Multiple Choice Items Essay 3

Multiple Choice Items Essay 3

Multiple Choice Items Essay 3

Answer each question below. Use complete sentences when providing short answer responses.

Don't use plagiarized sources. Get Your Custom Essay on
Multiple Choice Items Essay 3
From $8/Page
Order Essay

1. You are the AGACNP in the emergency room. A 55-year-old Caucasian male with a past medical history of HTN, thyroid cancer, and diverticulitis presents with crushing chest pain. His chest pain developed one hour ago after eating a large steak and potato dinner. He states the pain is 10 out of 10 and is not relieved by antacids. He is also diaphoretic and anxious. You review his 12 lead EKG, as per below.

Using the EKG strip, answer questions A-D.

A. What part of the area of the heart is showing an evolving infarct?

a. Inferior

b. Anterior

c. Lateral

d. Posterior

B. Which leads show ST elevation?

a. II, III, AVL

b. V1-V3

c. II, III, AVF

d. II, III, AVR

C. Where would you expect to find reciprocal changes?

a. Reciprocal changes in at least AVL

b. Reciprocal changes in lead III

c. Reciprocal changes in lead IV and V

d. There are No reciprocal changes.

D. What coronary artery is the likely cause?

a. The Right Coronary artery in most cases as it is usually dominant, however in some patients the left circumflex is dominant and thus the culprit for an inferior MI.

b. The left anterior descending

c. The septal artery

d. none of the above

2. A 67-year-old female is your established cardiology patient. She is following up with you regarding her uncomplicated mitral valve stenosis. During the visit, she happens to mention that she has suffered 9 hours of chest pain and sweating, which takes you by surprise. Your patient further describes the pain as both gnawing and intermittent. She thought she was experiencing heartburn, but admits that she has never experienced heartburn before, so she is not sure. You perform a 12-lead EKG immediately and call 911.

Interpret the EKG recording below. Multiple Choice Items Essay 3

What area of the heart is involved, what is your diagnosis, and which coronary artery is affected?

a. Anterior part of the heart; this is an ST elevation myocardial infarction (STEMI); and the Left anterior descending is affected

b. Inferior; this is a Non ST elevation MI (NSTEMI), and the right coronary artery is affected

c. Posterior; this is not an MI but does show ischemia, and the circumflex is involved

d. This simply pericarditis and thus the affected coronary arteries are not affected, the heart strain distribution is diffuse and global

 

3. What qualifies for “significant” ST elevation or depression in a 12 lead EKG- in the limb leads_(i)._____________? What is significant for the or the precordial leads_(ii)._____? These changes must be present in at least_(iii)___________consecutive leads in order to be considered diagnostic of myocardial pathology.

1. (i))1mm in a limb lead, (ii)1mm in precordial lead, (iii)and must be present 3 consecutive leads

1. (i)1mm in a limb lead, (ii)2mm in precordial lead, (iii)and must be present 2 consecutive leads

1. (i) 2mm in a limb lead; (ii)) 2 mm in a precordial lead, (iii) must be present in 3 consecutive leads

1. (i) 3 mm in a limb lead, (ii) 3 mm in a precordial lead, (iii) must be present in 2 consecutive leads

Instructor Notes: An ST segment elevation or depression is considered significant if there is at least 1 mm or 1 small square in a limb lead or 2 mm or 2 small squares in a precordial leads. These significant changes must be present in at least two consecutive leads.

4. A 27-year-old African-American female is admitted to the hospital with severe sepsis related to a cellulitis infection in the groin. The patient was treated appropriately with antibiotics, and then transferred out of the intensive care unit to the medical/surgical unit. On post-admission Day 4, she complains of feeling anxious, short of breath, and chest pain that is worse with deep inspiration. The resident provider on call orders a 12-lead EKG and asks you to interpret it for her. You assess the patient, then review the 12-lead EKG. What is your interpretation?

a. Left bundle branch block

b. Right bundle branch block

c. Normal EKG

d. First degree heart block

Normal adult 12-lead ECG

5. Your 52-year-old Asian female patient with a past medical history of smoking and maybe “some sort of bronchitis” presents to your cardiology clinic. She states she has been having palpitations, light-headedness, and a feeling as if her heart is beating irregularly. The symptoms are not constant, and she is currently not having any symptoms. You obtain a 12-lead EKG in the clinic. What is your interpretation of her 12 Lead EKG, as shown below?

a. Right atrial hypertrophy

b. Left ventricular hypertrophy

c. Complete heart block

d. Atrial fibrillation

 

6. A 77-year-old female with a history of dyslipidemia, hyperthyroidism, and colon cancer presents to the emergency room with chest pain that radiates to her left arm. She has a blood pressure of 70/43, is diaphoretic, and extremely nauseous. Her symptoms occurred after she left a nearby casino, where she had spent several hours. You attend to her in the emergency room and order a 12-lead EKG, stat.Multiple Choice Items Essay 3

A. You are suspicious of a posterior myocardial infarction. What kind of 12 lead EKG would best capture the ST changes of a posterior MI and how is this type of EKG performed?

a. Right sided EKG and move left sided anterior leads V4, V5, and V6, to the right anterior chest in a V7, V8, V9 configuration, also change setting on EKG machine to “right sided EKG.”

b. There is no such technique available, you simply have to infer that depression in atypical leads and multiple leads could indeed be indicative of a posterior MI.

c. Place all leads on the posterior left torso, thus mirroring the usual placement on anterior torso.

d. Obtain serial troponins and recheck the EKG in four hours.

Instructor Notes: ST segment depression (not elevation) in the septal and anterior precordial leads (V1 to V4), in other words ECG leads will “see” the MI backwards (since the leads are placed anteriorly, but the myocardial injury is posterior. A right sided EKG can be performed to better visualize these changes, in doing this you must remove V4, V5, and V6 on the left side of the anterior chest and instead place these leads as V7-V9 directly opposite on the right side of the anterior chest. The presence or absence of ST elevation in the posterior leads V7-9 will more clearly differentiate a posterior MI.

B. What findings would you expect to see in the leads that visualize an acute posterior wall myocardial infarction on your patient’s 12-lead EKG?

a. ST segment depression in Septal and anterior leads (V1-V4) in a normal EKG, and ST elevation in V7-V9 in a right sided EKG

b. ST segment depression in the Inferior leads and V2-V4, ST elevation in V7-V9.

c. ST elevation in Septal and anterior leads, and ST depression in V7-V9

d. ST elevation in all leads and depression in V7-V9

C. What symptoms are common in an posterior myocardial infarction?

a. Hypotension, nausea and vomiting, extreme weakness/ fatigue, any type of chest pain or pressure this is pretty individual.

b. No pain and nausea, vomiting, diaphoresis and diarrhea.

c. Neck pain, back pain, some euphoria.

d. Nausea, vomiting, and fever with abdominal pain

7. An 87-year-old female with long standing uncontrolled HTN presents to the emergency room after experiencing symptoms and signs of a stroke. You order an EKG as part of the standard procedures. What is your impression of the 12-lead EKG below?

a. Left ventricular hypertrophy is common with uncontrolled hypertension, and likewise hypertension, not well controlled is a risk factor for stroke.

b. Atrial hypertrophy and patient likely has also congestive heart failure

c. Right ventricular hypertrophy

d. Normal EKG

 

8. You are the hospitalist AGACNP on call, and you complete a follow-up assessment on a 72-year-old female who was admitted for syncope yesterday. You hear a loud first heart sound and mid-diastolic murmur, which was not documented by the attending provider in the admission note from yesterday. Today’s EKG is below. What is your interpretation of the murmur and the results on the 12-lead EKG?

a. This is atrial fibrillation with a rapid ventricular response and the heart murmur is not diagnostic with this EKG.

b. This is a new murmur and along with the EKG the diagnosis is a Non ST Elevation MI.

c. This is sinus tachycardia and it would be very difficult to auscultate a murmur at this rate

d. There is a new murmur and thus systolic dysfunction is the diagnosis and the EKG is atrial flutter.

Multiple Choice Items Essay 3

9. Using the EKG profile below, identify the AXIS.
a. Right Axis

b. Left Axis

10. You are an AGACNP in a busy emergency department. A 78-year-old male comes in with chief complaint of left sided chest pressure, dizziness, nausea, and vomiting. He is diaphoretic with a blood pressure of 78/50. You are handed an EKG and respond to the nursing staff , “No further interpretation on this one. What is the troponin?” On what types of EKG’s are you unable to interpret ST elevation or depression?

a. Paced rhythms and left bundle branch blocks

b. Atrial fibrillation at rapid rates

c. Right bundle branch blocks

d. Any patient with a prior ablation procedure

 

Calculate the price
Make an order in advance and get the best price
Pages (550 words)
$0.00
*Price with a welcome 20% discount applied.
Pro tip: If you want to save more money and pay the lowest price, you need to set a more extended deadline.
We know how difficult it is to be a student these days. That's why our prices are one of the most affordable on the market, and there are no hidden fees.

Instead, we offer bonuses, discounts, and free services to make your experience outstanding.
How it works
Receive a 100% original paper that will pass Turnitin from a top essay writing service
step 1
Upload your instructions
Fill out the order form and provide paper details. You can even attach screenshots or add additional instructions later. If something is not clear or missing, the writer will contact you for clarification.
Pro service tips
How to get the most out of your experience with Top Writers 4Me
One writer throughout the entire course
If you like the writer, you can hire them again. Just copy & paste their ID on the order form ("Preferred Writer's ID" field). This way, your vocabulary will be uniform, and the writer will be aware of your needs.
The same paper from different writers
You can order essay or any other work from two different writers to choose the best one or give another version to a friend. This can be done through the add-on "Same paper from another writer."
Copy of sources used by the writer
Our college essay writers work with ScienceDirect and other databases. They can send you articles or materials used in PDF or through screenshots. Just tick the "Copy of sources" field on the order form.
Testimonials
See why 10k+ students have chosen us as their sole writing assistance provider
Check out the latest reviews and opinions submitted by real customers worldwide and make an informed decision.
Classic English Literature
Great paper, thank you!
Customer 452591, May 5th, 2022
Communications
Thank you so much!
Customer 452461, June 23rd, 2021
English 101
Great work! Thanks!
Customer 452567, August 2nd, 2022
Communications
You're awesome! Thank you so much!
Customer 452483, July 27th, 2021
Nursing
Good job! Thank you
Customer 452487, October 17th, 2021
Psychology
Thank you for all of your help and hard work, truly appreciate you guys always being there with my hectic schedule. Thank you again!
Customer 452483, September 20th, 2021
Nursing
Excellent!!! Thank you.
Customer 452487, September 13th, 2021
Microbiology
Thank you so much for revising this paper for me. It looks great, truly appreciate it! You're awesome :)
Customer 452483, September 14th, 2021
Nursing
Good job. Thank you
Customer 452487, September 16th, 2021
Nursing
Excellent. Thank you.
Customer 452487, August 26th, 2021
Microbiology
Appreciate all of your hard work! Thank you so much!!
Customer 452483, September 14th, 2021
Communications
came in earlier than I thought and has all the sources listed and cited in APA format, overall all perfect!
Customer 452461, May 24th, 2021
1159
Customer reviews in total
96%
Current satisfaction rate
2 pages
Average paper length
47%
Customers referred by a friend
OUR GIFT TO YOU
20% OFF your first order
Use a coupon TOP20 and enjoy expert help with any task at the most affordable price.
Claim my 20% OFF Order in Chat