The nurse needs to quickly estimate the heart rate for a patient with a regular heart rhythm. Which method will be best to use?
a. Count the number of large squares in the R-R interval and divide by 300.
b. Print a 1-minute electrocardiogram (ECG) strip and count the number of QRS complexes.
c. Calculate the number of small squares between one QRS complex and the next and divide into 1500.
d. Use the 3-second markers to count the number of QRS complexes in 6 seconds and multiply by 10.
Question 2To determine whether there is a delay in impulse conduction through the atria, the nurse will measure the duration of the patient's
a. P wave.
b. Q wave.
c. P-R interval.
d. QRS complex.
Question 3Based on the Joint Commission Core Measures for patients with heart failure, which topics should the nurse include in the discharge teaching plan for a patient who has been hospitalized with chronic heart failure (select all that apply)?
a. How to take and record daily weight
b. Importance of limiting aerobic exercise
c. Date and time of follow-up appointment
d. Symptoms indicating worsening heart failure
e. Actions and side effects of prescribed medications
Question 4A patient who is receiving dobutamine (Dobutrex) for the treatment of acute decompensated heart failure (ADHF) has the following nursing interventions included in the plan of care.
Which action will be most appropriate for the registered nurse (RN) to delegate to an experienced licensed practical/vocational nurse (LPN/LVN)?
a. Assess the IV insertion site for signs of extravasation.
b. Teach the patient the reasons for remaining on bed rest.
c. Monitor the patient's blood pressure and heart rate every hour.
d. Titrate the rate to keep the systolic blood pressure >90 mm Hg.
Question 5An outpatient who has chronic heart failure returns to the clinic after 2 weeks of therapy with metoprolol (Toprol XL). Which assessment finding is most important for the nurse to report to the health care provider?
a. 2+ pedal edema
b. Heart rate of 56 beats/minute
c. Blood pressure (BP) of 88/42 mm Hg
d. Complaints of fatigue
Question 6A patient has recently started on digoxin (Lanoxin) in addition to furosemide (Lasix) and captopril (Capoten) for the management of heart failure. Which assessment finding by the home health nurse is a priority to communicate to the health care provider?
a. Presence of 1 to 2+ edema in the feet and ankles
b. Palpable liver edge 2 cm below the ribs on the right side
c. Serum potassium level 3.0 mEq/L after 1 week of therapy
d. Weight increase from 120 pounds to 122 pounds over 3 days
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