NURSl 480/l NURS480l Examl 2–l Advancedl
Medicall Surgicall Healthl Nursing|l WCUl
(Latestl 2026/l 2027l Update)l Review|l 100%l
Verifiedl Questionsl &l Answersl |l Gradel A
Q:l Whyl isl al transthoracicl echocardiographyl done?
Answer:
Diagnosel valvel disorders,l andl cardiomyopathy;l evaluatel thel size,l shape,l andl motionl ofl
thel structurel ofl thel heart;l andl measurel thel ejectionl fraction
Q:l Whatl isl anl intral opl considerationl forl transthoracicl echocardiography?
Answer:
Lifel onl leftl sidel anl remainl still
Q:l Whyl isl transesophageall echocardiographyl done?
Answer:
Providesl clearerl ultrasoundl imagesl becausel wavesl passl throughl lessl tissue
Q:l Howl isl al transesophageall echocardiographyl done?
Answer:
Smalll transducerl isl passedl throughl thel mouthl andl intol thel esophagusl tol providel imagesl
ofl thel heart
Q:l Whatl isl al prel opl considerationl forl transesophageall echocardiography?
Answer:
NPOl forl 6l hrsl prior
,Q:l Whatl arel postl opl considerationsl forl transesophageall echocardiography?
Answer:
Monitorl VS,l oxygenationl status,l LOC,l andl returnl ofl gagl reflex
Keepl HIBl atl 45l degrees
Q:l Whatl isl stressl testing?
Answer:
Clientl exercisesl thel cardiacl musclesl byl walkingl onl al treadmill
Q:l Howl isl al pulmonaryl arteryl catheterl instered?
Answer:
Intol al largel veinl (internall jugular,l femoral,l subclavian,l brachial)l andl threadedl throughl
thel rightl atrial andl ventriclel intol al branchl ofl thel PA
Q:l PAl cathetersl havel multiplel lumensl andl components.l Whatl arel theyl andl whatl arel
theyl usedl for?
Answer:
Proximall Lumen:l measuresl rightl atriall pressurel (centrall venousl pressurel orl CVP),l infusel
IVl fluids,l andl obtainl venousl bloodl samples
Distall Lumen:l Measuresl PAPl (PAl systolic,l PAl diastolic,l meanl PAl pressure,l andl PAl
wedgel pressure),l NOTl USEDl FORl IVl FLUIDS
Balloonl Inflationl Port:l PAWPl measurement,l shouldl bel deflatedl andl lockedl inl positionl
whenl notl inl use
Thermistor:l measuresl templ differencel betweenl thel rightl atriuml andl thel PAl inl orderl tol
determinel CO
Q:l Whatl measurel thel preloadl ofl thel rightl andl leftl heart?
Answer:
Right:l CVP
Left:l PAWP
Q:l Whatl arel manifestationl forl elevatedl CVPl andl PAWP?
,Answer:
Cracklesl inl lungs
JVD
Hepatomegaly
Peripherall edema
Tautl skinl turgor
Q:l Whatl arel manifestationsl forl decreasedl CVPl andl PAWP?
Answer:
Poorl skinl turgor
Dryl mucousl membranes
Q:l Whatl isl usedl tol measurel tol afterloadl ofl thel rightl andl leftl heart?
Answer:
Right:l pulmonaryl vascularl resistance
Left:l systemicl vascularl resistance
Q:l Whatl arel manifestationsl forl elevatedl afterload?
Answer:
Cooll extremities
Weakl peripherall pulses
Q:l Whatl arel manifestationsl forl decreasedl afterload?
Answer:
Warml extremities
Boundingl peripherall pulse
Q:l Whatl isl anotherl namel forl angiography?
Answer:
Cardiacl catheterization
PCI
Angiogram
, Q:l Whatl isl angiography?
Answer:
Anl invasivel procedurel usedl tol evaluatel thel degreel andl presencel ofl coronaryl arteryl
blockage.l Al renal,l liver,l cerebral,l upperl andl lowerl extremitiesl angiograml canl bel donel
tol determinel bloodl flowl andl areasl ofl possiblel blockagel ofl al vessel.l Itl involvesl
insertionl ofl thel catheterl intol femoral,l brachial,l orl radiall vessell andl threadingl intol thel
rightl orl leftl sidel ofl thel heart
Q:l Howl canl arteryl narrowsl and/orl occlusionsl bel identifiedl inl angiography?
Answer:
Injectionl ofl contrastl medial underl fluoroscopy
Q:l Whatl arel indicationsl forl angiography?
Answer:
Unstablel anginal andl ECGl changes
Confirml andl determinel locationl andl extentl ofl heartl disease
Q:l Whatl arel postprocedurel considerationsl forl angiography?
Answer:
Assessl VSl Q15Ml xl 4,l Q30Ml xl 2,l Q1Hl xl 1,l thenl Q4Hl perl facilityl protocol
Performl neurovascularl checksl atl thel samel intervalsl asl VSl tol assessl forl bleedingl andl
thrombosisl (documentl pedall pulse,l extremityl color,l andl temp)
Bedl restl inl supinel position,l typicallyl forl 6-8l hrs,l withl extremityl straightl forl prescribedl
time
Continuousl cardiacl monitoringl forl dysrhythmiasl
Administerl antiplateletl orl thrombolyticsl asl prescribedl tol preventl clotsl andl restenosisl
(Aspirin,l Clopidogrell orl Plavix,l Heparin,l Enoxaparinl orl Lovenox,l GPl IIb/IIIal inhibitorsl
suchl asl eptifibatide)
Administerl anxiolyticsl andl analgesicsl PRN
Monitorl urinel outputl andl givel IVFl forl hydration
Perform/assistl withl sheathl removal
Applyl pressurel tol arterial/venousl sitesl forl prescribedl time,l applyl pressurel dressing
Observel forl vagall responsel (hypotension,l bradycardia)
Medicall Surgicall Healthl Nursing|l WCUl
(Latestl 2026/l 2027l Update)l Review|l 100%l
Verifiedl Questionsl &l Answersl |l Gradel A
Q:l Whyl isl al transthoracicl echocardiographyl done?
Answer:
Diagnosel valvel disorders,l andl cardiomyopathy;l evaluatel thel size,l shape,l andl motionl ofl
thel structurel ofl thel heart;l andl measurel thel ejectionl fraction
Q:l Whatl isl anl intral opl considerationl forl transthoracicl echocardiography?
Answer:
Lifel onl leftl sidel anl remainl still
Q:l Whyl isl transesophageall echocardiographyl done?
Answer:
Providesl clearerl ultrasoundl imagesl becausel wavesl passl throughl lessl tissue
Q:l Howl isl al transesophageall echocardiographyl done?
Answer:
Smalll transducerl isl passedl throughl thel mouthl andl intol thel esophagusl tol providel imagesl
ofl thel heart
Q:l Whatl isl al prel opl considerationl forl transesophageall echocardiography?
Answer:
NPOl forl 6l hrsl prior
,Q:l Whatl arel postl opl considerationsl forl transesophageall echocardiography?
Answer:
Monitorl VS,l oxygenationl status,l LOC,l andl returnl ofl gagl reflex
Keepl HIBl atl 45l degrees
Q:l Whatl isl stressl testing?
Answer:
Clientl exercisesl thel cardiacl musclesl byl walkingl onl al treadmill
Q:l Howl isl al pulmonaryl arteryl catheterl instered?
Answer:
Intol al largel veinl (internall jugular,l femoral,l subclavian,l brachial)l andl threadedl throughl
thel rightl atrial andl ventriclel intol al branchl ofl thel PA
Q:l PAl cathetersl havel multiplel lumensl andl components.l Whatl arel theyl andl whatl arel
theyl usedl for?
Answer:
Proximall Lumen:l measuresl rightl atriall pressurel (centrall venousl pressurel orl CVP),l infusel
IVl fluids,l andl obtainl venousl bloodl samples
Distall Lumen:l Measuresl PAPl (PAl systolic,l PAl diastolic,l meanl PAl pressure,l andl PAl
wedgel pressure),l NOTl USEDl FORl IVl FLUIDS
Balloonl Inflationl Port:l PAWPl measurement,l shouldl bel deflatedl andl lockedl inl positionl
whenl notl inl use
Thermistor:l measuresl templ differencel betweenl thel rightl atriuml andl thel PAl inl orderl tol
determinel CO
Q:l Whatl measurel thel preloadl ofl thel rightl andl leftl heart?
Answer:
Right:l CVP
Left:l PAWP
Q:l Whatl arel manifestationl forl elevatedl CVPl andl PAWP?
,Answer:
Cracklesl inl lungs
JVD
Hepatomegaly
Peripherall edema
Tautl skinl turgor
Q:l Whatl arel manifestationsl forl decreasedl CVPl andl PAWP?
Answer:
Poorl skinl turgor
Dryl mucousl membranes
Q:l Whatl isl usedl tol measurel tol afterloadl ofl thel rightl andl leftl heart?
Answer:
Right:l pulmonaryl vascularl resistance
Left:l systemicl vascularl resistance
Q:l Whatl arel manifestationsl forl elevatedl afterload?
Answer:
Cooll extremities
Weakl peripherall pulses
Q:l Whatl arel manifestationsl forl decreasedl afterload?
Answer:
Warml extremities
Boundingl peripherall pulse
Q:l Whatl isl anotherl namel forl angiography?
Answer:
Cardiacl catheterization
PCI
Angiogram
, Q:l Whatl isl angiography?
Answer:
Anl invasivel procedurel usedl tol evaluatel thel degreel andl presencel ofl coronaryl arteryl
blockage.l Al renal,l liver,l cerebral,l upperl andl lowerl extremitiesl angiograml canl bel donel
tol determinel bloodl flowl andl areasl ofl possiblel blockagel ofl al vessel.l Itl involvesl
insertionl ofl thel catheterl intol femoral,l brachial,l orl radiall vessell andl threadingl intol thel
rightl orl leftl sidel ofl thel heart
Q:l Howl canl arteryl narrowsl and/orl occlusionsl bel identifiedl inl angiography?
Answer:
Injectionl ofl contrastl medial underl fluoroscopy
Q:l Whatl arel indicationsl forl angiography?
Answer:
Unstablel anginal andl ECGl changes
Confirml andl determinel locationl andl extentl ofl heartl disease
Q:l Whatl arel postprocedurel considerationsl forl angiography?
Answer:
Assessl VSl Q15Ml xl 4,l Q30Ml xl 2,l Q1Hl xl 1,l thenl Q4Hl perl facilityl protocol
Performl neurovascularl checksl atl thel samel intervalsl asl VSl tol assessl forl bleedingl andl
thrombosisl (documentl pedall pulse,l extremityl color,l andl temp)
Bedl restl inl supinel position,l typicallyl forl 6-8l hrs,l withl extremityl straightl forl prescribedl
time
Continuousl cardiacl monitoringl forl dysrhythmiasl
Administerl antiplateletl orl thrombolyticsl asl prescribedl tol preventl clotsl andl restenosisl
(Aspirin,l Clopidogrell orl Plavix,l Heparin,l Enoxaparinl orl Lovenox,l GPl IIb/IIIal inhibitorsl
suchl asl eptifibatide)
Administerl anxiolyticsl andl analgesicsl PRN
Monitorl urinel outputl andl givel IVFl forl hydration
Perform/assistl withl sheathl removal
Applyl pressurel tol arterial/venousl sitesl forl prescribedl time,l applyl pressurel dressing
Observel forl vagall responsel (hypotension,l bradycardia)
