Exam

Question 1

The two semilunar valves are the:

Answer 1

Aortic & Pulmonic

Question 2

Which of the following statements are true regarding coronary arteries:

Answer 2

Adequate diastolic blood pressure must be maintained to ensure adequate coronary perfusion

Question 3

All of the following statements are true regarding the cardiac cycle EXCEPT:

Answer 3

Diastole usually takes up 1/3 of the cardiac cycle

Question 4

Which of the following statements are true regarding atrial contraction:

Answer 4

B&C

Question 5

Beta-blockers:

Answer 5

Decrease HR and are negative inotropes

Question 6

Norepinephrine increases coronary blood flow by which of the following mechanisms:

Answer 6

Vasoconstriction and increased blood pressure

Question 7

Adenosine:

Answer 7

All of the above

Question 8

Which of the following statements regarding calcium channel blockers is true:

Answer 8

Verapamil is classified as a Class IV antiarrhythmic and is used to treat SVTs

Question 9

Contraindications to calcium channel blockers include all of the following except:

Answer 9

Coronary artery spasm

Question 10

Which of the following drugs decreases myocardial contractility and as a result may cause hypotension:

Answer 10

Diltiazem, metoprolol, and esmolol

Question 11

What is the USUAL dosage of dopamine used to increase cardiac output/blood pressure:

Answer 11

3-10 mcg/kg/min

Question 12

Which of the follow drugs can cause tissue necrosis if extravasation occurs and thus should be infused into a central line if at all possible?

Answer 12

Norepinephrine & Dopamine

Question 13

All of the following statements are true regarding chest tubes EXCEPT:

Answer 13

The chest tube should be clamped during patient transport

Question 14

Mr. Robert Smith is a 69 YO admitted to the CICU with ST elevation in leads V2-V4. Which of the following statements are true regarding this patient:

Answer 14

The patient should be monitored for signs of LV failure

Question 15

A patient is being treated for STEMI is likely to receive:

Answer 15

All of the above

Question 16

You notice that your PA waveform now appears to be an RV tracing. Which of the following actions would be most appropriate:

Answer 16

Turn the patient on their left side and inflate the balloon

Question 17

Right ventricular diastolic pressure is approximately equal to:

Answer 17

Right atrial mean pressure

Question 18

Preload:

Answer 18

May be estimated by measuring PAD or PAWP

Question 19

Afterload:

Answer 19

A&C

Question 20

In the absence of pulmonary disease, left ventricular end diastolic pressure can be estimated by:

Answer 20

B&C

Question 21

Increasing inspiratory pressure readings (or peak airway pressure) on a ventilator suggests a need for:

Answer 21

Suctioning

Question 22

The high pressure alarm on a ventilator may be triggered by all of the following EXCEPT:

Answer 22

A leaking endotracheal tube cuff

Question 23

Mr. Graft is a 60 YO male who underwent a thoracic aneurysm repair. Upon return to the CICU from OR he is cold and clammy, with all the following hemodynamic data:
HR 120, BOP 80/64 RR 12 T 36.3 CVP 2 PAWP6 CO 4 SVR 1860

Based on the above data, which of the following would be appropriate first-line therapy?

Answer 23

Volume replacement

Question 24

The right atrial pressure reflects (CVP):

Answer 24

Right sided preload

Question 25

Which of the following electrolytes should be evaluated in a patient with frequent ventricular ectopy?

Answer 25

Potassium & Magnesium

Question 26

The letters in the three-letter pacing code used for temporary pacing stand for:

Answer 26

Chamber paced, chamber sensed, response to sensing

Question 27

Signs of cardiac tamponade include:

Answer 27

B&C

Question 28

Gloves should be worn when manipulating temporary epicardial pacer wires in order to:

Answer 28

Protect the patient form stray electrical current

Question 29

When obtaining hemodynamic measurements, the pressure transducer should be leveled to:

Answer 29

The 4th intercostal space, 1/2 the AP diameter of the chest

Question 30

You are caring for a patient with a PA catheter. His PA pressure were 30/15 this morning but now you note that they are 27/3 with an acute change in the waveform and increasing ventricular ectopy. Which of the following is the most likely cause:

Answer 30

PA catheter has slipped into the RIGHT ventricle

Question 31

Your patient is on CPAP and breathing spontaneously. Which of the following describes the location of where to obtain your CVP reading?

Answer 31

End-expiration, at the end of the highest deflection

Question 32

Your patient is on AC ventilation. Which of the following decreasing the location of where to obtain your CVP reading?

Answer 32

End-expiration, at the end of the lowest deflection

Question 33

Potential complications associated with the use of higher levels of PEEP include:

Answer 33

Barotrauma / decreased cardiac output

Question 34

You are caring for a patient who has pneumonia and a history of cardiac problems. One hour after admission, the monitor alarms and you note sinus bradycardia at 36. The patient's BP is 70/40 and they are complaining of fleeing nauseated. Based on ALS guidelines, which intervention would you anticipate:

Answer 34

Atropine Prepare for transvenous pacing

Question 35

ICU sedation should always be titrated:

Answer 35

To an ordered RASS score

Question 36

Which of the following statements re: amiodarone is TRUE:

Answer 36

It can be used to treat both atrial and ventricular arrhythmias

Question 37

You are caring for a patient who is admitted with a diagnosis of pneumonia. During the admission assessment, the patient suddenly stops talking, and you note VFib on the monitor. The most appropriate intervention at this point would be:

Answer 37

Begin CPR and defibrillate with 200 joules as soon as possible.

Question 38

Initial treatment of emergent cardiac complications related to hyperkalemia will most likely include all of the following EXCEPT:

Answer 38

Administration of kayexalate

Question 39

Mr. Jones is admitted from the OR following repair of a perforated bowel. During the 4-hour surgery, Mr. Jones received 4 units of PRBC's and 3 L of lactated Ringer's solution. The morning after his surgery, the following hemodynamic profile is obtained: CO: 10.2 CI 4.8 CVP:4 PAWP:8 SVR:542 HR 117 BP 80/60 These hemodynamic numbers are consistent with a diagnosis of:

Answer 39

Septic Shock

Question 40

Your patient had a post-op hematocrit of 22.4 and the physician ordered two units of PRBC's to be given. During the first unit of packed cells, the patient became flushed, hypotensive, and developing wheezing. Your first action would be to:

Answer 40

Discontinue the transfusion.

Question 41

All of the following would indicate right ventricular failure EXCEPT:

Answer 41

Bilateral moist crackles

Question 42

Which of the following findings would be consistent with right tension pneumothorax and mediastinal shift?

Answer 42

Tracheal deviation to the LEFT

Question 43

Intubation of the RIGHT main stem bronchus results in:

Answer 43

Atelectasis of the LEFT lung

Question 44

Treatment of patients with shunting usually includes which of the following?

Answer 44

Use of PEEP with mechanical ventilation

Question 45

One of the primary goals of treatment for a patient with cardiogenic shock is:

Answer 45

Decrease the work of the LEFT ventricle

Question 46

Your patient had a stent placed to the LAD, which leads would be the priority for monitoring for reocclusion?

Answer 46

V1

Question 47

Your patient is status post AVR with epicardial wires. He is being V-paced at a rate of 80 when you note that occasionally there is a pacer spike with nothing following it and you diagnosis it as "intermittent failure to capture". Your intervention would be:

Answer 47

Increase milliamps

Question 48

Mr. Jones is admitted to the unit. A PA catheter is placed and the following hemodynamic profile is obtained: CI 1.8 CVP 12 PAWP 20 SVR 1652 BP 80/60 HR 92 These hemodynamic numbers are consistent with a diagnosis of:

Answer 48

Cardiogenic Shock

Question 49

Treatment interventions for Mr. Jones are likely to include:

Answer 49

Dobutamine and intra-aortic balloon pump

Question 50

The PA diastolic pressure will usually not provide a reliable estimate of the LEFT ventricular end diastolic pressure if the patient has which of the following conditions:

Answer 50

Severe pulmonary disease

Question 51

Mr. Blue, a patient with COPD, is admitted to ICU. He is combative and disorient to time and place. He has diffuse bilateral rhonchi and wheezes. pH 7.20 PaCO2 68 PaO2 35 HCO3 30 How would you interpret these ABGs

Answer 51

Respiratory acidosis

Question 52

What is the most likely cause of Mr. Blue's combativeness and disorientation?

Answer 52

Hypoxemia

Question 53

After 30 minutes of O2 at 2L/min via nasal prongs Mr. Blue's ABGs are as follows: pH 7.20 PaCO2 89 PaO2 48 HCO3 32 What is your evaluation of this data?

Answer 53

His alveolar hypoventilation is getting worse

Question 54

A decision is made to intubate and mechanically ventilate Mr. Blue. Which of the following ventilator parameters may be adjusted to improve his ventilation and maintain an appropriate PaCO2 level?

Answer 54

Tidal volume and ventilation rate

Question 55

Two hours after his intubation, Mr. Blue's ABGs are as follows: pH 7.44 PaCO2 46 Pa O2 54 HCO3 31 MODE: AC/VC FiO2 40% TV 650 mL PEEP 8 Which of the following changes in ventilator settings might be appropriate at this time?

Answer 55

B and C