Cardiac Nurse Education (61-65)

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61. The nurse notes an isolated premature ventricular contraction (PVC) on the cardiac monitor. The appropriate nursing action is to:

a) prepare for defibrillation
b) continue to monitor the rhythm
c) notify the physician immediately
d) prepare to administer lidocaine hydrochloride (xylocaine)

62. The nurse is caring for a client who has been transferred to the surgical unit after having a pelvic exenteration. During the postoperative period, the client complains of pain in the calf area. What action should the nurse take?

a) ask the client to walk and observe the gait
b) lightly massage the calf area to relieve the pain
c) check the calf area for temperature, color, and size
d) administer prn morphine as prescribed for postoperative pain

63. A client has developed atrial fibrillation and has a ventricular rate of 150 bpm. The nurse assesses the client for:

a) flat neck veins
b) nausea and vomiting
c) hypotension and dizziness
d) hypertension and headache

64. A 45 year old client is admitted to the hospital for evaluation of recurrent runs of ventricular tachycardia noted on Holter monitoring. The client is scheduled for electrophysiology studies (EPS) the following morning. Which statement should the nurse include in a teaching plan for this client?

a) you will continue to take your medications until the morning of the test
b) you will be sedated during the procedure and will not remember what has happened
c) this test is a noninvasive method of determining the effectiveness of your medication
d) during the procedure, a special wire is used to increase the heart rate and produce the irregular beats that caused your signs and symptoms

65. A nurse is providing diet teaching to a client with congestive heart failure (CHF). The nurse tells the client to avoid which of the following?

a) sherbet
b) steak sauce
c) apple juice
d) leafy green vegetables






Cardiac Nurse Education
Answers and Rationale

61) B

- As an isolated occurrence, the PVC is not life threatening. In this situation, the nurse should continue to monitor the client. Frequent PVCs, however, may be precursors of more life-threatening rhythms, such as ventricular tachycardia and ventricular fibrillation. If this occurs, the physician needs to be notified.

62) C

- The nurse monitors for postoperative complications such as deep vein thrombosis, pulmonary emboli, and wound infection. Pain in the calf area could indicate a deep vein thrombosis. Change in color, temperature, or size of the client's calf could also indicate this complication. Options A and B could result in an embolus if in fact the client had a deep vein thrombosis. Administering pain medication for this client complaint is not the appropriate nursing action. Further assessment needs to take place.

63) C

- The client with uncontrolled atrial fibrillation with a ventricular rate over 100 beats per minute is at risk for low cardiac output caused by 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.

64) D

- The purpose of EPS is to study the heart's electrical system. During this invasive procedure, a special wire is introduced into the heart to produce dysrhythmias. To prepare for this procedure, the client should be NPO for 6 to 8 hours before the test, and all antidysrhythmics are held for at least 24 hours before the test in order to study the dysrhythmias without the influence of medications. Because the client's verbal responses to the rhythm changes are extremely important, sedation is avoided if possible.

65) B

- Steak sauce is high in sodium. Leafy green vegetables, any juice (except tomato or V8 brand vegetable), and sherbet are all low in sodium. Clients with CHF should monitor sodium intake.


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Cardiac Nurse Education (1-5)


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Cardiac Nurse Education (66-70)