NURS 4450 Final Review Questions
and Answers 100% Pass
meds for intubation - ANSWER-propofol, ketamine, fentanyl, versed, etomidate,
rocuronium, succyylcholine
propofol SE - ANSWER-drop BP and HR
propofol dose - ANSWER-bolus of 20-50mg
how often do we change propofol tubing - ANSWER-every 12 hrs
important characteristic about propofol - ANSWER-lipophilic
ketamine SE - ANSWER-hallucinations and increased ICP
fentnayl SE - ANSWER-does not drop BP and HR as much
train of four - ANSWER-pulses to the ulnar nerve, if 2-4 twiches then sedated
enough, if <2 then too sedated
succyylcholine SE - ANSWER-hyperkalemia b/c keeps channels open
is succyylcholine procedural or maintenance - ANSWER-procedural
etomidate SE - ANSWER-increased HR, dizzy, confused
optimal place for ET tube - ANSWER-2 cm above the carina
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,VAP prevention measures - ANSWER-1. HOB at least 30
2. Sedation Vacation
3. Chloryhexidine
4. DVT Prophylaxis
5. PPI or H2 Blocker
Assist control vent setting - ANSWER-preset rate and volume
SIMV vent setting - ANSWER-preset rate and volume but pt can take an extra
breath
PEEP - ANSWER-keep alveoli open, increase in increments of 5
ARDS vent settings - ANSWER-decreased tidal volume and increased PEEP
ARDS cause - ANSWER-secondary to injury, most common = sepsis
ARDS Patho - ANSWER-damage to alveoli causes a decrease in surfactant ->
decrease in surfactant results in collapsed alveoli and atelectasis -> inflammatory
response kicks in after injury and sends fluids to place of injury -> interstitial space
between alveoli and capillaries fills with fluid -> alveoli fill with fluid ->pulmonary
edema ->cells in body begins to die b/c no receiving enough O2 -> hyaline
membrane begins to form from proteins from inflammatory response around the
alveoli -> stiff lungs
CXRAY w/ ARDS - ANSWER-White Out
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,early signs of ARDS - ANSWER-Tachypnea; respiratory alkalosis-> respiratory
acidosis
Central Line Insertion - ANSWER-Sterile, timeout before
Central Line most distal lumen - ANSWER-brown
Central Line Verification - ANSWER-CXRAY
Preload - ANSWER-Volume and amount of force; little stretch =little squeeze
Tests w/ Preload - ANSWER-CVP and PAWP
Contractility - ANSWER-force of the contraction
what increases contractility - ANSWER-inotropes (dopamine, dobutamine,
epinephrine)
afterload - ANSWER-resistance the blood has to overcome to leave the heart
tests w/ Afterload - ANSWER-PVR and SVR
MAP equation - ANSWER-MAP= (SBP + 2DBP)/3
Parasympathetic nerve - ANSWER-Vagus, relaxation
SA node rate - ANSWER-60-100
AV node rate - ANSWER-40-60
Purkinje Fibers rate - ANSWER-20-40
PR interval - ANSWER-3-4 boxes (0.12-0.2)
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, QRS Interval - ANSWER-1-3 boxes (0.04-0.12)
Cause for prolonged QTs - ANSWER-acetaminophen OD
cause of SVT - ANSWER-caffein
what HR will lead to a decreased CO - ANSWER-greater than 180
sx of decreased CO - ANSWER-pallor, dizziness, confusion, hypotension, SOB,
bad cap refill, AKI
tx for asymptomatic SVT - ANSWER-vagal maneuver or carotid massage
tx for symptomatic SVT - ANSWER-give adenosine then cardiovert, BB, CCB
what is the only heart rhythm that you can treat w/ BBs and CCBs - ANSWER-
SVT
tx for junctional rhythm - ANSWER-atropine to increased HR
tx for first degree AV block - ANSWER-obs
tx for wenckebach - ANSWER-atropine
tx for 2nd degree AV block - ANSWER-pacemaker
types of VTACH - ANSWER-polymorphic and monomorphic
polymorphic - ANSWER-irregular sizes
monomorphic VTACH - ANSWER-equal sizes
common polymorphic vtach - ANSWER-torsades de pointe
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and Answers 100% Pass
meds for intubation - ANSWER-propofol, ketamine, fentanyl, versed, etomidate,
rocuronium, succyylcholine
propofol SE - ANSWER-drop BP and HR
propofol dose - ANSWER-bolus of 20-50mg
how often do we change propofol tubing - ANSWER-every 12 hrs
important characteristic about propofol - ANSWER-lipophilic
ketamine SE - ANSWER-hallucinations and increased ICP
fentnayl SE - ANSWER-does not drop BP and HR as much
train of four - ANSWER-pulses to the ulnar nerve, if 2-4 twiches then sedated
enough, if <2 then too sedated
succyylcholine SE - ANSWER-hyperkalemia b/c keeps channels open
is succyylcholine procedural or maintenance - ANSWER-procedural
etomidate SE - ANSWER-increased HR, dizzy, confused
optimal place for ET tube - ANSWER-2 cm above the carina
COPYRIGHT 2025 ALL RIGHTS RESERVED, TRUSTED AND VERIFIED 1
,VAP prevention measures - ANSWER-1. HOB at least 30
2. Sedation Vacation
3. Chloryhexidine
4. DVT Prophylaxis
5. PPI or H2 Blocker
Assist control vent setting - ANSWER-preset rate and volume
SIMV vent setting - ANSWER-preset rate and volume but pt can take an extra
breath
PEEP - ANSWER-keep alveoli open, increase in increments of 5
ARDS vent settings - ANSWER-decreased tidal volume and increased PEEP
ARDS cause - ANSWER-secondary to injury, most common = sepsis
ARDS Patho - ANSWER-damage to alveoli causes a decrease in surfactant ->
decrease in surfactant results in collapsed alveoli and atelectasis -> inflammatory
response kicks in after injury and sends fluids to place of injury -> interstitial space
between alveoli and capillaries fills with fluid -> alveoli fill with fluid ->pulmonary
edema ->cells in body begins to die b/c no receiving enough O2 -> hyaline
membrane begins to form from proteins from inflammatory response around the
alveoli -> stiff lungs
CXRAY w/ ARDS - ANSWER-White Out
COPYRIGHT 2025 ALL RIGHTS RESERVED, TRUSTED AND VERIFIED 2
,early signs of ARDS - ANSWER-Tachypnea; respiratory alkalosis-> respiratory
acidosis
Central Line Insertion - ANSWER-Sterile, timeout before
Central Line most distal lumen - ANSWER-brown
Central Line Verification - ANSWER-CXRAY
Preload - ANSWER-Volume and amount of force; little stretch =little squeeze
Tests w/ Preload - ANSWER-CVP and PAWP
Contractility - ANSWER-force of the contraction
what increases contractility - ANSWER-inotropes (dopamine, dobutamine,
epinephrine)
afterload - ANSWER-resistance the blood has to overcome to leave the heart
tests w/ Afterload - ANSWER-PVR and SVR
MAP equation - ANSWER-MAP= (SBP + 2DBP)/3
Parasympathetic nerve - ANSWER-Vagus, relaxation
SA node rate - ANSWER-60-100
AV node rate - ANSWER-40-60
Purkinje Fibers rate - ANSWER-20-40
PR interval - ANSWER-3-4 boxes (0.12-0.2)
COPYRIGHT 2025 ALL RIGHTS RESERVED, TRUSTED AND VERIFIED 3
, QRS Interval - ANSWER-1-3 boxes (0.04-0.12)
Cause for prolonged QTs - ANSWER-acetaminophen OD
cause of SVT - ANSWER-caffein
what HR will lead to a decreased CO - ANSWER-greater than 180
sx of decreased CO - ANSWER-pallor, dizziness, confusion, hypotension, SOB,
bad cap refill, AKI
tx for asymptomatic SVT - ANSWER-vagal maneuver or carotid massage
tx for symptomatic SVT - ANSWER-give adenosine then cardiovert, BB, CCB
what is the only heart rhythm that you can treat w/ BBs and CCBs - ANSWER-
SVT
tx for junctional rhythm - ANSWER-atropine to increased HR
tx for first degree AV block - ANSWER-obs
tx for wenckebach - ANSWER-atropine
tx for 2nd degree AV block - ANSWER-pacemaker
types of VTACH - ANSWER-polymorphic and monomorphic
polymorphic - ANSWER-irregular sizes
monomorphic VTACH - ANSWER-equal sizes
common polymorphic vtach - ANSWER-torsades de pointe
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