Question 1

Which of the following will be found in a patient with asystole?
1) Increased ventricular activity
2) Absence of electrical activity
3) No blood pressure
4) Highly variable heart rate

Accepted Answer

Asystole is a state of no cardiac electrical activity, hence no contractions of the myocardium and no blood pressure, which corresponds to options 2 and 3.

Question 2

The respiratory therapist is monitoring a patient in the medical ICU and notes multiple premature ventricular complexes (PVCs) on the cardiac monitor. The respiratory therapist elects to review the patient's medication administration record (MAR) for medications the patient is receiving to rule out medication toxicity as a cause of the PVCs. Which of the following medications should the therapist evaluate as a possibility of inducing PVCs?

Accepted Answer

Theophylline can induce PVCs due to its stimulatory effects on the cardiovascular system, including increasing heart rate and potentially causing arrhythmias like PVCs.

Question 3

The respiratory therapist is called to a patient's room as part of the rapid response team (RRT). The patient is unconscious and pulseless. The EKG monitor displays asystole. Which of the following actions would be indicated at this time?
1) Call a code.
2) Begin CPR.
3) Defibrillate the patient.
4) Administer ACLS medications.

Accepted Answer

In the case of asystole, the immediate actions include calling a code to initiate a formal emergency response, beginning CPR to provide artificial circulation, and administering Advanced Cardiac Life Support (ACLS) medications as per protocol. Defibrillation is not indicated for asystole, as it is effective for treating certain types of arrhythmias, not the absence of electrical activity.

Question 4

When reviewing a cardiac rhythm strip, the respiratory therapist notices that there are three large boxes between two QRS complexes. Approximately what is this patient's heart rate?

Accepted Answer

The heart rate can be estimated by dividing 300 by the number of large boxes between two QRS complexes. Here, 300 divided by 3 equals 100, indicating a heart rate of approximately 100 beats per minute.

Question 5

A pulmonary artery (Swan-Ganz) catheter can be used for which of the following?
1) Measuring cardiac output
2) Arterial blood sampling
3) Measuring left atrial pressure
4) Measuring pulmonary artery pressure

Accepted Answer

A pulmonary artery (Swan-Ganz) catheter is primarily used for measuring cardiac output, left atrial pressure (indirectly through pulmonary capillary wedge pressure), and pulmonary artery pressure. It is not used for arterial blood sampling, which is typically done through an arterial line.

Question 6

Which of the following hemodynamic changes are commonly seen in a patient with cardiogenic pulmonary edema?
1) Increased pulmonary capillary wedge pressure (PCWP)
2) Increased pulmonary vascular resistance (PVR)
3) Decreased mean pulmonary artery pressure (PA)
4) Decreased cardiac output (CO)

Accepted Answer

Cardiogenic pulmonary edema is typically characterized by increased pulmonary capillary wedge pressure (PCWP) due to left ventricular failure, leading to backward failure and pulmonary congestion. Decreased cardiac output (CO) is also common as the heart's pumping efficiency is compromised.

Question 7

The T wave represents:

Accepted Answer

The T wave on an electrocardiogram (ECG) represents the repolarization of the ventricles, which is the process of the heart muscle cells returning to their resting state after contraction.

Question 8

A central venous pressure (CVP) catheter is used to:

Accepted Answer

A central venous pressure (CVP) catheter is primarily used to monitor right ventricular function and the return of venous blood to the heart, not the left side of the heart or its function.

Question 9

The respiratory therapist is assessing a patient with sinus tachycardia. Which of the following would least likely be a cause of the sinus tachycardia?

Accepted Answer

Beta-blocker medications are typically used to slow down the heart rate, not increase it, making them the least likely cause of sinus tachycardia compared to the other options which are known to potentially increase heart rate.

Question 10

A premature ventricular contraction (PVC) can be caused by:
1) sleep.
2) intrinsic myocardial disease.
3) hypoxemia.
4) acidemia.

Accepted Answer

PVCs can be caused by intrinsic myocardial disease, hypoxemia, and acidemia, as these conditions can alter the electrical stability of the heart, leading to premature beats. Sleep is not a direct cause of PVCs.

Question 11

Which of the following is found when a patient has sinus arrhythmia?
1) Rate decreases during expiration.
2) Rate decreases during inspiration.
3) Rate varies by more than 10% from beat to beat.
4) Rate increases during inspiration.

Accepted Answer

Sinus arrhythmia is characterized by a natural variation in heart rate during a breathing cycle: the rate increases during inspiration and decreases during expiration. The rate can vary by more than 10% from beat to beat, which is considered a normal finding, especially in young, healthy individuals.

Question 12

In which of the following is the atrial rate faster than the ventricular rate?
1) Atrial fibrillation
2) Sinus bradycardia
3) Atrial flutter
4) Sinus tachycardia

Accepted Answer

In both atrial fibrillation and atrial flutter, the atrial rate is faster than the ventricular rate due to the rapid firing of electrical impulses in the atria that not all are conducted to the ventricles.

Question 13

A premature ventricular contraction (PVC) can be identified by which of the following?
1) There is no P wave.
2) The QRS is wide.
3) The QRS looks normal.
4) The heart rate is altered.

Accepted Answer

PVCs are characterized by the absence of a P wave before the ventricular contraction (1), a wider QRS complex due to the abnormal ventricular depolarization (2), and they can alter the heart's normal rhythm, affecting the heart rate (4).

Quiz 7: Assessment of the Cardiovascular System

Which of the following will be found in a patient with asystole? 1) Increased ventricular activity 2) Absence of electrical activity 3) No blood pressure 4) Highly variable heart rate

When reviewing a cardiac rhythm strip, the respiratory therapist notices that there are three large boxes between two QRS complexes. Approximately what is this patient's heart rate?

A pulmonary artery (Swan-Ganz) catheter can be used for which of the following? 1) Measuring cardiac output 2) Arterial blood sampling 3) Measuring left atrial pressure 4) Measuring pulmonary artery pressure

Which of the following hemodynamic changes are commonly seen in a patient with cardiogenic pulmonary edema? 1) Increased pulmonary capillary wedge pressure (PCWP) 2) Increased pulmonary vascular resistance (PVR) 3) Decreased mean pulmonary artery pressure (PA) 4) Decreased cardiac output (CO)

The T wave represents:

A central venous pressure (CVP) catheter is used to:

The respiratory therapist is assessing a patient with sinus tachycardia. Which of the following would least likely be a cause of the sinus tachycardia?

A premature ventricular contraction (PVC) can be caused by: 1) sleep. 2) intrinsic myocardial disease. 3) hypoxemia. 4) acidemia.

Which of the following is found when a patient has sinus arrhythmia? 1) Rate decreases during expiration. 2) Rate decreases during inspiration. 3) Rate varies by more than 10% from beat to beat. 4) Rate increases during inspiration.

In which of the following is the atrial rate faster than the ventricular rate? 1) Atrial fibrillation 2) Sinus bradycardia 3) Atrial flutter 4) Sinus tachycardia

A premature ventricular contraction (PVC) can be identified by which of the following? 1) There is no P wave. 2) The QRS is wide. 3) The QRS looks normal. 4) The heart rate is altered.