ECG BASICS
WHAT REPRESENTS ATRIAL DEPOLARIZATION?
THE P WAVE
MONA INCLUDES THIS MEDICATION THAT PREVENTS FROM AN ENLARGING CLOT?
ASPIRIN
Which assessment finding requires immediate notification of the provider?
A. NPO for 8 hours
B. Blood pressure 132/78 mm Hg
C. Allergy to shellfish
D. Heart rate 82/min
Allergy to shellfish
Rationale:
Contrast dye used during angiography may trigger reactions in clients with iodine/shellfish allergies
WHAT IS THE NORMAL EJECTION FRACTION RANGE?
55-65%
WHAT MAP IS NEEDED FOR END ORGAN PERFUSION?
65
WHAT REFLECTS VENTRICULAR DEPOLARIZATION AND REPOLARIZATION?
WHAT IS THE QT INTERVAL?
WHAT IS THE GOLD STANDARD FOR DIAGNOSING STEMI?
12 LEAD EKG
A client asks the nurse about the difference between a pacemaker and an ICD.
Which response is correct?
A. "Both devices only treat slow heart rhythms."
B. "A pacemaker treats slow heart rates, while an ICD can shock dangerous rhythms."
C. "An ICD is only used after CABG surgery."
D. "Pacemakers and ICDs perform the same function."
B. A pacemaker treats slow heart rates, while an ICD can shock dangerous rhythms."
WHAT PROTEIN IS RELEASED FROM OVER STRETCHED VENTRICLES?
BNP
A client is admitted with chest pain following an anterior wall MI.
Telemetry shows:
Which action should the nurse anticipate?
A. Encourage ambulation
B. Prepare for pacemaker insertion
C. Administer adenosine
D. Increase IV fluids
B
2nd degree type 2 heart block
THIS COMPLEX CORRESPONDS TO VENTRICULAR DEPOLARIZATION?
WHAT IS THE QRS COMPLEX?
A 58-year-old client arrives in the emergency department reporting crushing chest pain radiating to the left arm. The client is diaphoretic and short of breath. The nurse suspects a myocardial infarction.
Which action should the nurse perform first?
A. Obtain a troponin level
B. Administer prescribed oxygen
C. Schedule an echocardiogram
D. Educate the client about lifestyle changes
b (MONA)
A nurse is caring for a client with complete heart block.
Which assessment finding is most concerning?
A. HR 40/min
B. BP 78/42 mm Hg
C. Fatigue
D. Mild dizziness
B. BP 78/42 mm Hg
Rationale:
Hypotension indicates severely compromised cardiac output and poor tissue perfusion.
A 22-year-old athlete collapses during a basketball game. The healthcare provider suspects hypertrophic cardiomyopathy.
Which statement is true regarding this condition?
A. It is the most common cause of sudden cardiac death in young athletes.
B. It always causes reduced ejection fraction.
C. It primarily affects the right ventricle.
D. It is caused by coronary artery disease.
A
A nurse is caring for a client with symptomatic bradycardia caused by a second-degree AV block.
Which findings should the nurse expect?
Select all that apply.
A. Hypotension
B. Syncope
C. Dizziness
D. Chest pain
E. Increased urine output
A,B,C,D
A nurse is reviewing a telemetry strip for a client admitted for chest pain. The rhythm is regular, every P wave is followed by a QRS complex, and the PR interval is 0.24 seconds.
Which action should the nurse take?
A. Prepare for transcutaneous pacing.
B. Continue monitoring the client.
C. Administer atropine immediately.
D. Activate the rapid response team.
B
A client with an inferior-wall myocardial infarction develops:
Which prescription should the nurse implement first?
A. Administer atropine.
B. Administer nitroglycerin.
C. Prepare for synchronized cardioversion.
D. Administer metoprolol.
A.
A nurse is caring for a client with third-degree heart block.
Which statement by a newly licensed nurse requires intervention?
A. "I should monitor the client's blood pressure."
B. "I should prepare for pacing."
C. "Atropine may be ineffective in this client."
D. "This client will likely improve with adenosine."
D. "This client will likely improve with adenosine."
A nurse is teaching a client with cardiomyopathy.
Which statement indicates understanding?
A. "I should report gaining 2 pounds in 24 hours."
B. "I should avoid all exercise."
C. "I can stop my medications when I feel better."
D. "I should increase sodium intake.
A. "I should report gaining 2 pounds in 24 hours."
A nurse reviews the following findings for a client:
Which action should the nurse take first?
A. Obtain a 12-lead ECG
B. Apply transcutaneous pacing pads
C. Reassess vital signs in 15 minutes
D. Encourage oral fluids
B. Apply transcutaneous pacing pads
Rationale:
The client is experiencing symptomatic third-degree heart block with signs of shock.
A nurse is caring for a client who develops symptomatic bradycardia. The telemetry monitor shows a second-degree AV block type I (Wenckebach). The client reports dizziness and weakness.
Which medication should the nurse anticipate administering first?
A. Epinephrine
B. Atropine
C. Adenosine
D. Digoxin
B
Atropine is the first-line medication for symptomatic bradycardia and is often effective in first-degree AV block and Mobitz I heart block.
A client with an inferior-wall MI develops:
What should the nurse do first?
A. Administer nitroglycerin
B. Apply transcutaneous pacing pads
C. Encourage coughing and deep breathing
D. Obtain a troponin level
B. Apply transcutaneous pacing pads
A nurse is caring for a client with symptomatic bradycardia. Which finding should prompt the nurse to administer atropine?
A. HR 48/min, BP 76/40 mm Hg, dizziness
B. HR 110/min, chest pain
C. HR 88/min, BP 128/74 mm Hg
D. HR 140/min, palpitations
A. HR 48/min, BP 76/40 mm Hg, dizziness
Rationale:
Atropine is indicated for symptomatic bradycardia causing poor perfusion.
A client with complete heart block is receiving atropine.
Which assessment finding indicates the medication is ineffective?
A. HR increases from 40/min to 72/min
B. Client reports less fatigue
C. Persistent HR of 34/min with hypotension
D. Blood pressure improves
C
Which client should the nurse assess first?
A. A client with heart failure who reports fatigue.
B. A client with cardiomyopathy who reports nausea.
C. A client with an arterial line who has no waveform on the monitor.
D. A client post-CABG reporting incisional pain rated 5/10.
C