Med/Surg Cardiovascular Exam Questions with Accurate Answers

Which of the EKG findings is most likely indicative of Acute Myocardial Infarction (AMI) in a patient presenting with acute chest pain? A. Wide and bizarre QRS complexes in the EKG B. ST segment changes (STEMI or NSTEMI) in the EKG C. A saw-toothed pattern in the EKG saw-toothed pattern in the EKG D. Flat line in the EKG - ANSWERSB. ST segment changes (STEMI or NSTEMI) in the EKG To determine whether there is a delay in impulse conduction through the atria, the nurse will measure the length of the patient's: A. P wave B. PR interval C. QT interval D. QRS complex - ANSWERSA. P wave The P wave represents the depolarization of the atria. The P-R interval represents depolarization of the atria, atrioventricular (AV) node, bundle of His, bundle branches, and the Purkinje fibers. The QRS represents ventricular depolarization. The Q-T interval represents depolarization and repolarization of the entire conduction system. The nurse needs to estimate quickly the heart rate for a patient with a regular heart rhythm. Which method will be best to use? A. Print a 1-minute electrocardiogram (ECG) strip and count the number of QRS complexes. B. Count the number of large squares in the R-R interval and divide by 300. C. Use the 3-second markers to count the number of QRS complexes in 6seconds and multiply by 10. D. Calculate the number of small squares between one QRS complex and the next and divide into 1500. - ANSWERSC. Use the 3-second markers to count the number of QRS complexes in 6seconds and multiply by 10. This is the quickest way to determine the ventricular rate for a patient with a regular rhythm. All the other methods are accurate, but take longer. The nurse obtains a monitor strip on a patient who has had a myocardial infarction and makes the following analysis: P wave not apparent, ventricular rate 162, R-R interval regular, P-R interval not measurable, and QRS complex wide and distorted, QRS duration 0.18 second. The nurse interprets the patient's cardiac rhythm as: A. Atrial fibrillation B. Sinus tachycardia C. Ventricular fibrillation D. Ventricular tachycardia - ANSWERSD. Ventricular tachycardia The absence of P waves, wide QRS, rate 150, and the regularity of the rhythm indicate ventricular tachycardia. Atrial fibrillation is grossly irregular, has a narrow QRS configuration, and has fibrillatory atrial activity. Sinus tachycardia has P waves. Ventricular fibrillation is irregular and does not have a consistent QRS duration. The absence of P waves, wide QRS, rate 150, and the regularity of the rhythm indicate ventricular tachycardia. Atrial fibrillation is grossly irregular, has a narrow QRS configuration, and has fibrillatory atrial activity. Sinus tachycardia has P waves. Ventricular fibrillation is irregular and does not have a consistent QRS duration. The nurse is admitting a patient who has chest pain. Which assessment data suggest that the pain is caused by an Acute Myocardial Infarction (AMI)? A. The pain is relieved after the patient takes nitroglycerin B. The pain is reproducible when the patient raises the left arm C. The pain increases with deep breathing D. The pain lasted longer than 30 minutes - ANSWERSD. The pain lasted longer than 30 minutes Which of the following is the most common diagnostic tool used in patients with HF? A. Serum Troponin level B. ABG C. Echocardiogram D. Coronary Angiography - ANSWERSC. Echocardiogram Question 70.07 / 0.07 pts After reviewing a patient's history, vital signs, physical assessment, and laboratory data, which of the following information is most important for the nurse to communicate to the healthcare provider? A. Hyperglycemia B. Elevated troponin C. T wave on EKG D. HR 110 bpm - ANSWERSB. Elevated troponin Which of the following is the worst complication of Acute Coronary Syndrome (ACS)? A. Sinus tachycardia B. Hypertension C. Sudden cardiac death D. Angina - ANSWERSC. Sudden cardiac death A patient who has chronic heart failure tells the nurse, "I was fine when I went to bed, but I woke up in the middle of the night feeling like I was suffocating! The nurse will document this assessment finding as: A. Orthopnea B. Paroxysmal nocturnal dyspnea C. Asthma attack D. Acute bilateral pleural effusion - ANSWERSB. Paroxysmal nocturnal dyspnea A 19-year-old has a mandatory electrocardiogram (ECG) before participating on a college swim team and is found to have sinus bradycardia, rate 52. BP is 114/54, and the student denies any health problems. What action by the nurse is appropriate? A. Allow the student to participate on the swim team. B. Refer the student to a cardiologist for further assessment. C. Obtain more detailed information about the student's health history. D. Tell the student to stop swimming immediately if any dyspnea occurs. - ANSWERSA. Allow the student to participate on the swim team. When analyzing the waveforms of a patient's electrocardiogram (ECG), the nurse will need to investigate further upon finding a: A. T wave of 0.16 second B. P-R interval of 0.18 second C. Q-T interval of 0.34 second D. QRS interval of 0.14 second - ANSWERSD. QRS interval of 0.14 second Because the normal QRS interval is 0.12 seconds, the patient's QRS interval of 0.14 seconds indicates that the conduction through the ventricular conduction system is prolonged. The P-R interval, Q-T interval, and T wave interval are within the normal range. Which assessment finding in a patient admitted with Acute Decompensated Heart Failure (ADHF) requires the most immediate action by the nurse? A. Weight gain of 1-2 lbs. over 2 weeks B. HR of 106 bpm C. O2 saturation of 88% D. Urine output of 60 ml over 2 hours - ANSWERSC. O2 saturation of 88% Which of the following is a most fatal dysrhythmia? A. Ventricular fibrillation B. Sinus tachycardia C. Atrial flutter D. Sinus bradycardia - ANSWERSA. Ventricular fibrillation A patient whose cardiac monitor shows sinus tachycardia, rate 102, is apneic and no pulses are palpable by the nurse. What is the first action that the nurse should take? A. Give 100% oxygen per non-rebreather mask B. Defibrillate C. Administer atropine per hospital protocol D. Start CPR - ANSWERSD. Start CPR The patient's clinical manifestations indicate pulseless electrical activity and the nurse should immediately start CPR. The other actions would not be of benefit to this patient. When developing a health teaching plan for a 60-year-old man with the following risk factors for coronary artery disease (CAD), the nurse should focus on the A. family history of coronary artery disease. B. increased risk associated with the patient's male sex. C. high incidence of cardiovascular disease in older people. D. elevation of the patient's serum low density lipoprotein (LDL) level. - ANSWERSD. elevation of the patient's serum low density lipoprotein (LDL) level. Serum LDL is the only modifiable risk factor. Which information given by a patient admitted with stable angina will help the nurse confirm this diagnosis? A. The patient rates the pain at a level 3 to 5 (0 to 10 scale). B. The patient states that the pain "wakes me up at night." C. The patient says that the frequency of the pain has increased over the last few weeks. D. The patient states that the pain is resolved after taking one sublingual nitroglycerin tablet. - ANSWERSweeks. D. The patient states that the pain is resolved after taking one sublingual nitroglycerin tablet. Chronic stable angina refers to chest pain that occurs intermittently over long period of time with similar pattern of onset, duration, and intensity of symptoms. The pain of chronic stable angina usually lasts only for a few minutes before subsiding with rest, calming down, or use of sublingual nitroglycerin (NTG) After the nurse has finished teaching a patient about use of sublingual nitroglycerin (Nitrostat), which patient statement indicates that the teaching has been EFFECTIVE? A. "I can expect indigestion as a side effect of nitroglycerin." B. "I can only take the nitroglycerin if I start to have chest pain." C. "I will call an ambulance if I still have pain 5 minutes after taking the nitroglycerin." D. "I will help slow down the progress of the plaque formation by taking nitroglycerin." - ANSWERSC. "I will call an ambulance if I still have pain 5 minutes after taking the nitroglycerin." Chest pain that continues after use of NTG may indicate a change to acute coronary syndrome (ACS).