Urden CBA2 Questions

Which mechanisms responsible for a myocardial infarction (MI)? (Select all that apply.) a. Coronary artery thrombosis b. Plaque rupture c. Coronary artery spasm near the ruptured plaque d. Preinfarction angina e. Hyperlipidemia

A, B, C

Heart murmurs are characterized by which criteria? (Select all that apply.) a. Intensity b. Location c. Quality d. Pitch e. Pathologic cause

A, B, C, D

Which physiologic effects can be associated with physical exercise? (Select all that apply.) a. Decreased LDL cholesterol b. Increased HDL cholesterol c. Decreased triglycerides d. Increased insulin resistance e. Decreased incidence of depression

A, B, C, E

Which statements describe S1, the first heart sound? (Select all that apply.) a. It is associated with closure of the mitral and tricuspid valves. b. It is a high-pitched sound. c. It can be heard most clearly with the diaphragm of the stethoscope. d. The best listening point is in the aortic area. e. The "split" sound can best be detected in the tricuspid area.

A, B, C, E S1 is the sound associated with mitral and tricuspid valve closure and is heard most clearly in the mitral and tricuspid areas. S1 sounds are high pitched and heard best with the diaphragm of the stethoscope.

A patient is diagnosed with third-degree heart failure. The nurse reviews the patient's medication list. Which classifications of drugs should be avoided with this patient? (Select all that apply.) a. Nonsteroidal antiinflammatory drugs (NSAIDs) b. Antidysrhythmics c. Angiotensin-converting enzyme (ACE) inhibitors d. Calcium channel blockers e. Beta-blockers

A, B, D

Which clinical manifestations are indicative of left ventricular failure? (Select all that apply.) a. Cool, pale extremities b. Jugular venous distention c. Liver tenderness d. Weak peripheral pulses e. Rales

A, D, E

An echocardiogram reveals an ejection fraction of 55%. On the basis of this information, how would the patient's cardiac function be described? a. Adequate b. Mildly decreased c. Moderately decreased d. Severely decreased

A. Adequate normal being at least greater than 50%

Which factors influence stroke volume? (Select all that apply.) a. Afterload b. Cardiac output c. Contractility d. Heart rate e. Preload

A. Afterload C. Contractility E. Preload

Which condition is usually associated with clubbing? a. Central cyanosis b. Peripheral cyanosis c. Carbon monoxide poisoning d. Acute hypoxemia

A. Central cyanosis

A patient presents with atrial fibrillation, a heart rate of 156 beats/min, and a blood pressure of 124/76 mm Hg. The practitioner orders diltiazem, a calcium channel blocker, to be given slowly by intravenous push. Why did the practitioner choose this medication to treat this patient's atrial tachyarrhythmia? a. Diltiazem decreases the calcium influx into the atrioventricular (AV) nodal tissue and decreases the speed of impulse conduction. b. Diltiazem increases the calcium influx into the AV nodal tissue and decreases the speed of impulse conduction. c. Diltiazem decreases the calcium influx into the myocardial tissue and decreases the strength of heart contraction. d. Diltiazem increases the calcium influx into the myocardial tissue and decreases the strength of heart contraction.

A. Diltiazem decreases the calcium influx into the atrioventricular (AV) nodal tissue and decreases the speed of impulse conduction.

Which diagnostic tool can be used to detect structural heart abnormalities? a. Echocardiogram b. Electrocardiogram (ECG) c. Exercise stress test d. 24-hour Holter monitor

A. Echocardiogram

When assessing a patient with PVCs, the nurse knows that the ectopic beat is multifocal because it appears in what way? a. In various shapes in the same lead b. With increasing frequency c. Wider than a normal QRS d. On the T wave

A. In various shapes in the same lead

A patient is admitted with left-sided heart failure related to mitral stenosis. Physical assessment findings reveal tachycardia with an S3 and a 3/6 systolic murmur. The grading of a murmur as a 3/6 refers to which characteristics of the murmur? a. Intensity b. Quality c. Timing d. Pitch

A. Intensity

What sounds are created by the turbulence of blood flow through a vessel caused by constriction of the blood pressure cuff? a. Korotkoff sounds b. Grating murmurs c. Blowing murmurs d. Gallops

A. Korotkoff sounds

An assessment finding of pulsus alternans may indicate evidence of what disorder? a. Left-sided heart failure b. Jugular venous distention c. Pulmonary embolism d. Myocardial ischemia

A. Left sided heart failure

A patient is admitted with a diagnosis of acute myocardial infarction. The monitor pattern reveals bradycardia. Occlusion of which coronary artery most likely resulted in bradycardia from sinoatrial node ischemia? a. Right b. Left anterior descending c. Circumflex d. Dominant

A. Right

The abdominojugular reflux test determines the presence of which disorder? a. Right ventricular failure b. Cirrhosis c. Liver failure d. Coronary artery disease

A. Right ventricular failure

A patient is admitted with right- and left-sided heart failure. The nurse's assessment reveals that the patient has 3+ pitting edema on the sacrum, blood pressure of 176/98 mm Hg, and bilateral crackles in the lungs. The patient is experiencing shortness of breath and chest discomfort. Increased afterload is probably present related to the patient's blood pressure. Which therapeutic measure will most likely decrease afterload in this patient? a. Administration of vasodilators b. Placement in high Fowler position c. Elevation of extremities d. Increasing intravenous fluids

A. administration of vasodilators

The patient's admitting 12-lead ECG shows wide, M-shaped P waves. What diagnosis could be responsible for this finding? a. Mitral stenosis b. Chronic pulmonary disease c. Hypotension d. Pericarditis

A. mitral stenosis

Which hemodynamic alteration is the most common cause of a decrease in cardiac output in the postoperative cardiovascular patient? a. Reduced preload b. Increased afterload c. Increased contractility d. Bradycardia

A. reduced preload

Nursing interventions after angioplasty would include which of the following? (Select all that apply.) a. Elevating the head of the bed to 45 degrees b. Hydration as a renal protection measure c. Assessing pedal pulses on the involved limb every 15 minutes for the first 2 hours after the procedure d. Monitoring the vascular hemostatic device for signs of bleeding e. Educating the patient on the necessity of staying supine for 1 to 2 hours after the procedure

B, C, D

The nurse assesses the dorsalis pedis and posterior tibial pulses as weak and thready. What should the nurse document for the pulse volume? a. 0 b. 1+ c. 2+ d. 3+

B. 1+

What percentage of volume does atrial kick contribute to ventricular filling? a. 10% b. 20% c. 5% d. 45%

B. 20%

Which of the following values reflects a normal cardiac output at rest? a. 2.5 L/min b. 5.8 L/min c. 7.3 L/min d. 9.6 L/min

B. 5.8 L/min normal at rest: 4-6 L/min

What are the two important proteins contained within the cardiac cells that contribute to contraction? a. Z-disk and A-band b. Actin and myosin c. I-band and M-band d. Renin and angiotensin

B. Actin and myosin

During a history examination, a patient tells the nurse, "The cardiologist says I have a leaking valve." The nurse documents that the patient has a history of what condition? a. Acute mitral regurgitation b. Aortic insufficiency c. Chronic mitral regurgitation d. Pericarditis

B. Aortic insufficiency

A patient with heart failure may be at risk for hypomagnesemia as a result of which factor? a. Pump failure b. Diuretic use c. Fluid overload d. Hemodilution

B. Diuretic use

What is the initial intervention in a patient with sinus tachycardia with the following vital signs: heart rate, 136 beats/min; blood pressure, 102/60 mm Hg; respiratory rate, 24 breaths/min; temperature, 99.2° F; SpO2, 94% on oxygen 2 L/min by nasal cannula? a. Administer adenosine IV push. b. Identify the cause. c. Administer nitroglycerine 0.4 mg sublingual. d. Administer lidocaine 75 mg IV push.

B. Identify the cause

What is the most common complication of a central venous catheter (CVC)? a. Air embolus b. Infection c. Thrombus formation d. Pneumothorax

B. Infection

Which calcium channel blocker is beneficial in the treatment of patients with coronary artery disease or ischemic stroke? a. Nifedipine b. Nicardipine c. Clevidipine d. Diltiaze

B. Nicardipine

Which portion of the electrocardiogram (ECG) is most valuable in diagnosing atrioventricular (AV) conduction disturbances? a. P wave b. PR interval c. QRS complex d. QT interval

B. PR interval

When is a patient a candidate for a surgical repair of an abdominal aortic aneurysm (AAA)? a. Size is 1 cm b. Patient experiencing symptoms c. Aneurysm size unchanged over several years d. Size less than 4 cm

B. Patient is experiencing symptoms

Mechanical contraction of the heart occurs during which phase of the cardiac cycle? a. Phase 0 b. Phase 2 c. Phase 3 d. Phase 4

B. Phase 2

A heart murmur is described as blowing, grating, or harsh. This description would fall under which criteria? a. Intensity b. Quality c. Timing d. Pitch

B. Quality

A positive signal-averaged electrocardiogram (ECG) indicates that a patient is at risk for what problem? a. Myocardial infarction b. Sudden cardiac death c. Coronary artery disease d. Stroke

B. Sudden cardiac death

A patient with a serum potassium level of 6.8 mEq/L may exhibit what type of electrocardiographic changes? a. A prominent U wave b. Tall, peaked T waves c. A narrowed QRS d. Sudden ventricular dysrhythmias

B. Tall, peaked T waves

The atrioventricular (AV) node delays the conduction impulse from the atria (0.8-1.2 seconds) for what reasons? a. To limit the amount of blood that fills the ventricle from the atria b. To provide time for the ventricles to fill during diastole c. To limit the number of signals the ventricles receive in some rhythms d. To allow the atria to rest between signals

B. To provide time for the ventricles to fill during diastole

What dysrhythmia is most frequently associated with sudden cardiac death? a. Premature ventricular contractions b. Ventricular tachycardia c. Third degree heart block d. Asystole

B. V tach

What is the major factor influencing the patient's response to atrial flutter? a. Atrial rate b. Ventricular response rate c. PR interval d. QRS duration

B. Ventricular response rate

What does the P wave component of the electrocardiographic waveform represent? a. Atrial contraction b. Atrial depolarization c. Sinus node discharge d. Ventricular contraction

B. atrial depolarization

The possibility of microshock when handling a temporary pacemaker can be minimized by which intervention? a. Decreasing the milliamperes b. Wearing gloves c. Positioning the patient on the left side d. Wearing rubber-soled shoes

B. wearing gloves

When performing a 12-lead electrocardiogram (ECG), how many wires are connected to the patient? a. 3 b. 5 c. 10 d. 12

C. 10

A 55-year-old patient is scheduled for a stress test. What is the estimation of the patient's maximal predicted heart rate? a. 65 beats/min b. 155 beats/min c. 165 beats/min d. 265 beats/min

C. 165 beats/min formula: 220-patient's age

What is the name of outermost layer of an artery? a. Tunica b. Intima c. Adventitia d. Media

C. Adventitia

A nurse palpates the descending aorta and feels a strong, bounding pulse. The nurse reports the findings to the physician because this result is suggestive of what disorder? a. Decreased cardiac output b. Increased cardiac output c. An aneurysm d. Aortic insufficiency

C. Aneurysm

What is the most common complication of fibrinolytic therapy? a. Reperfusion chest pain b. Lethargy c. Bleeding d. Heart blocks

C. Bleeding

Which diagnostic test is most effective for measuring overall heart size? a. 12-lead electrocardiography b. Echocardiography c. Chest radiography d. Vectorcardiography

C. Chest radiography

A patient is admitted with a diagnosis of "rule out myocardial infarction." The patient reports midchest pressure radiating into the jaw and shortness of breath when walking up stairs. When inspecting the patient, the nurse notes that the patient needs to sit in a high Fowler position to breathe. The nurse suspects the patient may be experiencing what problem? a. Pericarditis b. Anxiety c. Heart failure d. Angina

C. Heart failure

Which noninvasive imaging technique is useful in diagnosing complications of a myocardial infarction (MI)? a. 12-lead ECG b. CT c. MRI d. Echocardiography

C. MRI

Which phase is the final repolarization phase of the action potential? a. Phase 1 b. Phase 2 c. Phase 3 d. Phase 4

C. Phase 3

When checking the patient's back, the nurse pushes her thumb into the patient's sacrum. An indentation remains. What assessment finding should the nurse document? a. Sacral compromise b. Delayed skin turgor c. Pitting edema d. Dehydration

C. Pitting edema

A patient is admitted with a diagnosis of "rule out myocardial infarction." The patient reports midchest pressure radiating into the jaw and shortness of breath when walking up stairs. What factor influences the amount of history obtained during the admission assessment? a. Presence of cardiovascular risk factors b. Prior medical history c. Presenting symptoms d. Current medications

C. Presenting symptoms

Which structure is the primary or natural pacemaker of the heart? a. Ventricular tissue b. Atrioventricular node c. Sinoatrial node d. Purkinje fibers

C. Sinoatrial node

A patient was admitted with of acute myocardial infarction. Upon auscultation, the nurse hears a harsh, holosystolic murmur along the left sternal border. The nurse notifies the physician immediately because the symptoms indicate the patient has developed what complication? a. Papillary muscle rupture b. Tricuspid stenosis c. Ventricular septal rupture d. Pericarditis

C. Ventricular septal rupture

Assessment of a patient with pericarditis may reveal which signs and symptoms? a. Ventricular gallop and substernal chest pain b. Narrowed pulse pressure and shortness of breath c. Pericardial friction rub and pain d. Pericardial tamponade and widened pulse pressure

C. pericardial friction rub and pain

Why are vasopressors used cautiously in the treatment of critical care patients? a. They cause vasoconstriction of the smooth muscles. b. They cause vasodilation of the smooth muscles. c. They increase afterload. d. They decrease preload.

C. they increase afterload

Cardiac output equation

CO = HR x SV

ST segment monitoring for ischemia has gained increasing importance with the advent of thrombolytic therapy. What is the most accurate method for monitoring the existence of true ischemic changes? a. Biomarkers b. Echocardiogram c. 5-lead ECG d. 12-lead ECG

D. 12 lead ECG

What is the target range for an international normalized ratio (INR)? a. 1.0 to 2.0 b. 1.5 to 3.0 c. 1.5 to 2.5 d. 2.0 to 3.0

D. 2.0-3.0

The patient has a heart rate (HR) of 84 beats/min and a stroke volume (SV) of 65 mL. Calculate the cardiac output (CO). a. 149 mL b. 500 mL c. 4650 mL d. 5460 mL

D. 5460 mL

A nurse admits a patient with a diagnosis of syncope of unknown etiology. Orthostatic vital signs are lying: 110/80 mm/Hg; sitting: 100/74 mm/Hg; standing: 92/40 mm/Hg. Based on this information, what should the nurse monitor? a. Respirations b. Fluid intake c. Peripheral pulses d. Activity

D. Activity

A patient is admitted after a positive exercise treadmill test with a diagnosis of coronary artery disease (CAD) and stable angina. Radiographic tests show that the patient has blockage in the left main coronary artery and four other vessels. The nurse anticipates that the patient's treatment plan will include what treatment or procedure? a. Medical therapy b. PCI c. TAVR d. CABG

D. CABG

Evaluation of arterial circulation to an extremity is accomplished by assessing which of the following? a. Homans sign b. Skin turgor c. Peripheral edema d. Capillary refill

D. Capillary refill

Abnormal heart sounds are labeled S3 and S4 and are referred to as what when auscultated during a tachycardic episode? a. Korotkoff sounds b. Grating murmurs c. Blowing murmurs d. Gallops

D. Gallops

Which blood test standardizes prothrombin time (PT) results among worldwide clinical laboratories? a. aPTT b. ACT c. HDL d. INR

D. INR

A patient was admitted 3 days ago with a myocardial infarction. The patient is complaining of increased chest pain when coughing, swallowing, and changing positions. The nurse hears a systolic scratching sound upon auscultation of the apical pulse. Based on the symptoms, the nurse suspects the patient may have developed what condition? a. Acute mitral regurgitation b. Aortic insufficiency c. Chronic mitral regurgitation d. Pericarditis

D. Pericarditis

What is the name of the valve that allows blood flow into pulmonary artery? a. Aortic b. Tricuspid c. Mitral valve d. Pulmonic valves

D. Pulmonic valve

What major clinical finding present in a patient with ventricular fibrillation (VF)? a. Hypertension b. Bradycardia c. Diaphoresis d. Pulselessness

D. Pulselessness

Which findings would be reasons to abort an exercise stress test? a. Ventricular axis of +90 degrees b. Increase in blood pressure c. Inverted U wave d. ST segment depression or elevation

D. ST segment depression or elevation

Which of the following is most descriptive of the capillary? a. Large diameter, low pressure b. Small diameter, high pressure c. Large diameter, high pressure d. Small diameter, low pressure

D. Small diameter, low pressure

Which statement made by a patient would indicate the need for further education before an electrophysiology procedure? a. "I need to take all my heart medications the morning of the procedure." b. "The doctor is going to make my heart beat wrong on purpose." c. "I will be awake but relaxed during the procedure." d. "I will be x-rayed during the procedure."

a. "I need to take all my heart medications the morning of the procedure."

A nurse is providing care to a patient on fibrinolytic therapy. Which of the following statements from the patient warrants further assessment and intervention by the nurse? a. "My back is killing me!" b. "There is blood on my toothbrush!" c. "Look at the bruises on my arms!" d. "My arm is bleeding where my IV is!"

a. "My back is killing me!"

Place the following components of the cardiac conduction pathway in the correct anatomic order. 1. Atrioventricular node 2. Bundle branches 3. Bundle of His 4. Internodal pathways 5. Purkinje fibers 6. Sinoatrial node a. 6, 1, 4, 3, 2, 5 b. 6, 1, 3, 2, 4, 5 c. 6, 1, 4, 2, 3, 5 d. 4, 3, 2, 5, 6, 1

a. 6, 1, 4, 3, 2, 5

In the acute phase after ST segment elevation myocardial infarction (STEMI), fibrinolytic therapy is used in combination with heparin to recanalize the coronary artery. What dosage is the initial heparin bolus? a. 60 units/kg maximum 5000 units b. 30 units/kg maximum 3000 units c. 25 units/kg maximum of 2500 units d. 12 units/kg maximum of 1000 units

a. 60 units/kg maximum 5000 units

Pulsus paradoxus may be noted on the bedside monitor when what is observed? a. A decrease of more than 10 mm Hg in the arterial waveform during inhalation b. A single, nonperfused beat on the electrocardiogram (ECG) waveform c. Tall, tented T waves on the ECG waveform d. An increase in pulse pressure greater than 20 mm Hg on exhalation

a. A decrease of more than 10 mm Hg in the arterial waveform during inhalation

A sudden increase in left atrial pressure, acute pulmonary edema, and low cardiac output, caused by the ventricle contracting during systole, are all characteristics of what condition? a. Acute mitral regurgitation b. Aortic insufficiency c. Chronic mitral regurgitation d. Pericardial friction rub

a. Acute mitral regurgitation

A patient is admitted with hypertrophic cardiomyopathy. The nurse would expect the medical management of this patient to include which intervention? a. Administration of beta-blockers b. Administration of positive inotropes c. Plans for intensive exercise regimen d. Plans for an aortic valve replacement

a. Administration of beta-blockers

What two medications are commonly prescribed at discharge for patients who have had a coronary artery stent placed? a. Aspirin and prasugrel b. Aspirin and abciximab c. Clopidogrel and eptifibatide d. Tirofiban and tricagrelor

a. Aspirin and prasugrel

A patient's bedside electrocardiogram (ECG) strips show the following changes: increased PR interval; increased QRS width; and tall, peaked T waves. Vital signs are temperature 98.2° F; heart rate 118 beats/min; blood pressure 146/90 mm Hg; and respiratory rate 18 breaths/min. The patient is receiving the following medications: digoxin 0.125 mg PO every day; D51/2 normal saline with 40 mEq potassium chloride at 125 mL/hr; Cardizem at 30 mg PO q8h; and aldosterone at 300 mg PO q12h. The practitioner is notified of the ECG changes. What orders should the nurse expect to receive? a. Change IV fluid to D51/2 normal saline and draw blood chemistry. b. Give normal saline with 40 mEq of potassium chloride over a 6-hour period. c. Hold digoxin and draw serum digoxin level. d. Hold Cardizem and give 500 mL normal saline fluid challenge over a 2-hour period.

a. Change IV fluid to D51/2 normal saline and draw blood chemistry. consistent with hyperkalemia

A patient's arterial line waveform has become damped. What action should the nurse take to correct the situation? a. Check for kinks, blood, and air bubbles in the pressure tubing. b. Prepare for a normal saline fluid challenge for hypotension. c. Discontinue the arterial line as it has become nonfunctional. d. Check the patient's lung sounds for a change in patient condition

a. Check for kinks, blood, and air bubbles in the pressure tubing.

Which clinical manifestation is usually the first symptom of peripheral arterial disease (PAD)? a. Cramping when walking b. Thrombophlebitis c. Pulmonary embolism d. Cordlike veins

a. Cramping when walking

Which statement regarding the use of cuff blood pressures is true? a. Cuff pressures may be unreliable when a patient is in shock. b. Cuff pressures are more accurate than arterial line pressures. c. Cuff pressures and arterial line pressures should be nearly identical. d. Cuff pressures should not be compared to arterial line pressures.

a. Cuff pressures may be unreliable when a patient is in shock.

The patient is admitted with a diagnosis of cardiogenic shock. The patient's heart rate (HR) is 135 beats/min with weak peripheral pulses. The patient has bilaterally crackles in the bases of the lungs. O2 saturation is 90% on 4L/NC. The practitioner orders diuretics and vasodilators. What response should the nurse expect after starting the medications? a. Decreased preload and afterload b. Increased preload and afterload c. Decreased preload and increased afterload d. Increased preload and decreased afterload

a. Decreased preload and afterload

Which finding is a reliable indicator of reperfusion after fibrinolytic therapy? a. Dysrhythmias b. Q waves c. Elevated ST segments d. Immediate rapid decrease in cardiac biomarkers

a. Dysrhythmias

What are the clinical manifestations of right-sided heart failure? a. Elevated central venous pressure and sacral edema b. Pulmonary congestion and jugular venous distention c. Hypertension and chest pain d. Liver tenderness and pulmonary edema

a. Elevated central venous pressure and sacral edema

The patient is 72 hours postoperative for a coronary artery bypass graft (CABG). The patient's vital signs include temperature 103° F, heart rate 112, respiratory rate 22, blood pressure 134/78 mm Hg, and O2 saturation 94% on 3L nasal cannula. The nurse suspects that the patient has developed what problem? a. Infection and notifies the physician immediately b. Infection, which is common postoperatively, and monitors the patient's condition c. Cardiac tamponade and notifies the physician immediately d. Delirium caused by the elevated temperature

a. Infection and notifies the physician immediately

Why is a new-onset of atrial fibrillation serious? a. It increases the patient's risk for a stroke. b. It increases the patient's risk for a deep venous thrombosis. c. It may increase cardiac output to dangerous levels. d. It indicates the patient is about to have a myocardial infarction.

a. It increases the patient's risk for a stroke.

Patient education for a patient with a Holter monitor should include which instruction? a. Keep a diary of activities, symptoms, and any medications that are taken. b. Do not drink coffee while the recorder is on. c. Do not take a bath but a shower is alright. d. Carry the monitor in a purse or backpack.

a. Keep a diary of activities, symptoms, and any medications that are taken.

What is the function of the atrioventricular (AV) valves? a. Prevent backflow of blood into the atria during ventricular contraction b. Prevent blood regurgitation back into the ventricles c. Assist with blood flow to the lungs and aorta d. Contribute to ventricular filling by atrial kick

a. Prevent backflow of blood into the atria during ventricular contraction

Which statement regarding the difference between stable and unstable angina is accurate? a. Stable angina responds predictably well to nitrates. b. Stable angina is not precipitated by activity. c. Stable angina has a low correlation to coronary artery disease (CAD). d. Stable angina is a result of coronary artery spasm.

a. Stable angina responds predictably well to nitrates.

The physician is going to place a central venous catheter. Which anatomic site is associated with a lower risk of infection? a. Subclavian vein b. External jugular vein c. Internal jugular vein d. Femoral vein

a. Subclavian vein

A physician orders removal of the central venous catheter (CVC) line. The patient has a diagnosis of heart failure with chronic obstructive pulmonary disease. The nurse would place the patient in what position for this procedure? a. Supine in bed b. Supine in a chair c. Flat in bed d. Reverse Trendelenburg position

a. Supine in bed

Which statement best describes the purpose of the Allen test? a. The Allen test assesses the adequacy of blood flow through the ulnar artery. b. The Allen test evaluates oxygen saturation in the brachial artery. c. The Allen test assesses the patency of an internal graft. d. The Allen test determines the size of needle to be used for puncture.

a. The Allen test assesses the adequacy of blood flow through the ulnar artery.

How does a percutaneous transluminal coronary angioplasty (PTCA) improve blood flow? a. The balloon stretches the vessel wall, fractures the plaque, and enlarges the vessel lumen. b. Medication is delivered through the catheter that dissolves the plague and enhances vessel patency. c. The balloon removes blood clots from the vessel improving patency of the vessel. d. The balloon compresses the plaque against the vessel wall enlarging the vessel lumen.

a. The balloon stretches the vessel wall, fractures the plaque, and enlarges the vessel lumen.

Adenosine is an antidysrhythmic agent that is given primarily what reason? a. To convert supraventricular tachycardias b. To suppress premature ventricular contractions (PVCs) c. To treat second and third degree AV blocks d. To coarsen ventricular fibrillation so that defibrillation is effective

a. To convert supraventricular tachycardias

Why is the Allen test performed before placement of a radial arterial line placement? a. To evaluate collateral circulation to the hand b. To estimate patency of the radial artery c. To appraise the neurologic function of the hand d. To assess the sensitivity of the insertion point

a. To evaluate collateral circulation to the hand

A transvenous pacemaker is inserted through the right subclavian vein and threaded into the right ventricle. The pacemaker is placed on demand at a rate of 70. What is the three letter code for this pacing mode? a. VVI b. AOO c. DDD d. VAT

a. VVI

Which lead is best to monitor a patient? a. Varies based on the patient's clinical condition and recent clinical history b. Lead aVF c. Lead V1 d. Lead II

a. Varies based on the patient's clinical condition and recent clinical history

Why do women have higher mortality rates from acute myocardial infarction (MI) than men? a. Women wait longer to seek medical care. b. Women have more risk factors for coronary artery disease than men. c. Women have a higher risk of coronary spasm than men. d. Women have smaller hearts than men.

a. Women wait longer to seek medical care.

A patient asks why he had to take a deep breath when the radiology technician took his chest radiograph. Which statement is the best response? a. "Deep breaths get the chest wall closer to the machine." b. "When the lungs are filled with air, you get a clearer picture." c. "Taking a deep breath decreases the error caused by motion." d. "Holding your breath makes the heart appear larger."

b. "When the lungs are filled with air, you get a clearer picture."

On returning from the cardiac catheterization laboratory, the patient asks if he can get up in the chair. What should the nurse tell the patient? a. "You cannot get up because you may pass out." b. "You cannot get up because you may start bleeding." c. "You cannot get up because you may fall." d. "You cannot get up until you urinate."

b. "You cannot get up because you may start bleeding."

Through what mechanism does enalapril decrease blood pressure? a. Direct arterial vasodilation b. Block the conversion of angiotensin I to angiotensin II c. Increase fluid excretion at the loop of Henle d. Peripheral vasoconstriction and central vasodilation.

b. Block the conversion of angiotensin I to angiotensin II

The presence of a carotid or femoral bruit may be evidence of what anomaly? a. Left-sided heart failure b. Blood flow through a partially occluded vessel c. Early onset of pulmonary embolism d. Myocardial rupture

b. Blood flow through a partially occluded vessel

Which of the following is most indicative of decreased left ventricular preload? a. Increased pulmonary artery occlusion pressure (PAOP) b. Decreased pulmonary artery occlusion pressure (PAOP) c. Increased central venous pressure (CVP) d. Decreased central venous pressure (CVP)

b. Decreased pulmonary artery occlusion pressure (PAOP)

What is the physiologic effect of left ventricular afterload reduction? a. Decreased left atrial tension b. Decreased systemic vascular resistance c. Increased filling pressures d. Decreased cardiac output

b. Decreased systemic vascular resistance

What is one hemodynamic effect of a pericardial effusion? a. Increased ventricular ejection b. Decreased ventricular filling c. Myocardial ischemia d. Increased afterload

b. Decreased ventricular filling

What effect does ventricular tachycardia have on cardiac output? a. Increases cardiac output due to an increase in ventricular filling time b. Decreases cardiac output due to a decrease in stroke volume c. Increases cardiac output due to an increase in preload d. Decreases cardiac output due to a decrease in afterload

b. Decreases cardiac output due to a decrease in stroke volume

A patient with a potassium level of 2.8 mEq/L is given 60 mEq over a 12-hour period. A repeat potassium level is obtained, and the current potassium level is 3.2 mEq/L. In addition to administering additional potassium supplements, what intervention should now be considered? a. Discontinue spironolactone b. Drawing a serum magnesium level c. Rechecking the potassium level d. Monitoring the patient's urinary output

b. Drawing a serum magnesium level

A patient reports that he has been having "indigestion" for the last few hours. Upon further review the nurse suspects the patient is having of chest pain. Cardiac biomarkers and a 12-lead electrocardiogram (ECG) are done. What finding is most significant in diagnosing an acute coronary syndrome (ACS) within the first 3 hours? a. Inverted T waves b. Elevated troponin I c. Elevated B-type natriuretic peptide (BNP) d. Indigestion and chest pain

b. Elevated troponin I

Which anticoagulant enhances the activity of antithrombin III and does not require activated partial thromboplastin time (aPTT) or activated clotting time (ACT) monitoring? a. Heparin b. Enoxaparin c. Bivalirudin d. Argatroban

b. Enoxaparin

Which criteria are representative of the patient in normal sinus rhythm? a. Heart rate, 64 beats/min; rhythm regular; PR interval, 0.10 second; QRS, 0.04 second b. Heart rate, 88 beats/min; rhythm regular; PR interval, 0.18 second; QRS, 0.06 second c. Heart rate, 54 beats/min; rhythm regular; PR interval, 0.16 second; QRS, 0.08 second d. Heart rate, 92 beats/min; rhythm irregular; PR interval, 0.16 second; QRS, 0.04 second

b. Heart rate, 88 beats/min; rhythm regular; PR interval, 0.18 second; QRS, 0.06 second

Why is mixed venous oxygen saturation (SVO2) monitoring helpful in the management of the critically ill patient? a. It facilitates oxygen saturation monitoring at the capillary level. b. It can detect an imbalance between oxygen supply and metabolic tissue demand. c. It assesses the diffusion of gases at the alveolar capillary membrane. d. It estimates myocardial workload during heart failure and acute pulmonary edema.

b. It can detect an imbalance between oxygen supply and metabolic tissue demand.

A patient is admitted with left-sided heart failure related to mitral stenosis. Physical assessment findings reveal tachycardia with an S3 and a 3/6 systolic murmur. Which statement about an S3 is accurate? a. It is normal for a person this age. b. It is synonymous with a ventricular gallop. c. It is only heard during systole. d. It is best heard best with the diaphragm of the stethoscope.

b. It is synonymous with a ventricular gallop.

When assessing the pulmonary arterial waveform, the nurse notices dampening. After tightening the stopcocks and flushing the line, the nurse decides to calibrate the transducer. What are two essential components included in calibration? a. Obtaining a baseline blood pressure and closing the transducer to air b. Leveling the air-fluid interface to the phlebostatic axis and opening the transducer to air c. Having the patient lay flat and closing the transducer to air d. Obtaining blood return on line and closing all stopcocks

b. Leveling the air-fluid interface to the phlebostatic axis and opening the transducer to air

Which serum lipid value is a significant predictor of future acute myocardial infarction (MI) in persons with established coronary artery atherosclerosis? a. High-density lipoprotein (HDL) b. Low-density lipoprotein (LDL) c. Triglycerides d. Very-low-density lipoprotein

b. Low-density lipoprotein (LDL)

When analyzing the electocardiogram (ECG) strip of the patient with a pacemaker, the nurse notices there is a spike before each QRS complex. What is this phenomenon indicative of? a. 60-cycle electrical interference; check equipment b. Pacing artifact; the pacemaker is sensing and capturing c. Electrical artifact; the pacemaker is not sensing d. Patient movement; check electrodes

b. Pacing artifact; the pacemaker is sensing and capturing

What is the preferred initial treatment of an acute myocardial infarction? a. Fibrinolytic therapy b. Percutaneous coronary intervention (PCI) c. Coronary artery bypass surgery (CABG) d. Implanted Cardioverter defibrillator (ICD)

b. Percutaneous coronary intervention (PCI)

What parameter must be assessed frequently in the patient with an intraaortic balloon in place? a. Skin turgor in the affected extremity b. Peripheral pulses distal to the insertion site c. Blood pressures in both arms and legs d. Oxygen saturation

b. Peripheral pulses distal to the insertion site

A patient reports feeling dizzy after standing quickly. Which finding could provide a clue regarding the cause? a. Hemoglobin level of 14.0 g/dL and hematocrit level of 42.3% b. Poor skin turgor with extended tenting c. Supine blood pressure of 146/93 mm Hg d. Resting heart rate of 96 beats/min

b. Poor skin turgor with extended tenting

The patient's admitting 12-lead ECG shows tall, peaked P waves. What diagnosis could be responsible for this finding? a. Mitral stenosis b. Pulmonary edema c. Ischemia d. Pericarditis

b. Pulmonary edema

Depolarization of one myocardial cell will likely result in what physiologic response? a. Completion of the action potential in that cell before a new cell can accept an impulse b. Quick depolarization and spread to all of the heart c. Depolarization of only cells superior to the initial depolarization d. Quick depolarization of only cells inferior to the initial depolarization

b. Quick depolarization and spread to all of the heart

What type of atrioventricular (AV) block can be described as a gradually lengthening PR interval until ultimately the final P wave in the group fails to conduct? a. First-degree AV block b. Second-degree AV block, type I c. Second-degree AV block, type II d. Third-degree AV block

b. Second-degree AV block, type I

Which intervention is an essential aspect of the patient teaching plan for the patient with chronic heart failure? a. Instructing the patient to call the practitioner prior to dental surgery b. Stressing the importance of compliance with diuretic therapy c. Instructing the patient to take nitroglycerin if chest pain occurs d. Teaching the patient how to take an apical pulse

b. Stressing the importance of compliance with diuretic therapy

Which description best describes the pain associated with aortic dissection? a. Substernal pressure b. Tearing in the chest, abdomen, or back c. Numbness and tingling in the left arm d. Stabbing in the epigastric area

b. Tearing in the chest, abdomen, or back

A patient presents with atrial flutter with an atrial rate of 280 beats/min and a ventricular rate of 70 beats/min. Which statement best explains this discrepancy in rates? a. The ventricles are too tired to respond to all the atrial signals. b. The atrioventricular (AV) node does not conduct all the atrial signals to the ventricles. c. Some of the atrial beats are blocked before reaching the AV node. d. The ventricles are responding to a ventricular ectopic pacemaker.

b. The atrioventricular (AV) node does not conduct all the atrial signals to the ventricles.

Which step of impulse conduction is most conducive to atrial kick? a. The firing of the sinoatrial node, which results in atrial depolarization b. The conduction delay at the atrioventricular (AV) node, allowing time for filling c. Conduction through the bundle of His, enhancing ventricular depolarization d. Conduction to the Purkinje fibers, allowing for ventricular contraction

b. The conduction delay at the atrioventricular (AV) node, allowing time for filling

Which of the following statements regarding beta-blockers is correct? a. They increase heart rate and are contraindicated in tachydysrhythmias. b. They result in bronchospasm and should not be used in patients with chronic obstructive pulmonary disease (COPD). c. They increase cardiac output and help with left ventricular failure. d. They are helpful in increasing atrioventricular node conduction and are used in heart blocks.

b. They result in bronchospasm and should not be used in patients with chronic obstructive pulmonary disease (COPD).

Which electrocardiographic (ECG) abnormality is most often found in ventricular dysrhythmias? a. Retrograde P waves b. Wide QRS complexes c. No P waves d. An inverted T wave

b. Wide QRS complexes

A patient's blood pressure is 90/72 mm Hg. What is the patient's pulse pressure? a. 40 mm Hg b. 25 mm Hg c. 18 mm Hg d. 12 mm Hg

c. 18 mm Hg

The nurse developing a patient education plan for the patient with endocarditis. What information would be included in the plan? a. Endocarditis is a viral infection that is easily treated with antibiotics. b. The risk of this diagnosis is occlusion of the coronary arteries. c. A long course of antibiotics is needed to treat this disorder. d. Complications are rare after antibiotics have been started.

c. A long course of antibiotics is needed to treat this disorder.

What is the formula for calculating mean arterial pressure (MAP)? a. Averaging three of the patient's blood pressure readings over a 6-hour period b. Dividing the systolic pressure by the diastolic pressure c. Adding the systolic pressure and two diastolic pressures and then dividing by 3 d. Dividing the diastolic pressure by the pulse pressure

c. Adding the systolic pressure and two diastolic pressures and then dividing by 3

Why is the measurement of the QT interval important? a. It facilitates rhythm identification and is best assessed in Lead II. b. It helps differentiate myocardial ischemia from infarction. c. An increasing QT interval increases the risk of torsades de pointes. d. A decreasing QT interval increases the risk of torsades de pointes.

c. An increasing QT interval increases the risk of torsades de pointes.

What is the effect of preload on cardiac output? a. As preload increases, cardiac output increases. b. As preload increases, cardiac output decreases. c. As preload increases, cardiac output increases until it overstretches the ventricle and cardiac output decreases. d. Increased preload has no effect on cardiac output.

c. As preload increases, cardiac output increases until it overstretches the ventricle and cardiac output decreases.

The nursing management plan for a patient with angina would include which intervention? a. Immediate administration of antiplatelet therapy b. Teaching the patient how to perform the Valsalva maneuver c. Assessment and documentation of chest pain episodes d. Administration of prophylactic lidocaine for ventricular ectopy

c. Assessment and documentation of chest pain episodes

A patient was admitted 3 days ago with an acute myocardial infarction (MI). The patient complains of fatigue, not sleeping the past two nights, and change in appetite. Based on these findings the nurse suspects the patient may be experiencing which problem? a. Angina b. Anxiety c. Depression d. Endocarditis

c. Depression

A patient is admitted with an acute myocardial infarction (MI). What common complication should the nurse anticipate in this patient? a. Pulmonary edema b. Cardiogenic shock c. Dysrhythmias d. Deep vein thrombosis

c. Dysrhythmias

A patient is admitted with a fever of unknown origin. The patient is complaining of fatigue, malaise, joint pain, and shivering. The patient's vital signs include temperature, 103° F; heart rate, 90 beats/min; respiratory rate, 22 breaths/min; blood pressure, 132/78; and oxygen saturation, 94% on 2L nasal cannula. The patient has developed a cardiac murmur. The nurse suspects that the patient has developed which problem? a. Coronary artery disease b. Heart failure c. Endocarditis d. Pulmonary embolus

c. Endocarditis

A patient has been newly diagnosed with stable angina. He tells the nurse he knows a lot about his diagnosis already because his father had the same diagnosis 15 years ago. The nurse asks him to state what he already knows about angina. Which response indicates the need for additional education? a. He should stop smoking. b. He can no longer drink colas or coffee. c. He can no longer get a strong back massage. d. He should take stool softeners to prevent straining.

c. He can no longer get a strong back massage.

After a myocardial infarction, a patient presents with an increasing frequency of premature ventricular contractions (PVCs). The patient's heart rate is 110 beats/min, and electrocardiogram (ECG) indicates a sinus rhythm with up to five unifocal PVCs per minute. The patient is alert and responsive and denies any chest pain or dyspnea. What action should the nurse take next? a. Administer lidocaine 100 mg bolus IV push stat. b. Administer Cardizem 20 mg IV push stat. c. Notify the physician and monitor the patient closely. d. Nothing; PVCs are expected in this patient.

c. Notify the physician and monitor the patient closely.

A patient becomes unresponsive. The patient's heart rate is 32 beats/min in an idioventricular rhythm; blood pressure is 60/32 mm Hg; SpO2 is 90%; and respiratory rate is 14 breaths/min. Which intervention would the nurse do first? a. Notify the physician and hang normal saline wide open. b. Notify the physician and obtain the defibrillator. c. Notify the physician and obtain a temporary pacemaker. d. Notify the physician and obtain a 12-lead ECG.

c. Notify the physician and obtain a temporary pacemaker.

What characteristic is associated with junctional escape rhythms? a. Irregular rhythm b. Rate greater than 100 beats/min c. P wave may be present or absent d. QRS greater than 0.10 seconds

c. P wave may be present or absent

The nurse is caring for a patient with left-sided heart failure. The nurse suspects the patient is developing pulmonary edema. Which finding would confirm the nurse's suspicions? a. Pulmonary crackles b. Peripheral edema c. Pink, frothy sputum d. Elevated central venous pressure

c. Pink, frothy sputum

Which of the electrocardiogram (ECG) findings would be positive for an inferior wall myocardial infarction (MI)? a. ST segment depression in leads I, aVL, and V2 to V4 b. Q waves in leads V1 to V2 c. Q waves in leads II, III, and aVF d. T-wave inversion in leads V4 to V6, I, and aVL

c. Q waves in leads II, III, and aVF

A patient is connected to an external temporary pulse generator. What does the sensitivity control regulate? a. The time interval between the atrial and ventricular pacing stimuli b. The amount of electrical current and is measured in milliamperes c. The ability of the pacemaker to detect the heart's intrinsic electrical activity d. The number of impulses that can be delivered to the heart per minute

c. The ability of the pacemaker to detect the heart's intrinsic electrical activity

A patient is admitted with right- and left-sided heart failure. The nurse's assessment reveals that the patient has 3+ pitting edema on the sacrum, blood pressure of 176/98 mm Hg, and bilateral crackles in the lungs. The patient is experiencing shortness of breath and chest discomfort. On the basis of this information, how would the nurse evaluate the patient's preload status? a. The patient is hypovolemic and has too little preload. b. The patient is experiencing congestive heart failure (CHF) and has too little preload. c. The patient is experiencing heart failure and has too much preload. d. The patient is hypertensive and the preload is not a factor.

c. The patient is experiencing heart failure and has too much preload.

What is the rationale for giving the patient additional fluids after a cardiac catheterization? a. Fluids help keep the femoral vein from clotting at the puncture site. b. The patient had a nothing-by-mouth order before the procedure. c. The radiopaque contrast acts as an osmotic diuretic. d. Fluids increase cardiac output.

c. The radiopaque contrast acts as an osmotic diuretic.

Most chest radiographs of critically ill patients are obtained using a portable chest radiograph machine. What is the difference between a chest radiograph taken in the radiology department and one taken in the critical care unit? a. Portable chest radiographs are usually clearer. b. Only posterior views can be obtained in the critical care unit. c. The sharpness of the structures is decreased with a portable chest radiograph. d. Chest radiographs taken in radiology enlarge some thoracic structures.

c. The sharpness of the structures is decreased with a portable chest radiograph.

Which statement about coronary artery disease (CAD) is accurate? a. There is a low correlation between modifiable risk factors and CAD. b. The onset of CAD occurs in middle age women sooner than men of the same age. c. There is an association between development of specific risk factors and CAD. The lower the C-reactive protein level the higher the risk for a coronary event.

c. There is an association between development of specific risk factors and CAD.

A patient is admitted for palliative care for end-stage heart failure. What is the nurse's primary goal when caring for this patient? a. To reverse heart failure with the use of diuretics b. To increase activity tolerance c. To manage symptoms and relieve pain d. To increase cardiac output related to alteration of contractility

c. To manage symptoms and relieve pain

A patient with coronary artery disease (CAD) is admitted with chest pain. The patient is suddenly awakened with severe chest pain. Three nitroglycerin sublingual tablets are administered 5 minutes apart without relief. A 12-lead electrocardiograph (ECG) reveals nonspecific ST segment elevation. The nurse suspects the patient may have which disorder? a. Silent ischemia b. Stable angina c. Unstable angina d. Prinzmetal angina

c. Unstable angina

A patient has an implantable cardioverter defibrillator (ICD) for chronic ventricular tachydysrhythmias. What action should the nurse take when the patient's rhythm deteriorates to ventricular fibrillation? a. Apply an external defibrillator to the patient. b. Call a code and start cardiopulmonary resuscitation (CPR) on the patient. c. Wait for the ICD to defibrillate the patient. d. Turn the ICD off and administer epinephrine.

c. Wait for the ICD to defibrillate the patient.

14. What is the normal resting membrane potential of a myocardial cell? a. 10 to 20 mV b. 30 to 40 mV c. -20 to -30 mV d. -80 to -90 mV

d. -80 to -90 mV

At what size is an aortic aneurysm evaluated for surgical repair or stent placement? a. 2 cm b. 4 cm c. 5 cm d. >5 cm

d. >5 cm

Which intervention should be strictly followed to ensure accurate cardiac output readings? a. Inject 5 mL of iced injectate at the beginning of exhalation over 30 seconds. b. Inject 10 mL of warmed injectate into the pulmonary artery port three times. c. Ensure at least 5° C difference between injectate and the patient temperature. d. Administer the injectate within 4 seconds during inspiration.

d. Administer the injectate within 4 seconds during inspiration.

Which cardiac biomarker is elevated in decompensated heart failure? a. Triglycerides b. Troponin I c. Troponin T d. B-type natriuretic peptide (BNP)

d. B-type natriuretic peptide (BNP)

Which statement regarding the autonomic nervous system's role in the regulation of heart rate is true? a. Parasympathetic influences increase heart rate. b. Sympathetic influences are predominantly present. c. Parasympathetic influences are only compensatory. d. Both sympathetic and parasympathetic influences are normally active.

d. Both sympathetic and parasympathetic influences are normally active.

Patient is admitted with heart failure. The patient has developed dyspnea with wheezing, a nonproductive cough, and pulmonary crackles that progress to the gurgling sounds of pulmonary edema. The nurse suspects the patient may be developing with problem? a. Dyspnea b. Orthopnea c. Paroxysmal nocturnal dyspnea d. Cardiac asthma

d. Cardiac asthma

A patient's central venous pressure (CVP) reading suddenly increased from 10 to 48 mm Hg. His lungs are clear except for fine rales at the bases. What should the nurse do next? a. Nothing as this reading is still within normal limits. b. Place a STAT call into the physician. c. Administer ordered prn Lasix. d. Check the level of the transducer.

d. Check the level of the transducer.

A patient is admitted after a femorotibial bypass graft. What nursing action is critical in the immediate postoperative period? a. Frequent assessment of the skin b. Hourly assessment of intake and output c. Monitoring for ST segment changes d. Frequent pulse checks to the affected limb

d. Frequent pulse checks to the affected limb

Which value, when elevated, places the patient at lowest risk for coronary artery disease (CAD)? a. Very-low-density lipoproteins (VLDLs) b. Triglycerides c. Low-density lipoproteins (LDLs) d. High-density lipoproteins (HDLs)

d. High-density lipoproteins (HDLs)

Which laboratory value indicates a heightened risk for the development of coronary artery disease (CAD)? a. Total cholesterol level of 170 mg/dL b. HDL cholesterol level of 30 mg/dL c. Triglyceride level of 120 mg/dL d. LDL cholesterol level >190 mg/dL

d. LDL cholesterol level >190 mg/dL

A patient returns from the cardiac catheterization laboratory after angioplasty and stent placement (ECG changes had indicated an inferior wall myocardial infarction in progress). Which lead would best monitor this patient? a. Varies based on the patient's clinical condition and recent clinical history b. Lead V3 c. Lead V1 d. Lead II

d. Lead II

What parameter is used to assess the contractility of the left side of the heart? a. Pulmonary artery occlusion pressure b. Left atrial pressure c. Systemic vascular resistance d. Left ventricular stroke work index

d. Left ventricular stroke work index

An 82-year-old patient is admitted into the critical care unit with a diagnosis of left-sided heart failure related to mitral stenosis. Physical assessment findings reveal tachycardia with an S3 and a 3/6 systolic murmur. Which of the following descriptions best describes the murmur heard with mitral stenosis? a. High-pitched systolic sound b. Medium-pitched systolic sound c. High-pitched diastolic sound d. Low-pitched diastolic sound

d. Low-pitched diastolic sound

Which condition can cause an artificial increase in the pulmonary artery occlusion pressure (PAOP)? a. Aortic regurgitation b. Aortic stenosis c. Mitral stenosis d. Mitral regurgitation

d. Mitral regurgitation

A patient is admitted with an acute inferior myocardial infarction (MI). A 12-lead electrocardiogram (ECG) is done to validate the area of infarction. Which finding on the ECG is most conclusive for infarction? a. Inverted T waves b. Tall, peaked T waves c. ST segment depression d. Pathologic Q waves

d. Pathologic Q waves

What is the rationale for administrating a fibrinolytic agent to a patient experiencing acute ST-elevation myocardial infarction (STEMI)? a. Dilation of the blocked coronary artery b. Anticoagulation to prevent formation of new emboli c. Dissolution of atherosclerotic plaque at the site of blockage d. Restoration of blood flow via lysis of the thrombus

d. Restoration of blood flow via lysis of the thrombus

A new-onset myocardial infarction (MI) can be recognized by what electrocardiogram (ECG) change? a. Q waves b. Smaller R waves c. Widened QRS d. ST segment elevation

d. ST segment elevation

Which classification of dysrhythmia is most common with an inferior wall infarction in the first hour after ST segment elevation myocardial infarction (STEMI)? a. Sinus tachycardia b. Multifocal PVCs c. Atrial fibrillation d. Sinus bradycardia

d. Sinus bradycardia

A patient is admitted with left-sided heart failure and a blood pressure of 220/118 mm Hg. Which drug will be most effective in decreasing the blood pressure and reducing afterload? a. Dopamine b. Verapamil c. Propranolol d. Sodium nitroprussid

d. Sodium nitroprussid

A patient has been admitted in hypertensive crisis. Which medication would the nurse expect the practitioner to order for this patient? a. Digitalis b. Vasopressin c. Verapamil d. Sodium nitroprusside

d. Sodium nitroprusside

The nurse is caring for a patient with these vital signs: blood pressure 220/110, pulse 108, respiratory rate 24, temperature 103° F, and oxygen saturation of 94% on oxygen 2L nasal cannula. The patient is responsive and denies chest pain. The physician has ordered a work-up for coronary artery disease (CAD). These findings are suggestive of which diagnosis? a. Silent ischemia b. Prehypertension c. Stage 1 hypertension d. Stage 2 hypertension

d. Stage 2 hypertension

The nurse is developing a patient education plan for a patient with valvular heart disease. Which instruction would be included as part of that plan? a. Increase fluid intake to increase cardiac output. b. Take sodium replacement tablets to replace sodium lost with diuretics. c. Increase daily activity until shortness of breath occurs. d. Take prophylactic antibiotics before undergoing any invasive procedure.

d. Take prophylactic antibiotics before undergoing any invasive procedure.

Why do many patients with very high heart rates frequently have chest pain and shortness of breath? a. Patients with heart disease frequently have an anxiety disorder as well. b. The rapid pounding of the heart in the chest wall causes the physical pain. c. The heart muscle gets tired from the increased work. d. The decreased diastolic time decreases oxygen delivery to the myocardium.

d. The decreased diastolic time decreases oxygen delivery to the myocardium.

A nurse is obtaining the history of a patient who reveals that he had an myocardial infarction (MI) 5 years ago. When the admission 12-lead electrocardiogram (ECG) is reviewed, Q waves are noted in leads V3 and V4 only. Which conclusion is most consistent with this situation? a. The patient may have had a posterior wall MI. b. The patient must have had a right ventricular MI. c. The admission 12-lead ECG was done incorrectly. d. The patient may have had an anterior MI.

d. The patient may have had an anterior MI.

Which is an example of a physiologic shunt? a. A ventricular septal defect b. Blood returning from the inferior vena cava to the right atrium c. A septal infarct d. The thebesian vessels returning deoxygenated blood to the left ventricle

d. The thebesian vessels returning deoxygenated blood to the left ventricle