronized with R wave.

Clients with endocarditis should not take NSAIDS as they may worsen their pain. TRUE OR FALSE.

TRUE

Mitral valve prolapse is a deformity that usually produces no symptoms. TRUE OR FALSE.

TRUE

often the first and only sign of mitral valve prolapse is an extra heart sound referred to as a systolic click. TRUE OR FALSE.

TRUE

ventricular tachycardia is considered an emergency situation because the client is usually (but not always) unresponsive and pulseless. TRUE OR FALSE.

TRUE.

The first symptom of mitral stenosis often is _________ as a result of pulmonary venous hypertension.

dyspnea on exertion.

the non-pharmacological treatment for second degree heart block type I (wenkebach) is ___________________.

pacing

The electrical stimulation of the cardiac muscle cells is called depolarization; the mechanical contraction is called the ___________.

systole

A nurse is caring for a client who reports heart palpitations. An ECG confirms the client is experiencing ventricular tachycardia (VT). The nurse should anticipate the need for taking which of the following actions? A) defibrillation. B) elective cardioversion C) CPR D) radiofrequency catheter ablation

B) elective cardioversion this is the priority intervention when the client is awake and responsive. it requires intervention to prevent long term cardiac impairment.

A nurse on a telemetry unit is caring for a client who has premature ventricular contractions (PVCs). While sitting in a chair, the client feelings reports feeling lightheaded. If the client is having PVCs, which of the following findings should the nurse expect when auscultating the client's apical pulse? A) bounding pulsations. B) irregular pulsations. C) Tachycardia. D) bradycardia.

B) irregular pulsations Clients typically perceive PVCs as "palpitations" and can feel lightheaded if they occur frequently.

A nurse is caring for a client who reports a new onset of severe chest pan. Which of the following actions should the nurse take to determine if the client is experiencing a myocardial infarction? A) check the client's blood pressure. B) auscultate heart sounds. C) perform a 12-Lead ECG D) determine if pain radiates to the left arm.

C) Perform a 12-lead ECG the nurse should perform a 12 lead ECG when a client complains of chest pain to determine if the client is experiencing a MI.

A nurse is caring for a client who has cardiopulmonary arrest. The nurse anticipates the emergency response team will administer which of the following medications if the client's restored rhythm is symptomatic bradycardia? A) epinephrine. B) magnesium. C) atropine. D) sodium bicarbonate.

C) atropine. the team administers atropine during CPR if the client has symptomatic bradycardia, or is hemodynamically unstable.

A nurse is caring for a client who has valvular heart disease and is at risk for developing left-sided HF. which of the following manifestations should alert the nurse the client is developing this condition? A) anorexia B) weight gain C) breathlessness D) distended abdomen

C) breathlessness manifestations of left sided HF include crackles or wheezes and breathlessness due to pulmonary congestion.

A nurse is assessing a client who has atrial fibrillation. Which of the following pulse characteristics should the nurse expect? A) slow B) not palpable C) irregular D) bounding

C) irregular with a-fib, multiple ectopic foci stimulate the atria to contract. The AV node is unable to transmit all of these impulses of the ventricles, resulting in a pattern of highly irregular ventricular contractions and thus an irregular pulse.

A nurse is completing discharge planning for a client who has bacterial endocarditis. The client will need to receive 12 weeks of antibiotic therapy. Which of the following venous access devices should the nurse identify as appropriate for the client? A) short peripheral catheter B) implanted infusion port C) peripherally inserted central catheter D) arteriovenous fistula

C) peripherally inserted central catheter PICC line is used when client needs extended, but not permanent, IV access. it can remain in place for weeks or months. They can also be used to draw blood samples without the need for additional venipunctures.

The nurse notices that a client's heart rate decreases from 63 to 50 BPM on the monitor. What should the nurse do first? A) administer atropine 0.5mg IV push. B) auscultate for abnormal heart sounds. C) Prepare for transcutaneous pacing. D) Take the client's blood pressure.

D) Take the client's blood pressure. the nurse should first assess the client's tolerance to the drop in HR by checking the blood pressure and level of consciousness and determine if atropine is needed. If the client is symptomatic, atropine and transcutaneous pacing are interventions to treat.

A visitor to the hospital has a cardiac arrest. When determining to use an AED, the nurse should consider that AEDs are used in cardiac arrest in which circumstances? A) early defibrillation in cases of atrial fibrillation. B) cardioversion in cases of atrial fibrillation. C) pacemaker placement. D) early defibrillation in cases of ventricular fibrillation.

D) early defibrillation in cases of ventricular fibrillation. AHA place major emphasis on early defibrillation for Vfib and use of the AED as a tool to increase sudden cardiac arrest survival rates.

A nurse in a provider's office is assessing a client who reports occasional atypical chest pain, palpitations, and exercise intolerance. On auscultation, the nurse notes a systolic click. The nurse should recognize this manifestation of which of the following conditions? A) aortic regurgitation. B) mitral stenosis. C) aortic stenosis. D) mitral valve prolapse.

D) mitral valve prolapse. auscultation of a client who has mitral valve prolapse reveals a systolic click that is caused by a valve leaflet prolapsing into the left atrium.

Upon assessment of third-degree heart block on the monitor, what should the client do first? A) call a code. B) begin cardiopulmonary resucitation. C) place transcutaneous pacing pads on the client. D) prepare for defibrillation.

C) place transcutaneous pacing pads on the client. for a symptomatic client, pacing is the treatment of choice.

A nurse is caring for a client who has atrial fibrillation and is receiving heparin. Which of the following findings is the nurse's priority? A) the client's ECG tracing shows irregular heart rate without P waves. B) the client has an aPTT of 80 seconds. C) the client experience sudden weakness of one arm and leg. D) the client's urine output is cloudy and odorous.

C) the client experiences sudden weakness of one arm and leg. this is the nurse's priority finding; sudden weakness or numbness of the face and one arm or leg and can indicate that the client is at greatest risk for stroke.

A client has arrived at the ED with atrial fibrillation (AF) and does not recall how long the rapid pulse and irregular heart rate has been occurring. The nurse should include which goals of care at this time? SELECT ALL THAT APPLY. A) convert the heart rate to sinus rhythm. B) decrease cardiac output and workload. C) limit activity to being out of bed. D) Maintain a ventricular response below 100 bpm. E) prevent an embolic stroke.

C, D, E C) limit activity to being out of bed. - it is not necessary to limit activities; the client can resume normal activities and slowly increase exercise tolerance. D) maintain a ventricular response below 100 bpm - initially, it will be important to maintain a ventricular HR of <100. E) prevent an embolic stroke. - anticoagulants: prevent complications related to clot formation.

Catheter ________________ therapy is a treatment that destroys specific cells that are cause or central conduction route of a tachydysrhythmia that did not respond to medications.

ablation

sinus _____________ occurs when the SA node creates an impulse at a rate less than 60 beats per minute in an adult.

bradycardia

The nurse is assessing a client who has had an MI. The nurse notes a single PVC in the cardiac rhythm on the monitor. What should the nurse do FIRST? A) notify the MD. B) call the rapid response team. C) assess the client for changes in the rhythm. D) administer lidocaine as prescribed.

c) assess the client for changes in the rhythm. PVCs are potentially serious and can lead to VT/VF or cardiac arrest when they occur 6-10 times an hour in client with MI. if just one continue to monitor and note if the PVCs are increasing.

If tachycardia is persistent and causing hemodynamic instability, synchronized _______________ is the treatment of choice.

cardioversion