ENA Emergency Nursing Orientation
Cardiovascular Emergencies
ENA: Cardiac
1. Which effect does parasympathetic stimulation have on the heart?
A. It
... [Show More] increases peripheral vascular resistance.
B. It enhances atrioventricular node function.
C. It shortens His-Purkinje and ventricular muscle refractoriness.
D. It slows sinoatrial node discharge.: D.
Parasympathetic stimulation slows sinoatrial node discharge. Sympathetic stimulation enhances atrioventricular node function, shortens His-Purkinje and ventricular
muscle refractoriness, and increases peripheral vascular resistance.
2. Calcium channel blockers are indicated to treat which dysrhythmia?
A. Atrial fibrillation
B. Accelerated junctional tachycardia
C. Second-degree atrioventricular block, type II
D. Polymorphic ventricular tachycardia: A.
Treatment of atrial fibrillation aims to control the rapid ventricular rate with medications, such as calcium channel blockers or beta-blockers. Calcium channel
blockers are not used to treat the other dysrhythmias listed. Accelerated junctional
tachycardia is a transient rhythm that only requires treatment of the underlying
disorder.Patients with second-degree atrioventricular block, type II, require careful
monitoring and may need transcutaneous pacing. Treatment for polymorphic ventricular tachycardia is magnesium sulfate and defibrillation if the patient's condition
is unstable.
3. Which intervention is used to treat a patient with ventricular fibrillation
who has an implantable cardiac defibrillator?
A. Apply hands-free adhesive patches in the anterior-posterior position and
defibrillate.
B. Wait for the device to fire.
C. Apply hands-free adhesive patches in the standard position and cardiovert.
D. Apply one hands-free adhesive patch over the device and the other on the
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opposite side of the sternum and defibrillate.: A.
When a patient with an implantable cardiac defibrillator requires external defibrillation because the implanted device has malfunctioned or failed, ideally place
hands-free adhesive patches in the anterior-posterior position. Do not wait for
the device to fire because a malfunction has occurred if ventricular fibrillation
is present. Cardioversion is not appropriate because no QRS complexes are
present for synchronization. Do not place the adhesive patches directly over the
implantable cardiac defibrillator.
4. Which receptor is located in the lungs?
A. Alpha
B. Beta1
C. Beta2
D. Dopaminergic: C.
Beta2 receptors are located in the lungs and peripheral vessels. Alpha receptors
exist in vascular smooth muscle.Beta1 receptors are in the myocardium. Dopaminergic receptors are found in renal, mesenteric, cerebral, and coronary arteries.
5. Which dysrhythmia has premature P waves with a different configuration
than other P waves in the cardiac cycle?
A. Atrial flutter
B. Premature atrial complex
C. First-degree atrioventricular block
D. Second-degree atrioventricular block, type II: B.
Premature atrial complexes are ectopic beats that are initiated by an irritable atrial
focus. P waves are present, but because the ectopic focus originates the impulse
outside the sinoatrial node, the premature P waves have a different configuration.
Atrial flutter causes no P waves, but it causes flutter waves in a sawtoothed pattern.
First-degree atrioventricular block has a P wave for every QRS complex, but the
PR interval is consistently prolonged. Second-degree atrioventricular block, type
II, has one or more P waves for every QRS complex. In first-degree atrioventricular
block and second-degree atrioventricular block, type II, the P wave configuration
is consistent from P wave to P wave
6. Which method delivers nonsynchronous energy to the myocardium?
A.Transcutaneous pacing
B. Cardioversion
C. Defibrillation
D.Transvenous pacing: C [Show Less]