Question 1

Identify the rhythm.

Accepted Answer

A)  Ventricular tachycardia 
B)  Ventricular fibrillation 
C)  Supraventricular tachycardia 
D)  Torsades de pointes 
A)  Ventricular tachycardia 
B)  Ventricular fibrillation 
C)  Supraventricular tachycardia 
D)  Torsades de pointes

Question 2

Identify the rhythm.

Accepted Answer

A)  Junctional escape rhythm 
B)  Atrial fibrillation 
C)  Unifocal premature ventricular contractions 
D)  Ventricular tachycardia 
A)  Junctional escape rhythm 
B)  Atrial fibrillation 
C)  Unifocal premature ventricular contractions 
D)  Ventricular tachycardia

Question 3

What is the physiologic effect of left ventricular afterload reduction?

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

Question 4

What is the initial intervention in a patient with sinus tachycardia with the following vital signs: heart rate,136 beats/min; blood pressure,102/60 mm Hg; respiratory rate,24 breaths/min; temperature,99.2° F; SpO₂,94% on oxygen 2 L/min by nasal cannula?

Accepted Answer

A)  Administer adenosine IV push. 
B)  Identify the cause. 
C)  Administer nitroglycerine 0.4 mg sublingual. 
D)  Administer lidocaine 75 mg IV push. 
A)  Administer adenosine IV push. 
B)  Identify the cause. 
C)  Administer nitroglycerine 0.4 mg sublingual. 
D)  Administer lidocaine 75 mg IV push.

Question 5

When performing a 12-lead electrocardiogram (ECG),how many wires are connected to the patient?

Accepted Answer

A)  3 
B)  5 
C)  10 
D)  12 
A)  3 
B)  5 
C)  10 
D)  12

Question 6

What is the formula for calculating mean arterial pressure (MAP)?

Accepted Answer

A)  Averaging three of the patient's blood pressure readings over a 6-hour period 
B)  Dividing the systolic pressure by the diastolic pressure 
C)  Adding the systolic pressure and two diastolic pressures and then dividing by 3 
D)  Dividing the diastolic pressure by the pulse pressure 
A)  Averaging three of the patient's blood pressure readings over a 6-hour period 
B)  Dividing the systolic pressure by the diastolic pressure 
C)  Adding the systolic pressure and two diastolic pressures and then dividing by 3 
D)  Dividing the diastolic pressure by the pulse pressure

Question 7

A nurse is obtaining the history of a patient who reveals that he had an myocardial infarction (MI)5 years ago.When the admission 12-lead electrocardiogram (ECG)is reviewed,Q waves are noted in leads V3 and V4 only.Which conclusion is most consistent with this situation?

Accepted Answer

A)  The patient may have had a posterior wall MI. 
B)  The patient must have had a right ventricular MI. 
C)  The admission 12-lead ECG was done incorrectly. 
D)  The patient may have had an anterior MI. 
A)  The patient may have had a posterior wall MI. 
B)  The patient must have had a right ventricular MI. 
C)  The admission 12-lead ECG was done incorrectly. 
D)  The patient may have had an anterior MI.

Question 8

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 9

Which criteria are representative of the patient in normal sinus rhythm?

Accepted Answer

A)  Heart rate, 64 beats/min; rhythm regular; PR interval, 0.10 second; QRS, 0.04 second 
B)  Heart rate, 88 beats/min; rhythm regular; PR interval, 0.18 second; QRS, 0.06 second 
C)  Heart rate, 54 beats/min; rhythm regular; PR interval, 0.16 second; QRS, 0.08 second 
D)  Heart rate, 92 beats/min; rhythm irregular; PR interval, 0.16 second; QRS, 0.04 second 
A)  Heart rate, 64 beats/min; rhythm regular; PR interval, 0.10 second; QRS, 0.04 second 
B)  Heart rate, 88 beats/min; rhythm regular; PR interval, 0.18 second; QRS, 0.06 second 
C)  Heart rate, 54 beats/min; rhythm regular; PR interval, 0.16 second; QRS, 0.08 second 
D)  Heart rate, 92 beats/min; rhythm irregular; PR interval, 0.16 second; QRS, 0.04 second

Question 10

What is the major factor influencing the patient's response to atrial flutter?

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 11

What effect does ventricular tachycardia have on cardiac output?

Accepted Answer

A)  Increases cardiac output due to an increase in ventricular filling time 
B)  Decreases cardiac output due to a decrease in stroke volume 
C)  Increases cardiac output due to an increase in preload 
D)  Decreases cardiac output due to a decrease in afterload 
A)  Increases cardiac output due to an increase in ventricular filling time 
B)  Decreases cardiac output due to a decrease in stroke volume 
C)  Increases cardiac output due to an increase in preload 
D)  Decreases cardiac output due to a decrease in afterload

Question 12

Identify the rhythm.

Accepted Answer

A)  Junctional escape rhythm 
B)  Atrial fibrillation 
C)  Unifocal premature ventricular contractions 
D)  Ventricular tachycardia 
A)  Junctional escape rhythm 
B)  Atrial fibrillation 
C)  Unifocal premature ventricular contractions 
D)  Ventricular tachycardia

Question 13

A positive signal-averaged electrocardiogram (ECG)indicates that a patient is at risk for what problem?

Accepted Answer

A)  Myocardial infarction 
B)  Sudden cardiac death 
C)  Coronary artery disease 
D)  Stroke 
A)  Myocardial infarction 
B)  Sudden cardiac death 
C)  Coronary artery disease 
D)  Stroke

Question 14

Which condition can cause an artificial increase in the pulmonary artery occlusion pressure (PAOP)?

Accepted Answer

A)  Aortic regurgitation 
B)  Aortic stenosis 
C)  Mitral stenosis 
D)  Mitral regurgitation 
A)  Aortic regurgitation 
B)  Aortic stenosis 
C)  Mitral stenosis 
D)  Mitral regurgitation

Question 15

Patient education for a patient with a Holter monitor should include which instruction?

Accepted Answer

A)  Keep a diary of activities, symptoms, and any medications that are taken. 
B)  Do not drink coffee while the recorder is on. 
C)  Do not take a bath but a shower is alright. 
D)  Carry the monitor in a purse or backpack. 
A)  Keep a diary of activities, symptoms, and any medications that are taken. 
B)  Do not drink coffee while the recorder is on. 
C)  Do not take a bath but a shower is alright. 
D)  Carry the monitor in a purse or backpack.

Question 16

Why is the Allen test performed before placement of a radial arterial line placement?

Accepted Answer

A)  To evaluate collateral circulation to the hand 
B)  To estimate patency of the radial artery 
C)  To appraise the neurologic function of the hand 
D)  To assess the sensitivity of the insertion point 
A)  To evaluate collateral circulation to the hand 
B)  To estimate patency of the radial artery 
C)  To appraise the neurologic function of the hand 
D)  To assess the sensitivity of the insertion point

Question 17

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

Question 18

What is the rationale for giving the patient additional fluids after a cardiac catheterization?

Accepted Answer

A)  Fluids help keep the femoral vein from clotting at the puncture site. 
B)  The patient had a nothing-by-mouth order before the procedure. 
C)  The radiopaque contrast acts as an osmotic diuretic. 
D)  Fluids increase cardiac output. 
A)  Fluids help keep the femoral vein from clotting at the puncture site. 
B)  The patient had a nothing-by-mouth order before the procedure. 
C)  The radiopaque contrast acts as an osmotic diuretic. 
D)  Fluids increase cardiac output.

Question 19

A patient with heart failure may be at risk for hypomagnesemia as a result of which factor?

Accepted Answer

A)  Pump failure 
B)  Diuretic use 
C)  Fluid overload 
D)  Hemodilution 
A)  Pump failure 
B)  Diuretic use 
C)  Fluid overload 
D)  Hemodilution

Question 20

Why is mixed venous oxygen saturation (SVO₂)monitoring helpful in the management of the critically ill patient?

Accepted Answer

A)  It facilitates oxygen saturation monitoring at the capillary level. 
B)  It can detect an imbalance between oxygen supply and metabolic tissue demand. 
C)  It assesses the diffusion of gases at the alveolar capillary membrane. 
D)  It estimates myocardial workload during heart failure and acute pulmonary edema. 
A)  It facilitates oxygen saturation monitoring at the capillary level. 
B)  It can detect an imbalance between oxygen supply and metabolic tissue demand. 
C)  It assesses the diffusion of gases at the alveolar capillary membrane. 
D)  It estimates myocardial workload during heart failure and acute pulmonary edema.

Exam 13: Cardiovascular Diagnostic Procedures

Identify the rhythm.

Identify the rhythm.

What is the physiologic effect of left ventricular afterload reduction?

What is the initial intervention in a patient with sinus tachycardia with the following vital signs: heart rate,136 beats/min; blood pressure,102/60 mm Hg; respiratory rate,24 breaths/min; temperature,99.2° F; SpO₂,94% on oxygen 2 L/min by nasal cannula?

When performing a 12-lead electrocardiogram (ECG),how many wires are connected to the patient?

What is the formula for calculating mean arterial pressure (MAP)?

A nurse is obtaining the history of a patient who reveals that he had an myocardial infarction (MI)5 years ago.When the admission 12-lead electrocardiogram (ECG)is reviewed,Q waves are noted in leads V3 and V4 only.Which conclusion is most consistent with this situation?

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?

Which criteria are representative of the patient in normal sinus rhythm?

What is the major factor influencing the patient's response to atrial flutter?

What effect does ventricular tachycardia have on cardiac output?

Identify the rhythm.

A positive signal-averaged electrocardiogram (ECG)indicates that a patient is at risk for what problem?

Which condition can cause an artificial increase in the pulmonary artery occlusion pressure (PAOP)?

Patient education for a patient with a Holter monitor should include which instruction?

Why is the Allen test performed before placement of a radial arterial line placement?

Which lead is best to monitor a patient?

What is the rationale for giving the patient additional fluids after a cardiac catheterization?

A patient with heart failure may be at risk for hypomagnesemia as a result of which factor?

Why is mixed venous oxygen saturation (SVO₂)monitoring helpful in the management of the critically ill patient?

Critical Care Nursing Practice

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