Urden Critical Care Chapter 13 Cardiovascular Diagnostic Procedures

Urden Critical Care Chapter 13
Cardiovascular Diagnostic Procedures




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, Urden Critical Care Chapter 13
Cardiovascular Diagnostic Procedures
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Original
Chapter 13: Cardiovascular Diagnostic Procedures
Urden: Critical Care Nursing, 9th
Edition
MULTIPLE CHOICE
1. A patient with a serum potassium level of 6.8 mEq/L may exhibit what type of
electrocardiographic changes?
a. A prominent U wave b. Tall,
peaked T waves c. A narrowed
QRS
d. Sudden ventricular dysrhythmias
ANS: B
Normal serum potassium levels are 3.5 to 4.5 mEq/L. Tall, narrow peaked T waves are usually,
although not uniquely, associated with early hyperkalemia and are followed by prolongation of
the
PR interval, loss of the P wave, widening of the QRS complex, heart block, and asystole.
Severely
elevated serum potassium (greater than 8 mEq/L) causes a wide QRS tachycardia.
PTS: 1 DIF: Cognitive Level: Applying REF: p. 269
OBJ: Nursing Process Step: Assessment TOP: Cardiovascular
MSC: NCLEX: Physiologic Integrity
2. A patient with heart failure may be at risk for hypomagnesemia as a result of which factor?
a. Pump failure
b. Diuretic use
c. Fluid overload
d. Hemodilution
ANS: B
Hypomagnesemia can be caused by diuresis. Diuretic use with heart failure often contributes to
low
serum magnesium levels.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 270
OBJ: Nursing Process Step: Diagnosis TOP: Cardiovascular
MSC: NCLEX: Physiologic Integrity

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3. Which diagnostic test is most effective for measuring overall heart size?
a. 12-lead electrocardiography
b. Echocardiography
c. Chest radiography
d. Vectorcardiography
ANS: C
Chest radiography is the oldest noninvasive method for visualizing images of the heart, and it
remains a frequently used and valuable diagnostic tool. Information about cardiac anatomy and
physiology can be obtained with ease and safety at a relatively low cost. Radiographs of the
chest
are used to estimate the cardiothoracic ratio and measure overall heart size.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 277|Figure 13-88
OBJ: Nursing Process Step: Assessment TOP: Cardiovascular
MSC: NCLEX: Physiologic Integrity
4. ST segment monitoring for ischemia has gained increasing importance with the advent of
thrombolytic therapy. What is the most accurate method for monitoring the existence of true
ischemic
changes?
a. Biomarkers
b. Echocardiogram
c. 5-lead ECG
d. 12-lead ECG
ANS: D
Cardiac biomarkers are proteins that are released from damaged myocardial cells. The initial
elevation
of cTnI, cTnT, and CK-MB occurs 3 to 6 hours after the acute myocardial damage. This means
that if
an individual comes to the emergency department as soon as chest pain is experienced, the
biomarkers
will not have risen. For this reason, it is clinical practice to diagnose an acute myocardial
infarction by
12-lead electrocardiography and clinical symptoms without waiting for elevation of cardiac
biomarkers.
PTS: 1 DIF: Cognitive Level: Understanding REF: p. 244
OBJ: Nursing Process Step: Assessment TOP: Cardiovascular
MSC: NCLEX: Physiologic Integrity

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5. Which criteria are representative of the patient in normal sinus rhythm?
a. Heart rate, 64 beats/min; rhythm regular; PR interval, 0.10 second; QRS, 0.04 second