CSC STUDY EXAM QUESTIONS WITH
VERIFIED ANSWERS
What are the contraindications of percutaneous transluminal angioplasty of the lower
extremity?
A. Hypertensive patient of poor ventricular function
B. Patients having dyslipidemia
C. Medically unstable, diabetic patient, long arterial occlusion, poor distal run off
D. Patient who has undergone coronary angioplasty - ANSWER-C
Percutaneous transluminal angioplasty of the lower extremity is contraindicated in
patients who are medically unstable, have long arterial occlusion, have poor distal
run off, or who have diabetes.
Which of the following signs and symptoms would the attending nurse expect in a
patient with aneurysmal rupture?
A. Abdominal pain, hypertension, bradycardia
B. Hypotension, tachycardia, nausea, vomiting, shortness of breath, chest pain/lower
back/abdominal pain
C. Headache, nausea, vomiting, vertigo
D. Hypertension, chest pain, syncope - ANSWER-B
Signs and symptoms of aneurysmal rupture include hypotension, tachycardia,
lightheadedness, fainting, snausea, vomiting, sweating, shortness of breath, chest
pain/lower back/abdominal pain, and dizziness.
The nurse receives the blood test reports for a patient admitted to the hospital with
complaints of chest pain. The report shows an elevated CKMB. What does this
signify in this patient?
A. Damage to myocardium
B. Damage to intercostal muscles
C. Liver damage
D. None of the above - ANSWER-A
Cardiac enzymes get elevated in conditions of damage to the myocardium. CKMB is
one of the important cardiac enzymes used to assess damage to the myocardium.
Which systematic complications are associated with peripheral thrombolectomy?
,A. Vasospasm, bleeding, hematoma formation, compartment syndrome
B. Renal failure, rhabdomyolysis, vasospasm, hemorrhage
C. Edema, hyperkalemia, cardiac arrhythmia, renal failure, rhabdomyolysis
D. Vasospasm, thrombus formation, artery dissection, compartment syndrome -
ANSWER-C
Complications associated with peripheral thrombolectomy include thrombus
formation, vessel vasospasm, bleeding, hematoma formation, artery dissection,
compartment syndrome, venous thrombosis, edema, hyperkalemia, cardiac
arrhythmia, renal failure, and rhabdomyolysis.
A male smoker presents with pain in his extremities after exercise. He also
complains of color changes in his digits when exposed to cold. Which of the following
diseases needs to be ruled out before considering a diagnosis of Buerger's disease?
A. Systemic lupus erythematosus, diabetes, hypercoagulable conditions,
scleroderma
B. Bleeding disorders, dyslipidemia, systemic lupus erythematosus
C. Bleeding disorders, diabetes, hypertension, vasculitis
D. Hypercoagulable states, disorders of lipid metabolism, polyarteritis nodosa -
ANSWER-A
Blood tests are used as screening tools to aid in the diagnosis of Buerger's disease.
Tests are done to rule out scleroderma, lupus, diabetes, and other bleeding
conditions. Allen test is used to assess blood flow to the hands and feet.
Angiography, ultrasound, and echocardiography can be used to assess vascular
flow.
An obese 70-year-old man with a history of atrial fibrillation is recovering from open-
heart surgery for aortic valve replacement. To decrease the risk of developing
postoperative atrial fibrillation, which of the following medications is most commonly
administered for prophylaxis?
A. Metoprolol or atenolol
B. Amiodarone
C. Sotalol
D. Magnesium sulfate - ANSWER-A
Low-dose beta-blockers, such as metoprolol (25-50 mg twice daily) or atenolol (25
mg daily), are the most common drugs to prevent atrial fibrillation (Afib), decreasing
the incidence of Afib by up to 65%. Atrial flutter (> 380 bpm) and Afib (> 380 bpm)
occur in up to 30% of patients with open heart surgery. Risk factors include obesity,
chronic obstructive pulmonary disease, valve surgery, and a history of Afib.
Amiodarone is sometimes given alone or with beta-blockers. Sotalol is an effective
negative inotrope but has a number adverse effects. Magnesium sulfate is most
effective if administered with beta-blockers and with low serum magnesium levels
,When emergent chest reopening and internal defibrillation are necessary in the
intensive care unit (ICU), the primary responsibility of the sterile cardiac ICU nurse is
A. removing dressings and Steri-strips.
B. preparing medications and gathering equipment.
C. ensuring strict sterile technique.
D. preparing the defibrillator machine - ANSWER-C
When the intensive care unit is used as an operating room, a sterile nurse must
ensure that strict sterile technique is followed. A nonsterile nurse may remove the
dressing and Steri-strips, but the scrub (usually with povidone iodine poured over the
chest) should be done by the sterile nurse. The paddles for the internal defibrillator
are maintained in sterile coverings, but the machine is not. During the procedure,
one nurse should be responsible for recording details of the procedure, another for
administration of medications and fluids, and another (circulator) to get necessary
equipment or prepare medications while the sterile nurse assists with sterile
procedures.
Patients with nasogastric tubes inserted during surgery for gastric decompression
should receive which of the following medications by instillation during the first 12-24
hours?
A. H2-blocker (ranitidine)
B. Proton-pump inhibitor (omeprazole)
C. Promotility agent (metoclopramide)
D. Antiulcer drug (sucralfate) - ANSWER-D
Antiulcer drugs, such as sucralfate, should be instilled into nasogastric or orogastric
tubes in the first 12-24 hours to reduce the incidence of stress ulcers. Other drugs,
such as H2-blockers and proton-pump inhibitors, increase gastric pH and should be
avoided; however, if patients are very high risk, a proton-pump inhibitor may be
given in conjunction with sucralfate. Metoclopramide is sometimes used to reduce
nausea and vomiting when an nasogastric tube is inserted into a patient who is
awake.
One hour after surgery, a coronary artery bypass graft (CABG) patient starts to wake
up and the mixed venous oxygen saturation ( SvO2) decreases from 60% to 45%.
The change is most likely the result of which of the following?
A. Increase in oxygen consumption
B. Increase in hemoglobin
C. Increase in cardiac output
D. Increase in arterial saturation - ANSWER-A
SvO2 represents the oxygenation at the tissue level. The value reflects the tissue
oxygen delivery and consumption. Four factors influence SvO2 : hemoglobin, cardiac
output, arterial saturation, and oxygen consumption. An increase in oxygen
consumption will extract more oxygen at the tissue level and decrease the SvO2.
Oxygen consumption could be increased by pain, shivering, or exercise. A decrease
in oxygen consumption will provide more oxygen to the tissue level and increase the
SvO2 . Oxygen consumption might be reduced by hypothermia or anesthesia.
In addition to a decreasing BP, which of the following assessment findings is
consistent with cardiac tamponade?
, A. Urine output of 42 to 50 mL/h
B. Central venous pressure (CVP) of 11 to 20 mm Hg
C. Cardiac output 4.0 to 5.1 L/min
D. SvO2 58% to 65% - ANSWER-B
The accumulation of fluid around the heart compresses the atria, causing elevated
right atrial filling pressures. The decreased cardiac output leads to hypoperfusion of
the kidney, resulting in a sudden decrease in urine output or oliguria. The
compression of the atria constricts venous return to the heart, leading to a decreased
cardiac output. The decreased cardiac output and low hemoglobin level due to the
bleeding lead to decreased SvO2 .
After CABG, a patient weighing 70 kg and receiving mechanical ventilation has
orders to be weaned and extubated when stable. Which parameter indicates the
patient is ready to extubate?
A. RR 28/min
B. Vital capacity (VC) 500 mL
C. Able to sustain a head lift for at least 5 seconds
D. Minute volume 12 L - ANSWER-C
Parameters for readiness to wean are negative inspiratory pressure (NIP) > −25 cm
H2O, RR <25/min, HR <140/min, minute volume <10 L, VC >10 to 15 mL/kg. This
patient's RR needs to be <25/min; VC, 700 to 1050 mL/kg; and minute volume, <10
L. Adequate respiratory muscle strength is indicated by the ability to sustain a head
lift for at least 5 seconds.
Which of the following assessment findings is a contraindication to extubation?
A. Chest tube bleeding less than 50 mL/h
B. Chronic atrial fibrillation
C. Labile/fluctuating blood pressure
D. Minimal vasoactive support - ANSWER-C
Criteria for extubation include hemodynamical stability and neurologic and
respiratory readiness. Chest tube bleeding in excess of 100 mL/h, new arrhythmias,
and labile blood pressure reflect hemodynamic instability.
The following hemodynamic profile is noted upon admission in a postoperative
CABG patient: BP, 91/38 mm Hg; mean arterial pressure (MAP), 58 mm Hg; HR,
108/min; core temperature, 36.5°C; pulmonary arterial pressure (PAP), 20/12 mm
Hg; CVP, 6 mm Hg; SvO2, 59%; cardiac output, 3.6 L/min; cardiac index, 1.8;
systemic vascular resistance, 1006 dyne ⋅ sec ⋅ cm−5; stroke volume, 33 mL; pulse
VERIFIED ANSWERS
What are the contraindications of percutaneous transluminal angioplasty of the lower
extremity?
A. Hypertensive patient of poor ventricular function
B. Patients having dyslipidemia
C. Medically unstable, diabetic patient, long arterial occlusion, poor distal run off
D. Patient who has undergone coronary angioplasty - ANSWER-C
Percutaneous transluminal angioplasty of the lower extremity is contraindicated in
patients who are medically unstable, have long arterial occlusion, have poor distal
run off, or who have diabetes.
Which of the following signs and symptoms would the attending nurse expect in a
patient with aneurysmal rupture?
A. Abdominal pain, hypertension, bradycardia
B. Hypotension, tachycardia, nausea, vomiting, shortness of breath, chest pain/lower
back/abdominal pain
C. Headache, nausea, vomiting, vertigo
D. Hypertension, chest pain, syncope - ANSWER-B
Signs and symptoms of aneurysmal rupture include hypotension, tachycardia,
lightheadedness, fainting, snausea, vomiting, sweating, shortness of breath, chest
pain/lower back/abdominal pain, and dizziness.
The nurse receives the blood test reports for a patient admitted to the hospital with
complaints of chest pain. The report shows an elevated CKMB. What does this
signify in this patient?
A. Damage to myocardium
B. Damage to intercostal muscles
C. Liver damage
D. None of the above - ANSWER-A
Cardiac enzymes get elevated in conditions of damage to the myocardium. CKMB is
one of the important cardiac enzymes used to assess damage to the myocardium.
Which systematic complications are associated with peripheral thrombolectomy?
,A. Vasospasm, bleeding, hematoma formation, compartment syndrome
B. Renal failure, rhabdomyolysis, vasospasm, hemorrhage
C. Edema, hyperkalemia, cardiac arrhythmia, renal failure, rhabdomyolysis
D. Vasospasm, thrombus formation, artery dissection, compartment syndrome -
ANSWER-C
Complications associated with peripheral thrombolectomy include thrombus
formation, vessel vasospasm, bleeding, hematoma formation, artery dissection,
compartment syndrome, venous thrombosis, edema, hyperkalemia, cardiac
arrhythmia, renal failure, and rhabdomyolysis.
A male smoker presents with pain in his extremities after exercise. He also
complains of color changes in his digits when exposed to cold. Which of the following
diseases needs to be ruled out before considering a diagnosis of Buerger's disease?
A. Systemic lupus erythematosus, diabetes, hypercoagulable conditions,
scleroderma
B. Bleeding disorders, dyslipidemia, systemic lupus erythematosus
C. Bleeding disorders, diabetes, hypertension, vasculitis
D. Hypercoagulable states, disorders of lipid metabolism, polyarteritis nodosa -
ANSWER-A
Blood tests are used as screening tools to aid in the diagnosis of Buerger's disease.
Tests are done to rule out scleroderma, lupus, diabetes, and other bleeding
conditions. Allen test is used to assess blood flow to the hands and feet.
Angiography, ultrasound, and echocardiography can be used to assess vascular
flow.
An obese 70-year-old man with a history of atrial fibrillation is recovering from open-
heart surgery for aortic valve replacement. To decrease the risk of developing
postoperative atrial fibrillation, which of the following medications is most commonly
administered for prophylaxis?
A. Metoprolol or atenolol
B. Amiodarone
C. Sotalol
D. Magnesium sulfate - ANSWER-A
Low-dose beta-blockers, such as metoprolol (25-50 mg twice daily) or atenolol (25
mg daily), are the most common drugs to prevent atrial fibrillation (Afib), decreasing
the incidence of Afib by up to 65%. Atrial flutter (> 380 bpm) and Afib (> 380 bpm)
occur in up to 30% of patients with open heart surgery. Risk factors include obesity,
chronic obstructive pulmonary disease, valve surgery, and a history of Afib.
Amiodarone is sometimes given alone or with beta-blockers. Sotalol is an effective
negative inotrope but has a number adverse effects. Magnesium sulfate is most
effective if administered with beta-blockers and with low serum magnesium levels
,When emergent chest reopening and internal defibrillation are necessary in the
intensive care unit (ICU), the primary responsibility of the sterile cardiac ICU nurse is
A. removing dressings and Steri-strips.
B. preparing medications and gathering equipment.
C. ensuring strict sterile technique.
D. preparing the defibrillator machine - ANSWER-C
When the intensive care unit is used as an operating room, a sterile nurse must
ensure that strict sterile technique is followed. A nonsterile nurse may remove the
dressing and Steri-strips, but the scrub (usually with povidone iodine poured over the
chest) should be done by the sterile nurse. The paddles for the internal defibrillator
are maintained in sterile coverings, but the machine is not. During the procedure,
one nurse should be responsible for recording details of the procedure, another for
administration of medications and fluids, and another (circulator) to get necessary
equipment or prepare medications while the sterile nurse assists with sterile
procedures.
Patients with nasogastric tubes inserted during surgery for gastric decompression
should receive which of the following medications by instillation during the first 12-24
hours?
A. H2-blocker (ranitidine)
B. Proton-pump inhibitor (omeprazole)
C. Promotility agent (metoclopramide)
D. Antiulcer drug (sucralfate) - ANSWER-D
Antiulcer drugs, such as sucralfate, should be instilled into nasogastric or orogastric
tubes in the first 12-24 hours to reduce the incidence of stress ulcers. Other drugs,
such as H2-blockers and proton-pump inhibitors, increase gastric pH and should be
avoided; however, if patients are very high risk, a proton-pump inhibitor may be
given in conjunction with sucralfate. Metoclopramide is sometimes used to reduce
nausea and vomiting when an nasogastric tube is inserted into a patient who is
awake.
One hour after surgery, a coronary artery bypass graft (CABG) patient starts to wake
up and the mixed venous oxygen saturation ( SvO2) decreases from 60% to 45%.
The change is most likely the result of which of the following?
A. Increase in oxygen consumption
B. Increase in hemoglobin
C. Increase in cardiac output
D. Increase in arterial saturation - ANSWER-A
SvO2 represents the oxygenation at the tissue level. The value reflects the tissue
oxygen delivery and consumption. Four factors influence SvO2 : hemoglobin, cardiac
output, arterial saturation, and oxygen consumption. An increase in oxygen
consumption will extract more oxygen at the tissue level and decrease the SvO2.
Oxygen consumption could be increased by pain, shivering, or exercise. A decrease
in oxygen consumption will provide more oxygen to the tissue level and increase the
SvO2 . Oxygen consumption might be reduced by hypothermia or anesthesia.
In addition to a decreasing BP, which of the following assessment findings is
consistent with cardiac tamponade?
, A. Urine output of 42 to 50 mL/h
B. Central venous pressure (CVP) of 11 to 20 mm Hg
C. Cardiac output 4.0 to 5.1 L/min
D. SvO2 58% to 65% - ANSWER-B
The accumulation of fluid around the heart compresses the atria, causing elevated
right atrial filling pressures. The decreased cardiac output leads to hypoperfusion of
the kidney, resulting in a sudden decrease in urine output or oliguria. The
compression of the atria constricts venous return to the heart, leading to a decreased
cardiac output. The decreased cardiac output and low hemoglobin level due to the
bleeding lead to decreased SvO2 .
After CABG, a patient weighing 70 kg and receiving mechanical ventilation has
orders to be weaned and extubated when stable. Which parameter indicates the
patient is ready to extubate?
A. RR 28/min
B. Vital capacity (VC) 500 mL
C. Able to sustain a head lift for at least 5 seconds
D. Minute volume 12 L - ANSWER-C
Parameters for readiness to wean are negative inspiratory pressure (NIP) > −25 cm
H2O, RR <25/min, HR <140/min, minute volume <10 L, VC >10 to 15 mL/kg. This
patient's RR needs to be <25/min; VC, 700 to 1050 mL/kg; and minute volume, <10
L. Adequate respiratory muscle strength is indicated by the ability to sustain a head
lift for at least 5 seconds.
Which of the following assessment findings is a contraindication to extubation?
A. Chest tube bleeding less than 50 mL/h
B. Chronic atrial fibrillation
C. Labile/fluctuating blood pressure
D. Minimal vasoactive support - ANSWER-C
Criteria for extubation include hemodynamical stability and neurologic and
respiratory readiness. Chest tube bleeding in excess of 100 mL/h, new arrhythmias,
and labile blood pressure reflect hemodynamic instability.
The following hemodynamic profile is noted upon admission in a postoperative
CABG patient: BP, 91/38 mm Hg; mean arterial pressure (MAP), 58 mm Hg; HR,
108/min; core temperature, 36.5°C; pulmonary arterial pressure (PAP), 20/12 mm
Hg; CVP, 6 mm Hg; SvO2, 59%; cardiac output, 3.6 L/min; cardiac index, 1.8;
systemic vascular resistance, 1006 dyne ⋅ sec ⋅ cm−5; stroke volume, 33 mL; pulse
