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A patient in the ED with complaints of chest pain. The 12-lead EKG shows
ST elevation in leads V3 and V4. Occlusion of the affected coronary artery
most likely would affect perfusion to which portion of the conduction
system?
A. Sinoatrial (SA) node
B. Bachmann's bundle
C. Atrioventricular (AV) node
D. Bundle of His - ✔✔LAD so D. bundle of his
Which of the following is the preferred lead for ST segment monitoring for a
patient with a suspected RCA occlusion?
A.I
B. aVR
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,C. III
D. V1 - ✔✔c. III
Which of the following is not a manifestation of hypertrophic
cardiomyopathy?
A. Syncope
B. Murmur that increases with squatting
C. Chest pain
D. Sudden cardiac death - ✔✔*B
Classic manifestations of hypertrophic cardiomyopathy are chest pain,
syncope, and an aortic stenosis type of murmur that decreases when the
patient is in a squatting position. The first manifestation of this condition is
occasionally sudden cardiac death during exercise.
In which quadrant is the mean QRS complex axis located if the QRS
complex is predominantly positive in lead I and negative in lead aVF?
A. Normal quadrant
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,B. Left axis deviation quadrant
C. Right axis deviation quadrant
D. Indeterminant quadrant - ✔✔*B
Because the positive of lead I is the left arm, if the QRS complex is upright
in lead I, the mean QRS axis is to the left. Because the positive of lead aVF
(a unipolar lead) is at the foot, if the QRS complex is negative in lead aVF,
the mean QRS axis is upward away from the foot. This axis would be in the
upper left quadrant, described as left axis deviation.
A patient becomes apneic and pulseless. CPR has been initiated, and the
monitor shows asystole in two leads. Which of the following drugs would be
used initially?
A. Calcium gluconate
B. Atropine
C. Epinephrine
D. Amiodarone (Cordarone) - ✔✔C
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, After CPR is initiated and an intravenous access is established,
epinephrine should be given. Calcium was used in the past in asystole but
is used today only for hypocalcemia, calcium channel blocker toxicity,
hyperkalemia, and hypermagnesemia. Atropine is no longer recommended
for asystole. Amiodarone is not indicated in asystole because asystole is
the absolute absence of irritability.
What is associated w/ Mitral Stenosis
A. Pinkish discoloration of the cheeks
B. Systolic murmur
C. Widened pulse pressure
D. Narrow pulse pressure - ✔✔A
Patients with mitral stenosis may exhibit a pinkish discoloration of the
cheeks (i.e., malar blush). Mitral stenosis causes a diastolic murmur.
Widened pulse pressure is associated with aortic regurgitation. Narrowed
pulse pressure is associated with mitral regurgitation.
Four days after a mitral valve replacement, the patient develops atrial
fibrillation. The nurse initially would:
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