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WorksheetsMS2- Exam 1
Total questions: 45
Worksheet time: 45mins
The nursing educator is presenting a case study of an adult patient who has abnormal ventricular depolarization. This pathologic change would be most evident in what component of the ECG?
P wave
T wave
QRS Complex
U wave
The nurse is attempting to determine the ventricular rate and rhythm of a patient’s telemetry strip. Which will the nurse examine to determine this part of the analysis?
PP Interval
QT interval
RR Interval
TP interval
A patient with dilated cardiomyopathy is having frequent episodes of ventricular fibrillation. Which choice would be best to sense and terminate these episodes?
Implantable Cardioverter Defibrillator
Pacemaker
Atropine
Epinephrine
A patient who had a myocardial infarction is experiencing severe chest pain and alerts the nurse. The nurse begins the assessment but suddenly the patient becomes unresponsive, no pulse, with the monitor showing a rapid, disorganized ventricular rhythm. Which will the nurse interpret this rhythm to be?
Ventricular tachycardia
Atrial Fibrillation
Third Degree AV Block
Ventricular Fibrillation
The nurse is analyzing a rhythm strip. What component of the ECG corresponds to the resting state of the patient's heart?
P wave
T wave
U wave
QRS Complex
The nurse is caring for an adult patient who has gone into ventricular fibrillation. When assisting with defibrillating the patient, what must the nurse do?
Maintain firm contact between paddles and patient skin.
Apply a layer of water as a conducting agent.
Call "all clear" once before discharging the defibrillator.
Ensure the defibrillator is in the sync mode.
During a CPR class, a participant asks about the difference between cardioversion and defibrillation. What would be the instructor's best response
"Cardioversion is done on a beating heart; defibrillation is not."
"The difference is the timing of the delivery of the electric current."
"Defibrillation is synchronized with the electrical activity of the heart, but cardioversion is not."
"Cardioversion is always attempted before defibrillation because it has fewer risks."
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?
Defibrillation
ECG Monitoring
Implantation of an ICD
Angioplasty
Choose the Correct Rhythm
Sinus tachycardia
Atrial fibrillation
Ventricular Tachycardia
Ventricular Fibrillation
Choose the correct rhythm
Sinus tachycardia
Atrial fibrillation
Normal Sinus rhythm
Ventricular fibrillation
Choose the correct rhythm
Normal sinus rhythm
Sinus bradycardia
Atrial fibrillation
Ventricular fibrillation
Choose the correct rhythm
Ventricular fibrillation
Ventricular tachycardia
Sinus Tachycardia
Atrial fibrillation
Choose the correct rhythm
Sinus tachycardia
Sinus bradycardia
Normal sinus rhythm
Ventricular tachycardia
A patient presents to the walk-in clinic complaining of intermittent chest pain on exertion, which is eventually attributed to angina. The nurse should inform the patient that angina is most often attributable to what cause?
Decreased cardiac output
Decreased cardiac contractility
Infarction of the myocardium
Coronary arteriosclerosis
Which ECG finding(s) does the nurse observe in a patient who has had a myocardial infarction (MI)? (Select all that apply.)
Absent P wave
An abnormal Q wave
T-wave inversion
ST-Segment elevation
Prolonged PR Interval
The nurse is reviewing the laboratory results for a patient having a suspected myocardial infarction (MI). Which cardiac-specific isoenzyme does the nurse observe for myocardial cell damage?
Alkaline Phosphatase
Creatinine Kinase (CK-MB)
Myoglobin
Troponin
The nurse is caring for a patient who is experiencing chest pain associated with a myocardial infarction (MI). Which medication will the nurse administer intravenously to reduce pain and anxiety?
Meperidine hydrochloride
Hydromorphone hydrochloride
Morphine sulfate
Codeine sulfate
The nurse is assessing a postoperative patient who had a percutaneous transluminal coronary angioplasty (PTCA). Which potential complications should the nurse monitor for? (Select all that apply.)
Bleeding at the insertion site
Abrupt closure of the artery
Retroperitoneal bleeding
Arterial occlusion
Hyperlipidemia
A patient with angina has been prescribed nitroglycerin. Before administering the drug, the nurse should inform the patient about what potential adverse effects?
Nervousness or paresthesia
Throbbing headache or dizziness
Drowsiness or blurred vision
Tinnitus or diplopia
The nurse is providing an educational workshop about coronary artery disease (CAD) and its risk factors. The nurse explains to participants that CAD has many risk factors, some that can be controlled and some that cannot. What risk factors would the nurse list that can be controlled or modified?
Gender, obesity, family history, and smoking
Inactivity, stress, gender, and smoking
Obesity, inactivity, diet, and smoking
Stress, family history, and obesity
When discussing angina pectoris secondary to atherosclerotic disease with a patient, the patient asks why he tends to experience chest pain when he exerts himself. The nurse should describe which of the following phenomena?
Exercise increases the heart's oxygen demands.
Exercise causes vasoconstriction of the coronary arteries.
Exercise shunts blood flow from the heart to the mesenteric area.
Exercise increases the metabolism of cardiac medications.
An adult patient is admitted to the ED with chest pain. The patient states that he had developed unrelieved chest pain that was present for approximately 20 minutes before coming to the hospital. To minimize cardiac damage, the nurse should expect to administer which of the following interventions?
Thrombolytics, oxygen administration, and nonsteroidal antiinflammatories
Morphine sulphate, oxygen, and bed rest
Oxygen and betaadrenergic blockers
Bed rest, albuterol nebulizer treatments, and oxygen
The nurse is participating in the care conference for a patient with ACS. What goal should guide the care team's selection of assessments, interventions, and treatments?
Maximizing cardiac output while minimizing heart rate
Decreasing energy expenditure of the myocardium
Balancing myocardial oxygen supply with demand
Increasing the size of the myocardial muscle
The nurse is evaluating teaching provided to a patient with coronary artery disease. Which patient statement indicates that additional teaching is required?
“I will adhere to my smoking cessation plan.”
“I am to reduce my daily intake of saturated fat.”
“I can take up to three doses of nitroglycerin 15 minutes apart.”
“I am to follow the exercise plan for 30 minutes, five days a week.”
The triage nurse in the ED is assessing a patient with chronic HF who has presented with worsening symptoms. In reviewing the patient's medical history, what is a potential primary cause of the patient's heart failure?
Endocarditis
Pleural effusion
Atherosclerosis
Atrialseptal defect
A patient is admitted to the intensive care unit (ICU) with left-sided heart failure. Which clinical manifestations correlate with the left-sided heart failure identified by the nurse when performing an assessment? (Select all that apply.)
Jugular vein distention
Ascites
Pulmonary crackles
Dyspnea
Cough
Which assessment would be most appropriate for a patient who is receiving a loop diuretic for HF?
Monitor liver function studies
Monitor for hypotension
Assess the patient's vitamin D intake
Assess the patient for hyperkalemia
A patient admitted to the medical unit with HF is exhibiting signs and symptoms of pulmonary edema. The nurse is aware that positioning will promote circulation. How should the nurse best position the patient?
In a high Fowler's position
On the left side-lying position
In a flat, supine position
In the Trendelenburg position
The nurse is providing discharge education to a patient diagnosed with HF. What should the nurse teach this patient to do to assess her fluid balance in the home setting?
Monitor her blood pressure daily
Assess her radial pulses daily
Monitor her weight daily
Monitor her bowel movements
The nurse is visiting the home of a patient with peripheral arterial disease. For which observation should the nurse immediately intervene?
Sits with both feet on the floor
Walks around the house barefoot
Uses a mirror to examine the bottom of the feet
Eats grilled chicken on whole wheat bread for lunch
The nurse is caring for a patient with a large venous leg ulcer. What intervention should the nurse implement to promote healing and prevent infection?
Provide a high calorie, high protein diet.
Apply a clean occlusive dressing once daily and whenever soiled.
Irrigate the wound with hydrogen peroxide once daily
Apply an antibiotic ointment on the surrounding skin with each dressing change
A nurse is creating an education plan for a patient with venous insufficiency. What measure should the nurse include in the plan?
Avoiding tightfitting socks.
Limit activity whenever possible
Sleep with legs in a dependent position
Avoid the use of pressure stockings.
A nurse is admitting a 45 year old man to the medical unit who has a history of PAD. While providing his health history, the patient reveals that he smokes about two packs of cigarettes a day, has a history of alcohol abuse, and does not exercise. What would be the priority health education for this patient?
The lack of exercise, which is the main cause of PAD.
The likelihood that heavy alcohol intake is a significant risk factor for PAD.
Cigarettes contain nicotine, which is a powerful vasoconstrictor and may cause or aggravate PAD.
Alcohol suppresses the immune system, creates high glucose levels, and may cause PAD.
How should the nurse best position a patient who has leg ulcers that are venous in origin?
Keep the patient's legs flat and straight.
Keep the patient's knees bent to 45 degree angle and supported with pillows.
Elevate the patient's lower extremities.
Dangle the patient's legs over the side of the bed.
A nurse is closely monitoring a patient who has recently been diagnosed with an abdominal aortic aneurysm. What assessment finding would signal an impending rupture of the patient's aneurysm?
Sudden increase in blood pressure and a decrease in heart rate
Cessation of pulsating in an aneurysm that has previously been pulsating visibly
Sudden onset of severe back or abdominal pain
New onset of hemoptysis
A nurse is assessing a new patient who is diagnosed with PAD. The nurse cannot feel the pulse in the patient's left foot. How should the nurse proceed with assessment?
Have the primary care provider order a CT.
Apply a tourniquet for 3 to 5 minutes and then reassess.
Elevate the extremity and attempt to palpate the pulses.
Use Doppler ultrasound to identify the pulses.
The nurse is admitting a 32yearold woman to the presurgical unit. The nurse learns during the admission assessment that the patient takes oral contraceptives. Consequently, the nurse's postoperative plan of care should include what intervention?
Early ambulation and leg exercises
Cessation of the oral contraceptives until 3 weeks postoperative
Doppler ultrasound of peripheral circulation twice daily
Dependent positioning of the patient's extremities when at rest
A nurse in a long-term care facility is caring for an 83-year-old woman who has a history of HF and peripheral arterial disease (PAD). At present the patient is unable to stand or ambulate. The nurse should implement measures to prevent what complication?
Aoritis
Deep vein thrombosis
Thoracic aortic aneurysm
Raynaud's disease
A patient is brought to the emergency department reporting a “bad headache” and an increase in blood pressure. The blood pressure reading obtained by the nurse is 260/180 mm Hg. Which is the therapeutic goal for reduction of the mean blood pressure?
Reduce the blood pressure by 20% to 25% within the first hour of treatment
Reduce the blood pressure to about 140/80 mm Hg.
Rapidly reduce the blood pressure so the patient will not suffer a stroke.
Reduce the blood pressure by 50% within the first hour of treatment.
A patient arrives at the clinic for a follow-up visit for treatment of hypertension. The nurse obtains a blood pressure reading of 180/110 mm Hg but finds no evidence of impending or progressive organ damage when performing the assessment on the patient. Which situation does the nurse identify this patient is experiencing?
Hypertensive emergency
Primary hypertension
Secondary hypertension
Hypertensive urgency
An older adult is newly diagnosed with primary hypertension and has just been started on a betablocker. The nurse's health education should include which of the following?
Increasing fluids to avoid extracellular volume depletion from the diuretic effect of the betablocker
Maintaining a diet high in dairy to increase protein necessary to prevent organ damage
Use of strategies to prevent falls stemming from postural hypotension
Limiting exercise to avoid injury that can be caused by increased intracranial pressure
The critical care nurse is caring for a patient just admitted in a hypertensive emergency. The nurse should anticipate the administration of what medication?
Warfarin (Coumadin)
Furosemide (Lasix)
Sodium nitroprusside (Nitropress)
Ramipril (Altace)
A patient's recently elevated BP has prompted the primary care provider to prescribe furosemide (Lasix). The nurse should closely monitor which of the following?
The client's oxygen saturation level
The patient's red blood cells, hematocrit, and hemoglobin
The patient's level of consciousness
the patient's potassium level
A patient comes to the walk-in clinic complaining of frequent headaches. While assessing the patient's vital signs, the nurse notes the BP is 161/101 mm Hg. According to JNC 7, how would this patient's BP be defined if a similar reading were obtained at a subsequent office visit?
Normal
Prehypertensive
Stage 1 HTN
Stage 2 HTN
The nurse is reviewing the medication administration record of a patient who takes a variety of medications for the treatment of hypertension. What potential therapeutic benefits of antihypertensives should the nurse identify? Select all that apply.
Increased venous return
Decreased peripheral resistance
Decreased blood volume
Decreased strength and rate of myocardial contractions
Decreased blood viscosity
