Practice Test 1 CCRN (Pass CCRN)
What is vasogenic cerebral edema? - ANSVasogenic cerebral edema is an increase in
extracellular fluid caused by a breakdown of the blood-brain barrier with the resultant
increase in vascular permeability. This cerebral edema begins locally and becomes more
generalized. Common causes are trauma (including surgical trauma), tumors, hemorrhage,
and abscesses
What ventilator parameter indicates fluid volume excess? - ANSAn A:a gradient greater than
10 mm Hg is a reflection of a diffusion defect. Note that the process of diffusion is between
A (alveolus) and (a) arterial blood. An increase in intraalveolar fluid dilutes and inactivates
surfactant, causing alveolar collapse (decreasing vital capacity) and decreases lung
compliance. Peak inspiratory pressure increases reflect a decrease in lung compliance
What does autonomy refer to? - ANSThe patient's right to make decisions for themselves
What does beneficence mean? - ANSObligation to do good
What does nonmaleficence mean? - ANSObligation to do no harm
What does fidelity mean? - ANSthe obligation to abide by agreements and responsibilities
What does veracity mean? - ANSThe obligation to tell the truth
What are Diagnosis-Related groups? - ANSDRGs constitute a prospective payment program
for Medicare patients. Payment is based on primary and secondary diagnosis, primary and
secondary procedures, age, and length of hospitalization
BNP is secreted in response to? - ANSVentricular wall stretch
What are omnious signs in a patient with status asthmaticus? - ANSA normalization or
increase in the PaCO2. This patient is still tachypneic, and if ventilation is normal, PaCO2
should be decreased. The other ominous sign in this patient would be absence of wheezing or
rhonchi, because they would indicate that ventilation is insufficient to cause these noises.
What problems arise from losses from the GI tract? - ANSAny loss results in hypokalemia.
Vomiting results in loss of acidic contents, whereas losses below the pylorus result is alkalitic
losses leading to metabolic acidosis. Fluid is sequestered in the intestine leading to
hypovolemia, which could cause hypovolemic shock.
Actual problems are worse than potential problems!! - ANS
How can you differentiate the cause of jaundice? - ANSAn increase in direct bilirubin is
associated with biliary obstruction because direct bilirubin is conjugated. An increase in
indirect bilirubin is associated with hepatic disease or excessive hemolysis because indirect
bilirubin is unconjugated
What antihypertensive meds work best in African american patients? - ANSAfrican-
Americans do not respond well to angiotensin-converting enzyme inhibitors (e.g., captopril
, [Capoten]), but they do respond well to an angiotensin II blocker (valsartan [Diovan]). Of the
beta-blockers, labetalol works best. Of the calcium channel blockers, diltiazem works best
What lab values define acute respiratory failure? - ANS50-50!
PaO2<50 and/or PaCO2>50
Hyperkalemia can cause what? - ANSDiarrhea-increases gastric motility
Flaccid paralysis- partially depolarizes muscle cells, prevents further depolarization
Every 1 inch increase in abdominal girth equates to how much blood accumulation in the
abdomen - ANS500-1000mL
What pacing method would be used in a patient in atrial fib? - ANSVVI- you don't want to
sense or pace the atria.
1st letter-paced chamber
2nd letter-chamber sensed
What is the difference between an anaphylactic and anaphylactoid reaction? -
ANSAnaphylactoid reaction is clinically indistinguishable from anaphylactic reaction but
does not require previous exposure to the antigen. Anaphylactoid reaction is not IgE
mediated, and direct activation and degranulation of mast cells are thought to be triggered by
the complement system. Anaphylactic reaction requires previous exposure to the antigen and
is IgE mediated
Mitral stenosis is associated with what? - ANSPinkish discoloration of the cheeks. It is a
diastolic murmur
What murmur is associated with widened pulse pressure? - ANSAortic regurg
What murmur is associated with narrowed pulse pressure? - ANSMitral regurg
What lead changes are associated with left ventricle hyperthrophy? - ANSStrain pattern in V5
and V6 (asymmetric T wave inversion)
When the depth of the S wave in lead V1 or V2 plus the height of the R wave in lead V5 or
V6 is 35 mm or greater, this constitutes voltage
What lead changes are associated with right ventricle hypertrophy? - ANSstrain pattern in V1
and V2. Prominent R wave in V1 reverse progression of the R wave across the precordium.
What organ system is the most common to fail in severe sepsis? - ANSHematologic-
coagulopathies are common in severe sepsis
What are the early signs of hypoglycemia? - ANSThe early signs of hypoglycemia are
mediated by the sympathetic nervous system, which acts to mobilize glucose stores
(tachycardia, tachypnea, diaphoresis). Later signs of hypoglycemia are related to low glucose
levels in the brain (neuroglycopenia)
**Early signs can be masked in pts taking beta-blockers
What is vasogenic cerebral edema? - ANSVasogenic cerebral edema is an increase in
extracellular fluid caused by a breakdown of the blood-brain barrier with the resultant
increase in vascular permeability. This cerebral edema begins locally and becomes more
generalized. Common causes are trauma (including surgical trauma), tumors, hemorrhage,
and abscesses
What ventilator parameter indicates fluid volume excess? - ANSAn A:a gradient greater than
10 mm Hg is a reflection of a diffusion defect. Note that the process of diffusion is between
A (alveolus) and (a) arterial blood. An increase in intraalveolar fluid dilutes and inactivates
surfactant, causing alveolar collapse (decreasing vital capacity) and decreases lung
compliance. Peak inspiratory pressure increases reflect a decrease in lung compliance
What does autonomy refer to? - ANSThe patient's right to make decisions for themselves
What does beneficence mean? - ANSObligation to do good
What does nonmaleficence mean? - ANSObligation to do no harm
What does fidelity mean? - ANSthe obligation to abide by agreements and responsibilities
What does veracity mean? - ANSThe obligation to tell the truth
What are Diagnosis-Related groups? - ANSDRGs constitute a prospective payment program
for Medicare patients. Payment is based on primary and secondary diagnosis, primary and
secondary procedures, age, and length of hospitalization
BNP is secreted in response to? - ANSVentricular wall stretch
What are omnious signs in a patient with status asthmaticus? - ANSA normalization or
increase in the PaCO2. This patient is still tachypneic, and if ventilation is normal, PaCO2
should be decreased. The other ominous sign in this patient would be absence of wheezing or
rhonchi, because they would indicate that ventilation is insufficient to cause these noises.
What problems arise from losses from the GI tract? - ANSAny loss results in hypokalemia.
Vomiting results in loss of acidic contents, whereas losses below the pylorus result is alkalitic
losses leading to metabolic acidosis. Fluid is sequestered in the intestine leading to
hypovolemia, which could cause hypovolemic shock.
Actual problems are worse than potential problems!! - ANS
How can you differentiate the cause of jaundice? - ANSAn increase in direct bilirubin is
associated with biliary obstruction because direct bilirubin is conjugated. An increase in
indirect bilirubin is associated with hepatic disease or excessive hemolysis because indirect
bilirubin is unconjugated
What antihypertensive meds work best in African american patients? - ANSAfrican-
Americans do not respond well to angiotensin-converting enzyme inhibitors (e.g., captopril
, [Capoten]), but they do respond well to an angiotensin II blocker (valsartan [Diovan]). Of the
beta-blockers, labetalol works best. Of the calcium channel blockers, diltiazem works best
What lab values define acute respiratory failure? - ANS50-50!
PaO2<50 and/or PaCO2>50
Hyperkalemia can cause what? - ANSDiarrhea-increases gastric motility
Flaccid paralysis- partially depolarizes muscle cells, prevents further depolarization
Every 1 inch increase in abdominal girth equates to how much blood accumulation in the
abdomen - ANS500-1000mL
What pacing method would be used in a patient in atrial fib? - ANSVVI- you don't want to
sense or pace the atria.
1st letter-paced chamber
2nd letter-chamber sensed
What is the difference between an anaphylactic and anaphylactoid reaction? -
ANSAnaphylactoid reaction is clinically indistinguishable from anaphylactic reaction but
does not require previous exposure to the antigen. Anaphylactoid reaction is not IgE
mediated, and direct activation and degranulation of mast cells are thought to be triggered by
the complement system. Anaphylactic reaction requires previous exposure to the antigen and
is IgE mediated
Mitral stenosis is associated with what? - ANSPinkish discoloration of the cheeks. It is a
diastolic murmur
What murmur is associated with widened pulse pressure? - ANSAortic regurg
What murmur is associated with narrowed pulse pressure? - ANSMitral regurg
What lead changes are associated with left ventricle hyperthrophy? - ANSStrain pattern in V5
and V6 (asymmetric T wave inversion)
When the depth of the S wave in lead V1 or V2 plus the height of the R wave in lead V5 or
V6 is 35 mm or greater, this constitutes voltage
What lead changes are associated with right ventricle hypertrophy? - ANSstrain pattern in V1
and V2. Prominent R wave in V1 reverse progression of the R wave across the precordium.
What organ system is the most common to fail in severe sepsis? - ANSHematologic-
coagulopathies are common in severe sepsis
What are the early signs of hypoglycemia? - ANSThe early signs of hypoglycemia are
mediated by the sympathetic nervous system, which acts to mobilize glucose stores
(tachycardia, tachypnea, diaphoresis). Later signs of hypoglycemia are related to low glucose
levels in the brain (neuroglycopenia)
**Early signs can be masked in pts taking beta-blockers
