FCCN LEVEL 1 SETS UPDATED EXAM QUESTIONS AND
SOLUTIONS RATED A+
✔✔What would be appropriate ST alarm limits for a patient admitted with ACS with ST
segment elevations of 2mm? - ✔✔1.0 mm & 3.0 mm
✔✔Which lead(s) do you select to measure QT intervals? - ✔✔Use the lead in which
QT is the longest (usually V2 or V3)
✔✔What is considered a prolonged QTc? - ✔✔> 500 msec
✔✔What drugs lengthen the QT interval? - ✔✔"ANTIs"
Antiarrhymthics
Antipsychotics
Antidepressants
✔✔Left Bundle Branch Block - ✔✔WIDE QRS
usually means something (MI)!!!!
✔✔Right Bundle Branch Block - ✔✔2 R waves rabbit ears
Typically insignificant (benign)
✔✔When would you use an isotonic crystalloids? - ✔✔- blood transfusions
- hyponatermia
- metabolic alkalosis (large amounts of NG output)
- NG tube, Peg tube, Vented
- Hypotensive conditions
- 3rd spacing after trauma or surgery
✔✔What are some examples of hypotonic crystalloid fluids? - ✔✔0.45 NS (half normal
saline)
D5W
✔✔Purpose of hypotonic crystalloid fluids? - ✔✔pulls fluid into cells from intravascular
space
cells SWELL
✔✔When are hypotonic crystalloid fluids indicated? - ✔✔corrects cellular dehydration
hypernatremia
commonly used as a maintenance fluid
✔✔What are some examples of hypertonic crystalloid fluids? - ✔✔D5 .45 NS
D5 .9 NS
D5 LR
, 3%, 7%, 23.4% sodium chloride
✔✔Purpose of hypertonic crystalloid fluids? - ✔✔pulls fluid from the cells into the
vascular space
cells SHRINK
✔✔When are hypertonic crystalloid fluids indicated? - ✔✔suppresses inflammation
neuro critical rescutative fluid
treats cerebral edama/intracranial hypertension
✔✔S&S of hyponatermia include? - ✔✔Lethargy/Confusion (first sign!!)
Abdominal cramping
Weakness
HA
Seizures
RA
Coma
✔✔How do you treat hyponatremia? - ✔✔Think fluid overloaded!
Dependent on cause
in most cases: restrict fluids, treat cause, give IV fluids containing sodium
SEVERE: in an emergency (NA is <115 mEg/L give hypertonic saline if patient is
symptomatic - infuse slowly, be prepared to handle seizures
✔✔S&S of hypernatermia include? - ✔✔Think Dehydrated!
Thirst
Increased temp
Dry/sticky mucous membranes
Restless
Weakness
Disorientation/lethargy (1st)
Muscle irrativlity
Coma
Convulstions
✔✔How do you treat hypernatremia? - ✔✔Replace fluids
(free water orally, supplement TF with free water)
With neurological symptoms: hypotonic saline slowly
DI : give vasopressin
✔✔S&S of hypokalemia include? - ✔✔muscle weakness
ECG Changes: Flattened T waves (#1 sign)
SOLUTIONS RATED A+
✔✔What would be appropriate ST alarm limits for a patient admitted with ACS with ST
segment elevations of 2mm? - ✔✔1.0 mm & 3.0 mm
✔✔Which lead(s) do you select to measure QT intervals? - ✔✔Use the lead in which
QT is the longest (usually V2 or V3)
✔✔What is considered a prolonged QTc? - ✔✔> 500 msec
✔✔What drugs lengthen the QT interval? - ✔✔"ANTIs"
Antiarrhymthics
Antipsychotics
Antidepressants
✔✔Left Bundle Branch Block - ✔✔WIDE QRS
usually means something (MI)!!!!
✔✔Right Bundle Branch Block - ✔✔2 R waves rabbit ears
Typically insignificant (benign)
✔✔When would you use an isotonic crystalloids? - ✔✔- blood transfusions
- hyponatermia
- metabolic alkalosis (large amounts of NG output)
- NG tube, Peg tube, Vented
- Hypotensive conditions
- 3rd spacing after trauma or surgery
✔✔What are some examples of hypotonic crystalloid fluids? - ✔✔0.45 NS (half normal
saline)
D5W
✔✔Purpose of hypotonic crystalloid fluids? - ✔✔pulls fluid into cells from intravascular
space
cells SWELL
✔✔When are hypotonic crystalloid fluids indicated? - ✔✔corrects cellular dehydration
hypernatremia
commonly used as a maintenance fluid
✔✔What are some examples of hypertonic crystalloid fluids? - ✔✔D5 .45 NS
D5 .9 NS
D5 LR
, 3%, 7%, 23.4% sodium chloride
✔✔Purpose of hypertonic crystalloid fluids? - ✔✔pulls fluid from the cells into the
vascular space
cells SHRINK
✔✔When are hypertonic crystalloid fluids indicated? - ✔✔suppresses inflammation
neuro critical rescutative fluid
treats cerebral edama/intracranial hypertension
✔✔S&S of hyponatermia include? - ✔✔Lethargy/Confusion (first sign!!)
Abdominal cramping
Weakness
HA
Seizures
RA
Coma
✔✔How do you treat hyponatremia? - ✔✔Think fluid overloaded!
Dependent on cause
in most cases: restrict fluids, treat cause, give IV fluids containing sodium
SEVERE: in an emergency (NA is <115 mEg/L give hypertonic saline if patient is
symptomatic - infuse slowly, be prepared to handle seizures
✔✔S&S of hypernatermia include? - ✔✔Think Dehydrated!
Thirst
Increased temp
Dry/sticky mucous membranes
Restless
Weakness
Disorientation/lethargy (1st)
Muscle irrativlity
Coma
Convulstions
✔✔How do you treat hypernatremia? - ✔✔Replace fluids
(free water orally, supplement TF with free water)
With neurological symptoms: hypotonic saline slowly
DI : give vasopressin
✔✔S&S of hypokalemia include? - ✔✔muscle weakness
ECG Changes: Flattened T waves (#1 sign)
