Deck 30: Nursing Care of People With Cardiac Disorders

Question 1

The person has a pacemaker with one pacing spike seen on the ECG before every QRS complex. There is no change in the pacemaker rhythm over time, with rest or with activity. What type of pacemaker is this?

A)Atrial single-chamber pacing.
B)Asynchronous pacing.
C)Demand pacing.
D)Dual-chamber pacing.

Answer 1

Asynchronous pacing.

Question 2

The following persons come to the outpatient clinic for a physical exam. Which person has signs and symptoms of hypertension that require further assessment?

A)A 30-year-old Asian female with a blood pressure of 118/70.
B)A 48-year-old Caucasian male with a blood pressure of 138/86.
C)A 55-year-old indigenous Australian male with a blood pressure of 120/100.
D)A 60-year-old indigenous Australian female with a blood pressure of 135/65.

Answer 2

A 55-year-old indigenous Australian male with a blood pressure of 120/100.

Question 3

The nurse is caring for an adult who is admitted with chest pain that began four hours ago. Which of the following tests will be most specific in identifying acute heart damage?

A)CK-MB.
B)BUN.
C)Troponin.
D)CK.

Answer 3

Troponin.

Question 4

Sinus bradycardia (rate 56)is identified in a sleeping person on telemetry. What is the nursing priority for this person?

A)Check the medication administration record to see if a drug is ordered PRN that will help slow the heart rate.
B)Perform an immediate 12-lead ECG.
C)Call the doctor and report the dysrhythmia.
D)Awaken the person and see how the heart rate responds.

Question 5

What should a person who is taking a statin medication be monitored for?

A)Blood urea nitrogen and serum creatinine levels.
B)Constipation and sudden back pain.
C)Blood glucose and uric acid levels.
D)Serum cholesterol and liver enzymes.

Question 6

Cardiovascular heart disease (CHD)is a large problem in Australia. Persons with which of the following may require closer evaluation for CHD? (Select all that apply.)

A)Low HDL cholesterol.
B)Physical inactivity.
C)Diabetes.
D)Hypotension.

Question 7

The person has a pacemaker that creates a pacer spike before each QRS on the ECG when the intrinsic heart rate falls below 70. What is the significance of this? It is:

A)abnormal, because the asynchronous pacemaker is not maintaining the heart rate.
B)normal, because the asynchronous pacemaker is responding to the heart rate change as designed.
C)normal, because the demand pacemaker is responding to the heart rate drop at the preset level.
D)abnormal, because the demand pacemaker is not effectively pacing both the atria and ventricle.

Question 8

What are the appropriate nursing interventions for a person in sinus tachycardia? (Select all that apply.)

A)Observe the person for effects on cardiac function.
B)Administer isoprenaline IV push to halt the tachycardia.
C)Administer two tablets of paracetamol per doctor's order if an elevated temperature is present.
D)Administer normal saline 0.9% IV at 200 ml per hour if hypovolaemia is suspected as the cause.

Question 9

A person is commenced on a diet consisting of foods high in complex carbohydrates and fibre, low in cholesterol and low in fat. What else should the program also include?

A)Exercising three times a week for 30 minutes and eat only organic foods.
B)Supervised exercise twice a week and a daily multivitamin.
C)Vigorous aerobic exercise daily for 30 minutes and eat only organic foods.
D)Walking 45 minutes most days of the week.

Question 10

When teaching about metabolic syndrome, what is the most accurate information for the nurse to explain?

A)'This syndrome is not a concern for females unless they smoke.'
B)'This syndrome can be avoided by taking daily vitamins and drinking two litres of water a day.'
C)'This syndrome affects only older adults.'
D)'This syndrome is caused by overweight, physical inactivity and genetic factors.'

Question 11

The nurse realises that the person in the critical care unit with ventricular tachycardia will require which of the following? (Select all that apply.)

A)Immediate assessment and probable emergency intervention by the nurse.
B)Cardioversion, if sustained and symptomatic.
C)Close monitoring of vital observations prior to calling the doctor.
D)Defibrillation to convert the rhythm in the conscious person.

Question 12

The nurse notes an ECG rhythm with a rate of 80, a regular rhythm, a 1:1 relationship of P:QRS, a PR interval of 0.16 and a QRS complex measurement of 0.8. The nurse realises that this rhythm is evidence of which condition?

A)Paroxysmal supraventricular rhythm.
B)Normal sinus rhythm.
C)First-degree AV block.
D)Sinus tachycardia.

Question 13

The term 'pacemaker noncapture' requires the nurse to do the following: (Select all that apply.)

A)assess the person to determine their response to the pacemaker noncapture.
B)contact the doctor and describe what is documented on the ECG strip.
C)document the event by printing an ECG strip and making it part of the person's record.
D)administer glyceryl trinitrate sublingual stat.

Question 14

Which of the following statements is true about medications used to treat hyperlipidaemia? They:

A)include nicotinic acid as a first-line drug to lower cholesterol levels.
B)include statins, which act by lowering LDL levels.
C)do not include angiotensin-converting enzyme inhibitors.
D)act by increasing the LDL levels and decreasing the HDL levels.

Question 15

A nurse is teaching a group about risk factor management for cardiovascular heart disease at a senior citizens centre. What is the most important information for the nurse to include?

A)Stop smoking.
B)Drink in moderation.
C)Exercise when able.
D)Reduce the amount of salt in the diet.

Question 16

The nurse is caring for a person who develops atrial fibrillation with a heart rate above 100 beats per minute. Place the following nursing actions in sequence from the highest priority to the lowest priority:
1) check the patency of an intermittent IV.
2) assess the person for comfort level and vital signs.
3) call the doctor to report the dysrhythmia.
4) check the person's chart for laboratory results from today's tests.

Question 17

A person has a junctional escape rhythm. What is the priority care for this individual?

A)Assess the person for symptoms associated with the rhythm.
B)Prepare for a pacemaker insertion.
C)Eliminate caffeine from the diet.
D)Anticipate the need for cardioversion.

Question 18

When a person's ECG shows frequent premature ventricular contractions (PVCs), the nurse expects that the doctor will create an order for which of the following? (Select all that apply.)

A)Oxygen.
B)Anginine.
C)Beta-blockers.
D)Antiarrhythmic agents.

Question 19

Which of the following is correct for a 52-year-old obese male who is admitted with elevated triglycerides and a history of smoking two packs of cigarettes a day for 20 years? He:

A)possesses all non-modifiable risk factors for coronary artery disease that cannot be overcome.
B)possesses all modifiable risk factors for coronary artery disease that can be overcome.
C)is at high risk of coronary artery disease.
D)is not at an increased risk of coronary artery disease.

Question 20

The nurse is assessing a person who presents with chest pain. The person has been previously diagnosed with chest pain and now reports an increase in the frequency and duration of the chest pain. What is appropriate nursing care for this type of chest pain?

A)Aspirin 100 mg a day per the medical order.
B)Atropine 0.4 mg IVI.
C)Bed rest with toilet privileges.
D)Mylanta 30 ml as needed.