FCCN LEVEL 1 EXAM QUESTIONS
WITH COMPLETE OPTIONS
mean (MAP) ANSW✅✅- average pressure for circulation
- normal 70-105
- MAP < 60 is inadequate
blood pressure pitfalls ANSW✅✅- insensitive sign of early shock
- must compare to patient baseline
- first BP should always be done manually
*just because you have a BP does not mean the body is being perfused
3 components of stroke volume ANSW✅✅preload = blood volume
afterload = resistance (how clamped or dilated the vessels are)
contractility = Squeeze of the heart
preload ANSW✅✅- amount of fluid that is returning to the heart
- edema is not a part of intravascular volume
- you can have a lot of edema and be dehydrated at the same time
how constriction/dilation affected preload ANSW✅✅dilation = less preload (more dry)
constriction = more preload (more wet)
optimizing perfusion - preload ANSW✅✅low preload = give fluid (blood, fluids, colloids)
,high preload = give diuretics/vasodilators/dialysis
your patient is experiencing angina, the provider orders nitroglycerin. what do you anticipate will
happen
a. blood pressure will drecrease
b. preload will increase
c. preload will decrease
d. A and C ANSW✅✅D
optimizing perfusion - afterload ANSW✅✅- since the heart ejects into the arteries....the arteries
affect the afterload
- constricted = more resistance and decreased CO
- dilated = less resistance and increased CO
high afterload ANSW✅✅- constricted arteries
- physical assessment (cool extremities, pale, mottled
- treat = dilate arteries (ACE inhibitors, ARBs, morphine, rewarm patient)
SOO how to optimize perfusion ANSW✅✅1. consider fluid status
2. consider how clamped down the patient is
3. consider squeeze of the heart
low afterload ANSW✅✅- low resistance = dilated arteries
- caused by sepsis, neurogenic shock
, - physical = flushed and red skin, low BP
- treatment = ICU for vasopressors
the patient has developed new coarse crackles, SOB, and JVD. he has a hx of CHF and pitting edema
in the extremities. all of the assessments indicate he has high preload EXCEPT
a. course crackles
b. SOB
c. JVD
d. edema ANSW✅✅d
Pt. has dry mouth, tachycardia and low UO after diuresing 1.5 L from lasix. he has weak pedal pulses
and pale lower extremities. Which best describes his hemodynamics
a. high preload and vasodilated
b. high preload and vasoconstricted
c. low preload and dilated
d. low preload and constricted ANSW✅✅d
what is blood pressure ANSW✅✅- MAP = CO x SVR
- increase in CO or SVR will increase MAP and vice versa
- patient with MAP of 60 can have high or low CO and high or low SVR
*a good BP does not mean good perfusion*
V1 and V2 look at what part of the heart ANSW✅✅- septum
V3 and V4 look at what part of the heart ANSW✅✅- anterior
WITH COMPLETE OPTIONS
mean (MAP) ANSW✅✅- average pressure for circulation
- normal 70-105
- MAP < 60 is inadequate
blood pressure pitfalls ANSW✅✅- insensitive sign of early shock
- must compare to patient baseline
- first BP should always be done manually
*just because you have a BP does not mean the body is being perfused
3 components of stroke volume ANSW✅✅preload = blood volume
afterload = resistance (how clamped or dilated the vessels are)
contractility = Squeeze of the heart
preload ANSW✅✅- amount of fluid that is returning to the heart
- edema is not a part of intravascular volume
- you can have a lot of edema and be dehydrated at the same time
how constriction/dilation affected preload ANSW✅✅dilation = less preload (more dry)
constriction = more preload (more wet)
optimizing perfusion - preload ANSW✅✅low preload = give fluid (blood, fluids, colloids)
,high preload = give diuretics/vasodilators/dialysis
your patient is experiencing angina, the provider orders nitroglycerin. what do you anticipate will
happen
a. blood pressure will drecrease
b. preload will increase
c. preload will decrease
d. A and C ANSW✅✅D
optimizing perfusion - afterload ANSW✅✅- since the heart ejects into the arteries....the arteries
affect the afterload
- constricted = more resistance and decreased CO
- dilated = less resistance and increased CO
high afterload ANSW✅✅- constricted arteries
- physical assessment (cool extremities, pale, mottled
- treat = dilate arteries (ACE inhibitors, ARBs, morphine, rewarm patient)
SOO how to optimize perfusion ANSW✅✅1. consider fluid status
2. consider how clamped down the patient is
3. consider squeeze of the heart
low afterload ANSW✅✅- low resistance = dilated arteries
- caused by sepsis, neurogenic shock
, - physical = flushed and red skin, low BP
- treatment = ICU for vasopressors
the patient has developed new coarse crackles, SOB, and JVD. he has a hx of CHF and pitting edema
in the extremities. all of the assessments indicate he has high preload EXCEPT
a. course crackles
b. SOB
c. JVD
d. edema ANSW✅✅d
Pt. has dry mouth, tachycardia and low UO after diuresing 1.5 L from lasix. he has weak pedal pulses
and pale lower extremities. Which best describes his hemodynamics
a. high preload and vasodilated
b. high preload and vasoconstricted
c. low preload and dilated
d. low preload and constricted ANSW✅✅d
what is blood pressure ANSW✅✅- MAP = CO x SVR
- increase in CO or SVR will increase MAP and vice versa
- patient with MAP of 60 can have high or low CO and high or low SVR
*a good BP does not mean good perfusion*
V1 and V2 look at what part of the heart ANSW✅✅- septum
V3 and V4 look at what part of the heart ANSW✅✅- anterior
