Ch. 31 Lewis Cardiovascular
1. A 74-yr-old patient has just arrived in the emergency department. After
assessment reveals a pulse deficit of 46 beats, the nurse will anticipate
that the patient may
require
a. emergent cardioversion.
b. a cardiac catheterization.
c. hourly blood pressure (BP) checks.
d. electrocardiographic (ECG) monitoring.: ANS: D
Pulse deficit is a difference between simultaneously obtained apical
and radial pulses. It indicates
that there may be a cardiac dysrhythmia that would best be
detected with ECG monitoring.
Frequent BP monitoring, cardiac catheterization, and emergent
cardioversion are used for
diagnosis and/or treatment of cardiovascular disorders but would not
be as helpful in determining
the immediate reason for the pulse deficit.
2. The nurse is reviewing the 12-lead electrocardiograph (ECG) for a
healthy 74-yr-
old patient who is having an annual physical examination. What finding is
of most concern
to the nurse?
1/
,a. A right bundle-branch block. c. The QRS duration is 0.13 seconds.
b. The PR interval is 0.21 seconds. d. The heart rate (HR) is 41 beats/min.: -
ANS: D
2/
, Ch. 31 Lewis Cardiovascular
Study online at
https://quizlet.com/_32q7v7
The resting HR does not change with aging, so the decrease in HR
requires further investigation.
Bundle-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
3. During a physical examination of an older patient, the nurse palpates
the point of
maximal impulse (PMI) in the sixth intercostal space lateral to the left
mid- clavicular line.
The best follow-up action for the nurse to take will be to
a. ask about risk factors for atherosclerosis.
b. determine family history of heart disease.
c. assess for symptoms of left ventricular hypertrophy.
d. auscultate carotid arteries for the presence of a bruit.: ANS: C
The PMI should be felt at the intersection of the fifth intercostal space
and left midclavicular line.
A PMI located outside these landmarks indicates possible cardiac
enlargement, such as with left
ventricular hypertrophy (LVH). The other assessments are part of a
general cardiac assessment but
do not represent follow-up for LVH. Cardiac enlargement is not
necessarily asso- ciated with
atherosclerosis or carotid artery disease.
1. A 74-yr-old patient has just arrived in the emergency department. After
assessment reveals a pulse deficit of 46 beats, the nurse will anticipate
that the patient may
require
a. emergent cardioversion.
b. a cardiac catheterization.
c. hourly blood pressure (BP) checks.
d. electrocardiographic (ECG) monitoring.: ANS: D
Pulse deficit is a difference between simultaneously obtained apical
and radial pulses. It indicates
that there may be a cardiac dysrhythmia that would best be
detected with ECG monitoring.
Frequent BP monitoring, cardiac catheterization, and emergent
cardioversion are used for
diagnosis and/or treatment of cardiovascular disorders but would not
be as helpful in determining
the immediate reason for the pulse deficit.
2. The nurse is reviewing the 12-lead electrocardiograph (ECG) for a
healthy 74-yr-
old patient who is having an annual physical examination. What finding is
of most concern
to the nurse?
1/
,a. A right bundle-branch block. c. The QRS duration is 0.13 seconds.
b. The PR interval is 0.21 seconds. d. The heart rate (HR) is 41 beats/min.: -
ANS: D
2/
, Ch. 31 Lewis Cardiovascular
Study online at
https://quizlet.com/_32q7v7
The resting HR does not change with aging, so the decrease in HR
requires further investigation.
Bundle-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
3. During a physical examination of an older patient, the nurse palpates
the point of
maximal impulse (PMI) in the sixth intercostal space lateral to the left
mid- clavicular line.
The best follow-up action for the nurse to take will be to
a. ask about risk factors for atherosclerosis.
b. determine family history of heart disease.
c. assess for symptoms of left ventricular hypertrophy.
d. auscultate carotid arteries for the presence of a bruit.: ANS: C
The PMI should be felt at the intersection of the fifth intercostal space
and left midclavicular line.
A PMI located outside these landmarks indicates possible cardiac
enlargement, such as with left
ventricular hypertrophy (LVH). The other assessments are part of a
general cardiac assessment but
do not represent follow-up for LVH. Cardiac enlargement is not
necessarily asso- ciated with
atherosclerosis or carotid artery disease.
