Chapter 26 Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition

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Chapter 26  Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

1. The nurse is caring for a patient who has had an ECG. The nurse notes that leads I, II, and III differ from one another on the cardiac rhythm strip. How should the nurse best respond?

  1. A)  Recognize that the view of the electrical current changes in relation to the lead placement.
  2. B)  Recognize that the electrophysiological conduction of the heart differs with lead placement.
  3. C)  Inform the technician that the ECG equipment has malfunctioned.
  4. D)  Inform the physician that the patient is experiencing a new onset of dysrhythmia.

Ans: A

Feedback:

Each lead offers a different reference point to view the electrical activity of the heart. The lead displays the configuration of electrical activity of the heart. Differences between leads are not necessarily attributable to equipment malfunction or dysrhythmias.

2. The nurse is analyzing a rhythm strip. What component of the ECG corresponds to the resting state of the patient’s heart?

  1. A)  P wave
  2. B)  T wave
  3. C)  U wave
  4. D)  QRS complex

Ans: B

Feedback:

The T wave specifically represents ventricular muscle depolarization, also referred to as the resting state. Ventricular muscle depolarization does not result in the P wave, U wave, or QRS complex.

3. The nursing educator is presenting a case study of an adult patient who has abnormal ventricular depolarization. This pathologic change would be most evident in what component of the ECG?

  1. A)  P wave
  2. B)  T wave
  3. C)  QRS complex
  4. D)  U wave

Ans: C

Feedback:

The QRS complex represents the depolarization of the ventricles and, as such, the electrical activity of that ventricle.

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4. An adult patient with third-degree AV block is admitted to the cardiac care unit and placed on continuous cardiac monitoring. What rhythm characteristic will the ECG most likely show?

  1. A)  PP interval and RR interval are irregular.
  2. B)  PP interval is equal to RR interval.
  3. C)  Fewer QRS complexes than P waves
  4. D)  PR interval is constant.

Ans: C

Feedback:

In third-degree AV block, no atrial impulse is conducted through the AV node into the ventricles. As a result, there are impulses stimulating the atria and impulses stimulating the ventricles. Therefore, there are more P waves than QRS complexes due to the difference in the natural pacemaker (nodes) rates of the heart. The other listed ECG changes are not consistent with this diagnosis.

5. The nurse is writing a plan of care for a patient with a cardiac dysrhythmia. What would be the most appropriate goal for the patient?

  1. A)  Maintain a resting heart rate below 70 bpm.
  2. B)  Maintain adequate control of chest pain.
  3. C)  Maintain adequate cardiac output.
  4. D)  Maintain normal cardiac structure.

Ans: C

Feedback:

For patient safety, the most appropriate goal is to maintain cardiac output to prevent worsening complications as a result of decreased cardiac output. A resting rate of less than 70 bpm is not appropriate for every patient. Chest pain is more closely associated with acute coronary syndrome than with dysrhythmias. Nursing actions cannot normally influence the physical structure of the heart.

6. A patient has returned to the cardiac care unit after having a permanent pacemaker implantation. For which potential complication should the nurse most closely assess this patient?

  1. A)  Chest pain
  2. B)  Bleeding at the implantation site
  3. C)  Malignant hyperthermia
  4. D)  Bradycardia

Ans: B

Feedback:

Bleeding, hematomas, local infections, perforation of the myocardium, and tachycardia are complications of pacemaker implantations. The nurse should monitor for chest pain and bradycardia, but bleeding is a more common immediate complication. Malignant hyperthermia is unlikely because it is a response to anesthesia administration.

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