Question 1

The physiologic effect of left ventricular afterload reduction is

Accepted Answer

A)  decreased left atrial tension. 
B)  decreased systemic vascular resistance. 
C)  increased filling pressures. 
D)  decreased cardiac output. 
A)  decreased left atrial tension. 
B)  decreased systemic vascular resistance. 
C)  increased filling pressures. 
D)  decreased cardiac output. B

Question 2

A patient with ventricular fibrillation (VF)is

Accepted Answer

A)  hypertensive. 
B)  bradypneic. 
C)  diaphoretic. 
D)  pulseless. 
A)  hypertensive. 
B)  bradypneic. 
C)  diaphoretic. 
D)  pulseless. D

Question 3

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. A

Question 4

Which of the following AV blocks can be described as a gradually lengthening PR interval until ultimately the final P wave in the group fails to conduct?

Accepted Answer

A)  First-degree AV block 
B)  Second-degree AV block, type I 
C)  Second-degree AV block, type II 
D)  Third-degree AV block 
A)  First-degree AV block 
B)  Second-degree AV block, type I 
C)  Second-degree AV block, type II 
D)  Third-degree AV block

Question 5

A patient's CVP reading suddenly increased from 10 to 48 mm Hg.His lungs are clear except for fine rales at the bases.Immediate response should be which of the following?

Accepted Answer

A)  Nothing; this reading is still within normal limits. 
B)  Place a stat call into the physician. 
C)  Administer ordered prn Lasix. 
D)  Check the transducer level. 
A)  Nothing; this reading is still within normal limits. 
B)  Place a stat call into the physician. 
C)  Administer ordered prn Lasix. 
D)  Check the transducer level.

Question 6

When assessing the pulmonary arterial waveform,the nurse notices dampening.After tightening the stopcocks and flushing the line,the nurse decides to calibrate the transducer.What are two essential components included in calibration?

Accepted Answer

A)  Obtaining a baseline blood pressure and closing the transducer to air 
B)  Leveling the air-fluid interface to the phlebostatic axis and opening the transducer to air 
C)  Having the patient lay flat and closing the transducer to air 
D)  Obtaining blood return on line and closing all stopcocks 
A)  Obtaining a baseline blood pressure and closing the transducer to air 
B)  Leveling the air-fluid interface to the phlebostatic axis and opening the transducer to air 
C)  Having the patient lay flat and closing the transducer to air 
D)  Obtaining blood return on line and closing all stopcocks

Question 7

A patient is in shock.In this patient,

Accepted Answer

A)  cuff pressures may be unreliable. 
B)  cuff pressures are more accurate than A-line pressures. 
C)  cuff pressures and A-line pressures should be nearly identical. 
D)  A-lines should not be inserted. 
A)  cuff pressures may be unreliable. 
B)  cuff pressures are more accurate than A-line pressures. 
C)  cuff pressures and A-line pressures should be nearly identical. 
D)  A-lines should not be inserted.

Question 8

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 9

After bathing and repositioning a patient,the nurse notices the following readings on the bedside monitor: PAWP,20 mm Hg and PAP,28/12 mm Hg.Assessment notes no changes in patient condition.Which of the following statements would be true?

Accepted Answer

A)  The patient may be having a silent MI. 
B)  The monitoring system is not functioning properly. 
C)  The patient is at increased risk for congestive heart failure. 
D)  The patient has pericardial tamponade. 
A)  The patient may be having a silent MI. 
B)  The monitoring system is not functioning properly. 
C)  The patient is at increased risk for congestive heart failure. 
D)  The patient has pericardial tamponade.

Question 10

The most common complication of a central venous catheter (CVC)is

Accepted Answer

A)  air embolus. 
B)  infection. 
C)  thrombus formation. 
D)  pneumothorax. 
A)  air embolus. 
B)  infection. 
C)  thrombus formation. 
D)  pneumothorax.

Question 11

Why is the measurement of the QT interval important?

Accepted Answer

A)  It represents ventricular depolarization. 
B)  It represents ventricular contraction. 
C)  An increasing QT interval increases the risk of torsades de pointes. 
D)  A decreasing QT interval increases the risk of torsades de pointes. 
A)  It represents ventricular depolarization. 
B)  It represents ventricular contraction. 
C)  An increasing QT interval increases the risk of torsades de pointes. 
D)  A decreasing QT interval increases the risk of torsades de pointes.

Question 12

When assessing a patient with PVCs,the nurse knows that the ectopic beat is multifocal because it appears

Accepted Answer

A)  in various shapes in the same lead. 
B)  with increasing frequency. 
C)  to widen the QRS width. 
D)  in a specific pattern in the same lead. 
A)  in various shapes in the same lead. 
B)  with increasing frequency. 
C)  to widen the QRS width. 
D)  in a specific pattern in the same lead.

Question 13

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 14

A positive signal-averaged ECG indicates that the patient

Accepted Answer

A)  has had a heart attack. 
B)  is at increased risk of sudden cardiac death. 
C)  has no heart disease. 
D)  has no need for an electrophysiology study. 
A)  has had a heart attack. 
B)  is at increased risk of sudden cardiac death. 
C)  has no heart disease. 
D)  has no need for an electrophysiology study.

Question 15

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 16

The major key to the clinical significance of atrial flutter is the

Accepted Answer

A)  atrial rate. 
B)  ventricular response rate. 
C)  PR interval. 
D)  QRS duration. 
A)  atrial rate. 
B)  ventricular response rate. 
C)  PR interval. 
D)  QRS duration.

Question 17

To accurately measure the heart rate of a patient in normal sinus rhythm,which technique would be the most accurate?

Accepted Answer

A)  The number of R waves in a 6-second strip 
B)  The number of large boxes in a 6-second strip 
C)  The number of small boxes between QRS complexes divided into 1500 
D)  The number of large boxes between consecutive R waves divided into 300 
A)  The number of R waves in a 6-second strip 
B)  The number of large boxes in a 6-second strip 
C)  The number of small boxes between QRS complexes divided into 1500 
D)  The number of large boxes between consecutive R waves divided into 300

Question 18

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

Question 19

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

Accepted Answer

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

Question 20

Mechanical contraction of the heart occurs during which of the following phases of the cardiac cycle?

Accepted Answer

A)  Phase 0 
B)  Phase 2 
C)  Phase 3 
D)  Phase 4 
A)  Phase 0 
B)  Phase 2 
C)  Phase 3 
D)  Phase 4

Exam 14: Cardiovascular Diagnostic Procedures

The physiologic effect of left ventricular afterload reduction is

A patient with ventricular fibrillation (VF)is

Which of the following AV blocks can be described as a gradually lengthening PR interval until ultimately the final P wave in the group fails to conduct?

A patient's CVP reading suddenly increased from 10 to 48 mm Hg.His lungs are clear except for fine rales at the bases.Immediate response should be which of the following?

When assessing the pulmonary arterial waveform,the nurse notices dampening.After tightening the stopcocks and flushing the line,the nurse decides to calibrate the transducer.What are two essential components included in calibration?

A patient is in shock.In this patient,

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

After bathing and repositioning a patient,the nurse notices the following readings on the bedside monitor: PAWP,20 mm Hg and PAP,28/12 mm Hg.Assessment notes no changes in patient condition.Which of the following statements would be true?

The most common complication of a central venous catheter (CVC)is

Why is the measurement of the QT interval important?

When assessing a patient with PVCs,the nurse knows that the ectopic beat is multifocal because it appears

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

A positive signal-averaged ECG indicates that the patient

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?

The major key to the clinical significance of atrial flutter is the

To accurately measure the heart rate of a patient in normal sinus rhythm,which technique would be the most accurate?

Which lead is best to monitor a patient?

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

Mechanical contraction of the heart occurs during which of the following phases of the cardiac cycle?

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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?