ATI CARDIOVASCULAR 2026/2027 EXAM QUESTIONS AND
ANSWERS GRADED A+
✔✔Vascular Access- minimize the number of catheter insertions and risk for adverse
reactions- central catheters good for any fluids goes through the superior vena cava-
PICC line, Tunneled percutaneous central catheter (tripple lumen), & implanted port -
✔✔Care of PICC line- assess site q 8hrs (redness, swelling, drainage, tenderness, &
condition), change tube/positive pressure cap q 3 days, don't have BP taken on arm w/
PICC line
Central Line- long-term use, no dressing (skin forms barrier)
Implanted Port- inserted into chest wall, access w/ noncoring needle, flush after every
use & at least once per month
Complications-
- Phlebitis- chemical, bacterial or mechanical irritation(excess use): 1st sign is erythema
at site, pain or burning, warmth, edema, vein is heard/red streak/cordlike, slowing
infusion- observe every 2hrs for infection/infiltration, discontinue, apply warm compress
- Occlusion- flush every 12 hrs
- Catheter Thrombosis/Emboli- Flush- do not force fluid if resistance is encountered
- Infiltration/Extravasation- stop flow, do not use hand veins for vesicant medication,
apply pressure/cool compress/ elevation
- Air Embolism- central lines clamped when not in use, hold breath while tubing is
changed, if SOB- Trendelenburg on LT side/give oxygen/notify provider
✔✔Dysrhythmias
- Life threatening effects r/t decreased CO and ineffective tissue perfusion
- Treatment based on cardiac rhythm, may require- cardioversion,
defibrillation/pacemaker, and/or meds
- Symptoms present only w/ increased activity in older adults
- Treatment may follow- advanced cardiac life support - ✔✔*persons at risk for
dysrhythmias- metabolic alkalosis, COPD, stent placement in coronary artery
*Pacemaker is used w/ bradycardia
✔✔Cardioversion- direct countershock to the heart synchronized to the QRS complex-
elective treatment for atrial dysrhythmias and tachycardia w/ a pulse and symptomatic
Defibrillation- unsynchronized, direct countershock to the heart, stops all electrical
activity of the heart- for ventricular fibrillation or pulseless ventricular tachycardia -
✔✔Pre- Afib must receive anticoagulation for 4-6 wks prior, explain, consent, admin
oxygen, doc pre rhythm, ER equipment ready
Intra- sedation meds, admin prescribed antidysrhythmic *digoxin is held 48hrs prior to
cardioversion, ECG leads, "stand CLEAR"
Post- monitor VS, ABC, obtain ECG, Doc- post rhythm, # of defib/cardioversion
attempts, energy settings, time, and response, LOC, skin conditions
- Teach- assess pulse, report palpitations/irregularties
Complications:
, - Embolism- pulmonary embolism, cerebrovascular accident(decrease LOC, slurred
speech, muscle weakness/paralysis), MI(chest pain)- therapeutic anticoagulation
- Decreased CO & HF- S/S of Decreased CO- hypotension, syncope, ^HR; S/S of HF-
dyspnea, productive cough, edema, venous distention; medications that increase output
(inotropic agents)
✔✔Pacemakers- battery-operated device that electrically stimulates the heart when the
natural pacemaker of the heart fails to maintain an acceptable rhythm
Temporary pacemakers- energy source is provided by an external battery pack-
external (AED), epicardial, endocardial
Permanent pacemaker- fixed rate, demand mode, tachydysrhythmia function
Indications- sympatomatic bradycardia, complete heart block, sick sinus syndrome,
sinus arrest, atrial or ventricular tachydysrhythmias- S/S dizziness, palpitations, chest
pain/pressure, anxiety, fatigue, JVD, Brady/tachycardia, decreased CO
*must clean skin w/ soap and water before applying transcutaneous pacemaker pads
*fixed rate- pacemaker fires in an asynchronous pattern - ✔✔Pre- assess
knowledge/need for pacemaker, prepares skin (DO NOT shave, rub, or apply alcohol to
skin)
- Teach: temporary pacemaker- wires and box will be placed on chest after, DO NOT
touch dials, keep dry, DO NOT shower; permanent pacemaker- reprogrammed
externally after procedure, battery will last 10yrs then must be replaced
Intra- VS, O2, comfort, admin meds, pacemaker settings as prescribed- est threshold-
lowest stimulation that is achieved
Post- doc, continually monitor HR&R, maintain safety (electrical wires, leads, fall risk),
obtain pacemaker identification card
-Teach: prevent wire dislodge (wear sling when out of bed, do not raise arm above
shoulder for 1-2wks), take pulse daily at same time, notify HCP if HR <5 beats below
pacemaker rate; report- dizziness, fatigue, weakness, chest pain; follow activity
restrictions as prescribed- no heavy lifting for 3mon; NEVER place items that generate a
magnetic field over pacemaker; notify providers/dentists about pacemakers
Complications- infection/hematoma, pneumothorax/hemothorax, arrhythmias- ER
equipment ready
✔✔3 types of angina: - ✔✔Stable Angina- occurs w/ exercise or emotional stress and is
relieved by rest or nitroglycerin
Unstable Angina- occurs w/ exercise or emotional stress but it increases in occurrence,
severity, and duration over time
Variant Angina- due to coronary artery spasm, often occurring during periods of rest
✔✔An abrupt interruption of oxygen to the heart muscle produces? - ✔✔Myocardial
Ischemia
Ischemia can lead to tissue necrosis (infarction) if blood supply and O2 are not restored
Ischemia is reversible
Infarction results in permanent damage
ANSWERS GRADED A+
✔✔Vascular Access- minimize the number of catheter insertions and risk for adverse
reactions- central catheters good for any fluids goes through the superior vena cava-
PICC line, Tunneled percutaneous central catheter (tripple lumen), & implanted port -
✔✔Care of PICC line- assess site q 8hrs (redness, swelling, drainage, tenderness, &
condition), change tube/positive pressure cap q 3 days, don't have BP taken on arm w/
PICC line
Central Line- long-term use, no dressing (skin forms barrier)
Implanted Port- inserted into chest wall, access w/ noncoring needle, flush after every
use & at least once per month
Complications-
- Phlebitis- chemical, bacterial or mechanical irritation(excess use): 1st sign is erythema
at site, pain or burning, warmth, edema, vein is heard/red streak/cordlike, slowing
infusion- observe every 2hrs for infection/infiltration, discontinue, apply warm compress
- Occlusion- flush every 12 hrs
- Catheter Thrombosis/Emboli- Flush- do not force fluid if resistance is encountered
- Infiltration/Extravasation- stop flow, do not use hand veins for vesicant medication,
apply pressure/cool compress/ elevation
- Air Embolism- central lines clamped when not in use, hold breath while tubing is
changed, if SOB- Trendelenburg on LT side/give oxygen/notify provider
✔✔Dysrhythmias
- Life threatening effects r/t decreased CO and ineffective tissue perfusion
- Treatment based on cardiac rhythm, may require- cardioversion,
defibrillation/pacemaker, and/or meds
- Symptoms present only w/ increased activity in older adults
- Treatment may follow- advanced cardiac life support - ✔✔*persons at risk for
dysrhythmias- metabolic alkalosis, COPD, stent placement in coronary artery
*Pacemaker is used w/ bradycardia
✔✔Cardioversion- direct countershock to the heart synchronized to the QRS complex-
elective treatment for atrial dysrhythmias and tachycardia w/ a pulse and symptomatic
Defibrillation- unsynchronized, direct countershock to the heart, stops all electrical
activity of the heart- for ventricular fibrillation or pulseless ventricular tachycardia -
✔✔Pre- Afib must receive anticoagulation for 4-6 wks prior, explain, consent, admin
oxygen, doc pre rhythm, ER equipment ready
Intra- sedation meds, admin prescribed antidysrhythmic *digoxin is held 48hrs prior to
cardioversion, ECG leads, "stand CLEAR"
Post- monitor VS, ABC, obtain ECG, Doc- post rhythm, # of defib/cardioversion
attempts, energy settings, time, and response, LOC, skin conditions
- Teach- assess pulse, report palpitations/irregularties
Complications:
, - Embolism- pulmonary embolism, cerebrovascular accident(decrease LOC, slurred
speech, muscle weakness/paralysis), MI(chest pain)- therapeutic anticoagulation
- Decreased CO & HF- S/S of Decreased CO- hypotension, syncope, ^HR; S/S of HF-
dyspnea, productive cough, edema, venous distention; medications that increase output
(inotropic agents)
✔✔Pacemakers- battery-operated device that electrically stimulates the heart when the
natural pacemaker of the heart fails to maintain an acceptable rhythm
Temporary pacemakers- energy source is provided by an external battery pack-
external (AED), epicardial, endocardial
Permanent pacemaker- fixed rate, demand mode, tachydysrhythmia function
Indications- sympatomatic bradycardia, complete heart block, sick sinus syndrome,
sinus arrest, atrial or ventricular tachydysrhythmias- S/S dizziness, palpitations, chest
pain/pressure, anxiety, fatigue, JVD, Brady/tachycardia, decreased CO
*must clean skin w/ soap and water before applying transcutaneous pacemaker pads
*fixed rate- pacemaker fires in an asynchronous pattern - ✔✔Pre- assess
knowledge/need for pacemaker, prepares skin (DO NOT shave, rub, or apply alcohol to
skin)
- Teach: temporary pacemaker- wires and box will be placed on chest after, DO NOT
touch dials, keep dry, DO NOT shower; permanent pacemaker- reprogrammed
externally after procedure, battery will last 10yrs then must be replaced
Intra- VS, O2, comfort, admin meds, pacemaker settings as prescribed- est threshold-
lowest stimulation that is achieved
Post- doc, continually monitor HR&R, maintain safety (electrical wires, leads, fall risk),
obtain pacemaker identification card
-Teach: prevent wire dislodge (wear sling when out of bed, do not raise arm above
shoulder for 1-2wks), take pulse daily at same time, notify HCP if HR <5 beats below
pacemaker rate; report- dizziness, fatigue, weakness, chest pain; follow activity
restrictions as prescribed- no heavy lifting for 3mon; NEVER place items that generate a
magnetic field over pacemaker; notify providers/dentists about pacemakers
Complications- infection/hematoma, pneumothorax/hemothorax, arrhythmias- ER
equipment ready
✔✔3 types of angina: - ✔✔Stable Angina- occurs w/ exercise or emotional stress and is
relieved by rest or nitroglycerin
Unstable Angina- occurs w/ exercise or emotional stress but it increases in occurrence,
severity, and duration over time
Variant Angina- due to coronary artery spasm, often occurring during periods of rest
✔✔An abrupt interruption of oxygen to the heart muscle produces? - ✔✔Myocardial
Ischemia
Ischemia can lead to tissue necrosis (infarction) if blood supply and O2 are not restored
Ischemia is reversible
Infarction results in permanent damage
