Question 1

The nurse is reviewing the patient's medications and recognizes that which of the following medications can cause dysrhythmias? (Select all that apply. )

Accepted Answer

A)  Digoxin
B)  Amlodipine
C)  Amiodarone
D)  Lasix A,B,C

Question 2

The nurse understands that it is a priority to obtain the 12-lead ECG on the patient newly admitted with chest pain because the ECG must be obtained within how many minutes of the onset of pain?

Accepted Answer

A)  3 minutes
B)  5 minutes
C)  8 minutes
D)  10 minutes D

Question 3

The nurse is caring for a patient on continuous cardiac monitoring who is experiencing occasional premature ventricular contractions.Which of the following actions demonstrate appropriate protocol? (Select all that apply. )

Accepted Answer

A)  Review alarm trends and waveforms at least once per shift.
B)  Review alarm trends and waveforms upon report of an alarm.
C)  Record at least one rhythm strip per shift to the patient's medical record.
D)  Report any unexpected outcomes to the health care provider at the end of the shift. A,B,C

Question 4

The student nurse is preparing to perform a 12-lead ECG on an adult patient.Which action by the student should the nursing instructor question?

Accepted Answer

A)  Cleansing and preparing the isolated electrode area with soap and water
B)  Wiping the area with a rough cloth or gauze to gently scrape the area
C)  Clipping the excessive hair from the electrode area
D)  Using alcohol to cleanse the electrode area

Question 5

The nurse is preparing to apply electrodes for continuous cardiac monitoring to a newly admitted adult with syncope.Which action by the nurse follows appropriate procedure?

Accepted Answer

A)  Cleanse and prepare the chest area for electrode placement with chlorhexidine.
B)  Use a blanket to cover the patient's abdomen while the limb electrodes are being placed.
C)  Scrape the area to roughen the dermis layer of skin to allow electrical signals to travel more easily.
D)  Place the patient in a supine position.

Question 6

The nurse is obtaining a 12-lead ECG on a patient and notices that the ECG cannot be interpreted.Which of the following interventions are appropriate for the nurse to take? (Select all that apply. )

Accepted Answer

A)  Inspect the electrodes for secure placement.
B)  Reposition any wires that move as a result of patient breathing or movement.
C)  Reposition electrodes that are in the correct position.
D)  Remind the patient to remain still in order to obtain a good tracing.

Question 7

Identify the first step toward establishing appropriate alarms and response expectations.

Accepted Answer

A)  Instructing the patient and immediate family members about the necessity of the alarms
B)  Obtaining a physician's order for ECG monitoring
C)  Adjusting the volume of the alarms so the primary nurse can hear them
D)  Determining which patients require ECG monitoring

Question 8

The nurse has explained to the patient that a 12-lead ECG is indicated.The patient refused to have the procedure done citing that she fears that the electrodes will cause harm to her heart.The nurse recognizes that which of the following patient rationales are contraindications for a 12-lead ECG?

Accepted Answer

A)  Patient refusal
B)  The patient is receiving chemotherapy.
C)  The patient is ordered to have nothing by mouth (NPO) .
D)  The patient has just been medicated for a pain level of 8 on a scale of 1 to 10.

Question 9

Proper placement of the ECG electrodes is essential for which reason?

Accepted Answer

A)  To ensure real-time detection of arrhythmias
B)  To prevent painful removal of the electrodes
C)  To facilitate capture of all leads
D)  To reduce ventricular arrhythmias

Question 10

While the nurse is performing a 12-lead ECG tracing,the patient complains of crushing chest pain.The nurse recognizes that the timing of the chest pain is important to note for which of the following reasons?

Accepted Answer

A)  The 12-lead ECG must be held until the pain is relieved and continued as soon as it passes.
B)  The physician will order a follow-up ECG exactly 5 minutes post the last episode of chest pain.
C)  It helps to correlate the ECG changes to symptoms of chest pain.
D)  The ECG tracing must be stopped immediately.

Question 11

The nurse is obtaining a 12-lead ECG on a patient with chest discomfort and interprets the results as a very thick-lined waveform tracing.The nurse troubleshoots this tracing by performing which appropriate intervention?

Accepted Answer

A)  Unplugs the battery-operated equipment in the room one item at a time.
B)  Reapplies the electrodes to ensure proper connection with the skin.
C)  Adjusts the extremity electrodes on the wrists and ankles.
D)  Asks the patient to hold his breath to see if the tracing improves.

Question 12

_______________ develops when a person is exposed to an excessive number of alarms.

Accepted Answer

The answer of _______________ develops when a person is exposed...

Question 13

The nurse is caring for a patient who has chest discomfort.While obtaining the 12-lead ECG,the patient complains of feeling very anxious.Which of the following interventions should the nurse take in caring for the patient's anxiety? (Select all that apply. )

Accepted Answer

A)  Continue to monitor the patient.
B)  Reassess factors contributing to anxiety or distress.
C)  Ask the family caregiver to leave the room.
D)  Notify the health care provider.

Question 14

In order to determine the patient and family caregiver's level of understanding of the rationale for obtaining the 12-lead ECG,the nurse most effectively utilizes which of the following statements?

Accepted Answer

A)  Can you tell me why you need this test?
B)  Did you experience pain during the test?
C)  Can you tell me when the test results will be shared with you?
D)  Can you give me your name and date of birth?

Question 15

Some patients may have allergies,or more commonly,sensitivities to the adhesive used to affix the leads.In these cases,_____________ are available from various manufacturers.

Accepted Answer

The answer of Some patients may have allergies,or more commonly,sensitivities...

Question 16

The nurse is obtaining a 12-lead ECG on a patient with syncope.Which of the following actions,if taken by the nurse,are effective at reducing the presence of artifact in the ECG tracing?

Accepted Answer

A)  Instruct the patient to stop talking.
B)  Turn the ECG machine on after all the electrodes are applied.
C)  Position the patient in semi-Fowler's position.
D)  Maintain the gown on the patient to provide privacy.

Question 17

The nurse analyzes the patient's cardiac rhythm as follows: regular rhythm,rate 108 beats per minute,normal PQRS complex.The nurse interprets that the clinical significance of this cardiac rhythm is most likely related to which indication?

Accepted Answer

A)  Decreased cardiac output
B)  Dizziness
C)  Pain
D)  Syncope

Question 18

When applying ECG electrodes to a woman,it is important to give special consideration to which of the following objectives?

Accepted Answer

A)  Place the electrode as close to the chest wall as possible,close to the breast tissue.
B)  Place the electrode away from the chest wall,close to the breast tissue.
C)  Place the electrode as close to the chest wall as possible,avoiding the breast tissue.
D)  Place the electrode away from the chest way,avoiding the breast tissue.

Question 19

The nurse is assessing several patients who have returned from surgery when a 12-lead ECG is ordered for a newly admitted patient.Prioritizing patient needs,the nurse determines that obtaining the 12-lead ECG can be most appropriately delegated to which member of the health care team?

Accepted Answer

A)  Administrative secretary
B)  Registered nurse who is covering for lunch breaks
C)  Nursing assistive personnel (NAP) who has been specifically trained to obtain the measurement
D)  ECG technician from the vascular lab

Question 20

The nurse is reviewing the patient's Do Not Resuscitate orders when the cardiac alarm sounds.The rhythm is chaotic with no identifiable waves and the rate cannot be determined.Based on these clinical findings,the nurse determines that the patient is in which of the following cardiac rhythms?

Accepted Answer

A)  Asystole
B)  Ventricular fibrillation
C)  Ventricular tachycardia
D)  Sinus bradycardia

Exam 26: Cardiac Care