Complex Med Surg Exam 1

Front 1

Which of the following ECG components represent ventricular depolarization?

A. QRS complex. B. PR interval

C. P wave. D. T wave

Back 1

A. QRS complex

Front 2

On an ECG each small box represents how many seconds?

A. 0.4 B. 0.04

C. 1. D. 0.02

Back 2

B. 0.04 seconds

Front 3

On an ECG each large box represents how many seconds?

A. 0.02 B. 1

C. 0.2 D. 0.4

Back 3

0.2 seconds

Front 4

What is the normal range of the PR interval?

A. 0.06 - 0.12 seconds

B. 0.04 - 0.10 seconds

C. 0.12 - 0.20 seconds

D. 0.05 - 1 second

Back 4

C. 0.12 - 0.20 seconds

Front 5

What is the normal range of the P wave duration?

A. 0.12 - 0.20 B.0.04 - 0.10

C. 0.5 - 1 D. 0.06 - 0.12

Back 5

D. 0.06 - 0.12

Front 6

What is the normal range of the QRS complex duration?

A. 0.12 - 0.20 B. 0.04 - 0.10

C. 0.5 - 1 D. 0.06 - 0.12

Back 6

B. 0.04 - 0.10

Front 7

Which of the following EKG components represents ventricular repolarization. SATA

A. PR interval B. T wave

C. P Wave D. QRS complex

E. QT interval

Back 7

B. T wave

E. QT interval

Front 8

Calculate the HR for an irregular rhythm with 7 QRS complexes shown on a 6 second strip?

A. 50 bpm B. 70 bpm

C. 110 bpm C. 100 bpm

Back 8

B. 70 bpm

Front 9

Which method is most accurate to determine the HR for a regular rhythm?

A. P wave method

B. 6 sec strip method

C. Small block method

D. Big block method

Back 9

C. Small block method

Front 10

Which method can be used to determine the heart rate for an irregular rhythm?

A. Small block method

B. Big block method

C. 6 second strip method

D. P wave method

Back 10

C. 6 second strip method

Front 11

What are plavix and ASA ?

Back 11

Antiplatelets

Front 12

What are Coumadin (warfarin), heparin, lovenox, elaquis and xarelto?

Back 12

Anticoagulants

Front 13

What are TPA’s (tissue plasminogen activase)

Back 13

Thrombolytic/fibrolytic

Front 14

Treatment for MI?

Back 14

O2 - Nitro - morphine - chew aspirin

Front 15

What tells the degree of damage to heart with MI?

Back 15

Troponin

Front 16

What tells where the damage is in the heart with MI?

Back 16

ECG 12 lead

Front 17

Cardiac Tamponade signs and symptoms?

Back 17

BECKS TRIAD

B- JVD

E- extreme low BP (hypotension)

C- can’t hear heart sounds(muffled)

K- Pulse paradoxes - systolic drop of 10 mmhg (120/80 to 110/80)

ECG shows QRS complexes (short & uneven height)

Front 18

If taking Coumadin and flaxseed, how do you give them to patient?

Back 18

Give flaxseed 1 to 2 hours before Coumadin.

Front 19

What do you give for asystole or PEA?

Back 19

Epinephrine every 3 to 5 minutes

Front 20

What do you give for bradycardia?

Back 20

Atropine

Front 21

What do you do if patient is in V-fib or V Tach with no pulse?

Back 21

Defibrillation

Front 22

If you walk in and patient is on floor not breathing, no pulse ?

Back 22

Look, listen, feel

Give 2 rescue breaths

Start CPR

Front 23

What do you need to monitor when patient is on heparin?

Back 23

Platelet count

PTT

Front 24

What is the antidote for Coumadin?

Back 24

Vit K

Front 25

What do you watch for on a patient postop having a pacemaker put in?

Back 25

Hiccups ( lead wire perforation)

Front 26

Why is morphine given after bypass surgery?

Back 26

Promote deep breathing

Front 27

If no order for code status what do you do?

Back 27

CPR is given if no orders for no code

Front 28

Treatment for V Tach with pulse and symptomatic?

Back 28

Meds

Synchronized Cardioversion

Front 29

Hypervolemia (fluid overload) associated with HF. What are signs/symptoms?

Back 29

Increase BP, HR, Resp, urine output,

Decrease urine specific gravity, electrolytes, h & h.

Crackles, JVD

Front 30

Hypovolemia (dehydration) signs & symptoms?

Back 30

Increase HR, urine specific gravity, electrolytes and H&H

Decrease BP, urine output

Thready pulse

Skin tenting

Front 31

Low potassium effects what on ECG?

Back 31

U wave

Front 32

High potassium effects what on ECG?

Back 32

Peaked T wave

Front 33

Lab for heparin? Normal range? Therapeutic range?

Back 33

Lab - PTT , normal 20 to 30 seconds, therapeutic 1.5 to 2.5 x normal range.

Front 34

Lab for Coumadin? Normal? Therapeutic?

Back 34

Lab - PT

Normal- 11 to 12.5

INR-0.8-1.1

Therapeutic- 2 to 3

Front 35

Antidote for heparin?

Back 35

Protamine sulfate

Front 36

A patient is in hypervolemia how would it effect CBP?

Back 36

CBP would be elevated

Front 37

A patient is dehydrated. How would this effect CBP?

Back 37

CBP would be low

Front 38

After giving nitro monitor for?

Back 38

Hypotension

Front 39

Infective endocarditis s/s?

Back 39

Chest pain, SOB

Late signs- fever and splinter hemorrhages (spider like)

Front 40

IV drug use causes what?

Back 40

Infective endocarditis

Front 41

A nurse is assessing a client with heart failure who has gained 4 pounds in 3 days, ankles swollen and SOB. Which medication will need to be increased?

A. Hydralazine B. Lisinopril

C. Furosemide D. Bisoprolol

Back 41

C. Furosemide

Front 42

A nurse is teaching a student nurse about cardioversion. Which of the following should nurse include in teaching?

A. Use ultrasound gel on the conductor paddles

B. Place the conductor paddles over clients clothing

C. Avoid touching the clients bed during the procedure

D. Turn the synchronize mode off prior to procedure

Back 42

C. Avoid touching the clients bed during the procedure

Front 43

Which of the following complications would be most likely to occur following cardioversion?

A. Stroke

B. HTN

C. Nausea/Vomiting

D. Urinary incontinence

Back 43

A. Stroke

Front 44

Which of the following laboratory tests would be performed on a client with suspected myocardial infarction? SATA

A. Anti endomysial antibodies

B. CK-MB

C. Troponin

D. D-dimer

E. Chromogranin-A

Back 44

B. CK-MB

C. Troponin

Front 45

What is a nurse?

Back 45

Coordinator, motivator, evaluator, assessor

Front 46

What a nurse is NOT?

Back 46

Not a self confessor

Not a dominator

Front 47

Contraction is?

Back 47

Depolarization

Front 48

Relaxation is?

Back 48

Repolarization

Front 49

How does garlic affect Coumadin?

Back 49

Increases the absorption of Coumadin so might need Coumadin adjusted. Watch PT close.

Front 50

What signifies acute injury, the person is in the process of having a MI?

Back 50

ST elevation

Front 51

What may indicate ischemia or subendocardial MI?

Back 51

ST depression

Front 52

What only gives off low energy electrical pulses to correct certain irregular heartbeats?

Back 52

Pacemaker

Front 53

What can give off high energy electrical pulses needed to correct dangerous arrhythmias in the lower chambers of the heart(Ventricles)?

Back 53

ICD

Front 54

Weakness in section of dilated artery that causes ballooning of the wall of the vessel is?

Back 54

Aneurysm

Front 55

S/sx of AAA

Back 55

Pulsating abd mass (DONT PALPATE), bruit, elevated BP, flank or abd pain, gnawing feeling in abd

Front 56

Treatment for aneurysm?

Back 56

Anti-hypertensives

Surgery:AAA resection

Front 57

What size aneurysm is more likely to rupture in one year?

Back 57

>6cm

Front 58

Amount of blood pumped with contraction (depolarization)?

Back 58

Cardiac output

Front 59

Normal CVP (central venous pressure or right atrial pressure) ?

Back 59

0-5 mmHg

Front 60

Normal PAP (pulmonary artery pressure)? (Left side HF)

Back 60

20 - 30 mmHg (systolic)

7 - 12 mmHg (Diastolic)

Front 61

Normal PCWP (pulmonary capillary wedge pressure)? (Associated with Left side heart failure)

Back 61

8 - 12 mmHg

Front 62

Left sided heart failure =?

Back 62

Lungs

Front 63

Right sided heart failure =?

Back 63

Rest of body

Front 64

How often do you weigh with HF?

Back 64

Daily

Front 65

How much weight gain is to be reported with HF patient to PCP?

Back 65

1-2 lbs a day or 3-5 lbs a week

Front 66

Left sided HF symptoms?

Back 66

Dyspnea

Yellow secretions

Stridor decreased SaO2

Pulmonary crackles,

Nasal flaring grunting

Elevation in P, RR

Activity intolerance

Front 67

Right side HF symptoms

Back 67

Enlarged liver

Distended neck veins JVD

Enlarged spleen

Most edema in lower extremities

Ascites, increased wt >2 lbs in 24 hours

Edema will cause increase in HR, BP, RR, confusion

Front 68

Patient at home having angina and has nitro, when should they call 911?

Back 68

if your angina lasts longer than 5 minutes and 1 tablet has not relieved it.

Front 69

Causes of a aneurysm

Back 69

HTN, trauma, birth defect, weakening of artery wall, smoking/drinking, poor diet

Front 70

Aneurysm prevention

Back 70

Exercise, stop smoking, meditation, diet

Front 71

Diagnose a aneurysm

Back 71

CT, MRI, angiography

Front 72

A patient with A-fib is at risk for?

Back 72

Clots

Front 73

Asymptomatic A-fib how to treat?

Back 73

O2, IV, Monitor and figure out cause

Front 74

Patient symptomatic A-fib. How do we treat?

Back 74

Anti arrythmics-cardizem

Amiodarone IV

Adenosine

Sometimes beta blocker

Anticoagulant

Front 75

Used to correct heart arrhythmias not treatable with meds such as A-fib?

Back 75

Ablation