Cardio

A nurse is assessing an electrocardiogram rhythm strip. The P waves and QRS

complexes are regular. The PR interval is 0.16 second, and QRS complexes measure
0.06 second. The overall heart rate is 64 beats per minute. The nurse assesses the
cardiac rhythm as:

A. Normal sinus rhythm B. Sinus bradycardia C. Sick sinus syndrome D. First-degree

heart block

2. Question
A nurse notices frequent artifacts on the ECG monitor for a client whose leads are
connected by cable to a console at the bedside. The nurse examines the client to
determine the cause. Which of the following items is unlikely to be responsible for
the artifact?

A. Frequent movement of the client. B. Tightly secured cable connections. C. Leads

applied over hairy areas. D. Leads applied to the limbs.

3. Question
A nurse is watching the cardiac monitor and notices that the rhythm suddenly
changes. There are no P waves, the QRS complexes are wide, and the ventricular rate
is regular but over 100. The nurse determines that the client is experiencing:

A. Premature ventricular contractions B. Ventricular tachycardia C. Ventricular

fibrillation D. Sinus tachycardia

4. Question
A nurse is viewing the cardiac monitor in a client’s room and notes that the client
has just gone into ventricular tachycardia. The client is awake and alert and has
good skin color. The nurse would prepare to do which of the following?

A. Immediately defibrillate. B. Prepare for pacemaker insertion. C. Administer

amiodarone (Cordarone) intravenously. D. Administer epinephrine (Adrenaline)
intravenously.

5. Question
A nurse is caring for a client with unstable ventricular tachycardia. The nurse
instructs the client to do which of the following, if prescribed, during an episode
of ventricular tachycardia?

A. Breathe deeply, regularly, and easily. B. Inhale deeply and cough forcefully
every 1 to 3 seconds. C. Lie down flat in bed. D. Remove any metal jewelry.

6. Question
A client is having frequent premature ventricular contractions. A nurse would place
a priority on the assessment of which of the following items?

A. Blood pressure and peripheral perfusion. B. Sensation of palpitations. C.

Causative factors such as caffeine. D. Precipitating factors such as infection.

7. Question
A client has developed atrial fibrillation, which has a ventricular rate of 150
beats per minute. A nurse assesses the client for:

A. Hypotension and dizziness B. Nausea and vomiting C. Hypertension and headache D.

Flat neck veins

8. Question
A nurse is watching the cardiac monitor, and a client’s rhythm suddenly changes.
There are no P waves; instead, there are wavy lines. The QRS complexes measure 0.08
second, but they are irregular, with a rate of 120 beats a minute. The nurse
interprets this rhythm as:

A. Sinus tachycardia B. Atrial fibrillation C. Ventricular tachycardia D.

Ventricular fibrillation

9. Question
A client with rapid rate atrial fibrillation asks a nurse why the physician is
going to perform carotid massage. The nurse responds that this procedure may
stimulate the:

A. Vagus nerve to slow the heart rate. B. Vagus nerve to increase the heart rate;
overdriving the rhythm. C. Diaphragmatic nerve to slow the heart rate. D.
Diaphragmatic nerve to overdrive the rhythm.

10. Question
A nurse notes that a client with sinus rhythm has a premature ventricular
contraction that falls on the T wave of the preceding beat. The client’s rhythm
suddenly changes to one with no P waves or definable QRS complexes. Instead, there
are coarse wavy lines of varying amplitude. The nurse assesses this rhythm to be:

A. Ventricular tachycardia B. Ventricular fibrillation C. Atrial fibrillation D.

Asystole

11. Question
While caring for a client who has sustained an MI, the nurse notes eight PVCs in
one minute on the cardiac monitor. The client is receiving an IV infusion of D5W
and oxygen at 2 L/minute. The nurse’s first course of action should be to:

A. Increase the IV infusion rate. B. Notify the physician promptly. C. Increase the
oxygen concentration. D. Administer a prescribed analgesic.

12. Question
The adaptations of a client with complete heart block would most likely include:

A. Nausea and vertigo B. Flushing and slurred speech C. Cephalalgia and blurred
vision D. Syncope and slow ventricular rate

13. Question
A client with a bundle branch block is on a cardiac monitor. The nurse should
expect to observe:

A. Sagging ST segments. B. Absence of P wave configurations. C. Inverted T waves

following each QRS complex. D. Widening of QRS complexes to 0.12 second or greater.

14. Question
When ventricular fibrillation occurs in a CCU, the first person reaching the client
should:

A. Administer oxygen. B. Defibrillate the client. C. Initiate CPR. D. Administer

sodium bicarbonate intravenously.

15. Question
What criteria should the nurse use to determine normal sinus rhythm for a client on
a cardiac monitor? Select all that apply.

A. The RR intervals are relatively consistent. B. One P wave precedes each QRS
complex. C. Four to eight complexes occur in a 6-second strip. D. The ST segment is
higher than the PR interval. E. The QRS complex ranges from 0.12 to 0.20 second.

16. Question
When auscultating the apical pulse of a client who has atrial fibrillation, the
nurse would expect to hear a rhythm that is characterized by:

A. The presence of occasional coupled beats. B. Long pauses in an otherwise regular

rhythm. C. A continuous and totally unpredictable irregularity. D. Slow but strong
and regular beats.

17. Question
Atherosclerosis impedes coronary blood flow by which of the following mechanisms?

A. Plaques obstruct the vein. B. Plaques obstruct the artery. C. Blood clots form
outside the vessel wall. D. Hardened vessels dilate to allow blood to flow through.

18. Question
A paradoxical pulse occurs in a client who had a coronary artery bypass graft
(CABG) surgery two (2) days ago. Which of the following surgical complications
should the nurse suspect?

A. Left-sided heart failure B. Aortic regurgitation C. Complete heart block D.

Pericardial tamponade

19. Question
After cardiac surgery, a client’s blood pressure measures 126/80. The nurse
determines that the mean arterial pressure (MAP) is which of the following?

A. 46 mm Hg B. 80 mm Hg C. 95 mm Hg D. 90 mm Hg

20. Question
A woman with severe mitral stenosis and mitral regurgitation has a pulmonary artery
catheter inserted. The physician orders pulmonary artery pressure monitoring,
including pulmonary capillary wedge pressures. The purpose of this is to help
assess the:

A. Degree of coronary artery stenosis. B. Peripheral arterial pressure. C. Pressure

from fluid within the left ventricle. D. Oxygen and carbon dioxide concentration is
the blood.