NRSG430 Complex Care Final Exam Questions & Answers
aortic and pulmonic
Which two valves are open during ventricular
systole?
mitral and tricuspid
Which two valves are closed during ventricular
systole?
Amount of time systole takes in the cardiac 1/3 of cardiac cycle
cycle
2/3 of cardiac cycle
Amount of time diastole takes in the cardiac
cycle
after load: vasoconstriction
How does activation of the RASS system affect
preload: sodium and water retention
both preload and after load?
Always use an armboard for patients with an arterial line
___________
the phlebostatic axis (4th intercostal space/halfway point between anterior and posterior)
An arterial line should be leveled to
1. Stress
2. Dehydration
3. Pain
Causes of sinus tachycardia 4. Fever
5. Hypoxia
There needs to be adequate volume for there to be adequate stretch and contractility. This is
Starlings Law why with hypovolemia, contractility will eventually go down
1. Intravascular volume
2. Venous tone/pressure
3. Intra-pericardial pressure
4. Body position
Determinants of preload 5. Atrial Contraction
6. Pumping Action
Normal CVP 5
Normal wedge pressure 10
Measures of contractility CO/CI, SV/SVI, EF
Normal ejection fraction 60-65%
1. Preload/Afterload
2. Ventricular musculature
3. Neural control
4. Physiological depressants
5. Drug therapy
Determinants of contractility 6. Intrinsic depression
7. Electrolytes
Normal SVR 800-1200
Leads that look left main V1-V6, Lead 1, AVL
V2-V4
Leads that look at the left anterior descending
Circumflex/CX Lead 1 & Avl, V5 & V6
collateral circulation
The rate of cell death in an acute myocardial myocardial oxygen supply
infarction is dependent on restoration of blood flow
, NRSG430 Complex Care Final Exam Questions & Answers
Any prior ICH, known cerebral vascular lesion, known malignant intracranial neoplasm,
ischemic stroke within 3 months, suspected aortic dissection, active bleeding, significant
Contraindications for fibrinolytics closed head or facial trauma within three months, severe or uncontrolled hypertension
(unresponsive to emergency therapy)
within 30 minutes of hospital arrival
If fibrinolytic therapy is chosen as a primary
reperfusion strategy, when should it be given?
HFrEF EF of 40% or less accompanied by HF symptoms
HFpEF HF symptoms but and EF greater than 40%
Stage represents the presence of disease. Class indicates the presence of symptoms
Stage vs. Class of HF
No limitation of physical activity. Ordinary physical activity does not cause undue fatigue,
Class 1 HF patient symptoms palpitation, or dyspnea (shortness of breath)
Slight limitation of physical activity. Comfortable at rest, but ordinary physical activity
Class 2 HF patient symptoms results in fatigue, palpitation, or dyspnea.
Marked limitation of physical activity. Comfortable at rest, but less than ordinary activity
Class 3 HF patient symptoms causes fatigue, palpitation, or dyspnea.
Unable to carry out any physical activity without discomfort. Symptoms of cardiac
Class 4 HF patient symptoms insufficiency at rest. If any physical activity is undertaken, discomfort is increased.
Corticosteroids: sodium and fluid retention, blood pressure.
NSAIDS (naproxen, motrin, indocin, arthotec, bextra): Sodium and fluid retention
Antiarrythmic medications
Antihypertensive medications (alpha blockers, prazonsin, amlodipine)
Tricyclic antidepressants
Medications to Avoid in HF patients
Calcium Channel Blockers
Diabetic medications (metformin)
Treatment for patients in state B HF ACE or ARB
Stage
Treatment for HF is based on stage or class?
Treatment for stage C HF patients ACE, beta-blockers, ARB, Aldosterone antagonists, digitalis
Stage D HF treatment Heart transplant
True
True or False: never without an ace inhibitor
Diuretics are added at which stage of HF? Stage C
What is a race-selective medication used to Bids
treat African American HF patients?
Beneficial when given to reduce HF hospitalization for patients with symptomatic, stable
chronic HFrED who are receiving beta blockers at a maximum tolerated dose and who are in
Recommendation on giving Ivabradine sinus rhythm with a heart rate of 70 ppm or greater at rest
What does Ivabradine do? Reduces the HR to allow for greater filling times.
Do NOT give within 36 hours of last does of ACE/ARB or in patients with a hx of
Considerations for administering ARNI angioedema
aortic and pulmonic
Which two valves are open during ventricular
systole?
mitral and tricuspid
Which two valves are closed during ventricular
systole?
Amount of time systole takes in the cardiac 1/3 of cardiac cycle
cycle
2/3 of cardiac cycle
Amount of time diastole takes in the cardiac
cycle
after load: vasoconstriction
How does activation of the RASS system affect
preload: sodium and water retention
both preload and after load?
Always use an armboard for patients with an arterial line
___________
the phlebostatic axis (4th intercostal space/halfway point between anterior and posterior)
An arterial line should be leveled to
1. Stress
2. Dehydration
3. Pain
Causes of sinus tachycardia 4. Fever
5. Hypoxia
There needs to be adequate volume for there to be adequate stretch and contractility. This is
Starlings Law why with hypovolemia, contractility will eventually go down
1. Intravascular volume
2. Venous tone/pressure
3. Intra-pericardial pressure
4. Body position
Determinants of preload 5. Atrial Contraction
6. Pumping Action
Normal CVP 5
Normal wedge pressure 10
Measures of contractility CO/CI, SV/SVI, EF
Normal ejection fraction 60-65%
1. Preload/Afterload
2. Ventricular musculature
3. Neural control
4. Physiological depressants
5. Drug therapy
Determinants of contractility 6. Intrinsic depression
7. Electrolytes
Normal SVR 800-1200
Leads that look left main V1-V6, Lead 1, AVL
V2-V4
Leads that look at the left anterior descending
Circumflex/CX Lead 1 & Avl, V5 & V6
collateral circulation
The rate of cell death in an acute myocardial myocardial oxygen supply
infarction is dependent on restoration of blood flow
, NRSG430 Complex Care Final Exam Questions & Answers
Any prior ICH, known cerebral vascular lesion, known malignant intracranial neoplasm,
ischemic stroke within 3 months, suspected aortic dissection, active bleeding, significant
Contraindications for fibrinolytics closed head or facial trauma within three months, severe or uncontrolled hypertension
(unresponsive to emergency therapy)
within 30 minutes of hospital arrival
If fibrinolytic therapy is chosen as a primary
reperfusion strategy, when should it be given?
HFrEF EF of 40% or less accompanied by HF symptoms
HFpEF HF symptoms but and EF greater than 40%
Stage represents the presence of disease. Class indicates the presence of symptoms
Stage vs. Class of HF
No limitation of physical activity. Ordinary physical activity does not cause undue fatigue,
Class 1 HF patient symptoms palpitation, or dyspnea (shortness of breath)
Slight limitation of physical activity. Comfortable at rest, but ordinary physical activity
Class 2 HF patient symptoms results in fatigue, palpitation, or dyspnea.
Marked limitation of physical activity. Comfortable at rest, but less than ordinary activity
Class 3 HF patient symptoms causes fatigue, palpitation, or dyspnea.
Unable to carry out any physical activity without discomfort. Symptoms of cardiac
Class 4 HF patient symptoms insufficiency at rest. If any physical activity is undertaken, discomfort is increased.
Corticosteroids: sodium and fluid retention, blood pressure.
NSAIDS (naproxen, motrin, indocin, arthotec, bextra): Sodium and fluid retention
Antiarrythmic medications
Antihypertensive medications (alpha blockers, prazonsin, amlodipine)
Tricyclic antidepressants
Medications to Avoid in HF patients
Calcium Channel Blockers
Diabetic medications (metformin)
Treatment for patients in state B HF ACE or ARB
Stage
Treatment for HF is based on stage or class?
Treatment for stage C HF patients ACE, beta-blockers, ARB, Aldosterone antagonists, digitalis
Stage D HF treatment Heart transplant
True
True or False: never without an ace inhibitor
Diuretics are added at which stage of HF? Stage C
What is a race-selective medication used to Bids
treat African American HF patients?
Beneficial when given to reduce HF hospitalization for patients with symptomatic, stable
chronic HFrED who are receiving beta blockers at a maximum tolerated dose and who are in
Recommendation on giving Ivabradine sinus rhythm with a heart rate of 70 ppm or greater at rest
What does Ivabradine do? Reduces the HR to allow for greater filling times.
Do NOT give within 36 hours of last does of ACE/ARB or in patients with a hx of
Considerations for administering ARNI angioedema
