Question 1

Which anticoagulant(s)enhances activity of antithrombin III and does not require aPTT or ACT monitoring?

Accepted Answer

A)  Heparin 
B)  Enoxaparin (Lovenox) 
C)  Bivalirudin (Angiomax) 
D)  Argatroban (Argatroban) 
A)  Heparin 
B)  Enoxaparin (Lovenox) 
C)  Bivalirudin (Angiomax) 
D)  Argatroban (Argatroban) B

Question 2

The mechanism of dilation with percutaneous transluminal coronary angioplasty (PTCA)is

Accepted Answer

A)  stretching of the vessel wall, resulting in fracture of the plaque. 
B)  anticoagulation after the completion of the procedure, enhancing dilation. 
C)  plaque removal after balloon inflation. 
D)  compression of plaque against the vessel wall. 
A)  stretching of the vessel wall, resulting in fracture of the plaque. 
B)  anticoagulation after the completion of the procedure, enhancing dilation. 
C)  plaque removal after balloon inflation. 
D)  compression of plaque against the vessel wall. A

Question 3

A patient is admitted to the ICU after a positive exercise treadmill test with a diagnosis of CAD and stable angina.Radiographic test show that the patient has blockage in the left main coronary artery and four other vessels.The nurse anticipates that the patient will be scheduled for

Accepted Answer

A)  medical therapy antianginal medications. 
B)  PCI. 
C)  TAVR. 
D)  CABG. 
A)  medical therapy antianginal medications. 
B)  PCI. 
C)  TAVR. 
D)  CABG. D

Question 4

Which of the following patients would be a candidate for fibrinolytic therapy?

Accepted Answer

A)  The patient chest pain started 8 hours ago. She has a diagnosis of NSTEMI. 
B)  The patient chest pain started 3 hours ago, and her ECG shows a new left bundle branch block. 
C)  The patient presents to the emergency department with chest pain of 30 minutes' duration. She has a history of cerebrovascular accident 1 month ago. 
D)  The patient has a history of unstable angina. He has been experiencing chest pain with sudden onset. 
E)  The patient chest pain started 1 hour ago, and his ECG shows ST elevation. 
A)  The patient chest pain started 8 hours ago. She has a diagnosis of NSTEMI. 
B)  The patient chest pain started 3 hours ago, and her ECG shows a new left bundle branch block. 
C)  The patient presents to the emergency department with chest pain of 30 minutes' duration. She has a history of cerebrovascular accident 1 month ago. 
D)  The patient has a history of unstable angina. He has been experiencing chest pain with sudden onset. 
E)  The patient chest pain started 1 hour ago, and his ECG shows ST elevation.

Question 5

Identify complications with the above rhythm strip.

Accepted Answer

A)  Undersensing from a pacemaker 
B)  Oversensing from a pacemaker 
C)  ICD firing caused by VF 
D)  Atrial pacing failure to capture 
A)  Undersensing from a pacemaker 
B)  Oversensing from a pacemaker 
C)  ICD firing caused by VF 
D)  Atrial pacing failure to capture

Question 6

A reliable indicator of reperfusion after fibrinolytic therapy is

Accepted Answer

A)  dysrhythmias. 
B)  Q waves. 
C)  elevated ST segments. 
D)  a rapid decrease in serum CK levels. 
A)  dysrhythmias. 
B)  Q waves. 
C)  elevated ST segments. 
D)  a rapid decrease in serum CK levels.

Question 7

The most common complication of fibrinolytic therapy is

Accepted Answer

A)  reperfusion chest pain. 
B)  lethargy. 
C)  bleeding. 
D)  heart blocks. 
A)  reperfusion chest pain. 
B)  lethargy. 
C)  bleeding. 
D)  heart blocks.

Question 8

In caring for a postoperative cardiovascular patient, the nurse knows that the most frequent cause of a decreased cardiac output is

Accepted Answer

A)  reduced preload. 
B)  increased afterload. 
C)  increased contractility. 
D)  bradycardia. 
A)  reduced preload. 
B)  increased afterload. 
C)  increased contractility. 
D)  bradycardia.

Question 9

Vasopressors are used cautiously with critical care patients because they can cause

Accepted Answer

A)  vasoconstriction of the smooth muscles. 
B)  vasodilation of the smooth muscles. 
C)  increased afterload of the heart. 
D)  decreased preload of the heart. 
A)  vasoconstriction of the smooth muscles. 
B)  vasodilation of the smooth muscles. 
C)  increased afterload of the heart. 
D)  decreased preload of the heart.

Question 10

A nurse is providing care to a patient on fibrinolytic therapy.Which of the following statements from the patient warrants further assessment and intervention by the critical care nurse?

Accepted Answer

A)  "My back is killing me!" 
B)  "There is blood on my toothbrush!" 
C)  "Look at the bruises on my arms!" 
D)  "My arm is bleeding where my IV is!" 
A)  "My back is killing me!" 
B)  "There is blood on my toothbrush!" 
C)  "Look at the bruises on my arms!" 
D)  "My arm is bleeding where my IV is!"

Question 11

Nursing interventions after angioplasty would include which of the following?

Accepted Answer

A)  Elevating the head of the bed to 45 degrees 
B)  Hydration as a renal protection measure 
C)  Assessing pedal pulses on the involved limb every 15 minutes for the first 2 hours after the procedure 
D)  Monitoring the vascular hemostatic device for signs of bleeding 
E)  Educating the patient on the necessity of staying supine for 1 to 2 hours after the procedure 
A)  Elevating the head of the bed to 45 degrees 
B)  Hydration as a renal protection measure 
C)  Assessing pedal pulses on the involved limb every 15 minutes for the first 2 hours after the procedure 
D)  Monitoring the vascular hemostatic device for signs of bleeding 
E)  Educating the patient on the necessity of staying supine for 1 to 2 hours after the procedure

Question 12

Angiotensin-converting enzyme (ACE)inhibitors such as captopril (Capoten)and enalapril (Vasotec)decrease peripheral vascular resistance and decrease blood pressure by the mechanism of

Accepted Answer

A)  direct arterial vasodilation. 
B)  blocking the conversion of angiotensin I to angiotensin II. 
C)  increased fluid excretion at the loop of Henle in the renal tubules. 
D)  peripheral vasoconstriction and central vasodilation. 
A)  direct arterial vasodilation. 
B)  blocking the conversion of angiotensin I to angiotensin II. 
C)  increased fluid excretion at the loop of Henle in the renal tubules. 
D)  peripheral vasoconstriction and central vasodilation.

Question 13

In analyzing the ECG strip, the nurse notices a spike before each QRS complex.The patient's heart rate is 70 beats/min.This phenomenon is reflective of

Accepted Answer

A)  60-cycle electrical interference; check equipment. 
B)  pacing artifact; the pacemaker is sensing and capturing. 
C)  electrical artifact; the pacemaker is not sensing. 
D)  patient movement; check electrodes. 
A)  60-cycle electrical interference; check equipment. 
B)  pacing artifact; the pacemaker is sensing and capturing. 
C)  electrical artifact; the pacemaker is not sensing. 
D)  patient movement; check electrodes.

Question 14

A transvenous pacemaker is inserted through the right subclavian vein and threaded into the right ventricle.The pacemaker is placed on demand at a rate of 70.The pacing mode for this pacemaker is

Accepted Answer

A)  VVI. 
B)  AOO. 
C)  DDD. 
D)  VAT. 
A)  VVI. 
B)  AOO. 
C)  DDD. 
D)  VAT.

Question 15

Noninvasive emergency pacing is best achieved via the use of which type of temporary pacing?

Accepted Answer

A)  Transvenous (endocardial) 
B)  Epicardial 
C)  Transthoracic 
D)  Transcutaneous 
A)  Transvenous (endocardial) 
B)  Epicardial 
C)  Transthoracic 
D)  Transcutaneous

Question 16

A patient has an implantable cardioverter defibrillator (ICD)for chronic ventricular tachydysrhythmias.If the patient's rhythm deteriorates to ventricular fibrillation,

Accepted Answer

A)  an external defibrillator will need to be applied. 
B)  start CPR and call a code. 
C)  the ICD will defibrillate at a high energy level. 
D)  the ICD is programmed to cardiovert at a high energy level. 
A)  an external defibrillator will need to be applied. 
B)  start CPR and call a code. 
C)  the ICD will defibrillate at a high energy level. 
D)  the ICD is programmed to cardiovert at a high energy level.

Question 17

The predominant form of percutaneous coronary intervention (PCI)is

Accepted Answer

A)  Rotablator. 
B)  stents. 
C)  directional coronary atherectomy (DC
A) . 
D)  balloon angioplasty (PTC
A) . 
A)  Rotablator. 
B)  stents. 
C)  directional coronary atherectomy (DC
A) . 
D)  balloon angioplasty (PTC
A) .

Question 18

A patient is being monitored by continuous ECG after placement of a transvenous pacemaker."Loss of capture" is seen on the ECG.Which nursing intervention may correct this situation?

Accepted Answer

A)  Position the patient on the left side. 
B)  Decrease the milliamperes as ordered. 
C)  Increase the rate as ordered. 
D)  Monitor the patient in a different lead. 
A)  Position the patient on the left side. 
B)  Decrease the milliamperes as ordered. 
C)  Increase the rate as ordered. 
D)  Monitor the patient in a different lead.

Question 19

A patient suddenly develops a wide QRS complex tachycardia.The patient's heart rate is 220 beats/min and regular; blood pressure is 96/40 mm Hg; and respiratory rate is 22 breaths/min, and the patient is awake without complaint except for palpitations.Which of the following interventions would be best to try first?

Accepted Answer

A)  Adenosine 6 mg rapid IV push 
B)  Lidocaine 1 mg/kg IV push 
C)  Verapamil 0.5 mg IV push 
D)  Digoxin 0.25 mg IV push 
A)  Adenosine 6 mg rapid IV push 
B)  Lidocaine 1 mg/kg IV push 
C)  Verapamil 0.5 mg IV push 
D)  Digoxin 0.25 mg IV push

Question 20

Which of the following statements regarding beta-blockers is correct?

Accepted Answer

A)  They increase heart rate and are contraindicated in tachydysrhythmias. 
B)  They result in bronchospasm and should not be used in patients with COPD. 
C)  They increase cardiac output and help with left ventricular failure. 
D)  They are helpful in increasing atrioventricular node conduction and are used in heart blocks. 
A)  They increase heart rate and are contraindicated in tachydysrhythmias. 
B)  They result in bronchospasm and should not be used in patients with COPD. 
C)  They increase cardiac output and help with left ventricular failure. 
D)  They are helpful in increasing atrioventricular node conduction and are used in heart blocks.

Exam 13: Cardiovascular Therapeutic Management

Which anticoagulant(s)enhances activity of antithrombin III and does not require aPTT or ACT monitoring?

The mechanism of dilation with percutaneous transluminal coronary angioplasty (PTCA)is

A patient is admitted to the ICU after a positive exercise treadmill test with a diagnosis of CAD and stable angina.Radiographic test show that the patient has blockage in the left main coronary artery and four other vessels.The nurse anticipates that the patient will be scheduled for

Which of the following patients would be a candidate for fibrinolytic therapy?

Identify complications with the above rhythm strip.

A reliable indicator of reperfusion after fibrinolytic therapy is

The most common complication of fibrinolytic therapy is

In caring for a postoperative cardiovascular patient, the nurse knows that the most frequent cause of a decreased cardiac output is

Vasopressors are used cautiously with critical care patients because they can cause

A nurse is providing care to a patient on fibrinolytic therapy.Which of the following statements from the patient warrants further assessment and intervention by the critical care nurse?

Nursing interventions after angioplasty would include which of the following?

Angiotensin-converting enzyme (ACE)inhibitors such as captopril (Capoten)and enalapril (Vasotec)decrease peripheral vascular resistance and decrease blood pressure by the mechanism of

In analyzing the ECG strip, the nurse notices a spike before each QRS complex.The patient's heart rate is 70 beats/min.This phenomenon is reflective of

A transvenous pacemaker is inserted through the right subclavian vein and threaded into the right ventricle.The pacemaker is placed on demand at a rate of 70.The pacing mode for this pacemaker is

Noninvasive emergency pacing is best achieved via the use of which type of temporary pacing?

A patient has an implantable cardioverter defibrillator (ICD)for chronic ventricular tachydysrhythmias.If the patient's rhythm deteriorates to ventricular fibrillation,

The predominant form of percutaneous coronary intervention (PCI)is

A patient is being monitored by continuous ECG after placement of a transvenous pacemaker."Loss of capture" is seen on the ECG.Which nursing intervention may correct this situation?

Which of the following statements regarding beta-blockers is correct?

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 Clinical Assessment and Diagnostic Procedures

Cardiovascular Disorders

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

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