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CARDIAC QUESTIONS

CCRN

QuestionAnswer
Pericardial tamponade presents with which of the following symptoms? A. equalization of left and right atrial pressures (CVP and PAOP). B. hypotension C. distended neck veins.
Dysfunction of the pappillary muscle producing mitral regurgitation would be seen in which part of the left atrial PAOP tracing? GIANT V WAVES
Phase 0 of cellular impulse transmission refers to which phase of electrical action? DEPOLARIZATION
Spontaneous diastolic depolarization occurs during which phase of the cardiac action potential? PHASE 4
Which component of blood pressure regulation has the strongest effect on controlling the blood pressure? SVR
Normally , at approximately which PAOP does lung water begin to accumulate? > 18 mmHg
Which neurologic structure or system has the strongest effect on regulating the heart rate? PARASYMPATHETIC NERVOUS SYSTEM
Which could produce giant A waves? MITRAL STENOSIS
Posterior hemiblock is seen when which conduction defect occurs? Blockage of the posterior portion of the left bundle.
Which of the following leads are used in the diagnosis of a RV MI? V1, V2, V4R, V6R
An atrial premature beat with aberrant conduction usually has which characteristics? RBBB
APCs with abberant conduction is associated with. RBBB
PVCs are associated with. A. taller left peak (Rr'). B. marked left axis deviation. C. rS pattern in V6.
Define precordial concordancy. All QRS complexes have the same axis in V1 to V6.
Which type of dysrhythmia is more likely to occur in inferior as opposed to anterior MI? SECOND-DEGREE TYPE I
Anterior hemiblock is manifest by which 12-lead ECG patterns? left axis deviation greater than -30 degrees.
Posterior hemiblock is manifest by which of the following 12-lead ECG patterns? RIGHT AXIS DEVIATION GREATER THAN +90 DEGREES.
LV hypertrophy is manifest by which of the following ECG changes? S wave in V1 and R wave in V5 totaling > 35mm.
Which are examples of AV dissociation? VENTRICULAR TACHYCARDIA. THIRD-DEGREE HEART BLOCK. ATRIAL TACHYCARDIA WITH A 2:1 BLOCK.
Based on the diagnosis of inferior MI, how long will bradycardia last? IT WILL USUALLY BE TRANSIENT AND POSSIBLY SYMPTOMATIC.
What is the inherent rate of the AV nodal area? 40 - 60
Which type of dysrhythmia is more likely to occur in anterior than inferior MIS? SECOND-DEGREE TYPE II
Which lead is most likely to detect aberrantly conducted APCs? V1 LEAD
ECG changes seen in APCs. A. second R wave larger than the first in V1. B. RBBBC. right axis deviation.
Which isoenzyme is most diagnostic in identifying MI? TROPONIN I
Which stage of CHF poses a high risk of heart failure but is not associated with structural disease or symptoms? STAGE A
Troponin stays how long elevated following a MI? ABOUT 3 HRS
Which type of medication is common in the treatment of unstable angina? BETA BLOCKERS
Complications of thrombolytic therapy are. A. bradycardia. B. bleeding from venipuncture sites. C. ventricular ectopy.
Which is an indication for angioplasty or stent placement? PROXIMAL STENOSIS OF A CORONARY ARTERY
What are treatments for Prinzmetal's variant angina? NITRATES, CALCIUM CHANNEL BLOCKERS, PRAZOSIN
Indications for thrombolytic therapy. ONSET OF PAIN LESS THAN 4 HRS EARLIER
Dopamine is used with caution in patients with MI for which reason? ITS POTENTIAL FOR INCREASING MYOCARDIAL OXYGEN CONSUMPTION
What are characteristic of Prinzmetal's variant angina? UNPROVOKED CHEST PAIN WITH ST-segment ELEVATION
Pulsus paradoxus is utilized to identify which condition? CARDIAC TAMPONADE
Orthostatic hypotension is manifest by the following clinical symptoms following a change from lying down to sitting up. A fall in systolic blood pressure of > 25 mmHg and a decrease in diastoolic blood pressure of > 10 mmHg.
Which inflammatory marker is suggestive of coronary artery inflammation? INCREASED C-REACTIVE PROTEIN (CRP)
Furosemide is considered to affect primarily which component of stroke volume? PRELOAD
The statin category of drugs exerts its beneficial effect by which of the mechanism? REDUCING LDL LEVELS AND ANTI-INFLAMMATORY PROPERTIES
Identify the signs associated with CHF. A. DEPENDENT CRACKLES IN THE LUNGS. B. S3 HEART SOUND. C. DEPENDENT EDEMA.
Which medications produce vasodilation that could be useful in the treatment of CHF? CALCIUM CHANNEL BLOCKERS
Pericarditis presents on the 12-lead ECG with which changes? GENERALIZED ELEVATION OF ST SEGMENTS
Which are symptoms of pericarditis? A. FEVER B. INCREASED PAIN IN THE LEFT LATERAL POSITION C. PERICARDIAL FRICTION RUB
Where should inflation of the balloon in an intraortic balloon pump occur? NEAR THE DICROTIC NOTCH
Which is one danger of abdominal aortic aneurysm repair? OBSTRUCTION OF RENAL BLOOD FLOW
Deflation of the balloon in an IABP should occur at what point? BEFORE THE QRS COMPLEX
Hypovolemic shock differs from cardiogenic shock by exhibiting which hemodynamic changes LOW PRELOAD
Which are two benefits of an IABP assist? DECREASED AFTERLOAD AND INCREASED CORONARY ARTERY FILLING
Cardiogenic shock is characterized by the following parameters? I. CARDIAC INDEX LESS THAN 2.2 L/min/m2II. PAOP greater than 22 mmHg
Which would not be an expected treatment in CHF? CALCIUM CHANNEL BLOCKER
Which parameters best seperate dilutional from actual decreases in the hematocrit and hemoglobin? STROKE VOLUME, HEART RATE, AND PAOP
What are indications for CABG? UNSTABLE ANGINA, 90% NARROWING OF THE LAD CORONARY ARTERY, MULTIPLE-VESSEL STENOSIS
Which blood vessel is commonly used as the graft vessel in a CABG? INTERNAL MAMMARY ARTERY
What is the best method to treat cardiomyopathy? HEART TRANSPLANTATION
Approximagtely what percent of heart transplant recipients are alive after 5yrs? 50 to 75 %
What is the most common type of aortic aneurysm? ABDOMINAL
Dissection of an artery occurs because of which type of injury to the blood vessel? INTIMAL TEAR
What is the most common complication causing death following aortic surgery? MI
What are symptoms of obstructed arterial flow? A. PALLOR OF THE SKIN. B. INTERMITTENT CLAUDICATION. C. DECREASED PULSES.
What is a common sign of acute arterial obstruction? PAIN DISTAL TO THE OBSTRUCTION
Which physical sign would correlate with cardiac contusion? TACHYCARDIA DISPROPORTIONATE TO INJURY
It's best for the nurse to auscultate for heart murmurs by listening. In the direction of the blood flow, at the intercostal spaces.
When the nurse auscultates a murmur at the apex , it may be related to a. Mitral valve defect.
Asystolic murmur will be auscultated when regurgitant blood flows across which of the following heart valves? Mitral and tricuspid.
During chest auscultation, which heart murmurs would occur during systole? a. Tricuspid isufficiency. b. Aortic stenosis. c. Mitral insufficiency.
The nurse understands that a patient with a recent myocardial infarction and a pansystolic murmur loudest at the apex associated with a thrill would indicate Mitral insufficiency.
Regurgitant blood flow across which valves would cause a diastolic murmur? Pulmonic and aortic
The nurse identifies a diastolic murmur as the forward blood flow across which stenotic valves? Mitral and tricuspid
S3 heart sounds A. It can be best heard with the patient siting foward or in thew left lateral position. B. The absence of an S3 does not rule out the diagnosis of heart failure.C. It is heard immediately following closure of the semi-lunar valves.
Which best describes systolic heart failure? Systolic heart failure occurs when the left ventricle does not contract with enough force.
Nesiritide (Natrecor) 1. A brain natriuretic peptide, used in the management of acute heart failure. 2. It enhances sodium excreation and vasodilation. 3.It may result in a decrease in pulmonary capillary wedge pressure (PCWP) 4. It causes and increase inn urinary output.
INTRA-AORTIC BALLOON PUMP (IABP) Afterload reduction is a primary effect of intra-aortic balloon counterpulsation.During intra-aortic balloon counterpulsation systolic and diastolic blood pressures are reduced, but the MAP is elevated.
Created by: nerdismart