Barron's CCRN- Critical Care Registered Nurse Cardiac |
60 Questions Latest 2024/2025 Completely Solved
100% Correct/ Guarantee Pass
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 - ANSWER"high dose" dopamine causes vasoconstriction
and
(C) Increase afterload
What causes the S3 sound? - ANSWERPulmonary HTN and cor pulmonale;
Mitral, aortic, or tricuspid insufficiency
When are coronary arteries perfused? - ANSWERduring diastole
What may you hear before crackles when a patient is going into heart failure? -
ANSWERS3 heart sound
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 - ANSWERVariant or Prinzmetal's
Angina
There are changes in leads II, III, aVF....what type of MI? - ANSWERRCA, inferior LV
There are changes in leads V1, V3 V3, V4 - ANSWERLAD, anterior LV
,There are changes in leads V5, V6, I, aVL - ANSWERcircumflex, lateral LV
There are changes in leads V5, V6 - ANSWERLow lateral LB
There are changes in leads I aVL - ANSWERhigh lateral LB
There are changes in leads V1 and V2 - ANSWERRCA, posterior LV
There are changes in leads V3R, V4R - ANSWERRCA, right ventricular infarct
What are some signs of reperfusion following fibrinolytic treatment of a STEMI? -
ANSWERMarked 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
Your patient just had a percutaneous coronary intervention (PCI) (stenting) less than
24 hours ago:
He is experiencing unrelenting chest pain, his EKG shows ST elevation. What should
you do? What could be happening? - ANSWERcontact the physician. Could be
coronary artery re-occlusion/stent thrombosis.
Your patient just had a percutaneous coronary intervention (PCI) (stenting) less than
24 hours ago:
He is experiencing sudden low severe back pain and becomes hypotensive. What is
happening? - ANSWERretroperitoneal bleeding is most likely. Give fluids/blood
what is a normal ankle-brachial index (ABI)? - ANSWER>1 (get by dividing ankle
pressure by brachial pressure on the same side)
Your patient has PAD and just had a bypass graft. How should you care for the
extremity? How should the HOB be? - ANSWERdo not elevate the affected extremity,
it will decrease perfusion
Put bed in reverse trendelenburg
prolonged QT can lead to what deadly rhythm? - ANSWERtorsades
Causes of prolonged QT - ANSWERAmiodarone
, Haldol
Quinidine
Procainamide
Low mag, calcium, or potassium
Your patient has a pacemaker and has gone into Vtach. The pacemaker does not
correct the rhythm and your patient goes unresponsive. What do you do? -
ANSWERAmiodarone 150 mg IV over 10 min; Prepare for elective synchronized
cardioversion.
right sided heart failure - ANSWER1. Jungular Vein Distention
2. Ascending Dependent Edema
3. Weight Gain
4. Hepatomegaly (Liver Enlargement)
Left sided heart failure - ANSWER1. SOB
2. Crackles
3. Oliguria
4. Frothy Sputum
5. Displaced Apical Pulse (Hypertrophy)
*left goes away from lungs...takes your breath away
Ventricular assist device (VAD) - ANSWERA mechanical pump that helps the
ventricles pump blood, easing the workload of the heart in patients with left
ventricular heart failure, cardiogenic shock, and cardiac myopathies.
IABP - ANSWERinflates (INCREASES CORONARY ARTERY PERFUSION)
and deflates ( DECREASES AFTERLOAD)
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
CABG (Coronary Artery Bypass Graft) complications - ANSWERtamponade
pericarditis
long CABG can increase bleeding risk due to increased heparin dose in surgery
Signs of cardiac tamponade - ANSWERNarrowed pulse pressure (IE 82/68)
60 Questions Latest 2024/2025 Completely Solved
100% Correct/ Guarantee Pass
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 - ANSWER"high dose" dopamine causes vasoconstriction
and
(C) Increase afterload
What causes the S3 sound? - ANSWERPulmonary HTN and cor pulmonale;
Mitral, aortic, or tricuspid insufficiency
When are coronary arteries perfused? - ANSWERduring diastole
What may you hear before crackles when a patient is going into heart failure? -
ANSWERS3 heart sound
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 - ANSWERVariant or Prinzmetal's
Angina
There are changes in leads II, III, aVF....what type of MI? - ANSWERRCA, inferior LV
There are changes in leads V1, V3 V3, V4 - ANSWERLAD, anterior LV
,There are changes in leads V5, V6, I, aVL - ANSWERcircumflex, lateral LV
There are changes in leads V5, V6 - ANSWERLow lateral LB
There are changes in leads I aVL - ANSWERhigh lateral LB
There are changes in leads V1 and V2 - ANSWERRCA, posterior LV
There are changes in leads V3R, V4R - ANSWERRCA, right ventricular infarct
What are some signs of reperfusion following fibrinolytic treatment of a STEMI? -
ANSWERMarked 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
Your patient just had a percutaneous coronary intervention (PCI) (stenting) less than
24 hours ago:
He is experiencing unrelenting chest pain, his EKG shows ST elevation. What should
you do? What could be happening? - ANSWERcontact the physician. Could be
coronary artery re-occlusion/stent thrombosis.
Your patient just had a percutaneous coronary intervention (PCI) (stenting) less than
24 hours ago:
He is experiencing sudden low severe back pain and becomes hypotensive. What is
happening? - ANSWERretroperitoneal bleeding is most likely. Give fluids/blood
what is a normal ankle-brachial index (ABI)? - ANSWER>1 (get by dividing ankle
pressure by brachial pressure on the same side)
Your patient has PAD and just had a bypass graft. How should you care for the
extremity? How should the HOB be? - ANSWERdo not elevate the affected extremity,
it will decrease perfusion
Put bed in reverse trendelenburg
prolonged QT can lead to what deadly rhythm? - ANSWERtorsades
Causes of prolonged QT - ANSWERAmiodarone
, Haldol
Quinidine
Procainamide
Low mag, calcium, or potassium
Your patient has a pacemaker and has gone into Vtach. The pacemaker does not
correct the rhythm and your patient goes unresponsive. What do you do? -
ANSWERAmiodarone 150 mg IV over 10 min; Prepare for elective synchronized
cardioversion.
right sided heart failure - ANSWER1. Jungular Vein Distention
2. Ascending Dependent Edema
3. Weight Gain
4. Hepatomegaly (Liver Enlargement)
Left sided heart failure - ANSWER1. SOB
2. Crackles
3. Oliguria
4. Frothy Sputum
5. Displaced Apical Pulse (Hypertrophy)
*left goes away from lungs...takes your breath away
Ventricular assist device (VAD) - ANSWERA mechanical pump that helps the
ventricles pump blood, easing the workload of the heart in patients with left
ventricular heart failure, cardiogenic shock, and cardiac myopathies.
IABP - ANSWERinflates (INCREASES CORONARY ARTERY PERFUSION)
and deflates ( DECREASES AFTERLOAD)
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
CABG (Coronary Artery Bypass Graft) complications - ANSWERtamponade
pericarditis
long CABG can increase bleeding risk due to increased heparin dose in surgery
Signs of cardiac tamponade - ANSWERNarrowed pulse pressure (IE 82/68)
