1) Early acute left-sided heart failure assessment findings a) pink frothy sputum b) Hepatosplenomegaly and tachycardia c) Bubbling crackles and tachycardia d) Peripheral edema and cool, diaphoretic skin 2) Acronym FACES identifies early heart failure symptoms a) Fatigue, Activity limitations, Chest congestion/cough, Edema, Shortness of breath b) Factors of Risk, Activity, Cough, Emotional upsets, Salt intake c) Follow activity plan, Continue Exercise, know Signs of problems d) Frequent Activity leads to Cough in the Elderly and Swelling 3) Pathophysiologic mechanism resulting in pulmonary edema of left-sided heart failure a) Increased right ventricular preload b) Increased pulmonary hydrostatic pressure c) Impaired alveolar oxygen and carbon dioxide exchange d) Increased lymphatic flow of pulmonary extravascular fluid 4) What describes the action of natriuretic peptides and nitric oxide in their counter-regulatory processes in response to heart failure? a) Excretion of Potassium b) Increased release of ADH c) Vasodilation and decreased blood pressure d) Decreased glomerular filtration rate and edema 5) Chronic biventricular heart failure for paroxysmal nocturnal dyspnea results in which? a) The presence of restlessness and confusion b) Frequent awakening to void during the night c) The presence of swelling in dependent body areas d) Waking in a panic with a feeling of suffocation 6) Most common cause of death in heart transplant patients during the first year a) Infection b) Heart failure c) Embolization d) Malignant conditioins 7) Successful treatment of heart failure is determines when the patient demonstrates a) weight loss and diuresis b) warm skin and less fatigue c) clear lung sounds and decreased HR d) Absence of chest pain and improved level of consciousness 8) A pt with CHF is treated with hydrochlorothiazide, digoxin, and lisinopril. To prevent digoxin toxicity what is MOST important to monitor? a) Heart rate b) Potassium levels c) Blood pressure d) Gastrointestinal function 9) Which test is MOST useful in differentiating dyspnea related to pulmonary effects of heart failure from dyspnea related to pulmonary disease? a) Exercise stress testing b) Cardiac catheterization c) B-type natriuretic peptide levels (BNP) d) Determination of blood urea nitrogen (BUN) 10) Spironolactone (Aldactone) is administered for Heart Failure. What diet education should the nurse provide? a) Decrease both sodium and potassium intake b) Increase calcium intake and decrease sodium intake c) Decrease sodium intake and increase potassium intake d) Decrease sodium intake by using salt substitutes for seasoning 11) What accurately describes the PR interval? a) 0.12 to 0.20 seconds and measure beginning of P wave to beginning of QRS b) <0.12 seconds and measure between T wave and QRS c) 0.16 to 0.24 seconds and measure from P wave to ST segment d) Time of depolarization and repolarization of ventricles 12) The patient's PR interval comprises six small boxes on the ECG graph. What does this indicate? a) A normal finding b) A problem with ventricular depolarization c) A disturbance in the repolarization of the atria d) A problem with conduction from the SA node to the ventricular cells 13) What describes the SA node's ability to discharge an electrical impulse spontaneously? a) Excitability b) Contractility c) Condutivity d) Automaticity 14) The most important thing to understand about pulseless electrical activity (PEA) is a) The heart rate is 40-60 bpm b) Hypoxemia and hypervolemia are common with PEA c) There is dissociated activity of the ventricle and atrium d) There is electrical activity with no mechanical response 15) While providing D/C instructions to pt with an implantable cardioverter-defibrillator (ICD) inserted, the nurse teaches that after ICD fires, the most important thing for the pt to do is a) Lie down b) Call the cardiologist c) Push the reset button on the pulse generator d) Immediately take his or her antidysrhythmic medication 16) In a pt with a dysrhythmia, which assessment indicates decreased cardiac output? a) Hypertension and bradycardia b) Chest pain and decreased mentation c) Abdominal distention and hepatomegaly d) Bounding pulses and a ventricular heave 17) A pt with an acute MI has sinus tachycardia of 126 bpm. If this dysrhythmia is not treated, what is the worst thing the pt is likely to experience? a) Hypertension b) Escape rhythms c) Ventricular tachycardia d) An increase in infarct size 18) A pt with a sinus node dysfunction has a permanent pacemaker inserted. Before discharge, the nurse should include what in teaching? a) Avoid cooking with microwave ovens b) Avoid standing near antitheft devices in doorways c) Use mild analgesics to control the chest spasms caused by the pacing current d) Start lifting the arm above the shoulder right away to prevent a "frozen shoulder" 19) Which rhythm pattern finding is indicative of PVC's? a) A QRS complex >0.12 seconds followed by a P wave or with a hidden P wave b) Continuous wide QRS complexes with a ventricular rate of 160 bpm c) QRS complexes < 0.12 seconds with a regular rhythm of 120 bpm d) Saw-toothed P waves with no measureable PR interval and an irregular rhythm 20) Rationale for using cardiac defibrillation for a pt experiencing ventricular fibrillation (VF)? a) Enhance repolarization and relaxation of ventricular myocardial cells b) Provide an electrical impulse that stimulates normal myocardial contractions c) Depolarize the cells of the myocardium to allow the SA node to resume pacemaker function d) Deliver an electrical impulse to the heart at the time of ventricular contraction to convert the heart to a sinus rhythm 21) Pt is in ventricular fibrillation (VF) and unresponsive. After initiating EMS call, what is next priority for the nurse? a) Get the crash cart b) Begin CPR c) Administer amiodarone IV d) Defibrillate with 360 joules 22) Priority decision: A pt with an acute MI has multifocal PVCs and couplets. He is alert with BP 118/78 with an irregular pulse of 86 bpm. What is priority nursing action? a) Continue to assess patient b) Ask the patient to perform Valsalva maneuver c) Prepare to administer antidysrhythmic drugs per protocol d) Be prepared to administer cardiopulmonary resuscitation (CPR) 23) Pt with chest pain unrelieved by nitroglycerin is admitted to coronary care unit for observation. What ECG finding would most concern the nurse? a) Occasional PVCs b) QRS complex change c) ST segment elevation d) A PR interval of 0.18 seconds 24) The pt is in the ED with acute coronary syndrome (ACS). What changes would the nurse expect to see on the ECG if only myocardial injury has occurred? a) Absent P wave b) A wide QT interval c) Tall, peaked T wave d) ST-segment elevation 25) The pt with acute pericarditis is having a pericardiocentesis. Postoperatively, what complication should the nurse monitor the pt for? a) Pneumonia b) Pneumothorax c) Myocardial infarction (MI) d) Cerebrovascular accident (CVA) 26) A pt with aortic valve endocarditis develops dyspnea, crackles in lungs, and restlessness. What should nurse suspect that pt is experiencing? a) Pulmonary embolization from valve vegetations b) Vegetative embolization to the coronary arteries c) Valvular incompetence with resulting heart failure d) Nonspecific manifestations that accompany infectious diseases 27) When obtaining a nursing history for a pt with myocarditis, what should the nurse specifically question the pt about? a) Prior use of digoxin for treatment of cardiac problems b) Recent symptoms of a viral illness, such as fever and maliase c) A history of coronary artery disease (CAD) with or without an MI d) A recent streptococcal infection treatment with penicillin 28) When obtaining a health history for a 72-year-old man with peripheral arterial disease (PAD) of the lower extremities, the nurse asks about a history of related conditions, including a) Venous thrombosis b) Venous stasis ulcers c) Pulmonary embolism d) Coronary artery disease 29) A pt is admitted post-radiation therapy with symptoms of cardiomyopathy (CMP). Which type of CMP should the nurse suspect that the pt is experiencing? a) Dilated b) Restrictive c) Takotsubo d) Hypertrophic

Cardiac Nursing

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