Alyssa Magill
Quiz by , created more than 1 year ago

PCCN review questions

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Alyssa Magill
Created by Alyssa Magill almost 5 years ago
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Cardiac PCCN

Cardiac PCCN

Question 1 of 24

1

Which of the following is most likely the cause of a systolic murmur auscultated at the R sternal border, 2nd ICS?

Select one of the following:

  • Mitral stenosis

  • Aortic stenosis

  • Mitral insufficiency

  • Aortic insufficiency

Explanation

Question 2 of 24

1

A murmur associated with mitral stenosis is best auscultated

Select one of the following:

  • at the left mid-clavicular line, during diastole

  • at the left mid-clavicular line, during systole

  • at the right sternal border, during diastole

  • at the right sternal border, during systole

Explanation

Question 3 of 24

1

pt presents in heart failure with acute SOB. When auscultating lung sounds you observe crackles through all lung fields. You also expect to hear which heart tone?

Select one of the following:

  • S4

  • Split S1

  • Pericardial friction rub

  • S3

Explanation

Question 4 of 24

1

pt with mitral insufficiency is prone to which of the following dysrhythmias?

Select one of the following:

  • complete heart block

  • AV dissociation

  • A fib

  • 2nd degree AV block, type 1

Explanation

Question 5 of 24

1

pt with aortic stenosis, you can expect which of the following upon exam

Select one of the following:

  • narrowed pulse pressure

  • diastolic murmur

  • systolic murmur

  • widened pulse pressure

Explanation

Question 6 of 24

1

Which of the following is used to treat coronary vasospasm caused by variant (prinzmetal's) angina?

Select one of the following:

  • alpha-adrenergic blocking agent

  • beta-adrenergic blocking agent

  • calcium channel blocking agent

  • cholinergic agent

Explanation

Question 7 of 24

1

pt presents with chest pain and ST segment elevation in leads II, III and aVF. You know the patient is experiencing an infarction in which wall of the heart?

Select one of the following:

  • Anterior wall

  • Inferior wall

  • Posterior wall

  • Lateral wall

Explanation

Question 8 of 24

1

56 yo F presents with sub-sternal chest pain. 12 lead ECG reveals ST segment elevation in leads II, III, and aVF. You would expect reciprocal changes in which leads?

Select one of the following:

  • v1, v2

  • I, aVL

  • aVR, aVL, v1

  • v3, v4

Explanation

Question 9 of 24

1

pt with an inferior wall MI and right ventricular infarction develops tachycardia and hypotension. What would be the best initial treatment for hypotension?

Select one of the following:

  • Nitroglycerin infusion

  • Dopamine infusion

  • Dobutamine

  • Fluid (crystalloid) boluses

Explanation

Question 10 of 24

1

Which of the following complications would the nurse assess for after an arteriogram?

Select one of the following:

  • impaired renal function

  • acid-base imbalance

  • elevated liver enzymes

  • increased mean arterial pressure

Explanation

Question 11 of 24

1

Which type of heart block would you monitor for if your patient has an anterior wall MI?

Select one of the following:

  • 1st degree AV block

  • 2nd degree type I (Wenckebach)

  • 2nd degree type II

  • sinus bradycardia

Explanation

Question 12 of 24

1

pt with mid sternal chest pain that is bettwe when sitting up and leaning forward. NSAIDs are the only medication relieving the pain. the pt is likely experiencing

Select one of the following:

  • acute anterior wall MI

  • acute pericarditis

  • acute lateral wall MI

  • acute decompensated heart failure

Explanation

Question 13 of 24

1

58 year old with anterior wall MI 2 days ago has CP and dizziness, upon auscultation you note a new loud systolic murmur. what do you suspect may be the issue

Select one of the following:

  • acute tricuspid regurgitation

  • acute aortic stenosis

  • L ventricular outflow obstruction

  • acute papillary muscle dysfunction

Explanation

Question 14 of 24

1

Clinical signs of cardiogenic shock secondary to acute left ventricular failure include:

Select one of the following:

  • hypotension, S4 heart sound, pericardial friction rub

  • S3 heart sound, hypotension, systolic murmur

  • diastolic murmur, s4 heart sound, hypertension

  • crackles, s3 heart sound, hypotension

Explanation

Question 15 of 24

1

HF pt develops hypotension, tachycardia, decreasing LOC, cool clammy skin, decreasing UOP and tachypnea. Which would be included in plan of care?

Select one of the following:

  • positive inotropic agents, diuretics & vasodilators ensuring BP & perfusion are adequate

  • ACE inhibitors, adenosine, beta blockers

  • beta blockers, diuretics, CCBs

  • negative inotropic medications, digoxin, anti-dysrhythmics

Explanation

Question 16 of 24

1

HF pt develops hypotension, tachycardia, decreasing LOC, cool clammy skin, decreasing UOP & tachypnea. Which would be included in plan of care?

Select one of the following:

  • positive inotropic agents, diuretics, vasodilators ensuring BP & perfusion are adequate

  • ACE inhibitors, adenosine, beta blockers

  • beta blockers, diuretics, CCBs

  • negative inotropic medications, digoxin, antidysrhythmics

Explanation

Question 17 of 24

1

the primary effect & rationale for using dobutamine in cardiogenic shock is to

Select one of the following:

  • decrease myocardial ischemia

  • improve urine output

  • improve myocardial contractility

  • increase oxygen consumption

Explanation

Question 18 of 24

1

signs of cardiac tamponade include

Select one of the following:

  • increased CVP, narrow pulse pressure & hypertension

  • wide mediastinum on chest xray, narrow pulse pressure & hypotension

  • widening pulse pressure, hypotension & elevated CVP

  • a fall in SBP > 10mmHg during inspiration, decreased CVP & hypotension

Explanation

Question 19 of 24

1

A 54 yo patient with mild HF goes into SVT at a rate of 176, BP is 96/58. vagal maneuvers were unsuccessful. The nurse should anticipate which of the following?

Select one of the following:

  • administration of amiodarone 150mg followed by an infusion

  • synchronized cardioversion

  • administration of adenosine

  • precordial thump to the mid-sternum

Explanation

Question 20 of 24

1

52 yo male just underwent CABG x3. He has been in NSR and suddenly converts into Afib at a rate of 160. His BP drops to 72/46 & is feeling SOB. You anticipate which of the following?

Select one of the following:

  • Adenosine 6mg rapid IVP

  • Defibrillation with 100 joules

  • synchronized cardioversion with 100 joules

  • Diltiazem bolus followed by an infusion

Explanation

Question 21 of 24

1

Ibutilide (corvert) 1mg IV over 10 min is started for a pt in rapid Afib, you know you must discontinue ibutilide for which of the following reasons?

Select one of the following:

  • prolonged PR interval

  • development of PJCs

  • Narrowing QRS

  • prolonged QT interval

Explanation

Question 22 of 24

1

Long term medical management for heart failure include which of the following?

Select one of the following:

  • beta blockers, ACE inhibitors & aldosterone antagonists

  • ACE inhibitors, ARBs and vasopressors

  • ARBs, beta blockers & CCBs

  • Beta blockers, ACE inhibitors & CCBs

Explanation

Question 23 of 24

1

A medication regimen for a patient with hypertrophic cardiomyopathy would include

Select one of the following:

  • cardiac glycosides & beta blockers

  • beta blockers & vasopressors

  • CCBs & beta blockers

  • vasopressors & inotropes

Explanation

Question 24 of 24

1

pt is POD for cardiac transplant. develops symptomatic bradycardia, your best action would be

Select one of the following:

  • administer atropine 1mg IV and apply 100% O2

  • connect epicardial pacing wires to a generator and pace the patient

  • give atropine and start an Isuprel infusion

  • start a dopamine infusion

Explanation

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