NUR 221 (Critical Care - Test 3) Study Notes Questions with Correct
Answers (Grade A+)
Question 1: What are the 3 layers of the heart?
Answer: 1. Epicardium 2. Myocardium 3. Endocardium
Question 2: The right side of the heart has what type of pressure?
Answer: Low pressure
Question 3: The left side of the heart has what type of pressure?
Answer: High pressure
Question 4: The sympathetic nervous system releases what?
Answer: Norepinephrine **Flight or Flight response
Question 5: The parasympathetic nervous system releases what?
Answer: Acetylcholine
Question 6: The first heart sound heard and has been described as "lub" is known as what?
Answer: S1
Question 7: The second heart sound hear and has been described as "dub" is known as what?
Answer: S2
Question 8: Which heart sound is also known as ventricular gallop, and usually represents a
pathological process in older adults but is normal in young children?
Answer: S3 **Rapid left ventricular filling when heart is already overfilled or poorly compliant
Question 9: Which heart sound is also known as atrial gallop, and is produced from atrial contraction
that is more forceful than normal and is often heard after an acute myocardial infarction (AMI)?
Answer: S4
Page 1
,Question 10: Heart murmur
Answer: A rumbling, blowing, harsh, or musical sound heard in the heart that is caused by turbulence of
blood flow through the valves of the heart
Question 11: Coronary Artery Disease (CAD)
Answer: A progressive condition that causes narrowing of the coronary arteries by atherosclerosis which
leads to ischemia due to lack of adequate oxygenation
Question 12: What are some nonmodifiable risk factors for coronary artery disease (CAD)?
Answer: 1. Age (men >45; women >55) 2. Heredity (family history) 3. Gender
Question 13: What are some modifiable risk factors for coronary artery disease (CAD)?
Answer: 1. Smoking 2. Inactivity 3. Overweight/Obesity 4. Cholesterol 5. Diabetes 6. Hypertension
Question 14: The mnemonic PQRST which is an assessment of the patient with chest pain stands for?
Answer: P = Provocation Q = Quality R = Region/Radiation S = Severity T = Timing (when began) and
Treatment
Question 15: Why is it important to know the history of the patient's use of erectile dysfunction
medication when they have chest pain?
Answer: These medications potentiate the hypotensive effects of nitrates, therefore they should not be taken
together
Question 16: What type of diagnostic tests are used with patients with coronary artery disease (CAD)?
Answer: 1. 12-lead electrocardiography (ECG) 2. Chest x-ray 3. Holter monitor (used to detect
dysrhythmias) 4. Exercise tolerance test (stress test) 5. Pharmacological stress test 6. Nuclear stress test 7.
Transesophageal echocardiography (TEE) 8. Echocardiography 9. Multigated blood acquisition study
(MUGA) 10. Cardiac magnetic resonance imaging (MRI) 11. Positron emission tomography (PET)
Question 17: Transesophageal echocardiography (TEE)
Answer: Specialized echocardiography procedure in which patient swallows ultrasound head in order to
better visualize internal cardiac structures, especially cardiac valves **shows the BACK of the heart
**KEEP PATIENT NPO BEFORE PROCEDURE
Question 18: Multigated blood acquisition study (MUGA)
Answer: Diagnostic test used to assess the left ventricular function of the heart (left ventricular ejection
fraction)
Page 2
, Question 19: What is the normal left ventricular ejection fraction?
Answer: 55% to 60%
Question 20: What are some nursing interventions for after cardiac catheterization and angiography
care?
Answer: 1. Maintain the patient on bedrest 2. Keep the extremity used catheter insertion immobilized 3.
Observe insertion site for bleeding or hematoma 4. Assess for bruits 5. Maintain head of bed elevation no
higher than 30 degrees 6. Monitor peripheral pulses 7. Observe cardiac rhythms 8. Encourage fluid intake
(if not contraindicated) 9. Monitor intake/output 10. Observe for adverse reaction to dye (angiography) 11.
Assess for chest pain, back pain, and shortness of breath and notify health care provider
Question 21: What laboratory values aids in the early diagnosis of acute myocardial infarction due to
becoming elevated as early as 1 hour after myocardial cell injury?
Answer: Troponin I and Troponin T
Question 22: The normal value of Troponin I is less than what?
Answer: 0.03 ng/L
Question 23: The normal value of Troponin T is less than what?
Answer: 0.1 ng/L
Question 24: Which cholesterol is good?
Answer: HDL
Question 25: Which cholesterol is bad?
Answer: LDL
Question 26: A patient with no coronary heart disease (CHD) and has fewer than two risk factors
should have a LDL target level of what?
Answer: Less than 160 mg/dL
Question 27: A patient with no coronary heart disease (CHD) and has two or more risk factors should
have a LDL target level of what?
Answer: Less than 130 mg/dL
Page 3
Answers (Grade A+)
Question 1: What are the 3 layers of the heart?
Answer: 1. Epicardium 2. Myocardium 3. Endocardium
Question 2: The right side of the heart has what type of pressure?
Answer: Low pressure
Question 3: The left side of the heart has what type of pressure?
Answer: High pressure
Question 4: The sympathetic nervous system releases what?
Answer: Norepinephrine **Flight or Flight response
Question 5: The parasympathetic nervous system releases what?
Answer: Acetylcholine
Question 6: The first heart sound heard and has been described as "lub" is known as what?
Answer: S1
Question 7: The second heart sound hear and has been described as "dub" is known as what?
Answer: S2
Question 8: Which heart sound is also known as ventricular gallop, and usually represents a
pathological process in older adults but is normal in young children?
Answer: S3 **Rapid left ventricular filling when heart is already overfilled or poorly compliant
Question 9: Which heart sound is also known as atrial gallop, and is produced from atrial contraction
that is more forceful than normal and is often heard after an acute myocardial infarction (AMI)?
Answer: S4
Page 1
,Question 10: Heart murmur
Answer: A rumbling, blowing, harsh, or musical sound heard in the heart that is caused by turbulence of
blood flow through the valves of the heart
Question 11: Coronary Artery Disease (CAD)
Answer: A progressive condition that causes narrowing of the coronary arteries by atherosclerosis which
leads to ischemia due to lack of adequate oxygenation
Question 12: What are some nonmodifiable risk factors for coronary artery disease (CAD)?
Answer: 1. Age (men >45; women >55) 2. Heredity (family history) 3. Gender
Question 13: What are some modifiable risk factors for coronary artery disease (CAD)?
Answer: 1. Smoking 2. Inactivity 3. Overweight/Obesity 4. Cholesterol 5. Diabetes 6. Hypertension
Question 14: The mnemonic PQRST which is an assessment of the patient with chest pain stands for?
Answer: P = Provocation Q = Quality R = Region/Radiation S = Severity T = Timing (when began) and
Treatment
Question 15: Why is it important to know the history of the patient's use of erectile dysfunction
medication when they have chest pain?
Answer: These medications potentiate the hypotensive effects of nitrates, therefore they should not be taken
together
Question 16: What type of diagnostic tests are used with patients with coronary artery disease (CAD)?
Answer: 1. 12-lead electrocardiography (ECG) 2. Chest x-ray 3. Holter monitor (used to detect
dysrhythmias) 4. Exercise tolerance test (stress test) 5. Pharmacological stress test 6. Nuclear stress test 7.
Transesophageal echocardiography (TEE) 8. Echocardiography 9. Multigated blood acquisition study
(MUGA) 10. Cardiac magnetic resonance imaging (MRI) 11. Positron emission tomography (PET)
Question 17: Transesophageal echocardiography (TEE)
Answer: Specialized echocardiography procedure in which patient swallows ultrasound head in order to
better visualize internal cardiac structures, especially cardiac valves **shows the BACK of the heart
**KEEP PATIENT NPO BEFORE PROCEDURE
Question 18: Multigated blood acquisition study (MUGA)
Answer: Diagnostic test used to assess the left ventricular function of the heart (left ventricular ejection
fraction)
Page 2
, Question 19: What is the normal left ventricular ejection fraction?
Answer: 55% to 60%
Question 20: What are some nursing interventions for after cardiac catheterization and angiography
care?
Answer: 1. Maintain the patient on bedrest 2. Keep the extremity used catheter insertion immobilized 3.
Observe insertion site for bleeding or hematoma 4. Assess for bruits 5. Maintain head of bed elevation no
higher than 30 degrees 6. Monitor peripheral pulses 7. Observe cardiac rhythms 8. Encourage fluid intake
(if not contraindicated) 9. Monitor intake/output 10. Observe for adverse reaction to dye (angiography) 11.
Assess for chest pain, back pain, and shortness of breath and notify health care provider
Question 21: What laboratory values aids in the early diagnosis of acute myocardial infarction due to
becoming elevated as early as 1 hour after myocardial cell injury?
Answer: Troponin I and Troponin T
Question 22: The normal value of Troponin I is less than what?
Answer: 0.03 ng/L
Question 23: The normal value of Troponin T is less than what?
Answer: 0.1 ng/L
Question 24: Which cholesterol is good?
Answer: HDL
Question 25: Which cholesterol is bad?
Answer: LDL
Question 26: A patient with no coronary heart disease (CHD) and has fewer than two risk factors
should have a LDL target level of what?
Answer: Less than 160 mg/dL
Question 27: A patient with no coronary heart disease (CHD) and has two or more risk factors should
have a LDL target level of what?
Answer: Less than 130 mg/dL
Page 3
