ECG Final Exam ch.11-14 2024 AND PRACTICE QUESTIONS |ACCURATE ANSWERS|, Exams of Nursing

Download ECG Final Exam ch.11-14 2024 AND PRACTICE QUESTIONS |ACCURATE ANSWERS| and more Exams Nursing in PDF only on Docsity! ECG Final Exam ch.11-14 2024 AND PRACTICE QUESTIONS |ACCURATE ANSWERS| VERIFIED FOR GUARANTEED PASS |GRADED A |NEW VERSION WITH 200 QUESTIONS WITH 100+ QUESTIONS What minimally invasive procedure is frequently performed to open narrowed or blocked blood vessels? - ANSWERS-Angioplasty When angioplasty is performed on a coronary vessel, a stent is typically inserted to do what? - ANSWERS-Help prevent restenosis You are preparing Mrs. Bayfield for percutaneous coronary intervention. As you explain the procedure to her, she states, "They are going to put a stent in my heart, so why do they need to inject dye in my arm?" What should you tell Mrs. Bayfield? - ANSWERS-The dye is used to find the exact location of the blockage. A patient has been brought to the emergency department complaining of chest pain and dizziness. When assessing this patient, what should the health care professional do? - ANSWERS-Gather information quickly and efficiently and report it immediately to the physician. A patient is brought to the emergency department by ambulance. He is having severe chest pain that is radiating through his left arm and difficulty breathing. You suspect that the patient will be rushed into surgery soon. What must you do before the patient is given narcotics for the pain? - ANSWERS-Have the patient sign a consent form. Treatment for hypovolemia may include which of the following therapies? - ANSWERS-IV fluid challenge What is the term for a concentrated amount of medication administered over a short period of time? - ANSWERS-Bolus What is the term for a medication that is administered intravenously to convert plasminogen to plasmin, which then breaks down the fibrin in a clot? - ANSWERS-Thrombolytic agent For which of the following patients is fibrinolytic therapy not appropriate? - ANSWERS-A 52-year-old female patient with a blood pressure of 160/110 mmHg For which of the following conditions might Coumadin be prescribed for a patient? - ANSWERS-Hypercoagulopathy Which of the following foods would be restricted in a patient's diet while he or she is taking Coumadin? - ANSWERS-Spinach Which of the following procedures is a reasonable alternative for a patient who has had heart failure and is not strong enough to withstand heart catheterization? - ANSWERS-Enhanced external counter pulsation What is the term for an abnormal collection of fluid within the pleural space of the lungs due to congestive heart failure? - ANSWERS-Pulmonary edema - ANSWERS-Hypertrophy Which leads are used to determine the presence of axis deviation? - ANSWERS-Leads I and aVF What does the patient have if leads I and aVF are both predominantly positive? - ANSWERS-A normal axis (no deviation) What does the patient have if lead I is predominantly positive and lead aVF is predominantly negative? - ANSWERS-Left axis deviation What does the patient have if lead I is predominantly negative and lead aVF is predominantly positive? - ANSWERS-Right axis deviation What does the patient have if leads I and aVF are both predominantly negative? - ANSWERS-Extreme right axis deviation Which of the following is not a possible cause of left axis deviation? - ANSWERS-Anterolateral wall MI Right axis deviation is considered normal in which group of patients? - ANSWERS-Children and tall, thin adults Which of the following can cause extreme right axis deviation? - ANSWERS-Hyperkalemia Which lead is referenced to distinguish a right bundle branch block (RBBB) from a left bundle branch block (LBBB)? - ANSWERS-V1 In a right bundle branch block (RBBB), how does the QRS appear? - ANSWERS-Positively deflected In a left bundle branch block (LBBB), how does the QRS appear? - ANSWERS-Negatively deflected When analyzing V1 to determine the presence of a bundle branch block, what should you look for? - ANSWERS-A QRS complex that measures 0.12 seconds or greater and a P wave To determine the presence of left ventricular hypertrophy, which leads should you refer to? - ANSWERS-V1, V2, V5, and V6 When totaled, how many millimeters are necessary to suspect left ventricular hypertrophy? - ANSWERS-35 mm* With left ventricular hypertrophy, how does the QRS complex appear? - ANSWERS-Taller and deeper than normal If a patient has left ventricular hypertrophy, what type of axis deviation will be seen? - ANSWERS-Left When determining the electrical axis, which portion of the ECG tracing should you focus on? - ANSWERS-QRS complex Where can bundle branch block be seen? - ANSWERS-In the precordial leads You have run a 12-lead ECG on Mrs. Simmons. In lead V1, you notice that the QRS is positive and has a bunny ears appearance. What does Mrs. Simmons most likely have? - ANSWERS-Right bundle branch block The V1 tracing shown here is from a 12-lead ECG performed on a 36-year-old male patient as part of a yearly physical examination. The patient appears to be in good general health. What does this tracing show? - ANSWERS-Left bundle branch block You have run a 12-lead ECG on Ms. Reilly, a patient in the cardiac care unit of the hospital where you work. A portion of the V1 tracing is shown here. What cardiac condition would you suspect based on this tracing? - ANSWERS-Right bundle branch block What is the term for a thickening of the ventricular walls due to chronic pressure overload? - ANSWERS-Ventricular hypertrophy Ventricular hypertrophy occurs when the heart must exert more effort to maintain normal cardiac output. Why is this greater effort needed? - ANSWERS-Increased peripheral vascular resistance When determining the presence of left ventricular hypertrophy, you measure to the tip of the deepest QS complex in V1 or V2 and to the tip of the tallest R wave in V5 or V6. For both of these measurements, where should you start the measurement? - ANSWERS-Isoelectric line When a chemical stress test is performed using Persantine, adenosine, or a similar chemical, how does the chemical affect the patient? - ANSWERS-It stimulates the heart to exercise artificially. Which of the following procedures is considered invasive? - ANSWERS-Chemical stress test Which of the following would you include when instructing a patient about an upcoming exercise electrocardiography test? - ANSWERS-Check the order and then advise the patient regarding any medications that should or should not be taken before the procedure. Which of the following medications would most likely be stopped before a treadmill stress test? - ANSWERS-Beta blocker You are preparing a 72-year-old patient for exercise electrocardiography who says he is frightened of all modern technology. Which of the following would not help alleviate this patient's fears during exercise electrocardiography? - ANSWERS-Explaining the location of the crash cart Of the following, which concept is least important for the patient to understand before signing the consent form for an exercise electrocardiography procedure? - ANSWERS-When the test results will be available A complete history of the patient is needed before an exercise electrocardiography. Which of the following information is not needed for the history? - ANSWERS-The amount of sleep the patient had the night before You are explaining the exercise electrocardiography procedure to a 36-year-old female patient. She tells you she has a very low pain tolerance and is afraid the procedure will hurt. Which of the following symptoms would you tell her to expect during exercise electrocardiography? - ANSWERS-Mild fatigue, increased heart rate, and increased respiratory rate Which statement is correct regarding your responsibilities during an exercise electrocardiography test? - ANSWERS-You will instruct the patient about the procedure, attach the electrodes, and monitor the patient during the procedure. What is the purpose of the hyperventilation ECG during pretesting? - ANSWERS-To identify ECG changes caused by breathing Which of the following equipment is not needed to prepare a patient for a treadmill exercise test? - ANSWERS-Eye protection and face shield Which is the most commonly used stress test protocol? - ANSWERS-Bruce protocol Which statement is correct regarding the patient who achieves the target heart rate (THR) during the test? - ANSWERS-The test results are more reliable when the patient nears or achieves the THR. What is the rate pressure product? - ANSWERS-Systolic blood pressure times heart rate After an exercise stress test, the patient will have a cooling-off period. How long does this last and what should you do during this time? - ANSWERS-It will last 6 to 15 minutes and you should monitor the patient for any changes. Which of the following statements about exercise electrocardiography results is true? - ANSWERS-False-positive results occur more frequently in women than in men. The purpose of calculating the rate pressure product is to estimate the patient's ______. - ANSWERS-Oxygen utilization For which of the following patients would the Naughton protocol for exercise electrocardiography most likely be used? - ANSWERS-A 56-year-old man who has congestive heart failure In the context of a nuclear stress test, what does gating mean? - ANSWERS-Triggering the camera to record at specific points during the cardiac cycle What is the condition in which a person's heart fails to pump an adequate volume of blood to provide oxygen and nutrients to the body tissues? - ANSWERS-Congestive heart failure What is the medical term for high blood pressure? - ANSWERS-Hypertension What does an inconclusive exercise electrocardiography test mean? - ANSWERS-Additional testing must be done to determine whether the patient has heart disease. Which of the following should you include in patient instructions after exercise electrocardiography? - ANSWERS-You should not take a hot shower or bath for at least 2 hours. You should prepare the electrode sites on a patient's skin using a skin rasp, which is ______. - ANSWERS-A rough piece of material for abrading the skin Which of the following is the term for the practice of placing the limb leads on the upper chest and torso instead of the arms and legs for exercise electrocardiography? - ANSWERS-Mason- Likar attachment Which of the following signs or symptoms should the patient be instructed to report during an exercise electrocardiography test? - ANSWERS-Dizziness You have assisted during Mr. Rafferty's exercise electrocardiography test and are monitoring him during his cooling-off period. He tells you he feels fine and asks, "So what do the test results say? Am I healthy?" What should you do? - ANSWERS-Refer Mr. Rafferty to the physician for the results. Which of the following is not a reason to use an ambulatory monitor? - ANSWERS-To evaluate oxygen utilization by the myocardium What are the two most common types of ambulatory monitoring? - ANSWERS-Continuous and intermittent Which type of monitoring requires the patient to activate the monitor when experiencing symptoms? - ANSWERS-Transtelephonic postsymptom event monitor Which of the following patients is not a candidate for ambulatory monitoring? - ANSWERS-Miss Jeffers, who is confused and living in a nursing home What is the advantage of continuous monitoring over intermittent monitoring? - ANSWERS- Continuous monitoring provides a complete tracing and records before, during, and after the time the patient activates the event marker. Which type of ambulatory monitoring is performed in a hospital? - ANSWERS-Telemetry monitoring When would a patient use an event marker during ambulatory monitoring? - ANSWERS-To mark the ECG tracing when symptoms occur Which patient will be asked to keep a diary? - ANSWERS-Ms. Fisher, whose physician ordered ambulatory monitoring this morning Mrs. Hansen has an ambulatory monitor in place. What instructions do you give her regarding the electrodes? - ANSWERS-If an electrode becomes loose, she should press it in the center to reapply; however, she must return to the clinic if one comes off completely Which of the following instructions would be given to a patient scheduled for ambulatory monitoring? - ANSWERS-Wear a loose-fitting shirt, preferably one that buttons down the front, and you will be more comfortable during the procedure. During ambulatory monitoring, which of the following would not be recorded in the patient diary? - ANSWERS-Trimming fingernails or toenails When an ambulatory monitor is used, when should the patient start his or her diary? - ANSWERS-When the monitor is turned on Which of the following devices should a patient avoid while wearing an ambulatory monitor? - ANSWERS-Electric blankets You need to prepare a 10-year-old boy for an ambulatory monitoring procedure. Which of the following should you include in your patient teaching? - ANSWERS-Allow the child to touch the equipment before applying it. Which of the following equipment will not be needed in preparation for applying an ambulatory monitoring device? - ANSWERS-Oxygen supplies You are putting a new type of ambulatory monitor on Mrs. Farmer. It uses a five-lead system that is unfamiliar to you. What should you do before placing the electrodes? - ANSWERS- Consult the manufacturer's instructions; they are the best resource for using new equipment. You are preparing an 82-year-old patient for ambulatory monitoring. What precautions do you need to take when applying electrodes to this patient? - ANSWERS-Manipulate the electrodes as little as possible. What should be done with a Holter monitor before entering a patient's room to begin the procedure? - ANSWERS-Insert new batteries in the monitor. Mr. Benson's Holter monitor was applied yesterday at 9:00 am. At that time, he was told to return this morning at 9:00 am to have the monitor removed. He arrives at 10:30 am but did not bring his diary. What should you do? - ANSWERS-Ask him to return home to get the diary before removing the monitor. Which of the following is a correct statement regarding the results received from an outside laboratory for ambulatory monitoring? - ANSWERS-Results will be available in 7 to 10 days and placed on the chart for the physician to discuss with the patient. Mr. Freeman asked you about the results of his test. You saw the final report and know there were abnormalities. How do you respond? - ANSWERS-You tell him he needs to discuss the results with his physician. What additional test is not likely to be ordered if the ambulatory monitor results are abnormal? - ANSWERS-Pulmonary function test What is the first step in reducing a patient's fear of ambulatory monitoring? - ANSWERS-Help the patient understand the procedure. Which of the following activities is not allowed during ambulatory monitoring? - ANSWERS- Taking a tub bath What is the proper procedure for connecting electrodes for ambulatory monitoring to reduce tugging and pulling during patient movement? - ANSWERS-Tape the electrodes in place. While you are preparing Mrs. Trevor for ambulatory monitoring, she asks you a question that you cannot answer. What should you do? - ANSWERS-Ask your supervisor or the licensed practitioner. What does the term ambulating mean? - ANSWERS-Walking What is the function of the tunica media? - ANSWERS-Dilate and constrict to maintain homeostasis What is the innermost layer of the coronary artery called? - ANSWERS-Tunica intima What is the function of the tunica intima? - ANSWERS-Come in direct contact with the blood Which layer of the coronary artery is prone to disruption when atherosclerotic plaque is ruptured and peels away? - ANSWERS-Tunica intima What is the term for an oppressive pain or pressure in the chest that occurs when the heart muscle does not receive enough oxygen due to partial or complete blockage of a coronary artery? - ANSWERS-Angina Which of the following conditions is not a common source of noncardiac chest pain? - ANSWERS-Cirrhosis of the liver Which of the following are not symptoms that may occur due to blockage of the coronary arteries? - ANSWERS-Edema and decreased urinary output Unstable angina is a warning sign that a patient's cardiac disease has ________. - ANSWERS- Worsened Which of the following are signs of unstable angina? - ANSWERS-Chest pain occurs for shorter periods but is more intense. Which three groups of patients may present with atypical cardiac complaints or problems? - ANSWERS-Women, the elderly, patients with diabetes Which of the following are common cardiac symptoms in women? - ANSWERS-Unusual fatigue and cold sweats What is the term for fatty deposits accumulated by elevated glucose levels? - ANSWERS- Atherosclerotic plaque What condition caused by chronic diabetes impairs sensations or causes a loss of sensation? - ANSWERS-Neuropathy Which of the following are not common cardiac symptoms in elderly patients? - ANSWERS- Hypertension and edema Which of the following is referred to as the "classic MI"? - ANSWERS-STEMI What causes STEMI? - ANSWERS-Complete occlusion of a coronary artery Which of the following changes does not typically occur in an ECG tracing with a STEMI? - ANSWERS-Absence of P waves What percentage of patients present with STEMI? - ANSWERS-75% to 80% Why does non-STEMI present a challenge to the health care team? - ANSWERS-The ECG tracing does not reflect ST segment deviation or presence of a pathologic Q wave. What is the term for inadequate flow of arterial blood, typically as a result of left ventricular failure? - ANSWERS-Cardiogenic shock What is the most common cause of heart failure? - ANSWERS-MI What is the term for an abnormal collection of fluid in the lungs due to left ventricular failure? - ANSWERS-Pulmonary edema Which of the following are not symptoms of left ventricular failure? - ANSWERS-Hypertension and increased thirst What three symptoms, when presented together, are known as the "clinical triad" and are indicative of right ventricular failure? - ANSWERS-Jugular vein distention, hypotension, and normal breath sounds The mnemonic O-P-Q-R-S-T helps health care professionals remember the questions to ask when evaluating which of the following? - ANSWERS-Pain or discomfort the patient is experiencing What is the S-A-M-P-L-E mnemonic used for? - ANSWERS-Gathering additional medical information Which procedure allows visualization of the coronary arteries and placement of a stent? - ANSWERS-Cardiac catheterization What is Coumadin used for? - ANSWERS-To reduce clot formation in the blood Which of the following is one reason heart disease is slightly more common in men than in women? - ANSWERS-Hormones produced during the childbearing years reduce the risk in women. What is the broad term that refers to STEMI, NSTEMI, and unstable angina? - ANSWERS-Acute coronary syndrome What is a typical cause of NSTEMI? - ANSWERS-An incomplete occlusion of a coronary artery