Telemetry in Healthcare, Exams of Nursing

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NUR 2243

Professional Nursing

Skills

COMPLETED EXAM w/

RATIONALES

1. Which of the following is the correct sequence of actions for performing high-quality CPR on an adult victim of cardiac arrest? A) Check for responsiveness, activate emergency response system, get AED, open airway, give 2 breaths, start chest compressions B) Check for responsiveness, open airway, give 2 breaths, start chest compressions, activate emergency response system, get AED C) Check for responsiveness, activate emergency response system, get AED, start chest compressions, open airway, give 2 breaths D) Check for responsiveness, start chest compressions, activate emergency response system, get AED, open airway, give 2 breaths Answer: D. The correct sequence of actions for performing high-quality CPR on an adult victim of cardiac arrest is CAB: Compressions-Airway-Breathing. The first step is to check for responsiveness and pulse. If the victim is unresponsive and has no pulse, start chest compressions immediately at a rate of 100-120 per minute and a depth of at least 2 inches. The second step is to activate the emergency response system and get an AED as soon as possible. The third step is to open the airway and give 2 breaths with a barrier device after every 30 compressions. The ratio of compressions to breaths is 30:2 for single rescuers and 15:2 for two rescuers.

Answer: D. CPR is the most appropriate initial treatment for a patient with pulseless electrical activity (PEA). PEA is a condition where there is electrical activity in the heart but no effective mechanical contraction or pulse. The causes of PEA are usually reversible and include hypovolemia, hypoxia, hydrogen ion (acidosis), hyperkalemia or hypokalemia, hypothermia, tension pneumothorax, tamponade (cardiac), toxins, thrombosis (pulmonary or coronary). The mnemonic Hs and Ts can help remember these causes. The treatment of PEA is to identify and treat the underlying cause while performing high-quality CPR and administering epinephrine every 3- 5 minutes. Defibrillation is not indicated for PEA because there is no shockable rhythm. Atropine is not indicated for PEA because it does not increase the contractility of the heart.

4. Which of the following is the most common cause of ventricular fibrillation (VF) in adults? A) Coronary artery disease B) Congenital heart disease C) Cardiomyopathy D) Electrolyte imbalance Answer: A. Coronary artery disease is the most common cause of ventricular fibrillation (VF) in adults. VF is a life- threatening arrhythmia where the ventricles quiver

chaotically instead of pumping blood effectively. The causes of VF include ischemia, infarction, reperfusion injury, electrolyte imbalance, drug toxicity, hypothermia, trauma, and electric shock. The treatment of VF is immediate defibrillation followed by CPR and administration of antiarrhythmic drugs such as amiodarone or lidocaine. Congenital heart disease, cardiomyopathy, and electrolyte imbalance are less common causes of VF in adults.

5. Which of the following signs indicates that a patient has a patent airway? A) Absence of stridor B) Presence of wheezes C) Absence of cyanosis D) Presence of cough Answer: A. Absence of stridor indicates that a patient has a patent airway. Stridor is a high-pitched sound that occurs when the upper airway is partially obstructed by swelling, inflammation, foreign body, or tumor. A patent airway is essential for effective ventilation and oxygenation. The assessment of airway patency includes looking for signs of obstruction such as stridor, snoring, gurgling, or use of accessory muscles. The management of airway obstruction includes opening the airway with head tilt-chin lift or jaw thrust maneuvers, removing the foreign body with finger

7. Which of the following is the most common complication of cardiopulmonary resuscitation (CPR)? A) Rib fractures B) Pneumothorax C) Liver laceration D) Spinal injury Answer: A. Rib fractures are the most common complication of cardiopulmonary resuscitation (CPR). CPR involves applying forceful chest compressions to maintain blood circulation in a cardiac arrest victim. Chest compressions can cause rib fractures, especially in elderly patients with osteoporosis or in patients with chest wall deformities. Rib fractures can lead to pain, bleeding, infection, or lung injury. Pneumothorax, liver laceration, and spinal injury are less common complications of CPR.
8. Which of the following is an indication for synchronized cardioversion? A) Ventricular fibrillation B) Ventricular tachycardia with pulse C) Asystole D) Pulseless electrical activity Answer: B. Ventricular tachycardia with pulse is an indication for synchronized cardioversion. Synchronized cardioversion is a procedure where an electric shock is

delivered to the heart in synchrony with the QRS complex on the electrocardiogram (ECG). The purpose of synchronized cardioversion is to terminate an abnormal rhythm and restore a normal sinus rhythm. Synchronized cardioversion is indicated for hemodynamically unstable tachyarrhythmias such as ventricular tachycardia with pulse, supraventricular tachycardia, atrial fibrillation, or atrial flutter. Ventricular fibrillation, asystole, and pulseless electrical activity are indications for unsynchronized defibrillation, which delivers an electric shock at any time during the cardiac cycle.

9. Which of the following is a contraindication for administering adenosine? A) Atrial fibrillation B) Sinus bradycardia C) Second-degree AV block type II D) Wolff-Parkinson-White syndrome Answer: D. Wolff-Parkinson-White syndrome is a contraindication for administering adenosine. Wolff- Parkinson-White syndrome is a condition where there is an accessory pathway between the atria and ventricles that bypasses the AV node. This can cause rapid and irregular heartbeats called paroxysmal supraventricular tachycardia (PSVT). Adenosine is a drug that slows down the conduction through the AV node and can be used to treat

2. Which of the following is an advantage of using telemetry in healthcare? a) Increased patient comfort and mobility b) Limited range of monitoring capabilities c) High cost of equipment and maintenance d) Inability to provide real-time data Answer: a) Increased patient comfort and mobility Rationale: With the use of telemetry, patients are not confined to their beds and can move freely while being continuously monitored. This improves patient comfort and allows for early mobility, which can aid in faster recovery.
3. Which body system is typically monitored using telemetry? a) Musculoskeletal system b) Gastrointestinal system c) Cardiovascular system d) Endocrine system Answer: c) Cardiovascular system Rationale: Telemetry is primarily used to monitor the cardiovascular system, including heart rate, rhythm, and EKG changes. This allows for prompt detection of any abnormalities, such as arrhythmias or ischemic events.

4. What technology is commonly used for the wireless transmission of telemetry data? a) Bluetooth b) Wi-Fi c) Infrared d) Radiofrequency Answer: d) Radiofrequency Rationale: Radiofrequency technology is commonly used for wireless telemetry transmission in healthcare settings. It allows for secure, reliable, and real-time data transmission between the patient and the monitoring station.
5. What is the purpose of telemetry alarms? a) To ensure patients remain immobile during monitoring b) To alert healthcare providers to monitored parameter deviations c) To prevent patients from tampering with monitoring equipment d) To track patients' physical activity levels Answer: b) To alert healthcare providers to monitored parameter deviations Rationale: Telemetry alarms are designed to notify healthcare providers when there are deviations from predetermined parameters, indicating potential issues that require attention. This enables timely interventions and

telemetry monitoring devices. They continuously record the electrical activity of the heart and transmit it wirelessly for interpretation.

8. Which of the following is an example of a telemetry monitoring technique used in critical care settings? a) Intracranial pressure monitoring b) Palpation of peripheral pulses c) Aspiration of pleural fluid d) Vital signs measurement with a manual sphygmomanometer Answer: a) Intracranial pressure monitoring Rationale: Intracranial pressure monitoring, commonly used in critical care settings, involves the placement of an invasive device to measure the pressure within the brain. This data can be telemetered to monitor any changes in intracranial pressure.
9. How can electronic health records (EHRs) be integrated with telemetry systems? a) EHRs allow healthcare providers to access telemetry data remotely b) EHRs eliminate the need for telemetry monitoring altogether c) EHRs can be used to adjust telemetry alarm settings

remotely d) EHRs have no connection with telemetry systems Answer: a) EHRs allow healthcare providers to access telemetry data remotely Rationale: Integration of EHRs with telemetry systems allows healthcare providers to view patients' telemetry data remotely, facilitating comprehensive patient care and timely decision-making.

10. What is the purpose of telemetry technicians in a healthcare setting? a) To perform invasive diagnostic procedures b) To provide patient education on telemetry monitoring c) To interpret telemetry data and notify healthcare providers of any abnormalities d) To handle administrative tasks and maintain telemetry equipment Answer: c) To interpret telemetry data and notify healthcare providers of any abnormalities Rationale: Telemetry technicians are responsible for interpreting telemetry data, recognizing abnormalities or critical events, and promptly notifying the appropriate healthcare providers for further management.

activity outside the healthcare facility Rationale: Telemetry monitoring with ambulatory patients allows healthcare providers to monitor their vital signs, cardiac activity, or specific parameters while the patients are outside the traditional healthcare setting, providing valuable data for diagnosis and treatment.

13. What is telemetry overreading? a) Transferring telemetry data to a cloud-based storage system b) Reviewing and interpreting telemetry data to provide additional insights or confirm findings c) Replacing wireless telemetry transmission with wired connections d) Using telemetry devices as an external defibrillator during cardiac arrests Answer: b) Reviewing and interpreting telemetry data to provide additional insights or confirm findings Rationale: Telemetry overreading involves the review and interpretation of telemetry data by a healthcare provider, such as a nurse or physician, to obtain additional insights or confirm preliminary findings before recommending interventions or treatment plans.

14. Which of the following situations would require immediate intervention based on telemetry monitoring? a) A heart rate of 70 beats per minute (bpm) in an adult at rest b) Temporary and brief loss of telemetry signal due to patient movement c) Slight ST segment elevation in a patient with known cardiac disease d) Ventricular tachycardia with hemodynamic instability Answer: d) Ventricular tachycardia with hemodynamic instability Rationale: Ventricular tachycardia, especially when associated with hemodynamic instability, requires immediate intervention and management to prevent further deterioration and potential cardiac arrest.
15. How does telemetry contribute to patient safety? a) By reducing the need for continuous patient monitoring b) By providing real-time identification of medication errors c) By eliminating the need for traditional physical examinations d) By allowing for early detection of adverse events or changes in patient conditions Answer: d) By allowing for early detection of adverse

Answer: A) Checking for a pulse Rationale: Checking for a pulse is a critical step in CPR to determine if the person's heart has stopped beating and if CPR is necessary. Question: What is the recommended compression rate for adult CPR? A) 60-80 compressions per minute B) 100-120 compressions per minute C) 140-160 compressions per minute D) 180-200 compressions per minute Answer: B) 100-120 compressions per minute Rationale: The recommended compression rate for adult CPR is 100-120 compressions per minute to maintain blood flow to vital organs. Question: During CPR, how should the chest compressions be performed on an adult? A) Using one hand only B) Using two fingers C) Using the heel of one hand D) Using the flat part of both hands Answer: D) Using the flat part of both hands Rationale: Chest compressions on an adult should be

performed using the flat part of both hands, with fingers interlocked. Question: What is the purpose of rescue breaths in CPR? A) To restore consciousness B) To relieve chest pain C) To maintain oxygen supply to the brain and vital organs D) To clear the airway of obstructions Answer: C) To maintain oxygen supply to the brain and vital organs Rationale: Rescue breaths in CPR are aimed at maintaining oxygen supply to the brain and vital organs when the person is not breathing normally. Question: When should an AED (Automated External Defibrillator) be used during CPR? A) Before starting chest compressions B) After administering rescue breaths C) As soon as it becomes available D) Only if the person is under 40 years old Answer: C) As soon as it becomes available Rationale: An AED should be used as soon as it becomes available to deliver an electric shock to the heart and