cc 4
16. The nurse is reading the cardiac monitor and notes that the patient's heart rhythm is extremely irregular and there are no discernible P waves. The ventricular rate is 90 beats per minute, and the patient is hemodynamically stable. The nurse realizes that the patient is demonstrating what rhythm? a. Atrial fibrillation b. Atrial flutter c. Atrial flutter with rapid ventricular response d. Junctional escape rhythm
a. Atrial fibrillation
3. Sinus bradycardia is a symptom of which of the following? (Select all that apply.) a. Calcium channel blocker medication b. Beta-blocker medication c. Athletic conditioning d. Hypothermia e. Hyperthyroidism
a. Calcium channel blocker medication b. Beta-blocker medication c. Athletic conditioning d. Hypothermia
4. A patient is admitted with an acute myocardial infarction (AMI). The nurse monitors for which potential complications? (Select all that apply.) a. Cardiac dysrhythmias b. Heart failure c. Pericarditis d. Ventricular rupture e. Chest pain
a. Cardiac dysrhythmias b. Heart failure c. Pericarditis d. Ventricular rupture
13. The patient presenting to the ED with severe chest discomfort is taken for cardiac catheterization and angiography that shows 80% occlusion of the left main coronary artery. Which procedure will be most likely followed? a. Coronary artery bypass graft surgery b. Intracoronary stent placement c. Percutaneous transluminal coronary angioplasty (PTCA) d. Transmyocardial revascularization
a. Coronary artery bypass graft surgery
3. Which statements are true regarding the symptoms of an AMI? (Select all that apply.) a. Dysrhythmias are common occurrences. b. Men have more atypical symptoms than women. c. Midsternal chest pain is a common presenting symptom. d. Some patients are asymptomatic. e. Patients may report jaw or back pain.
a. Dysrhythmias are common occurrences. c. Midsternal chest pain is a common presenting symptom. d. Some patients are asymptomatic. e. Patients may report jaw or back pain.
5. Because of the location of the AV node, the possible P waveforms that are associated with junctional rhythms include which of the following? (Select all that apply.) a. No P wave b. Inverted P wave c. Shortened PR interval d. P wave after the QRS complex e. Normal P wave and PR interval
a. No P wave b. Inverted P wave c. Shortened PR interval d. P wave after the QRS complex
4. The nurse is caring for a patient diagnosed with atrial fibrillation. Sequelae that place the patient at greater risk for mortality/morbidity include which of the following? (Select all that apply.) a. Stroke b. Ashman beats c. Pulmonary emboli d. Prolonged PR interval e. Decreased cardiac output
a. Stroke c. Pulmonary emboli e. Decreased cardiac output
13. Which statement is true about a patient diagnosed with sinus arrhythmia? a. The heart rate varies, dependent on vagal tone and respiratory pattern. b. Immediate treatment is essential to prevent death. c. Sinus arrhythmia is not well tolerated by most patients. d. PR and QRS interval measurements are prolonged.
a. The heart rate varies, dependent on vagal tone and respiratory pattern.
27. The patient has a permanent pacemaker inserted. The provider has set the pacemaker to the demand mode at a rate of 60 beats per minute. How does the nurse interpret this? a. The pacemaker will pace only if the patient's intrinsic heart rate is less than 60 beats per minute. b. The demand mode often competes with the patient's own rhythm. c. The demand mode places the patient at risk for the R-on-T phenomenon. d. The fixed rate mode is safer and is the mode of choice.
a. The pacemaker will pace only if the patient's intrinsic heart rate is less than 60 beats per minute.
6. The patient is in third-degree heart block (complete heart block) and is symptomatic. The treatment for this patient is which of the following? (Select all that apply.) a. Transcutaneous pacemaker b. Atropine IV c. Temporary transvenous pacemaker d. Permanent pacemaker e. Amiodarone IV
a. Transcutaneous pacemaker c. Temporary transvenous pacemaker d. Permanent pacemaker
22. Which comment by the patient indicates a good understanding of the diagnosis of coronary heart disease? a. "I had a heart attack because I work too hard and it puts too much strain on my heart." b. "The pain in my chest gets worse each time it happens. I think that there is more damage to my heart vessels as time goes on." c. "If I change my diet and exercise more, I should get over this and be healthy." d. "What kind of pills can you give me to get me over this and back to my lifestyle?"
b. "The pain in my chest gets worse each time it happens. I think that there is more damage to my heart vessels as time goes on."
26. The patient's wife is confused about the scheduling of a stent insertion. She says that she thought the angioplasty was surgery to fix her husband's heart problem. The nurse should provide what explanation to her? a. "The angioplasty was a failure, and so this procedure has to be done to fix the heart vessel." b. "The stent is inserted to enhance the results of the angioplasty, by helping to keep the vessel open and prevent it from closing again." c. "This procedure is being done instead of using clot-dissolving medication to help keep the heart vessel open." d. "The stent will remove any clots that are in the vessel and protect the heart muscle from damage."
b. "The stent is inserted to enhance the results of the angioplasty, by helping to keep the vessel open and prevent it from closing again."
6. Electrocardiogram (ECG) paper contains a standardized grid where the horizontal axis measures time and the vertical axis measures voltage or amplitude. The nurse must understand that each horizontal box indicates what? a. 200 milliseconds or 0.20 seconds duration b. 40 milliseconds or 0.04 seconds duration c. 3 seconds duration d. Millivolts of amplitude
b. 40 milliseconds or 0.04 seconds duration
24. What aspect of teaching is essential in preventing recurrence of heart failure? a. Notifying the physician if a 2-lb weight gain occurs in 24 hours. b. Compliance with diuretic therapy. c. Taking nitroglycerin if chest pain occurs. d. Assessment of an apical pulse.
b. Compliance with diuretic therapy.
2. What is one of the functions of the atrioventricular (AV) node? a. Pacing the heart if the ventricles fail b. Slowing the impulse arriving from the SA node c. Sending the impulse to the SA node d. Allowing for ventricular filling during systole
b. Slowing the impulse arriving from the SA node
11. The patient is admitted with a fever and rapid heart rate and a temperature of 103 F (39.4 C).The nurse places the patient on a cardiac monitor and finds the patient's atrial and ventricular rates are above 105 beats per minute. P waves are clearly seen and appear normal in configuration. QRS complexes are normal in appearance and 0.08 seconds wide. The rhythm is regular, and blood pressure is normal. What should be the nurse's initial focus? a. Medications to lower heart rate b. Treatment to lower temperature c. Treatment to lower cardiac output d. Treatment to reduce heart rate
b. Treatment to lower temperature
22. The nurse notices that a patient is in first-degree AV block but everything else about the rhythm is normal. The nurse should be prepared to take what action? a. Placing the patient on a transcutaneous pacemaker. b. Giving the patient atropine to shorten the PR interval. c. Monitor the rhythm and patient's condition. d. Giving the patient an antiarrhythmic medication.
c. Monitor the rhythm and patient's condition.
19. The primary care provider orders a pharmacological stress test for a patient with activity intolerance. The nurse would anticipate that the drug of choice would be a. dopamine b. dobutamine c. adenosine d. atropine
c. adenosine
15. The patient's heart rate is 165 beats per minute and the cardiac monitor shows a rapid rate with narrow QRS complexes. The P waves cannot be seen, but the rhythm is regular. The patient's blood pressure has dropped from 124/62 to 78/30; skin is cold and diaphoretic and the patient is reporting nausea. The nurse prepares the patient for what intervention? a. Administration of beta-blockers b. Administration of atropine c. Transcutaneous pacemaker insertion d. Emergent cardioversion
d. Emergent cardioversion
21. Percutaneous coronary intervention is contraindicated for patients with lesions in which coronary artery? a. Right coronary artery b. Left coronary artery c. Circumflex d. Left main coronary artery
d. Left main coronary artery
8. A patient has elevated blood lipids. The nurse anticipates which classification of drugs to be prescribed for the patient? a. Bile acid resins b. Nicotinic acid c. Nitroglycerin d. Statins
d. Statins
27. The nurse is providing care to a patient on fibrinolytic therapy. Which statement from the patient warrants further assessment and intervention by the critical care 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!"
5. The patient's husband tells the nurse, "We didn't think she was having a heart attack because the pain was in her neck and back." What response should the nurse provide? (Select all that apply.) a. "Pain can occur anywhere in the chest, neck, arms, or back. Don't hesitate to call the emergency medical services if you think it's a heart attack." b. "For many people chest pain from a heart attack occurs in the center of the chest, behind the breastbone." c. "The sooner the patient can get medical help, the less damage is likely to occur in case of a heart attack." d. "You need to make sure it's a heart attack before you call the emergency response personnel." e. "Often symptoms can be treated with nitroglycerin, so be sure to take several before calling 911."
a. "Pain can occur anywhere in the chest, neck, arms, or back. Don't hesitate to call the emergency medical services if you think it's a heart attack." b. "For many people chest pain from a heart attack occurs in the center of the chest, behind the breastbone." c. "The sooner the patient can get medical help, the less damage is likely to occur in case of a heart attack."
1. The normal width of the QRS complex is which of the following? (Select all that apply.) a. 0.06 to 0.10 seconds. b. 0.12 to 0.20 seconds. c. 1.5 to 2.5 small boxes. d. 3.0 to 5.0 small boxes. e. 0.04 seconds or greater.
a. 0.06 to 0.10 seconds. c. 1.5 to 2.5 small boxes.
16. A patient is admitted to the emergency department with clinical indications of an acute myocardial infarction with symptoms that began 3 hours ago. The facility does not have the capability for percutaneous coronary intervention. Given this scenario, what is the priority intervention in the treatment and nursing management of this patient? a. Administer thrombolytic therapy unless contraindicated b. Diurese aggressively and monitor daily weight c. Keep oxygen saturation levels at least 88% d. Maintain heart rate above 100 beats/min
a. Administer thrombolytic therapy unless contraindicated
2. What are the priority interventions for managing symptoms of an acute myocardial infarction (AMI) in the ED? (Select all that apply.) a. Administration of morphine b. Administration of nitroglycerin c. Dopamine infusion d. Oxygen therapy e. Transfusion of packed red blood cells
a. Administration of morphine b. Administration of nitroglycerin d. Oxygen therapy
26. The patient is in chronic junctional escape rhythm with no atrial activity noted. Studies have demonstrated normal AV node function. This patient may be a candidate for which type of pacing? a. Atrial pacing b. Ventricular pacing c. Dual-chamber pacing d. Transcutaneous pacing
a. Atrial pacing
1. The patient diagnosed with chronic heart failure for the past 10 years has been treated with beta-blockers and angiotensin-converting enzyme inhibitors as well as diuretics. The symptoms have recently worsened, and now the patient presents to the ED with severe shortness of breath and crackles throughout lung fields. Respirations are labored and arterial blood gases show that there is at risk for respiratory failure. Which of the following therapies may be used for acute, short-term management of the patient? (Select all that apply.) a. Dobutamine b. Intraaortic balloon pump c. Nesiritide d. Ventricular assist device e. Biventricular pacemaker
a. Dobutamine b. Intraaortic balloon pump c. Nesiritide
4. A patient presents to the emergency department (ED) with chest pain occurring for the past 2 hours. The patient is nauseous and diaphoretic with skin that is dusky in color. The electrocardiogram shows ST elevation in leads II, III, and aVF. Which therapeutic intervention would the nurse question? a. Emergent pacemaker insertion b. Emergent percutaneous coronary intervention c. Emergent thrombolytic therapy d. Immediate coronary artery bypass graft surgery
a. Emergent pacemaker insertion
17. A patient has been prescribed nitroglycerin in the ED for chest pain. In taking the health history, the nurse should verify whether the patient has taken medications prior to admission for which condition? a. Erectile dysfunction b. Prostate enlargement c. Asthma d. Peripheral vascular disease
a. Erectile dysfunction
2. Which of the following are common causes of sinus tachycardia? (Select all that apply.) a. Hyperthyroidism b. Hypovolemia c. Hypothyroidism d. Heart Failure e. Sleep
a. Hyperthyroidism b. Hypovolemia d. Heart Failure
9. The patient has an irregular heart rhythm. To determine an accurate heart rate, the nurse will take what action first? a. Identify the markers on the ECG paper that indicate a 6-second strip. b. Count the number of large boxes between two consecutive P waves. c. Count the number of small boxes between two consecutive QRS complexes. d. Divide the number of complexes in a 6-second strip by 10.
a. Identify the markers on the ECG paper that indicate a 6-second strip.
1. Why is the sinus node identified as the pacemaker of the heart? a. It contains the fastest pacemaker cell in the heart. b. It has the only pacemaker cell in the heart. c. It contains the only cell that does not affect the cardiac cycle. d. It is located in the left side of the heart.
a. It contains the fastest pacemaker cell in the heart.
6. Which clinical manifestations are indicative of right ventricular failure? (Select all that apply.) a. Jugular venous distention b. Peripheral edema c. Crackles audible in the lungs d. Weak peripheral pulses
a. Jugular venous distention b. Peripheral edema
17. The patient's heart rhythm shows an inverted P wave with a PR interval of 0.06 seconds. The heart rate is 54 beats per minute. The nurse recognizes the rhythm as a junctional escape rhythm, and understands that the rhythm is due to what cause? a. Loss of sinus node activity b. Increased rate of the AV node c. Increased rate of the SA node d. Decreased rate of the AV node
a. Loss of sinus node activity
1. The patient is admitted with a suspected acute myocardial infarction (MI). In assessing the 12-lead electrocardiogram (ECG) changes, which findings would indicate to the nurse that the patient is in the process of an evolving Q wave myocardial infarction(MI)? a. ST-segment elevation on ECG and elevated CPK-MB or troponin levels b. Depressed ST-segment on ECG and elevated total CPK c. Depressed ST-segment on ECG and normal cardiac enzymes d. Q wave on ECG with normal enzymes and troponin levels
a. ST-segment elevation on ECG and elevated CPK-MB or troponin levels
12. A patient presents to the ED complaining of severe substernal chest pressure radiating to his left shoulder and back that started about 16 hours ago. The patient delayed coming to the ED hoping the pain would go away. The patient's 12-lead ECG shows ST-segment depression in the inferior leads. Troponin and CK-MB are both elevated. The hospital does not have the capability for percutaneous coronary intervention. Thrombolysis is one possible treatment. Based on these data, the nurse correctly comes to what conclusion? a. The patient is not a candidate for thrombolysis. b. The patient's history makes him a good candidate for thrombolysis. c. Thrombolysis is appropriate for a candidate having a non-Q wave MI. d. Thrombolysis should be started immediately.
a. The patient is not a candidate for thrombolysis.
19. The patient is having premature ventricular contractions (PVCs). What is the nurse's greatest concern? a. The proximity of the R wave of the PVC to the T wave of a normal beat. b. The fact that PVCs are occurring, because they are so rare. c. If the number of PVCs are decreasing. d. If the PVCs are wider than 0.12 seconds.
a. The proximity of the R wave of the PVC to the T wave of a normal beat.
20. The patient's wife is feeling overwhelmed and tells the nurse that she doesn't know if she can manage to cook different dinners for her husband and the rest of the family to satisfy his cholesterol-reducing diet. The nurse should provide what response? a. "It will be worth it to have him healthy, won't it?" b. "The low-cholesterol diet is one from which everyone can benefit." c. "As long as you change at least a few things in the diet, it will be okay." d. "You can go on the diet with him, and then just let the children eat whatever they want."
b. "The low-cholesterol diet is one from which everyone can benefit."
3. What is the normal rate for the SA node when the patient is at rest? a. 40 to 60 beats per minute b. 60 to 100 beats per minute c. 20 to 40 beats per minute d. More than 100 beats per minute
b. 60 to 100 beats per minute
10. The nurse is calculating the rate for a regular rhythm. There are 20 small boxes between each P wave and 20 small boxes between each R wave. What is the ventricular rate? a. 50 beats/min b. 75 beats/min c. 85 beats/min d. 100 beats/min
b. 75 beats/min
18. The patient's heart rate is 70 beats per minute with the P waves coming after the QRS complex. The nurse correctly determines that the patient is demonstrating what heart rhythm? a. A normal junctional rhythm b. An accelerated junctional rhythm c. A junctional tachycardia d. Atrial fibrillation
b. An accelerated junctional rhythm
23. The patient has undergone open chest surgery for coronary artery bypass grafting. One of the nurse's responsibilities is to monitor the patient for which common postoperative dysrhythmia? a. Second degree heart block b. Atrial fibrillation or flutter c. Ventricular ectopy d. Premature junctional contractions
b. Atrial fibrillation or flutter
20. The nurse notices ventricular tachycardia on the heart monitor. When the patient is assessed, the patient is found to be unresponsive with no pulse. The nurse should take what action immediately? a. Treat with intravenous amiodarone or lidocaine. b. Begin cardiopulmonary resuscitation and advanced life support. c. Provide electrical cardioversion. d. Ignore the rhythm since it is benign.
b. Begin cardiopulmonary resuscitation and advanced life support.
29. The rhythm on the cardiac monitor is showing numerous pacemaker spikes, but no P waves or QRS complexes following the spikes. The nurse realizes this as what? a. Normal pacemaker function b. Failure to capture c. Failure to pace d. Failure to sense
b. Failure to capture
18. A patient was admitted in terminal heart failure and is not eligible for transplant. The family wants everything possible done to maintain life. Which procedure might be offered to the patient for this condition to increase the patient's quality of life? a. Intraaortic balloon pump (IABP) b. Left ventricular assist device (LVAD) c. Nothing, because the patient is in terminal heart failure d. Nothing additional; medical management is the only option
b. Left ventricular assist device (LVAD)
9. The patient is admitted with an acute myocardial infarction (AMI). Three days later the nurse is concerned that the patient may have a papillary muscle rupture. Which assessment data may indicate a papillary muscle rupture? a. Gallop rhythm b. Murmur c. S1 heart sound d. S3 heart sound
b. Murmur
7. The nurse is examining the patient's cardiac rhythm strip in lead II and notices that all of the P waves are upright and look the same except one that has a different shape and is inverted. The nurse realizes that the P wave with the abnormal shape is probably a result of what? a. Originating from the SA node since all P waves come from the SA node. b. Originating from some area in the atria other than the SA node. c. Ventricular depolarization. d. Normal firing even though it is inverted in lead II.
b. Originating from some area in the atria other than the SA node.
25. The patient scheduled to have a permanent pacemaker implanted asks the nurse, "How long will the battery in this thing last?" What answer should the nurse provide? a. "Life expectancy is about 1 year. Then it will need to be replaced." b. "Pacemaker batteries can last up to 25 years with constant use." c. "Battery life varies depending on usage, but it can last up to 10 years." d. "Pacemakers are used to treat temporary problems so the batteries don't last long."
c. "Battery life varies depending on usage, but it can last up to 10 years."
25. The patient's wife asks the nurse if the angioplasty will remove all the buildup in the vessel walls so that the patient will be healthy again. What explanation should the nurse provide? a. "The operation will remove all of the plaque, and if your husband exercises and diets he will be free of cardiac problems." b. "The surgery will remove all the buildup, but it will reaccumulate and he will probably need this surgery again this time next year." c. "The best outcome will be if 20% to 50% of the diameter of the vessel can be restored. Your husband will need to diet and exercise carefully to avoid further cardiac risk." d. "The surgeon will only be able to get 5% to 10% of the plaque, but this will bring about marked relief of your husband's symptoms."
c. "The best outcome will be if 20% to 50% of the diameter of the vessel can be restored. Your husband will need to diet and exercise carefully to avoid further cardiac risk."
24. The patient is asymptomatic but is diagnosed with second-degree heart block Mobitz I. The patient is on digitalis medication at home. The nurse should expect that action to be taken? a. The patient has had an anterior wall myocardial infarction. b. The physician will order the digitalis to be continued in the hospital. c. A digitalis level would be ordered upon admission. d. The patient will require a transcutaneous pacemaker.
c. A digitalis level would be ordered upon admission.
14. The patient is admitted with sinus pauses causing periods of loss of consciousness. The patient is currently asymptomatic, awake and alert, but fatigued and answers questions appropriately. When admitting this patient, what should be the nurse's initial action? a. Prepare the patient for temporary pacemaker insertion. b. Prepare the patient for permanent pacemaker insertion. c. Assess the patient's medication profile. d. Apply transcutaneous pacemaker paddles.
c. Assess the patient's medication profile.
15. The patient presents to the ED with sudden severe sharp chest discomfort radiating to the back and down both arms, as well as numbness in the left arm. While taking the patient's vital signs, the nurse notices a 30-point discrepancy in systolic blood pressure between the right and left arm. Based on these findings, what should the nurse do in addition to informing the primary care provider? a. Report the cardiac enzyme results. b. Prepare the patient for thrombolytic therapy. c. Begin prepping the patient for emergency surgery. d. Give the patient aspirin and heparin.
c. Begin prepping the patient for emergency surgery.
10. While instructing a patient on what occurs with a myocardial infarction, the nurse plans to explain which process? a. Coronary artery spasm. b. Decreased blood flow (ischemia). c. Death of cardiac muscle from lack of oxygen (tissue necrosis). d. Sporadic decrease in oxygen to the heart (transient oxygen imbalance).
c. Death of cardiac muscle from lack of oxygen (tissue necrosis).
2. The nurse is assessing a patient diagnosed with left-sided heart failure. Which symptom would the nurse expect to find? a. Dependent edema b. Distended neck veins c. Dyspnea and crackles d. Nausea and vomiting
c. Dyspnea and crackles
7. A patient diagnosed with coronary artery disease is having a cardiac evaluation to assess for possible valvular disease. Which study best identifies valvular function and measures the size of the cardiac chambers? a. 12-lead electrocardiogram b. Cardiac catheterization c. Echocardiogram d. Electrophysiology study
c. Echocardiogram
28. The patient has a permanent pacemaker in place with a demand rate set at 60 beats/min. The cardiac monitor is showing a heart rate of 44 beats/min with no pacemaker spikes. How does the nurse interpret this? a. Normal pacemaker function b. Failure to capture c. Failure to pace d. Failure to sense
c. Failure to pace
8. The QT interval is the total time taken for ventricular depolarization and repolarization. Prolongation of the QT interval will result in what outcome? a. Decreased risk of lethal dysrhythmias b. Increase in heart rate c. Increase in the risk of lethal dysrhythmias. d. Will only be measured with irregular rhythms.
c. Increase in the risk of lethal dysrhythmias.
3. A patient is admitted with an acute myocardial infarction (AMI). The nurse knows that an angiotensin-converting enzymes (ACE) inhibitor should be started within 24 hours to reduce the incidence of which process? a. Myocardial stunning b. Hibernating myocardium c. Myocardial remodeling d. Tachycardia
c. Myocardial remodeling
6. A patient is admitted with an angina attack. The nurse anticipates which drug regimen to be initiated? a. ACE inhibitors and diuretics b. Morphine sulfate and oxygen c. Nitroglycerin, oxygen, and beta-blockers d. Statins, bile acid, and nicotinic acid
c. Nitroglycerin, oxygen, and beta-blockers
23. The nurse understands what to be true of a third-degree AV block? a. Every P wave is conducted to the ventricles b. Some P waves are conducted to the ventricles c. None of the P waves are conducted to the ventricles d. The PR interval is prolonged
c. None of the P waves are conducted to the ventricles
5. A patient is admitted with the diagnosis of unstable angina. The nurse knows that the physiological mechanism present is most likely which of the following? a. Complete occlusion of a coronary artery b. Fatty streak within the intima of a coronary artery c. Partial occlusion of a coronary artery with a thrombus d. Vasospasm of a coronary artery
c. Partial occlusion of a coronary artery with a thrombus
14. The patient is admitted with recurrent supraventricular tachycardia that the cardiologist believes to be related to an accessory conduction pathway or a reentry pathway. The nurse anticipates which procedure to be planned for this patient? a. Implantable cardioverter-defibrillator placement b. Permanent pacemaker insertion c. Radiofrequency catheter ablation d. Temporary transvenous pacemaker placement
c. Radiofrequency catheter ablation
11. A 72-year-old woman is brought to the ED by her family. The family states that she's "just not herself." Her respirations are slightly labored, and her heart monitor shows sinus tachycardia (rate 110 beats/min) with frequent premature ventricular contractions (PVCs). She denies any chest pain, jaw pain, back discomfort, or nausea. Her troponin levels are elevated, and her 12-lead electrocardiogram (ECG) shows elevated ST segments in leads II, III, and AVF. The nurse knows that these symptoms are most likely associated with which diagnosis? a. Hypokalemia b. Non-Q wave MI c. Silent myocardial infarction d. Unstable angina
c. Silent myocardial infarction
4. When assessing the 12-lead electrocardiogram (ECG) or a rhythm strip, it is helpful to understand that the electrical activity is viewed in relation to the positive electrode of that particular lead. What is the effect on the inflection when an electrical signal is aimed directly at the positive electrode? a. Negative b. Upside down c. Upright d. Equally positive and negative
c. Upright
12. The nurse working on the night shift when notices sinus bradycardia on the patient's cardiac monitor. What initial action should the nurse take? a. Give atropine to increase heart rate. b. Begin transcutaneous pacing of the patient. c. Start a dopamine infusion to stimulate heart function. d. Assess for hemodynamic instability.
d. Assess for hemodynamic instability.
21. The nurse is talking with the patient when the monitor alarms and shows a wavy baseline without a PQRST complex. The nurse should take what action immediately? a. Defibrillate the patient immediately. b. Initiate basic life support. c. Initiate advanced life support. d. Assess the patient and the electrical leads.
d. Assess the patient and the electrical leads.
5. The patient is admitted with a condition that requires cardiac rhythm monitoring. To apply the monitoring electrodes, the nurse must first take what action? a. Apply a moist gel to the chest. b. Make certain that the electrode gel is dry. c. Avoid soaps to avoid skin irritation. d. Clip chest hair if needed.
d. Clip chest hair if needed.
