RCIS Practice Test 2023/ 2024-197 Questions and Answers- solved

RCIS Practice Test 2023/197 Questions and Answers- solved What is the formula for calculating cardiac output? - -CO= HR x SV -What is stroke volume related to? - -preload -Preload is most impacted by..... - -Increased filling volumes -A patient with chronic untreated hypertension would demonstrate.... - -Increased afterload -Vascular resistance/pressure is most influenced by.... - -Radius of the vessel -The formula for BP is.... - -BP = CO x SVR -What component of a Pulmonary Capillary Wedge pressure indicates Mitral insufficiency - -V wave -An elevated RVEDP is found in which pathology - -RV infarct -If the RA waveform is 2x the normal value, where would this be demonstrated in the physical assessment - -JVD -What is the most common cause of Pulmonic stenosis - -Congenital -The Blue proximal part of the swan is located how far from the distal tip of the swan - - 30 cm -When performing a thermodilution cardiac output, the operator injects 10 cc of saline into the _____ and the temperature change is measured in the ______ - -RA, PA -Equalization of RVEDP and LVEDP are found in - -restrictive pericarditis -Signs of Right sided heart failure include - -JVD -Based on these oxygen saturations, what type of shunt is present? SVC sat= 67% IVC sat= 71% RA sat= 85% RV sat= 85% PA sat= 85% LA sat= 98% LV sat= 98% AO sat= 98% - -L to R ASD -What type of ASD, located in the middle 1/3 of the atrial septum (the former site of the fossa ovalis) is called - -Ostium Secundum -What is the Flamm's equation - -3(SVC) + 1(IVC)/4 -The formula used to calculate MAP is - -1 (systolic) + 2 (diastolic)/3 -What are the four anomalies associated with Tetralogy of Fallot - -Pulmonic stenosis, over riding aorta, RVH, VSD -Which fetal anomaly is characterized by a large VSD over which a large single great vessel arises - -Truncas Arteriosus -Pulsus Paradoxus is a sign of - -Cardiac Tamponade -What does RAD stand for - -Radiation absorbed dose -What component of the X-ray system converts light rays into images - -Image intensifier -What is the maximum annual dose of radiation one can receive annually - -5 REM -Lead protection should be at least how many millimeters of lead - -.5 -What is the minimum safe distance to position oneself from the X-ray source - -6 feet -In an X-ray tube what is the charge on the cathode and the anode - -Cathode: positive Anode: negative -Which view exposes the operator to the greatest amount of radiation - -Lateral -What converts x-rays into an image - -Image Intensifier -The contrast that is best for a patient is - -low osmolality -Radiolucent means - -X-rays are permitted to pass through -Radiopaque means - -X-rays are not permitted to pass through -ReoPro works on - -IIb/IIIa receptors -Heparin potentiates the action of - -Antithrombin -Fibrinogen is converted to Fibrin by the action of - -Thrombin -There are _________ known pathways to imitate the clotting cascade - -2 -Aspirin inhibits the action of - -Arachidonic Acid -Which agent is not an antiplatelet - -Heparin -If a patient has diabetes and renal failure with a creatinine of 2.0 what would you give - -fluids to hydrate -If a patient is taking NPH insulin, which medication should not be given - -Protamine -Which medication is most commonly given to a patient with SVT - -Adenosine -True/False If a patient has a creatinine greater than 1.4 contrast volume should be minimized - -True -Lidocaine converts from 2GM in 500cc to - -4 mg in 1 cc -Dopamine concentration 1600 mcg/ml in 250cc yields a concetration of - -400 mg in 250cc -The best short acting medication/anxietolytic to sedate a patient is - - Versed/Midazolam -The drug of choice for treating coronary spasm is - -NTG -Amiodarone is used to treat - -Atrial and ventricular arrhythmias -What medication is used as a preload and afterload reducer - -NTG -Diabetic patients have a greater incidence of developing _______ post contrast administration - -Renal failure -Which rhythm is most likely to become lethal - -Mobitz 2 -The Impella catheter most closely resembles - -Pigtail -When performing an LV angiogram with the LV injector, what is the purpose of setting a "rate of rise" - -It makes for a smoother injection, less catheter whip, limits ectopy -An EKG demonstrates ST elevation in leads II, III, and AVF. What type of infarct would you suspect - -inferior wall -An EKG demonstrates ST elevation in leads V5, V6, Lead 1, and AVL. Which coronary artery is most likely occluded - -Cx -How do you test the defibrillator - -discharge into the defibrillator (dummy load) -What happens if you deliver a shock to a patient on the T Wave - -You could put them into Vfib -In 1st degree heart block, where is the conductive delay - -AV node -What is the normal PR interval - -.12-.20 -If a patient is attached to the monitor, V tach is rhythm, the patient has no pulse and is not responding, what should you do - -Unsymchronized cardioversion -If a patient is on a monitor in SVT, SBP is 70, the patient is diaphoretic, dusky and SOB. What should you do - -Do immediate synchronized cardioversion -A common complication of placing a pacing electrode/wire is - -Perforation/Preicardial Effusion/Tamponade -A pacing generator that paces in both chambers, senses in the ventricle, and inhibits QRS complexes is a - -DVI -A pacing generator that paces both chambers, senses both chambers, and triggers or inhibits is a - -DDD -A pacing generator that paces in the atria, senses the atria, and inhibits pacing is a - - AAI -What is the formula for calculating SVR - -Mean OR- Mean RA/CO -Which cardiac output would be most accurate in a patient with tricuspid regurgitation - -FICK -Which right heart pressure best reflects LV preload - -PCWP -Which balloon is used for valvuloplasty - -inoue -Aortic stenosis demonstrates a pressure that is elevated in the left ventricle and a pressure that is lower in the - -Aortic arch -Calculate the cardiac output of a patient with the following data Arterial O2 sat= 98% Pulmonary artery O2 = 74% RV O2 sat= 71% Hgb= 14.7 PCWP= 12 O2 consumption= 250 ml/min Constant= 1.36 RA= 5 Mean gradient= 70 - -5.2 L/min -Calculate the stroke volume on this patient ESV= 35 EDV= 85 BP= 120/74 EF= 40% HR= 70 - -50 cc -Calculate an Aortic valve area with the following information HR= 85 Mean gradient= 64 CO= 4.2L/min BP= 136/74 Sep= .37 - -.37 cm2 -Calculate the regurgitant fraction of a patient who has a thermal CO of 4.1L/min and an angiographic CO of 5.4L/min - -24% -This patient has a cardiac output of 5.1L/min. Calculate the SVR of this patient with the following data Mean PA= 24 Mean RA= 5 Mean PCWP= 15 Mean AO= 95 - -1411 dynec/sec/cm-5 -If a patient has a pulsatile mass below the sheath site, and a bruit is a present, what should be suspected - -Pseudoaneurysm -An abdominal aortic pulsation greater than 3.0 cm can be a finding for what - -Aortic aneurysm -Back pain not relieved NTG, morphine or oxygen and not associated with EKG changes can indicate - -Aortic dissection -Which stent is self expanding - -Wall stent -A catheter has a diameter of 2.66mm. What French size is it - -BFR -In relation to a coronary lesion where should the wire not be placed A. As distal as possible B. In the nearest side branch C. In a distal side branch D. Proximal to the lesion E. All of the above - -All of the above -Which lesion is best addressed with a Rotoblador - -Calcified -Which catheter should be used to cannulate an LAD with a high take off - -Amplatz -Landmarks for an internal jugular approach include - -Head of the sternocledomastoid muscle and the clavicular head -When performing a myocardial biopsy where are the tissue samples taken from - -RV -Hypokinetic means - -decreased movement -In the formula BP= HR x SV x Systematic Vascular Resistance, Dobutamie acts as an ____, to ____ by increasing____ - -Inotrope, increase stroke volume, contractility -Which of the following are Angiostensin Receptor Blockers (ARBS) A. Lisiopril B. Losartan C. Metoprolol D. Valstartan - -Losartan and Valstartan -NTG works to decrease preload when given during an MI by dilating - -Veins -What is the function of low dose dopamine, 1-5mcg/kg/min - -Improves renal function and urine output -If the patient complains of pain down the leg when attempting to cannulate the right femoral artery, which way do you move the needle - -Medial -Coronary arteries perfuse best during - -Diastole -What is the purpose of the IABP - -Increased coronary perfusion, decreased afterload -An IMA catheter most nearly resembles a - -IR 4 -What is the recommended rate of Burr rotation when using a Rotoblador - -160,000- 210,000 -Overtightening of the Tuohy Borst will - -prevent balloon inflation or deflation -The best device for management of an acute thrombus in a vessel is - -Angioget -Which device employs the use of sterile heperinilized saline to evacuate thrombus - - Angioget -What are the signs and symptoms of a retroperitoneal blood - -back or flank pain, drop in blood pressure, tachycardia, drop in Hgb and Hct -Calcified lesions are best managed with which device - -Cutting/scoring balloon -When using a temporary pacer, where is the lead placed - -RV -When performing a myocardial biopsy post heart transplant, the biopsy is performed to evaluate - -potential for rejection of the transplanted heart -The drive to breath in a person with no respiratory diseases is - -Elevated CO2 -The drive to breath in a person with COPD is - -Decreased O2 -The greatest risk when performing myocardial biopsy is - -Perforating of the RV -When using the Rotoblador, when should the burr start rotating - -just proximal to the lesion -Akinetic meaans - -no movement at all -Dyskinetic means - -disorganized movement -An ABI measures - -the difference between brachial and ankle systemic blood pressure -The dorsalis pedal pulse is located - -on the anterior foot -The posterior tibial pulse is located - -near the medial malleolus -The site of myoxma is in the - -LA -The best catheter to cross a stenotic aortic valve is - -AL2 -What medications are commonly given when performing a radial procedure - -NTG, Verapamil, Heparin -The Allen's Test assesses the flow in the - -blood flow in the radial and ulnar arteries -The IABP catheter should be placed - -above the renal artery and below the left subdivision -Which of the following symptoms after the use of a closure device warrants evaluation - -loss of pulses in the foot -If the heart rate slows, what happens to stroke volume - -increases -what happens to myocardial contractile force (dp/dt) when the heart rate slows down - -Increases -The Eustachian valve is located - -between the inferior vena cava and the right atrium -The Amplatzer Septal Occluder device is used to - -Close a PFO -Function of the percutamneous Impella - -Evacuates 2.5 LPM from the LV; delivers it to the ascending aorta, improves CO, increases SV, improves coronary perfusion -The head hunter catheter is used to visualize the - -left and right ICA and ECA -The fossa ovalis is located - -between the RA and LA -What is the most common cause of renal artery stenosis - -Atherosclerosis -Renal artery stenosis is most commonly found in the - -proximal renal artery -FFR measures - -pressure distal to a stenosis -True/False when interpreting FFR, an FFR of .80 means that a stenosis causes a 20% drop in blood pressure distal to a lesion - -True -True/False FFR expresses the maximal flow down a vessel in the presence of a stenosis compared to the maximal flow in the absence of a stenosis - -True -True/False When considering FFR, values greater than .75-.80 indicate a non-significant stenosis and lower values indicate a significant stenosis - -True -True/False When considering FFR, a significant stenosis (>70%) may yield an FFR >.80 if there is significant collateral flow to the vessel with the lesion in it - -True -True/False Pulses alternans is a sign of left sided heart failure - -True -True/False Prior to mitral valvuloplasty a TEE is needed as atrial thrombus is an absolute contraindication - -True -How would you monitor heparin therapy if ACT is not available - -PT/PTT -An elevated PCWP, orthopnea, increased LVEDP, and decreased O2 sat are signs of - - left sided heart failure -What is the NYHA classification of a patient on a ventricle assist device - -IV-Severe limitation of activity; symptomatic at rest -A washer that is visulaized on fluoroscopy is placed to mark the - -proximal vein graft -An ABI measures the difference between the _____ and _____ pulses and a reading of ____ indicates a flow limiting lesion - -left brachial and left pedal; .7 -Cannulation of the femoral artery should be - -one finger breath below the inguinal fold -Choose the correct answers about a pseudo aneurysm (PSA) A. PSA occurs when an arterial puncture does not seal B. Pulsatile blood tracks into the perivascular space C. Blood is contained by the perivascular structure D. Takes on the appearance of a SAC E. Is the result of cannulating needle penetrating the anterior and posterior vessel walls F. All of the Above - -All of the Above -Treatment of a PSA includes A. Thrombin injection into the SAC B. Ultrasound guided compression C. Surgical management D. All of the above - -All of the above -PSA's occur most commonly when the puncture site is the (Choose all that apply) A. CFA B. SFA C. External iliac artery D.Given inadequate compression time - -SFA, external iliac artery, given inadequate compression time -Physical signs of PSA may include (Choose all that apply) A. Palpable pulsatile mass B. Presence of a systolic bruit C. Significant site pain D. Loss of pulse in the opposite legg - -A. Palpable pulsatile mass B. Presence of a systolic bruit C. Significant site pain -Which of the following are not associated with a retroperitoneal blood - -Cannulation 1 finger breath below the inguinal fold -Which organ system is responsible for metabolic changes in pH - -Kidneys -Which of the following organ systems cannot cause changes in pH (Choose all that apply) A. GI/endocrine B. Liver/pancreas C. Heart/vascular D. Kidneys/Lungs - -A. GI/endocrine B. Liver/pancreas C. Heart/vascular -Which of the following are necessary prior to correcting an ASD (Choose all that apply) A. Documentation using the ICE catheter B. Evaluation using a sizing balloon C. Identifying the shunt to be in the ostium secundum D. Identifying the shunt to be in the ostium premium - -A. Documentation using the ICE catheter B. Evaluation using a sizing balloon C. Identifying the shunt to be in the ostium secundum -Identify all of the following that pertain to the crushing stent technique A. Created for lesions in a side branch B. Created for lesions in a bifurcation C. The first stent is positioned in the side branch with about 1/3 of its length protruding into the main branch D. A second stent is positioned in the main branch E. The side branch stent is deployed first F. The main branch stent is deployed second crushing the portion of the side branch stent in the main branch - -All of the Above -Contraindications for closure devices include (Choose all that apply) A. PVD B. Diabetes C. Cannulation above the inguinal fold D. Cannulation in the profunda - -All of the above -The incidence of vascular complications increases when the groin stick is how far below the inguinal fold (Choose all that Apply) A. <1 cm B. 2-3 cm C. 3-4 cm D. >4 cm - -B. 2-3 cm C. 3-4 cm D. >4 cm -The PR interval is .26. the conduction delay is not in the (Choose all that apply) A. SA node B. AV node C. Bundle of His D. Purkinje fibers - -A. SA node C. Bundle of His D. Purkinje fibers -The laser as an interventional technique eliminates plaque by - -vaporizing -The Impella device evacuates blood from the _____ and delivers it to the _____ - -LV, AO -Which of the following are not desired TIMI flow post procedures (Choose all that apply) A. TIMI 0 (no flow) B. TIMI 1 (faint flow) C. TIMI 2 (sluggish flow) D. TIMI 3 (normal flow) - -A. TIMI 0 (no flow) B. TIMI 1 (faint flow) C. TIMI 2 (sluggish flow) -Increasing the rate of rise on the power injector results in (Choose all that apply) A. Decreased catheter whip B. Decreased amount of contrast needed C. Increased amount of contrast needed D. No change in the amount of contrast needed E. Decreased chance of injuring the LV - -A. Decreased catheter whip D. No change in the amount of contrast needed E. Decreased chance of injuring the LV -True/False Arteriosclerosis is the thickening/hardening and loss of elasticity of the walls of the arteries - -True -True/False Atherosclerosis is the build-up of plaque on the arterial wall - -True -what does a a properly timed atrial contraction do (Choose all that apply) A. Increases SV B. Decreases SV C. Increases CO D. Decreases CO - -A. Increases SV C. Increases CO -Symptoms of a retroperitoneal bleed include (Choose all that apply) A. Back pain B. Decreased Hgh and Hct C. Tachycardia D. Increased SV - -A. Back pain B. Decreased Hgh and Hct C. Tachycardia -Which of the following increases one's risk of a stroke (Choose all that apply) A. A Fib B. V Fib C. V Flutter D. A Flutter - -A. A Fib D. A Flutter -Balloon expandable stents are used in the ____ and self-expanding stents are used in the _____ - -Coronaries and corotids -When heart rate slows (dp/dt) cardiac muscle fiber contraction.... - -Increases -Cardiac output is measured using which of the following parameters A. Pulmonary systolic pressure B. Heart rate C. SVC pressure D. SV - -B. Heart rate D. SV -Stoke volume is most affected by - -preload -Preload is impacted by - -filling volumes -Chronic untreated hypertension demonstrates (Choose all that apply) A. A risk factor for CAD B. Decreased preload C. increased afterload D. An indication for Coumadin therapy - -A. A risk factor for CAD C. increased afterload -Choose from the following all of the correct BP equations A. BP = SV x SVR B. BP = CP x SVR C. BP = HR x SV D. BP = HR x SV x SVR - -B. BP = CP x SVR D. BP = HR x SV x SVR -Mitral insufficiency is evaluated by which of the following components of a waveform - -v wave -In order to determine if a patient has MR which of the following pressures must be recorded - -PCW -Identify which pathologies would increase RVEDP (choose all that apply) A. RV infarct B. Systemic hypertension C. Chronic COPD D. Chronic pulmonary hypertension - -A. RV infarct C. Chronic COPD D. Chronic pulmonary hypertension -An elevated RA waveform and elevated RA pressure could be caused by (Choose all that apply) A. TR B. RV MI C. Decreased O2 sat D. ASD - -A. TR B. RV MI D. ASD -Pulmonic stenosis (Choose all that apply) A. Result from MR B. is a congenital anomaly C. Occurs with cardiomyopathy and pulmonary hypertension D. Is a narrowing of the pulmonic valve - -B. is a congenital anomaly D. Is a narrowing of the pulmonic valve -The blue proximal port of the swan (Choose all that apply) A. is located 45 cm from the distal tip of the swan B. the port used to measure PCW C. Is located 30 cm from the distal tip of the swan D. The port used to inject saline for a cardiac output - -C. Is located 30 cm from the distal tip of the swan D. The port used to inject saline for a cardiac output -The transducer is zeroed and falls off the table to the floor (Choose all that apply) A. The pressure being read is now reading higher B. The pressure being read is now lower C. The transducer dropping to the floor wont affect the pressure readings D. The transducer should be re-zeroed - -A. The pressure being read is now reading higher D. The transducer should be re-zeroed -Pulsus paradoxus (Choose all that apply) A. is a sign of tamponade B. Demonstrates abnormal variation in filling pressures during inspiration C. Can be seen on a PCW tracing D. Is caused by cardiomyopathy - -A. is a sign of tamponade B. Demonstrates abnormal variation in filling pressures during inspiration C. Can be seen on a PCW tracing -Signs of LV failure include (Choose all that apply) A. Bilateral peripheral edema B. Ascities C. Orthopnea and pulmonary congestion D. Decreased exercise tolerance and a decreased EF - -C. Orthopnea and pulmonary congestion D. Decreased exercise tolerance and a decreased EF -Constrictive pericarditis (Choose all that apply) A. causes equalization of RVEDP and LVEDP B. Decreases SV C. Decreased CO D. increases exercise tolerance - -A. causes equalization of RVEDP and LVEDP B. Decreases SV C. Decreased CO -Right heart failure (Choose all that apply) A. Causes a decreased O2 sat B. causes JVD C. causes unilateral peripheral edema D. Causes bilateral peripheral edema - -B. causes JVD D. Causes bilateral peripheral edema -Choose the views that result in a higher dose to the patient A. Lateral B. LAO 60 and 30 cranial C. AP D. RAO 40 - -A. Lateral B. LAO 60 and 30 cranial D. RAO 40 -Choose the practices that would minimize a decrease in kidney function post catheterization (Choose all that apply) A. Keeping the patient NPO B. Pre procedure hydration C. Use of low osmolality contrast D. Minimize contrast given to the patient - -B. Pre procedure hydration C. Use of low osmolality contrast D. Minimize contrast given to the patient -ReoPro (Choose all that apply) A. is a platelet inhibitor B. thrombin inhibitor C. IIB/IIIa receptor blocker D. Increases bleeding time - -A. is a platelet inhibitor C. IIB/IIIa receptor blocker D. Increases bleeding time -Heparin (Choose all that apply) A. Decreases bleeding time B. Increases bleeding time C. is an antithrombin D. is an antiplatelet - -B. Increases bleeding time C. is an antithrombin -Which of the following are anti-platelets A. ReoPro B. Plavix C. ASA D. Heparin E. Coumadin - -A. ReoPro B. Plavix C. ASA -If the patient has an elevated creatinine and a decreased GFR which of the following should not be given - -Lasix -ACE inhibitors (Choose all that apply) A. Decrease HR B. Decrease BP C. Lower BP via the kidneys D. lower the BP via the SA node - -B. Decrease BP C. Lower BP via the kidneys -A common adverse effect of ACE inhibitors is - -Cough -Select all the ACE inhibitors A. Enalapril B. Lasix C. Lisinopril D. NTG - -A. Enalapril C. Lisinopril -Which of the following are calcium channel blockers? A. Amlodipine B. Metoprolol C. Felodipine D. Nifedipine - -A. Amlodipine C. Felodipine D. Nifedipine -Choose all of the following tests used to elevate kidney function A. Urine output B. GFR C. Creatinine D. Creatinine clearance - -A. Urine output B. GFR C. Creatinine D. Creatinine clearance -An inferior wall MI (Choose all that apply) A. Demonstrates ST elevation in leads II, III, and AVE B. Involves the LAD C. Involves the RCA D. Involves the LCx - -A. Demonstrates ST elevation in leads II, III, and AVE C. Involves the RCA -In a 1st degree heart block (Choose all that Apply) A. The delay is in the SA node B. The delay is in the AV node C. The PR interval is >.20 D. The PR interval is <.20 - -B. The delay is in the AV node C. The PR interval is >.20 -An increased LVEDP (Choose all that apply) A. Increases the LV Preload B. Increases the PCWP C. Increases the LA pressure D. Causes no change in pressures - -A. Increases the LV Preload B. Increases the PCWP C. Increases the LA pressure -An aortic dissection (Choose all that apply) A. Presents with back pain B. Presents with abdominal pain and RUQ pain C. Presents with back pain not relieved with NTG, Morphine, O2 D. Presents with back pain not associated with EKG changes - -A. Presents with back pain C. Presents with back pain not relieved with NTG, Morphine, O2 D. Presents with back pain not associated with EKG changes -The patient c/o pain down the leg when attempting to cannulate the RFA (Choose all that apply) A. The attempt was to lateral B. The attempt was too far above the inguinal fold C. The cannulating needle needs to be re-positioned medially D. the attempt was too inferior (below) the inguinal field - -A. The attempt was to lateral C. The cannulating needle needs to be re-positioned medially -Accurate timing of the IABP (Choose all that apply) A. decreases preload B. increases preload C. Decreases afterload D. increases afterload E. improves coronary circulation F. Does not affect coronary circulation - -C. Decreases afterload E. improves coronary circulation -Calcified lesions are best managed with (Choose all that apply) A. Streptokinase B. ReoPro and a Rotoblador C. Cutting balloon D. Rotoblador - -C. Cutting balloon D. Rotoblador -A person with chronic COPD (choose all that apply) A. has marginally normal saturation B. Has increased CO2 content and a normal O2 sat C. Has increased CO2 and a decreased O2 sat D. Has an increased respiratory rate E. The drive to breath is a decreased O2 sat - -C. Has increased CO2 and a decreased O2 sat D. Has an increased respiratory rate E. The drive to breath is a decreased O2 sat -A common complication of a Rotoblador is - -Distal embolization -