6566 Midterm | UPDATED Questions with 100% Verified
Answers
Walden University • NRNP 6566
Q1: What are the indications for an ABI
A: Claudication ischemic ulcers gangrene GSW soft signs
Q2: how do you determine Mean arterial pressure
A: diastolic doubled up + systolic divided by 3 example 83/50= 50+50=100+83=183/3= 66 is the map Map 70-110
Q3: pulsus paradoxus
A: beats have weaker amplitude with respiratory inspiration, stronger with expiration
Q4: how to perform pulsus paradoxus
A: Recline patient at 30° Inflate a standard BP cuff until quarter cough sounds over the brachial artery disappear Lower
the pressure in the cuff a few millimeters of mercury per second until the first quarter cough sound appears during
expiration Very slowly lower cuff pressure until corticost sounds are heard throughout the respiratory cycle. record
this cuff pressure The difference between pressures recorded in the two previous steps is then recorded as the
measurement A pulses paradoxus > 12 mm HD is abnormal but non-specific
Q5: What is the sympathetic reflex compensation in hemorrhagic shock
A: Arterial vasoconstriction Venus capacitance basal constriction Central nervous system ischemic response
Q6: What is the restoration of blood volumeduring hemorrhagic shock
A: Renin-Angiotensin-aldosterone axis activation Antidiuretic hormone secretion Trans capillary refill Increase
thirstresulting in increased fluid intake Increased erythropoiesis
Q7: ET Tube Medications
A: Lidocaine Epinephrine Atropine Naloxone Vasopressin
Q8: How to administer medications through an endotracheal tube
A: Ventilate the patient Advance the catheter through the ET tube so that the distal end extends 1 cm beyond the distal
end of the tube
,Q9: What medications can be given intranasally
A: Pain relief Sedation/Anxiolysis Seizure control Narcotic overdose
Q10: What are the indications for rectal administration of medication
A: When desirable routes are unavailable or impractical Children frightened of intravenous catheterization Patients who
refuse parenteral Drug Administration Patients with nausea / vomiting or inability to swallow
Q11: Contraindications for rectal administration of medications
A: Immunosuppression Severe thrombocytopenia or coagability Active GI bleed Diarrhea Chronic anal rectal
problems-such as fissures, hemorrhoids, or fistula
Q12: Complications of rectal administration of medication
A: Erratic absorption Delayed prolonged or unusually rapid absorption Localized trauma Pain
Q13: Common drugs that can be given rectally
A: Pain-Aspirin,Tylenol.Indomethacin,Diclofenac,Morphine Sedatives/Sedation-Midazolam,Methohexital,Thiopental
Anti-convulsants -diazepam Anti-emetics-Phenergan, Compazine Cation exchange resin -kayexalate
Q14: What is hypodermoclysis
A: Slow infusion of isotonic fluids into the subcutaneous tissues
Q15: normal sinus rhythm
A: heart rhythm originating in the sinoatrial node with a rate in patients at rest of 60 to 100 beats per minute
Q16: Sinus Arrhythmia
A: A sinus rhythm in which the rate varies with respiration, causing an irregular rhythm.
Q17: Junctional Rhythm
A: the SA node is nonfunctional, P waves are absent, and heart is paced by the AV node at 40-60 beats/min
,Q18: What is the etiology and treatment of a junctional rhythm
A: Etiology-metabolic or electrolyte disturbances, medications, digitalis toxicity, Lyme disease, cardiac ischemia,
myocarditis, intrinsic conduction dysfunction Treatment-ECP or cardiologist, AV nodalblocking medication
stopped,evaluate electrolyte abnormalities, atropine, 0.5 mg IV push to a maximum of 3 mg, consider pacing if patient
is severely bradycardic
Q19: What are premature atrial contractions?
A: They are a common cardiac arrhythmia characterized by premature heartbeats originating in the atria. While the
sinoatrial node typically regulates the heartbeat during normal sinus rhythm, PACs occur when another region of the
atria depolarizes before the sinoatrial node and thus triggers a premature heartbeat.
Q20: What is atrial tachycardia
A: When there is an abnormal focus in the atrium The atria depolarise faster than 150/min P waves can be seen
superimposed on the T waves of the preceding beats Symptoms-asymptomatic, chest pressure, palpitations,with
poor perfusion may cause hypertension
Q21: Treatment for atrial tachycardia
A: - Adenosine - procainamide - amiodarone - BB -CCB Vagal Cardiac ablation
Q22: Chad'sscore-stroke risk assessment in atrial fibrillation
A: 1 - heart failure or lvef <40 1-hypertension 2-age>75 1-diabetes 2-stroke/tia 1-vascular disease 1-age 65-74 1-female
Q23: NOAC guidelines for atrial fibrillation
A: Aspirin for Chad score of 0 or 1 Warfarin should be considered in patients with creatinine clearance of less than 15 or
dialysis
Q24: What is NOAC
A: Novel oral anticoagulants Non vitamin K oral anticoagulants
Q25: What is a DOAC?
A: Direct oral anticoagulant
Q26: What is the HAS-BLED score?
A: Scoring system to determine risk for hemorrhage (Max score of 9)
, Q27: What does HAS-BLED stand for?
A: Hypertension Abnormal liver or renal function (1 point each) Stroke Bleeding history Labile INRs Elderly (>65 yo)
Drugs or alcohol abuse (1 point each) The more risk factors, the higher the risk of bleeding. The point of this
algorithm is to reduce modifiable risk factors of bleeding.
Q28: what is a LAA occlusion?
A: a procedure done to prevent stroke in patients with a-fib by sealing off the left atrial appendage, where a majority of
clots will occur
Q29: What is a LARIAT device closure system
A: Extra vascular soft-tissue snare. The Snare is induced the pericardial space, Guided by fluoroscopy and t e e
Imaging. It uses a magnet-based guide rail in the laa and pericardial space to snare or lasso the LAA at the base
Q30: Etiology of atrial flutter
A: Advancing age, longstanding hypertension, obesity, diabetes, HF, ischemic heart disease, heavy alcohol or drug use,
hyperthyroidism, and sleep apnea
Q31: What is Av nodal reentry tachycardia
A: Most common form of SVT, rates of 150 to 190,usually found in patients with underlying heart disease, most common
in women
Q32: What is Wolf- Parkinson- White - Syndrome (WPW)?
A: WPW Pattern-an asymptomatic patient with the presence of a short PR and Delta wave on ECG with no evidence of
SVT WPW Syndrome-defined as a symptomatic patient with presence of short PR and Delta wave on ECG along
with evidence of SVT
Q33: What is a wolf Parkinson cardiac defect
A: The AV electrical Insulation at the AV Groove due to the presence of an accessory pathway.These accessory
Pathways connect the atrium in the ventricles and allow electrical activity to travel through this accessory pathway.
Conduction through an accessory pathway that can conduct both integrade and retrogradeconduction which
produces a Delta wave
Q34: What is a first degree AV block?
A: Regular, prolonged PR intervals. Normal HR and rhythm, and normal QRS, but the impulse from the SA node is
"delayed" somewhere in the AV node, causing the extended PR.
Q35: What is mobitz type 1/Wenckebach
A: the AV node is partially blocked the AV node will let impulse's through but then completely block an impulse getting to
the ventricles causes a dropped beat
Answers
Walden University • NRNP 6566
Q1: What are the indications for an ABI
A: Claudication ischemic ulcers gangrene GSW soft signs
Q2: how do you determine Mean arterial pressure
A: diastolic doubled up + systolic divided by 3 example 83/50= 50+50=100+83=183/3= 66 is the map Map 70-110
Q3: pulsus paradoxus
A: beats have weaker amplitude with respiratory inspiration, stronger with expiration
Q4: how to perform pulsus paradoxus
A: Recline patient at 30° Inflate a standard BP cuff until quarter cough sounds over the brachial artery disappear Lower
the pressure in the cuff a few millimeters of mercury per second until the first quarter cough sound appears during
expiration Very slowly lower cuff pressure until corticost sounds are heard throughout the respiratory cycle. record
this cuff pressure The difference between pressures recorded in the two previous steps is then recorded as the
measurement A pulses paradoxus > 12 mm HD is abnormal but non-specific
Q5: What is the sympathetic reflex compensation in hemorrhagic shock
A: Arterial vasoconstriction Venus capacitance basal constriction Central nervous system ischemic response
Q6: What is the restoration of blood volumeduring hemorrhagic shock
A: Renin-Angiotensin-aldosterone axis activation Antidiuretic hormone secretion Trans capillary refill Increase
thirstresulting in increased fluid intake Increased erythropoiesis
Q7: ET Tube Medications
A: Lidocaine Epinephrine Atropine Naloxone Vasopressin
Q8: How to administer medications through an endotracheal tube
A: Ventilate the patient Advance the catheter through the ET tube so that the distal end extends 1 cm beyond the distal
end of the tube
,Q9: What medications can be given intranasally
A: Pain relief Sedation/Anxiolysis Seizure control Narcotic overdose
Q10: What are the indications for rectal administration of medication
A: When desirable routes are unavailable or impractical Children frightened of intravenous catheterization Patients who
refuse parenteral Drug Administration Patients with nausea / vomiting or inability to swallow
Q11: Contraindications for rectal administration of medications
A: Immunosuppression Severe thrombocytopenia or coagability Active GI bleed Diarrhea Chronic anal rectal
problems-such as fissures, hemorrhoids, or fistula
Q12: Complications of rectal administration of medication
A: Erratic absorption Delayed prolonged or unusually rapid absorption Localized trauma Pain
Q13: Common drugs that can be given rectally
A: Pain-Aspirin,Tylenol.Indomethacin,Diclofenac,Morphine Sedatives/Sedation-Midazolam,Methohexital,Thiopental
Anti-convulsants -diazepam Anti-emetics-Phenergan, Compazine Cation exchange resin -kayexalate
Q14: What is hypodermoclysis
A: Slow infusion of isotonic fluids into the subcutaneous tissues
Q15: normal sinus rhythm
A: heart rhythm originating in the sinoatrial node with a rate in patients at rest of 60 to 100 beats per minute
Q16: Sinus Arrhythmia
A: A sinus rhythm in which the rate varies with respiration, causing an irregular rhythm.
Q17: Junctional Rhythm
A: the SA node is nonfunctional, P waves are absent, and heart is paced by the AV node at 40-60 beats/min
,Q18: What is the etiology and treatment of a junctional rhythm
A: Etiology-metabolic or electrolyte disturbances, medications, digitalis toxicity, Lyme disease, cardiac ischemia,
myocarditis, intrinsic conduction dysfunction Treatment-ECP or cardiologist, AV nodalblocking medication
stopped,evaluate electrolyte abnormalities, atropine, 0.5 mg IV push to a maximum of 3 mg, consider pacing if patient
is severely bradycardic
Q19: What are premature atrial contractions?
A: They are a common cardiac arrhythmia characterized by premature heartbeats originating in the atria. While the
sinoatrial node typically regulates the heartbeat during normal sinus rhythm, PACs occur when another region of the
atria depolarizes before the sinoatrial node and thus triggers a premature heartbeat.
Q20: What is atrial tachycardia
A: When there is an abnormal focus in the atrium The atria depolarise faster than 150/min P waves can be seen
superimposed on the T waves of the preceding beats Symptoms-asymptomatic, chest pressure, palpitations,with
poor perfusion may cause hypertension
Q21: Treatment for atrial tachycardia
A: - Adenosine - procainamide - amiodarone - BB -CCB Vagal Cardiac ablation
Q22: Chad'sscore-stroke risk assessment in atrial fibrillation
A: 1 - heart failure or lvef <40 1-hypertension 2-age>75 1-diabetes 2-stroke/tia 1-vascular disease 1-age 65-74 1-female
Q23: NOAC guidelines for atrial fibrillation
A: Aspirin for Chad score of 0 or 1 Warfarin should be considered in patients with creatinine clearance of less than 15 or
dialysis
Q24: What is NOAC
A: Novel oral anticoagulants Non vitamin K oral anticoagulants
Q25: What is a DOAC?
A: Direct oral anticoagulant
Q26: What is the HAS-BLED score?
A: Scoring system to determine risk for hemorrhage (Max score of 9)
, Q27: What does HAS-BLED stand for?
A: Hypertension Abnormal liver or renal function (1 point each) Stroke Bleeding history Labile INRs Elderly (>65 yo)
Drugs or alcohol abuse (1 point each) The more risk factors, the higher the risk of bleeding. The point of this
algorithm is to reduce modifiable risk factors of bleeding.
Q28: what is a LAA occlusion?
A: a procedure done to prevent stroke in patients with a-fib by sealing off the left atrial appendage, where a majority of
clots will occur
Q29: What is a LARIAT device closure system
A: Extra vascular soft-tissue snare. The Snare is induced the pericardial space, Guided by fluoroscopy and t e e
Imaging. It uses a magnet-based guide rail in the laa and pericardial space to snare or lasso the LAA at the base
Q30: Etiology of atrial flutter
A: Advancing age, longstanding hypertension, obesity, diabetes, HF, ischemic heart disease, heavy alcohol or drug use,
hyperthyroidism, and sleep apnea
Q31: What is Av nodal reentry tachycardia
A: Most common form of SVT, rates of 150 to 190,usually found in patients with underlying heart disease, most common
in women
Q32: What is Wolf- Parkinson- White - Syndrome (WPW)?
A: WPW Pattern-an asymptomatic patient with the presence of a short PR and Delta wave on ECG with no evidence of
SVT WPW Syndrome-defined as a symptomatic patient with presence of short PR and Delta wave on ECG along
with evidence of SVT
Q33: What is a wolf Parkinson cardiac defect
A: The AV electrical Insulation at the AV Groove due to the presence of an accessory pathway.These accessory
Pathways connect the atrium in the ventricles and allow electrical activity to travel through this accessory pathway.
Conduction through an accessory pathway that can conduct both integrade and retrogradeconduction which
produces a Delta wave
Q34: What is a first degree AV block?
A: Regular, prolonged PR intervals. Normal HR and rhythm, and normal QRS, but the impulse from the SA node is
"delayed" somewhere in the AV node, causing the extended PR.
Q35: What is mobitz type 1/Wenckebach
A: the AV node is partially blocked the AV node will let impulse's through but then completely block an impulse getting to
the ventricles causes a dropped beat
