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MS2- Exam 1

Total questions: 45

Worksheet time: 45mins

Name
Class
Date
1.

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?

a)

P wave

b)

T wave

c)

QRS Complex

d)

U wave

2.

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?

a)

PP Interval

b)

QT interval

c)

RR Interval

d)

TP interval

3.

A patient with dilated cardiomyopathy is having frequent episodes of ventricular fibrillation. Which choice would be best to sense and terminate these episodes?

a)

Implantable Cardioverter Defibrillator

b)

Pacemaker

c)

Atropine

d)

Epinephrine

4.

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?

a)

Ventricular tachycardia

b)

Atrial Fibrillation

c)

Third Degree AV Block

d)

Ventricular Fibrillation

5.

The nurse is analyzing a rhythm strip. What component of the ECG corresponds to the resting state of the patient's heart?

a)

P wave

b)

T wave

c)

U wave

d)

QRS Complex

6.

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?

a)

Maintain firm contact between paddles and patient skin.

b)

Apply a layer of water as a conducting agent.

c)

Call "all clear" once before discharging the defibrillator.

d)

Ensure the defibrillator is in the sync mode.

7.

During a CPR class, a participant asks about the difference between cardioversion and defibrillation. What would be the instructor's best response

a)

"Cardioversion is done on a beating heart; defibrillation is not."

b)

"The difference is the timing of the delivery of the electric current."

c)

"Defibrillation is synchronized with the electrical activity of the heart, but cardioversion is not."

d)

"Cardioversion is always attempted before defibrillation because it has fewer risks."

8.

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 an ICD

d)

Angioplasty

9.

Choose the Correct Rhythm

a)

Sinus tachycardia

b)

Atrial fibrillation

c)

Ventricular Tachycardia

d)

Ventricular Fibrillation

10.

Choose the correct rhythm

a)

Sinus tachycardia

b)

Atrial fibrillation

c)

Normal Sinus rhythm

d)

Ventricular fibrillation

11.

Choose the correct rhythm

a)

Normal sinus rhythm

b)

Sinus bradycardia

c)

Atrial fibrillation

d)

Ventricular fibrillation

12.

Choose the correct rhythm

a)

Ventricular fibrillation

b)

Ventricular tachycardia

c)

Sinus Tachycardia

d)

Atrial fibrillation

13.

Choose the correct rhythm

a)

Sinus tachycardia

b)

Sinus bradycardia

c)

Normal sinus rhythm

d)

Ventricular tachycardia

14.

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?

a)

Decreased cardiac output

b)

Decreased cardiac contractility

c)

Infarction of the myocardium

d)

Coronary arteriosclerosis

15.

Which ECG finding(s) does the nurse observe in a patient who has had a myocardial infarction (MI)? (Select all that apply.)

a)

Absent P wave

b)

An abnormal Q wave

c)

T-wave inversion

d)

ST-Segment elevation

e)

Prolonged PR Interval

16.

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?

a)

Alkaline Phosphatase

b)

Creatinine Kinase (CK-MB)

c)

Myoglobin

d)

Troponin

17.

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?

a)

Meperidine hydrochloride

b)

Hydromorphone hydrochloride

c)

Morphine sulfate

d)

Codeine sulfate

18.

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.)

a)

Bleeding at the insertion site

b)

Abrupt closure of the artery

c)

Retroperitoneal bleeding

d)

Arterial occlusion

e)

Hyperlipidemia

19.

A patient with angina has been prescribed nitroglycerin. Before administering the drug, the nurse should inform the patient about what potential adverse effects?

a)

Nervousness or paresthesia

b)

Throbbing headache or dizziness

c)

Drowsiness or blurred vision

d)

Tinnitus or diplopia

20.

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?

a)

Gender, obesity, family history, and smoking

b)

Inactivity, stress, gender, and smoking

c)

Obesity, inactivity, diet, and smoking

d)

Stress, family history, and obesity

21.

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?

a)

Exercise increases the heart's oxygen demands.

b)

Exercise causes vasoconstriction of the coronary arteries.

c)

Exercise shunts blood flow from the heart to the mesenteric area.

d)

Exercise increases the metabolism of cardiac medications.

22.

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?

a)

Thrombolytics, oxygen administration, and nonsteroidal antiinflammatories

b)

Morphine sulphate, oxygen, and bed rest

c)

Oxygen and betaadrenergic blockers

d)

Bed rest, albuterol nebulizer treatments, and oxygen

23.

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?

a)

Maximizing cardiac output while minimizing heart rate

b)

Decreasing energy expenditure of the myocardium

c)

Balancing myocardial oxygen supply with demand

d)

Increasing the size of the myocardial muscle

24.

The nurse is evaluating teaching provided to a patient with coronary artery disease. Which patient statement indicates that additional teaching is required?

a)

“I will adhere to my smoking cessation plan.”

b)

“I am to reduce my daily intake of saturated fat.”

c)

“I can take up to three doses of nitroglycerin 15 minutes apart.”

d)

“I am to follow the exercise plan for 30 minutes, five days a week.”

25.

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?

a)

Endocarditis

b)

Pleural effusion

c)

Atherosclerosis

d)

Atrialseptal defect

26.

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.)

a)

Jugular vein distention

b)

Ascites

c)

Pulmonary crackles

d)

Dyspnea

e)

Cough

27.

Which assessment would be most appropriate for a patient who is receiving a loop diuretic for HF?

a)

Monitor liver function studies

b)

Monitor for hypotension

c)

Assess the patient's vitamin D intake

d)

Assess the patient for hyperkalemia

28.

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?

a)

In a high Fowler's position

b)

On the left side-lying position

c)

In a flat, supine position

d)

In the Trendelenburg position

29.

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?

a)

Monitor her blood pressure daily

b)

Assess her radial pulses daily

c)

Monitor her weight daily

d)

Monitor her bowel movements

30.

The nurse is visiting the home of a patient with peripheral arterial disease. For which observation should the nurse immediately intervene?

a)

Sits with both feet on the floor

b)

Walks around the house barefoot

c)

Uses a mirror to examine the bottom of the feet

d)

Eats grilled chicken on whole wheat bread for lunch

31.

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?

a)

Provide a high calorie, high protein diet.

b)

Apply a clean occlusive dressing once daily and whenever soiled.

c)

Irrigate the wound with hydrogen peroxide once daily

d)

Apply an antibiotic ointment on the surrounding skin with each dressing change

32.

A nurse is creating an education plan for a patient with venous insufficiency. What measure should the nurse include in the plan?

a)

Avoiding tightfitting socks.

b)

Limit activity whenever possible

c)

Sleep with legs in a dependent position

d)

Avoid the use of pressure stockings.

33.

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?

a)

The lack of exercise, which is the main cause of PAD.

b)

The likelihood that heavy alcohol intake is a significant risk factor for PAD.

c)

Cigarettes contain nicotine, which is a powerful vasoconstrictor and may cause or aggravate PAD.

d)

Alcohol suppresses the immune system, creates high glucose levels, and may cause PAD.

34.

How should the nurse best position a patient who has leg ulcers that are venous in origin?

a)

Keep the patient's legs flat and straight.

b)

Keep the patient's knees bent to 45 degree angle and supported with pillows.

c)

Elevate the patient's lower extremities.

d)

Dangle the patient's legs over the side of the bed.

35.

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?

a)

Sudden increase in blood pressure and a decrease in heart rate

b)

Cessation of pulsating in an aneurysm that has previously been pulsating visibly

c)

Sudden onset of severe back or abdominal pain

d)

New onset of hemoptysis

36.

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?

a)

Have the primary care provider order a CT.

b)

Apply a tourniquet for 3 to 5 minutes and then reassess.

c)

Elevate the extremity and attempt to palpate the pulses.

d)

Use Doppler ultrasound to identify the pulses.

37.

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?

a)

Early ambulation and leg exercises

b)

Cessation of the oral contraceptives until 3 weeks postoperative

c)

Doppler ultrasound of peripheral circulation twice daily

d)

Dependent positioning of the patient's extremities when at rest

38.

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?

a)

Aoritis

b)

Deep vein thrombosis

c)

Thoracic aortic aneurysm

d)

Raynaud's disease

39.

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?

a)

Reduce the blood pressure by 20% to 25% within the first hour of treatment

b)

Reduce the blood pressure to about 140/80 mm Hg.

c)

Rapidly reduce the blood pressure so the patient will not suffer a stroke.

d)

Reduce the blood pressure by 50% within the first hour of treatment.

40.

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?

a)

Hypertensive emergency

b)

Primary hypertension

c)

Secondary hypertension

d)

Hypertensive urgency

41.

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?

a)

Increasing fluids to avoid extracellular volume depletion from the diuretic effect of the betablocker

b)

Maintaining a diet high in dairy to increase protein necessary to prevent organ damage

c)

Use of strategies to prevent falls stemming from postural hypotension

d)

Limiting exercise to avoid injury that can be caused by increased intracranial pressure

42.

The critical care nurse is caring for a patient just admitted in a hypertensive emergency. The nurse should anticipate the administration of what medication?

a)

Warfarin (Coumadin)

b)

Furosemide (Lasix)

c)

Sodium nitroprusside (Nitropress)

d)

Ramipril (Altace)

43.

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?

a)

The client's oxygen saturation level

b)

The patient's red blood cells, hematocrit, and hemoglobin

c)

The patient's level of consciousness

d)

the patient's potassium level

44.

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?

a)

Normal

b)

Prehypertensive

c)

Stage 1 HTN

d)

Stage 2 HTN

45.

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.

a)

Increased venous return

b)

Decreased peripheral resistance

c)

Decreased blood volume

d)

Decreased strength and rate of myocardial contractions

e)

Decreased blood viscosity