Question 1

The patient's admitting 12-lead ECG shows wide,M-shaped P waves.What diagnosis could be responsible for this finding?

Accepted Answer

A)  Mitral stenosis 
B)  Chronic pulmonary disease 
C)  Hypotension 
D)  Pericarditis 
A)  Mitral stenosis 
B)  Chronic pulmonary disease 
C)  Hypotension 
D)  Pericarditis A

Question 2

The patient has a heart rate (HR)of 84 beats/min and a stroke volume (SV)of 65 mL.Calculate the cardiac output (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 D

Question 3

Which electrocardiographic (ECG)abnormality is most often found in ventricular dysrhythmias?

Accepted Answer

A)  Retrograde P waves 
B)  Wide QRS complexes 
C)  No P waves 
D)  An inverted T wave 
A)  Retrograde P waves 
B)  Wide QRS complexes 
C)  No P waves 
D)  An inverted T wave B

Question 4

Pulsus paradoxus may be noted on the bedside monitor when what is observed?

Accepted Answer

A)  A decrease of more than 10 mm Hg in the arterial waveform during inhalation 
B)  A single, nonperfused beat on the electrocardiogram (ECG) waveform 
C)  Tall, tented T waves on the ECG waveform 
D)  An increase in pulse pressure greater than 20 mm Hg on exhalation 
A)  A decrease of more than 10 mm Hg in the arterial waveform during inhalation 
B)  A single, nonperfused beat on the electrocardiogram (ECG) waveform 
C)  Tall, tented T waves on the ECG waveform 
D)  An increase in pulse pressure greater than 20 mm Hg on exhalation

Question 5

Which serum lipid value is a significant predictor of future acute myocardial infarction (MI)in persons with established coronary artery atherosclerosis?

Accepted Answer

A)  High-density lipoprotein (HDL) 
B)  Low-density lipoprotein (LDL) 
C)  Triglycerides 
D)  Very-low-density lipoprotein 
A)  High-density lipoprotein (HDL) 
B)  Low-density lipoprotein (LDL) 
C)  Triglycerides 
D)  Very-low-density lipoprotein

Question 6

What parameter is used to assess the contractility of the left side of the heart?

Accepted Answer

A)  Pulmonary artery occlusion pressure 
B)  Left atrial pressure 
C)  Systemic vascular resistance 
D)  Left ventricular stroke work index 
A)  Pulmonary artery occlusion pressure 
B)  Left atrial pressure 
C)  Systemic vascular resistance 
D)  Left ventricular stroke work index

Question 7

Which findings would be reasons to abort an exercise stress test?

Accepted Answer

A)  Ventricular axis of +90 degrees 
B)  Increase in blood pressure 
C)  Inverted U wave 
D)  ST segment depression or elevation 
A)  Ventricular axis of +90 degrees 
B)  Increase in blood pressure 
C)  Inverted U wave 
D)  ST segment depression or elevation

Question 8

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

Accepted Answer

A)  In various shapes in the same lead 
B)  With increasing frequency 
C)  Wider than a normal QRS 
D)  On the T wave 
A)  In various shapes in the same lead 
B)  With increasing frequency 
C)  Wider than a normal QRS 
D)  On the T wave

Question 9

What is the effect of preload on cardiac output?

Accepted Answer

A)  As preload increases, cardiac output increases. 
B)  As preload increases, cardiac output decreases. 
C)  As preload increases, cardiac output increases until it overstretches the ventricle and cardiac output decreases. 
D)  Increased preload has no effect on cardiac output. 
A)  As preload increases, cardiac output increases. 
B)  As preload increases, cardiac output decreases. 
C)  As preload increases, cardiac output increases until it overstretches the ventricle and cardiac output decreases. 
D)  Increased preload has no effect on cardiac output.

Question 10

Which statement expresses the correct order when working with an invasive pressure monitor?

Accepted Answer

A)  Level the transducer, locate the phlebostatic axis, zero the transducer, and take the reading. 
B)  Locate the phlebostatic axis, level the transducer, zero the transducer, and take the reading. 
C)  Take the reading, level the transducer, locate the phlebostatic axis, and zero the transducer. 
D)  Locate the phlebostatic axis, zero the transducer, level the transducer, and take the reading. 
A)  Level the transducer, locate the phlebostatic axis, zero the transducer, and take the reading. 
B)  Locate the phlebostatic axis, level the transducer, zero the transducer, and take the reading. 
C)  Take the reading, level the transducer, locate the phlebostatic axis, and zero the transducer. 
D)  Locate the phlebostatic axis, zero the transducer, level the transducer, and take the reading.

Question 11

After a myocardial infarction,a patient presents with an increasing frequency of premature ventricular contractions (PVCs).The patient's heart rate is 110 beats/min,and electrocardiogram (ECG)indicates a sinus rhythm with up to five unifocal PVCs per minute.The patient is alert and responsive and denies any chest pain or dyspnea.What action should the nurse take next?

Accepted Answer

A)  Administer lidocaine 100 mg bolus IV push stat. 
B)  Administer Cardizem 20 mg IV push stat. 
C)  Notify the physician and monitor the patient closely. 
D)  Nothing; PVCs are expected in this patient. 
A)  Administer lidocaine 100 mg bolus IV push stat. 
B)  Administer Cardizem 20 mg IV push stat. 
C)  Notify the physician and monitor the patient closely. 
D)  Nothing; PVCs are expected in this patient.

Question 12

What is the target range for an international normalized ratio (INR)?

Accepted Answer

A)  1.0 to 2.0 
B)  1.5 to 3.0 
C)  1.5 to 2.5 
D)  2.0 to 3.0 
A)  1.0 to 2.0 
B)  1.5 to 3.0 
C)  1.5 to 2.5 
D)  2.0 to 3.0

Question 13

Which of the electrocardiogram (ECG)findings would be positive for an inferior wall myocardial infarction (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 14

The patient is admitted with a diagnosis of cardiogenic shock.The patient's heart rate (HR)is 135 beats/min with weak peripheral pulses.The patient has bilaterally crackles in the bases of the lungs.O₂ saturation is 90% on 4L/NC.The practitioner orders diuretics and vasodilators.What response should the nurse expect after starting the medications?

Accepted Answer

A)  Decreased preload and afterload 
B)  Increased preload and afterload 
C)  Decreased preload and increased afterload 
D)  Increased preload and decreased afterload 
A)  Decreased preload and afterload 
B)  Increased preload and afterload 
C)  Decreased preload and increased afterload 
D)  Increased preload and decreased afterload

Question 15

Most chest radiographs of critically ill patients are obtained using a portable chest radiograph machine.What is the difference between a chest radiograph taken in the radiology department and one taken in the critical care unit?

Accepted Answer

A)  Portable chest radiographs are usually clearer. 
B)  Only posterior views can be obtained in the critical care unit. 
C)  The sharpness of the structures is decreased with a portable chest radiograph. 
D)  Chest radiographs taken in radiology enlarge some thoracic structures. 
A)  Portable chest radiographs are usually clearer. 
B)  Only posterior views can be obtained in the critical care unit. 
C)  The sharpness of the structures is decreased with a portable chest radiograph. 
D)  Chest radiographs taken in radiology enlarge some thoracic structures.

Question 16

A patient returns from the cardiac catheterization laboratory after angioplasty and stent placement (ECG changes had indicated an inferior wall myocardial infarction in progress).Which lead would best monitor this patient?

Accepted Answer

A)  Varies based on the patient's clinical condition and recent clinical history 
B)  Lead V3 
C)  Lead V1 
D)  Lead II 
A)  Varies based on the patient's clinical condition and recent clinical history 
B)  Lead V3 
C)  Lead V1 
D)  Lead II

Question 17

A patient's bedside electrocardiogram (ECG)strips show the following changes: increased PR interval; increased QRS width; and tall,peaked T waves.Vital signs are temperature 98.2° F; heart rate 118 beats/min; blood pressure 146/90 mm Hg; and respiratory rate 18 breaths/min.The patient is receiving the following medications: digoxin 0.125 mg PO every day; D₅1/2 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 practitioner 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.

Question 18

What is the most common complication of a central venous catheter (CVC)?

Accepted Answer

A)  Air embolus 
B)  Infection 
C)  Thrombus formation 
D)  Pneumothorax 
A)  Air embolus 
B)  Infection 
C)  Thrombus formation 
D)  Pneumothorax

Question 19

Why is a new-onset of atrial fibrillation serious?

Accepted Answer

A)  It increases the patient's risk for a stroke. 
B)  It increases the patient's risk for a deep venous thrombosis. 
C)  It may increase cardiac output to dangerous levels. 
D)  It indicates the patient is about to have a myocardial infarction. 
A)  It increases the patient's risk for a stroke. 
B)  It increases the patient's risk for a deep venous thrombosis. 
C)  It may increase cardiac output to dangerous levels. 
D)  It indicates the patient is about to have a myocardial infarction.

Question 20

A patient presents with atrial flutter with an atrial rate of 280 beats/min and a ventricular rate of 70 beats/min.Which statement best explains this discrepancy in rates?

Accepted Answer

A)  The ventricles are too tired to respond to all the atrial signals. 
B)  The atrioventricular (AV) node does not conduct all the atrial signals to the ventricles. 
C)  Some of the atrial beats are blocked before reaching the AV node. 
D)  The ventricles are responding to a ventricular ectopic pacemaker. 
A)  The ventricles are too tired to respond to all the atrial signals. 
B)  The atrioventricular (AV) node does not conduct all the atrial signals to the ventricles. 
C)  Some of the atrial beats are blocked before reaching the AV node. 
D)  The ventricles are responding to a ventricular ectopic pacemaker.

Exam 13: Cardiovascular Diagnostic Procedures

The patient's admitting 12-lead ECG shows wide,M-shaped P waves.What diagnosis could be responsible for this finding?

The patient has a heart rate (HR)of 84 beats/min and a stroke volume (SV)of 65 mL.Calculate the cardiac output (CO).

Which electrocardiographic (ECG)abnormality is most often found in ventricular dysrhythmias?

Pulsus paradoxus may be noted on the bedside monitor when what is observed?

Which serum lipid value is a significant predictor of future acute myocardial infarction (MI)in persons with established coronary artery atherosclerosis?

What parameter is used to assess the contractility of the left side of the heart?

Which findings would be reasons to abort an exercise stress test?

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

What is the effect of preload on cardiac output?

Which statement expresses the correct order when working with an invasive pressure monitor?

What is the target range for an international normalized ratio (INR)?

Which of the electrocardiogram (ECG)findings would be positive for an inferior wall myocardial infarction (MI)?

Most chest radiographs of critically ill patients are obtained using a portable chest radiograph machine.What is the difference between a chest radiograph taken in the radiology department and one taken in the critical care unit?

A patient returns from the cardiac catheterization laboratory after angioplasty and stent placement (ECG changes had indicated an inferior wall myocardial infarction in progress).Which lead would best monitor this patient?

What is the most common complication of a central venous catheter (CVC)?

Why is a new-onset of atrial fibrillation serious?

A patient presents with atrial flutter with an atrial rate of 280 beats/min and a ventricular rate of 70 beats/min.Which statement best explains this discrepancy in rates?

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