NUR 434 Final Exam Questions with Verified Answers
1. Teamstepps: CUS; Advocacy & Assertion; feedback & task assistance: CUS
Words
I am Concerned
I am Uncomfortable
This is a Safety Issue
"Stop the line"
2. Feedback: Feedback is information provided that can positively or negatively
impact team performance.
It may be:
-Nonverbal (not paying attention, looking upset, smiling and affirming what's being
said)
-Verbal (making a suggesting, agreeing, or disagreeing.
-Intentional (a message you were deliberately sending)
-Unintentional ( a reaction you were not trying to communicate)
3. Task Assistance: Team members foster a climate in which it is expected that
assistance will be actively sought and offered as a method for reducing error risks
and workplace stress and burnout.
4. Advocacy and Assertion: Advocate for the patient:
-Invoked when team members' viewpoints don't concede with that of a decision
maker and patient safety is at risk
Assert a corrective action in a firm and respectful manner.
-Respects and supports authority
-Clearly asserts concerns and suggestions
-Is nonthreatening and ensures critical information is addressed.
Five-Step Process:
1. open the discussion
2. state the concern
3. state the problem (real or perceived)
4. offer a solution
5. obtain an agreement on next steps
5. Effective communication (think about how we really should be talking to
each other as nurses and to our patient: Effective formative feedback is:
,-Appropriate
-Timely
-Respectful
-Specific
-Directed towards improvement
-Considerate
-Patient focused
6. Asystole s/sx: no regularity, no rate, no P waves, no PR interval, no QRS
complex. Flatline.
Causes: H'S & T's
-Hypovolemia; Hypoxia; Hydrogen Ions (Acidosis); Hypo/Hyperkalemia: Hypother-
mia
-Tension Pneumo; tamponade; toxins; thrombosis (pulmonary or Coronary)
7. Asystole Treatment: Call for help, CPR/ACLS, treat underlying cause
Check your patient (leads may be off)
8. Vtach s/sx; nursing care (pulse & pulseless); when do we use cardioversion
vs defibrillati: Regularity: Regular
Rate: > 100 bpm
P waves: none
PR interval: noneQRS complex: wide and bizarre
(> 0.12 sec)
9. V Tach w/ pulse treatment: Cardioversion
10. Pulseless V Tach Treatment: SCREAM
Shock
CPR
Rhythm Check
Epinephrine
Antiarrhythmic
-(Amiodarone)
Magnesium Sulfate
11. AV Heart Blocks: Delayed in conduction through normal pathways
Delayed at the AV junction which slows down heart rate and affects how well the
heart pumps blood.
,Types:
1st degree
2nd degree (type I and II)
3rd degree
12. 1st Degree AV Heart Block: PR interval > 0.20 seconds
Causes:
-Beta blockers, calcium channel blockers, Dig, anti-arrhythmics
-MI
-Ischemia
-Age related changes
13. 1st Degree AV Heart Block Treatment: Generally one; monitor.
Causes: may be normal, hypoxemia, MI, myocarditis, hypothyroidism, hyperkalemia,
meds
Regularity: regular
Rate: usually sinus (can be tachy/Brady)
P waves: normal, precede each QRS
Pr interval: prolonged,constant
QRS complex: usually normal
14. 2nd Degree Block Type I: Regularity: Irregular
Rate: rate may vary
P waves: normal
PR Interval: progressive lengthening, some P waves not followed by QRS, cyclical
QRS Complex: usually normal
15. 2nd Degree Block Type I Treatment: Causes:
-hypoxemia
-MI
-Heart disease
-Rheumatic fever
-Vagal stimulation
-Electrolyte imbalances
-Meds
Treatment: generally notreatment neccessary, treat underlying cause, monitor, pace.
, AKA Wenckebach
16. 2nd Degree Block Type II: Regularity: irregular
Rate: rate may vary
P waves: normal in size and shape, some P waves not followed by QRS
PR Interval: normal or prolonged BUT always constant for conducted beats
QRS complex: usually normal but absent at times
17. 2nd Degree Block Type II Treatment: Causes:
-Hypoxemia
-MI
-Ischemia
Treatment:
-O2 if needed
-may need pacing
-correct underlying cause
More serious than type I, may progress to complete heart block or asystole.
18. 3rd Degree Block: Regularity: atrial and ventricular rhythms are independently
regular
Rate:
Atrial: 60-100 bpm
Ventricular: 20-40 bpm
P waves: normal but not related to QRS
PR interval: none due to dissociation
QRS Complex: depends on level of escape rhythm
19. 3rd Degree Block Treatment: Causes:
-Hypoxemia
-MI
-Ischemia
-Electrolyte imbalance
-Rheumatic Fever
Treatment:
-Call for HELP!!!
1. Teamstepps: CUS; Advocacy & Assertion; feedback & task assistance: CUS
Words
I am Concerned
I am Uncomfortable
This is a Safety Issue
"Stop the line"
2. Feedback: Feedback is information provided that can positively or negatively
impact team performance.
It may be:
-Nonverbal (not paying attention, looking upset, smiling and affirming what's being
said)
-Verbal (making a suggesting, agreeing, or disagreeing.
-Intentional (a message you were deliberately sending)
-Unintentional ( a reaction you were not trying to communicate)
3. Task Assistance: Team members foster a climate in which it is expected that
assistance will be actively sought and offered as a method for reducing error risks
and workplace stress and burnout.
4. Advocacy and Assertion: Advocate for the patient:
-Invoked when team members' viewpoints don't concede with that of a decision
maker and patient safety is at risk
Assert a corrective action in a firm and respectful manner.
-Respects and supports authority
-Clearly asserts concerns and suggestions
-Is nonthreatening and ensures critical information is addressed.
Five-Step Process:
1. open the discussion
2. state the concern
3. state the problem (real or perceived)
4. offer a solution
5. obtain an agreement on next steps
5. Effective communication (think about how we really should be talking to
each other as nurses and to our patient: Effective formative feedback is:
,-Appropriate
-Timely
-Respectful
-Specific
-Directed towards improvement
-Considerate
-Patient focused
6. Asystole s/sx: no regularity, no rate, no P waves, no PR interval, no QRS
complex. Flatline.
Causes: H'S & T's
-Hypovolemia; Hypoxia; Hydrogen Ions (Acidosis); Hypo/Hyperkalemia: Hypother-
mia
-Tension Pneumo; tamponade; toxins; thrombosis (pulmonary or Coronary)
7. Asystole Treatment: Call for help, CPR/ACLS, treat underlying cause
Check your patient (leads may be off)
8. Vtach s/sx; nursing care (pulse & pulseless); when do we use cardioversion
vs defibrillati: Regularity: Regular
Rate: > 100 bpm
P waves: none
PR interval: noneQRS complex: wide and bizarre
(> 0.12 sec)
9. V Tach w/ pulse treatment: Cardioversion
10. Pulseless V Tach Treatment: SCREAM
Shock
CPR
Rhythm Check
Epinephrine
Antiarrhythmic
-(Amiodarone)
Magnesium Sulfate
11. AV Heart Blocks: Delayed in conduction through normal pathways
Delayed at the AV junction which slows down heart rate and affects how well the
heart pumps blood.
,Types:
1st degree
2nd degree (type I and II)
3rd degree
12. 1st Degree AV Heart Block: PR interval > 0.20 seconds
Causes:
-Beta blockers, calcium channel blockers, Dig, anti-arrhythmics
-MI
-Ischemia
-Age related changes
13. 1st Degree AV Heart Block Treatment: Generally one; monitor.
Causes: may be normal, hypoxemia, MI, myocarditis, hypothyroidism, hyperkalemia,
meds
Regularity: regular
Rate: usually sinus (can be tachy/Brady)
P waves: normal, precede each QRS
Pr interval: prolonged,constant
QRS complex: usually normal
14. 2nd Degree Block Type I: Regularity: Irregular
Rate: rate may vary
P waves: normal
PR Interval: progressive lengthening, some P waves not followed by QRS, cyclical
QRS Complex: usually normal
15. 2nd Degree Block Type I Treatment: Causes:
-hypoxemia
-MI
-Heart disease
-Rheumatic fever
-Vagal stimulation
-Electrolyte imbalances
-Meds
Treatment: generally notreatment neccessary, treat underlying cause, monitor, pace.
, AKA Wenckebach
16. 2nd Degree Block Type II: Regularity: irregular
Rate: rate may vary
P waves: normal in size and shape, some P waves not followed by QRS
PR Interval: normal or prolonged BUT always constant for conducted beats
QRS complex: usually normal but absent at times
17. 2nd Degree Block Type II Treatment: Causes:
-Hypoxemia
-MI
-Ischemia
Treatment:
-O2 if needed
-may need pacing
-correct underlying cause
More serious than type I, may progress to complete heart block or asystole.
18. 3rd Degree Block: Regularity: atrial and ventricular rhythms are independently
regular
Rate:
Atrial: 60-100 bpm
Ventricular: 20-40 bpm
P waves: normal but not related to QRS
PR interval: none due to dissociation
QRS Complex: depends on level of escape rhythm
19. 3rd Degree Block Treatment: Causes:
-Hypoxemia
-MI
-Ischemia
-Electrolyte imbalance
-Rheumatic Fever
Treatment:
-Call for HELP!!!
