Question 1

The possibility of microshock when handling a temporary pacemaker can be minimized by

Accepted Answer

A)  decreasing the milliamperes. 
B)  wearing gloves. 
C)  positioning the patient on the left side. 
D)  wearing rubber-soled shoes. 
A)  decreasing the milliamperes. 
B)  wearing gloves. 
C)  positioning the patient on the left side. 
D)  wearing rubber-soled shoes. B

Question 2

Which of the following would indicate successful reperfusion after administration of a fibrinolytic agent?

Accepted Answer

A)  Gradual decrease in chest pain 
B)  Intermittent, multifocal premature ventricular contractions 
C)  Rapid resolution of ST elevation 
D)  Rapid rise in creatine kinase MB fraction 
A)  Gradual decrease in chest pain 
B)  Intermittent, multifocal premature ventricular contractions 
C)  Rapid resolution of ST elevation 
D)  Rapid rise in creatine kinase MB fraction B,C,D

Question 3

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) . B

Question 4

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 5

When an intra-aortic balloon is in place,it is essential for the nurse to frequently assess

Accepted Answer

A)  for a pulse deficit. 
B)  peripheral pulses distal to the catheter insertion site. 
C)  bilateral blood pressures. 
D)  coronary artery perfusion. 
A)  for a pulse deficit. 
B)  peripheral pulses distal to the catheter insertion site. 
C)  bilateral blood pressures. 
D)  coronary artery perfusion.

Question 6

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 7

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 8

Which of the following mechanisms is responsible for the augmentation of coronary arterial blood flow and increased myocardial oxygen supply seen with the intra-aortic balloon pump?

Accepted Answer

A)  The vacuum created in the aorta as a result of balloon deflation 
B)  Diastolic inflation with retrograde perfusion 
C)  Forward flow to the peripheral circulation 
D)  Inflation during systole to augment blood pressure 
A)  The vacuum created in the aorta as a result of balloon deflation 
B)  Diastolic inflation with retrograde perfusion 
C)  Forward flow to the peripheral circulation 
D)  Inflation during systole to augment blood pressure

Question 9

Adenosine (Adenocard)is an antidysrhythmic agent given primarily to

Accepted Answer

A)  convert supraventricular tachycardias. 
B)  act as a second-line drug for premature ventricular contractions (PVCs). 
C)  treat AV blocks. 
D)  coarsen ventricular fibrillation so that defibrillation is effective. 
A)  convert supraventricular tachycardias. 
B)  act as a second-line drug for premature ventricular contractions (PVCs). 
C)  treat AV blocks. 
D)  coarsen ventricular fibrillation so that defibrillation is effective.

Question 10

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 11

The rationale for administration of a fibrinolytic agent is

Accepted Answer

A)  dilation of the blocked coronary artery. 
B)  anticoagulation to prevent formation of new emboli. 
C)  dissolution of atherosclerotic plaque at the site of blockage. 
D)  restoration of blood flow to the obstructed coronary artery via lysis of the thrombus. 
A)  dilation of the blocked coronary artery. 
B)  anticoagulation to prevent formation of new emboli. 
C)  dissolution of atherosclerotic plaque at the site of blockage. 
D)  restoration of blood flow to the obstructed coronary artery via lysis of the thrombus.

Question 12

A patient is admitted with left-sided heart failure and a blood pressure of 220/118 mm Hg.Which of the following drugs will be most effective in decreasing the blood pressure and reducing afterload?

Accepted Answer

A)  Dopamine (Intropin) 
B)  Verapamil (Calan) 
C)  Propranolol (Inderal) 
D)  Sodium nitroprusside (Nipride) 
A)  Dopamine (Intropin) 
B)  Verapamil (Calan) 
C)  Propranolol (Inderal) 
D)  Sodium nitroprusside (Nipride)

Question 13

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)

Question 14

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 15

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 16

The patient is 12 hours postoperative for a CABG.The patient's vital signs include: T 103° F,HR 112,RR 22,BP 134/78 mm Hg,and O2 sat 94% on 3L/NC.The nurse suspects that the patient has developed

Accepted Answer

A)  infection and notifies the physician immediately. 
B)  infection, which is common postoperatively, and monitors the patient's condition. 
C)  cardiac tamponade and notifies the physician immediately. 
D)  delirium caused by the elevated temperature. 
A)  infection and notifies the physician immediately. 
B)  infection, which is common postoperatively, and monitors the patient's condition. 
C)  cardiac tamponade and notifies the physician immediately. 
D)  delirium caused by the elevated temperature.

Question 17

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.

Question 18

A pacemaker is connected to an external temporary pulse generator.The sensitivity control

Accepted Answer

A)  determines heart rate to muscle activity. 
B)  determines the milliamperes needed to achieve capture. 
C)  regulates the ability of the pacemaker to detect the heart's intrinsic electrical activity. 
D)  allows for selection of intervals between atria and ventricles. 
A)  determines heart rate to muscle activity. 
B)  determines the milliamperes needed to achieve capture. 
C)  regulates the ability of the pacemaker to detect the heart's intrinsic electrical activity. 
D)  allows for selection of intervals between atria and ventricles.

Question 19

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.

Question 20

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.

Exam 16: Cardiovascular Therapeutic Management

The possibility of microshock when handling a temporary pacemaker can be minimized by

Which of the following would indicate successful reperfusion after administration of a fibrinolytic agent?

The predominant form of percutaneous coronary intervention (PCI)is

Identify complications with the above rhythm strip.

When an intra-aortic balloon is in place,it is essential for the nurse to frequently assess

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

Which of the following mechanisms is responsible for the augmentation of coronary arterial blood flow and increased myocardial oxygen supply seen with the intra-aortic balloon pump?

Adenosine (Adenocard)is an antidysrhythmic agent given primarily to

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

The rationale for administration of a fibrinolytic agent is

A patient is admitted with left-sided heart failure and a blood pressure of 220/118 mm Hg.Which of the following drugs will be most effective in decreasing the blood pressure and reducing afterload?

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

Nursing interventions after angioplasty would include which of the following?

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?

The patient is 12 hours postoperative for a CABG.The patient's vital signs include: T 103° F,HR 112,RR 22,BP 134/78 mm Hg,and O2 sat 94% on 3L/NC.The nurse suspects that the patient has developed

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

A pacemaker is connected to an external temporary pulse generator.The sensitivity control

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

The most common complication of fibrinolytic therapy is

Critical Care Nursing Practice

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The patient is 12 hours postoperative for a CABG.The patient's vital signs include: T 103° F,HR 112,RR 22,BP 134/78 mm Hg,and O₂ sat 94% on 3L/NC.The nurse suspects that the patient has developed