Jessica Levine
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(Cardiac) Nursing Test sobre Chapter 26, creado por Jessica Levine el 06/10/2016.

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Jessica Levine
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Chapter 26

Pregunta 1 de 40

1

The nurse is caring for a patient who has had an ECG. The nurse notes that leads I, II, and III differ from one another on the cardiac rhythm strip. How should the nurse best respond?

Selecciona una de las siguientes respuestas posibles:

  • Recognize that the view of the electrical current changes in relation to the lead placement.

  • Recognize that the electrophysiological conduction of the heart differs with lead placement.

  • Inform the technician that the ECG equipment has malfunctioned.

  • Inform the physician that the patient is experiencing a new onset of dysrhythmia.

Explicación

Pregunta 2 de 40

1

The nurse is analyzing a rhythm strip. What component of the ECG corresponds to the resting state of the patient’s heart?

Selecciona una de las siguientes respuestas posibles:

  • P wave

  • T wave

  • U wave

  • QRS complex

Explicación

Pregunta 3 de 40

1

The nursing educator is presenting a case study of an adult patient who has abnormal ventricular depolarization. This pathologic change would be most evident in what component of the ECG?

Selecciona una de las siguientes respuestas posibles:

  • P wave

  • T wave

  • QRS complex

  • U wave

Explicación

Pregunta 4 de 40

1

An adult patient with third-degree AV block is admitted to the cardiac care unit and placed on continuous cardiac monitoring. What rhythm characteristic will the ECG most likely show?

Selecciona una de las siguientes respuestas posibles:

  • PP interval & RR interval are irregular

  • PP interval is equal to RR interval

  • Fewer QRS complexes than P waves

  • PR interval is constant

Explicación

Pregunta 5 de 40

1

The nurse is writing a plan of care for a patient with a cardiac dysrhythmia. What would be the most appropriate goal for the patient?

Selecciona una de las siguientes respuestas posibles:

  • Maintain a resting heart rate below 70 bpm.

  • Maintain adequate control of chest pain.

  • Maintain adequate cardiac output.

  • Maintain normal cardiac structure.

Explicación

Pregunta 6 de 40

1

A patient has returned to the cardiac care unit after having a permanent pacemaker implantation. For which potential complication should the nurse most closely assess this patient?

Selecciona una de las siguientes respuestas posibles:

  • Chest pain

  • Bleeding at the implantation site

  • Malignant hyperthermia

  • Bradycardia

Explicación

Pregunta 7 de 40

1

A patient the nurse is caring for has a permanent pacemaker implanted with the identification code beginning with VVI. What does this indicate?

Selecciona una de las siguientes respuestas posibles:

  • Ventricular paced, ventricular sensed, inhibited

  • Variable paced, ventricular sensed, inhibited

  • Ventricular sensed, ventricular situated, implanted

  • Variable sensed, variable paced, inhibited

Explicación

Pregunta 8 de 40

1

The nurse is caring for an adult patient who has gone into ventricular fibrillation. When assisting with defibrillating the patient, what must the nurse do?

Selecciona una de las siguientes respuestas posibles:

  • Maintain firm contact between paddles and patient skin.

  • Apply a layer of water as a conducting agent.

  • Call “all clear” once before discharging the defibrillator.

  • Ensure the defibrillator is in the sync mode.

Explicación

Pregunta 9 de 40

1

A patient who is a candidate for an implantable cardioverter defibrillator (ICD) asks the nurse about the purpose of this device. What would be the nurse’s best response?

Selecciona una de las siguientes respuestas posibles:

  • “To detect and treat dysrhythmias such as ventricular fibrillation and ventricular tachycardia”

  • “To detect and treat bradycardia, which is an excessively slow heart rate”

  • “To detect and treat atrial fibrillation, in which your heart beats too quickly and inefficiently”

  • “To shock your heart if you have a heart attack at home”

Explicación

Pregunta 10 de 40

1

A nurse is providing health education to a patient scheduled for cryoablation therapy. The nurse should describe what aspect of this treatment?

Selecciona una de las siguientes respuestas posibles:

  • Peeling away the area of endocardium responsible for the dysrhythmia

  • Using electrical shocks directly to the endocarduim to eliminate the source of dysrhythmia

  • Using high-frequency sound waves to eliminate the source of dysrhythmia

  • Using a cooled probe to eliminate the source of dysrhythmia

Explicación

Pregunta 11 de 40

1

The nurse is caring for a patient who has just had an implantable cardioverter defibrillator (ICD) placed. What is the priority area for the nurse’s assessment?

Selecciona una de las siguientes respuestas posibles:

  • Assessing the patient’s activity level

  • Facilitating transthoracic echocardiography

  • Vigilant monitoring of the patient’s ECG

  • Close monitoring of the patient’s peripheral perfusion

Explicación

Pregunta 12 de 40

1

During a patient’s care conference, the team is discussing whether the patient is a candidate for cardiac conduction surgery. What would be the most important criterion for a patient to have this surgery?

Selecciona una de las siguientes respuestas posibles:

  • Angina pectoris not responsive to other treatments

  • Decreased activity tolerance related to decreased cardiac output

  • Atrial and ventricular tachycardias not responsive to other treatments

  • Ventricular fibrillation not responsive to other treatments

Explicación

Pregunta 13 de 40

1

A nurse is caring for a patient who is exhibiting ventricular tachycardia (VT). Because the patient is pulseless, the nurse should prepare for what intervention?

Selecciona una de las siguientes respuestas posibles:

  • Defibrillation

  • ECG monitoring

  • Implantation of a cardioverter defibrillator

  • Angioplasty

Explicación

Pregunta 14 de 40

1

A patient converts from normal sinus rhythm at 80 bpm to atrial fibrillation with a ventricular response at 166 bpm. Blood pressure is 162/74 mm Hg. Respiratory rate is 20 breaths per minute with normal chest expansion and clear lungs bilaterally. IV heparin and Cardizem are given. The nurse caring for the patient understands that the main goal of treatment is what?

Selecciona una de las siguientes respuestas posibles:

  • Decrease SA node conduction

  • Control ventricular heart rate

  • Improve oxygenation

  • Maintain anticoagulation

Explicación

Pregunta 15 de 40

1

The nurse and the other members of the team are caring for a patient who converted to ventricular fibrillation (VF). The patient was defibrillated unsuccessfully and the patient remains in VF. According to national standards, the nurse should anticipate the administration of what medication?

Selecciona una de las siguientes respuestas posibles:

  • Epinephrine 1 mg IV push

  • Lidocaine 100 mg IV push

  • Amiodarone 300 mg IV push

  • Sodium bicarbonate 1 amp IV push

Explicación

Pregunta 16 de 40

1

The nurse is planning discharge teaching for a patient with a newly inserted permanent pacemaker. What is the priority teaching point for this patient?

Selecciona una de las siguientes respuestas posibles:

  • Start lifting the arm above the shoulder right away to prevent chest wall adhesion.

  • Avoid cooking with a microwave oven.

  • Avoid exposure to high-voltage electrical generators.

  • Avoid walking through store and library antitheft devices.

Explicación

Pregunta 17 de 40

1

A patient is brought to the ED and determined to be experiencing symptomatic sinus bradycardia. The nurse caring for this patient is aware the medication of choice for treatment of this dysrhythmia is the administration of atropine. What guidelines will the nurse follow when administering atropine?

Selecciona una de las siguientes respuestas posibles:

  • Administer atropine 0.5 mg as an IV bolus every 3 to 5 minutes to a maximum of 3.0 mg.

  • Administer atropine as a continuous infusion until symptoms resolve.

  • Administer atropine as a continuous infusion to a maximum of 30 mg in 24 hours.

  • Administer atropine 1.0 mg sublingually.

Explicación

Pregunta 18 de 40

1

An ECG has been ordered for a newly admitted patient. What should the nurse do prior to electrode placement?

Selecciona una de las siguientes respuestas posibles:

  • Clean the skin with providone-iodine solution.

  • Ensure that the area for electrode placement is dry.

  • Apply tincture of benzoin to the electrode sites and wait for it to become “tacky.”

  • Gently abrade the skin by rubbing the electrode sites with dry gauze or cloth.

Explicación

Pregunta 19 de 40

1

The nurse is caring for a patient who has just undergone catheter ablation therapy. The nurse in the step-down unit should prioritize what assessment?

Selecciona una de las siguientes respuestas posibles:

  • Cardiac monitoring

  • Monitoring the implanted device signal

  • Pain assessment

  • Monitoring the patient’s level of consciousness (LOC)

Explicación

Pregunta 20 de 40

1

The ED nurse is caring for a patient who has gone into cardiac arrest. During external defibrillation, what action should the nurse perform?

Selecciona una de las siguientes respuestas posibles:

  • Place gel pads over the apex and posterior chest for better conduction.

  • Ensure no one is touching the patient at the time shock is delivered.

  • Continue to ventilate the patient via endotracheal tube during the procedure.

  • Allow at least 3 minutes between shocks.

Explicación

Pregunta 21 de 40

1

A group of nurses are participating in orientation to a telemetry unit. What should the staff educator tell this class about ST segments?

Selecciona una de las siguientes respuestas posibles:

  • They are the part of an ECG that reflects systole.

  • They are the part of an ECG used to calculate ventricular rate and rhythm.

  • They are the part of an ECG that reflects the time from ventricular depolarization through repolarization.

  • They are the part of an ECG that represents early ventricular repolarization.

Explicación

Pregunta 22 de 40

1

The nurse is providing care to a patient who has just undergone an electrophysiologic (EP) study. The patient states that she is nervous about “things going wrong” during the procedure. What is the nurse’s best response?

Selecciona una de las siguientes respuestas posibles:

  • “This is basically a risk-free procedure.”

  • “Thousands of patients undergo EP every year.”

  • “Remember that this is a step that will bring you closer to enjoying good health.”

  • “The whole team will be monitoring you very closely for the entire procedure.”

Explicación

Pregunta 23 de 40

1

New nurses on the telemetry unit have been paired with preceptors. One new nurse asks her preceptor to explain depolarization. What would be the best answer by the preceptor?

Selecciona una de las siguientes respuestas posibles:

  • “Depolarization is the mechanical contraction of the heart muscles.”

  • “Depolarization is the electrical stimulation of the heart muscles.”

  • “Depolarization is the electrical relaxation of the heart muscles.”

  • “Depolarization is the mechanical relaxation of the heart muscles.”

Explicación

Pregunta 24 de 40

1

A cardiac care nurse is aware of factors that result in positive chronotropy. These factors would affect a patient’s cardiac function in what way?

Selecciona una de las siguientes respuestas posibles:

  • Exacerbating an existing dysrhythmia

  • Initiating a new dysrhythmia

  • Resolving ventricular tachycardia

  • Increasing the heart rate

Explicación

Pregunta 25 de 40

1

The nurse is caring for a patient with refractory atrial fibrillation who underwent the maze procedure several months ago. The nurse reviews the result of the patient’s most recent cardiac imaging, which notes the presence of scarring on the atria. How should the nurse best respond to this finding?

Selecciona una de las siguientes respuestas posibles:

  • Recognize that the procedure was unsuccessful.

  • Recognize this as a therapeutic goal of the procedure.

  • Liaise with the care team in preparation for repeating the maze procedure.

  • Prepare the patient for pacemaker implantation.

Explicación

Pregunta 26 de 40

1

A patient is scheduled for catheter ablation therapy. When describing this procedure to the patient’s family, the nurse should address what aspect of the treatment?

Selecciona una de las siguientes respuestas posibles:

  • Resetting of the heart’s contractility

  • Destruction of specific cardiac cells

  • Correction of structural cardiac abnormalities

  • Clearance of partially occluded coronary arteries

Explicación

Pregunta 27 de 40

1

A patient has undergone diagnostic testing and received a diagnosis of sinus bradycardia attributable to sinus node dysfunction. When planning this patient’s care, what nursing diagnosis is most appropriate?

Selecciona una de las siguientes respuestas posibles:

  • Acute pain

  • Risk for unilateral neglect

  • Risk for activity intolerance

  • Risk for fluid volume excess

Explicación

Pregunta 28 de 40

1

The nurse is caring for a patient on telemetry. The patient’s ECG shows a shortened PR interval, slurring of the initial QRS deflection, and prolonged QRS duration. What does this ECG show?

Selecciona una de las siguientes respuestas posibles:

  • Sinus bradycardia

  • Myocardial infarction

  • Lupus-like syndrome

  • Wolf-Parkinson-White (WPW) syndrome

Explicación

Pregunta 29 de 40

1

A patient is undergoing preoperative teaching before his cardiac surgery and the nurse is aware that a temporary pacemaker will be placed later that day. What is the nurse’s responsibility in the care of the patient’s pacemaker?

Selecciona una de las siguientes respuestas posibles:

  • Monitoring for pacemaker malfunction or battery failure

  • Determining when it is appropriate to remove the pacemaker

  • Making necessary changes to the pacemaker settings

  • Selecting alternatives to future pacemaker use

Explicación

Pregunta 30 de 40

1

The nurse caring for a patient whose sudden onset of sinus bradycardia is not responding adequately to atropine. What might be the treatment of choice for this patient?

Selecciona una de las siguientes respuestas posibles:

  • Implanted pacemaker

  • Trancutaneous pacemaker

  • ICD

  • Asynchronous defibrillator

Explicación

Pregunta 31 de 40

1

The nurse is caring for a patient who has had a dysrhythmic event. The nurse is aware of the need to assess for signs of diminished cardiac output (CO). What change in status may signal to the nurse a decrease in cardiac output?

Selecciona una de las siguientes respuestas posibles:

  • Increased blood pressure

  • Bounding peripheral pulses

  • Changes in level of consciousness

  • Skin flushing

Explicación

Pregunta 32 de 40

1

Following cardiac resuscitation, a patient has been placed in a state of mild hypothermia before being transferred to the cardiac intensive care unit. The nurse’s assessment reveals that the patient is experiencing neuromuscular paralysis. How should the nurse best respond?

Selecciona una de las siguientes respuestas posibles:

  • Administer hypertonic IV solution.

  • Administer a bolus of warned normal saline.

  • Reassess the patient in 15 minutes.

  • Document this as an expected assessment finding.

Explicación

Pregunta 33 de 40

1

The nurse is caring for a patient who has had a biventricular pacemaker implanted. When planning the patient’s care, the nurse should recognize what goal of this intervention?

Selecciona una de las siguientes respuestas posibles:

  • Resynchronization

  • Defibrillation

  • Angioplasty

  • Ablation

Explicación

Pregunta 34 de 40

1

When planning the care of a patient with an implanted pacemaker, what assessment should the nurse prioritize?

Selecciona una de las siguientes respuestas posibles:

  • Core body temperature

  • Heart rate and rhythm

  • Blood pressure

  • Oxygen saturation level

Explicación

Pregunta 35 de 40

1

The nurse is assessing a patient who had a pacemaker implanted 4 weeks ago. During the patient’s most recent follow-up appointment, the nurse identifies data that suggest the patient may be socially isolated and depressed. What nursing diagnosis is suggested by these data?

Selecciona una de las siguientes respuestas posibles:

  • Decisional conflict related to pacemaker implantation

  • Deficient knowledge related to pacemaker implantation

  • Spiritual distress related to pacemaker implantation

  • Ineffective coping related to pacemaker implantation

Explicación

Pregunta 36 de 40

1

The nurse is caring for a patient who is in the recovery room following the implantation of an ICD. The patient has developed ventricular tachycardia (VT). What should the nurse assess and document?

Selecciona una de las siguientes respuestas posibles:

  • ECG to compare time of onset of VT and onset of device’s shock

  • ECG so physician can see what type of dysrhythmia the patient has

  • Patient’s level of consciousness (LOC) at the time of the dysrhythmia

  • Patient’s activity at time of dysrhythmia

Explicación

Pregunta 37 de 40

1

The staff educator is teaching a CPR class. Which of the following aspects of defibrillation should the educator stress to the class?

Selecciona una de las siguientes respuestas posibles:

  • Apply the paddles directly to the patient’s skin.

  • Use a conducting medium between the paddles and the skin.

  • Always use a petroleum-based gel between the paddles and the skin.

  • Any available liquid can be used between the paddles and the skin.

Explicación

Pregunta 38 de 40

1

During a CPR class, a participant asks about the difference between cardioversion and defibrillation. What would be the instructor’s best response?

Selecciona una de las siguientes respuestas posibles:

  • “Cardioversion is done on a beating heart; defibrillation is not.”

  • “The difference is the timing of the delivery of the electric current.”

  • “Defibrillation is synchronized with the electrical activity of the heart, but cardioversion is not.”

  • “Cardioversion is always attempted before defibrillation because it has fewer risks.”

Explicación

Pregunta 39 de 40

1

A patient is admitted to the cardiac care unit for an electrophysiology (EP) study. What goal should guide the planning and execution of the patient’s care?

Selecciona una de las siguientes respuestas posibles:

  • Ablate the area causing the dysrhythmia.

  • Freeze hypersensitive cells.

  • Diagnose the dysrhythmia.

  • Determine the nursing plan of care.

Explicación

Pregunta 40 de 40

1

A patient calls his cardiologist’s office and talks to the nurse. He is concerned because he feels he is being defibrillated too often. The nurse tells the patient to come to the office to be evaluated because the nurse knows that the most frequent complication of ICD therapy is what?

Selecciona una de las siguientes respuestas posibles:

  • Infection

  • Failure to capture

  • Premature battery depletion

  • Oversensing of dysrhythmias

Explicación