Question 1

Which of the following diagnostic tests is most effective for measuring overall heart size?

Accepted Answer

A)  Twelve-lead electrocardiography 
B)  Echocardiography 
C)  Chest radiography 
D)  Vectorcardiography 
A)  Twelve-lead electrocardiography 
B)  Echocardiography 
C)  Chest radiography 
D)  Vectorcardiography

Question 2

The patient has an HR of 84 beats/min and an SV of 65 mL.Calculate the CO.

Accepted Answer

A)  149 mL 
B)  500 mL 
C)  4650 mL 
D)  5460 mL 
A)  149 mL 
B)  500 mL 
C)  4650 mL 
D)  5460 mL

Question 3

A nurse palpates the descending aorta and feels a strong, bounding pulse.The nurse reports the findings to the physician because the results suggest

Accepted Answer

A)  decreased cardiac output. 
B)  increased cardiac output. 
C)  an aneurysm. 
D)  aortic insufficiency. 
A)  decreased cardiac output. 
B)  increased cardiac output. 
C)  an aneurysm. 
D)  aortic insufficiency.

Question 4

A physician orders removal of the central venous catheter (CVC)line.The patient has a diagnosis of heart failure with chronic obstructive pulmonary disease.The nurse would place the patient in what position for this procedure?

Accepted Answer

A)  Supine in bed 
B)  Supine in a chair 
C)  Flat in bed 
D)  Reverse Trendelenburg position 
A)  Supine in bed 
B)  Supine in a chair 
C)  Flat in bed 
D)  Reverse Trendelenburg position

Question 5

Zeroing the pressure transducer on hemodynamic monitoring equipment occurs when the displays reads

Accepted Answer

A)  0. 
B)  250. 
C)  600. 
D)  760. 
A)  0. 
B)  250. 
C)  600. 
D)  760.

Question 6

Which of the ECG findings would be positive for an inferior wall MI?

Accepted Answer

A)  ST segment depression in leads I, aVL, and V2 to V4 
B)  Q waves in leads V1 to V2 
C)  Q waves in leads II, III, and aVF 
D)  T-wave inversion in leads V4 to V6, I, and aVL 
A)  ST segment depression in leads I, aVL, and V2 to V4 
B)  Q waves in leads V1 to V2 
C)  Q waves in leads II, III, and aVF 
D)  T-wave inversion in leads V4 to V6, I, and aVL

Question 7

An 82-year-old patient is admitted into the critical care unit with a diagnosis of left-sided heart failure related to mitral stenosis.Physical assessment findings reveal tachycardia with an S3 and a 3/6 systolic murmur.The grading of a murmur as a 3/6 refers to which of the following characteristics of murmurs?

Accepted Answer

A)  Intensity 
B)  Quality 
C)  Timing 
D)  Pitch 
A)  Intensity 
B)  Quality 
C)  Timing 
D)  Pitch

Question 8

Evaluation of arterial circulation to an extremity is accomplished by assessing which of the following?

Accepted Answer

A)  Homans sign 
B)  Skin turgor 
C)  Peripheral edema 
D)  Capillary refill 
A)  Homans sign 
B)  Skin turgor 
C)  Peripheral edema 
D)  Capillary refill

Question 9

When checking the patient's back, the nurse pushes her thumb into the patient's sacrum.An indentation remains.The nurse charts that the patient has

Accepted Answer

A)  sacral compromise. 
B)  delayed skin turgor. 
C)  pitting edema. 
D)  dehydration. 
A)  sacral compromise. 
B)  delayed skin turgor. 
C)  pitting edema. 
D)  dehydration.

Question 10

Which of the following conditions is usually associated with clubbing?

Accepted Answer

A)  Central cyanosis 
B)  Peripheral cyanosis 
C)  Carbon monoxide poisoning 
D)  Acute hypoxemia 
A)  Central cyanosis 
B)  Peripheral cyanosis 
C)  Carbon monoxide poisoning 
D)  Acute hypoxemia

Question 11

A patient was admitted to the ICU 3 days ago with a diagnosis of myocardial infarction.The patient is complaining of increased chest pain when coughing, swallowing, and changing positions.The nurse hears a systolic scratching sound upon auscultation of the apical pulse.The nurse notifies the physician.Based on the symptoms, the physician suspects a(n)

Accepted Answer

A)  acute mitral regurgitation. 
B)  aortic insufficiency. 
C)  chronic mitral regurgitation. 
D)  pericardial friction rub. 
A)  acute mitral regurgitation. 
B)  aortic insufficiency. 
C)  chronic mitral regurgitation. 
D)  pericardial friction rub.

Question 12

Which of the following describe(s)S1, the first heart sound?

Accepted Answer

A)  It is associated with closure of the mitral and tricuspid valves. 
B)  It is a high-pitched sound. 
C)  It can be heard most clearly with the diaphragm of the stethoscope. 
D)  The best listening point is in the aortic area. 
E)  The "split" sound can best be detected in the tricuspid area. 
A)  It is associated with closure of the mitral and tricuspid valves. 
B)  It is a high-pitched sound. 
C)  It can be heard most clearly with the diaphragm of the stethoscope. 
D)  The best listening point is in the aortic area. 
E)  The "split" sound can best be detected in the tricuspid area.

Question 13

A characteristic event in junctional dysrhythmias is

Accepted Answer

A)  irregular rhythm. 
B)  rapid depolarization to the ventricles. 
C)  the spread of the impulse in two directions at once. 
D)  a widened QRS. 
A)  irregular rhythm. 
B)  rapid depolarization to the ventricles. 
C)  the spread of the impulse in two directions at once. 
D)  a widened QRS.

Question 14

A patient becomes unresponsive.The patient's heart rate is 32 beats/min, idioventricular rhythm; blood pressure is 60/32 mm Hg; SpO2 is 90%; and respiratory rate is 14 breaths/min.Which of the following interventions would the nurse do first?

Accepted Answer

A)  Notify the physician and hang normal saline wide open. 
B)  Notify the physician and obtain the defibrillator. 
C)  Notify the physician and obtain a temporary pacemaker. 
D)  Notify the physician and obtain a 12-lead ECG. 
A)  Notify the physician and hang normal saline wide open. 
B)  Notify the physician and obtain the defibrillator. 
C)  Notify the physician and obtain a temporary pacemaker. 
D)  Notify the physician and obtain a 12-lead ECG.

Question 15

Which lead is best to monitor a patient?

Accepted Answer

A)  Varies based on the patient's clinical condition and recent clinical history 
B)  Lead MCL1 
C)  Lead V1 
D)  Lead II 
A)  Varies based on the patient's clinical condition and recent clinical history 
B)  Lead MCL1 
C)  Lead V1 
D)  Lead II

Question 16

An 82-year-old patient is admitted into the critical care unit with a diagnosis of left-sided heart failure related to mitral stenosis.Physical assessment findings reveal tachycardia with an S3 and a 3/6 systolic murmur.The nurse knows that the presence of an S3 heart sound is

Accepted Answer

A)  normal for a person this age. 
B)  a ventricular gallop. 
C)  a systolic sound. 
D)  heard best with the diaphragm of the stethoscope. 
A)  normal for a person this age. 
B)  a ventricular gallop. 
C)  a systolic sound. 
D)  heard best with the diaphragm of the stethoscope.

Question 17

Which of the following interventions should be strictly followed to ensure accurate cardiac output readings?

Accepted Answer

A)  Use 5 mL of iced injectate only. 
B)  Inject the fluid into the pulmonary artery port only. 
C)  Ensure a difference of at least 5° C between injectate temperature and the patient's body temperature. 
D)  Administer the injectate within 4 seconds. 
A)  Use 5 mL of iced injectate only. 
B)  Inject the fluid into the pulmonary artery port only. 
C)  Ensure a difference of at least 5° C between injectate temperature and the patient's body temperature. 
D)  Administer the injectate within 4 seconds.

Question 18

Pulsus paradoxus may be seen on intra-arterial blood pressure monitoring when

Accepted Answer

A)  there is a decrease of more than 10 mm Hg in the arterial waveform before inhalation. 
B)  there is a single, nonperfused beat. 
C)  the waveform demonstrates tall, tented T waves. 
D)  the pulse pressure is greater than 20 mm Hg on exhalation. 
A)  there is a decrease of more than 10 mm Hg in the arterial waveform before inhalation. 
B)  there is a single, nonperfused beat. 
C)  the waveform demonstrates tall, tented T waves. 
D)  the pulse pressure is greater than 20 mm Hg on exhalation.

Question 19

The Allen test is used before radial arterial line placement to assess

Accepted Answer

A)  collateral circulation to the hand. 
B)  patency of the radial artery. 
C)  neurologic function of the hand. 
D)  pain sensation at the insertion point. 
A)  collateral circulation to the hand. 
B)  patency of the radial artery. 
C)  neurologic function of the hand. 
D)  pain sensation at the insertion point.

Question 20

A patient's bedside ECG strips show the following changes: increased PR interval; increased QRS width; and tall, peaked T waves.Vital signs are T 98.2° F; HR 118 beats/min; BP 146/90 mm Hg; and RR 18 breaths/min.The patient is receiving the following medications: digoxin 0.125 mg PO every day; D?1/2 normal saline with 40 mEq potassium chloride at 125 mL/hr; Cardizem at 30 mg PO q8h; and aldosterone at 300 mg PO q12h.The physician is notified of the ECG changes.What orders should the nurse expect to receive?

Accepted Answer

A)  Change IV fluid to D51/2 normal saline and draw blood chemistry. 
B)  Give normal saline with 40 mEq of potassium chloride over a 6-hour period. 
C)  Hold digoxin and draw serum digoxin level. 
D)  Hold Cardizem and give 500 mL normal saline fluid challenge over a 2-hour period. 
A)  Change IV fluid to D51/2 normal saline and draw blood chemistry. 
B)  Give normal saline with 40 mEq of potassium chloride over a 6-hour period. 
C)  Hold digoxin and draw serum digoxin level. 
D)  Hold Cardizem and give 500 mL normal saline fluid challenge over a 2-hour period.

Exam 11: Cardiovascular Clinical Assessment and Diagnostic Procedures

Which of the following diagnostic tests is most effective for measuring overall heart size?

The patient has an HR of 84 beats/min and an SV of 65 mL.Calculate the CO.

A nurse palpates the descending aorta and feels a strong, bounding pulse.The nurse reports the findings to the physician because the results suggest

A physician orders removal of the central venous catheter (CVC)line.The patient has a diagnosis of heart failure with chronic obstructive pulmonary disease.The nurse would place the patient in what position for this procedure?

Zeroing the pressure transducer on hemodynamic monitoring equipment occurs when the displays reads

Which of the ECG findings would be positive for an inferior wall MI?

Evaluation of arterial circulation to an extremity is accomplished by assessing which of the following?

When checking the patient's back, the nurse pushes her thumb into the patient's sacrum.An indentation remains.The nurse charts that the patient has

Which of the following conditions is usually associated with clubbing?

Which of the following describe(s)S1, the first heart sound?

A characteristic event in junctional dysrhythmias is

A patient becomes unresponsive.The patient's heart rate is 32 beats/min, idioventricular rhythm; blood pressure is 60/32 mm Hg; SpO2 is 90%; and respiratory rate is 14 breaths/min.Which of the following interventions would the nurse do first?

Which lead is best to monitor a patient?

An 82-year-old patient is admitted into the critical care unit with a diagnosis of left-sided heart failure related to mitral stenosis.Physical assessment findings reveal tachycardia with an S3 and a 3/6 systolic murmur.The nurse knows that the presence of an S3 heart sound is

Which of the following interventions should be strictly followed to ensure accurate cardiac output readings?

Pulsus paradoxus may be seen on intra-arterial blood pressure monitoring when

The Allen test is used before radial arterial line placement to assess

Caring for the Critically Ill Patient

Ethical and Legal Issues

Patient and Family Education

Psychosocial and Spiritual Alterations and Management

Sleep Alterations

Nutritional Alterations

Gerontological Alterations

Pain and Pain Management

Sedation, Agitation and Delirium Management

End of Life Care

Cardiovascular Disorders

Cardiovascular Therapeutic Management

Pulmonary Clinical Assessment and Diagnostic Procedures

Pulmonary Disorders

Pulmonary Therapeutic Management

Neurologic Clinical Assessment and Diagnostic Procedures

Neurologic Disorders and Therapeutic Management

Kidney Clinical Assessment and Diagnostic Procedures

Kidney Disorders and Therapeutic Management

Gastrointestinal Clinical Assessment and Diagnostic Procedures

Gastrointestinal Disorders and Therapeutic Management

Endocrine Clinical Assessment and Diagnostic Procedures

Endocrine Disorders and Therapeutic Management

Trauma

Shock, Sepsis, and Multiple Organ Dysfunction Syndrome

Hematologic Disorders and Oncologic Emergencies

Filters

Which of the following describe(s)S₁, the first heart sound?

A patient becomes unresponsive.The patient's heart rate is 32 beats/min, idioventricular rhythm; blood pressure is 60/32 mm Hg; SpO₂ is 90%; and respiratory rate is 14 breaths/min.Which of the following interventions would the nurse do first?

An 82-year-old patient is admitted into the critical care unit with a diagnosis of left-sided heart failure related to mitral stenosis.Physical assessment findings reveal tachycardia with an S₃ and a 3/6 systolic murmur.The nurse knows that the presence of an S₃ heart sound is