EKG changes
The patient is admitted with acute shortness of breath, chest pain, ST elevation on the ECG, and a loud systolic murmur at the apex of the heart. What has most likely occurred?
Inferior MI with acute mitral valve insufficiency(Question 1)
The patient has acute dyspnea, hypoxemia, bilateral lung crackles to the scapulae, S3 heart sound, and apical shift to the left. Which of the following chronic problems may lead to these signs and symptoms?
Hypertension, aortic regurgitation (Question 28).
What are the benefits of intra-aortic balloon (IAB) therapy for a patient with cardiogenic shock?
Decrease afterload with balloon deflation and increase diastolic augmentation with balloon inflation (Question 20).
The patient’s temporary pacemaker is not functioning normally. The nurse repositioned the patient, and the pacemaker problem was corrected. Which pacemaker malfunction most likely occurred?
Failure to capture (Question 38).
What is an appropriate intervention for a patient with acute right leg thrombosis?
Place the bed in the reverse Trendelenburg position. (Question 13).
What type of heart failure exhibits left ventricular hypertrophy pattern on the ECG?
Diastolic heart failure (Question 16).
What are signs of development of a ventricular septal defect?
Systolic murmur, loudest at the left sternal border (Question 4).
The patient develops chest pain with deep inspiration, a low-grade fever, and ST elevation in all leads three days post-MI. Treatment will include which of the following?
Anti-inflammatory agents (Question 25).
A patient, who admitted with an acute MI, received reperfusion therapy (PCI). What are signs of successful reperfusion?
Chest pain relief, ST returns to baseline, short runs of VT (Question 3).
The patient complains of a right-sided headache on the day of discharge status post right carotid endarterectomy. The nurse will do which of the following?
Contact the physician; the patient is at risk for seizure activity (Question 17).
The nurse notices that a patient’s QT interval has increased to 0.50 seconds. The nurse notifies the physician, knowing that the patient may be at risk for which of the following?
Torsades de pointes (Question 14).
The patient was being monitored post-PCI with stent placement in the right coronary artery. The patient c/o severe low back pain, dizziness, and hypotension. What should the nurse suspect?
The patient has retroperitoneal bleeding and will need fluid resuscitation (Question 11).
The patient has cardiomyopathy with an ejection fraction (EF) 50%, an enlarged ventricular septum on the echocardiogram (ECHO), and a normal heart size on the chest radiograph. The nurse anticipates that which of the following drugs may be part of the patient’s plan of care?
Diltiazem (Cardizem) (Question 29).
The monitor shows sustained ventricular tachycardia (VT). The patient’s blood pressure is 112/60. The patient denies having dyspnea, pain, and dizziness. The nurse anticipates that immediate treatment will include:
Antiarrhythmic therapy (Question 34).
The patient suddenly develops CP, dyspnea, hypotension & sinus bradycardia. Exam reveals (JVD), lungs clear, S4 heart sound, and no murmurs. The ECG reveals ST elevation in II, III, and aVF. In addition to preparing for PCI, which interventions should the nurse anticipate?
Aggressive fluid administration, right-sided ECG (Question 2).
The monitor alarm sounds and reveals a heart rate of 38 beats/ minute, and the patient is hypotensive. The PR intervals are variable, the R-R intervals are regular, and the QRS complexes are wide. What is the cardiac rhythm and the appropriate intervention?
Third-degree heart block; begin transcutaneous pacing (Question 40).
Which of the following are indicative of cardiac tamponade post-op heart surgery?
Muffled heart tones, minimal chest tube output, pulsus paradoxus (Question 23).
The patient is day 2 post-aortic valve replacement. In addition to preventing thrombus formation, the RN will anticipate which of the following as part of the patient’s plan of care?
Close monitoring for conduction disturbances (Question 30).
The patient was admitted 6 hours ago with unstable angina and an ECG showing ST depression in leads II, III, and aVF. A nitroglycerin (Tridil) drip at 30 mcg/min is infusing. Chest pain reoccurred, a repeat ECG demonstrated ST elevation in leads II, III, and aVF, and a right-sided ECG showed ST elevation in V3R and V4R. The patient’s blood pressure is 88/52, the heart rate is 92 beats/minute, and the lungs are clear. What are the priority interventions for this patient?
Discontinue the nitroglycerin drip, and start a fluid bolus. (Question 36).
The patient presented with chest pressure, a BP of 218/130, and an ECG with 2 mm ST depression in V5 and V6. What will the patient require?
Labetalol (Normodyne, Trandate) IV, admission to the critical care unit (Question 12).
These clinical signs are likely to be seen with which type of MI's:
ST elevation in II, III and aVF
Inferior MI's (Question 8).
The nurse is assessing a patient who is status post transcatheter aortic valve replacement (TAVR). Which of the following assessments should the nurse anticipate for this patient?
Femoral hematoma (Question 47).
What is the primary effect of alpha adrenergic drugs?
Arterial constriction (Question 41).
The patient developed hypotension, distended neck veins, and distant heart sounds post-op coronary artery bypass surgery. The mediastinal chest tube is noted to have minimal drainage. The nurse anticipates that the patient will need which of the following interventions?
A return to the OR (Question 43).
A 29-year-old patient has cardiomyopathy and NYHA Class IV heart failure. An assessment includes a point of maximal impulse (PMI) shift to the left, an enlarged heart size, and bilateral pulmonary edema on the chest X-ray as well as an ejection fraction (EF) of 18% on the echocardiogram (ECHO). What interventions will the nurse anticipate for this patient’s plan of care?
Administering positive inotropes for systolic dysfunction (Question 44).