NCLEX Nursing Practice Test On Cardiovascular System

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NCLEX Nursing Practice Test On Cardiovascular System - Quiz

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Questions and Answers
  • 1. 

    A nurse is assessing an electrocardiogram rhythm strip. The P waves and QRS complexes are regular. The PR interval is 0.16 second. and QRS complexes measure 0.06 second. The overall heart rate is 64 beats per minute. The nurse assesses the cardiac rhythm as:

    • A.

      Normal sinus rhythm

    • B.

      Sinus bradycardia

    • C.

      Sick sinus syndrome

    • D.

      First-degree heart block.

    Correct Answer
    A. Normal sinus rhythm
    Explanation
    measurements are normal. measuring 0.12 to 0.20 second and 0.4 to 0.10 second. respectively.

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  • 2. 

    A nurse notices frequent artifact on the ECG monitor for a client whose leads are connected by cable to a console at the bedside. The nurse examines the client to determine the cause. Which of the following items is unlikely to be responsible for the artifact?

    • A.

      Frequent movement of the client

    • B.

      Tightly secured cable connections

    • C.

      Leads applied over hairy areas

    • D.

      Leads applied to the limbs

    Correct Answer
    B. Tightly secured cable connections
    Explanation
    Motion artifact. or “noise.” can be caused by frequent client movement. electrode placement on limbs. and insufficient adhesion to the skin. such as placing electrodes over hairy areas of the skin. Electrode placement over bony prominences also should be avoided. Signal interference can also occur with electrode removal and cable disconnection.

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  • 3. 

    A nurse is watching the cardiac monitor and notices that the rhythm suddenly changes. There are no P waves. the QRS complexes are wide. and the ventricular rate is regular but over 100. The nurse determines that the client is experiencing:

    • A.

      Premature ventricular contractions

    • B.

      Ventricular tachycardia

    • C.

      Ventricular fibrillation

    • D.

      Sinus tachycardia

    Correct Answer
    B. Ventricular tachycardia
    Explanation
    Ventricular tachycardia is characterized by the absence of P waves. wide QRS complexes (usually greater than 0.14 second). and a rate between 100 and 250 impulses per minute. The rhythm is usually regular.

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  • 4. 

    A nurse is viewing the cardiac monitor in a client’s room and notes that the client has just gone into ventricular tachycardia. The client is awake and alert and has good skin color. The nurse would prepare to do which of the following?

    • A.

      Immediately defibrillate

    • B.

      Prepare for pacemaker insertion

    • C.

      Administer amiodarone (Cordarone) intravenously

    • D.

      Administer epinephrine (Adrenaline) intravenously

    Correct Answer
    C. Administer amiodarone (Cordarone) intravenously
    Explanation
    First-line treatment of ventricular tachycardia in a client who is hemodynamically stable is the use of antidysrhythmics such as amiodarone (Cordarone). lidocaine (Xylocaine). and procainamide (Pronestyl). Cardioversion also may be needed to correct the rhythm (cardioversion is recommended for stable ventricular tachycardia).Option A: Defibrillation is used with pulseless ventricular tachycardia.Option D: Epinephrine would stimulate and already excitable ventricle and is contraindicated.

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  • 5. 

    A nurse is caring for a client with unstable ventricular tachycardia. The nurse instructs the client to do which of the following. if prescribed. during an episode of ventricular tachycardia?

    • A.

      Breathe deeply. regularly. and easily.

    • B.

      Inhale deeply and cough forcefully every 1 to 3 seconds.

    • C.

      Lie down flat in bed

    • D.

      Remove any metal jewelry

    Correct Answer
    B. Inhale deeply and cough forcefully every 1 to 3 seconds.
    Explanation
    Cough Cardiopulmonary Resuscitation (CPR) sometimes is used in the client with unstable ventricular tachycardia. The nurse tells the client to use cough CPR. if prescribed. by inhaling deeply and coughing forcefully every 1 to 3 seconds. Cough CPR may terminate the dysrhythmia or sustain the cerebral and coronary circulation for a short time until other measures can be implemented.

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  • 6. 

    A client is having frequent premature ventricular contractions. A nurse would place priority on assessment of which of the following items?

    • A.

      Blood pressure and peripheral perfusion

    • B.

      Sensation of palpitations

    • C.

      Causative factors such as caffeine

    • D.

      Precipitating factors such as infection

    Correct Answer
    A. Blood pressure and peripheral perfusion
    Explanation
    Premature ventricular contractions can cause hemodynamic compromise. The shortened ventricular filling time with the ectopic beats leads to decreased stroke volume and. if frequent enough. to decreased cardiac output.Option B: The client may be asymptomatic or may feel palpitations.Options C and D: PVCs can be caused by cardiac disorders or by any number of physiological stressors. such as infection. illness. surgery. or trauma. and by the intake of caffeine. alcohol. or nicotine.

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  • 7. 

     A client has developed atrial fibrillation. which a ventricular rate of 150 beats per minute. A nurse assesses the client for:

    • A.

      Hypotension and dizziness

    • B.

      Nausea and vomiting

    • C.

      Hypertension and headache

    • D.

      Flat neck veins

    Correct Answer
    A. Hypotension and dizziness
    Explanation
    The client with uncontrolled atrial fibrillation with a ventricular rate more than 150 beats a minute is at risk for low cardiac output because of loss of atrial kick. The nurse assesses the client for palpitations. chest pain or discomfort. hypotension. pulse deficit. fatigue. weakness. dizziness. syncope. shortness of breath. and distended neck veins.

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  • 8. 

    A nurse is watching the cardiac monitor. and a client’s rhythm suddenly changes. There are no P waves; instead. there are wavy lines. The QRS complexes measure 0.08 second. but they are irregular. with a rate of 120 beats a minute. The nurse interprets this rhythm as:

    • A.

      Sinus tachycardia

    • B.

      Atrial fibrillation

    • C.

      Ventricular tachycardia

    • D.

      Ventricular fibrillation

    Correct Answer
    B. Atrial fibrillation
    Explanation
    Atrial fibrillation is characterized by a loss of P waves; an undulating. wavy baseline; QRS duration that is often within normal limits; and an irregular ventricular rate. which can range from 60 to 100 beats per minute (when controlled with medications) to 100 to 160 beats per minute (when uncontrolled).

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  • 9. 

    A client with rapid rate atrial fibrillation asks a nurse why the physician is going to perform carotid massage. The nurse responds that this procedure may stimulate the:

    • A.

      Vagus nerve to slow the heart rate

    • B.

      Vagus nerve to increase the heart rate; overdriving the rhythm.

    • C.

      Diaphragmatic nerve to slow the heart rate

    • D.

      Diaphragmatic nerve to overdrive the rhythm

    Correct Answer
    A. Vagus nerve to slow the heart rate
    Explanation
    Carotid sinus massage is one of the maneuvers used for vagal stimulation to decrease a rapid heart rate and possibly terminate a tachydysrhythmias. The others include inducing the gag reflex and asking the client to strain or bear down. Medication therapy often is needed as an adjunct to keep the rate down or maintain the normal rhythm.

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  • 10. 

    A nurse notes that a client with sinus rhythm has a premature ventricular contraction that falls on the T wave of the preceding beat. The client’s rhythm suddenly changes to one with no P waves or definable QRS complexes. Instead. there are coarse wavy lines of varying amplitude. The nurse assesses this rhythm to be:

    • A.

      Ventricular tachycardia

    • B.

      Ventricular fibrillation

    • C.

      Atrial fibrillation

    • D.

      Asystole

    Correct Answer
    B. Ventricular fibrillation
    Explanation
    Ventricular fibrillation is characterized by irregular. chaotic undulations of varying amplitudes. Ventricular fibrillation has no measurable rate and no visible P waves or QRS complexes and results from electrical chaos in the ventricles.

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