Cardiovascular Med Surg Exam
Questions45
Which of the EKG findings is most likely indicative of Acute Myocardial Infarction (AMI) in a
patient presenting with acute chest pain?
A. Wide and bizarre QRS complexes in the EKG
B. ST segment changes (STEMI or NSTEMI) in the EKG
C. A saw-toothed pattern in the EKG saw-toothed pattern in the EKG
D. Flat line in the EKG - ANSWERSB. ST segment changes (STEMI or NSTEMI) in the EKG
To determine whether there is a delay in impulse conduction through the atria, the nurse will
measure the length of the patient's:
A. P wave
B. PR interval
C. QT interval
D. QRS complex - ANSWERSA. P wave
The P wave represents the depolarization of the atria. The P-R interval represents depolarization
of the atria, atrioventricular (AV) node, bundle of His, bundle branches, and the Purkinje fibers.
The QRS represents ventricular depolarization. The Q-T interval represents depolarization and
repolarization of the entire conduction system.
The nurse needs to estimate quickly the heart rate for a patient with a regular heart rhythm.
Which method will be best to use?
A. Print a 1-minute electrocardiogram (ECG) strip and count the number of QRS complexes.
B. Count the number of large squares in the R-R interval and divide by 300.
,C. Use the 3-second markers to count the number of QRS complexes in 6seconds and multiply
by 10.
D. Calculate the number of small squares between one QRS complex and the next and divide
into 1500. - ANSWERSC. Use the 3-second markers to count the number of QRS complexes in
6seconds and multiply by 10.
This is the quickest way to determine the ventricular rate for a patient with a regular rhythm. All
the other methods are accurate, but take longer.
The nurse obtains a monitor strip on a patient who has had a myocardial infarction and makes
the following analysis: P wave not apparent, ventricular rate 162, R-R interval regular, P-R
interval not measurable, and QRS complex wide and distorted, QRS duration 0.18 second. The
nurse interprets the patient's cardiac rhythm as:
A. Atrial fibrillation
B. Sinus tachycardia
C. Ventricular fibrillation
D. Ventricular tachycardia - ANSWERSD. Ventricular tachycardia
The absence of P waves, wide QRS, rate >150, and the regularity of the rhythm indicate
ventricular tachycardia. Atrial fibrillation is grossly irregular, has a narrow QRS configuration, and
has fibrillatory atrial activity. Sinus tachycardia has P waves. Ventricular fibrillation is irregular
and does not have a consistent QRS duration. The absence of P waves, wide QRS, rate >150,
and the regularity of the rhythm indicate ventricular tachycardia. Atrial fibrillation is grossly
irregular, has a narrow QRS configuration, and has fibrillatory atrial activity. Sinus tachycardia
has P waves. Ventricular fibrillation is irregular and does not have a consistent QRS duration.
The nurse is admitting a patient who has chest pain. Which assessment data suggest that the
pain is caused by an Acute Myocardial Infarction (AMI)?
A. The pain is relieved after the patient takes nitroglycerin
B. The pain is reproducible when the patient raises the left arm
C. The pain increases with deep breathing
,D. The pain lasted longer than 30 minutes - ANSWERSD. The pain lasted longer than 30 minutes
Which of the following is the most common diagnostic tool used in patients with HF?
A. Serum Troponin level
B. ABG
C. Echocardiogram
D. Coronary Angiography - ANSWERSC. Echocardiogram
Question 70..07 pts
After reviewing a patient's history, vital signs, physical assessment, and laboratory data, which
of the following information is most important for the nurse to communicate to the healthcare
provider?
A. Hyperglycemia
B. Elevated troponin
C. T wave on EKG
D. HR 110 bpm - ANSWERSB. Elevated troponin
Which of the following is the worst complication of Acute Coronary Syndrome (ACS)?
A. Sinus tachycardia
B. Hypertension
C. Sudden cardiac death
D. Angina - ANSWERSC. Sudden cardiac death
A patient who has chronic heart failure tells the nurse, "I was fine when I went to bed, but I
woke up in the middle of the night feeling like I was suffocating! The nurse will document this
assessment finding as:
A. Orthopnea
, B. Paroxysmal nocturnal dyspnea
C. Asthma attack
D. Acute bilateral pleural effusion - ANSWERSB. Paroxysmal nocturnal dyspnea
A 19-year-old has a mandatory electrocardiogram (ECG) before participating on a college swim
team and is found to have sinus bradycardia, rate 52. BP is 114/54, and the student denies any
health problems. What action by the nurse is appropriate?
A. Allow the student to participate on the swim team.
B. Refer the student to a cardiologist for further assessment.
C. Obtain more detailed information about the student's health history.
D. Tell the student to stop swimming immediately if any dyspnea occurs. - ANSWERSA. Allow the
student to participate on the swim team.
When analyzing the waveforms of a patient's electrocardiogram (ECG), the nurse will need to
investigate further upon finding a:
A. T wave of 0.16 second
B. P-R interval of 0.18 second
C. Q-T interval of 0.34 second
D. QRS interval of 0.14 second - ANSWERSD. QRS interval of 0.14 second
Because the normal QRS interval is <0.12 seconds, the patient's QRS interval of 0.14 seconds
indicates that the conduction through the ventricular conduction system is prolonged. The P-R
interval, Q-T interval, and T wave interval are within the normal range.
Which assessment finding in a patient admitted with Acute Decompensated Heart Failure
(ADHF) requires the most immediate action by the nurse?
A. Weight gain of 1-2 lbs. over 2 weeks
B. HR of 106 bpm
Questions45
Which of the EKG findings is most likely indicative of Acute Myocardial Infarction (AMI) in a
patient presenting with acute chest pain?
A. Wide and bizarre QRS complexes in the EKG
B. ST segment changes (STEMI or NSTEMI) in the EKG
C. A saw-toothed pattern in the EKG saw-toothed pattern in the EKG
D. Flat line in the EKG - ANSWERSB. ST segment changes (STEMI or NSTEMI) in the EKG
To determine whether there is a delay in impulse conduction through the atria, the nurse will
measure the length of the patient's:
A. P wave
B. PR interval
C. QT interval
D. QRS complex - ANSWERSA. P wave
The P wave represents the depolarization of the atria. The P-R interval represents depolarization
of the atria, atrioventricular (AV) node, bundle of His, bundle branches, and the Purkinje fibers.
The QRS represents ventricular depolarization. The Q-T interval represents depolarization and
repolarization of the entire conduction system.
The nurse needs to estimate quickly the heart rate for a patient with a regular heart rhythm.
Which method will be best to use?
A. Print a 1-minute electrocardiogram (ECG) strip and count the number of QRS complexes.
B. Count the number of large squares in the R-R interval and divide by 300.
,C. Use the 3-second markers to count the number of QRS complexes in 6seconds and multiply
by 10.
D. Calculate the number of small squares between one QRS complex and the next and divide
into 1500. - ANSWERSC. Use the 3-second markers to count the number of QRS complexes in
6seconds and multiply by 10.
This is the quickest way to determine the ventricular rate for a patient with a regular rhythm. All
the other methods are accurate, but take longer.
The nurse obtains a monitor strip on a patient who has had a myocardial infarction and makes
the following analysis: P wave not apparent, ventricular rate 162, R-R interval regular, P-R
interval not measurable, and QRS complex wide and distorted, QRS duration 0.18 second. The
nurse interprets the patient's cardiac rhythm as:
A. Atrial fibrillation
B. Sinus tachycardia
C. Ventricular fibrillation
D. Ventricular tachycardia - ANSWERSD. Ventricular tachycardia
The absence of P waves, wide QRS, rate >150, and the regularity of the rhythm indicate
ventricular tachycardia. Atrial fibrillation is grossly irregular, has a narrow QRS configuration, and
has fibrillatory atrial activity. Sinus tachycardia has P waves. Ventricular fibrillation is irregular
and does not have a consistent QRS duration. The absence of P waves, wide QRS, rate >150,
and the regularity of the rhythm indicate ventricular tachycardia. Atrial fibrillation is grossly
irregular, has a narrow QRS configuration, and has fibrillatory atrial activity. Sinus tachycardia
has P waves. Ventricular fibrillation is irregular and does not have a consistent QRS duration.
The nurse is admitting a patient who has chest pain. Which assessment data suggest that the
pain is caused by an Acute Myocardial Infarction (AMI)?
A. The pain is relieved after the patient takes nitroglycerin
B. The pain is reproducible when the patient raises the left arm
C. The pain increases with deep breathing
,D. The pain lasted longer than 30 minutes - ANSWERSD. The pain lasted longer than 30 minutes
Which of the following is the most common diagnostic tool used in patients with HF?
A. Serum Troponin level
B. ABG
C. Echocardiogram
D. Coronary Angiography - ANSWERSC. Echocardiogram
Question 70..07 pts
After reviewing a patient's history, vital signs, physical assessment, and laboratory data, which
of the following information is most important for the nurse to communicate to the healthcare
provider?
A. Hyperglycemia
B. Elevated troponin
C. T wave on EKG
D. HR 110 bpm - ANSWERSB. Elevated troponin
Which of the following is the worst complication of Acute Coronary Syndrome (ACS)?
A. Sinus tachycardia
B. Hypertension
C. Sudden cardiac death
D. Angina - ANSWERSC. Sudden cardiac death
A patient who has chronic heart failure tells the nurse, "I was fine when I went to bed, but I
woke up in the middle of the night feeling like I was suffocating! The nurse will document this
assessment finding as:
A. Orthopnea
, B. Paroxysmal nocturnal dyspnea
C. Asthma attack
D. Acute bilateral pleural effusion - ANSWERSB. Paroxysmal nocturnal dyspnea
A 19-year-old has a mandatory electrocardiogram (ECG) before participating on a college swim
team and is found to have sinus bradycardia, rate 52. BP is 114/54, and the student denies any
health problems. What action by the nurse is appropriate?
A. Allow the student to participate on the swim team.
B. Refer the student to a cardiologist for further assessment.
C. Obtain more detailed information about the student's health history.
D. Tell the student to stop swimming immediately if any dyspnea occurs. - ANSWERSA. Allow the
student to participate on the swim team.
When analyzing the waveforms of a patient's electrocardiogram (ECG), the nurse will need to
investigate further upon finding a:
A. T wave of 0.16 second
B. P-R interval of 0.18 second
C. Q-T interval of 0.34 second
D. QRS interval of 0.14 second - ANSWERSD. QRS interval of 0.14 second
Because the normal QRS interval is <0.12 seconds, the patient's QRS interval of 0.14 seconds
indicates that the conduction through the ventricular conduction system is prolonged. The P-R
interval, Q-T interval, and T wave interval are within the normal range.
Which assessment finding in a patient admitted with Acute Decompensated Heart Failure
(ADHF) requires the most immediate action by the nurse?
A. Weight gain of 1-2 lbs. over 2 weeks
B. HR of 106 bpm
