CEN Study Guide: Questions & Answers
What are the 3 signs of cushings triad? Correct Ans - 1) Widening
Pulse Pressure (or hypotension) 2) Bradycardia 3) Irregular Breathing
Patterns
What is the 2 most concerning causes of a widening pulse pressure?
Correct Ans - 1) Aortic Aneurysm 2) Aortic Dissection
Which peripheral nervous system increases heart rate? Correct Ans -
Sympathetic
Which peripheral nervous system decreases heart rate? Correct Ans -
Parasympathetic
What is the frank-sterling law? Correct Ans - Too little stretch doesn't
give a good contraction, too much stretch also effects the contraction ability,
need just the right amount of stretch for optimal contraction.
How do you calculate MAP? Correct Ans - 2x diastolic plus systolic
divided by 3.
Where do Chronotropic drugs bind to the heart? Correct Ans - At the
SA node
What effect do inotropic drugs have on the heart? Correct Ans -
Increases force of contraction... (I KNOW!!!)
What medication affects the heart rate by changing the generation of electrical
impulse? Correct Ans - Chronotropic
What medication affects the contractility of the the heart by increasing the
force of contraction? Correct Ans - Inotropic
What medication affects the automaticity of the heart by changing electrical
impulse velocity? Correct Ans - Dromotropic
,What does stimulation of ALPHA receptors cause? Correct Ans -
Peripheral vascular Contraction (AbCd)
What does stimulation of BETA receptors cause? Correct Ans -
Bronchial smooth Dilation (aBcD)
What medication ends in -pril? Correct Ans - ACE inhibitors
If a patient doesn't tolerate ACE inhibitors well, what medication is next in
line? Correct Ans - Angiotension receptor blockers (ARBs)
What 4 adverse effects should you monitor for when administering an ACE
inhibitor? Correct Ans - 1) Rash 2) Renal Impairment 3) Angioedema
4) Dry cough (ACE is RRAD)
ACE inhibitors are catagory D in pregnant women, which means what?
Correct Ans - Avoid during pregnancy
What does ACE inhibitors do? Correct Ans - Decrease BP and afterload
(means less filling of ventricles often helping those in heart failure)
What medication ends in -sartan? Correct Ans - Angiotension receptor
blockers (ARBs)
What 2 conditions would you administer an ARB? Correct Ans - 1)
hypertension 2) Heart Failure
In Addison's Crisis, what do you expect the sodium, potassium, and blood
pressure to be? Correct Ans - 1) Hyponatremia 2) Hyperkalemia 3)
Hypotension
In Addison's Crisis, what organ is having the problem and what is the
problem? Correct Ans - Adrenal glands are not sufficiently producing
or releasing cortisone or aldosterone
In DIC, what diagnostic lab do you test for diagnosis? Correct Ans - D-
Dimer (positive is elevated D-Dimer)
,When do you use unsynchronized cardioversion (defibrillation) vs
synchronized cardioversion? Correct Ans - PULSELESS V-Tach or
PULSELES V-Fib is Unsynchronized, everything with a pulse is syncronized.
What medication do you give to someone with myasthenia gravis? Correct
Ans - edrophonium (Tensilon)
What medication do you give to someone with gout? Correct Ans -
allopurinol (Zyloprim)
When is a patient likely to experience a gout pain attack? Correct Ans -
At night b/c low body temp, decreased O2 (especially if they have sleep
apnea), and nighttime dip in cortosol
What is a medical emergency, strangulated or incarcerated hernia?
Correct Ans - Strangulated
After delivery, what should the uterus feel like? Correct Ans - Firm
What is the treatment of an aortic aneurysm if it is stable? Correct Ans -
BP control with beta blockers or calcium channel blockers
What medication can sometimes cause Second-Degree AV block Type I
(Wenckenback)? Correct Ans - Digoxin
What are 3 things treat Second-Degree AV block Type II (Mobitz)? Correct
Ans - 1) Temporary Pacemaker 2) Supplemental Oxygen 3) IV Atropine
What is happening during Complete Heart Block? Correct Ans - No
atrial impulses to the ventricles, so the SA node impulses are not reaching the
AV node
What is the treatment of complete heart block? Correct Ans - Cardiac
Pacing
How long can life be sustained while in Ventricular Fibrillation? Correct
Ans - 6 minutes, afterwards death occurs
, What 3 medications do you give for a patient in V-Tach? Correct Ans -
Lidocaine, Magnesium Sulfate, and Amiodarone
How do you treat V-Fib? Correct Ans - 100% O2, Epinephrine, and
defibrillation (Unsynchronized Cardioversion)
What are Osler's Nodes? What to they indicate? Correct Ans - Red,
tender spots seen under the skin of fingers. Indicates Endocarditis.
What is the definition of Hypertensive Crisis? Correct Ans - Dialstolic
BP greater than 120 mmHg.
How do you treat Cardiac Tamponade? Correct Ans -
Pericardiocentesis or Thoracotomy, Oxygen, IV fluids, and medications to
raise the BP
If your patient has pericarditis, which leads do you expect to have ST elevation
in? Correct Ans - All leads except aVR and V1
How should you auscultate heart sounds for a patient who has pericarditis?
Correct Ans - Sitting forward and upright while exhaling
What is intermittent claudication? Correct Ans - pain in legs with
exertion, relieved by rest
What medication ends in -dipine? Correct Ans - Calcium Channel
Blockers
What medication ends in -olol? Correct Ans - Beta blockers
What potential adverse effect does ARBs have on potassium? Correct Ans
- Hyperkalemia
If someone has right sided heart failure, what non-invasive way can you look
for this? Correct Ans - JVD
If someone has left sided heart failure, what non-invasive way can you look for
this? Correct Ans - Lung sounds
What are the 3 signs of cushings triad? Correct Ans - 1) Widening
Pulse Pressure (or hypotension) 2) Bradycardia 3) Irregular Breathing
Patterns
What is the 2 most concerning causes of a widening pulse pressure?
Correct Ans - 1) Aortic Aneurysm 2) Aortic Dissection
Which peripheral nervous system increases heart rate? Correct Ans -
Sympathetic
Which peripheral nervous system decreases heart rate? Correct Ans -
Parasympathetic
What is the frank-sterling law? Correct Ans - Too little stretch doesn't
give a good contraction, too much stretch also effects the contraction ability,
need just the right amount of stretch for optimal contraction.
How do you calculate MAP? Correct Ans - 2x diastolic plus systolic
divided by 3.
Where do Chronotropic drugs bind to the heart? Correct Ans - At the
SA node
What effect do inotropic drugs have on the heart? Correct Ans -
Increases force of contraction... (I KNOW!!!)
What medication affects the heart rate by changing the generation of electrical
impulse? Correct Ans - Chronotropic
What medication affects the contractility of the the heart by increasing the
force of contraction? Correct Ans - Inotropic
What medication affects the automaticity of the heart by changing electrical
impulse velocity? Correct Ans - Dromotropic
,What does stimulation of ALPHA receptors cause? Correct Ans -
Peripheral vascular Contraction (AbCd)
What does stimulation of BETA receptors cause? Correct Ans -
Bronchial smooth Dilation (aBcD)
What medication ends in -pril? Correct Ans - ACE inhibitors
If a patient doesn't tolerate ACE inhibitors well, what medication is next in
line? Correct Ans - Angiotension receptor blockers (ARBs)
What 4 adverse effects should you monitor for when administering an ACE
inhibitor? Correct Ans - 1) Rash 2) Renal Impairment 3) Angioedema
4) Dry cough (ACE is RRAD)
ACE inhibitors are catagory D in pregnant women, which means what?
Correct Ans - Avoid during pregnancy
What does ACE inhibitors do? Correct Ans - Decrease BP and afterload
(means less filling of ventricles often helping those in heart failure)
What medication ends in -sartan? Correct Ans - Angiotension receptor
blockers (ARBs)
What 2 conditions would you administer an ARB? Correct Ans - 1)
hypertension 2) Heart Failure
In Addison's Crisis, what do you expect the sodium, potassium, and blood
pressure to be? Correct Ans - 1) Hyponatremia 2) Hyperkalemia 3)
Hypotension
In Addison's Crisis, what organ is having the problem and what is the
problem? Correct Ans - Adrenal glands are not sufficiently producing
or releasing cortisone or aldosterone
In DIC, what diagnostic lab do you test for diagnosis? Correct Ans - D-
Dimer (positive is elevated D-Dimer)
,When do you use unsynchronized cardioversion (defibrillation) vs
synchronized cardioversion? Correct Ans - PULSELESS V-Tach or
PULSELES V-Fib is Unsynchronized, everything with a pulse is syncronized.
What medication do you give to someone with myasthenia gravis? Correct
Ans - edrophonium (Tensilon)
What medication do you give to someone with gout? Correct Ans -
allopurinol (Zyloprim)
When is a patient likely to experience a gout pain attack? Correct Ans -
At night b/c low body temp, decreased O2 (especially if they have sleep
apnea), and nighttime dip in cortosol
What is a medical emergency, strangulated or incarcerated hernia?
Correct Ans - Strangulated
After delivery, what should the uterus feel like? Correct Ans - Firm
What is the treatment of an aortic aneurysm if it is stable? Correct Ans -
BP control with beta blockers or calcium channel blockers
What medication can sometimes cause Second-Degree AV block Type I
(Wenckenback)? Correct Ans - Digoxin
What are 3 things treat Second-Degree AV block Type II (Mobitz)? Correct
Ans - 1) Temporary Pacemaker 2) Supplemental Oxygen 3) IV Atropine
What is happening during Complete Heart Block? Correct Ans - No
atrial impulses to the ventricles, so the SA node impulses are not reaching the
AV node
What is the treatment of complete heart block? Correct Ans - Cardiac
Pacing
How long can life be sustained while in Ventricular Fibrillation? Correct
Ans - 6 minutes, afterwards death occurs
, What 3 medications do you give for a patient in V-Tach? Correct Ans -
Lidocaine, Magnesium Sulfate, and Amiodarone
How do you treat V-Fib? Correct Ans - 100% O2, Epinephrine, and
defibrillation (Unsynchronized Cardioversion)
What are Osler's Nodes? What to they indicate? Correct Ans - Red,
tender spots seen under the skin of fingers. Indicates Endocarditis.
What is the definition of Hypertensive Crisis? Correct Ans - Dialstolic
BP greater than 120 mmHg.
How do you treat Cardiac Tamponade? Correct Ans -
Pericardiocentesis or Thoracotomy, Oxygen, IV fluids, and medications to
raise the BP
If your patient has pericarditis, which leads do you expect to have ST elevation
in? Correct Ans - All leads except aVR and V1
How should you auscultate heart sounds for a patient who has pericarditis?
Correct Ans - Sitting forward and upright while exhaling
What is intermittent claudication? Correct Ans - pain in legs with
exertion, relieved by rest
What medication ends in -dipine? Correct Ans - Calcium Channel
Blockers
What medication ends in -olol? Correct Ans - Beta blockers
What potential adverse effect does ARBs have on potassium? Correct Ans
- Hyperkalemia
If someone has right sided heart failure, what non-invasive way can you look
for this? Correct Ans - JVD
If someone has left sided heart failure, what non-invasive way can you look for
this? Correct Ans - Lung sounds
