CCRN PRACTICE TEST 1 QUESTIONS & ANSWERS
What is vasogenic cerebral edema? - Answers -Vasogenic cerebral edema is an
increase in extracellular fluid caused by a breakdown of the blood-brain barrier with the
resultant increase in vascular permeability. This cerebral edema begins locally and
becomes more generalized. Common causes are trauma (including surgical trauma),
tumors, hemorrhage, and abscesses
What ventilator parameter indicates fluid volume excess? - Answers -An A:a gradient
greater than 10 mm Hg is a reflection of a diffusion defect. Note that the process of
diffusion is between A (alveolus) and (a) arterial blood. An increase in intraalveolar fluid
dilutes and inactivates surfactant, causing alveolar collapse (decreasing vital capacity)
and decreases lung compliance. Peak inspiratory pressure increases reflect a decrease
in lung compliance
What does autonomy refer to? - Answers -The patient's right to make decisions for
themselves
What does beneficence mean? - Answers -Obligation to do good
What does nonmaleficence mean? - Answers -Obligation to do no harm
What does fidelity mean? - Answers -the obligation to abide by agreements and
responsibilities
Mitral stenosis is associated with what? - Answers -Pinkish discoloration of the cheeks.
It is a diastolic murmur
What murmur is associated with widened pulse pressure? - Answers -Aortic regurg
What murmur is associated with narrowed pulse pressure? - Answers -Mitral regurg
What lead changes are associated with left ventricle hyperthrophy? - Answers -Strain
pattern in V5 and V6 (asymmetric T wave inversion)
When the depth of the S wave in lead V1 or V2 plus the height of the R wave in lead V5
or V6 is 35 mm or greater, this constitutes voltage
What lead changes are associated with right ventricle hypertrophy? - Answers -strain
pattern in V1 and V2. Prominent R wave in V1 reverse progression of the R wave
across the precordium.
What organ system is the most common to fail in severe sepsis? - Answers -
Hematologic- coagulopathies are common in severe sepsis
, What are the early signs of hypoglycemia? - Answers -The early signs of hypoglycemia
are mediated by the sympathetic nervous system, which acts to mobilize glucose stores
(tachycardia, tachypnea, diaphoresis). Later signs of hypoglycemia are related to low
glucose levels in the brain (neuroglycopenia)
**Early signs can be masked in pts taking beta-blockers
What is the systolic BP at different locations if you are able to palpate a pulse? -
Answers -If the radial artery can be palpated, the systolic BP is at least 80 mm Hg. If the
brachial artery can be palpated, the systolic BP is at least 70 mm Hg. If only the carotid
artery can be palpated, the systolic BP is approximately 60 mm Hg
What happens to SvO2 if oxygen delivery decreases for any reason - Answers -SvO2 is
a reflection of oxygen reserve. If oxygen delivery is decreased, oxygen consumption
continues, and oxygen reserve decreases. SvO2 decreases any time the delivery of
oxygen decreases or the consumption of the tissues increases
A simple way to estimate CVP is to add 5 cm to the measured height that the jugular
veins are distended above the sternal angle (angle of Louis) with the patient in a 45-
degree angle - Answers -
What is the most common cause of right ventricular failure? - Answers -Left ventricular
failure- causes pulmonary congestion and pulmonary HTN which increases the
workload for the right side of the heart
Other causes- primary pulmonary hypertension, RV infarction, pulmonic stenosis, PE,
mitral stenosis
What findings would be consistent with a massive hemothorax? - Answers -Fluid, such
as blood, will be dull to flat to percussion. The blood in the pleural space compresses
normal lung tissue and causes diminished to absent breath sounds. A large volume of
blood in the pleural space may cause the trachea to shift away from the affected side
toward the unaffected side
How does positive pressure ventilation affect ICP - Answers -It increases intrathoracic
pressure, which leads to increased ICP
What is the difference between active and passive euthanasia? - Answers -Passive
euthanasia is allowing a person to die without taking lifesaving measures. Hydration and
nutrition is usually maintained. Active euthanasia is doing something that causes death
To minimize respiratory fluctuations on PAOP, you measure it - Answers -At the end of
expiration
Patient breathing-peak
Ventilator-valley
What is vasogenic cerebral edema? - Answers -Vasogenic cerebral edema is an
increase in extracellular fluid caused by a breakdown of the blood-brain barrier with the
resultant increase in vascular permeability. This cerebral edema begins locally and
becomes more generalized. Common causes are trauma (including surgical trauma),
tumors, hemorrhage, and abscesses
What ventilator parameter indicates fluid volume excess? - Answers -An A:a gradient
greater than 10 mm Hg is a reflection of a diffusion defect. Note that the process of
diffusion is between A (alveolus) and (a) arterial blood. An increase in intraalveolar fluid
dilutes and inactivates surfactant, causing alveolar collapse (decreasing vital capacity)
and decreases lung compliance. Peak inspiratory pressure increases reflect a decrease
in lung compliance
What does autonomy refer to? - Answers -The patient's right to make decisions for
themselves
What does beneficence mean? - Answers -Obligation to do good
What does nonmaleficence mean? - Answers -Obligation to do no harm
What does fidelity mean? - Answers -the obligation to abide by agreements and
responsibilities
Mitral stenosis is associated with what? - Answers -Pinkish discoloration of the cheeks.
It is a diastolic murmur
What murmur is associated with widened pulse pressure? - Answers -Aortic regurg
What murmur is associated with narrowed pulse pressure? - Answers -Mitral regurg
What lead changes are associated with left ventricle hyperthrophy? - Answers -Strain
pattern in V5 and V6 (asymmetric T wave inversion)
When the depth of the S wave in lead V1 or V2 plus the height of the R wave in lead V5
or V6 is 35 mm or greater, this constitutes voltage
What lead changes are associated with right ventricle hypertrophy? - Answers -strain
pattern in V1 and V2. Prominent R wave in V1 reverse progression of the R wave
across the precordium.
What organ system is the most common to fail in severe sepsis? - Answers -
Hematologic- coagulopathies are common in severe sepsis
, What are the early signs of hypoglycemia? - Answers -The early signs of hypoglycemia
are mediated by the sympathetic nervous system, which acts to mobilize glucose stores
(tachycardia, tachypnea, diaphoresis). Later signs of hypoglycemia are related to low
glucose levels in the brain (neuroglycopenia)
**Early signs can be masked in pts taking beta-blockers
What is the systolic BP at different locations if you are able to palpate a pulse? -
Answers -If the radial artery can be palpated, the systolic BP is at least 80 mm Hg. If the
brachial artery can be palpated, the systolic BP is at least 70 mm Hg. If only the carotid
artery can be palpated, the systolic BP is approximately 60 mm Hg
What happens to SvO2 if oxygen delivery decreases for any reason - Answers -SvO2 is
a reflection of oxygen reserve. If oxygen delivery is decreased, oxygen consumption
continues, and oxygen reserve decreases. SvO2 decreases any time the delivery of
oxygen decreases or the consumption of the tissues increases
A simple way to estimate CVP is to add 5 cm to the measured height that the jugular
veins are distended above the sternal angle (angle of Louis) with the patient in a 45-
degree angle - Answers -
What is the most common cause of right ventricular failure? - Answers -Left ventricular
failure- causes pulmonary congestion and pulmonary HTN which increases the
workload for the right side of the heart
Other causes- primary pulmonary hypertension, RV infarction, pulmonic stenosis, PE,
mitral stenosis
What findings would be consistent with a massive hemothorax? - Answers -Fluid, such
as blood, will be dull to flat to percussion. The blood in the pleural space compresses
normal lung tissue and causes diminished to absent breath sounds. A large volume of
blood in the pleural space may cause the trachea to shift away from the affected side
toward the unaffected side
How does positive pressure ventilation affect ICP - Answers -It increases intrathoracic
pressure, which leads to increased ICP
What is the difference between active and passive euthanasia? - Answers -Passive
euthanasia is allowing a person to die without taking lifesaving measures. Hydration and
nutrition is usually maintained. Active euthanasia is doing something that causes death
To minimize respiratory fluctuations on PAOP, you measure it - Answers -At the end of
expiration
Patient breathing-peak
Ventilator-valley
