quiz 2

When giving adenosine, it is important to remember to 1. give it as a fast intravenous push. 2. give it as a slow intravenous push over 5 minutes. 3. offer it with food or milk. 4. prepare to set up for an intravenous drip infusion.

1

Which of the following conditions is most commonly responsible for myocardial infarction? Aneurysm Heart failure Coronary artery thrombosis Renal failure

1. Coronary artery thrombosis

Which of the following actions is first priority of care for a client exhibiting signs & symptoms of coronary artery disease? Decrease anxiety Enhance myocardial oxygenation Administer sublingual nitroglycerin Educate the client about his symptoms

1. Enhance myocardial oxygenation

2,Which of the following heart block dysrhythmias is identified by a repetitious prolonging PR interval pattern after each blocked QRS complex? 1,second degree type I 2,second degree type II 3,third degree heart block 4,first degree heart block

2

The client is exhibiting ventricular tachycardia. Which intervention should the nurse implement first? 1. Administer lidocaine, an antidysrhythmic, IVP. 2. Prepare to defibrillate the client. 3. Assess the client's apical pulse and blood pressure. 4. Start basic cardiopulmonary resuscitation.

3. determine if the client is in cardiac arrest and then treat as v fib. If heart is beating, nurse would then administer lidocaine

A nurse is caring for a patient who is exhibiting ventricular tachycardia (VT). Because the patient is pulseless, the nurse should prepare for what intervention? A) Defibrillation B) ECG monitoring C) Implantation of a cardioverter defibrillator D) Angioplasty

A Any type of VT in a patient who is unconscious and without a pulse is treated in the same manner as ventricular fibrillation: Immediate defibrillation is the action of choice. ECG monitoring is appropriate, but this is an assessment, not an intervention, and will not resolve the problem. An ICD and angioplasty do not address dysrhythmia.

When caring for a patient in acute septic shock, what should the nurse anticipate? A. Infusing large amounts of IV fluids B. Administering osmotic and/or loop diuretics C. Administering IV diphenhydramine (Benadryl) D. Assisting with insertion of a ventricular assist device (VAD)

A Septic shock is characterized by a decreased circulating blood volume. Volume expansion with the administration of IV fluids is the cornerstone of therapy. The administration of diuretics is inappropriate. VADs are useful for cardiogenic shock not septic shock. Diphenhydramine (Benadryl) may be used for anaphylactic shock but would not be helpful with septic shock.

The nurse is preparing to administer adenosine to the patient with the following rhythm which is symptomatic. What should the nurse plan on having in the patient room? Physician Crash cart IV pump EKG monitor Lidocaine

A, B, and D. Adenosine is administered as a very quick IV push. The physician must be present in the room and the crash cart must be on hand. An ekg monitor should be in the room to monitor the effectiveness of the medication.

A patient is complaining of chest pain. On the bedside cardiac monitor you observe pronounce T-wave inversion. You obtain the patient's vital signs and find the following: Blood pressure 190/98, HR 110, oxygen saturation 96% on room air, and respiratory rate 20. Select-all-that-apply in regards to the MOST IMPORTANT nursing interventions you will provide based on the patient's current status:* A.Obtain a 12-lead EKG B.Place the patient in supine position C.Assess urinary output D.Administer Nitroglycerin sublingual as ordered per protocol E.Collect cardiac enzymes as ordered per protocol F.Encourage patient to cough and deep breath G. Administer Morphine IV as ordered per protocol H. Place patient on oxygen via nasal cannula No interventions are needed at this time

A, D, E, G, H

When teaching a patient about beta blockers such as atenolol (tenormin) and metoprolol (Lopressor), it is important for the nurse to instruct the patient about which drug information? A. Abrupt medication withdrawal may lead to a rebound hypertension. B. Alcohol intake is encouraged for its vasodilating effects. C. Hot baths and showers will help increase the therapeutic effects of this drug. D. These medications may be taken with antacids to minimize gastrointestinal distress.

A. Abrupt medication withdrawal may lead to a rebound hypertension.

The nurse knows which drug is an example of a cardioselective beta blocker? A. Atenolol (Tenormin) B. Sotalol (Betapace) C. Propranolol (Inderal) D. Labetalol (Normodyne)

A. Atenolol (Tenormin) **At therapeutic dosages, atenolol selectively blocks only the beta1 receptors in the heart, not the beta2 receptors located in the lungs.

For which potential side effects would the nurse monitor patients prescribed amiodarone? (Select all that apply) A. Bluish skin discoloration B. Hyperglycemia C. Hypothyroidism D. Photosensitivity

A. Bluish skin discoloration, C. Hypothyroidism, D. Photosensitivity

The patient who has recently been experiencing runs of ventricular tachycardia suddenly loses consciousness. The patient is defibrillated, and the rate returns as the following. What should the nurse do first? A) Begin compressions B) Shock the client again immediately C) Prepare for intubation D) Administer adenosine

A. Following defibrillation, CPR is immediately initiated if a perfusable rhythm is not initiated. The client may need to be shocked again, but chest compressions must begin first

A patient is taking Digoxin. What medication on the patient's medication list increases the patient's risk of experiencing Digoxin toxicity? Furosemide Metformin Nitroglycerin Coumadin

A. Furosemide is a loop-diuretic and this medication wastes potassium. Remember hypokalemia (low potassium level) increases the risk of a patient developing Digoxin toxicity. Hypercalcemia (>10.2 mg/dL) and hypomagnesemia ( < 1.5 mg/dL)also increases Digoxin toxicity.

The patient has hypokalemia, and the nurse obtains the following measurements on the rhythm strip: Heart rate of 86 with a regular rhythm; the P wave is 0.06 seconds (sec) and normal shape; the PR interval is 0.24 sec; the QRS is 0.09 sec. How should the nurse document this rhythm? First-degree AV block Second-degree AV block Premature atrial contraction (PAC) Premature ventricular contraction (PVC)

A. In first-degree AV block there is prolonged duration of AV conduction that lengthens the PR interval above 0.20 sec. In type I second-degree AV block the PR interval continues to increase in duration until a QRS complex is blocked. In Type II the PR interval may be normal or prolonged, the ventricular rhythm may be irregular, and the QRS is usually greater than 0.12 sec. PACs cause an irregular rhythm with a different-shaped P wave than the rest of the beats, and the PR interval may be shorter or longer. PVCs cause an irregular rhythm, and the QRS complex is wide and distorted in shape.

In regards to the patient in the previous question, after administering the first dose of Nitroglycerin sublingual the patient's blood pressure is now 68/48. The patient is still having chest pain and T-wave inversion on the cardiac monitor. What is your next nursing intervention? A. Hold further doses of Nitroglycerin and notify the doctor immediately for further orders. B. Administer Morphine IV and place the patient in reverse Trendelenburg position. C. Administer Nitroglycerin and monitor the patient's blood pressure. D. All the options are incorrect.

A. Nitroglycerin can cause hypotension, however, if there is a significant drop in blood pressure with SBP <90, further doses of Nitroglycerin should be held. The doctor should be notified for further orders, especially since the patient is still having chest pain and t-wave inversion. Morphine should NOT be given because it can cause hypotension.

A 55- yr-old male suddenly collapsed at the mall. He was in V- fib cardiac arrest and was rapidly resuscitated with return of spontaneous circulation Therapeutic hypothermia would be contraindicated in all EXCEPT Patient had arrested 12 hours ago DNR status Patient needs coronary angiography and stenting Widespread malignancy Active bleeding

A. Patient had arrested 12 hours ago Patients who have suffered cardiac arrest more than 12 hours ago are less likely to benefit from induced therapeutic hypothermia. The patients should however be kept normothermic and fever must be controlled

After assessing a client who is receiving an amiodarone intravenous infusion for unstable ventricular tachycardia, the nurse documents the findings and compares these with the previous assessment findings: Nursing Assessment Time: 08:00 Client alert and oriented. Cardiac rhythm: normal sinus rhythm. Skin: warm, dry, and appropriate for race. Respirations are equal and unlabored. Client denies shortness of breath and chest pain. Time: 10:00 Client alert and oriented. Cardiac rhythm: sinus bradycardia. Skin: warm, dry, and appropriate for race. Respirations are equal and unlabored. Client denies shortness of breath and chest pain. Client voids 420 mL of clear yellow urine. Based on the assessments, what action would the nurse take? A. Stop the infusion and flush the IV. B. Slow the amiodarone infusion rate. C. Administer IV normal saline. D. Ask the client to cough and deep breathe.

ANS: B

You are watching the cardiac monitor, and a patient's rhythm suddenly changes. There are no P waves. Instead, there are fine, wavy lines between the QRS complexes. The QRS complexes each measure 0.08 second (narrow), but they occur irregularly with a rate of 120 beats/minute. You correctly interpret that this rhythm is A. sinus tachycardia. B. atrial fibrillation. C. ventricular fibrillation. D. ventricular tachycardia.

ANS: B Atrial fibrillation is represented on the cardiac monitor by irregular R-R intervals and small fibrillatory (F) waves. There are no normal P waves because the atria are not contracting, just fibrillating.

A 62-year-old man is to receive lidocaine as treatment for a symptomatic dysrhythmia. Upon assessment, the nurse notes that he has a history of alcoholism and has late-stage liver failure. The nurse will expect which adjustments to his drug therapy? A. The lidocaine will be changed to an oral dosage form. B. Digoxin will be added to the lidocaine. C. An increased dosage of lidocaine will be prescribed so as to obtain adequate blood levels. D. The dosage will be reduced by 50%.

ANS: D Because lidocaine is metabolized primarily by the liver, a reduction of the dosage by 50% may be necessary in cases of liver failure or cirrhosis. Lidocaine does not come in oral form.

Adenosine is used to treat which condition? 1. Atrial fibrillation 2. Atrial flutter 3. Paroxysmal supraventricular tachycardia (PSVT) 4. Second-degree atrioventricular block

ANSWER: 3 Rationale: The only therapeutic indication of use for adenosine is the treatment of PSVT.

What should the nurse reading the monitor strip call a rhythm with a regular PR interval but a blocked QRS complex? 1. Asystole 2. Atrial fibrillation 3. First-degree AV block 4. Type II second-degree AV block

ANSWER: 4 Rationale: In type II second-degree AV block, a P wave is nonconducted without progressive PR interval lengthening. It is usually from a block in a bundle branch, occurs in a ratio of 2 P waves-to-1 QRS complex, 3:1, and so on. Asystole is absence of ventricular activity. Atrial fibrillation has a chaotic P wave. First-degree AV block is a prolonged AV conduction time, so the PR interval is prolonged.

2. When preparing to rewarm a patient with hypothermia, the nurse will plan to a. attach a cardiac monitor. b. insert a urinary catheter. c. assist with endotracheal intubation. d. have sympathomimetic drugs available.

ANSWER: A. Attach a cardiac monitor

1. After resuscitation, a patient who had a cardiac arrest is nonresponsive to commands and therapeutic hypothermia is prescribed. Which action will the nurse include in the plan of care? a. Rapidly infuse cold normal saline. b. Avoid the use of sedative medications. c. Check neurologic status every 30 minutes. d. Rewarm if temperature is >91 F (32.8 C).

ANSWER: A. Rapidly infuse cold normal saline

The telemetry nurse is reviewing a rhythm strip for a client with a 2nd degree type II heart block. The nurse notes a QRS complex of 0.16 seconds, no measurable PR interval, and a regular R to R and P to P interval. The nurse assesses the client and determines the client is responsive but dizzy with a pulse rate of 50 bpm. Which action by the nurse is most appropriate? 1. Continue to monitor 2. Prepare the client for pacemaker insertion 3. Have the client perfrom a vagal maneuver 4. Call a code blue

ANSWER: B Rantionale: The client's rhythm has deteriorated from a 2nd degree heart block to a comlpete heart block. This is a medical emergency, and the client requires pacing. The nurse will prepare the client for pacemaker insertion, and possibly temporary pacing until a permanent pacer can be placed.

For which problem is percutaneous coronary intervention (PCI) most clearly indicated? Chronic stable angina Left-sided heart failure Coronary artery disease Acute myocardial infarction

Acute myocardial infarction

A patient has returned to the cardiac care unit after having a permanent pacemaker implantation. For which potential complication should the nurse most closely assess this patient? A) Chest pain (B) Bleeding at the implantation site (C) Malignant hyperthermia (D) Bradycardia

Ans: (B)

The nurse caring for a patient whose sudden onset of sinus bradycardia is not responding adequately to atropine. What might be the treatment of choice for this patient? (A) Implanted pacemaker (B) Trancutaneous pacemaker (C) ICD (D) Asynchronous defibrillator

Ans: (B) Rationale: If a patient suddenly develops a bradycardia, is symptomatic but has a pulse, and is unresponsive to atropine, emergency pacing may be started with transcutaneous pacing, which most defibrillators are now equipped to perform. An implanted pacemaker is not a time-appropriate option. An asynchronous defibrillator or ICD would not provide relief.

A patient with dilated cardiomyopathy has new onset atrial fibrillation that has been unresponsive to drug therapy for several days. The priority teaching needed for this patient would include information about a. anticoagulant therapy. b. permanent pacemakers. c. electrical cardioversion. d. IV adenosine (Adenocard).

Ans: A Atrial fibrillation therapy that has persisted for more than 48 hours requires anticoagulant treatment for 3 weeks before attempting cardioversion. This is done to prevent embolization of clots from the atria. Cardioversion may be done after several weeks of anticoagulation therapy. Adenosine is not used to treat atrial fibrillation. Pacemakers are routinely used for patients with bradydysrhythmias. Information does not indicate that the patient has a slow heart rate.

1. A goal of the induction phase of therapeutic hypothermia after cardiac arrest is to: A. quickly warm the patient to target body temperature. B. slowly cool the patient to target body temperature. C. quickly cool the patient to target body temperature. D. slowly warm the patient to target body temperature.

Ans: c. In the induction phase, the goal is to cool the patient to target body temperature as quickly as possible.

Question 1: You begin your shift and assess an electrocardiogram rhythm strip. The P waves and QRS complexes are regular. The PR interval are not discernable, and the QRS complexes are 0.10 seconds. The overall atrial rate is 240 beats per minute with sawtooth like appearances. The nurse assesses the cardiac rhythm as: Atrial Flutter Atrial Fibrillation First Degree Heart Block Sinus Tachycardia

Answer: 1 Rational: Atrial flutter consist of an increased atrial rate and has a saw tooth appearance present on the EKG.

The client diagnosed with a myocardial infarction is six hours post-right femoral percutaneous transluminal coronary angioplasty (PTCA), also known as balloon surgery. Which assessment data would require immediate intervention by the nurse? 1. The client is keeping the affected extremity straight 2. The pressure dressing to the right femoral area is intact 3. The client is complaining of numbness in the right foot 4. The client's right pedal pulse is +3 and bounding

Answer: 3. Rationale: Any neurovascular assessment data that is abnormal requires intervention by the nurse; numbness may indicate decreased blood flow to the right foot.

The nurse is assessing the client with chest pain to evaluate whether the client is suffering from angina or myocardial infarction (MI). Which symptom is indicative of an MI? 1. Chest pain brought on by exertion or stress 2. Substernal chest discomfort occurring at rest 3. Substernal chest discomfort relieved by nitroglycerin or rest 4. Substernal chest pressure relieved only by opioids

Answer: 4. Rationale: Substernal chest pressure relieved only by opioids is typically indicative of MI. Chest pain brought on by exertion or stress is indicative of angina. Substernal chest discomfort that occurs at rest is not necessarily indicative of MI; it could be a sign of unstable angina. Substernal chest discomfort relieved by nitroglycerin or rest is indicative of angina.

The nurse is caring for a client with atrial fibrillation. In addition to an antidysrhythmic, what medication does the nurse plan to administer? a. Heparin b. Atropine c. Dobutamine d. Magnesium sulfate

Answer: A Clients with atrial fibrillation are prone to blood pooling in the atrium, clotting, then embolizing. Heparin is used to prevent thrombus development in the atrium and the consequence of embolization (i.e., stroke).

The nurse is preparing to administer adenosine to the patient with the following rhythm which is symptomatic. What should the nurse plan on having in the patient room? a) Physician b) Crash cart c) IV pump d) EKG monitor e) Lidocaine

Answer: A, B, and D. Adenosine is administered as a very quick IV push. The physician must be present in the room and the crash cart must be on hand. An ekg monitor should be in the room to monitor the effectiveness of the medication.

When giving adenosine, it is important to remember to? A. Give it as a fast intravenous push B. Give it as a slow intravenous push over 5 minutes C. Offer it with food or milk D. Prepare to set up for an intravenous drip infusion

Answer: A: Adenosine must be given as rapidly as possible, followed by a 50-mL normal saline flush in order to get all of the medication into the circulation quickly since the half-life of adenosine is <10 seconds.

The patient with a history of HTN and DM has the following rhythm strip (attached). The patient's vitals are as follows: BP 145/49, HR 90, SpO2 95%, RR 19. Which of the following does the nurse expect to do at this time? A. Prepare the client for cardioversion STAT B. Begin administering anticoagulants C. Grab the crash cart for administration of adenosine D. Teach the client about possibility of pacemaker installation

Answer: B Rationale: Atrial Flutter places the client at high risk for development of clot formation in the atria because the client is stable at this time, cardioversion or adenosine would not be performed at this time. Before cardioversion can occur in a patient, anticoagulant therapy should be begun at least 48 hours before hand if possible.

You are caring for a patient with hypothermia who is undergoing the rewarming process. What nursing diagnosis would you want to include in this patient's care plan? Deficient knowledge Risk for injury Risk for infection Pain

Answer: B - The patient is at highest risk for injury during the rewarming process. The nurse should make this the priority nursing diagnosis for the care plan. All other diagnoses may be relevant to the patient but are not priorities.

The nurse is watching the cardiac monitor, and a patient's rhythm suddenly changes. There are no P waves. Instead there are fine, wavy lines between the QRS complexes. The QRS complexes measure 0.08 sec (narrow), but they occur irregularly with a rate of 120 beats/min. The nurse correctly interprets this rhythm as what? A. Sinus tachycardia B. Atrial fibrillation C. Ventricular fibrillation D. Ventricular tachycardia

Answer: B Atrial fibrillation is represented on the cardiac monitor by irregular R-R intervals and small fibrillatory (f) waves. There are no normal P waves because the atria are not truly contracting, just fibrillating. Sinus tachycardia is a sinus rate above 100 beats/minute with normal P waves. Ventricular fibrillation is seen on the ECG without a visible P wave; an unmeasurable heart rate, PR or QRS; and the rhythm is irregular and chaotic. Ventricular tachycardia is seen as three or more premature ventricular contractions (PVCs) that have distorted QRS complexes with regular or irregular rhythm, and the P wave is usually buried in the QRS complex without a measurable PR interval.

1) The nurse prepares a discharge teaching plan for a 44-year-old male patient who has recently been diagnosed with coronary artery disease. Which risk factor should the nurse plan to focus on during the teaching session? A) Type A personality B) Elevated serum lipids C) Family cardiac history D) Hyperhomocysteinemia

Answer: B Elevated serum lipids

The nurse recognizes that the mechanism for action of beta-adrenergic blockers in the treatment of angina is: A) Positive chronotropic effect. B) Negative inotropic effect. C) Positive inotropic effect. D) Antidysrhythmia.

Answer: B) Negative inotropic effect. Rationale: Beta blockers decrease the workload of the heart by slowing heart rate (negative chronotropic effect) and reducing contractility (negative inotropic effect).

Select all the beta blocker medications listed below that affect ONLY beta 1 receptors* A. Timolol B. Atenolol C. Metoprolol D. Esmolol

Answer: B, C, D

Which patient teaching points should the nurse include when providing discharge instructions to a patient with a new permanent pacemaker and the caregiver (select all that apply)?a. Avoid or limit air travel.b. Take and record a daily pulse rate.c. Obtain and wear a Medic Alert ID device at all times.d. Avoid lifting arm on the side of the pacemaker above shoulder.e. Avoid microwave ovens because they interfere with pacemaker function

Answer: B, C, D

The nurse is preparing to administer digoxin to a patient with heart failure. In preparation, laboratory results are reviewed with the following findings: sodium 139 mEq/L, potassium 5.6 mEq/L, chloride 103 mEq/L, and glucose 106 mg/dL. What should the nurse do next? A. Withhold the daily dose until the following day. B. Withhold the dose and report the potassium level. C. Give the digoxin with a salty snack, such as crackers. D. Give the digoxin with extra fluids to dilute the sodium level.

Answer: B. Withhold the dose and report the potassium level.

A patient has received atropine. It is most important for the nurse to assess the patient for which effect? A. Anxiety B. Constipation C. Urinary retention D. Impaired oral mucous membrane

Answer: C Rationale: Urinary retention is the highest priority because it is more serious to systemic homeostasis than anxiety, constipation, or a dry mouth.

At 1000 your patient is scheduled to take a dose of Atenolol. What finding below would require you to hold the scheduled dose and notify the physician? A. The patient's heart rate is 120 beats per minute. B. The patient's blood pressure is 102/76. C. The patient has swelling in lower extremities, dyspnea, and crackles in lung fields.

Answer: C The patient is showing signs and symptoms of uncompensated heart failure (beta blockers are not used when uncompensated heart failure presents, but they can be sometimes be used when the patient is in compensated/stable heart failure). The reason is because beta blockers slow down the heart rate and decrease the strength of contractions (negative inotropic effect), which can lead to heart failure in SOME patients, and this is why the nurse must monitor for this.

A patient with neurogenic shock is experiencing a heart rate of 30 bpm. What medication does the nurse anticipate will be ordered by the physician STAT?* A. Adenosine B. Warfarin C. Atropine D. Norepinephrine

Answer: C. Rationale: Atropine will quickly increase the heart rate and block the effects of the parasympathetic system on the body. Remember bradycardia occurs in neurogenic shock because the sympathetic nervous system (which increases the heart rate) loses its ability to stimulate nerves. The sympathetic and parasympathetic systems are, in a way, balancing each other out when it comes to the heart rate. The sympathetic system increases it, while the parasympathetic decreases it. If the sympathetic system isn't working the way it should, it can NOT oppose the parasympathetic system....which will take over and lead to bradycardia.

Which of the following conditions is most commonly responsible for myocardial infarction? A. Aneurysm B. Heart failure C. Coronary artery thrombosis D. Renal failure

Answer: C. Coronary artery thrombosis Rationale: Coronary artery thrombosis causes an inclusion of the artery, leading to myocardial death

Adenosine is used to treat which condition? A. Atrial fibrillation B. Atrial flutter C. Paroxysmal supraventricular tachycardia (PSVT) D. second-degree atrioventricular block

Answer: C: The only therapeutic indication of use for adenosine is the treatment of PSVT.

A 38-year-old teacher who reported dizziness and shortness of breath while supervising recess is admitted with a dysrhythmia. Which medication, if ordered, requires the nurse to carefully monitor the patient for asystole? A. Atropine sulfate B. Digoxin (Lanoxin) C. Metoprolol (Lopressor) D. Adenosine (Adenocard)

Answer: D IV adenosine (Adenocard) is the first drug of choice to convert supraventricular tachycardia to a normal sinus rhythm. Adenosine is administered IV rapidly (over 1 or 2 seconds) followed by a rapid, normal saline flush. The nurse should monitor the patient's ECG continuously because a brief period of asystole after adenosine administration is common and expected. Atropine sulfate increases heart rate, whereas lanoxin and metoprolol slow the heart rate.

A patient has been started on therapy of a continuous infusion of lidocaine. The nurse will monitor the patient for which adverse effects? A. Drowsiness B. Nystagmus C. Dry mouth D. Convulsions

Answer: D. Convulsions

Question 2: True or False: Diltiazem helps control control the ventricular rate in atrial fibrillation and atrial flutter.

Answer: true Rational: Diltiazem is a calcium channel blocker used to treat hypertension, angina, and certain heart rhythm disorders such as atrial flutter and atrial fibrillation.

The nurse is administering a dose of digoxin (Lanoxin) to a patient with heart failure (HF). The nurse would become concerned with the possibility of digitalis toxicity if the patient reported which symptom(s)? Muscle aches Constipation Pounding headache Anorexia and nausea

Answer:D. Anorexia and nausea Anorexia, nausea, vomiting, blurred or yellow vision, and cardiac dysrhythmias are all signs of digitalis toxicity. The nurse would become concerned and notify the health care provider if the patient exhibited any of these symptoms.

The nurse is administering the medication adenosine. Which condition is the nurse most likely administering the medication to treat? Junctional Rhythm Supraventicular Tachycardia Atrial Fibrillation Adenosine Deaminase Deficiency Abdominal Cramps

B

You're providing discharge instructions to a patient who will be taking a calcium channel blocker at home. Which statement by the patient demonstrates they did NOT understand the teaching instructions and needs re-education? A. "I will follow a low-fat and high-fiber diet." B. "I will limit my consumption of soft drinks and try to incorporate more healthy options, like grapefruit juice." C. "This medication can enlarge my gums so I will maintain good oral hygiene." D. "I will monitor my blood pressure regularly because this medication can cause low blood pressure."

B

A patient is to have synchronized cardioversion for treatment of atrial flutter. He has received Heparin 500 Units subcutaneously. Which of the following interventions should now be performed? Assist the MD in intubating the patient to stabilize airway. Sedate the patient with Versed 2 mg IV push per protocol. Set the defibrillator in asynchronous mode and charge to 300 joules. Steadily increase the voltage until the beats are captured.

B Rationale: B. Is correct since the cardioversion is very painful, the patient should be sedated prior to the procedure.

1) A hospitalized patient with a history of chronic stable angina tells the nurse that she is having chest pain. The nurse bases his actions on the knowledge that ischemia A) will always progress to myocardial infarction B) will be relieved by rest, nitroglycerin, or both C) indicates that irreversible myocardial damage is occurring D) is frequently associated with vomiting and extreme fatigue

B) will be relieved by rest, nitroglycerin, or both

The nurse provides preoperative teaching for a client on the side effects of atropine given as a preoperative medication. The nurse informs the client to expect: Decreased heart rate. Dry mouth. Sedation. Increased urination.

B. Dry mouth.

A patient calls the cardiac clinic you are working at and reports that they have taken 3 sublingual doses of Nitroglycerin as prescribed for chest pain, but the chest pain is not relieved. What do you educate the patient to do next? A. Take another dose of Nitroglycerin in 5 minutes. B. Call 911 immediately C. Lie down and rest to see if that helps with relieving the pain D. Take two doses of Nitroglycerin in 5 minutes

B. If a patient's chest pain is not relieved with 3 doses of Nitroglycerin, taken 5 minutes apart, they should call 911 immediately. The patient should never exceed more than 3 doses of Nitroglycerin or take 2 doses at one time.

The nurse administers amiodarone (Cordarone) to a client with ventricular tachycardia. Which monitoring by the nurse is necessary with this drug? Select all that apply. A. Respiratory rate B. QT interval C. Heart rate & rhythm D. Mg level E. Urine output

B. QT interval, C. Heart rate & rhythm, D. Mg level

The nurse obtains a 6-second rhythm strip and charts the following analysis: TAB 1 ATRIAL DATA: Rate: 70, regular; Variable PR interval; Independent beats TAB 2 VENTRICULAR DATA: Rate: 40, regular; Isolated escape beats TAB 3 ADDITIONAL DATA: QRS: 0.04 sec; P wave and QRS complexes unrelated What is the correct interpretation of this rhythm strip? A. Sinus arrhythmias B. Third-degree heart block C. Wenckebach phenomenon D. Premature ventricular contractions

B. Third-degree heart block

Which is an indication for use of the antidysrhythmic drug lidocaine? A. Bradycardia B. Ventricular arrhythmias C. Atrial arrhythmias D. Heart block

B. Ventricular arrhythmias

A nurse is watching the cardiac monitor and notices that the rhythm suddenly changes. There are no P waves, the QRS complexes are wide, and the ventricular rate is regular but over 100. The nurse determines that the client is experiencing: Premature ventricular contractions Ventricular tachycardia Ventricular fibrillation Sinus tachycardia

B. Ventricular tachycardia

A patient who was admitted with a myocardial infarction experiences a 45-second episode of ventricular tachycardia, then converts to sinus rhythm with a heart rate of 98 beats/min. Which action should the nurse take next? A) Immediately notify the health care provider. B) Document the rhythm and continue to monitor the patient. C) Prepare to give IV amiodarone per agency dysrhythmia protocol. D) Perform synchronized cardioversion per agency dysrhythmia protocol.

C) Prepare to give IV amiodarone per agency dysrhythmia protocol.

What is the therapeutic range of the drug Digoxin? 2-3.5 ng/mL 0.1-2 ng/mL 0.5-2 ng/mL 3.5-5 ng/mL

C. A normal Digoxin level should be 0.5 - 2 ng/mL. Any levels greater than 2 ng/mL is considered toxic.

At 1000 your patient is scheduled to take a dose of Atenolol. What finding below would require you to hold the scheduled dose and notify the physician?* A. The patient's heart rate is 120 beats per minute B. The patient's blood pressure is 102/76 C. The patient has swelling in lower extremities, dyspnea, and crackles in lung fields

C. In option C, the patient is showing signs and symptoms of uncompensated heart failure (beta blockers are not used when uncompensated heart failure presents, but they can be sometimes be used when the patient is in compensated/stable heart failure). The reason is because beta blockers slow down the heart rate and decrease the strength of contractions (negative inotropic effect), which can lead to heart failure in SOME patients, and this is why the nurse must monitor for this

A patient is diagnosed with cardiac tamponade. When planning care, the nurse will include interventions to address which type of shock? Obstructive Hypovolemic Distributive Cardiogenic

Correct Answer: 1 Rationale 1: Cardiac tamponade can lead to obstructive shock. Rationale 2: Cardiac tamponade will not lead to hypovolemic shock. Rationale 3: Cardiac tamponade will not lead to distributive shock. Rationale 4: Cardiac tamponade will not lead to cardiogenic shock.

Which life-threatening complications would the nurse anticipate developing in the patient being treated for hypovolemic shock? Select all that apply. 1. Fluid volume overload 2. Renal insufficiency 3. Cerebral ischemia 4. Gastric stress ulcer 5. Pulmonary edema

Correct Answer: 2,3

The nurse, caring for a patient in hypovolemic shock, will not utilize a hypotonic solution for fluid resuscitation because hypotonic solutions: Move quickly into the interstitial spaces and can cause third spacing Stay longer to expand the intravascular space but deplete intracellular fluid levels Do not stay in the intravascular space long enough to expand the circulating blood volume Need a smaller bore needle to run at a slower rate to keep the intravascular space low

Correct Answer: 3 Rationale 1: Hypotonic solutions do not cause third spacing. Rationale 2: Hypotonic solutions do not stay in the intravascular space long enough to expand the circulating blood volume. Rationale 3: Hypotonic solutions do not stay in the intravascular space long enough to expand the circulating blood volume. Rationale 4: The bore size of the needle does not affect the displacement or shifting of fluids.

2. Conduction defects will most likely be an adverse associated with the use of: A. verapamil (Isoptin) B. nifedipine (Adalat CC) C. diltiazem (Cardizem) D. felodipine (Plendil)

Correct Answer: A. verapamil (Isoptin).

1. Which of the following effects of calcium channel blockers causes a reduction in blood pressure? A. Increased cardiac output. B. Decreased peripheral vascular resistance. C. Decreased renal blood flow. D. Calcium influx into cardiac muscles.

Correct Answer: B. Decreased peripheral vascular resistance. One of the effects of calcium channel blockers is to decrease peripheral vascular resistance. Cardiovascular indications include hypertension, coronary spasm, angina pectoris, supraventricular dysrhythmias, hypertrophic cardiomyopathy, and pulmonary hypertension. In addition to these, they are also prescribed for Raynaud phenomenon, subarachnoid hemorrhage, and migraine headaches. The other options describe the opposite effects of calcium channel blockers.

When ventricular fibrillation occurs in a CCU, the first person reaching the client should: A. Administer oxygen. B. Defibrillate the client. C. Initiate CPR. D. Administer sodium bicarbonate intravenously.

Correct Answer: B. Defibrillate the client Ventricular fibrillation is a death-producing dysrhythmia and, once identified, must be terminated immediately by precordial shock (defibrillation). This is usually a standing physician's order in a CCU. Pulseless VT and VF are both shockable rhythms, and once the staff identifies the rhythm as VF, patients should be shocked immediately with 120 to 200 joules on a biphasic defibrillator or 360 joules using a monophasic.

1. A nurse notes that a client with sinus rhythm has a premature ventricular contraction that falls on the T wave of the preceding beat. The client's rhythm suddenly changes to one with no P waves or definable QRS complexes. Instead, there are coarse wavy lines of varying amplitude. The nurse assesses this rhythm to be: A. Ventricular tachycardia B. Ventricular fibrillation C. Atrial fibrillation D. Asystole

Correct Answer: B. Ventricular fibrillation Ventricular fibrillation is characterized by irregular, chaotic undulations of varying amplitudes. Ventricular fibrillation has no measurable rate and no visible P waves or QRS complexes and results from electrical chaos in the ventricles. VF is a WCT caused by irregular electrical activity and characterized by a ventricular rate of usually greater than 300 with discrete QRS complexes on the electrocardiogram (ECG). QRS morphology in VF varies in shape, amplitude, and duration with a prominent irregular rhythm.

A nurse is watching the cardiac monitor and notices that the rhythm suddenly changes. There are no P waves, the QRS complexes are wide, and the ventricular rate is regular but over 100. The nurse determines that the client is experiencing: A. Premature ventricular contractions B. Ventricular tachycardia C. Ventricular fibrillation D. Sinus tachycardia

Correct Answer: B. Ventricular tachycardia Ventricular tachycardia is characterized by the absence of P waves, wide QRS complexes (usually greater than 0.14 second), and a rate between 100 and 250 impulses per minute. The rhythm is usually regular. Ventricular tachycardia is characterized as a wide complex (QRS duration greater than 120 milliseconds) tachyarrhythmia at a heart rate greater than 100 beats per minute. It is classified by duration as non-sustained or sustained. Non-sustained ventricular tachycardia is defined as more than 3 beats of ventricular origin at a rate greater than 100 beats per minute that lasts less than 30 seconds in duration.

2. A nurse is viewing the cardiac monitor in a client's room and notes that the client has just gone into ventricular tachycardia. The client is awake and alert and has good skin color. The nurse would prepare to do which of the following? A. Immediately defibrillate. B. Prepare for pacemaker insertion. C. Administer amiodarone (Cordarone) intravenously. D. Administer epinephrine (Adrenaline) intravenously.

Correct Answer: C. Administer amiodarone (Cordarone) intravenously. First-line treatment of ventricular tachycardia in a client who is hemodynamically stable is the use of antidysrhythmics such as amiodarone (Cordarone), lidocaine (Xylocaine), and procainamide (Pronestyl). Cardioversion also may be needed to correct the rhythm (cardioversion is recommended for stable ventricular tachycardia). Procainamide will terminate between 50% and 80% of ventricular tachycardias, and it will slow the conduction of those that it does not terminate. Amiodarone will convert about 30% of patients to sinus rhythm but is very effective in reducing the reversion rate of refractory SMVT.

A nurse is viewing the cardiac monitor in a client's room and notes that the client has just gone into ventricular tachycardia. The client is awake and alert and has good skin color. The nurse would prepare to do which of the following? A. Immediately defibrillate. B. Prepare for pacemaker insertion. C. Administer amiodarone (Cordarone) intravenously D. Administer epinephrine (Adrenaline) intravenously.

Correct Answer: C. Administer amiodarone (Cordarone) intravenously. First-line treatment of ventricular tachycardia in a client who is hemodynamically stable is the use of antidysrhythmics such as amiodarone (Cordarone), lidocaine (Xylocaine), and procainamide (Pronestyl). Cardioversion also may be needed to correct the rhythm (cardioversion is recommended for stable ventricular tachycardia). Procainamide will terminate between 50% and 80% of ventricular tachycardias, and it will slow the conduction of those that it does not terminate. Amiodarone will convert about 30% of patients to sinus rhythm but is very effective in reducing the reversion rate of refractory SMVT.

The adaptations of a client with complete heart block would most likely include: A. Nausea and vertigo B. Flushing and slurred speech C. Cephalalgia and blurred vision D. Syncope and slow ventricular rate

Correct Answer: D. Syncope and slow ventricular rate In complete atrioventricular block, the ventricles take over the pacemaker function in the heart but at a much slower rate than that of the SA node. As a result, there is decreased cerebral circulation, causing syncope. Patients with third-degree blocks can have varying clinical presentations. Rarely, patients are asymptomatic. Usually, they may present with generalized fatigue, tiredness, chest pain, shortness of breath, presyncope, or syncope. They may have significant hemodynamic instability and can be obtunded.

The client with peripheral vascular disease has been prescribed diltiazem (Cardizem). The nurse should determine the effectiveness of this medication by assessing the client for: Relief of anxiety. Sedation. Vasoconstriction. Vasodilation.

Correct D. Diltiazem (Cardizem) is a calcium channel blocker that blocks the influx of calcium into the cell. In this situation, the primary use of diltiazem is to promote vasodilation and prevent spasms of the arteries. As a result of the vasodilation, blood, oxygen, and nutrients can reach the muscle and tissues. Diltiazem is not an antianxiety agent and does not promote sedation. It also does not cause vasoconstriction, which would be contraindicated for the client with PVD.

The nurse instructs the client to do which of the following to prevent dislodgment of the pacing catheter after insertion of a permanent demand pacemaker via the right subclavian vein has been made? A. Limit movement and abduction of left arm B. Ask for help in getting out of bed and use walker to ambulate C. Limit movement and abduction of right arm D. Do active range-of-motion exercises with right arm

Correct answer: Limit movement and abduction of right arm Rationale: The nurse should instruct the patient to limit movement and abduction of right arm. The muscles and movement of the right arm most directly effect the placement of the pacing catheter.

The nurse has been teaching a patient about ways to decrease risk factors for coronary artery disease (CAD). Which statement by the patient indicates an adequate understanding? A) "I will add weightlifting to my exercise program." B) "I will change my diet to increase my intake of saturated fats." C) "I need to switch to smokeless tobacco instead of smoking cigarettes." D) "I will change my lifestyle to reduce activities that increase my stress."

D) "I will change my lifestyle to reduce activities that increase my stress."

The nurse has received change-of-shift report about the following patients on the progressive care unit. Which patient should the nurse see first? A) A patient with atrial fibrillation, rate 88 and irregular, who has a dose of warfarin (Coumadin) due B) A patient with second-degree atrioventricular (AV) block, type 1, rate 60, who is dizzy when ambulating C) A patient who is in a sinus rhythm, rate 98 and regular, recovering from an elective cardioversion 2 hours ago D) A patient whose implantable cardioverter-defibrillator (ICD) fired twice today and has a dose of amiodarone (Cordarone) due

D) A patient whose implantable cardioverter-defibrillator (ICD) fired twice today and has a dose of amiodarone (Cordarone) due

2) When caring for a patient with acute coronary syndrome who has returned to the coronary care unit after having angioplasty with stent placement, the nurse obtains the following assessment data. Which data indicate the need for immediate action by the nurse? A) Heart rate 102 beats/min B) Pedal pulses 1+ bilaterally C) Blood pressure 103/54 mm Hg D) Chest pain level 7 on a 0 to 10 point scale

D) Chest pain level 7 on a 0 to 10 point scale

A massive gastrointestinal bleed has resulted in hypovolemic shock in an older patient. What is a priority nursing diagnosis?A. Acute painB. Impaired tissue integrityC. Decreased cardiac outputD. Ineffective tissue perfusion

D, The many deleterious effects of shock are all related to inadequate perfusion and oxygenation of every body system. This nursing diagnosis supersedes the other diagnoses.

A nurse prepares to defibrillate a client who is in ventricular fibrillation. Which priority intervention should the nurse perform prior to defibrillating this client? Make sure the defibrillator is set to the synchronous mode. Administer 1 mg of intravenous epinephrine. Test the equipment by delivering a smaller shock at 100 joules. Ensure that everyone is clear of contact with the client and the bed.

D. Ensure that everyone is clear of contact with the client and the bed

The adaptations of a client with complete heart block would most likely include: Nausea and vertigo Flushing and slurred speech Cephalalgia and blurred vision Syncope and slow ventricular rate

D. Syncope and slow ventricular rate

In Third Degree Heart Block: the SA node and AV node are blocked some beats are conducted, while others are not the bundle branches are blocked the atria and ventricles are completely dissociated

D. The atria and ventricles are completely dissociated

A patient who has diabetes will be started on Metoprolol for medical management of coronary artery disease. Which of the following will you include in your discharge teaching about this medication? A. Check your heart rate regularly because Metoprolol can cause an irregular heart rate. B. Check your glucose regularly because this medication can cause hyperglycemia. C. Check your blood pressure regularly because this medication can cause hypertension. D. Check your glucose regularly because this medication can mask the typical signs and symptoms of hypoglycemia.

D. This patient needs to be educated to check their glucose levels regularly because this medication can mask the typical signs and symptoms of hypoglycemia. This is very important since the patient is diabetic.

The nurse caring for a client with hypothermia understands the compensatory mechanisms that are activated during this condition to decrease oxygen demands on the body. Which clinical manifestation should the nurse expect upon assessment for this​ client? (Select all that​ apply.) Increased respiratory rate Increased GI motility Increased heart rate Decreased respiratory rate Decreased heart rate

Decreased respiratory rate Decreased heart rate

The nurse prepares a discharge teaching plan for a 44-year-old male patient who has recently been diagnosed with coronary artery disease. Which risk factor should the nurse plan to focus on during the teaching session? Type A personality Elevated serum lipids Family cardiac history Hyperhomocysteinemia

Elevated serum lipids Dyslipidemia is one of the four major modifiable risk factors for coronary artery disease (CAD). The other major modifiable risk factors are hypertension, tobacco use, and physical inactivity. Research findings related to psychologic states (i.e., type A personality) as a risk factor for coronary artery disease have been inconsistent. Family history is a nonmodifiable risk factor. High homocysteine levels have been linked to an increased risk for CAD.

A client with a complete heart block has had a demand ventricular pacemaker inserted. The nurse assesses for proper pacemaker function by examining the electrocardiogram (ECG) strip for the presence of pacemaker spikes at what point? 1.Before each P wave 2.Just after each P wave 3.Just after each T wave 4.Before each QRS complex

If a ventricular pacemaker is functioning properly, there will be a pacer spike followed by a QRS complex. An atrial pacemaker spike precedes a P wave if an atrial pacemaker is implanted. A demand pacemaker fires only when needed and should therefore discharge only when no electrical activity is occurring in the client's own heart.

You are a nurse taking care of a patient during a rapid response call. The patient is bradycardic and you are asked to administer atropine. Which of the following best describes the mechanism of action of atropine? Muscarinic acetylcholine receptor antagonist Muscarinic acetylcholine receptor agonist Alpha-adrenergic blocker Beta-adrenergic blocker Monoamine oxidase inhibitor

Muscarinic acetylcholine receptor antagonist

1.The nurse administers amiodarone (Cordarone) to a client with ventricular tachycardia. Which monitoring by the nurse is necessary with this drug? Select all that apply. Respiratory rate QT interval Heart rate and rhythm Magnesium level Urine output

QT interval; Heart rate and rhythm; Magnesium level Rationale: Amiodarone causes prolongation of the QT interval, which can precipitate dysrhythmia. Antidysrhythmic medications cause changes in cardiac rhythm and rate; therefore monitoring of heart rate and rhythm is needed.Electrolyte depletion, specifically potassium and magnesium, may predispose to further dysrhythmia. Although it is always important to monitor vital signs and urine output, these assessments are not specific to amiodarone.

At 1000 your patient is scheduled to take a dose of Atenolol. What finding below would require you to hold the scheduled dose and notify the physician?* A. The patient's heart rate is 120 beats per minute. B. The patient's blood pressure is 102/76. C. The patient has swelling in lower extremities, dyspnea, and crackles in lung fields.

The answer is C. In option C, the patient is showing signs and symptoms of uncompensated heart failure (beta blockers are not used when uncompensated heart failure presents, but they can be sometimes be used when the patient is in compensated/stable heart failure). The reason is because beta blockers slow down the heart rate and decrease the strength of contractions (negative inotropic effect), which can lead to heart failure in SOME patients, and this is why the nurse must monitor for this.

A patient is complaining of chest pain. On the bedside cardiac monitor you observe pronounce T-wave inversion. You obtain the patient's vital signs and find the following: Blood pressure 190/98, HR 110, oxygen saturation 96% on room air, and respiratory rate 20. Select-all-that-apply in regards to the MOST IMPORTANT nursing interventions you will provide based on the patient's current status: A. Obtain a 12-lead EKG B. Place the patient in supine position C. Assess urinary output D. Administer Nitroglycerin sublingual as ordered per protocol E. Collect cardiac enzymes as ordered per protocol F. Encourage patient to cough and deep breath G. Administer Morphine IV as ordered per protocol H. Place patient on oxygen via nasal cannula

The answers are A, D, E, G, and H

A patient is prescribed Diltiazem for the treatment of a cardiac disorder. Which findings below would require the nurse to hold the ordered dose of Diltiazem and notify the physician for further orders? Select all that apply: A. Blood pressure 198/102 B. EKG shows 3rd Degree Atrioventricular Block C. EKG shows Atrial Fibrillation with Rapid Ventricular Response D. Heart Rate 46 beats per minute

The answers are B and D

A patient is prescribed Diltiazem (Cardizem) for the treatment of a cardiac disorder. Which findings below would require the nurse to hold the ordered dose of Diltiazem and notify the physician for further orders? Select all that apply: Blood pressure 198/102 EKG shows 3rd Degree Atrioventricular Block EKG shows Atrial Fibrillation with Rapid Ventricular Response Heart Rate 46 beats per minute

The answers are B and D. Diltiazem (Cardizem) is a calcium channel blocker that helps treat arrhythmias (supraventricular tachycardia and atrial fibrillation), hypertension, and angina. It is contraindicated if bradycardia or 2nd/3rd AV blocks occur. This is because this medication decreases the function of the SA and AV nodes (which is advantageous if a-fib with rapid ventricular response is occurring). However, if a 2nd degree AV block is presenting or bradycardia, the SA and AV nodes are not working properly and this medication could further impede their function

For which of the following dysrhythmias is defibrillation primarily indicated? Ventricular fibrillation Third-degree AV block Uncontrolled atrial fibrillation Ventricular tachycardia with a pulse

Ventricular fibrillation

1.Which finding indicates that rehydration is complete and hypovolemic shock has been successfully treated in a patient? a. CVP = 8 mm Hg b. MAP = 45 mm Hg c. Urinary output of 0.1 mL/kg/hr d. Hct = 54%

a

Guidelines for Therapeutic Hypothermia include cooling patients to a. 32° C to 34° C for 12 to 24 hours. b. 32° C to 34° C for 24 to 48 hours. c. 30° C to 32° C for 12 to 24 hours. d. 30° C to 32° C for 24 to 48 hours.

a

A client with angina pectoris must learn how to reduce risk factors that exacerbate this condition. When developing the client's care plan, which expected outcome should a nurse include? a) "Client will verbalize the intention to stop smoking." b) "Client will verbalize an understanding of the need to call the physician if acute pain lasts more than 2 hours." c) "Client will verbalize the intention to avoid exercise." d) "Client will verbalize an understanding of the need to restrict dietary fat, fiber, and cholesterol."

a) "Client will verbalize the intention to stop smoking."

You are a nurse taking care of a patient during a rapid response call. The patient is bradycardic and you are asked to administer atropine. Which of the following best describes the mechanism of action of atropine? a. Muscarinic acetylcholine receptor antagonist b. Muscarinic acetylcholine receptor agonist c. Alpha-adrenergic blocker d. Beta-adrenergic blocker e. Monoamine oxidase inhibitor

a. Muscarinic acetylcholine receptor antagonist

2. The most important diagnostic feature for any of the AV blocks is the: -rate -PRI -QRS complex -P wave

answer:PRI

Which of the following heart block dysrhythmias is identified by missing QRS complexes and a consistent PR interval measurement? 1,second degree type I 2,second degree type II 3,third degree heart block 4,first degree heart block

answers:2.

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

b. Third degree or complete heart block is recognized with the atrial and ventricular dissociation and treated with a pacemaker. Sinus bradycardia does not have atrial and ventricular dissociation. Atrial fibrillation does not have normal P waves, as they are stimulated by ectopic foci. In type 1 second degree AV heat block, the PR interval gradually lengthens and a QRS complex is dropped. Then the cycle begins again.

The client diagnosed with rule-out myocardial infarction is experiencing chest pain while walking to the bathroom. Which action should the nurse implement first? a) Administer sublingual nitroglycerin b) Obtain a stat 12 Lead ECG c) Have the client sit down immediately d) Assess the client's vital signs

c) Have the client sit down immediately Stopping all activity will decrease the need of the myocardium for oxygen and may help decrease the chest pain.

When no atrial impulse is conducted through the AV node into the ventricles, the patient is said to be experiencing which type of AV block a) First degree b) Second degree, type II c) Third degree d) Second degree, type I

c) Third degree In third degree heart block, two impulses stimulate the heart, one impulse stimulates the ventricles and other stimulates the atria. In first degree heart block, all the atrial impulses are conducted through the AV node into the ventricles at a rate slower than normal. In second degree AV block, type I, all but one of the atrial impulses are conducted through the AV node into the ventricles. In second degree AV block, type II, only some of the atrial impulses are conducted through the AV node into the ventricles.

The nurse teaches the patient receiving atropine (Atreza) to expect which side effect? a. Diarrhea b. Bradycardia c. Blurred vision d. Frequent urination

c. Blurred vision

Which heart rhythm occurs when the atrial and ventricular rhythms are both regular, but independent of each other? a) Second-degree heart block b) Asystole c) First-degree AV block d) Third-degree atrioventricular (AV) heart block

d) Third-degree atrioventricular (AV) heart block

1. Therapeutic Hypothermia after cardiac arrest is primarily used to lower body temperature to a. protect cardiac muscle from further damage. b. prevent a second cardiac arrest. c. shunt blood from the brain to the heart. d. prevent neurologic injury.

d.

1. In Third Degree Heart Block: -the SA node and AV node are blocked -some beats are conducted, while others are not -the bundle branches are blocked -the atria and ventricles are completely dissociated

the atria and ventricles are completely dissociated