Question 1

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 D

Question 2

The nurse is supervising a nursing assistive personnel (NAP)while applying electrodes for continuous cardiac monitoring to an elderly patient.The nurse recognizes the need for further education when the NAP attaches which monitor lead to the electrode?

Accepted Answer

A)  White is negative.
B)  Black is neutral.
C)  Red is the ground lead.
D)  Brown is positive. B

Question 3

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 A

Question 4

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 5

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?

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 6

After obtaining a 12-lead ECG,the nurse records the date and time the ECG was obtained,the reason for obtaining the ECG,and who the ECG was given to for interpretation in the patient's chart.After this documentation,what is the appropriate action of the nurse?

Accepted Answer

A)  Immediately report any unexpected outcomes.
B)  Reposition the patient to a position of comfort.
C)  Report to the nursing assistive personnel that the 12-lead ECG is completed.
D)  Invite the family caregivers to visit at the bedside.

Question 7

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

Accepted Answer

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

Question 8

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 9

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 10

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 11

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

Question 12

When preparing the skin before ECG electrode placement,clipping the hair in the electrode area is preferred over shaving due to risk of _________________.

Accepted Answer

The answer of When preparing the skin before ECG electrode...

Question 13

The nurse identifies the appropriate equipment necessary to obtain a 12-lead ECG and gathers the following supplies.

Accepted Answer

A)  12-Lead ECG machine
B)  Clean,dry towel
C)  Hair clippers
D)  Betadine cleanser

Question 14

The nurse is caring for a patient on continuous cardiac monitoring.The nurse assesses the rhythm as regular with a normal PQRST complex and a rate of 62 beats per minute.Which analysis is the correct interpretation of this cardiac rhythm?

Accepted Answer

A)  Sinus bradycardia
B)  Sinus tachycardia
C)  Premature bradycardia
D)  Normal sinus rhythm

Question 15

The nurse changes the ECG electrodes on a patient who is on a continuous cardiac monitor.The patient tells the nurse that the electrodes were just changed the previous day.Which of the following rationales is the correct explanation for the nurse to share with the patient?

Accepted Answer

A)  Changing the electrodes more often than 24 hours can result in skin breakdown.
B)  It is not necessary to change the electrodes daily.
C)  It was not documented that the electrodes were changed.
D)  Changing the electrodes daily will decrease the number of false alarms.

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

When describing the rationale for connecting electrodes to each limb and around the heart,the nurse shares with the patient which appropriate explanation?

Accepted Answer

A)  The leads view a specific portion of the heart's surface to help determine which part has sustained damage.
B)  Multiple leads are necessary to provide a three-dimensional view of the heart.
C)  The electrodes are necessary to provide a shock to the heart if needed during cardiac conversion.
D)  The limb electrodes are required to provide a backup study in the event of artifact.

Question 18

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 19

Reduction of alarm fatigue is an important nursing practice.The nurse addresses this concern when which of the following actions is implemented?

Accepted Answer

A)  Change the electrodes once per shift.
B)  Provide initial and ongoing education about the intravenous pumps.
C)  Monitor all patients diagnosed with cancer on continuous cardiac monitoring.
D)  Set the parameters for the pulse oximetry machine within the standard normal range.

Question 20

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?

Exam 26: Cardiac Care