Ch. 26 NCLEX Style Questions

Ch. 26 NCLEX Style Questions ScienceMedicineCardiology Sarah_Pantanella Save NCLEX cardiac questions 64 terms brittanyadcock Preview Ch. 5 Hemodynamics NCLEX Questi...30 terms kimnunez2022 Preview EKG NCLEX Questions

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carterknw503Preview ICP Nc 120 term Ma The nurse is caring for a patient who has had an ECG. The nurse notes that leads I, II, and III differ from one another on the cardiac rhythm strip.How should the nurse best respond?

• Recognize that the view of the electrical current changes in relation to the lead placement.
• Recognize that the electrophysiological conduction of the heart differs with lead placement.
• Inform the technician that the ECG equipment has malfunctioned.
• Inform the physician that the patient is experiencing a new onset of dysrhythmia.

A - Each lead offers a different reference point to view the electrical activity of the heart. The lead displays the configuration of electrical activity of the heart. Differences between leads are not necessarily attributable to equipment malfunction or dysrhythmias.The nursing educator is presenting a case study of an adult patient who has abnormal ventricular depolarization. This pathologic change would be most evident in what component of the ECG?

• P wave
• T wave
• QRS complex
• U wave

C QRS complex represents ventricular depolarization (contraction).

The nurse is analyzing a rhythm strip. What component of the ECG corresponds to the resting state of the patient's heart?

• P wave
• T wave
• U wave
• QRS complex

B The T wave specifically represents ventricular muscle repolarization, also referred to as the resting state. Ventricular muscle depolarization does not result in the P wave, U wave, or QRS complex.Also could deduce because P = atrial contraction (depolarization), QRS = ventricular contraction (depolarization) and some pts don't have a U wave (heart has to rest at some point or it will fail and go into asystole).An adult patient with third-degree AV block is admitted to the cardiac care unit and placed on continuous cardiac monitoring. What rhythm characteristic will the ECG most likely show?

• PP interval and RR interval are irregular.
• PP interval is equal to RR interval.
• Fewer QRS complexes than P waves
• PR interval is constant.

C If Ps and Qs don't agree, then you have a THIRD DEGREE.In third degree heart block, there are more P waves than QRS complexes. No atrial impulse is being conducted through the AV node into the

ventricles. There are two separate impulses:

--1 stimulates the atria (before P wave) --1 stimulates the ventricles (before QRS) Gives the illusion that there are more P waves than QRS segments.The nurse is writing a plan of care for a patient with a cardiac dysrhythmia. What would be the most appropriate goal for the patient?

• Maintain a resting heart rate below 70 bpm.
• Maintain adequate control of chest pain.
• Maintain adequate cardiac output.
• Maintain normal cardiac structure.

C For patient safety, the most appropriate goal is to MAINTAIN CARDIAC OUTPUT to prevent worsening complications as a result of decreased cardiac output.A resting rate of less than 70 bpm is not appropriate for every patient. Chest pain is more closely associated with acute coronary syndrome than with dysrhythmias. Nursing actions cannot normally influence the physical structure of the heart.

A patient has returned to the cardiac care unit after having a permanent pacemaker implantation. For which potential complication should the nurse most closely assess this patient?

• Chest pain
• Bleeding at the implantation site
• Malignant hyperthermia
• Bradycardia

B Bleeding, hematomas, local infections, perforation of the myocardium, and tachycardia are complications of pacemaker implantations.The nurse should monitor for chest pain and bradycardia, but bleeding is a more common immediate complication.Malignant hyperthermia is unlikely because it is a response to anesthesia administration.A patient the nurse is caring for has a permanent pacemaker implanted with the identification code beginning with VVI. What does this indicate?

• Ventricular paced, ventricular sensed, inhibited
• Variable paced, ventricular sensed, inhibited
• Ventricular sensed, ventricular situated, implanted
• Variable sensed, variable paced, inhibited

A The nurse is caring for an adult patient who has gone into ventricular fibrillation. When assisting with defibrillating the patient, what must the nurse do?

• Maintain firm contact between paddles and patient skin.
• Apply a layer of water as a conducting agent.
• Call "all clear" once before discharging the defibrillator.
• Ensure the defibrillator is in the sync mode.

A When defibrillating an adult patient, the nurse should maintain good contact between the paddles and the patient's skin to prevent arcing, apply an appropriate conducting agent (not water) between the skin and the paddles, and ensure the defibrillator is in the nonsync mode. "Clear" should be called three times before discharging the paddles.A patient who is a candidate for an implantable cardioverter defibrillator (ICD) asks the nurse about the purpose of this device. What would be the nurse's best response?

• "To detect and treat dysrhythmias such as ventricular fibrillation and ventricular tachycardia"
• "To detect and treat bradycardia, which is an excessively slow heart rate"
• "To detect and treat atrial fibrillation, in which your heart beats too quickly and inefficiently"
• "To shock your heart if you have a heart attack at home"

A AICDs defibrillate the heart when it goes into pVT or VF.Pacemakers are used to treat bradycardia.

A nurse is providing health education to a patient scheduled for cryoablation therapy. The nurse should describe what aspect of this treatment?

• Peeling away the area of endocardium responsible for the dysrhythmia
• Using electrical shocks directly to the endocarduim to eliminate the source of dysrhythmia
• Using high-frequency sound waves to eliminate the source of dysrhythmia
• Using a cooled probe to eliminate the source of dysrhythmia

D Cryoablation therapy involves using a cooled probe to create a small scar on the endocardium to eliminate the source of the dysrhythmias.Endocardium resection involves peeling away a specified area of the endocardium.Electrical ablation involves using shocks to eliminate the area causing the dysrhythmias.Radio frequency ablation uses high-frequency sound waves to destroy the area causing the dysrhythmias.The nurse is caring for a patient who has just had an implantable cardioverter defibrillator (ICD) placed. What is the priority area for the nurse's assessment?

• Assessing the patient's activity level
• Facilitating transthoracic echocardiography
• Vigilant monitoring of the patient's ECG
• Close monitoring of the patient's peripheral perfusion

C After a permanent electronic device (pacemaker or ICD) is inserted, the patient's heart rate and rhythm are monitored by ECG. This is a priority over peripheral circulation and activity. Echocardiography is not indicated.During a patient's care conference, the team is discussing whether the patient is a candidate for cardiac conduction surgery. What would be the most important criterion for a patient to have this surgery?

• Angina pectoris not responsive to other treatments
• Decreased activity tolerance related to decreased cardiac output
• Atrial and ventricular tachycardias not responsive to other treatments
• Ventricular fibrillation not responsive to other treatments

C Cardiac conduction surgery is considered in patients who do not respond to medications and antitachycardia pacing. Angina, reduced activity tolerance, and ventricular fibrillation are not criteria.