Cardio DrillCardio Drill

• 1. While caring for client who sustained an 1. While caring for client who sustained an MI, the nurse notes eight premature MI, the nurse notes eight premature ventricular contractions (PVC’s) in one ventricular contractions (PVC’s) in one minute on the cardiac monitor. The client is minute on the cardiac monitor. The client is receiving an intravenous infusion of 5% receiving an intravenous infusion of 5% dextrose in water and 2 liters/minute of dextrose in water and 2 liters/minute of oxygen. The nurse’s first course of action oxygen. The nurse’s first course of action should be toshould be to

• A. increase the intravenous infusion rateA. increase the intravenous infusion rate• B. notify the physician promptlyB. notify the physician promptly• C. increase the oxygen concentrationC. increase the oxygen concentration• D. administer a prescribed analgesicD. administer a prescribed analgesic

• 2. The priority nursing 2. The priority nursing diagnosis for the client with diagnosis for the client with dysrhythmias is:dysrhythmias is:

• a. decreased tissue a. decreased tissue perfusionperfusion

• b. decreased cardiac outputb. decreased cardiac output• c. alteration in comfortc. alteration in comfort• d. activity intoleranced. activity intolerance

• 3. Which of the following is 3. Which of the following is true of cardioversion?true of cardioversion?

• a. it is done to revert cardiac a. it is done to revert cardiac arrestarrest

• b. the electric shock is applied b. the electric shock is applied during the R waveduring the R wave

• c. it involves unsynchronized c. it involves unsynchronized application of electric shock to application of electric shock to the heartthe heart

• d. it is done on the T waved. it is done on the T wave

• 4. Which of the following 4. Which of the following terms is used to describe the terms is used to describe the ability of cardiac muscle to ability of cardiac muscle to initiate an electrical impulse?initiate an electrical impulse?

• a. ablationa. ablation• b. conductivityb. conductivity• c. automaticity c. automaticity • d. repolarizationd. repolarization

• 5.5. Which of the following Which of the following is the DOC to reduce is the DOC to reduce PVCs during an MI?PVCs during an MI?

• a)a) Digoxin (Lanoxin)Digoxin (Lanoxin)• b)b) Lidocaine (Xylocaine)Lidocaine (Xylocaine)• c)c) Phenytoin (Dilantin)Phenytoin (Dilantin)• d)d) Procainamide Procainamide

(Pronestyl)(Pronestyl)

• 6. What is also known 6. What is also known as AV dissociation?as AV dissociation?

• A. 1st degree AV blockA. 1st degree AV block• B. mobitz type 1B. mobitz type 1• C. mobitz type 2C. mobitz type 2• D. 3rd degree AV blockD. 3rd degree AV block

• 7.7. The most accurate The most accurate diagnostic test for infective diagnostic test for infective endocarditis is:endocarditis is:

• A.A. ECG ECG• B.B. Cardiac catheterization Cardiac catheterization • C. Blood cultureC. Blood culture• D. ArteriographyD. Arteriography

• 8.8. A patient who is at risk A patient who is at risk for infective endocarditis for infective endocarditis requires prophylactic antibiotic requires prophylactic antibiotic therapy before undergoing therapy before undergoing which of the following?which of the following?

• A.A. ECG ECG• B.B. Dental procedures Dental procedures • C. X-rayC. X-ray• D. ExercisingD. Exercising

• 9.9. While interviewing the patient, you know While interviewing the patient, you know that which of the following findings put the that which of the following findings put the patient at risk for developing endocarditis?patient at risk for developing endocarditis?

• A.A. The patient candidly states that she The patient candidly states that she engages in premarital sex with her boyfriendengages in premarital sex with her boyfriend

• B.B. The patient’s father is currently on short The patient’s father is currently on short course chemotherapy for TBcourse chemotherapy for TB

• C.C. The patient admits that she occasionally The patient admits that she occasionally engages in the use of illicit intravenous drugsengages in the use of illicit intravenous drugs

• D.D. The patient has a history of heart The patient has a history of heart disease in the familydisease in the family

• 10.10. Which finding should the Which finding should the nurse report promptly to the nurse report promptly to the physician?physician?

• A.A. Patient complained of Patient complained of involuntary muscle spasmsinvoluntary muscle spasms

• B.B. New heart murmurs heard on New heart murmurs heard on auscultationauscultation

• C.C. Sudden appearance of rash Sudden appearance of rash on the upper armson the upper arms

• D.D. Patient complained of painful Patient complained of painful jointsjoints

• 11.Caused by accumulation of 11.Caused by accumulation of fluid in the pericardium which fluid in the pericardium which causes compression of the causes compression of the heart and restriction of blood heart and restriction of blood flow in and out of the ventricles.flow in and out of the ventricles.

• a. Pericarditisa. Pericarditis• b. Cardiac tamponadeb. Cardiac tamponade• c. Myocarditisc. Myocarditis• d. Infective Endocarditisd. Infective Endocarditis

• 12. Pericardiocentesis is 12. Pericardiocentesis is performed on a patient with performed on a patient with cardiac tamponade. This cardiac tamponade. This procedure would be deemed procedure would be deemed effective if: effective if:

– A. Aspirated blood clots rapidlyA. Aspirated blood clots rapidly– B. Dyspnea is relievedB. Dyspnea is relieved– C. Blood pressure increasesC. Blood pressure increases– D. Heart sounds become muffledD. Heart sounds become muffled

• 13.A client with a prescription of 13.A client with a prescription of sodium warfarin (Coumadin) sodium warfarin (Coumadin) should be given the following should be given the following instructions, except:instructions, except:

• A.A. Check for bleeding Check for bleeding• B.B. Eat green leafy vegetables Eat green leafy vegetables

once a weekonce a week• C.C. Inject the drug Inject the drug

subcutaneously onlysubcutaneously only• D.D. Avoid engaging in contract Avoid engaging in contract

sports or using power toolssports or using power tools

• 14.14. A diabetic taking beta blockers A diabetic taking beta blockers should be instructed to:should be instructed to:

• A.A. Increase insulin dosage Increase insulin dosage because hyperglycemia is a side because hyperglycemia is a side effecteffect

• B.B. Reduce physical activity to Reduce physical activity to reduce cardiac workloadreduce cardiac workload

• C.C. Monitor blood glucose more Monitor blood glucose more frequently for hypoglycemiafrequently for hypoglycemia

• D.D. Check blood pressure before Check blood pressure before taking the next dose of the drugtaking the next dose of the drug

• 15.15. A hospitalized patient with angina A hospitalized patient with angina complained of chest pain to the nurse. complained of chest pain to the nurse. What should the nurse do?What should the nurse do?

• A.A. Administer oxygen by mask and Administer oxygen by mask and give patient morphine sulfategive patient morphine sulfate

• B.B. Call the physician and prepare for Call the physician and prepare for CPRCPR

• C.C. Give patient nitroglycerin tablet Give patient nitroglycerin tablet and let patient restand let patient rest

• D.D. Place patient on semi-fowler’s Place patient on semi-fowler’s position and administer oxygenposition and administer oxygen

• 16. When monitoring a client who is 16. When monitoring a client who is receiving tissue plasminogen receiving tissue plasminogen activator the nurse understands it is activator the nurse understands it is important to monitor vital signs and important to monitor vital signs and have resuscitation equipment have resuscitation equipment available because reperfusion of the available because reperfusion of the cardiac tissue can result in which of cardiac tissue can result in which of the following?the following?

• A. hypertensionA. hypertension• B. seizureB. seizure• C. cardiac dysrhythmiasC. cardiac dysrhythmias• D. hypothermiaD. hypothermia

• 17. The nursing management of a 17. The nursing management of a client with acute CHF will include client with acute CHF will include all of the following all of the following ExceptExcept::

• A.A. Improving cardiac output Improving cardiac output• B.B. Increasing urine production Increasing urine production • C. Reducing the heart’s workloadC. Reducing the heart’s workload• D. Decreasing myocardial D. Decreasing myocardial

contractilitycontractility

• 18. An exercise program is prescribed for 18. An exercise program is prescribed for the client with HPN. Which intervention the client with HPN. Which intervention would be most likely to assist the client in would be most likely to assist the client in maintaining an exercise program?maintaining an exercise program?

• A. giving the client a written exercise A. giving the client a written exercise programprogram

• B. explaining the exercise program to the B. explaining the exercise program to the clients spouseclients spouse

• C. reassuring the client that he or she C. reassuring the client that he or she can do the exercise programcan do the exercise program

• D. tailoring a program to the clients D. tailoring a program to the clients needs and abilitiesneeds and abilities

• 19. The nurse understands 19. The nurse understands that a priority nursing that a priority nursing diagnosis for the client with diagnosis for the client with HPN would be;HPN would be;

• A. PainA. Pain• B. Deficient fluid volumeB. Deficient fluid volume• C. Impaired skin integrityC. Impaired skin integrity• D. Ineffective health D. Ineffective health

maintenancemaintenance

• 20. The most important long 20. The most important long term goal for a client with HPN term goal for a client with HPN would be to:would be to:

• A. Learn how to avoid stressA. Learn how to avoid stress• B. Explore a job change or B. Explore a job change or

early retirementearly retirement• C. Make a commitment to long C. Make a commitment to long

term therapyterm therapy• D. Lose weightD. Lose weight

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