Exam 4- MSN 377 CH 31-36 Questions & Answers.
1. CH 31:
D. electrocardiographic (ECG)
A 74-yr-old patient has just arrived
monitor- ing.
in the emergency department. After
assessment
reveals a pulse deficit of 46 beats, the nurse
Explanation/Rationale:Pulse
deficit is a dif-
anticipate that the patient may require
will
simultaneously obtained ference between
A. emergent cardioversion.
B. a cardiac catheterization. 3. CH 31:
C. hourly blood pressure (BP) checks. During a physical
D. electrocardiographic (ECG) examination of an
monitoring. old- er patient, the
nurse palpates the
point of maximal
impulse (PMI) in the
sixth inter- costal
space lateral to the
left midclavicular
2. CH 31:
The nurse is reviewing the 12-lead
electro- cardiograph (ECG) for a
healthy 74-yr-old patient who is
having an annual physical
examination. What finding is of
most con- cern to the nurse?
A. A right bundle-branch block.
B. The PR interval is 0.21 seconds.
C. The QRS duration is 0.13 seconds.
D. The heart rate (HR) is 41
beats/min.
, Exam 4- MSN 377 CH 31-36 Questions & Answers.
apical and radial pulses. It indicates that there may be a
cardiac dysrhythmia that would best be detected with ECG
mon- itoring. Frequent BP monitoring, cardiac
catheterization, and emergent cardiover- sion are used for
diagnosis and/or treat- ment of cardiovascular disorders but
would not be as helpful in determining the imme- diate
reason for the pulse deficit.
D. The heart rate (HR) is 41 beats/min.
Explanation/Rationale:The resting HR does not change with
aging, so the decrease
in HR requires further investigation. Bun- dle-branch block and
slight increases in PR interval or QRS duration are common
in older individuals because of increases in conduction time
through the AV node, bundle of His, and bundle branches.
C. assess for symptoms of left ventricular hypertrophy.
Explanation/Rationale:The PMI should be
, Exam 4- MSN 377 CH 31-36 Questions & Answers.
line. The best follow-up action for the nurse felt at the intersection of the fifth
intercostal
to take will be to laboratory test
A. ask about risk factors for result will the nurse
atherosclero- sis. plan to review?
B. determine family history of A. Troponin
heart dis- ease. B. Homocysteine
C. assess for symptoms of left (Hcy)
ventricular hypertrophy.
D. auscultate carotid arteries for the
pres- ence of a bruit.
4. CH 31:
To auscultate for S3 or S4 gallops in
the mitral area, the nurse listens
with the
A. diaphragm of the stethoscope
with the patient lying flat.
B. bell of the stethoscope with the
patient in the left lateral position.
C. diaphragm of the stethoscope
with the patient in a supine position.
D. bell of the stethoscope with
the patient sitting and leaning
forward
5. CH 31:
To determine the effects of
therapy for a patient who is being
treated for heart fail- ure, which
, Exam 4- MSN 377 CH 31-36 Questions & Answers.
space and left midclavicular line. A PMI located outside
these landmarks indicates possible cardiac enlargement,
such as with left ventricular hypertrophy (LVH). The oth- er
assessments are part of a general car- diac assessment but
do not represent fol- low-up for LVH. Cardiac enlargement is
not necessarily associated with atherosclerosis or carotid artery
disease.
B. bell of the stethoscope with the patient in the left lateral
position.
Explanation/Rationale:Gallop rhythms generate low-pitched
sounds and are most easily heard with the bell of the
stetho- scope. Sounds associated with the mitral valve are
accentuated by turning the pa- tient to the left side, which
brings the heart closer to the chest wall. The diaphragm
of the stethoscope is best to use for the higher pitched
sounds such as S1 and S2.
D. B-type natriuretic peptide (BNP)
Explanation/Rationale:Increased levels of BNP are a marker
for heart failure. The other laboratory results would be used
to assess for myocardial infarction (troponin)
1. CH 31:
D. electrocardiographic (ECG)
A 74-yr-old patient has just arrived
monitor- ing.
in the emergency department. After
assessment
reveals a pulse deficit of 46 beats, the nurse
Explanation/Rationale:Pulse
deficit is a dif-
anticipate that the patient may require
will
simultaneously obtained ference between
A. emergent cardioversion.
B. a cardiac catheterization. 3. CH 31:
C. hourly blood pressure (BP) checks. During a physical
D. electrocardiographic (ECG) examination of an
monitoring. old- er patient, the
nurse palpates the
point of maximal
impulse (PMI) in the
sixth inter- costal
space lateral to the
left midclavicular
2. CH 31:
The nurse is reviewing the 12-lead
electro- cardiograph (ECG) for a
healthy 74-yr-old patient who is
having an annual physical
examination. What finding is of
most con- cern to the nurse?
A. A right bundle-branch block.
B. The PR interval is 0.21 seconds.
C. The QRS duration is 0.13 seconds.
D. The heart rate (HR) is 41
beats/min.
, Exam 4- MSN 377 CH 31-36 Questions & Answers.
apical and radial pulses. It indicates that there may be a
cardiac dysrhythmia that would best be detected with ECG
mon- itoring. Frequent BP monitoring, cardiac
catheterization, and emergent cardiover- sion are used for
diagnosis and/or treat- ment of cardiovascular disorders but
would not be as helpful in determining the imme- diate
reason for the pulse deficit.
D. The heart rate (HR) is 41 beats/min.
Explanation/Rationale:The resting HR does not change with
aging, so the decrease
in HR requires further investigation. Bun- dle-branch block and
slight increases in PR interval or QRS duration are common
in older individuals because of increases in conduction time
through the AV node, bundle of His, and bundle branches.
C. assess for symptoms of left ventricular hypertrophy.
Explanation/Rationale:The PMI should be
, Exam 4- MSN 377 CH 31-36 Questions & Answers.
line. The best follow-up action for the nurse felt at the intersection of the fifth
intercostal
to take will be to laboratory test
A. ask about risk factors for result will the nurse
atherosclero- sis. plan to review?
B. determine family history of A. Troponin
heart dis- ease. B. Homocysteine
C. assess for symptoms of left (Hcy)
ventricular hypertrophy.
D. auscultate carotid arteries for the
pres- ence of a bruit.
4. CH 31:
To auscultate for S3 or S4 gallops in
the mitral area, the nurse listens
with the
A. diaphragm of the stethoscope
with the patient lying flat.
B. bell of the stethoscope with the
patient in the left lateral position.
C. diaphragm of the stethoscope
with the patient in a supine position.
D. bell of the stethoscope with
the patient sitting and leaning
forward
5. CH 31:
To determine the effects of
therapy for a patient who is being
treated for heart fail- ure, which
, Exam 4- MSN 377 CH 31-36 Questions & Answers.
space and left midclavicular line. A PMI located outside
these landmarks indicates possible cardiac enlargement,
such as with left ventricular hypertrophy (LVH). The oth- er
assessments are part of a general car- diac assessment but
do not represent fol- low-up for LVH. Cardiac enlargement is
not necessarily associated with atherosclerosis or carotid artery
disease.
B. bell of the stethoscope with the patient in the left lateral
position.
Explanation/Rationale:Gallop rhythms generate low-pitched
sounds and are most easily heard with the bell of the
stetho- scope. Sounds associated with the mitral valve are
accentuated by turning the pa- tient to the left side, which
brings the heart closer to the chest wall. The diaphragm
of the stethoscope is best to use for the higher pitched
sounds such as S1 and S2.
D. B-type natriuretic peptide (BNP)
Explanation/Rationale:Increased levels of BNP are a marker
for heart failure. The other laboratory results would be used
to assess for myocardial infarction (troponin)
