C HAPTER 10: C ARDIOVASCULAR C LINICAL
A SSESSMENT AND D IAGNOSTIC P ROCEDURES
Urden: Priorities in Critical Care Nursing, 8th Edition
MULTIPLE CHOICE
1. Which portion of the ECG is most valuable in diagnos ing
atrioventricular (AV) conduction disturbances?
a. P wave
b. QRS complex
c. PR interval
d. QT interval
ANS: C
The PR interval is an indicator of atrioventricular nodal function. The
P wave represents atrial depolarization. The QRS complex represents
ventricular depolarization, corresponding to phase 0 of the ventricular
action potential. The QT interval is measured from the beginning of the
QRS complex to the end of the T wave and indicates the total time
interval from the onset of depolarization to the completio n of
repolarization.
PTS: 1 DIF: Cognitive Level: Appl ying OBJ: Nursing
Process Step: Assessment TOP: Cardiovascular Clinical
Assessment and Diagnostic Procedures MSC: NC LEX:
Physiological Integrity: Reduction of Risk Potential
,2. While preparing a p atient for a cardiac catheterization, the patient asks
why it is necessary to drink additional fluids after a cardiac
catheterization. Which response by the nurse is the most accurate?
a. “To keep the femoral vein from clotting at the puncture site after
the procedure”
b. “To make sure your electrol ytes stay in balance and prevent
dysrhythmias”
c. “To protect your kidneys from the damaging effects of the
contrast medium”
d. “To increase your cardiac output so you will not feel dizz y after
the procedure”
ANS: C
To protect the kidneys from the damaging effects of the contrast
medium, IV saline is infused to ensure adequate hydration. Post -
procedure oral hydration is continued. Contrast -induced acute kidney
injury is estimated to occur in up to 30% of patients who receiv e
iodinated contrast dye during cardiac catheterization. The other
statements are not accurate.
PTS: 1 DIF: Cognitive Level: Appl ying OBJ: Nursing
Process Step: Implementation TOP: Cardiovascular
Clinical Assessment and Diagnostic Procedures MSC: NC LEX:
Health Promotion and Maintenance
3. Pulsus paradoxus may be noted on the bedside monitor when what is
observed?
, a. A decrease of more than 10 mm Hg in the arterial waveform
during inhalation
b. A single, nonperfused beat on the ECG waveform
c. Tall, tented T w aves on the ECG waveform
d. An increase in pulse pressure greater than 20 mm Hg on
exhalation
ANS: A
Pulsus paradoxus is a decrease of more than 10 mm Hg in the arterial
waveform that occurs during inhalation. It is caused by a fall in CO as
a result of incre ased negative intrathoracic pressure during inhalation.
PTS: 1 DIF: Cognitive Level: Understanding OBJ:
Nursing Process Step: Assessment TOP: Cardiovascular
Clinical Assessment and Diagnostic Procedures MSC: NC LEX:
Physiological Integrity: Reduction of Risk Potential
4. The nurse is questioning the accuracy of the arterial catheter readings.
Which two actions should the nurse perform to ensure the accuracy of
the transducer?
a. Obtain a cuff blood pressure and adjust the monitor to match.
b. Level the transducer to the phlebostatic axis and zero the
transducer.
c. Have the patient laid flat and closing the transducer to air.
d. Obtain blood return on the arterial line and closing all the
stopcocks.
ANS: B
A SSESSMENT AND D IAGNOSTIC P ROCEDURES
Urden: Priorities in Critical Care Nursing, 8th Edition
MULTIPLE CHOICE
1. Which portion of the ECG is most valuable in diagnos ing
atrioventricular (AV) conduction disturbances?
a. P wave
b. QRS complex
c. PR interval
d. QT interval
ANS: C
The PR interval is an indicator of atrioventricular nodal function. The
P wave represents atrial depolarization. The QRS complex represents
ventricular depolarization, corresponding to phase 0 of the ventricular
action potential. The QT interval is measured from the beginning of the
QRS complex to the end of the T wave and indicates the total time
interval from the onset of depolarization to the completio n of
repolarization.
PTS: 1 DIF: Cognitive Level: Appl ying OBJ: Nursing
Process Step: Assessment TOP: Cardiovascular Clinical
Assessment and Diagnostic Procedures MSC: NC LEX:
Physiological Integrity: Reduction of Risk Potential
,2. While preparing a p atient for a cardiac catheterization, the patient asks
why it is necessary to drink additional fluids after a cardiac
catheterization. Which response by the nurse is the most accurate?
a. “To keep the femoral vein from clotting at the puncture site after
the procedure”
b. “To make sure your electrol ytes stay in balance and prevent
dysrhythmias”
c. “To protect your kidneys from the damaging effects of the
contrast medium”
d. “To increase your cardiac output so you will not feel dizz y after
the procedure”
ANS: C
To protect the kidneys from the damaging effects of the contrast
medium, IV saline is infused to ensure adequate hydration. Post -
procedure oral hydration is continued. Contrast -induced acute kidney
injury is estimated to occur in up to 30% of patients who receiv e
iodinated contrast dye during cardiac catheterization. The other
statements are not accurate.
PTS: 1 DIF: Cognitive Level: Appl ying OBJ: Nursing
Process Step: Implementation TOP: Cardiovascular
Clinical Assessment and Diagnostic Procedures MSC: NC LEX:
Health Promotion and Maintenance
3. Pulsus paradoxus may be noted on the bedside monitor when what is
observed?
, a. A decrease of more than 10 mm Hg in the arterial waveform
during inhalation
b. A single, nonperfused beat on the ECG waveform
c. Tall, tented T w aves on the ECG waveform
d. An increase in pulse pressure greater than 20 mm Hg on
exhalation
ANS: A
Pulsus paradoxus is a decrease of more than 10 mm Hg in the arterial
waveform that occurs during inhalation. It is caused by a fall in CO as
a result of incre ased negative intrathoracic pressure during inhalation.
PTS: 1 DIF: Cognitive Level: Understanding OBJ:
Nursing Process Step: Assessment TOP: Cardiovascular
Clinical Assessment and Diagnostic Procedures MSC: NC LEX:
Physiological Integrity: Reduction of Risk Potential
4. The nurse is questioning the accuracy of the arterial catheter readings.
Which two actions should the nurse perform to ensure the accuracy of
the transducer?
a. Obtain a cuff blood pressure and adjust the monitor to match.
b. Level the transducer to the phlebostatic axis and zero the
transducer.
c. Have the patient laid flat and closing the transducer to air.
d. Obtain blood return on the arterial line and closing all the
stopcocks.
ANS: B
