Urden: Priorities in Critical Care Nursing, 8th Edition
MULTIPLE CHOICE
1. A patient is admitted with an acute inferior m yocardial infarction (MI).
A 12-lead electrocardiogram (ECG) is done to validate the area of
infarction. Which finding on the ECG is most conclusive for infarction?
a. Inverted T waves
b. Tall, peaked T waves
c. ST segment depression
d. Pathologic Q waves
ANS: D
The changes in repolarization are seen by the presence of new Q
waves. These new, pathologic Q waves are deeper and wider than tiny
Q waves found on the normal 12 -lead ECG.
PTS: 1 DIF: Cognitive Level: Appl ying OBJ: Nursing
Process Step: Assessment TOP: Cardiovascular Disorders
MSC: NC LEX: Physiological Integrit y: Reduction of Risk
Potential
2. A patient is admitted with an acute inferior m yocardial infarction (MI).
A 12-lead electrocardiogram (ECG) is done to validate the area of
infarction. Which leads on the ECG would correlate with an infer ior
wall MI?
, a. II, III, aVF
b. V5 to V6, I, aVL
c. V2 to V4
d. V1 to V2
ANS: A
Inferior infarctions are manifested by electrocardiographic (ECG)
changes in leads II, III, and aVF. Lateral wall infarctions are
manifested by ECG changes in leads V5 to V6, I, and aVL . Anterior
wall infarctions are manifested by ECG changes in leads V2 to V4.
Posterior wall infarctions are manifested by ECG changes in leads V1
to V2.
PTS: 1 DIF: Cognitive Level: Appl ying OBJ: Nursing
Process Step: Assessment TOP: Cardiovascular D isorders
MSC: NC LEX: Physiological Integrit y: Reduction of Risk
Potential
3. A patient is admitted with an acute m yocardial infarction (MI). What
common dysrhythmia should the nurse anticipate in this patient?
a. Bradycardia
b. Atrioventricular heart block
c. Premature ventricular contractions
d. Ventricular fibrillation
ANS: C
Premature ventricular contractions (PVCs) are seen in almost all
patients within the first few hours after MI. They are initiall y
, controlled through administration of oxygen to reduce m yocardi al
hypoxia and by correcting acid -base or electrol yte imbalances. Other
dysrhythmias can occur but not as frequentl y as PVCs.
PTS: 1 DIF: Cognitive Level: Anal yzing OBJ: Nursing
Process Step: Assessment TOP: Cardiovascular Disorders
MSC: NC LEX: Physiological Integrit y: Physiological
Adaptation
4. A patient has been admitted with an inferior wall m yocardial infarction.
Which dysrhythmia is more prevalent in this t ype of infarction?
a. Sinus tachycardia
b. Ventricular fibrillation
c. Atrial fibrillation
d. Sinus bradycardia
ANS: D
Sinus bradycardia (heart rate less than 60 beats/min) occurs in 30% to
40% of patients who sustain an acute m yocardial infarction (MI). It is
more prevalent with an inferior wall infarction in the first hour after
ST segment elevation MI.
PTS: 1 DIF: Cognitive Level: Appl ying OBJ: Nursing
Process Step: Assessment TOP: Cardiovascular Disorders
MSC: NC LEX: Physiological Integrit y: Physiological
Adaptation