BARRON'S CCRN EXAM QUESTIONS AND ANSWERS
"high dose" dopamine causes vasoconstriction and
(C) Increase afterload - Answers -What is the primary hemodynamic effect of:
Dopamine >10 mcg/kg/min
(A) Increase preload
(B) Decrease preload
(C) Increase afterload
(D) Decreased afterload
(E) Increase contractility
(D) Decrease contractility
Pulmonary HTN and cor pulmonale;
Mitral, aortic, or tricuspid insufficiency - Answers -What causes the S3 sound?
during diastole - Answers -When are coronary arteries perfused?
S3 heart sound - Answers -What may you hear before crackles when a patient is going
into heart failure?
Variant or Prinzmetal's Angina - Answers -What is this called?
Unstable angina with transient ST segment elevation
Can occur at rest or may be cyclic (occurring at the same time daily)
troponin negative
Can be precipitated by nicotine, coke, or ETOH
RCA, inferior LV - Answers -There are changes in leads II, III, aVF....what type of MI?
LAD, anterior LV - Answers -There are changes in leads V1, V3 V3, V4
circumflex, lateral LV - Answers -There are changes in leads V5, V6, I, aVL
Low lateral LB - Answers -There are changes in leads V5, V6
,high lateral LB - Answers -There are changes in leads I aVL
RCA, posterior LV - Answers -There are changes in leads V1 and V2
RCA, right ventricular infarct - Answers -There are changes in leads V3R, V4R
Marked ELEVATION of troponin/CK-MB: due to miocardial stunning when vessel opens
reperfusion arrhythmias: VT, Vfib, accelerated idioventricular rhythm (due to stunning)
resolution of ST segment deviations
Chest pain relief - Answers -What are some signs of reperfusion following fibrinolytic
treatment of a STEMI?
contact the physician. Could be coronary artery re-occlusion/stent thrombosis. -
Answers -Your patient just had a percutaneous coronary intervention (PCI) (stenting)
less than 24 hours ago:
Inflates at dicrotic notch of the arterial waveform, beginning of diastole
Deflates before systole begins, determined by set trigger for deflation, R-wave of ECG
or upstroke of arterial pressure wave - Answers -IABP
tamponade
pericarditis
long CABG can increase bleeding risk due to increased heparin dose in surgery -
Answers -CABG (Coronary Artery Bypass Graft) complications
Narrowed pulse pressure (IE 82/68)
Pulsus paradoxus: excessive drop is SBP (>12mmgh during inspiration). Cardiac
muscle restriction due to tamponade with inspiration, intrathoracic pressure increases
thus decreasing venous return
Restlessness and agitation.
Distended neck veins (JVD), hypotension, diminished heart sounds (Beck's triad);
equalization of CVP: pulmonary artery diastolic and PAOP - Answers -Signs of cardiac
tamponade
4-12 mmHg - Answers -PAWP (pulmonary artery wedge pressure) (same as PAOP)
normal?
hypovolemia (low PAWP, low volume)
, normal is 4-12 - Answers -PAWP (same as PAOP) of 1-3 mmhg means?
Hypervolemia (high volume, high PAWP)
normal is 4-12 - Answers -PAWP(same as PAOP) of >12 mmhg means?
- Answers -https://www.youtube.com/watch?v=i1oJ-WyTvo8
Good video for swan ganz
nose to alveoli: Air within the trachea, pharynx, larynx, bronchi, and nasal passages -
Answers -Anatomic dead space is considered to be the:
PE. No blood flow past the PE, so all alveoli past it is dead space - Answers -what
causes alveolar dead space?
right side. good lung down! if the right lung is down, more blood flows to it, thus
increasing o2 - Answers -you have a patient with left-sided pneumonia, the right lung is
largely unaffected. Which position would you place them in to improve oxygenation?
0.8
=4 L ventilation/5L perfusion - Answers -normal VQ ratio
a pathologic shunt. Blood goes thru the lungs but does not get oxygenated resulting in
refractory hypoxemia - Answers -ARDS is an example of what?
0-5% normal
carbon monoxide clings to Hgb and O2 cannot attach when CO is already attached.
Pulse oximetry is unreliable because it just detects Hgb saturation. Thus if a patient has
a CO level of 40%, they cannot have more than 60% O2 sat.
Treatment is 100% fiO2 until CO is >10% or hyperbaric - Answers -what is the normal
level for carbon monoxide?
What should be considered when monitoring O2 sats?
What is the treatment for excess?
suspected pneumothorax
hemodynamic instability/life threatening arrhthmias
secretions/aspiration risks - Answers -contraindications to NIV (BiPAP/CPAP)?
Increased WOB/hypoxic respiratory failure.
"high dose" dopamine causes vasoconstriction and
(C) Increase afterload - Answers -What is the primary hemodynamic effect of:
Dopamine >10 mcg/kg/min
(A) Increase preload
(B) Decrease preload
(C) Increase afterload
(D) Decreased afterload
(E) Increase contractility
(D) Decrease contractility
Pulmonary HTN and cor pulmonale;
Mitral, aortic, or tricuspid insufficiency - Answers -What causes the S3 sound?
during diastole - Answers -When are coronary arteries perfused?
S3 heart sound - Answers -What may you hear before crackles when a patient is going
into heart failure?
Variant or Prinzmetal's Angina - Answers -What is this called?
Unstable angina with transient ST segment elevation
Can occur at rest or may be cyclic (occurring at the same time daily)
troponin negative
Can be precipitated by nicotine, coke, or ETOH
RCA, inferior LV - Answers -There are changes in leads II, III, aVF....what type of MI?
LAD, anterior LV - Answers -There are changes in leads V1, V3 V3, V4
circumflex, lateral LV - Answers -There are changes in leads V5, V6, I, aVL
Low lateral LB - Answers -There are changes in leads V5, V6
,high lateral LB - Answers -There are changes in leads I aVL
RCA, posterior LV - Answers -There are changes in leads V1 and V2
RCA, right ventricular infarct - Answers -There are changes in leads V3R, V4R
Marked ELEVATION of troponin/CK-MB: due to miocardial stunning when vessel opens
reperfusion arrhythmias: VT, Vfib, accelerated idioventricular rhythm (due to stunning)
resolution of ST segment deviations
Chest pain relief - Answers -What are some signs of reperfusion following fibrinolytic
treatment of a STEMI?
contact the physician. Could be coronary artery re-occlusion/stent thrombosis. -
Answers -Your patient just had a percutaneous coronary intervention (PCI) (stenting)
less than 24 hours ago:
Inflates at dicrotic notch of the arterial waveform, beginning of diastole
Deflates before systole begins, determined by set trigger for deflation, R-wave of ECG
or upstroke of arterial pressure wave - Answers -IABP
tamponade
pericarditis
long CABG can increase bleeding risk due to increased heparin dose in surgery -
Answers -CABG (Coronary Artery Bypass Graft) complications
Narrowed pulse pressure (IE 82/68)
Pulsus paradoxus: excessive drop is SBP (>12mmgh during inspiration). Cardiac
muscle restriction due to tamponade with inspiration, intrathoracic pressure increases
thus decreasing venous return
Restlessness and agitation.
Distended neck veins (JVD), hypotension, diminished heart sounds (Beck's triad);
equalization of CVP: pulmonary artery diastolic and PAOP - Answers -Signs of cardiac
tamponade
4-12 mmHg - Answers -PAWP (pulmonary artery wedge pressure) (same as PAOP)
normal?
hypovolemia (low PAWP, low volume)
, normal is 4-12 - Answers -PAWP (same as PAOP) of 1-3 mmhg means?
Hypervolemia (high volume, high PAWP)
normal is 4-12 - Answers -PAWP(same as PAOP) of >12 mmhg means?
- Answers -https://www.youtube.com/watch?v=i1oJ-WyTvo8
Good video for swan ganz
nose to alveoli: Air within the trachea, pharynx, larynx, bronchi, and nasal passages -
Answers -Anatomic dead space is considered to be the:
PE. No blood flow past the PE, so all alveoli past it is dead space - Answers -what
causes alveolar dead space?
right side. good lung down! if the right lung is down, more blood flows to it, thus
increasing o2 - Answers -you have a patient with left-sided pneumonia, the right lung is
largely unaffected. Which position would you place them in to improve oxygenation?
0.8
=4 L ventilation/5L perfusion - Answers -normal VQ ratio
a pathologic shunt. Blood goes thru the lungs but does not get oxygenated resulting in
refractory hypoxemia - Answers -ARDS is an example of what?
0-5% normal
carbon monoxide clings to Hgb and O2 cannot attach when CO is already attached.
Pulse oximetry is unreliable because it just detects Hgb saturation. Thus if a patient has
a CO level of 40%, they cannot have more than 60% O2 sat.
Treatment is 100% fiO2 until CO is >10% or hyperbaric - Answers -what is the normal
level for carbon monoxide?
What should be considered when monitoring O2 sats?
What is the treatment for excess?
suspected pneumothorax
hemodynamic instability/life threatening arrhthmias
secretions/aspiration risks - Answers -contraindications to NIV (BiPAP/CPAP)?
Increased WOB/hypoxic respiratory failure.
