NR 464 Exam 2 (Cardiac & Endocrine) – Study Guide, Practice
Questions & Revision Notes
The nurse is caring for a patient who has had an ECG. The nurse notes that leads I, II, and III
differ from one another on the cardiac rhythm strip. How should the nurse best respond? -
correct answer ✔✔Ans: Recognize that the view of the electrical current changes in relation to
the lead placement.
Feedback: Rational
Each lead offers a different reference point to view the electrical activity of the heart. The lead
displays the configuration of electrical activity of the heart.
The nurse is analyzing a rhythm strip. What component of the ECG corresponds to the resting
state of the patient's heart? - correct answer ✔✔The T wave specifically represents ventricular
muscle depolarization, also referred to as the resting state.
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? - correct answer ✔✔The QRS complex represents the depolarization of the ventricles
and, as such, the electrical activity of that ventricle.
An adult patient with third-degree AV block is admitted to the cardiac care unit and placed on
continuous cardiac monitoring. What rhythm characteristic will the ECG most likely show? -
correct answer ✔✔Fewer QRS complexes than P waves
Rational
In third-degree AV block, no atrial impulse is conducted through the AV node into the ventricles.
As a result, there are impulses stimulating the atria and impulses stimulating the ventricles.
Therefore, there are more P waves than QRS complexes due to the difference in the natural
pacemaker (nodes) rates of the heart.
, The nurse is writing a plan of care for a patient with a cardiac dysrhythmia. What would be the
most appropriate goal for the patient? - correct answer ✔✔For patient safety, the most
appropriate goal is to maintain cardiac output to prevent worsening complications as a result of
decreased cardiac output.
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? - correct answer ✔✔Bleeding, hematomas, local infections, perforation of the
myocardium, and tachycardia are complications of pacemaker implantations. The nurse should
monitor for chest pain and bradycardia, but bleeding is a more common immediate
complication.
A patient the nurse is caring for has a permanent pacemaker implanted with the identification
code beginning with VVI. What does this indicate? - correct answer ✔✔The identification of VVI
indicates ventricular paced, ventricular sensed, inhibited.
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? - correct answer ✔✔When defibrillating
an adult patient, the nurse should maintain good contact between the paddles and the patient's
skin to prevent arcing, apply an appropriate conducting agent (not water) between the skin and
the paddles, and ensure the defibrillator is in the nonsync mode. "Clear" should be called three
times before discharging the paddles.
A patient who is a candidate for an implantable cardioverter defibrillator (ICD) asks the nurse
about the purpose of this device. What would be the nurse's best response? - correct answer
✔✔The ICD is a device that detects and terminates life-threatening episodes of ventricular
tachycardia and ventricular fibrillation.
A nurse is providing health education to a patient scheduled for cryoablation therapy. The nurse
should describe what aspect of this treatment? - correct answer ✔✔Cryoablation therapy
involves using a cooled probe to create a small scar on the endocardium to eliminate the source
of the dysrhythmias.
Questions & Revision Notes
The nurse is caring for a patient who has had an ECG. The nurse notes that leads I, II, and III
differ from one another on the cardiac rhythm strip. How should the nurse best respond? -
correct answer ✔✔Ans: Recognize that the view of the electrical current changes in relation to
the lead placement.
Feedback: Rational
Each lead offers a different reference point to view the electrical activity of the heart. The lead
displays the configuration of electrical activity of the heart.
The nurse is analyzing a rhythm strip. What component of the ECG corresponds to the resting
state of the patient's heart? - correct answer ✔✔The T wave specifically represents ventricular
muscle depolarization, also referred to as the resting state.
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? - correct answer ✔✔The QRS complex represents the depolarization of the ventricles
and, as such, the electrical activity of that ventricle.
An adult patient with third-degree AV block is admitted to the cardiac care unit and placed on
continuous cardiac monitoring. What rhythm characteristic will the ECG most likely show? -
correct answer ✔✔Fewer QRS complexes than P waves
Rational
In third-degree AV block, no atrial impulse is conducted through the AV node into the ventricles.
As a result, there are impulses stimulating the atria and impulses stimulating the ventricles.
Therefore, there are more P waves than QRS complexes due to the difference in the natural
pacemaker (nodes) rates of the heart.
, The nurse is writing a plan of care for a patient with a cardiac dysrhythmia. What would be the
most appropriate goal for the patient? - correct answer ✔✔For patient safety, the most
appropriate goal is to maintain cardiac output to prevent worsening complications as a result of
decreased cardiac output.
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? - correct answer ✔✔Bleeding, hematomas, local infections, perforation of the
myocardium, and tachycardia are complications of pacemaker implantations. The nurse should
monitor for chest pain and bradycardia, but bleeding is a more common immediate
complication.
A patient the nurse is caring for has a permanent pacemaker implanted with the identification
code beginning with VVI. What does this indicate? - correct answer ✔✔The identification of VVI
indicates ventricular paced, ventricular sensed, inhibited.
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? - correct answer ✔✔When defibrillating
an adult patient, the nurse should maintain good contact between the paddles and the patient's
skin to prevent arcing, apply an appropriate conducting agent (not water) between the skin and
the paddles, and ensure the defibrillator is in the nonsync mode. "Clear" should be called three
times before discharging the paddles.
A patient who is a candidate for an implantable cardioverter defibrillator (ICD) asks the nurse
about the purpose of this device. What would be the nurse's best response? - correct answer
✔✔The ICD is a device that detects and terminates life-threatening episodes of ventricular
tachycardia and ventricular fibrillation.
A nurse is providing health education to a patient scheduled for cryoablation therapy. The nurse
should describe what aspect of this treatment? - correct answer ✔✔Cryoablation therapy
involves using a cooled probe to create a small scar on the endocardium to eliminate the source
of the dysrhythmias.
