Question 1

The nurse is obtaining a 12-lead ECG on a patient with chest discomfort and interprets the results as a very thick-lined waveform tracing.The nurse troubleshoots this tracing by performing which appropriate intervention?

Accepted Answer

Thick-lined waveform tracing can be caused by electrical interference from other equipment. Unplugging battery-operated equipment one item at a time can help identify and eliminate the source of interference.

Question 2

The nurse changes the electrocardiogram (ECG)electrodes on a patient who is on a continuous cardiac monitor.The patient tells the nurse that the electrodes were just changed the previous day.Which of the following rationales is the correct explanation for the nurse to share with the patient?

Accepted Answer

Changing the electrodes daily helps ensure good contact with the skin, which can reduce the number of false alarms due to poor signal quality.

Question 3

The nurse understands that it is a priority to obtain the 12-lead electrocardiogram (ECG)on the patient newly admitted with chest pain because the ECG must be obtained within how many minutes of the onset of pain?

Accepted Answer

The standard guideline is to obtain a 12-lead ECG within 10 minutes of a patient presenting with chest pain to quickly assess for any signs of acute myocardial infarction or other cardiac issues.

Question 4

Proper placement of the electrocardiogram (ECG)electrodes is essential for which reason?

Accepted Answer

The answer of Proper placement of the electrocardiogram (ECG)electrodes is...

Question 5

While the nurse is performing a 12-lead electrocardiogram (ECG)tracing,the patient complains of crushing chest pain.The nurse recognizes that the timing of the chest pain is important to note for which of the following reasons?

Accepted Answer

Correlating the ECG changes to the timing of chest pain is crucial for diagnosing conditions like myocardial infarction, as certain changes on the ECG may only be present during episodes of pain.

Question 6

The nurse is assessing several patients who have returned from surgery when a 12-lead electrocardiogram (ECG)is ordered for a newly admitted patient.Prioritizing patient needs,the nurse determines that obtaining the 12-lead ECG can be most appropriately delegated to which member of the health care team?

Accepted Answer

Another registered nurse is qualified to perform a 12-lead ECG, making it appropriate to delegate this task to them.

Question 7

To determine the patient's and caregiver's levels of understanding of the rationale for obtaining the 12-lead ECG,the nurse most effectively uses which of the following statements?

Accepted Answer

This statement directly asks the patient or caregiver to explain their understanding of the reason for the test, which assesses their level of understanding.

Question 8

Identify the first step toward establishing appropriate alarms and response expectations.

Accepted Answer

Determining which patients require ECG monitoring is the first step, as it helps identify who needs the alarms, ensuring that resources are appropriately allocated and that monitoring is necessary.

Question 9

The nurse is caring for a 6-year-old child after open-heart surgery.When assessing the patient,the nurse notes that the position of the leads may be different in the pediatric population.Which lead placement explains this special consideration?

Accepted Answer

The position of the brown lead can be changed to mirror one of the precordial (chest)lead positions,V1 to V6.The standard placement is for V1 at the fourth intercostal space,right sternal border.In general,the mechanisms of dysrhythmias are the same in children as they are in adults;however,the appearance of the arrhythmias on the ECG may differ because of developmental issues such as heart size,baseline heart rate,sinus and AV node function,and autonomic innervation.

Question 10

The nurse is supervising a nursing student while applying electrodes for continuous cardiac monitoring to an elderly patient.The nurse recognizes the need for further education when the student makes which comment about polarity while attaching the monitor leads to the electrode?

Accepted Answer

In standard cardiac monitoring, the black lead is typically used as the negative lead, not neutral. The white lead is usually positive, and the red lead is often used as the ground. The brown lead is used in some systems as a positive lead.

Question 11

The student nurse is preparing to perform a 12-lead electrocardiogram (ECG)on an adult patient.Which action by the student should the nursing instructor question?

Accepted Answer

Using alcohol to cleanse the electrode area can dry out the skin and increase resistance, which may interfere with the ECG readings.

Question 12

The nurse analyzes the patient's cardiac rhythm as follows: regular rhythm,rate 108 beats per minute,normal PQRST complex.The nurse interprets that the clinical significance of this cardiac rhythm is most likely related to which indication?

Accepted Answer

The cardiac rhythm described is sinus tachycardia, which is a regular rhythm with a rate over 100 beats per minute and normal PQRST complexes. Sinus tachycardia can be a physiological response to pain, as the body increases heart rate to meet the increased metabolic demands.

Question 13

Which of the following is true about alarm fatigue?

Accepted Answer

Alarm fatigue occurs when individuals become desensitized to alarms due to their excessive frequency, leading to slower response times or missed alarms.

Question 14

The nurse is observing a nursing student perform a 12-lead electrocardiogram (ECG)tracing on a newly admitted patient.The nurse recognizes that the student requires additional training on this skill when he or she observes which of the following erroneous lead placements?

Accepted Answer

V2 should be placed at the fourth intercostal space at the left sternal border, not the right.

Question 15

The nurse is preparing to apply electrodes for continuous cardiac monitoring to a newly admitted adult with syncope.Which action by the nurse follows appropriate procedure?

Accepted Answer

The chest area is prepared for electrode placement with soap and water.There are no limb electrodes for continuous cardiac monitoring.Ensure the patient's abdomen and thighs are covered.Roughening the skin helps to remove the epidermis outer layer to allow electrical signals to travel.Do not roughen the dermis layer of skin.Electrodes should be applied when the patient is in the supine position.

Question 16

The nurse has explained to the patient that a 12-lead electrocardiogram (ECG)is indicated.The patient refused to have the procedure done citing that she fears that the electrodes will cause harm to her heart.The nurse recognizes that which of the following patient rationales are contraindications for a 12-lead ECG?

Accepted Answer

Refusal of the test by the patient is a contraindication for performing a 12-lead ECG, as informed consent is necessary for non-emergency procedures.

Question 17

The nurse is caring for a patient on continuous cardiac monitoring.The nurse assesses the rhythm as regular with a normal PQRST complex and a rate of 62 beats per minute.Which analysis is the correct interpretation of this cardiac rhythm?

Accepted Answer

The rhythm is regular with a normal PQRST complex and a rate of 62 beats per minute, which corresponds to normal sinus rhythm. Sinus bradycardia would have a rate <60 beats per minute, sinus tachycardia would have a rate >100 beats per minute, and premature bradycardia is not a recognized cardiac rhythm.

Question 18

The nurse is reviewing the patient's do-not-resuscitate orders when the cardiac alarm sounds.The rhythm is chaotic with no identifiable waves and the rate cannot be determined.Based on these clinical findings,the nurse determines that the patient is in which of the following cardiac rhythms?

Accepted Answer

The description of a chaotic rhythm with no identifiable waves and an undeterminable rate is characteristic of ventricular fibrillation.

Question 19

When applying electrocardiogram (ECG)electrodes to a woman,it is important to give special consideration to which of the following objectives?

Accepted Answer

The electrodes should be placed as close to the chest wall as possible while avoiding the breast tissue to ensure accurate readings and avoid interference.

Question 20

Reduction of alarm fatigue is an important nursing practice.The nurse addresses this concern when which of the following actions is implemented?

Accepted Answer

Provides initial and ongoing education about the intravenous pumps

Quiz 26: Cardiac Care

The nurse is obtaining a 12-lead ECG on a patient with chest discomfort and interprets the results as a very thick-lined waveform tracing.The nurse troubleshoots this tracing by performing which appropriate intervention?

The nurse changes the electrocardiogram (ECG) electrodes on a patient who is on a continuous cardiac monitor.The patient tells the nurse that the electrodes were just changed the previous day.Which of the following rationales is the correct explanation for the nurse to share with the patient?

The nurse understands that it is a priority to obtain the 12-lead electrocardiogram (ECG) on the patient newly admitted with chest pain because the ECG must be obtained within how many minutes of the onset of pain?

Proper placement of the electrocardiogram (ECG) electrodes is essential for which reason?

While the nurse is performing a 12-lead electrocardiogram (ECG) tracing,the patient complains of crushing chest pain.The nurse recognizes that the timing of the chest pain is important to note for which of the following reasons?