FCCN Level 1 [2026/2027] | UPDATED ACTUAL
Exam Question and Answer | Step-by-Step
Solutions
• preload -✓✓ the stretch before a contraction, when the ventricle fills. how wet or dry
the pt is
• low preload -✓✓ pt is dry, give fluids
• high preload -✓✓ pt is wet, give lasix, vasodilators, dialysis
• contractility -✓✓ how much squeeze the heart has
• low afterload -✓✓ dilated arteries. caused by sepsis, shock. transfer pt to ICU for
vasoconstrictors
• high afterload -✓✓ constricted arteries. can be caused by hypothermia, hypovolemia,
cardiogenic shock. treat the cause
• afterload -✓✓ the resistance the ventricle muscle has to go up against to pump out the
blood. how clamped down or dilated the pt is
• low contractility -✓✓ give positive inotropes
• positive inotropes -✓✓ digoxin, dobutamine, dopamine, milrinone
• stable angina -✓✓ chest pain that occurs when a person is active or under severe
stress. caused by imbalance of O2 delivery and demand
• unstable angina -✓✓ chest pain that occurs while a person is at rest and not exerting
himself. caused by plaque rupture and thrombus formation
• NSTEMI -✓✓ ST depression or T wave inversion, cardiac ischemia. thrombus is
intermittently occlusive, causes non full thickness infarction of myocardium
• STEMI -✓✓ ST elevation MI, real-time ongoing death of heart tissue due to cardiac
injury. thrombus is occlusive and causes full thickness infarction
• ACS -✓✓ unstable angina w/ normal troponin, NSTEMI w/ elevated troponin, STEMI
with elevated troponin
• MI treatment -✓✓ Notify physician, obtain 12 lead ECG within 10 minutes.
, Morphine - pain relief, decreases workload of heart
Oxygen if sats <92% - improve oxygenation
Nitroglycerin - increase perfusion to heart
Aspirin - stops platelets from forming
Heparin - prevents formation of fibrin
Beta blocker - slows heart, decreases O2 demand of heart
Transfer to cath lab
• how to measure ST elevation -✓✓ 0.06 seconds (box and a half) after J point, count
boxes vertically up from isoelectric line
• J point -✓✓ Point where the QRS complex and ST segment meet
• QT interval -✓✓ ventricular depolarization and repolarization, beginning of QRS to end
of T wave
• QTc -✓✓ QT corrected for heart rate, prolonged >500
• sodium -✓✓ 135-145
• hyponatremia -✓✓ causes: dilutional or depletional
s/s: n/v, abd cramping, lethargy, weakness, headache, seizures, coma
• hypernatremia -✓✓ causes: water deficit or excessive sodium intake
s/s: thirst, increased temp, dry/sticky mucous membranes, restlessness, disorientation,
convulsions
• potassium -✓✓ 3.5-5.0
• hypokalemia -✓✓ causes: GI losses, diuretics, poor intake
s/s: flattened T waves, U wave (late sign)
• hyperkalemia -✓✓ causes: medications, renal failure, high intake, acidosis
s/s: tall peaked T waves, muscle weakness, AV blocks
• calcium -✓✓ 8.5-10.5
• hypocalcemia -✓✓ causes: excessive loss from diarrhea, malabsorption syndromes
s/s: positive Chvostek's (facial spasm), positive Trousseau's (carpal spasm), prolonged
QT interval, seizures, decreased cardiac contractility
• hypercalcemia -✓✓ causes: hyperparathyroidism, high intake
Exam Question and Answer | Step-by-Step
Solutions
• preload -✓✓ the stretch before a contraction, when the ventricle fills. how wet or dry
the pt is
• low preload -✓✓ pt is dry, give fluids
• high preload -✓✓ pt is wet, give lasix, vasodilators, dialysis
• contractility -✓✓ how much squeeze the heart has
• low afterload -✓✓ dilated arteries. caused by sepsis, shock. transfer pt to ICU for
vasoconstrictors
• high afterload -✓✓ constricted arteries. can be caused by hypothermia, hypovolemia,
cardiogenic shock. treat the cause
• afterload -✓✓ the resistance the ventricle muscle has to go up against to pump out the
blood. how clamped down or dilated the pt is
• low contractility -✓✓ give positive inotropes
• positive inotropes -✓✓ digoxin, dobutamine, dopamine, milrinone
• stable angina -✓✓ chest pain that occurs when a person is active or under severe
stress. caused by imbalance of O2 delivery and demand
• unstable angina -✓✓ chest pain that occurs while a person is at rest and not exerting
himself. caused by plaque rupture and thrombus formation
• NSTEMI -✓✓ ST depression or T wave inversion, cardiac ischemia. thrombus is
intermittently occlusive, causes non full thickness infarction of myocardium
• STEMI -✓✓ ST elevation MI, real-time ongoing death of heart tissue due to cardiac
injury. thrombus is occlusive and causes full thickness infarction
• ACS -✓✓ unstable angina w/ normal troponin, NSTEMI w/ elevated troponin, STEMI
with elevated troponin
• MI treatment -✓✓ Notify physician, obtain 12 lead ECG within 10 minutes.
, Morphine - pain relief, decreases workload of heart
Oxygen if sats <92% - improve oxygenation
Nitroglycerin - increase perfusion to heart
Aspirin - stops platelets from forming
Heparin - prevents formation of fibrin
Beta blocker - slows heart, decreases O2 demand of heart
Transfer to cath lab
• how to measure ST elevation -✓✓ 0.06 seconds (box and a half) after J point, count
boxes vertically up from isoelectric line
• J point -✓✓ Point where the QRS complex and ST segment meet
• QT interval -✓✓ ventricular depolarization and repolarization, beginning of QRS to end
of T wave
• QTc -✓✓ QT corrected for heart rate, prolonged >500
• sodium -✓✓ 135-145
• hyponatremia -✓✓ causes: dilutional or depletional
s/s: n/v, abd cramping, lethargy, weakness, headache, seizures, coma
• hypernatremia -✓✓ causes: water deficit or excessive sodium intake
s/s: thirst, increased temp, dry/sticky mucous membranes, restlessness, disorientation,
convulsions
• potassium -✓✓ 3.5-5.0
• hypokalemia -✓✓ causes: GI losses, diuretics, poor intake
s/s: flattened T waves, U wave (late sign)
• hyperkalemia -✓✓ causes: medications, renal failure, high intake, acidosis
s/s: tall peaked T waves, muscle weakness, AV blocks
• calcium -✓✓ 8.5-10.5
• hypocalcemia -✓✓ causes: excessive loss from diarrhea, malabsorption syndromes
s/s: positive Chvostek's (facial spasm), positive Trousseau's (carpal spasm), prolonged
QT interval, seizures, decreased cardiac contractility
• hypercalcemia -✓✓ causes: hyperparathyroidism, high intake
