Cardiac
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. A nurse assesses a client’s electrocardiograph tracing and observes that not all QRS complexes are
preced
...
Cardiac
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. A nurse assesses a client’s electrocardiograph tracing and observes that not all QRS complexes are
preceded by a P wave. How should the nurse interpret this observation?
a. The client has hyperkalemia causing irregular QRS complexes.
b. Ventricular tachycardia is overriding the normal atrial rhythm.
c. The client’s chest leads are not making sufficient contact with the skin.
d. Ventricular and atrial depolarizations are initiated from different sites.
____ 2. A nurse is assessing clients on a medical-surgical unit. Which client should the nurse identify as
being at greatest risk for atrial fibrillation?
a. A 45-year-old who takes an aspirin daily
b. A 50-year-old who is post coronary artery bypass graft surgery
c. A 78-year-old who had a carotid endarterectomy
d. An 80-year-old with chronic obstructive pulmonary disease
____ 3. A nurse assesses a client with atrial fibrillation. Which manifestation should alert the nurse to the
possibility of a serious complication from this condition?
a. Sinus tachycardia
b. Speech alterations
c. Fatigue
d. Dyspnea with activity
____ 4. A nurse evaluates prescriptions for a client with chronic atrial fibrillation. Which medication
should the nurse expect to find on this client’s medication administration record to prevent a
common complication of this condition?
a. Sotalol (Betapace)
b. Warfarin (Coumadin)
c. Atropine (Sal-Tropine)
d. Lidocaine (Xylocaine)
____ 5. A nurse cares for a client with an intravenous temporary pacemaker for bradycardia. The nurse
observes the presence of a pacing spike but no QRS complex on the client’s electrocardiogram.
Which action should the nurse take next?
a. Administer intravenous diltiazem (Cardizem).
b. Assess vital signs and level of consciousness.
c. Administer sublingual nitroglycerin.
d. Assess capillary refill and temperature.
____ 6. A nurse prepares to defibrillate a client who is in ventricular fibrillation. Which priority
intervention should the nurse perform prior to defibrillating this client?
a. Make sure the defibrillator is set to the synchronous mode.
b. Administer 1 mg of intravenous epinephrine.
c. Test the equipment by delivering a smaller shock at 100 joules.
d. Ensure that everyone is clear of contact with the client and the bed.
____ 7. After teaching a client who has an implantable cardioverter-defibrillator (ICD), a nurse assesses
the client’s understanding. Which statement by the client indicates a correct understanding of the
teaching?
a. “I should wear a snug-fitting shirt over the ICD.”
b. “I will avoid sources of strong electromagnetic fields.”
c. “I should participate in a strenuous exercise program.”
d. “Now I can discontinue my antidysrhythmic medication.”
____ 8. A nurse assists with the cardioversion of a client experiencing acute atrial fibrillation. Which
action should the nurse take prior to the initiation of cardioversion?
a. Administer intravenous adenosine.
b. Turn off oxygen therapy.
c. Ensure a tongue blade is available.
d. Position the client on the left side.
____ 9. A nurse assesses a client with tachycardia. Which clinical manifestation requires immediate
intervention by the nurse?
a. Mid-sternal chest pain
b. Increased urine output
c. Mild orthostatic hypotension
d. P wave touching the T wave
____ 10. A nurse teaches a client who experiences occasional premature atrial contractions (PACs)
accompanied by palpitations that resolve spontaneously without treatment. Which statement
should the nurse include in this client’s teaching?
a. “Minimize or abstain from caffeine.”
b. “Lie on your side until the attack subsides.”
c. “Use your oxygen when you experience PACs.”
d. “Take amiodarone (Cordarone) daily to prevent PACs.”
____ 11. A nurse assesses a client’s electrocardiogram (ECG) and observes the reading shown below:
How should the nurse document this client’s ECG strip?
a. Ventricular tachycardia
b. Ventricular fibrillation
c. Sinus rhythm with premature atrial contractions (PACs)
d. Sinus rhythm with premature ventricular contractions (PVCs)
____ 12. A nurse cares for a client who is on a cardiac monitor. The monitor displayed the rhythm shown
below:
Which action should the nurse take first?
a. Assess airway, breathing, and level of consciousness.
b. Administer an amiodarone bolus followed by a drip.
c. Cardiovert the client with a biphasic defibrillator.
d. Begin cardiopulmonary resuscitation (CPR).
____ 13. The nurse is caring for a client on the medical-surgical unit who suddenly becomes unresponsive
and has no pulse. The cardiac monitor shows the rhythm below:
After calling for assistance and a defibrillator, which action should the nurse take next?
a. Perform a pericardial thump.
b. Initiate cardiopulmonary resuscitation (CPR).
c. Start an 18-gauge intravenous line.
d. Ask the client’s family about code status.
____ 14. A nurse assesses clients on a cardiac unit. Which client should the nurse identify as being at
greatest risk for the development of left-sided heart failure?
a. A 36-year-old woman with aortic stenosis
b. A 42-year-old man with pulmonary hypertension
c. A 59-year-old woman who smokes cigarettes daily
d. A 70-year-old man who had a cerebral vascular accident
____ 15. A nurse assesses a client in an outpatient clinic. Which statement alerts the nurse to the possibility
of left-sided heart failure?
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