Nursing Cardiac 3 Flashcards
the nurse understands that which of the following defines a cardiac cycle?
- circulation of the blood throughout the body
- circulation of the blood through the heart
- depolarization and repolarization of heart chambers
- pumping action of the heart
-depolarization and repolarization of heart chambers
the complete heartbeat consisting of contraction, or systole, and relaxation or diastole, of the atria and ventricles
the heart receives blood returning from the body through which of the following?
- pulmonary vein
- aorta
- vena cavae
- right coronary artery
-vena cavae
the superior and inferior vena cava
which of the following separates the right side of the heart from the left?
- chamber
- pericardium
- valve
- septum
-septum
which of the following chambers of the heart is largest and has the thickest myocardium?
- left ventricle
- right ventricle
- right atrium
- left atrium
-left ventricle
which of the following waveforms represents the resting state of the ventricle on the ECG?
- P wave
- QRS complex
- U wave
- T wave
-T wave
T wave represents ventricular depolarization, or the resting state of the heart when the ventricles are filling with blood and preparing to receive the next impulse
which of the following is the inherent rate for the atriventricular node? 20-40 beats per minute 40-60 beats per minute 60-100 beats per minute more than 100 beats per minute
40-60 beats per minute
40-60 bpm is the inherent rate for the AV node
the nurse understands that rhythms arising from the primary pacing node of the heart are referred to as which of the following?
- escape beats
- bundle branch blocks
- sinus rhythms
- ectopic rhythms
-sinus rhythms
sinus rhythms identify the impulse as having originated in the SA node
the nurse notes a life-threatening dysrhythmia on a pts cardiac monitor. which of the following is the nurse’s first appropriate action?
- notify the physician immediately
- assess the pt
- administer the appropriate medication for the noted dysrhythmia
- obtain vital signs
-assess the pt
examine the pt. monitored rhythms can be deceptive. always “treat the pt, not the monitor”
the nurse is teaching a pt about digoxin. which of the following should the nurse include in the teaching?
- digoxin decreases ectopic beats
- the force of contractions is increased with digoxin
- the resting HR increases when digoxin is taken
- digoxin raises the resting blood pressure
-the force of contractions is increased with digoxin
digoxin slows the heart rate and increases the force of contraction
the nurse is providing care to a pt withh atrial fibrillation. which of the following statements, if made by the pt, would be the most concern?
- aspirin upsets my stomach, so i quit taking it
- it seems like my feet are a little swollen
- my wife and i got a membership at the local health club
- i’ve been having trouble falling asleep at night
-aspirin upsets my stomach, so i quit taking it
atrial fibrillation can cause interruption in the movement of blood through the heart and and the formation of a thrombus. aspirin or warfarin will be used to prevent thrombus formation and remain an important component of pt care
which of the following treatments is appropriate for a pt with atrial fibrillation? SELECT ALL THAT APPLY
- amiodarone (Cordarone)
- Nitroglycerin
- warfarin (Coumadin)
- digoxin (Lanoxin)
- cardioversion
- epinephrine
- amiodarone (Cordarone)
- warfarin (Coumadin)
- digoxin (Lanoxin)
- cardioversion
the nurse is caring for a pt who has had a run of three or more PVCs together. the nurse should document this as which of the following
- ventricular tachycardia
- bigeminy
- trigeminy
- multifocal PVCs
-ventricular tachycardia
the nurse is caring for a pt in ventricular tachycardia who is hemodynamically stable. which of the following is the initial treatment for this dysrhythmia?
- cardioversion
- pacemaker
- defibrillation
- antiarrhythmic intravenous medication
-antiarrythmic intravenous medication
in a hemodynamically stable pt, treatment with mediation is the first choice
the nurse is caring for a pt whose ECG monitor shows a total absence of electrical impulse. the nurse does not detect a pulse. the nurse documents this as which of the following rhythms?
- agonal
- asystole
- sinus arrest
- ventricular standstill
-asystole
a pt with a cardiac disorer is having increased PVCs and feels “anxious.” after assessment and vital signs, what is the next action for the nurse to take?
- order an ECG and cardiac enzymes
- call the physician
- elevate the head of the bed and start oxygen at 2L
- put the bed in modified Trendelenburg’s position
-elevate the head of the bed and start oxygen at 2L
this will improve oxygenation because oxygen hunger is a common cause of heart irritability. call the physician next
for which of the following dysrhythmias will the nurse anticipate a pts need for a permanent pacemaker?
- ventricular fibrillation
- first degree heart block
- atrial fibrillation
- third degree heart block
- symptomatic bradycardia
- PACs
- third degree heart block
- symptomatic bradycardia
a pt is being digoxin (Lanoxin) to treat heart failure. which of the following is a usual adult daily dosage of digoxin?
- 005mg
- 025mg
- 25mg
- 5mg
0.25mg by mouth
when the nurse is reviewing a pts daily lab test results, which of the following electrolyte imbalances should the nurse recognize as predisposing the pt to digoxin toxicity
- hypokalemia
- hyperkalemia
- hyponatermia
- hypernatremia
hypokalemia
if a pt has elevated pulmonary vascular pressures, the nurse understands that the pt is most likely to develop which of the following physiological cardiac changes? -left atrial atrophy right atrial atrophy left ventricular hypertrophy right ventricular hypertrophy
right ventricular hypertrophy
right ventricle enlarges from the extra workload that occurs from the increased pulmonary pressures while ejecting blood into the pulmonary artery.
a pt is admitted to a medical unit with a Dx of heart failure. the pt reports increasing fatigue during the past 2 weeks. which of the following is the most likely cause of this fatigue?
- dyspnea
- decreased cardiac output
- dry cough
- orthopnea
-decreased cardiac output
decreased cardiac output occurs with heart failure, leading to reduced oxygenation of the tissues and therefore fatigue
a pt asks the nurse what diagnosis of heart failure means. which of the following is the nurse’s best response?
- your heart briefly stops
- your heart has an area of muscle that is dead
- your heart is pumping too much blood
- your heart is not an efficient pump
-your heart is not an efficient pump
the heart if failing as a pump to move blood forward
a pts chest xray examination indicates fluid in both lung bases. which of the following s/s present during the nurse’s data collection most reflects these xray examination findings
- fatigue
- peripheral edema
- bilateral crackles
- jugular venous distention
bilateral crackles
to monitor the severity of a pts heart failure, which of the following data is the most appropriate for the nurse to gather daily?
- weight
- calorie count
- appetitie
- abd girth
weight
which of the following signs indicates to the nurse that digoxin (Lanoxin) has been effective for a pt
- urine output decreases
- urine output increases
- HR higher than 95 beats per minute
- HE lower than 50 beats per minute
-urine output increases
lanoxin increases the strength of the heart’s contraction. this allows better emptying of the ventricle, which improves cardiac output and increases blood flow to the kidneys, so increased urine output occurs
for a pt who is being discharged on digoxin, the nurse should include which of the following in an explanation to the pt on the s/s of digoxin toxicity?
- poor appetite
- constipation
- halos around lights
- tachycardia
-poor appetite
the pt is being discharged on furosemide (Lasix). the nurse evaluates the pt as understanding medication teaching if the pt states that which of the following lab tests will be monitored as ordered?
- i will have my urine sodium checked
- i will have my calcium level checked
- i will have my prothrombin time checked
- i will have my potassium level checked
i will have my potassium level checked
which of the following does the nurse understand are the reason a pt with pulmonary edema is given morphine sulfate? SELECT ALL THAT APPLY
- to reduce anxiety
- to relieve chest pain
- to strengthen heart contractions
- to increase blood pressure
- to reduce preload and afterload
- to induce amnesia
- to reduce anxiety
- to reduce preload and after load
morphine sulfate is given t relieve the pts anxiety caused by the dyspnea of pulmonary edema. it also reduces preload and after load to the decrease the workload of the failing heart
the nurse evaluates that bumetanide (Bumex) IV is effective in treating pulmonary edema if which of the following pt s/s is resolved
- pedal edema
- jugular venous distention
- pink frothy sputum
- bradycardia
pink frothy sputum
a pt is being taught the action of digoxin, which is an inotropic agent. the nurse defines an inotropic agent as a medication that has which of the following actions?
- decrease HR
- increase HR
- increases conduction time
- strengthens heart contraction
strengthens heart contration
for a pt receiving furosemide, the nurse evaluates the medication as being effective if which of the following effects occurs?
- bilateral crackles diminish
- serum potassium decreases
- HR increases
- pulse pressure increases
bilateral crackles diminish
when caring for an anxious pt with dyspnea, which of the following nursing actions is most helpful to include in the plan of care to relieve anxiety
- increases activity levels
- stay at pts bedside
- pull the privacy curtain
- close the pts door
stay at pts bedside
