Nurse Practitioner Cardiology
Midterm Exam
Course Introduction
This course provides advanced theoretical knowledge and clinical skills necessary for nurse practitioners specializing in cardiology. It focuses on the assessment, diagnosis, and management of acute and chronic cardiovascular conditions across the lifespan, including hypertension, heart failure, coronary artery disease, arrhythmias, and valvular disorders. Emphasis is placed on evidence-based practice, pharmacologic and non-pharmacologic interventions, diagnostic procedures, and collaborative care strategies within an interprofessional healthcare environment. Students will also explore patient education, prevention strategies, and ethical considerations unique to cardiovascular care, preparing them for autonomous and collaborative roles in diverse healthcare settings.
Recommended Textbook
ECGs Made Easy 5th Edition by Barbara J Aehlert
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515 Flashcards
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Chapter 1: Anatomy and Physiology
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Sample Questions
Q1) Stimulation of beta-adrenergic receptor sites will result in peripheral vasoconstriction.
A)True
B)False
Answer: False
Q2) Blood flows from the right atrium through the _____ valve into the right ventricle.
A) mitral
B) aortic
C) pulmonic
D) tricuspid
Answer: D
Q3) The right ventricle expels blood through the _____ valve into the pulmonary trunk.
A) mitral
B) aortic
C) pulmonic
D) tricuspid
Answer: C
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Page 3
Chapter 2: Basic Electrophysiology
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Sample Questions
Q1) In the limb leads,the ST segment is normally isoelectric,or less than 1 mm above or below the isoelectric line.
A)True
B)False
Answer: True
Q2) Which part of the conduction system receives an impulse from the bundle of His and relays it to the Purkinje fibers?
A) SA node
B) AV node
C) Right and left atria
D) Right and left bundle branches
Answer: D
Q3) On the ECG,what do the ST segment and T wave represent?
Answer: On the ECG,the ST segment represents early ventricular repolarization and the T wave presents ventricular repolarization.
Q4) List three causes of artifact on an ECG tracing.
Answer: Artifacts may be due to loose electrodes,broken wires or ECG cables,muscle tremor,patient movement,external chest compressions,or 60-cycle interference.
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Page 4
Chapter 3: Sinus Mechanisms
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Sample Questions
Q1) Which of the following are possible causes of sinus bradycardia?
A) Elevated temperature,pain
B) Increased intracranial pressure,beta-blocker overdose
C) Hypoxia,fright,caffeine-containing beverages
D) Hypovolemia,administration of sympathomimetics
Answer: B
Q2) The rate of a sinus bradycardia is _____ beats/min.
A) slower than 60
B) 60 to 100
C) 80 to 120
D) faster than 100
Answer: B
Q3) In sinus arrhythmia,a gradual increasing of the heart rate is usually associated with _____.
A) expiration
B) inspiration
C) excessive caffeine intake
D) early signs of heart failure
Answer: B
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Page 5
Chapter 4: Atrial Rhythms
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Sample Questions
Q1) Complete the following ECG criteria for atrial tachycardia: Rlythm______________________________________
p waves_____________________________________________
PR interval_________________________________________
QRS duration____________________________________________
Q2) Upon conversion of atrial fibrillation to sinus rhythm,the patient should be observed for signs of a possible stroke.
A)True
B)False
Q3) Which of the following correctly describes multifocal atrial tachycardia?
A) Atrial rhythm is regular.
B) Ventricular rhythm is irregular.
C) Atrial and ventricular rhythms are regular.
D) Atrial and ventricular rhythms are irregular.
Q4) The most common type of supraventricular tachycardia (SVT)is _____.
A) atrial tachycardia
B) atrial flutter
C) AV reentrant tachycardia (AVRT)
D) AV nodal reentrant tachycardia (AVNRT)
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Chapter 5: Junctional Rhythms
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Sample Questions
Q1) In a junctional rhythm viewed in lead II,where is the location of the P wave on the ECG if atrial and ventricular depolarization occur simultaneously?
A) Before the QRS complex
B) During the QRS complex
C) After the QRS complex
Q2) If the AV junction paces the heart,the electrical impulse must travel in a backward direction to activate the atria.This is called _____ conduction.
Q3) Depending on the severity of the patient's signs and symptoms,management of slow rhythms originating from the AV junction may require intervention including _____.
A) defibrillation
B) intravenous atropine
C) synchronized cardioversion
D) vagal maneuvers or adenosine,or both
Q4) Adenosine is the drug of choice when treating a symptomatic patient with a junctional rhythm at a rate of 40 beats/min.
A)True
B)False
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Chapter 6: Ventricular Rhythms
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Sample Questions
Q1) Which of the following best describes an idioventricular rhythm?
A) Rapid,chaotic rhythm with no pattern or regularity
B) Gradual alteration in the amplitude and direction of the QRS; atrial rate indiscernible; ventricular rate 150 to 250 beats/min
C) Essentially regular ventricular rhythm with QRS complexes measuring 0.12 seconds or greater; atrial rate not discernible; ventricular rate 20 to 40 beats/min
D) Regular ventricular rhythm with QRS complexes measuring less than 0.10 seconds; P waves may occur before,during,or after the QRS; ventricular rate 40 to 60 beats/min
Q2) Complete the following ECG criteria for asystole:
Q3) An idioventricular (ventricular escape)rhythm has an intrinsic rate of 40 to 60 beats/min.
A)True
B)False
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Chapter 7: Heart Blocks
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Sample Questions
Q1) In 2:1 AV block,the PR interval _____.
A) shortens
B) lengthens
C) is absent
D) remains constant
Q2) In third-degree AV block,_____.
A) the atrial rhythm (P-P interval)is irregular
B) the ventricular rhythm (R-R interval)is irregular
C) there is no PR interval because the atria and ventricles beat independently of each other
D) the PR interval after a nonconducted P wave is shorter than the interval preceding the nonconducted beat
Q3) Complete the following ECG criteria for second-degree AV block type I:
Q4) A _____ bundle branch block produces a QS pattern in lead V?.
Q5) A _____ bundle branch block produces a RSR pattern in lead V?.
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Chapter 8: Pacemaker Rhythms
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Sample Questions
Q1) Capture is _____.
A) the electrical stimulus delivered by a pacemaker's pulse generator
B) a vertical line on the ECG that indicates the pacemaker has discharged
C) the time measured between a sensed cardiac event and the next pacemaker output
D) the ability of a pacing stimulus to successfully depolarize the cardiac chamber that is being paced
Q2) In pacing,sensitivity refers to _____.
A) the ability of a pacemaker to recognize and respond to intrinsic electrical activity
B) a pacing lead with a single electrical pole at the distal tip of the pacing lead through which the stimulating pulse is delivered
C) the successful conduction of an artificial pacemaker's impulse through the myocardium,resulting in depolarization
D) the length of time between an atrial sensed or atrial paced event and the delivery of a ventricular pacing stimulus
Q3) Your patient has a VVI pacemaker.Briefly explain the meaning of each of these letters.
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Chapter 9: Introduction to the 12-Lead ECG
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Sample Questions
Q1) Which leads face the septum?
A) II,aVF
B) V<sub>1</sub>,V<sub>2</sub>
C) V<sub>5</sub>,V<sub>6</sub>
D) I,aVL
Q2) Normal electrical axis lies between _____ degrees.
A) -30 and +90
B) +90 and +180
C) -91 and -180
D) -1 and -90
Q3) Acute coronary syndromes consist of three major syndromes that are related.List the three syndromes.
Q4) Lead II views the _____ wall of the left ventricle.
A) anterior
B) inferior
C) septal
D) lateral
Q5) When reviewing a 12-lead ECG,intervals and duration are usually expressed in _____.
Q6) List six leads that view the heart in the frontal plane.
Page 11
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Chapter 10: Post-Test
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Sample Questions
Q1) Sometimes,when a premature atrial complex (PAC)occurs very prematurely and close to the T wave of the preceding beat,only a P wave may be seen with no QRS after it (appearing as a pause).This type of PAC is termed a(n)_____ PAC.
Q2) In most ECG leads,a normal Q wave is less than 0.04 seconds in duration and less than one-third of the amplitude of the R wave in that lead.
A)True
B)False
Q3) On an ECG,what is the first negative deflection seen after the P wave?
A) Q wave
B) R wave
C) S wave
D) T wave
Q4) Which side of the heart is a high-pressure system that pumps arterial blood to the systemic circulation?
A) Left
B) Right
Q5) If the AV junction paces the heart,the electrical impulse must travel in a backward direction to activate the atria.This is called _____ conduction.
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