1.
Injury to the heart muscle will cause the following change in a patient's EKG?
Correct Answer
C. A elevated ST segment
Explanation
Inverted T waves are from ischemia, large Q waves are from infarcted muscle
2.
What are the signs and symptoms of Angina?
Correct Answer(s)
A. Chest pain lasting < 15 minutes
D. Relief of symptoms with NTG administration
E. Brought on by exertion and stress
Explanation
radiating chest pain past the arm and diaphoresis are signs and symptoms of a MI, not angina
3.
A MI is more lethal to a younger person than an older person
Correct Answer
A. True
Explanation
Older adults have more collateral circlation giving their hearts more perfusion to survive a MI
4.
A woman experiencing a MI's symptoms may differ from a man in what ways?
Correct Answer(s)
A. More Fatigue
C. Back Pain
Explanation
Women may have a slower build up of plaque in their arteries resulting in more gradual and less severe s/s of MI
5.
ST elevations on leads V1, V2, V3 and V4 indicate a:
Correct Answer
A. Anterior MI
Explanation
Leads V1-V4 are close to the anterior surface of the heart and will pick up damaged heart muscle in that area
6.
A lateral MI would be observed in what EKG leads?
Correct Answer
B. V5 and V6
Explanation
Leads V5 and V6 are on the side of the chest/heart and show damage to the lateral muscles
7.
ST elevation in this lead indicates an Inferior MI
Correct Answer
B. Lead 2
Explanation
Lead 2 is looking "down" from the right shoulder toward the left foot and will more accurately show damage to the bottom part of the heart.
8.
What does the Acronym MONA stand for when referring to care for a MI patient?
Correct Answer
Morphine, Oxygen, NTG, Aspirin
Explanation
The acronym MONA stands for Morphine, Oxygen, NTG (nitroglycerin), and Aspirin. These are the recommended interventions for providing care to a patient experiencing a myocardial infarction (MI). Morphine helps relieve the pain associated with the MI, while oxygen ensures adequate oxygenation to the heart. NTG helps dilate the blood vessels, improving blood flow, and aspirin helps prevent further blood clotting. Together, these interventions aim to alleviate symptoms, improve blood flow, and reduce the risk of complications in MI patients.
9.
Which would be a contraindication for the use of clot busting drugs such as Streptokinase/TPA?
Correct Answer
D. Recent trauma or surgery in past 10 days
Explanation
The clot busting drugs may cause recurrent bleeding from past trauma and surgery. Also pt should not have had a stroke in the past 2 months
10.
Revascularization of the Coronary Artery after a cardiac cath might cause:
Correct Answer(s)
A. Abrupt cessation of pain
C. Sudden onset of dysrhyhtmias
D. Resolution of ST elevations
Explanation
pain should be resolved b/c blood flow is returned to the heart
11.
Non- STEMI patients:
Correct Answer
D. Should be sent to the cath lab withing 90 minutes of admit to ER
Explanation
non-STEMIs are not candidates for clot-busting therapy; MI patients should make it to the cath lab within 120 minutes of their fist s/s of chest pain
12.
What is the priority assessment for a patient following CABG (coronary bypass graft) surgery?
Correct Answer
A. Blood Pressure
Explanation
If a patient's BP goes too high it can cause the graft to tear- if too low, the graft can collapse (Systolic should be kept above 90)
13.
Why is it important to put a cardiac post-op patient on stool softeners or laxatives?
Correct Answer
C. Constipation may cause the pt to strain during BMs causing the Valsalva Manuver which could affect the heart
Explanation
The Valsalva Manuver is a respose of the Vagus nerve triggered by straining during a BM- this nerve stimulation slows the hart and lowers BP which could cause arrhytmias in a heart surgery pt.
14.
What medication can be given to reduce the retention of water and sodium as a result of aldosterne production which will put less work on the heart?
Correct Answer
A. Lisinopril (zestril)
Explanation
Lisinopril is an ACE inhibitor (prils=ACE)- low BP activates the kidneys to produce renin which produces angiotensin 1 (not active) ACE (angiotensin converting enzyme) turns angiotensin 1 into angiotensin 2 (active) Angiotensin 2 causes vasoconstriction and stimultes the kidneys to produce aldosterone which causes water and sodium retention. Lisinopril inhibits atn 1-2 preventing vasoconstriction and water retention
15.
What are the signs and symptoms of Left sided heart failure?
Correct Answer(s)
B. Crackles and dyspnea
C. Oliguria
Explanation
When the left side of the heart fails, blood can't go out to the body so it backs up into the lungs causin respiratory symptoms
16.
What are the signs and symptoms of Right sided heart failure?
Correct Answer(s)
A. JVD
D. Dependent edema
E. Ascites
Explanation
When the right side of the heart fails, blood backs up into the veneous system causing problems with the body verus lungs- circulation decreases to the kidneys, backed up blood causes fluid to leak in liver and blood from the head can't get down to the heart causing JVD
17.
What is the hallmark sign of pulmonary edema?
Correct Answer
D. Frothy pink tinged sputum
Explanation
all these could be characteristics of pulmonay edema, but the frothy pink sputum is the hallmark sign-
18.
The ejection fraction is the % of blood ejected from the ventricles of the heart with each beat and is used as an assessment of cardiac function. If the ventricles can hold 70 ml of blood but only eject 25 mL of blood, the EJ fraction is _____ which is normal/abnormal
Correct Answer
B. 36% and abnormal
Explanation
Ejection fraction is the amount pumped out over the total volume= 25/70= .357 or 36% If you got 40%, you might have used the formula for finding MAP or mean arterial pressue (2x diastlic + systolic /3) An EF fo 55% is normal so this is an abnormal reading
19.
A BNP reading of 90 indicates imminent heart failure
Correct Answer
B. False
Explanation
A BNP reading under 100 is considered normal
20.
The therapeutic serum levels for Lanoxin (digoxin) are
Correct Answer
0.8-1.2
Explanation
The therapeutic serum levels for Lanoxin (digoxin) are 0.8-1.2. These levels indicate the range of digoxin concentration in the blood that is considered effective and safe for treating certain heart conditions. Maintaining digoxin levels within this range helps ensure that the medication is providing its desired therapeutic effects without causing toxicity or side effects.
21.
What are the differences betwen Heart Failure and Cardiogenic Shock?
Correct Answer(s)
B. Decrease in tissue perfusion
E. Ischemia to organs
Explanation
HF does not result in decreased tissue perfusion or organ ischemia- these are specific to Cardiogenic Shock
22.
Your patient has a BP of 100/50. Their MAP is ______ which is/isn't sufficent for proper tissue perfusion
Correct Answer
C. 67, is sufficient
Explanation
Mean Arterial pressure is calculated by diastolic x2 + systolic/3. A MAP of 65 or above is sufficient for tissue perfusion
23.
Physicians use a Swan-Ganz catheter to measure the pulmonary artery pressure on your patient. The readings are: SPAP: 28, DPAP: 12. Your patient has_____________ and needs______________
Correct Answer
A. A normal PAP and just needs to be monitored
Explanation
normal PAP is between 15/5 and 28/16
24.
You can administer medications through a Swan-Ganz catheter
Correct Answer
A. True
Explanation
The Swan Ganz catheter goes directly into the heart allowing for even distribution of medications-NEVER ADMINISTER MEDS through a arterial line catheter
25.
During Hemodynamic Monitoring, you notice the PAP go to 10/4. Your initial itervenion is:
Correct Answer
C. Administer a fluid bolus
Explanation
a fluid bolus should always be administered first for DFV or LBP before vasoconstrictors b/c a dehydrated patient may experience dangerous tachycardia if put on meds without being hydrated
26.
Levophed (norepinepherine) is a vasoconstrictor used to increase blood pressure. What advantage does this drug have over dopamine?
Correct Answer
D. It does not constrict the CA so angina is not a side effect
Explanation
dopamine constricts all blood vessels including the CA which decreases blood to the heart causin angina as a SE- levophed does not.
27.
Why would a patient be perscribed Dobutmine (dobutrex)?
Correct Answer
C. Cardiogenic shock
Explanation
dobutrex increases cardiac contractility and is used to treat HF and cardiogenic shock
28.
Nitroglycerin acts by decreasing ____________ and increasing ____________
Correct Answer
C. Preload, cardiac output
Explanation
NTG causes vasodilation which decreases preload; a decrease in preload increases cardiac output. Lanoxin and dobutrex increase contractility
29.
A patient is on arterial pressre monitoring. The nurse notices the patiens systolic BP increases by between 10 and 15 mm of Hg upon exhalation. This could indicate:
Correct Answer
D. Cardiac tamponade
Explanation
the increase of systolic BP on expiration is called pulsus paradoxus- if it is 10 or over, cardiac tamponade should be suspected
30.
The following signs and symptoms are possible with cardiac tampoade
Correct Answer(s)
A. JVD
B. Hypotension
C. Muffled heart sounds
D. Paradoxical pulse
E. A feeling of fulless in the chest
Explanation
all of these are s/s of cardiac tamponade
31.
What would be an appropriate treatment for Cardiac Tamponade?
Correct Answer
D. Performing a pericardial window procedure
Explanation
Cardiac tamponade is a medical emergency- fluid must be pulled off the heart immediately so the pericardial window would be correct
32.
The most common cause of thoracic and abdominal aneurysms is hyperlipidemia
Correct Answer
B. False
Explanation
artherosclerosis is the most common cause of aneurysms followed by HTN and smoking
33.
The following are s/s of thoracic aneurysms
Correct Answer(s)
A. Cough/ loss of voice
B. Pain
C. Hypovolemic shock
D. Pulsating mass under skin
E. Dyspnea
Explanation
The given answer is a list of signs and symptoms of thoracic aneurysms. These symptoms include cough/loss of voice, pain, hypovolemic shock, pulsating mass under the skin, and dyspnea. A thoracic aneurysm is a condition where there is a bulging or ballooning in the wall of the aorta, the main blood vessel that carries blood from the heart to the rest of the body. The symptoms listed in the answer are commonly associated with thoracic aneurysms and can help in identifying and diagnosing the condition.
34.
The blood pressure of a pt who has come out of surgery from a thoracic aneurysm should be between ________ and _______
Correct Answer(s)
100, 120
Explanation
After undergoing surgery for a thoracic aneurysm, it is important for the patient's blood pressure to be within the range of 100 to 120. This range is considered normal for a post-surgery patient and indicates that the blood pressure is stable and within a healthy range. Maintaining blood pressure within this range helps to ensure proper healing and recovery from the surgery, while also reducing the risk of complications such as bleeding or damage to the repaired area.
35.
More than half of the patiets diagnosed with abdominal aneurysms use tobacco
Correct Answer
B. False
Explanation
over half have HTN
36.
A patients systolic blood pressure must be kept below ________ to decrease the risk of aneurysm ruputure
Correct Answer
C. 100
Explanation
To decrease the risk of aneurysm rupture, a patient's systolic blood pressure must be kept below 100. High blood pressure puts strain on the walls of blood vessels, including aneurysms, which are weakened areas. Keeping the blood pressure below 100 helps to reduce the stress on the aneurysm, decreasing the likelihood of it rupturing.
37.
A dissecting aorta may be difficult to diagnose because its signs and symptoms mimic a
Correct Answer
C. MI
Explanation
pain onset is severe and sudden and is near the heart; pt may also have diaphoresis, pain, pallor and tachycardia which are all s/s of a MI
38.
When doing hemodynamic monitoring, you know you are getting a good PAP reading by observing:
Correct Answer
B. The dicrotic notch in the waves
Explanation
The dicrotic notch indicates the opening and closing of the atria which means the catheter is placed properly
39.
During hemodynamic monitoring, the transducer that transmits the PAP to an electrical signal should be placed
Correct Answer
A. At heart level
Explanation
The correct answer is "at heart level". When performing hemodynamic monitoring, it is important to place the transducer at heart level to accurately measure the pulmonary artery pressure (PAP). Placing the transducer at heart level ensures that the pressure measurements are not affected by gravity, as placing it higher or lower than the heart can result in inaccurate readings. Therefore, positioning the transducer at heart level allows for the most accurate transmission of PAP to an electrical signal.
40.
The antidote for digoxin toxicity is
Correct Answer
A. Digibind
Explanation
Digibind is the correct answer because it is an antidote specifically used to treat digoxin toxicity. Digoxin is a medication commonly used to treat heart conditions, but an overdose or toxicity can occur, leading to symptoms such as irregular heart rhythm, nausea, and confusion. Digibind works by binding to the excess digoxin in the body and preventing it from causing harm. Other options like protamine sulfate, vitamin K, and narcan are not used to treat digoxin toxicity.
41.
Beta blockers should be used cautiously in patients with
Correct Answer
B. Asthma
Explanation
Beta blockers should be used cautiously in patients with asthma because beta blockers can potentially trigger bronchospasm and worsen asthma symptoms. These medications block the action of beta receptors, which can lead to constriction of the airways and narrowing of the bronchial tubes. As a result, patients with asthma, who already have compromised lung function, may experience difficulty breathing and increased wheezing. Therefore, it is important to monitor these patients closely and consider alternative medications or lower doses if beta blockers are necessary for their treatment.
42.
What drug can cause hyperkalemia?
Correct Answer
D. ACE inhibitors
Explanation
ACE inhibitors can cause hyperkalemia because they block the action of an enzyme called angiotensin-converting enzyme (ACE), which is responsible for converting angiotensin I to angiotensin II. This leads to decreased aldosterone production, which in turn reduces the excretion of potassium by the kidneys. As a result, potassium levels in the blood can rise, leading to hyperkalemia.
43.
Common indications for using a intra-aortic balloon pump are
Correct Answer(s)
A. Pt awaiting a cardiac transplant
B. Recovery from a MI
C. Cardiogenic shock
Explanation
The common indications for using an intra-aortic balloon pump include a patient awaiting a cardiac transplant, recovery from a myocardial infarction (MI), and cardiogenic shock. These conditions can all lead to decreased cardiac function and compromised circulation, which can be supported and improved with the use of an intra-aortic balloon pump.
44.
The IABP is placed in the ascending aorta
Correct Answer
B. Fase
Explanation
descending aorta
45.
What would be the main post procedure assessment after having a IABP inserted?
Correct Answer
A. Bleeding at the site of insertion
Explanation
ABC's
46.
What date is the pinning ceremony this year?
Correct Answer
C. December 17th
Explanation
The correct answer is December 17th. This is the date for the pinning ceremony this year.
47.
Krispen is the most amazing test creator in the universe
Correct Answer
A. True
Explanation
The given statement states that Krispen is the most amazing test creator in the universe. The word "amazing" indicates that Krispen is exceptionally good at creating tests. Since there is no information provided to contradict this statement, it can be assumed to be true. Therefore, the correct answer is True.
48.
The pericardial sac usually contains less than 50 mL of fluid
Correct Answer
A. True
Explanation
The pericardial sac is a double-layered membrane that surrounds the heart. It contains a small amount of fluid called pericardial fluid, which acts as a lubricant to reduce friction between the heart and the surrounding structures. Normally, the pericardial sac contains less than 50 mL of this fluid. Therefore, the statement "The pericardial sac usually contains less than 50 mL of fluid" is true.
49.
Normal urine output is _______mL and hour
Correct Answer
30
Explanation
The normal urine output is 30 mL per hour. This means that on average, a person should produce around 30 mL of urine every hour. This is considered to be within the normal range for urine output and indicates that the kidneys are functioning properly.
50.
Oxygen is a drug
Correct Answer
A. True
Explanation
Oxygen is considered a drug because it is a medication that is prescribed and administered to patients in specific doses and for specific purposes. It is used to treat conditions such as hypoxemia, respiratory distress, and chronic obstructive pulmonary disease (COPD). Oxygen therapy is a medical intervention that requires careful monitoring and regulation by healthcare professionals to ensure its safe and effective use. Therefore, the statement "oxygen is a drug" is true.