PCCN Review – Cardiac Test
Questions and Answers
A reflex tachycardia caused by the stretch of the right atrial receptors is known as the
____
• Herring-Sines law
• Renin-angiotensin system
• Starling's law
• Bainbridge reflex - Answer-BAINBRIDGE REFLEX
It is believed that this reflex exists to speed up the HR if the right side becomes
overloaded, thereby helping equalize pressures on both sides
Diastole comprises what & of the cardiac cycle?
•½
• 2/3
•¼
• 1/3 - Answer-2/3
Some people that the heart is virtually static during diastole.
During this period, the cardiac vessels and chambers fill—a process that takes up 2/3s
of the time necessary to complete the cardiac cycle
What is the MAP (mean arterial pressure) for pt:
BP 120/70
HR 80 - Answer-MAP=2(DBP) + (SBP)/3
MAP=2(70) + 120/3
MAP=260/3
MAP=86.6
Pts should maintain a MAP of at least 60 to ensure adequate perfusion to the brain and
kidneys.
What is the MAP (mean arterial pressure) for pt:
BP 120/70
HR 80
MAP=2(DBP) + (SBP)/3 - Answer-MAP=2(70) + 120/3
MAP=260/3
MAP=86.6
Pts should maintain a MAP of at least 60 to ensure adequate perfusion to the brain and
kidneys.
Calculate CI (cardiac index)
,HR 80
BP 110/70
SV 60
BSA 2.0 m2
Expressed in L/min/m2 - Answer-CI=CO/BSA
CO=HR X SV
CO=80 X 60
CI=4800/2.0
CI=2400
CI=2.4 L/min/m2
Calculate CI (cardiac index)
HR 80
BP 110/70
SV 60
BSA 2.0 m2
Expressed in L/min/m2
CI=CO/BSA - Answer-CI=CO/BSA
CO=HR X SV
CO=80 X 60
CI=4800/2.0
CI=2400
CI=2.4 L/min/m2
The resistance against which the right ventricle must work to eject its volume is known
as
• Resting heart pressure
• Systemic vascular pressure
• Central venous pressure
• Pulmonary vascular resistance - Answer-Pulmonary Vascular Resistance
This pressure represents a mean pressure in the systemic vasculature. The higher the
resistance, the harder the heart has to work against it.
EXA: Colder temperatures will cause vasoconstriction; the heart then has to pump
harder to deliver blood through the narrowed vasculature.
Mr. Ironclaw lives on a nearby Indian Reservation. He is retired and on a fixed income
with no insurance. He is being discharged today after an observational stay for Chest
Pain. In planning his discharge care, which of the following should be considered FIRST
to increase compliance with plan of care once home?
• Arrange for Home Health 1X/week
• Ask doc to consider an OTC antiplatelet medication
• Schedule his follow-up appt with the cardiologist in 3 months
,• Suggest a gym membership - Answer-ASK DOC TO CONSIDER AN OTC
ANTIPLATELET MEDICATION
Although he may wish to be compliant with plan of care at home, financial limitations
may prohibit him from expensive treatments, meds, and support services.
William was diagnosed with unstable angina. He is scheduled for an exercise stress
test. He tells you he has a "bad hip" and an old knee injury that makes it difficult for him
to walk or stand for more than 20 minutes. You tell him:
• You only need to walk for 10 minutes
• You can ride a bike for 20 minutes instead
• I will call the doc and ask for the Weight-life test instead
• I will call the doc and ask for a stress echocardiography test instead - Answer-I WILL
CALL THE DOC AND ASK FOR A STRESS ECHOCARDIOGRAPHY TEST INSTEAD
The exercise stress test requires the pt to walk on a treadmill or stationary bike for 30-
60 minutes.
The Stress Echocardiography test uses Dobutamine to stress the cardiac tissues
without requiring the pt to walk or ride.
The Weight lift test does not exist.
Approximately what % of coronary artery blockage is needed to cause angina?
• 45%
• 60%
• 75%
• 90% - Answer-75%
Anginal pain usually occurs when approximately 75% of the artery's diameter becomes
occluded. Pain is usually more pronounced with exertion or emotional distress, when
O2 demand by cardiac tissue cannot be met by O2 supply via the occluded arteries.
The severity of the pain may be compounded with vasospams that further restrict blood
flow through the coronary arteries.
A heart murmur associated with acute valvular regurg would be?
• S3
• S2
• S1
• S4 - Answer-S4
S1 and S2 are normal heart sounds
S3 is associated with fluid status
S4 is associated with compliance.
Which is the best lead to monitor a RBBB?
• Lead II
Lead I
• Lead V1
, • Lead V6 - Answer-Lead V1
Tall, peaked T waves on an EKG may be indicative of?
• Hypocalcemia
• A non-STEMI
• Hyperkalemia
• A LBBB - Answer-HYPERKALEMIA
The PR interval may become prolonged. Also, if the K is greater than 8, a wide-complex
tachycardia may occur. Keep in mind that low levels of calcium or sodium may
potentiate the cardiac effects, as can a low pH.
Mrs. P suffered a cardiac arrest at home. The family did not perform CPR and
paramedics arrived 6 minutes after the arrest. The pt was found in pulseless V-tach.
Defib and continuous CPR were provided during transport to the ED. The pt was tx-ed
to tele. The doc initiated hypothermic measures and administered vecuronium. This
med is for?
• Controlling ventral dysrhythmias
• Prevent shivering
• Sedative
• Pain control - Answer-PREVENT SHIVERING
Vecuronium is a paralytic and will prevent shivering. If a pt shivers, her temperature will
rise.
Your pt was admitted for malaise, severe dyspnea and had a syncopal episode at work.
He states he has a midline burning sensation in his chest that worsens when he is
supine. You suspect?
• Pleural effusion
• Pericardial tamponade
• GERD
• Myocarditis - Answer-MYOCARDITIS
Calculate the cardiac output for a pt with a HR of 70 and a SV of 65 ml. - Answer-HR X
SV=CO
70 X 65= 4550
4.6 L/min
Calculate the cardiac output for a pt with a HR of 70 and a SV of 65 ml.
HR X SV=CO - Answer-HR X SV=CO
70 X 65= 4550
4.6 L/min
What % of the cardiac cycle is provided by the atrial kick?
• 15%
• 20%
Questions and Answers
A reflex tachycardia caused by the stretch of the right atrial receptors is known as the
____
• Herring-Sines law
• Renin-angiotensin system
• Starling's law
• Bainbridge reflex - Answer-BAINBRIDGE REFLEX
It is believed that this reflex exists to speed up the HR if the right side becomes
overloaded, thereby helping equalize pressures on both sides
Diastole comprises what & of the cardiac cycle?
•½
• 2/3
•¼
• 1/3 - Answer-2/3
Some people that the heart is virtually static during diastole.
During this period, the cardiac vessels and chambers fill—a process that takes up 2/3s
of the time necessary to complete the cardiac cycle
What is the MAP (mean arterial pressure) for pt:
BP 120/70
HR 80 - Answer-MAP=2(DBP) + (SBP)/3
MAP=2(70) + 120/3
MAP=260/3
MAP=86.6
Pts should maintain a MAP of at least 60 to ensure adequate perfusion to the brain and
kidneys.
What is the MAP (mean arterial pressure) for pt:
BP 120/70
HR 80
MAP=2(DBP) + (SBP)/3 - Answer-MAP=2(70) + 120/3
MAP=260/3
MAP=86.6
Pts should maintain a MAP of at least 60 to ensure adequate perfusion to the brain and
kidneys.
Calculate CI (cardiac index)
,HR 80
BP 110/70
SV 60
BSA 2.0 m2
Expressed in L/min/m2 - Answer-CI=CO/BSA
CO=HR X SV
CO=80 X 60
CI=4800/2.0
CI=2400
CI=2.4 L/min/m2
Calculate CI (cardiac index)
HR 80
BP 110/70
SV 60
BSA 2.0 m2
Expressed in L/min/m2
CI=CO/BSA - Answer-CI=CO/BSA
CO=HR X SV
CO=80 X 60
CI=4800/2.0
CI=2400
CI=2.4 L/min/m2
The resistance against which the right ventricle must work to eject its volume is known
as
• Resting heart pressure
• Systemic vascular pressure
• Central venous pressure
• Pulmonary vascular resistance - Answer-Pulmonary Vascular Resistance
This pressure represents a mean pressure in the systemic vasculature. The higher the
resistance, the harder the heart has to work against it.
EXA: Colder temperatures will cause vasoconstriction; the heart then has to pump
harder to deliver blood through the narrowed vasculature.
Mr. Ironclaw lives on a nearby Indian Reservation. He is retired and on a fixed income
with no insurance. He is being discharged today after an observational stay for Chest
Pain. In planning his discharge care, which of the following should be considered FIRST
to increase compliance with plan of care once home?
• Arrange for Home Health 1X/week
• Ask doc to consider an OTC antiplatelet medication
• Schedule his follow-up appt with the cardiologist in 3 months
,• Suggest a gym membership - Answer-ASK DOC TO CONSIDER AN OTC
ANTIPLATELET MEDICATION
Although he may wish to be compliant with plan of care at home, financial limitations
may prohibit him from expensive treatments, meds, and support services.
William was diagnosed with unstable angina. He is scheduled for an exercise stress
test. He tells you he has a "bad hip" and an old knee injury that makes it difficult for him
to walk or stand for more than 20 minutes. You tell him:
• You only need to walk for 10 minutes
• You can ride a bike for 20 minutes instead
• I will call the doc and ask for the Weight-life test instead
• I will call the doc and ask for a stress echocardiography test instead - Answer-I WILL
CALL THE DOC AND ASK FOR A STRESS ECHOCARDIOGRAPHY TEST INSTEAD
The exercise stress test requires the pt to walk on a treadmill or stationary bike for 30-
60 minutes.
The Stress Echocardiography test uses Dobutamine to stress the cardiac tissues
without requiring the pt to walk or ride.
The Weight lift test does not exist.
Approximately what % of coronary artery blockage is needed to cause angina?
• 45%
• 60%
• 75%
• 90% - Answer-75%
Anginal pain usually occurs when approximately 75% of the artery's diameter becomes
occluded. Pain is usually more pronounced with exertion or emotional distress, when
O2 demand by cardiac tissue cannot be met by O2 supply via the occluded arteries.
The severity of the pain may be compounded with vasospams that further restrict blood
flow through the coronary arteries.
A heart murmur associated with acute valvular regurg would be?
• S3
• S2
• S1
• S4 - Answer-S4
S1 and S2 are normal heart sounds
S3 is associated with fluid status
S4 is associated with compliance.
Which is the best lead to monitor a RBBB?
• Lead II
Lead I
• Lead V1
, • Lead V6 - Answer-Lead V1
Tall, peaked T waves on an EKG may be indicative of?
• Hypocalcemia
• A non-STEMI
• Hyperkalemia
• A LBBB - Answer-HYPERKALEMIA
The PR interval may become prolonged. Also, if the K is greater than 8, a wide-complex
tachycardia may occur. Keep in mind that low levels of calcium or sodium may
potentiate the cardiac effects, as can a low pH.
Mrs. P suffered a cardiac arrest at home. The family did not perform CPR and
paramedics arrived 6 minutes after the arrest. The pt was found in pulseless V-tach.
Defib and continuous CPR were provided during transport to the ED. The pt was tx-ed
to tele. The doc initiated hypothermic measures and administered vecuronium. This
med is for?
• Controlling ventral dysrhythmias
• Prevent shivering
• Sedative
• Pain control - Answer-PREVENT SHIVERING
Vecuronium is a paralytic and will prevent shivering. If a pt shivers, her temperature will
rise.
Your pt was admitted for malaise, severe dyspnea and had a syncopal episode at work.
He states he has a midline burning sensation in his chest that worsens when he is
supine. You suspect?
• Pleural effusion
• Pericardial tamponade
• GERD
• Myocarditis - Answer-MYOCARDITIS
Calculate the cardiac output for a pt with a HR of 70 and a SV of 65 ml. - Answer-HR X
SV=CO
70 X 65= 4550
4.6 L/min
Calculate the cardiac output for a pt with a HR of 70 and a SV of 65 ml.
HR X SV=CO - Answer-HR X SV=CO
70 X 65= 4550
4.6 L/min
What % of the cardiac cycle is provided by the atrial kick?
• 15%
• 20%
