Cardiac-Vascular Nursing (CVRN) Practice Exam

What initial test should the nurse prepare a patient for who reports palpitations and dizziness with irregular apical pulse?

1. Computed tomography (CT) scan of the head w/out contrast

2. Coronary angiography

3. Twelve-lead electrocardiogram (ECG)

4. Vascular doppler studies

The correct answer is: Twelve-lead electrocardiogram (ECG)

The appropriate initial test for a patient presenting with palpitations and dizziness, especially with an irregular apical pulse, is the twelve-lead electrocardiogram (ECG). This test is crucial because it provides immediate, valuable information about the electrical activity of the heart. Palpitations can be symptomatic of various arrhythmias, and the ECG can help identify these conditions by showing abnormal heart rhythms or evidence of ischemia. In this scenario, the ECG allows the healthcare provider to quickly ascertain whether there are any underlying cardiac issues contributing to the patient's symptoms. Irregularities noted on the ECG could indicate atrial fibrillation, other types of arrhythmias, or other cardiac anomalies that need further management. The other tests listed, such as a CT scan of the head, coronary angiography, or vascular doppler studies, would not be the first-line evaluations for someone with these specific symptoms. A CT scan of the head may be relevant in cases of neurological concerns, coronary angiography focuses on the coronary arteries to evaluate for blockages, and vascular doppler studies assess blood flow in the arteries and veins but do not provide information about heart rhythm or electrical activity. Therefore, the twelve-lead ECG is the most appropriate and effective initial diagnostic tool