Critical Care Exam #1 Practice Questions
Mr. Joseph has a history of chronic atrial fibrillation. He takes digitalis. He recently developed nausea and vomiting. Twenty-four hours later, he was still vomiting. He told his wife he felt like his heart was "just not working right," so they went to the ER. Upon admission, he was connected to the ECG monitor. The nurse obtained the rhythm strip below. A. Atrial fibrillation B. Sinus tachycardia C. Ventricular fibrillation D. Atrial flutter E. Ventricular tachycardia
A
QRS complexes: Present, all shaped the same Regularity: Regular rhythm, HR: 47 bpm P waves: Upright, matching, 1 per QRS, P-P interval regular PR interval: 0.16 seconds, QRS interval: 0.06-0.08 seconds, QT interval: 0.40 seconds Which of the following rhythms is displayed in the above ECG strip? A. Sinus Bradycardia B. Sinus Tachycardia C. Normal Sinus Rhythm D. Premature atrial contractions
A
The nurse is assessing a patient's arterial waveform and notes a notch on the descending portion of the waveform. The nurse associates this notch with which physiological events? A. Closure of the aortic valve B. The highest systolic pressure C. Systolic ejection of blood D. The diastolic pressure
A
The nurse is caring for a patient who has undergone cardioversion for the management of a tachy dysrhythmia. Which outcome on the ECG would the nurse evaluate as indicating that cardioversion has been successful? A. Normal sinus rhythm B. Atrial fibrillation C. Atrial flutter D. Ventricular tachycardia
A
Your patient MAP is 52 mmHg, what is your interpretation of this MAP? A. The MAP is low B. The MAP is normal
A
A patient who was stabbed multiple times in the chest and abdomen has just returned from emergency surgery. Hemodynamic monitoring was initiated during surgery and now reveals that the patient's central venous pressure has dropped to 2 mmHg. The nurse would assess for findings of which conditions? Select all that apply. A. Fluid loss during surgery B. Vasodilation from drugs administered during surgery C. Internal hemorrhage D. Left heart failure E. Cardiac tamponade
A,B, C
Mrs. Brandon was diagnosed with atrial fibrillation. her vital signs are stable, but she reports that she has felt these "palpitations" in her chest for over two weeks. The nurse would discuss which topics with Mrs. Brandon before she is discharged home? (Select all that apply.) . A. Possible side effects of beta-blocking agents B. The purposes and use of anticoagulation C. Signs and symptoms of stroke and pulmonary embolism D. Discussion of the need for immediate defibrillation.
A,B,C
Your patient has a MAP of 52. What physical assessment findings would you suspect a patient with this MAP to have? (Select All that Apply) A. cyanotic extremities B. decreased level of consciousness C. decreased urine output D. warm extremities
A,B,C
which electrolyte imbalances would cause rhythm disturbances? (Select all that apply.) A. Hypokalemia B. Hypernatremia C. Hypermagnesemia D. Hyperkalemia E. Hyponatremia
A,B,D,E
What effect does the rhythm identified in question 9 on Mr. Joseph's hemodynamic status? (Select All That Apply) A. Decreased blood pressure B. Increased mean arterial pressure C.Decreased cardiac output D.Increased cardiac output
A,C
The critical care nurse is caring for a client with sinus bradycardia. Which of the following findings requires the nurse to intervene? (Select all that apply.) A. Hypotension B. A heart rate of 60 C. Angina D. Dizziness
A,C,D
An ICU patient is on arterial pressure monitoring. The nurse noticed the physiologic monitor alarm sounds. Which of the following indicates correct nursing actions? Select all that apply A. Check to see whether the catheter is kinked. B. Add IV solution through the arterial pressure monitoring system. C. Check the patency of the catheter. D. Check to see whether the stopcocks are turned the wrong way. E. Make sure that there is sufficient pressure in the pressure bag.
A,C,D,E
A client has received atropine for symptomatic sinus bradycardia. Which outcome indicates to the nurse that this drug is having the desired effect? A. Decrease in heart rate B. Increase in heart rate C. Constipation D. Dry mouth
B
A nurse receives a report for the shift. Which client should the nurse plan to see first? A. A client with a history of myocardial infarction 10 years ago B. A client with hyperkalemia, prolonged PR interval, and wide QRS complexes C. A client with a temperature of 100°F D.A client with fluid volume deficit, HR 100, rate regular
B
Mr. Joseph was admitted to the coronary care unit. Three hours later, the monitor alarm went off for the following rhythm. What is your interpretation? A. Pulseless Electrical Activity B. Asystole C. Fine ventricular fibrillation D. Third-degree AV block
B
Mr. Joshua is on mechanical ventilation after chest trauma. Mr. Joshua is having frequent episodes of dysrhythmia. There are three PVC in a row with a rate of 110. There are no identifiable P waves, the R-R interval is regular, and the QRS complex is 0.20 seconds. How would the nurse interpret this rhythm? A. Ventricular fibrillation B. Ventricular tachycardia C. Atrial fibrillation D. Atrial flutter
B
What assessment finding would necessitate holding a client's usual morning dose of digitalis? A. Atrial fibrillation with a rate of 102 B. Sinus rate of 62 C. Atrial flutter with a rate of 110 D. Sinus rate of 100
B
Which of the following is the normal cardiac electrical conduction pathway? A. Purkinje fibers - bundle branches - bundle of His - AV node - SA node B. SA node - AV node - the bundle of His - bundle branches - Purkinje fibers. C.AV node - the bundle of His - SA node - bundle branches - Purkinje fiber
B
A client is having PVCs. Which circumstance would warrant the nurse's notifying the health care provider? Select all that apply. A. The client has PVCs at least once an hour. B. The nurse notes more than six PVCs in a one-minute ECG strip. C. The PVCs begin to occur in sets of two. D. There are more than 3 PVCs in a row.
B,C,D
For the rhythm identified in question 11, according to the ACLS 2020 Adult Cardiac Arrest Algorithm, what interventions and medications would you anticipate for this rhythm? A. Atropine B. Epinephrine C. Defibrillation D. CPR
B,D
A critical care nurse is caring for a patient who is receiving Amiodarone for the management of dysrhythmias. Which of the following statements is correct about Amiodarone? A. It causes vasodilation B. It blocks the action of the vagus nerve, causing the heart rate to increase C. It slows the heart D. It is considered inotropic medication
C
Critical care nursing is interpreting the patient's ECG. The nurse noted the following: HR 80 bpm, R-R intervals are regular, each P wave looks the same, the PR interval is 0.12 seconds, each P wave is followed by a QRS, the QRS complex is 0.11 seconds, and the QT interval is half the R-R interval. How should the nurse interpret this rhythm? A.Sinus bradycardia B.Sinus bradycardia C. Normal sinus rhythm
C
What does it mean when the QRS interval is equal to 4 small boxes? A.Normal rate and rhythm B.Slowed repolarization of the ventricle C.Slowed ventricular depolarization D.Slowed conduction through the atria
C
Your patient MAP is 52, what interventions would you anticipate for a patient with this MAP? (Select All that Apply) A. Vasodilators B. Diuretics C. fluid administration D. Vasoconstrictors
C,D
Which of the following if observed on the cardiac monitor, requires an intervention? (Select all that apply.) A. R-R intervals are regular. B. The ST segment is on the isoelectric line. C. PR interval is 0.30 seconds. D. P waves precede QRS complexes. E. QRS interval is 0.20 seconds.
C,E
A critical care nurse is assessing the patient's ECG strip. The client's ECG strip reveals a rate of 85 bpm, P waves preceding every QRS, a QRS following each P wave, a PR interval of 0.27 seconds, and a QRS of 0.09 seconds. How should the nurse interpret this rhythm? A. Type I second-degree block B. Normal sinus rhythm C. Left bundle branch block D. First degree AV block
D
A patient requires the insertion of an arterial catheter. Which nursing action is indicated? A. Call for the rapid response team. B. Obtain sterile gowns, gloves, caps, and masks for all persons who will be present during the insertion. C. Instill air in all stopcocks. D. Prime the pressure monitoring system.
D
Mr. Christopher's morning potassium is 2.0 mEq/L. As a result, the nurse identifies which nursing diagnosis as having the greatest priority? A. Altered urinary elimination B. Alteration in fluid volume (deficit) C. Altered nutrition (less than) body requirements D. Decreased cardiac output
D
QRS complexes: Present, all shaped the same Regularity: Underlying regular rhythm with one premature beat, HR: 115; 6th QRS complex occurred earlier than expected. P waves: Underlying rhythm - upright, matching, 1 per QRS; P-P interval regular in underlying rhythm; 5th P wave occured earlier than expected and appearance does not match PR interval: 0.18 sec. QRS interval: 0.08 sec. QT interval:0.30 sec. Which of the following rhythms is displayed in the above ECG strip? A. Sinus Tachycardia B. Normal Sinus Rhythm C. Sinus Bradycardia D. Sinus tachycardia with one premature atrial contraction (PAC)
D
QRS complexes: Present, all shaped the same Regularity: Regular rhythm, HR: 120 bpm P waves: Upright, matching, 1 per QRS, P-P interval regular PR interval: 0.12 seconds, QRS interval: 0.10 seconds, QT interval: not measurable (no measurable T wave in this lead) Which of the following rhythms is displayed in the above ECG strip?
Sinus Tachycardia
The above rhythm is showing the following ECG features: QRS complexes: Present, all shaped the same Regularity: Regular rhythm, HR: 120 bpm P waves: Upright, matching, 1 per QRS, P-P interval regular PR interval: 0.14 seconds, QRS interval: 0.08 seconds; QT interval: 0.32 seconds Which of the following rhythms is displayed in the above ECG strip? A.Sinus Tachycardia B.Normal Sinus Rhythm C.Sinus Bradycardia D.Premature atrial contractions
Sinus Tachycardia
"in layman terms"what is SVT?
The patient has an extra conduction pathway in her heart; this causes their heart to beat much faster."
PR interval
Time from SA node stimulation to ventricular depolarization
QT interval
Total time for ventricular depolarization and repolarization
P Wave
atrial depolarization
QRS complex
ventricular depolarization
T wave
ventricular repolarization
