BCEN STUDY GUIDE PART ONE
A 7 y/o suddenly develops ventricular fibrillation. The child weighs 66 lbs (30 kg). CPR is started
immediately. What is the correct defibrillation dose for the initial shock?
A. 60 joules
B. 30 joules
C. 120 joules
D. 90 joules - ANS-A) 60 joules
The child weighs 30 kg. The initial joule dose is 2 joules per kg. The correct dose would be 60
joules for the initial shock and increasing to 4 joules per kg. This dose can be increased to a
maximum of 10 joules per kg.
A conscious pulseless patient with a continuous-flow left ventricular assist decide (LVAD) and a
history of end-stage heart failure presents to the ED because of a "low-flow" alarm. The nurse
anticipates performing which intervention first?
A. Obtain a BP using a Doppler and sphygmomanometer
B. Auscultation over the pump to ascertain if the device is working
C. Administer IV fluids
D. Begin chest compressions - ANS-A) Obtain a BP using a Doppler and sphygmomanometer
The "low-flow" alarm may be because of decrease preload from hypotension, dehydration, on
structure of the inflow or outflow cannula, or disconnection of percutaneous leads. LVAD
patients should have a MAP 70-80. In a conscious patient, determining the patient's BP will help
guide therapy and troubleshooting. The patient's LVAD coordinator also be contacted as soon
as possible.
WRONG ANSWER RATIONALES:
B) auscultation of the pump is prudent to determine if the pump is functioning properly. device
failure has been reported as the second most common cause of death in LVAD patients. signs
of pump failure include absence of power light on the controller, undetectable blood pressure
while using the Doppler, and inability to auscultation the motor.
C) IV fluids only indicated if MAP is low
, D) compressions no indicated in conscious patient
A patient being evaluated in the ED is noted to have Janeway lesions, Roth's spots, and Osler's
nodes along with elevated body temperature and elevated WBC. Patient assessment reveals
the presence of several recent body piercings. The ED. It's suspects the patient has:
A. Endocarditis
B. Pericarditis
C. Myocarditis
D. Leukemia - ANS-A) Endocarditis
The patient's symptoms are classic for endocarditis. Janeway lesions are petechial lesions
found on the palms of the hands or soles of the feet. Osler's nodes are defined as painful
fingertip lesions, and Roth's spots are retinal hemorrhages with the presence of whitish spots in
the center. The patient may experience fevers along with an elevated WBC. Recent body
piercings may be a source of infections leading to endocarditis. The endocarditis infection may
also spread to valve structures in the heart, resulting in permanent valvular dysfunction.
WRONG ANSWER RATIONALES:
B) pericarditis is characterized by elevated WBC, a pericardial friction rub, and ST changes
throughout the EKG.
C) myocarditis is characterized by chest pain, cardiac rhythm abnormalities, poor nutrition and
fatigue. myocarditis is typically a viral infection that presents with fevers and elevated WBC.
D) leukemia is diagnosed by abnormalities in WBC counts
A patient comes in with chest pain, diaphoresis, denies dyspnea. VSS, breath sounds clear and
equal, EKG shows inferior wall ST segment elevation. You anticipate the following oxygen order:
A. No supplemental oxygen
B. Nasal cannula at 6 L per minute
C. Partial rebreather mask at 10 L per minute
D. Nonrebreather mask at 15 L per minute - ANS-A. No supplemental oxygen at this time as it is
not indicated in normoxia. Giving supplemental oxygen in the setting of normoxia does not
improve outcome and has been shown to extend the size of an MI.
A patient complains of chest pain, dyspnea, and diaphoresis. Which of the following assessment
factors would indicate a possible diagnosis of acute coronary syndrome?
A 7 y/o suddenly develops ventricular fibrillation. The child weighs 66 lbs (30 kg). CPR is started
immediately. What is the correct defibrillation dose for the initial shock?
A. 60 joules
B. 30 joules
C. 120 joules
D. 90 joules - ANS-A) 60 joules
The child weighs 30 kg. The initial joule dose is 2 joules per kg. The correct dose would be 60
joules for the initial shock and increasing to 4 joules per kg. This dose can be increased to a
maximum of 10 joules per kg.
A conscious pulseless patient with a continuous-flow left ventricular assist decide (LVAD) and a
history of end-stage heart failure presents to the ED because of a "low-flow" alarm. The nurse
anticipates performing which intervention first?
A. Obtain a BP using a Doppler and sphygmomanometer
B. Auscultation over the pump to ascertain if the device is working
C. Administer IV fluids
D. Begin chest compressions - ANS-A) Obtain a BP using a Doppler and sphygmomanometer
The "low-flow" alarm may be because of decrease preload from hypotension, dehydration, on
structure of the inflow or outflow cannula, or disconnection of percutaneous leads. LVAD
patients should have a MAP 70-80. In a conscious patient, determining the patient's BP will help
guide therapy and troubleshooting. The patient's LVAD coordinator also be contacted as soon
as possible.
WRONG ANSWER RATIONALES:
B) auscultation of the pump is prudent to determine if the pump is functioning properly. device
failure has been reported as the second most common cause of death in LVAD patients. signs
of pump failure include absence of power light on the controller, undetectable blood pressure
while using the Doppler, and inability to auscultation the motor.
C) IV fluids only indicated if MAP is low
, D) compressions no indicated in conscious patient
A patient being evaluated in the ED is noted to have Janeway lesions, Roth's spots, and Osler's
nodes along with elevated body temperature and elevated WBC. Patient assessment reveals
the presence of several recent body piercings. The ED. It's suspects the patient has:
A. Endocarditis
B. Pericarditis
C. Myocarditis
D. Leukemia - ANS-A) Endocarditis
The patient's symptoms are classic for endocarditis. Janeway lesions are petechial lesions
found on the palms of the hands or soles of the feet. Osler's nodes are defined as painful
fingertip lesions, and Roth's spots are retinal hemorrhages with the presence of whitish spots in
the center. The patient may experience fevers along with an elevated WBC. Recent body
piercings may be a source of infections leading to endocarditis. The endocarditis infection may
also spread to valve structures in the heart, resulting in permanent valvular dysfunction.
WRONG ANSWER RATIONALES:
B) pericarditis is characterized by elevated WBC, a pericardial friction rub, and ST changes
throughout the EKG.
C) myocarditis is characterized by chest pain, cardiac rhythm abnormalities, poor nutrition and
fatigue. myocarditis is typically a viral infection that presents with fevers and elevated WBC.
D) leukemia is diagnosed by abnormalities in WBC counts
A patient comes in with chest pain, diaphoresis, denies dyspnea. VSS, breath sounds clear and
equal, EKG shows inferior wall ST segment elevation. You anticipate the following oxygen order:
A. No supplemental oxygen
B. Nasal cannula at 6 L per minute
C. Partial rebreather mask at 10 L per minute
D. Nonrebreather mask at 15 L per minute - ANS-A. No supplemental oxygen at this time as it is
not indicated in normoxia. Giving supplemental oxygen in the setting of normoxia does not
improve outcome and has been shown to extend the size of an MI.
A patient complains of chest pain, dyspnea, and diaphoresis. Which of the following assessment
factors would indicate a possible diagnosis of acute coronary syndrome?
