Cardiac
Cardiac
Diabetes
Diabetes
CHF
100
A. Regular atrial rhythm
B. Irregular ventricular rhythm
C. PR Interval < 0.20 seconds
D. QRS complex > 0.12 seconds
E. Equal atrial and ventricular rate
F. Atrial rate > than ventricular rate
G. First-Degree Heart Block
H. Sinus bradycardia
I. Normal Sinus Rhythm
The answers are A, C, E and I. This is normal sinus rhythm with a regular atrial and ventricular rhythm, PR Interval < 0.20 seconds, QRS complex < 0.12 seconds, and same atrial and ventricular rate.
100
Your patient's ECG shows atrial flutter. What complication can arise from this type of rhythm?(Required)
A. Pericarditis
B. Stroke
C. Hypoglycemia
D. Endocarditis
The answer is B. Atrial flutter can increase the patient’s risk of developing a blood clot which can lead to a stroke. This is because the atria are not fully contracting but quivering. The quivering leads blood to pool in the atria which can coagulate and form a clot. The clot can leave the heart and travel to the brain or lungs and cause a stroke or pulmonary embolism.
100
What are the 3 P's of diabetes
1. Polydypsia
2. Polyuria
3. Polyphagia
100
What are some of the presenting factors for HHS (Hyperosmolar Hyperglycemic Syndrome)
a. Occurs with Type 1 Diabetes
b. UTI's, pneumonia and sepsis
c. Impaired thirst and unable to replace fluids
d. chronic illness
b and c
100
- Which of the following patients are MOST at risk for developing heart failure? Select-all-that-apply:*
- A. A 69 year old male with a history of alcohol abuse and is recovering from a myocardial infarction.
- B. A 55 year old female with a health history of asthma and hypoparathyroidism.
- C. A 30 year old male with a history of endocarditis and has severe mitral stenosis.
- D. A 45 year old female with lung cancer stage 2.
- E. A 58 year old female with uncontrolled hypertension and is being treated for influenza.
The answers to this question are options: A, C, E. These patients are at most risk for heart failure. Remember risks factor for developing heart failure include: remember the mnemonic FAILURE: Faulty heart valves ( Option C mitral stenosis in this case), Arrhythmias, Infarction (Option A), Lineage, Uncontrolled hypertension (Option E), Recreational drug usage, Evaders (Option E with influenza)
200
The nurse notes the rhythm above on the cardiac monitor. The nurse does a pulse check and a pulse is present. What next action by the nurse is most appropriate?(Required)
A. Continue to monitor
B. Prepare for the administration of Atropine
C. Start chest compressions
D. Activate the emergency response system
The answer is A. This rhythm is normal sinus rhythm. This rhythm requires no treatment and the nurse should continue to monitor the patient.
200
TRUE or FALSE: A Third-Degree Heart Block is unlikely to cause symptoms in a patient and usually requires no treatment.(Required)
True
False
The answer is False: A third-degree heart block requires treatment and will usually cause symptoms for the patient.
200
DKA - which of the following are precipitating factors, select all that apply:
a. illness
b. cough
c. infection
d. inadequate insulin dosing
e. neglect
f. undiagnosed Type 1 diabetes
a, c, d, e, f
200
Are ketones present in HHS?
a. yes
b. no
b. no
200
Which of the following are NOT typical signs and symptoms of right-sided heart failure? Select-all-that-apply:*
- A. Jugular venous distention
- B. Persistent cough
- C. Weight gain
- D. Crackles
- E. Nocturia
- F. Orthopnea
The answers are B, D, and F. Persistent cough, crackles (also called rales), and orthopnea are signs and symptoms of LEFT-sided heart failure...not right-sided heart failure.
300
You obtain an ECG on a patient and the rhythm is sinus bradycardia with a rate of 52 bpm. Your NEXT nursing action is to?(Required) A. Prepare to administer Atropine IV push B. Set-up for transcutaneous pacing C. Assess the patient D. Call a rapid response
The answer is C: Assess the patient. When discovering sinus bradycardia, the nurse should determine if the patient is having symptoms. Not all cases of this rhythm require medical treatment.
300
Which of the following is NOT a finding in a Second-Degree Type II heart block (Mobitz II) ECG reading?(Required)
A. Normal p waves with constant PR intervals
B. Missing QRS complexes
C. Progressively prolonged PR intervals
D. Regular atrial rhythm
The answer is C: Progressively prolonged PR intervals. This is a finding in Second-Degree Type I (Mobitz I/Wenckebach).
300
Can you name the characteristics of DKA as indicated in your presentation in class? There were 5 listed.
1. Hyperglycemia
2. Ketosis
3. Acidosis
4. Dehydration
5. Type 1 Diabetes
300
HHS is a medical emergency with a high mortality rate, which of the following are needed?
a. IV insulin and NSS
b. less fluid replacement
c. Potassium is normal and does not need replacement
d. Correct the underlying precipitating cause
a nd d
300
A patient is diagnosed with left-sided systolic dysfunction heart failure. Which of the following are expected findings with this condition?*
- A. Echocardiogram shows an ejection fraction of 38%.
- B. Heart catheterization shows an ejection fraction of 65%.
- C. Patient has frequent episodes of nocturnal paroxysmal dyspnea.
- D. Options A and C are both expected findings with left-sided systolic dysfunction heart failure.
The answer is D. Both Options A and C are correct. Option B is a finding expected in left-sided DIASTOLIC dysfunction heart failure because the issue is with the ability of the ventricle to FILL properly...therefore a patient usually has a normal ejection fraction. Remember a normal EF is >60% in a healthy heart.
400
You're analyzing an ECG strip. In order for the rhythm to be identified as Sinus Tachycardia, what must be present in the rhythm? (Select all that apply):(Required)
A. One p wave present in front of every QRS complex
B. Atrial rate >100 bpm
C. Ventricular rate >100 bpm
D. Regular atrial rate and irregular ventricular rate
E. Regular atrial and ventricular rate
F. Atrial rate <60 bpm
G. QRS complex <0.12 seconds
H. PR interval 0.12-0.20 seconds
I. PR interval >0.20 seconds
The answers are: A, B, C, E, G, H
400
True or False: A hallmark finding in a Second-Degree type I (Mobitz I or Wenckebach) heart block is that the PR interval will remain constant throughout the rhythm but there will be a dropped QRS complex after a p wave.(Required)
True
False
The answer is FALSE. This described a Second-Degree type I heart block. A Second-Degree type I (Mobitz I or Wenckebach) occurs when the PR interval follows a pattern where they gradually lengthen (so the p wave is getting further and further away from the QRS complex), and then all of the sudden there is a p wave without the QRS complex. Then this cycle will repeat itself again.
400
What is a diabetic's worst enemy when it comes to illness and the risk of DKA? Can you name the symptom?
Dehydration
400
What are the signs and symptoms of hypoglycemia, select all that apply:
a. palpatations
b. confusion
c. normal vision
d. stupor
e. altered mental status
f. diaphoresis
a, b, d, e, f
400
A patient has a history of heart failure. Which of the following statements by the patient indicates the patient may be experiencing heart failure exacerbation?*
- A. “I’ve noticed that I’ve gain 6 lbs in one week.”
- B. “While I sleep I have to prop myself up with a pillow so I can breathe.”
- C. “I haven’t noticed any swelling in my feet or hands lately.”
- D. Options B and C are correct.
- E. Options A and B are correct.
- F. Options A, B, and C are all correct.
The answer is E. Options A and B are classic signs and symptoms a patient may experience with heart failure exacerbation.
500
The patient is experiencing the rhythm above. The patient is presenting with a blood pressure of 70/42, mental status changes, and is clammy and pale. A pulse is present. The nurse preps the patient for?(Required)
A. CPR
B. Synchronized cardioversion
C. Defibrillation
D. Atropine IV
The answer is B. The rhythm above is ventricular tachycardia. The patient is unstable and demonstrating signs and symptoms related to decreased cardiac output. A pulse is present. The patient is currently unstable; therefore, synchronized cardioversion needs to be performed to convert the patient to a normal rhythm. An antiarrhythmic like Amiodarone may be started to maintain the normal rhythm.
500
What medication below could cause a First-Degree Heart Block?(Required)
A. Lisinopril
B. Dilitiazem
C. Furosemide
D. Clopidogrel
The answer is B: Dilitiazem is a calcium channel blocker which slows down conduction through the AV node. This could lead to a heart block.
500
Which of the following are clinical manifestations of DKA?
a. Lethargy and weakness
b. overeating
c. abdominal pain w/nausea and vomiting
d. Kussmaul respirations
e. sour breath
f. Blood glucose 120-180mg/dl
g. moderate to high ketones in urine
a, c, d, g
500
Is glucagon used to treat hypoglycemia?
a. yes
b. no
What is a side effect of glucagon?
Yes. Vomiting is a side effect, patient should be on their side if they are unresponsive.
500
A 74 year old female presents to the ER with complaints of dyspnea, persistent cough, and unable to sleep at night due to difficulty breathing. On assessment, you note crackles throughout the lung fields, respiratory rate of 25, and an oxygen saturation of 90% on room air. Which of the following lab results confirm your suspicions of heart failure?*
- A. K+ 5.6
- B. BNP 820
- C. BUN 9
- D. Troponin <0.02
The answer is option B. BNP (b-type natriuretic peptide) is a biomarker released by the ventricles when there is excessive pressure in the heart due to heart failure. <100 no failure, 100-300 present, >300 pg/mL mild, >600 pg/mL >moderate, 900 pg/mL severe