PCCN CARDIAC CORRECT EXAMS QUESTIONS AND
ANSWERS SET A+
✔✔Aortic Dissection - ✔✔Tearing of inner layer of aortic wall, allowing blood to leak in
to wall and causes seperation. Presents with severe CP radiating to the back. Usually
caused by hypertension. SX needed. control bp
✔✔P/O considerations in AA pts - ✔✔Increased risk for MI and bleeding, Renal failure
and acute limb ischemia
✔✔Most common cardiomyopathy - ✔✔Dilated cardiomyopathy. S/s HF. Decreased SV
and EF and pulmonary congestion. treated like HR. Inotropic agents (
dobutamine/milrinon (acute) dig in cronic)diuretics vasodilators (ACE/BB)
✔✔Hypertropic cardiomyopathy - ✔✔IHSS. Diastolic dysfunction as a result of the
inability of the heart to relax during diastole. S/s pulmonary congestion but close to
normal ef and sv until end stages
✔✔treatment of cardiomyopathy - ✔✔Positive inotropes and Vasodilators (not IHSS).
reduce afterload and preeload(diuretics, BB, CCB, IXBP, Vasodilators and fluid
restriction)
✔✔QT interval - ✔✔depolarization and repolarization of the ventricals. QRS to end of
the T wave. Normally less that 0.40
✔✔Ishemia on ECG - ✔✔Look for ST elevation. Oppisite leads may show ST
depression (recipocal changes).
Twave may become inverted
Q wave formation is the primary indication that a patient has had am MI. Q waves are
negative deflections in front of the R waves. Considered significant is the are wide
(>0.04) and large (>that o1/3 the hight of the R wave)...take 24h to form(if present to old
for some treatments
, ✔✔Wandering Atrial Pacemaker - ✔✔Rate-usually normal Rhythm-slightly irregular
Pacemaker site-varies among the sa node, atrial tissue, and the av junction. P waves-
morphology changes from beat to beat; P waves may disappear entirely PR interval-
varies QRS complex-normal.. Monitor and only treat if low HR or symptomatic
✔✔SVT - ✔✔150-250. cant see p waves
✔✔Hypovolemic Shock - ✔✔Low Bp, increased HR, orthostatic hypotension. Restless
confusion, agitation. pallor, increased RR. Increased SVR and lactate levels. Decreased
UOP, CO, PAWP, CVP..fluid and blood
✔✔Cardiogenic shock - ✔✔JVD, peripheral edema, ventricular gallop, dyspnea,
crackles.
✔✔Arterial PVD - ✔✔Pain with walking, relieved with rest of dependant position of lower
limbs. NO edema. Cool skinHair loss, shiny skin and nail thicking. pwllor when elevated
and red when dependant. Ulcers on toes and lateral areas(gangrene poss). Sexual
dysfunction
✔✔Venous PVD - ✔✔Pain with standing, relieved with elevation. Swollen, warm skin.
Brownish pigment and cyanotic when dependant. Ulcers on ankles, medial or pretibial
areas
✔✔Treatment of PVD - ✔✔ASA, Coumadin, Ticlid, plavix, Hormones.. Invasive PTA,
Atherectomy stents and graphs
✔✔junctional rhythm - ✔✔40-60 rate. Irregular. P waves abnormal/maynot be seen or
inverted. Protective rhythm, takes over for the SA node when it slows below 40. Monitor
for synptoms. atropine if needed. PVC common..may need pacemaker. could be drug
toxicity
✔✔idioventricular rhythm - ✔✔no pacemaker above the ventricals. dying heart. 20-40
no p wave qrs wide and bizarre >0.12
✔✔coronary sinus - ✔✔main venous drainage vessel of the heart
✔✔two situations that may produce a systolic murmur - ✔✔aortic stenosis and mitral
reguritation
✔✔Pericardial tamponade - ✔✔Hypotension, tachycardia, distended neck veins, clear
lungs, pulsus paradoxus (systolic blood pressure decreaed by 20) equalization of left
and right filling pressure (CVPand PAOP =)
ANSWERS SET A+
✔✔Aortic Dissection - ✔✔Tearing of inner layer of aortic wall, allowing blood to leak in
to wall and causes seperation. Presents with severe CP radiating to the back. Usually
caused by hypertension. SX needed. control bp
✔✔P/O considerations in AA pts - ✔✔Increased risk for MI and bleeding, Renal failure
and acute limb ischemia
✔✔Most common cardiomyopathy - ✔✔Dilated cardiomyopathy. S/s HF. Decreased SV
and EF and pulmonary congestion. treated like HR. Inotropic agents (
dobutamine/milrinon (acute) dig in cronic)diuretics vasodilators (ACE/BB)
✔✔Hypertropic cardiomyopathy - ✔✔IHSS. Diastolic dysfunction as a result of the
inability of the heart to relax during diastole. S/s pulmonary congestion but close to
normal ef and sv until end stages
✔✔treatment of cardiomyopathy - ✔✔Positive inotropes and Vasodilators (not IHSS).
reduce afterload and preeload(diuretics, BB, CCB, IXBP, Vasodilators and fluid
restriction)
✔✔QT interval - ✔✔depolarization and repolarization of the ventricals. QRS to end of
the T wave. Normally less that 0.40
✔✔Ishemia on ECG - ✔✔Look for ST elevation. Oppisite leads may show ST
depression (recipocal changes).
Twave may become inverted
Q wave formation is the primary indication that a patient has had am MI. Q waves are
negative deflections in front of the R waves. Considered significant is the are wide
(>0.04) and large (>that o1/3 the hight of the R wave)...take 24h to form(if present to old
for some treatments
, ✔✔Wandering Atrial Pacemaker - ✔✔Rate-usually normal Rhythm-slightly irregular
Pacemaker site-varies among the sa node, atrial tissue, and the av junction. P waves-
morphology changes from beat to beat; P waves may disappear entirely PR interval-
varies QRS complex-normal.. Monitor and only treat if low HR or symptomatic
✔✔SVT - ✔✔150-250. cant see p waves
✔✔Hypovolemic Shock - ✔✔Low Bp, increased HR, orthostatic hypotension. Restless
confusion, agitation. pallor, increased RR. Increased SVR and lactate levels. Decreased
UOP, CO, PAWP, CVP..fluid and blood
✔✔Cardiogenic shock - ✔✔JVD, peripheral edema, ventricular gallop, dyspnea,
crackles.
✔✔Arterial PVD - ✔✔Pain with walking, relieved with rest of dependant position of lower
limbs. NO edema. Cool skinHair loss, shiny skin and nail thicking. pwllor when elevated
and red when dependant. Ulcers on toes and lateral areas(gangrene poss). Sexual
dysfunction
✔✔Venous PVD - ✔✔Pain with standing, relieved with elevation. Swollen, warm skin.
Brownish pigment and cyanotic when dependant. Ulcers on ankles, medial or pretibial
areas
✔✔Treatment of PVD - ✔✔ASA, Coumadin, Ticlid, plavix, Hormones.. Invasive PTA,
Atherectomy stents and graphs
✔✔junctional rhythm - ✔✔40-60 rate. Irregular. P waves abnormal/maynot be seen or
inverted. Protective rhythm, takes over for the SA node when it slows below 40. Monitor
for synptoms. atropine if needed. PVC common..may need pacemaker. could be drug
toxicity
✔✔idioventricular rhythm - ✔✔no pacemaker above the ventricals. dying heart. 20-40
no p wave qrs wide and bizarre >0.12
✔✔coronary sinus - ✔✔main venous drainage vessel of the heart
✔✔two situations that may produce a systolic murmur - ✔✔aortic stenosis and mitral
reguritation
✔✔Pericardial tamponade - ✔✔Hypotension, tachycardia, distended neck veins, clear
lungs, pulsus paradoxus (systolic blood pressure decreaed by 20) equalization of left
and right filling pressure (CVPand PAOP =)
