NBCRNA TEST BANK 1000+ QUESTIONS
AND CORRECT DETAILED ANSWERS
2023-2024 UPDATE ALREADY A GRADED
What are some drugs that make SAM of the anterior leaflet worse? - ANSWER-
Nipride
Dobutamine
What makes SAM better? - ANSWER- vasoconstrictors and volume expansion -
phenylephrine
What is the best pressor tx for a patient with mitral stenosis?
why? - ANSWER- vasopressin or phenylephrine
- pure vasoconstrictor b/c it doesn't increase HR
What drug is most likely to increase the degree of prolapse in the patient with MV
prolapse?
What size ventricle increases or decreases prolapse? - ANSWER- Ketamine -
avoid it!
Large ventricle reduces prolapse, small increases prolapse.
What is the primary mgmt goal of MV prolapse?
What should you avoid? - ANSWER- prevent excessive cardiac emptying
,Avoid: SNS stim -> contractility
Decreased SVR Hypovolemia
upright posture (reverse T/sitting)
Systolic murmurs caused by? - ANSWER- AS or MR
Diastolic murmurs are caused by? - ANSWER- AI or MS
What valvular d/o's are heard best at the apex or left axilla? - ANSWER- MS or
regurgitation
Where are AS and insufficiency best heard? - ANSWER- right sternal border
How do you estimate coronary perfusion pressure?
Surrogates for LVEDP? - ANSWER- Aortic DBP - LVEDP
LVEDP = PAD = PAOP
Class of HF and what it entails.
I - IV - ANSWER- I: asymptomatic
II: symptomatic w/mod activity
III: symptomatic w/mild activity
IV: symptomatic at rest
,Anesthetic considerations with systolic HF includes: - ANSWER- increased HR to
maximize CO
Preload already high, don't let it get higher
Decrease afterload to reduce the LV workload
Inotropic support as needed for contractility
Hallmark of systolic HF: - ANSWER- decreased EF with an increased enddiastolic
volume (ventricle doesn't empty well)
Amt of failure quantified with EF
What is most closely associated with diastolic HF? - ANSWER- aortic stenosis
ischemic heart disease essential hypertension
DECREASED COMPLIANCE
- unable to relax to accept volume, doesn't fill properly
EDP overestimates EDV
Defining characteristic of diastolic heart failure: - ANSWER- symptomatic heart
failure with a normal EF!
S4 heart sounds
Contractility generally preserved until late stage of disease
Most common causes of diastolic heart failure? - ANSWER- concentric
hypertrophy old age valve stenosis hypertrophic CMP cor pulmonale
obesity
, What two drugs have been proven to reverse left ventricular remodeling in the
patient with HF? - ANSWER- enalapril (ACE-I) spironolactone (aldosterone
inhibitors)
C ventricle = ventricular volume/ventricular pressure
Decreased Cv from? and how does it affect the curve?
Increased Cv from? how does it affect the curve? - ANSWER- conditions that
cause a stiff heart Curve shifts up and left
increased from conditions that dilate the heart, the curve shifts down and to the
right
- aortic insufficiency
What region of the myocardium receives the least amount of perfusion during
systole? - ANSWER- left ventricular subendocardium
- primary perfused during diastole
Elevated CK-MB is most consistent with? - ANSWER- myocardial infarction
Infarcted myocardium release what 3 key biomarkers? - ANSWER- CK-MB,
troponin I and T
CK-MB:
AND CORRECT DETAILED ANSWERS
2023-2024 UPDATE ALREADY A GRADED
What are some drugs that make SAM of the anterior leaflet worse? - ANSWER-
Nipride
Dobutamine
What makes SAM better? - ANSWER- vasoconstrictors and volume expansion -
phenylephrine
What is the best pressor tx for a patient with mitral stenosis?
why? - ANSWER- vasopressin or phenylephrine
- pure vasoconstrictor b/c it doesn't increase HR
What drug is most likely to increase the degree of prolapse in the patient with MV
prolapse?
What size ventricle increases or decreases prolapse? - ANSWER- Ketamine -
avoid it!
Large ventricle reduces prolapse, small increases prolapse.
What is the primary mgmt goal of MV prolapse?
What should you avoid? - ANSWER- prevent excessive cardiac emptying
,Avoid: SNS stim -> contractility
Decreased SVR Hypovolemia
upright posture (reverse T/sitting)
Systolic murmurs caused by? - ANSWER- AS or MR
Diastolic murmurs are caused by? - ANSWER- AI or MS
What valvular d/o's are heard best at the apex or left axilla? - ANSWER- MS or
regurgitation
Where are AS and insufficiency best heard? - ANSWER- right sternal border
How do you estimate coronary perfusion pressure?
Surrogates for LVEDP? - ANSWER- Aortic DBP - LVEDP
LVEDP = PAD = PAOP
Class of HF and what it entails.
I - IV - ANSWER- I: asymptomatic
II: symptomatic w/mod activity
III: symptomatic w/mild activity
IV: symptomatic at rest
,Anesthetic considerations with systolic HF includes: - ANSWER- increased HR to
maximize CO
Preload already high, don't let it get higher
Decrease afterload to reduce the LV workload
Inotropic support as needed for contractility
Hallmark of systolic HF: - ANSWER- decreased EF with an increased enddiastolic
volume (ventricle doesn't empty well)
Amt of failure quantified with EF
What is most closely associated with diastolic HF? - ANSWER- aortic stenosis
ischemic heart disease essential hypertension
DECREASED COMPLIANCE
- unable to relax to accept volume, doesn't fill properly
EDP overestimates EDV
Defining characteristic of diastolic heart failure: - ANSWER- symptomatic heart
failure with a normal EF!
S4 heart sounds
Contractility generally preserved until late stage of disease
Most common causes of diastolic heart failure? - ANSWER- concentric
hypertrophy old age valve stenosis hypertrophic CMP cor pulmonale
obesity
, What two drugs have been proven to reverse left ventricular remodeling in the
patient with HF? - ANSWER- enalapril (ACE-I) spironolactone (aldosterone
inhibitors)
C ventricle = ventricular volume/ventricular pressure
Decreased Cv from? and how does it affect the curve?
Increased Cv from? how does it affect the curve? - ANSWER- conditions that
cause a stiff heart Curve shifts up and left
increased from conditions that dilate the heart, the curve shifts down and to the
right
- aortic insufficiency
What region of the myocardium receives the least amount of perfusion during
systole? - ANSWER- left ventricular subendocardium
- primary perfused during diastole
Elevated CK-MB is most consistent with? - ANSWER- myocardial infarction
Infarcted myocardium release what 3 key biomarkers? - ANSWER- CK-MB,
troponin I and T
CK-MB:
