HDEV JERSEY COLLEGE MIDTERM PRACTICE
QUESTIONS AND DETAILED SOLUTIONS
◉ locations of chest pain?
Answer: typically felt behind the sternum and may radiate to:neck,
jaw, shoulders, and along the inner aspect of the left arm.
◉ what is the classic finding of angina?
Answer: it is relieved with rest or nitroglycerine
◉ Pt. education for nitroglycerin?
Answer: 1. keep in a dark bottle
2.renew every 6 months
3.place under tongue, never swallowed
4. can take every 5 minutes x 3 doses
5. call 911 after the first dose if pain is not relieved
◉ decrease in cardiac output, expect the pulse to be?
Answer: weak, thready pulse
◉ signs of hypokalemia?
,Answer: muscle weakness
fatigue
muscle cramps
constipation
inverted T waves and a U wave on ekg
◉ metabolic syndrome increases the risk of?
Answer: heart disease
◉ spironolactone is a potassium sparing diuretic that could?
Answer: potentiate fluid and electrolyte imbalances ( if given with
potassium supplements, hyperkalemia can occur)
◉ how do bet-blockers work? end in -olol
Answer: decreases heart rate and blood pressure. mask the signs of
hypoglycemia or worsen asthma because of bronchoconstriction
◉ why should you avoid discontinuing anti-hypertensives
medications abruptly?
Answer: increase risk for rebound hypertension
◉ ACE inhibitors and Angiotensin 2 receptor blockers (ARBs)
increase the risk of?
,Answer: hyperkalemia
◉ ACE inhibitors, how do they work? ends in -pril
Answer: stop angiotensin 1 from converting to angiotensin 2
(powerful vasoconstrictor) thereby lowering total peripheral
vascular resistance and blood pressure
◉ How to take a proper blood pressure reading?
Answer: instruct pt. to not eat or drink for 30 mins
support arm at heart level
make sure both feet are flat on the floor
◉ the target organs affected by long standing hypertension?
Answer: retinopathy
neuropathy
nephropathy
◉ decrease in output could cause what?
Answer: decrease in tissue perfusion which results in organ failure
◉ Following a pulmonary artery pressure reading you should deflate
the balloon. Why?
, Answer: to restore the blood flow through the pulmonary artery
◉ Straining with bowel movements is not good because?
Answer: it triggers the valsalva maneuver which increases
intrathoracic pressure decreasing the venous blood flow to the heart
and results in decrease cardiac output.
◉ change patients position slowly to prebent?
Answer: orthostatic hypotension
◉ Low central venous pressure levels could suggests?
Answer: could suggest dehydration or overdiuresis
◉ increase central venous pressure could suggest?
Answer: heart failure
◉ increase central venous pressure provides a measurement of
what?
Answer: measurement of the volume of blood that returned to the
right side of the heart (2-6 mm Hg)
◉ Hemodynamic monitoring is performed where?
Answer: in ICU and allows for direct cardiac monitoring
QUESTIONS AND DETAILED SOLUTIONS
◉ locations of chest pain?
Answer: typically felt behind the sternum and may radiate to:neck,
jaw, shoulders, and along the inner aspect of the left arm.
◉ what is the classic finding of angina?
Answer: it is relieved with rest or nitroglycerine
◉ Pt. education for nitroglycerin?
Answer: 1. keep in a dark bottle
2.renew every 6 months
3.place under tongue, never swallowed
4. can take every 5 minutes x 3 doses
5. call 911 after the first dose if pain is not relieved
◉ decrease in cardiac output, expect the pulse to be?
Answer: weak, thready pulse
◉ signs of hypokalemia?
,Answer: muscle weakness
fatigue
muscle cramps
constipation
inverted T waves and a U wave on ekg
◉ metabolic syndrome increases the risk of?
Answer: heart disease
◉ spironolactone is a potassium sparing diuretic that could?
Answer: potentiate fluid and electrolyte imbalances ( if given with
potassium supplements, hyperkalemia can occur)
◉ how do bet-blockers work? end in -olol
Answer: decreases heart rate and blood pressure. mask the signs of
hypoglycemia or worsen asthma because of bronchoconstriction
◉ why should you avoid discontinuing anti-hypertensives
medications abruptly?
Answer: increase risk for rebound hypertension
◉ ACE inhibitors and Angiotensin 2 receptor blockers (ARBs)
increase the risk of?
,Answer: hyperkalemia
◉ ACE inhibitors, how do they work? ends in -pril
Answer: stop angiotensin 1 from converting to angiotensin 2
(powerful vasoconstrictor) thereby lowering total peripheral
vascular resistance and blood pressure
◉ How to take a proper blood pressure reading?
Answer: instruct pt. to not eat or drink for 30 mins
support arm at heart level
make sure both feet are flat on the floor
◉ the target organs affected by long standing hypertension?
Answer: retinopathy
neuropathy
nephropathy
◉ decrease in output could cause what?
Answer: decrease in tissue perfusion which results in organ failure
◉ Following a pulmonary artery pressure reading you should deflate
the balloon. Why?
, Answer: to restore the blood flow through the pulmonary artery
◉ Straining with bowel movements is not good because?
Answer: it triggers the valsalva maneuver which increases
intrathoracic pressure decreasing the venous blood flow to the heart
and results in decrease cardiac output.
◉ change patients position slowly to prebent?
Answer: orthostatic hypotension
◉ Low central venous pressure levels could suggests?
Answer: could suggest dehydration or overdiuresis
◉ increase central venous pressure could suggest?
Answer: heart failure
◉ increase central venous pressure provides a measurement of
what?
Answer: measurement of the volume of blood that returned to the
right side of the heart (2-6 mm Hg)
◉ Hemodynamic monitoring is performed where?
Answer: in ICU and allows for direct cardiac monitoring
