CHA 1 Exam 4 – Cardiac System – NWTC – Study Guide and Exam Review
Material
Heart failure is mostly caused by:
a. Pneumonia
b. Hypertension
c. Cancer
d. Tuberculosis - ✔✔b. Hypertension
Identifying details of Supraventricular Tachycardia - ✔✔rapid stimulation of atrial tissue that
occurs at a rate of 100-280 bpm, with a mean of 170 bpm in adults
A nurse is caring for a client who is prescribed isosorbide mononitrate (Imdur) for chronic stable
angina and develops reflex tachycardia. Which of the following medications should the nurse
expect to administer?
a. furosemide (Lasix)
b. captopril (Capoten)
c. ranolazine (Ranexa)
d. metoprolol (Lopressor) - ✔✔d. metoprolol (Lopressor)
Metoprolol is a beta-blocker that may be used to manage reflex tachycardia resulting from
Imdur. Furosemide, captopril, and ranolazine are not used for this purpose.
Cardiac output, the volume of blood ejected by the heart per minute, is calculated by doing
which mathematical equation? - ✔✔heart rate (HR) x stroke volume (SV) = cardiac output (CO)
Identifying details of Ventricular Tachycardia (V tach) - ✔✔repetitive firing of an irritable
ectopic focus, usually at a rate of 140-180 bpm
,The nurse is reviewing the protocol for administration of IV adenosine (Adenocard). What is the
MOST important nursing intervention to remember when giving this medication?
a. Monitor the infusion site for hematoma
b. Assess for burning sensation at the IV site
c. Flush the IV catheter with normal saline
d. Administer it as a fast IV push - ✔✔d. Administer it as a fast IV push
Adenosine must be given as rapidly as possible because it has an extremely short half-life of less
than 10 seconds. For this reason, it is administered only IV and only as a fast IV push.
Name four modifiable risk factors to acute coronary syndrome - ✔✔elevated serum
cholesterol
cigarette smoking
hypertension
impaired glucose tolerance - diabetes (prevent and control hyperglycemia)
obesity
diet
physical inactivity
stress
Identifying details of Sinus Bradycardia - ✔✔when the rate of sinus node discharge is less than
60 bpm
State the normal values for the following segments/intervals when measuring EKGs or
telemetry:
- PR interval
,- QRS duration
- QT interval - ✔✔PR interval: 0.12-0.20 seconds
QRS duration: 0.04-0.12 seconds
QT interval: 0.34-0.43 seconds
Propranolol (Inderal) is contraindicated for a client who has which of the following conditions?
a. Asthma
b. Diabetes
c. Angina
d. Dementia - ✔✔a. Asthma
Propranolol is a non-selective beta-adrenergic blocker and blocks both beta1 and beta2
receptors. Blockade of beta2 receptors in the lungs causes bronchoconstriction, so it is
contraindicated in clients with asthma. Use propranolol cautiously with clients who have
diabetes, but it is not contraindicated. Propranolol can be used to treat angina. It is not
contraindicated in dementia.
A client has a new prescription for spironolactone (Aldactone). Which of the following
laboratory values should the nurse recognize as a reason to hold the morning dose of this
medication and notify the provider?
a. Serum sodium 148 mEq/L
b. Serum potassium 5.2 mEq/L
c. Serum creatinine 1.2 mg/dL
d. Serum chloride 106 mEq/L - ✔✔b. Serum potassium 5.2 mEq/L
The nurse should not administer spironolactone, a potassium-sparing diuretic, if the serum
potassium is higher than 5.0. A serum sodium of 148 is elevated, but this would not be a
contraindication to giving the medication. The serum creatinine and serum chloride levels are
WNL ranges.
, The nurse is preparing to administer digoxin (Lanoxin) 0.25mg IV push to a patient. Which is an
expected patient outcome related to the administration of digoxin?
a. Low serum potassium
b. Reduction in urine output
c. Increase in blood pressure
d. Decrease in heart rate - ✔✔d. Decrease in heart rate
Digoxin has a negative chronotropic effect (decreased heart rate)
When teaching a patient about symptoms of hypokalemia, the nurse will instruct the patient to
notify the health care provider if which symptom occurs?
a. Diaphoresis
b. Constipation
c. Blurred vision
d. Muscle weakness - ✔✔d. Muscle weakness
Muscle weakness is a common symptom of hypokalemia. The other answers are incorrect.
Identifying details of Sinus Tachycardia - ✔✔when the rate of the SA node discharge exceeds
100 bpm
Which medication should the nurse question if prescribed together with ACE inhibitors?
a. docusate sodium (Colace)
b. furosemide (Lasix)
c. potassium chloride (K-dur)
d. morphine - ✔✔c. potassium chloride (K-dur)
Material
Heart failure is mostly caused by:
a. Pneumonia
b. Hypertension
c. Cancer
d. Tuberculosis - ✔✔b. Hypertension
Identifying details of Supraventricular Tachycardia - ✔✔rapid stimulation of atrial tissue that
occurs at a rate of 100-280 bpm, with a mean of 170 bpm in adults
A nurse is caring for a client who is prescribed isosorbide mononitrate (Imdur) for chronic stable
angina and develops reflex tachycardia. Which of the following medications should the nurse
expect to administer?
a. furosemide (Lasix)
b. captopril (Capoten)
c. ranolazine (Ranexa)
d. metoprolol (Lopressor) - ✔✔d. metoprolol (Lopressor)
Metoprolol is a beta-blocker that may be used to manage reflex tachycardia resulting from
Imdur. Furosemide, captopril, and ranolazine are not used for this purpose.
Cardiac output, the volume of blood ejected by the heart per minute, is calculated by doing
which mathematical equation? - ✔✔heart rate (HR) x stroke volume (SV) = cardiac output (CO)
Identifying details of Ventricular Tachycardia (V tach) - ✔✔repetitive firing of an irritable
ectopic focus, usually at a rate of 140-180 bpm
,The nurse is reviewing the protocol for administration of IV adenosine (Adenocard). What is the
MOST important nursing intervention to remember when giving this medication?
a. Monitor the infusion site for hematoma
b. Assess for burning sensation at the IV site
c. Flush the IV catheter with normal saline
d. Administer it as a fast IV push - ✔✔d. Administer it as a fast IV push
Adenosine must be given as rapidly as possible because it has an extremely short half-life of less
than 10 seconds. For this reason, it is administered only IV and only as a fast IV push.
Name four modifiable risk factors to acute coronary syndrome - ✔✔elevated serum
cholesterol
cigarette smoking
hypertension
impaired glucose tolerance - diabetes (prevent and control hyperglycemia)
obesity
diet
physical inactivity
stress
Identifying details of Sinus Bradycardia - ✔✔when the rate of sinus node discharge is less than
60 bpm
State the normal values for the following segments/intervals when measuring EKGs or
telemetry:
- PR interval
,- QRS duration
- QT interval - ✔✔PR interval: 0.12-0.20 seconds
QRS duration: 0.04-0.12 seconds
QT interval: 0.34-0.43 seconds
Propranolol (Inderal) is contraindicated for a client who has which of the following conditions?
a. Asthma
b. Diabetes
c. Angina
d. Dementia - ✔✔a. Asthma
Propranolol is a non-selective beta-adrenergic blocker and blocks both beta1 and beta2
receptors. Blockade of beta2 receptors in the lungs causes bronchoconstriction, so it is
contraindicated in clients with asthma. Use propranolol cautiously with clients who have
diabetes, but it is not contraindicated. Propranolol can be used to treat angina. It is not
contraindicated in dementia.
A client has a new prescription for spironolactone (Aldactone). Which of the following
laboratory values should the nurse recognize as a reason to hold the morning dose of this
medication and notify the provider?
a. Serum sodium 148 mEq/L
b. Serum potassium 5.2 mEq/L
c. Serum creatinine 1.2 mg/dL
d. Serum chloride 106 mEq/L - ✔✔b. Serum potassium 5.2 mEq/L
The nurse should not administer spironolactone, a potassium-sparing diuretic, if the serum
potassium is higher than 5.0. A serum sodium of 148 is elevated, but this would not be a
contraindication to giving the medication. The serum creatinine and serum chloride levels are
WNL ranges.
, The nurse is preparing to administer digoxin (Lanoxin) 0.25mg IV push to a patient. Which is an
expected patient outcome related to the administration of digoxin?
a. Low serum potassium
b. Reduction in urine output
c. Increase in blood pressure
d. Decrease in heart rate - ✔✔d. Decrease in heart rate
Digoxin has a negative chronotropic effect (decreased heart rate)
When teaching a patient about symptoms of hypokalemia, the nurse will instruct the patient to
notify the health care provider if which symptom occurs?
a. Diaphoresis
b. Constipation
c. Blurred vision
d. Muscle weakness - ✔✔d. Muscle weakness
Muscle weakness is a common symptom of hypokalemia. The other answers are incorrect.
Identifying details of Sinus Tachycardia - ✔✔when the rate of the SA node discharge exceeds
100 bpm
Which medication should the nurse question if prescribed together with ACE inhibitors?
a. docusate sodium (Colace)
b. furosemide (Lasix)
c. potassium chloride (K-dur)
d. morphine - ✔✔c. potassium chloride (K-dur)
