Deck 13: Ambulatory Monitoring

Question 1

Which type of monitoring device can hold up to 96 hours of data and allows licensed practitioners to capture significant cardiac events even when the patient is not experiencing symptoms?

A)Loop recorder
B)MCOT device
C)Symptom event monitor
D)Holter monitor

Answer 1

MCOT device

Question 2

What is another term for loss of consciousness (fainting)?

A)Cyanosis
B)Asystole
C)Syncope
D)Apnea

Answer 2

Syncope

Question 3

As a health care professional, your responsibilities with the ambulatory monitor include which of the following?

A)Purchasing the equipment
B)Applying and removing the monitor
C)Interpreting the results of the monitoring
D)Explaining the test results to the patient

Answer 3

Applying and removing the monitor

Question 4

Which of the following is an instrument that records the electrical activity of the heart during a patient's normal daily activities?

A)Exercise electrocardiograph
B)Ambulatory monitor
C)Pacemaker
D)Single-channel recorder

Question 5

Which of the following is not a reason to use an ambulatory monitor?

A)To evaluate the effectiveness of cardiac medications
B)To evaluate artificial pacemaker functioning
C)To evaluate oxygen utilization by the myocardium
D)To evaluate the function of the heart after a recent myocardial infarction

Question 6

Which patient will be asked to keep a diary?

A)Mr. Abram, who is complaining of chest discomfort and is having an ECG
B)Ms. Fisher, whose physician ordered Holter monitoring this morning
C)Mr. Evans, who is on telemetry
D)Mrs. Jones, who is scheduled for a stress test

Question 7

Which type of ambulatory monitoring requires the patient to keep a diary of all daily activities, abnormal experiences, and symptoms?

A)Loop recorder
B)MCOT device
C)Symptom event monitor
D)Holter monitor

Question 8

Why might ambulatory monitoring be used in addition to 12-lead ECG monitoring?

A)The patient requested the additional testing.
B)The 12-lead ECG results showed a serious heart condition.
C)The patient was complaining of palpitations but did not have any symptoms during the 12-lead ECG.
D)The 12-lead ECG could not be completed because of patient syncope.

Question 9

Which of the following statements about telemetry monitoring is correct?

A)It sends data to a licensed practitioner automatically when a cardiac anomaly is detected.
B)The patient activates it when he or she experiences symptoms.
C)It has two types: loop-memory monitor and symptom event monitor.
D)It consists of a small transmitting device attached to the chest with electrodes.

Question 10

Mrs. Hansen has an ambulatory monitor in place. What instructions do you give her regarding the electrodes?

A)If an electrode comes off, she should just document it in the diary and not worry about it
B)If an electrode becomes loose, she should press the event marker
C)If an electrode becomes loose, she should press it in the center to reapply; however, she must return to the clinic if one comes off completely
D)If an electrode comes off, she should replace it with one of the extras that you provided

Question 11

How long does an ambulatory monitor typically record an ECG?

A)12 hours
B)24 to 48 hours
C)60 days
D)3 months

Question 12

Which of the following patients is not a candidate for Holter monitoring?

A)Mr. Jackson, who is complaining of dizziness and has normal ECG and stress tests
B)Ms. Jones, who is complaining of chest pain; she is independent in care but confined to a wheelchair
C)Miss Jeffers, who is confused and living in a nursing home
D)Mr. Peters, who is complaining of palpitations but has inconclusive ECG and stress test results

Question 13

Which type of monitoring device can be implanted under the skin with a single lead?

A)Loop recorder
B)MCOT device
C)Symptom event monitor
D)Holter monitor

Question 14

Which of the following instructions would be given to a patient scheduled for ambulatory monitoring?

A)You may take a tub bath as long as you do not let the monitor drop in the water.
B)You should not take your heart medications during the ambulatory monitoring procedure unless instructed to do so by your physician.
C)You should avoid alcohol and caffeine during ambulatory monitoring.
D)Wear a loose-fitting shirt, preferably one that buttons down the front, and you will be more comfortable during the procedure.

Question 15

Which type of ambulatory monitoring device is often used in a hospital?

A)Telemetry monitor
B)implantable loop recorder
C)Symptom event monitor
D)Wearable monitor with defibrillator

Question 16

Which monitoring device can be worn on the wrist and records a bipolar lead I ECG tracing?

A)Loop-memory monitor
B)Symptom event monitor
C)Holter monitor
D)MCOT device

Question 17

During ambulatory monitoring, which of the following would not be recorded in the patient diary?

A)Urination and bowel movements
B)Hours of sleep
C)An argument with a spouse or child
D)Trimming fingernails or toenails

Question 18

When would a patient use an event marker during ambulatory monitoring?

A)To mark the beginning and end of ambulatory monitoring
B)To mark the ECG tracing when symptoms occur
C)To identify the type of event or symptom when it occurs
D)To mark the ECG tracing after any symptoms occur

Question 19

What is the term for fast, irregular heartbeat sensations felt by the patient, which may or may not be associated with complaints of chest pain?

A)Polarizations
B)Palpitations
C)Precordial beats
D)PVCs

Question 20

How many leads are attached to a patient's chest with ambulatory monitoring?

A)1 to 2 leads
B)3 to 5 leads
C)10 leads
D)12 leads

Question 21

What is the last thing you should do before having the patient put on his or her shirt during ambulatory monitoring?

A)Run a baseline ECG tracing.
B)Double-check the lead wires and electrodes to ensure there is no pulling.
C)Tape each electrode in place.
D)Place the monitor in its carrying case.

Question 22

Which of the following is a correct statement regarding the results received from an outside laboratory for ambulatory monitoring?

A)Results will be available in 1 to 3 days and placed on the chart for the physician to discuss with the patient.
B)Results will be available in 7 to 10 days; the patient will be called if abnormalities are found.
C)Results will be available in 7 to 10 days and placed on the chart for the physician to discuss with the patient.
D)The final report will be available in 7 to 10 days and sent to the patient.

Question 23

When a Holter monitor is used, when should the patient start his or her diary?

A)When the monitor is turned on
B)Before coming to the clinic for monitor placement
C)When the patient first experiences chest pain during monitoring
D)After the patient leaves the clinic

Question 24

Mr. Freeman asked you about the results of his test. You saw the final report and know there were abnormalities. How do you respond?

A)You tell him the results and encourage him to discuss them with his physician.
B)You tell him he needs to discuss the results with his physician.
C)You ignore the question and ask about his week.
D)To avoid upsetting him, you tell him the test results were OK.

Question 25

What additional test is not likely to be ordered if the ambulatory monitor results are abnormal?

A)Pulmonary function test
B)Echocardiogram
C)Coronary angiogram
D)CT scan

Question 26

For ambulatory monitoring, why is it recommended that chest hair should be clipped, not shaved?

A)Clipping reduces the chance that the patient will scratch the skin, causing an artifact on the tracing.
B)Clipping results in a rougher skin surface, so the electrodes are more likely to stay in place.
C)Shaving may result in tiny cuts in the skin, which may encourage microbial growth and infection.
D)Shaving takes longer and requires more equipment, increasing the preparation time for monitoring.

Question 27

Which of the following cardiac conditions cannot be confirmed by performing an ambulatory monitoring test?

A)Heart valve defects
B)Rhythm abnormalities
C)Premature atrial contractions
D)Premature ventricular complexes

Question 28

How can you ensure that each electrode is firmly attached?

A)Place the electrodes on the patient before attaching the lead wires.
B)Warm the electrode in your hands to increase the strength of the adhesive.
C)Run your finger around the edge of each electrode.
D)Use a large quantity of electrode gel in the center of each electrode.

Question 29

You are preparing an 82-year-old patient for ambulatory monitoring. What precautions do you need to take when applying electrodes to this patient?

A)Avoid shaving the patient's chest, even if it is hairy.
B)Manipulate the electrodes as little as possible.
C)Use more pressure to apply the electrodes so they will stick on the patient's wrinkled skin.
D)Use an abrasive cleaner instead of a skin rasp to prepare the patient's skin.

Question 30

What is the first step in reducing a patient's fear of ambulatory monitoring?

A)Explain why the physician ordered the monitoring.
B)Help the patient understand the procedure.
C)Tell the patient there is nothing to be afraid of.
D)Encourage the patient's family to remain with him at all times.

Question 31

Which of the following devices should a patient avoid while wearing an ambulatory monitor?

A)Electric coffeemakers
B)Microwave ovens
C)Electric blankets
D)Computers

Question 32

When preparing a patient for ambulatory monitoring, it is important to ensure that which of the following occurs?

A)A family member is present during the entire monitoring period
B)The patient agrees to avoid regular physical activities during the monitoring period
C)The patient understands the physical requirements of the monitoring procedure
D)The physician is notified immediately when the monitoring begins

Question 33

Which of the following factors may reduce the accuracy of ambulatory monitoring?

A)The patient did her usual 5-mile run this morning.
B)One of the leads became loose overnight and the patient put it back in place.
C)The patient felt ill, so he did not follow his normal routine.
D)The patient recorded all of her activities in the diary.

Question 34

What should be done with a Holter monitor before entering a patient's room to begin the procedure?

A)Attach the lead wires to the monitor.
B)Insert new batteries in the monitor.
C)Document in the patient's chart that the procedure has begun.
D)Record the name of the physician on the digital disk.

Question 35

Which of the following equipment will not be needed in preparation for applying an ambulatory monitoring device?

A)Electrodes
B)Oxygen supplies
C)Skin preparation equipment
D)Patient diary

Question 36

Mr. Benson's Holter monitor was applied yesterday at 9:00 am. At that time, he was told to return this morning at 9:00 am to have the monitor removed. He arrives at 10:30 am but did not bring his diary. What should you do?

A)Ask him to return home to get the diary before removing the monitor.
B)Leave the monitor in place and ask him to return the next day with the diary.
C)Remove the monitor and ask him to return home and bring the diary to you.
D)Have him fax or bring the diary to you later or the next day.

Question 37

When asked by a patient or the parent of a patient whether ambulatory monitoring is painful, what would be your best response?

A)The only pain you will feel is from the electrodes that are placed on the chest.
B)Ambulatory monitoring is completely pain free.
C)The monitoring is not painful; however, there may be some discomfort while the electrodes are in place.
D)It is uncomfortable when the hair on the chest is shaved.

Question 38

You need to prepare a 10-year-old boy for an ambulatory monitoring procedure. Which of the following should you include in your patient teaching?

A)Ask the parents to leave the room so the child will not be embarrassed.
B)Allow the child to touch the equipment before applying it.
C)Tell the child that there may be some pain initially.
D)Explain the procedure using the proper medical terminology.

Question 39

You are putting a new type of ambulatory monitor on Mrs. Farmer. It uses a five-lead system that is unfamiliar to you. What should you do before placing the electrodes?

A)Check the facility's policy on lead placement.
B)Ask a coworker about the unit.
C)Consult the manufacturer's instructions; they are the best resource for using new equipment.
D)Get an ambulatory monitor with which you are familiar.

Question 40

Which of the following activities is not allowed during ambulatory monitoring?

A)Drinking alcohol
B)Lifting heavy objects
C)Taking a tub bath
D)Exercising with friends

Question 41

What is the proper procedure for connecting electrodes for ambulatory monitoring to reduce tugging and pulling during patient movement?

A)Use an electrode gel that contains a strong adhesive.
B)Press the electrodes in place more firmly than for an ECG.
C)Wrap the torso with an elastic wrap to hold them in place.
D)Tape the electrodes in place.

Question 42

Which of the following tests is not typically ordered to follow up on results of ambulatory monitoring?

A)Magnetic resonance imaging
B)Exercise electrocardiography
C)Echocardiogram
D)Positron emission tomography

Question 43

What is the purpose of antidysrhythmic medications?

A)To lower the patient's blood pressure
B)To increase the strength of myocardial contractions
C)To prevent cardiac rhythm abnormalities
D)To reduce atherosclerotic plaque in the blood vessels

Question 44

Which type of monitor saves and transmits an ECG tracing for up to 5 minutes before a patient experiences symptoms?

A)Cardiac event monitor
B)Holter monitor
C)Telemetry monitor
D)Loop-memory monitor

Question 45

Which type of monitoring device activates itself when its electrode feet are pressed onto the patient's chest?

A)Holter monitor
B)Telemetry monitor
C)Symptom event monitor
D)MCOT device

Question 46

In which type of monitoring is a continuous tracing of the heart always sent directly to a monitoring station to be viewed in real time?

A)Holter monitoring
B)Telemetry monitoring
C)Symptom event monitoring
D)Loop-memory monitoring

Question 47

What does the term ambulating mean?

A)Performing daily activities
B)Wearing chest electrodes
C)Breathing
D)Walking

Question 48

While you are preparing Mrs. Trevor for ambulatory monitoring, she asks you a question that you cannot answer. What should you do?

A)Use your smartphone to look up the answer.
B)Ask your supervisor or the licensed practitioner.
C)Refer to the manufacturer's user guide.
D)Look it up in the employee handbook.

Question 49

What is the first thing you should do after removing a patient's ambulatory monitor?

A)Change the batteries in the monitor.
B)Evaluate the results.
C)Document and label the report, diary, and disk.
D)Report the results to your supervisor.

Question 50

What is another name for a stress ECG?

A)Exercise electrocardiography
B)Ambulatory monitoring
C)Telemetry
D)Transtelephonic monitoring

Question 51

Once the patient turns in the ambulatory monitor and diary, who is the person that typically provides the final interpretation of the ambulatory monitoring data?

A)Medical assistant
B)Laboratory technologist
C)Nurse
D)Physician