Cardiac Vascular Nursing Exam Technology & Digital Applications 3 — Questions and Answers
Question 1: A cardiac nurse receives a CPOE (Computerized Physician Order Entry) alert stating a newly ordered beta-blocker is contraindicated due to the patient's documented allergy to carvedilol. What is the most appropriate action?
- Override the alert and administer the medication
- Contact the prescriber to clarify the order before administering (Correct answer)
- Hold all beta-blockers indefinitely without notifying anyone
- Document the alert and administer a half dose
Correct answer: Contact the prescriber to clarify the order before administering
Clinical decision support alerts should prompt nurse-prescriber communication to clarify intended therapy, as cross-reactivity within drug classes must be evaluated before administration.
Question 2: Which feature of a cardiac implantable electronic device (CIED) remote monitoring platform most directly reduces unplanned hospital readmissions?
- Automatic device recharging
- Early detection of fluid accumulation through impedance trending (Correct answer)
- Color-coded patient risk stratification dashboards
- Automatic scheduling of in-person device checks
Correct answer: Early detection of fluid accumulation through impedance trending
Intrathoracic impedance monitoring detects early fluid accumulation in heart failure patients, allowing intervention before symptoms necessitate hospitalization.
Question 3: A nurse uses a barcode medication administration (BCMA) system before giving IV heparin. The scanner returns a 'patient mismatch' error. What should the nurse do?
- Administer the medication since the dose appears correct
- Scan the patient band again and, if error persists, investigate the discrepancy before giving the drug (Correct answer)
- Bypass the scanner and proceed with manual verification only
- Report the scanner as malfunctioning and skip scanning
Correct answer: Scan the patient band again and, if error persists, investigate the discrepancy before giving the drug
A patient mismatch error means the scanned medication or patient band did not match the active order, requiring investigation to prevent a wrong-patient medication error.
Question 4: Which digital tool provides the most comprehensive real-time data when managing a patient on extracorporeal membrane oxygenation (ECMO)?
- Standard telemetry monitor only
- Integrated ECMO console with hemodynamic and oxygenation parameters (Correct answer)
- Pulse oximetry alone
- Portable 12-lead ECG machine
Correct answer: Integrated ECMO console with hemodynamic and oxygenation parameters
The integrated ECMO console displays flow rates, sweep gas, membrane oxygenator function, and hemodynamic parameters simultaneously, which is essential for safe ECMO management.
Question 5: A cardiologist requests that a nurse transmit a 12-lead ECG to a telecardiology service for STEMI consultation. Which patient identifier must be included in the digital transmission?
- Only the patient's first name
- Full name, date of birth, and medical record number (Correct answer)
- Hospital name and cardiologist's pager number only
- Room number and bed assignment
Correct answer: Full name, date of birth, and medical record number
Complete patient identifiers (full name, date of birth, MRN) must accompany all transmitted clinical data to ensure the correct patient is identified and treated.
Question 6: When programming a dual-chamber pacemaker post-implant, which digital parameter is adjusted to prevent pacemaker-mediated tachycardia (PMT)?
- Lower rate limit
- Post-ventricular atrial refractory period (PVARP) (Correct answer)
- Sensitivity threshold
- Pacing output amplitude
Correct answer: Post-ventricular atrial refractory period (PVARP)
Extending the PVARP prevents the pacemaker from tracking retrograde P waves that could initiate and sustain PMT.
Question 7: A vascular surgery patient has a Doppler ultrasound flow probe connected to a digital display. The nurse notes the audible signal changes from triphasic to monophasic. What does this indicate?
- Normal post-operative finding requiring no action
- Possible arterial occlusion or graft failure requiring immediate assessment (Correct answer)
- Probe malfunction requiring equipment replacement
- Venous insufficiency detected by the arterial probe
Correct answer: Possible arterial occlusion or graft failure requiring immediate assessment
A change from triphasic to monophasic Doppler signal indicates reduced arterial flow, which may signal occlusion or graft failure requiring urgent vascular assessment.
Cardiac Vascular Nursing Exam Technology & Digital Applications 3
A cardiac nurse receives a CPOE (Computerized Physician Order Entry) alert stating a newly ordered beta-blocker is contraindicated due to the patient's documented allergy to carvedilol.
What is the most appropriate action?