CCRN Practice – Cardiac Conduction and EKG Interpretation Part 2
This flashcard set focuses on interpreting EKG findings and understanding coronary artery involvement in cardiac conduction. It reinforces knowledge of lead placement, ST segment changes, and their correlation to affected conduction system structures.
If a murmur is audible at the same time that the carotid pulse is felt, the murmur is:
A. systolic.
B. diastolic.
C. always normal.
D. always pathologic.
A. systolic
Key Terms
If a murmur is audible at the same time that the carotid pulse is felt, the murmur is:
A. systolic.
B. diastolic.
C. always normal.
D. always pathologic.
A. systolic
Which drug has Class II and Class III properties?
A. Verapamil (Calan)
B. Propranolol (Inderal)
C. Sotalol (Betapace)
D. Tocainide (Tonocard)
C. Sotalol (Betapace)
The skin changes associated with chronic peripheral arterial disease are:
A. thickened with brownish discoloration at the ankles.
B. pale and shiny.
C. ulcerations at the sides of the ankles.
D. rubor when in dependent position.
B. pale and shiny.
If the air fluid meniscus of the zero reference port of the transducer of a pressure monitoring system is 2 inches below the phlebostatic axis, what effect would it have on pressure measurements?
A. The pressures recorded would be falsely high by about 2 mm Hg.
B. The pressures recorded would be falsely low by about 2 mm Hg.
C. The pressures recorded would be falsely high by about 4 mm Hg.
D. The pressures recorded would be falsely low by about 4 mm Hg.
C. The pressures recorded would be falsely high by about 4 mm Hg.
A patient is admitted to the coronary care unit in third-degree AV heart block with syncopal episodes. Which of the following defines syncope?
A. Dizziness
B. Ataxia
C. Vertigo
D. Transient loss of consciousness
D. Transient loss of consciousness
Clinical indications of a right tension pneumothorax include which of the following?
A. Tracheal shift toward the right with diminished or absent breath sounds on the left
B. Tracheal shift toward the left with diminished or absent breath sounds on the right
C. Tracheal shift toward the left with diminished or absent breath sounds on the left
D. Tracheal shift toward the right with diminished or absent breath sounds on the right
B. Tracheal shift toward the left with diminished or absent breath sounds on the right
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| Term | Definition |
|---|---|
If a murmur is audible at the same time that the carotid pulse is felt, the murmur is: | A. systolic |
Which drug has Class II and Class III properties? | C. Sotalol (Betapace) |
The skin changes associated with chronic peripheral arterial disease are: | B. pale and shiny. |
If the air fluid meniscus of the zero reference port of the transducer of a pressure monitoring system is 2 inches below the phlebostatic axis, what effect would it have on pressure measurements? | C. The pressures recorded would be falsely high by about 4 mm Hg. |
A patient is admitted to the coronary care unit in third-degree AV heart block with syncopal episodes. Which of the following defines syncope? | D. Transient loss of consciousness |
Clinical indications of a right tension pneumothorax include which of the following? | B. Tracheal shift toward the left with diminished or absent breath sounds on the right |
A 70-year-old woman, weighing 50 kg, comes to the ED complaining of chest pain and shortness of breath. EKG shows ventricular tachycardia HR 150. Which treatment is appropriate in this situation? | D. |
A patient is admitted to the coronary care unit with third-degree AV heart block, and a transvenous temporary ventricular pacemaker is inserted. Four hours later the patient complains of dizziness while lying in bed. The monitor shows third-degree AV heart block with a ventricular rate of 52 beats/min and no pacing spikes. This indicates failure to pace, and the patient is taken to surgery for insertion of a DVI permanent pacemaker. Which of the following describes the function of a DVI pacemaker? | C. Paces atrium and ventricle; senses ventricle; inhibited by the QRS complex |
Shortly after returning from PCI, a patient begins to complain of chest pain similar in intensity and character to the pre-PCI pain. The pain is unresponsive to nitroglycerin infusion titration. The patient should be prepared for: | A. return to cardiac catheterization for an additional procedure. |
Which of the following would not be associated with a false-positive result for an acute MI using the total creatine kinase (CK)? | D. Ulcerative colitis |
While auscultating the patient's heart, an S3 is noted. What does this heart sound indicate? | D. Rapid ventricular filling into an already distended ventricle |
Which of the following is the best hemodynamic parameter for assessing LV function? | A. PAOP |
Which of the following are therapeutic goals for drug therapy for dilated cardiomyopathy? | C. Increasing contractility, decreasing afterload and preload |
A 65-year-old black man comes to the ER with complaints of headache. His admission BP 220/150. A nitroprusside (Nipride) drip is initiated. Which of the following would not be an important aspect of care for a patient receiving nitroprusside? | C. Checking the patient's serum glucose every 6 hours |
A patient has just arrived in the ED with severe dyspnea. His history includes an inferior MI approximately 1 week ago. Physical assessment reveals a loud, blowing holosystolic murmur that is loudest at the apex and radiates to the axilla. Crackles are audible throughout the lung fields, and pulse oximetry reveals hypoxemia. What is the most likely cause of the patient's deterioration? | D. Ruptured papillary muscle |
A patient has developed a 2:1 AV block. Which of the following two factors would be helpful in deciding that it is most likely type II second-degree AV block? | B. The QRS complex is 0.14 second wide, and the patient has had an anterior MI. |
Occlusion of the RCA would cause ST elevation in which leads? | B. II, III, aVF |
Which of the following correlates with brain natriuretic peptide (BNP) levels? | C. Pulmonary artery occlusive pressure (PAOP) |
A patient is receiving low-molecular-weight dextran after an aortofemoral bypass graft. What is the purpose of this therapy for this patient? | C. Decrease platelet aggregation |
Which of the following findings would occur in dilated cardiomyopathy? | A. Murmur of mitral regurgitation |
Which of the following would be contraindicated in a patient with Wolff-Parkinson-White (WPW) syndrome? | D. Verapamil (Calan) |
A 67-year-old woman with unstable angina is admitted to the cardiac unit. She has a history of DM and reports having had chest pain intermittently for 4 days. The EKG shows nonspecific ST changes. Which of the following studies is most diagnostic in identifying a MI in this patient? | C. Elevated troponin I |
A patient is in cardiogenic shock and requires careful volume titration to enhance contractility. Which of the following ranges describes the most likely optimal PAOP in this patient? | C. 15-20 mm Hg |
Which of the following drugs prescribed for a patient with stable angina does not decrease myocardial oxygen consumption? | D. Aspirin |
Which of the following is the most common complication of infective endocarditis? | B. Emboli |
Which of the following is likely to correlate most directly with the need for electrical cardioversion for a tachydysrhythmia? | A. Degree of instability |
What is the most frequently identified primary mechanism of cardiac arrest? | D. Ventricular fibrillation |
Which are the two most common dysrhythmias associated with Wolff-Parkinson-White syndrome? | A. Atrial fibrillation and supraventricular tachycardia |
patient in ED with complaints of severe headache. She states that she has been out of her BP pills for 3 weeks and cannot afford to buy more. BP ranges from 250/128 to 200/110. Nitroprusside (Nipride) is being titrated, and the patient is on O2 by NC. In considering the risk for cardiac failure and pulmonary edema, consideration should be made to the physiologic principle that the majority of myocardial oxygen consumption occurs during which phase of the cardiac cycle? | B. Isovolumetric contraction |
A postoperative cardiac surgery patient's blood pressure suddenly drops to 70 mm Hg palpable, with a loss of the a wave in the PAOP waveform. What change in his cardiac rhythm would cause this change in his PAOP waveform? | D. afib |
A 40-year-old patient has been admitted to the critical care unit after sustaining multiple injuries from a cave-in accident this morning. X-ray confirm multiple fractures, including the left femur. During the afternoon he was taken to surgery for internal fixation of the left femur. It is now 10 pm, and the patient is complaining of severe throbbing pain in his thigh. The patient received 5 mg of morphine sulfate IV 30 minutes ago. The anterior left thigh is firm to touch, and the pain increases when the patient flexes his left leg. The nurse should suspect which of the following? | B. Abnormal pain related to compartment syndrome |
Which of the following medications is associated with thiocyanate toxicity? | D. Nitroprusside (Nipride) |
patient is in cardiac and respiratory arrest. The selection of medications to reestablish cardiac function would stimulate the sympathetic nervous system beta1 receptors. This stimulation would result in increased automaticity and which of the following? | A. Increased myocardial contractility |
A 55-year-old man had a heart transplant 10 hours ago. Present assessment includes cold, clammy skin, jugular venous distention, bilateral crackles, and tachycardia. Vital signs are temperature 98.6° F, BP 80/60, HR 120 and RR 24 . Mediastinal tube drainage is approximately 50 mL/hr. He is diagnosed with decreased cardiac contractility. Which of the following would be an appropriate treatment for this patient? | A. Beta-adrenergic stimulant (e.g., dobutamine) |
Which vessel is used as a graft when the minimally invasive direct coronary artery bypass grafting (MIDCABG) procedure is performed? | A. Internal thoracic artery |
Which of the following may be useful in systolic dysfunction but may be detrimental in diastolic dysfunction? | D. Vasodilators |
A 90-year-old patient is admitted with acute respiratory distress. Vital signs are blood pressure 92/66 mm Hg, heart rate 132 beats/min and regular rhythm, and respiratory rate 36 breaths/min and labored. Auscultation of breath sounds reveals crackles to the scapular level bilaterally. Which of the following is the most likely pathophysiologic problem in this patient? | D. Acute pulmonary edema |
Which of the following are two significant adverse effects of angiotensin-converting enzyme (ACE) inhibitors (e.g., captopril [Capoten])? | B. Proteinuria and hyperkalemia |
A patient has just returned to the critical care unit from the operating room. He has a VDD pacemaker. Which of the following is an accurate description of this type of pacemaker? | D. The ventricle is paced in response to a sensed intrinsic atrial impulse or inhibited by a sensed intrinsic ventricular impulse |
While placing a patient on the monitor during admission, a wide-notched P wave is noted in lead II. What does this most likely indicate? | D. Mitral valve disease |
When pulmonary arterial diastolic pressure (PAd) is more than 5 mm Hg higher than pulmonary artery occlusive pressure (PAOP), it signals which abnormal condition? | C. Pulmonary HTN |