Barron/Elsevier CCRN practice test questions with answers, Exams of Nursing

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Barron/Elsevier CCRN practice test

questions with answers

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✔Phenytoin inhibits _______ secretion Right ✔Most episodes of aspiration result in (right/left) lung infiltrates. urine creatinine clearance ✔Best indicator of GFR Auto-PEEP ✔In a vented patient with status asthmaticus, check for _______________ Air trapping ✔An increase in auto-PEEP is a sign of _________________. obstructive pulmonary disease ✔A patient with a flattened diaphragm on a Chest X-ray and decreased expiratory flow rate most likely has what type of disease? II and V ✔____ and ______ are the two best P wave leads. wide, notched P waves ✔What is a manifestation of left atrial enlargement on an EKG in lead II? normal ✔Diphasic P waves in lead V1 on 12-lead EKG are abnormal/normal. myoglobin ✔_________ is the earliest cardiac biomarker for a MI (elevated within 3hrs s/p MI) and is nonspecific. pleurodesis

✔injection of a sclerosing agent into the pleural space and is used for pleural effusion LAD ✔The__________ coronary artery supplies the bundle of His and bundle branches anterior (LAD affected) ✔_____________ MIs may cause blocks of the bundle of His or bundle branches Right Coronary Artery (RCA)... LCA in 10% of ppl ✔Type I AV block, also called Wenckebach, is a block at the AV node, and the AV node is supplied by the ___________________ (in 90% of people) sinus ✔the ____________ node is supplied by the RCA in 55% of ppl and LCA in 45% pale and shiny ✔The skin changes associated with chronic peripheral arterial disease pain, pallor, pulselessness, paresthesia, paralysis, and polar (cold) ✔what are the 6 Ps of acute arterial occlusion? less ✔There is (more/less) risk of burning of the skin with biphasic waveform defibrillation than with monophasic. necrosis ✔adding too much air to a ETT cuff can cause overinflation and tracheal ______________. myocardial infarction (MI) ✔What is the most common cause of death after vascular surgery? CAD ✔Because atherosclerosis does not occur in one vessel, patients requiring vascular surgery are likely also to have ___________________________. dissecting aortic aneurysm

✔The first diagnostic test should be a CXR film for probable diagnosis. The film would reveal a widening mediastinum. An additional, more indicative finding would be calcified aortic knob with extension of the aortic wall. left ✔A wide, notched P wave is an indication of ________ atrial enlargement. P mitrale ✔Left atrial enlargement causes the P wave to be wide (greater than 0.1 second) and notched. This sometimes is referred to as ___ __________. mitral ✔___________ valve stenosis causes LA enlargement and wide, notched P Waves RCA (as seen in inferior wall MIs) ✔SA blocks, second-degree AV block type I, and third-degree AV heart block at the level of the AV node would occur in _______________ occlusion left ✔The anterolateral heart wall is supplied by the ______ coronary artery right ✔The SA node and the atrioventricular (AV) node are supplied by the ________ coronary artery in most hearts. AV ✔second degree Type I AV block is located anatomically at the _____ node Bundle of His ✔Second degree AV block Type II is located anatomically at the ________________. junctional escape ✔A third-degree AV heart block would have to be blocked above the bundle of His to have what kind of rhythm? erythropoietin (EPO) ✔The hypoxemia that results from COPD causes release of _______________ from the kidney, which stimulates release of red blood cells from the bone marrow and polycythemia

COPD causes pulmonary hypertension, right ventricular hypertrophy, and right atrial enlargement. The right atrial enlargement causes stretching of the atrial tissue and frequently results in atrial dysrhythmias. ✔How does COPD result in atrial fibrillation and predisposition to PEs? Nitrates ✔___________ are used primarily as antispasmodics in cath lab patients. widened ✔(Widened/narrowed) pulse pressure is associated with aortic regurgitation narrowed ✔(Widened/narrowed) pulse pressure is associated with mitral regurgitation diastolic ✔mitral stenosis causes a (systolic/diastolic) murmur. mitral stenosis ✔_____________ stenosis results in pinkish discoloration of the cheeks, aka "malar blush." programmability ✔_____________________ is the ability to noninvasively change one of several aspects of the function of a pacemaker, using a device placed over the pulse generator. Pressure-controlled inverse ratio ventilation ✔______________________________ ventilation, which flips the normal inspiration/expiration ratio to make inspiration longer than expiration, allows trapping of air in the lungs. This inadvertent PEEP is called auto-PEEP. hypokalemia, hypercalcemia, and hypomagnesemia ✔which electrolyte imbalances increase sensitivity to digitalis toxicity? decreases; decreases ✔Positive pressure ventilation (increases/decreases) venous return to the heart and (increases/decreases) cardiac output and perfusion to the kidney. increase (because of heart failure)

✔Stunned myocardium and intraoperative myocardial infarction more likely would cause an (increase/decrease) in PAOP. 30 ✔Ideally, fibrinolytic therapy should be initiated within ____ minutes of the patient's arrival in the emergency department. heart, brain, kidney, and retina ✔The target organs of hypertension (most susceptible to changes in pressure and perfusion) alveolar dead space ✔______________________________ is ventilation without perfusion (also referred to as high ventilation/perfusion [V/Q] ratio). intrapulmonary shunt ✔______________________________ is perfusion without ventilation (also referred to as low V/Q ratio). beta blockers (BBs) ✔Which drug category is used to block the maladaptive sympathetic nervous system (SNS) innervation in heart failure? increased CO; increased SvO ✔hemodynamic parameters in a ventricular septal rupture (VSR) will include (increased/decreased) CO and (increased/decreased) SvO2. 15-20mmHg (Although 8-12 mm Hg is considered normal this does not cause optimal stretch, esp in a pt with a dilated LV. The theoretical optimal PAOP is 15-20 mm Hg). ✔A patient is in cardiogenic shock and requires careful volume titration to enhance contractility. What is an optimal pulmonary artery occlusive pressure (PAOP) in this patient? RV (it is the most directly anterior chamber, located directly beneath the sternum). ✔Which heart chamber is at greatest risk for trauma in myocardial contusion? pulmonary artery occlusion pressure (PAOP) ✔The best indicator of intravascular volume is __________.

because it is released in response to increased intravascular volume ✔Why is BNP correlated with PAOP and LVEDV? Pursed lip breathing ✔__________________________ is an expiratory maneuver that slows expiration, prevents airway collapse, and decreases air trapping. This method is a complementary therapy used by patients with obstructive pulmonary disease. sensing; capture ✔in temporary pacemakers, increase sensitivity for________ malfunction. Increase the voltage for ___________ malfunction. To decrease intrapulmonary shunt by re-opening collapsed alveoli (alveolar recruitment) ✔What is the purpose of a higher PEEP in treating a pt with ARDS? to increase the driving pressure of oxygen, to decrease surface tension and the work of breathing, and to decrease shunt by reopening collapsed alveoli ✔What are the 3 main purposes of PEEP? atrial fibrillation. ✔The loss of the a wave in a PAOP waveform equals the loss of atrial contraction, which is certain in __________________________. forward failure of the left ventricle ✔Submassive or massive pulmonary embolism causes obstruction in the pulmonary circuit, which results in impairment in left ventricular filling, often called what? 20 ✔carbon dioxide is _____ times more diffusible than oxygen hypoxemia ✔Impaired perfusion equals impaired diffusion equals ___________. J receptors ✔____ receptors are stimulated by an increase in interstitial fluid volume. Stimulation of these receptors may cause laryngeal constriction, hypotension, bradycardia, mucous production, and dyspnea. J (juxtacapillary) receptors, aka pulmonary C-fiber receptors

✔__ ________________ are sensory nerve endings located within the alveolar walls in juxtaposition to the pulmonary capillaries of the lung and are innervated by fibers of the vagus nerve. left main coronary artery ✔Inflation of a balloon to dilate the _______________ coronary artery, such as in a balloon angioplasty, could result in potentially fatal ischemia or infarction of the left ventricle. can only do this if this vessel is "protected," aka a bypass graft already placed around it. infrarenal (90%) ✔Where do most abdominal aortic aneurysms (AAAs) occur? Durant's maneuver ✔When a pt has likely developed an air embolism s/p TLC removal, place pt immediately in a head-down position on left side. This prevents the air embolus from entering the right ventricular outflow tract & allows time for the air embolism to be absorbed. What is this maneuver called? left atrial pressure (LAP) ✔PAOP is an indirect evaluation of ___________ ____________ pressure. hypoxemia ✔_____________ is decreased oxygen in the blood hypoxia ✔____________ is decreased oxygen in the tissues calcium (which will cause hypocalcemia) ✔Alkalosis (i.e. respiratory alkalosis from hyperventilation) causes an increase in the binding between___________ and albumin. fluid or mucus ✔Rhonchi indicate ____________ in the airway and indicate that a patient should be helped to cough or that secretions should be suctioned multisystem ✔A significantly elevated LDH, such as in acute respiratory syndrome, is associated with __________________ involvement.

Afib and SVT ✔Which are the two most common dysrhythmias associated with Wolff-Parkinson- White syndrome? S ✔LBBB causes a paradoxical splitting of the (S1/S2) heart sound. This means that it is split on expiration but not on inspiration. (split on inspiration is normal) left ✔When the depth of the S wave in lead V1 or V2 plus the height of the R wave in lead V5 or V6 is 35 mm or greater, this constitutes voltage criteria for (left/right) ventricular hypertrophy. amiodarone ✔The first drug for a wide QRS complex tachycardia narrow QRS complex (such as in SVT) ✔Verapamil and adenosine typically are used for what type of tachycardia? Valsalva ✔Isometric exercises, such as weight lifting, cause _________ maneuver and should be avoided in pts w/ stable angina. dilator ✔Morphine is a venous vaso(constrictor/dilator). does not cause a significant effect on the arteries, meaning it doesn't really affect afterload. shock; blood is shunted away from lungs (remember that the SNS shunts blood to the brain and heart when it redistributes blood from nonessential to essential...damage to type 2 pneumocytes occurs) ✔What is the leading cause of ARDS? surfactant ✔what do type 2 pneumocytes produce? increases permeability ✔shock triggers SIRS, which (increases/decreases) the permeability of the alveolar- capillary membrane... which can lead to ARDS Dextran 40

✔Drug that frequently is used in vascular surgery patients to inhibit platelet aggregation at the site of intimal trauma lower (normally 2-5mmHg lower) ✔The PAOP/PAWP should be (higher/lower) than the PAD. isovolumetric contraction ✔the majority of myocardial oxygen consumption occurs during which phase of the cardiac cycle? isovolumetric contraction ✔During this phase of the cardiac cycle, the valves are closed and contraction occurs without a change in volume, in order to generate a pressure high enough to overcome the resistance in the arterial (pulmonary or systemic) circulation, to open the semilunar valves (pulmonic or aortic), and to propel blood into the great vessels (pulmonary artery or aorta) Hypotension ✔Nesiritide is a vasodilator with diuretic effects. What is the most common side effect? a waves ✔Mitral stenosis causes large ____ waves on the PAOP waveform a and v waves ✔Cardiac tamponade and left ventricular failure cause high pressures and large __ and __ waves on a PAOP waveform v waves ✔Mitral regurgitation causes large ___ waves on a PAOP waveform left ✔The PAOP waveform is a reflection of the (right/left) atrium. 300 ✔Normal PaO2/FiO2 ratio is greater than ______ mm Hg. ARDS

✔The PaO2/FiO2 (sometimes simply called the P/F) ratio of less than or equal to 200 mm Hg is an international criterion for ______. kidney ✔Hypoperfusion of which organ activates the renin-angiotensin-aldosterone system (RAAS)? end of expiration ✔At which point in the ventilatory cycle should the pulmonary artery occlusive pressure be measured? more ✔Inverse ratio ventilation allows (more/less) time for inspiration than for expiration. thiocyanate poisoning ✔what type of toxicity should you monitor for in someone on a nipride gtt? strain pattern (asymmetric T wave inversion) in V5 and V ✔what is the ST-T wave change associated with left ventricular hypertrophy? tachycardia ✔Vasodilators cause stimulation of the baroreceptors (pressure receptors), which causes a reflex ______________. dullness/flatness; bronchial (tubular sounding) ✔Consolidation (i.e. in pneumonia) causes _________ to percussion over affected area of thorax and ___________ breath sounds RBB, the left anterior branch of the LBB, and the left posterior branch of the LBB ✔What are the three fascicles of the intraventricular conduction system? RBBB and left anterior hemiblock ✔What is the most common form of bifascicular block? 2 to 3 days ✔During mechanical ventilation, make every effort to limit FiO2 of greater than 0.6 to no more than ____________ days to prevent oxygen toxicity, even if it means coming up on PEEP 24 hours

✔During mechanical ventilation, make every effort to limit exposure to 100% FiO2 to no more than ______ hours to avoid oxygen toxicity, even if it means coming up on PEEP. afib ✔about 20% of all ischemic strokes are due to what arrhythmia? true ✔True/False: antidiuretic hormone (ADH) secretion is stimulated by positive pressure ventilation. shows extent and location; newly infarcted areas appear as "hot spots" within 1- days after the MI ✔what does a technetium scan do in diagnosing MIs? lower ✔PetCO2 is usually 1-5mmHg (higher/lower) than PaCO direct ✔PetCO2 and PaCO2 have a (direct/inverse) relationship with regards to change in ventilation. Greenfield filter ✔A ______________ ___________, or vena cava umbrella, is placed when the patient has recurrent PEs despite anticoagulant therapy or when anticoagulants are contraindicated. pulmonary HTN ✔If the PAD is more than 5mmHg higher than the PAOP, what is present? diastolic ✔S4 is an indication of (systolic/diastolic) dysfunction systolic ✔S3 is an indication of (systolic/diastolic) dysfunction 20-40 beats/min ✔The intrinsic rate of the Purkinje system is ___________ beats/min, i.e. in ventricular escape rhythms.

venous (RA, RV) ✔Only clots from the (venous/arterial) side of the heart would become pulmonary emboli palpitations ✔most common presenting symptom in supraventricular tachycardias pace ✔Return of a pre-pacemaker rhythm in a pt w/ a pacemaker indicates a failure to _______, as no pacing spikes are evident. sense ✔failure to __________ causes competition between the pacemaker and the intrinsic rhythm. evidenced by pacing spikes occurring on time, regardless of the patient's intrinsic rhythm. V1 and V ✔Which leads are most helpful in differentiating VT from a SVT with aberrancy? bell ✔S3 and S4 are best heard with the _____ of a stethoscope since they are lower pitched over the apex, preceding S1, using the bell of a stethoscope ✔where will an S4 be heard? Approximately 150 mL/min/m ✔What is a normal oxygen consumption index (VO2I)? methemoglobinemia ✔Nitrites and nitrates such as nitroglycerin, nitroprusside, and nitric oxide can cause

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Normal parameters are 100% out, 25% use, and 75% reserve ✔Normal parameters are 100% out, 25% use, and 75% reserve Remember that a run of wide QRS complex tachycardia triggered by a PAC is likely a SVT with aberrancy, whereas a run of wide QRS complex tachycardia triggered by a premature ventricular contraction is likely VT.

✔Remember that a run of wide QRS complex tachycardia triggered by a PAC is likely a SVT with aberrancy, whereas a run of wide QRS complex tachycardia triggered by a premature ventricular contraction is likely VT. rust ✔Streptococcus causes _____-colored sputum. pinkish ✔Staphylococcus is likely to cause sputum to be _________ colored. greenish ✔Pseudomonas is likely to cause sputum to be ___________. currant ✔Klebsiella is likely to cause sputum to be ____________-colored. Second intercostal space at the midclavicular line on the affected side ✔where would a needle puncture be done in an emergency decompression of a tension pneumothorax? methemoglobinemia ✔condition in which normal ferrous hemoglobin is converted to ferric hemoglobin, which cannot carry oxygen. s/s hypoxia ensue 1-2% ✔Normal methemoglobin levels thoracic aortogram ✔What diagnostic test would be most definitive in identifying an aortic rupture? remember for afib... ibutilide (Corvert) = convert ✔remember for afib... ibutilide (Corvert) = convert low fowler's (20-30 degrees) ✔best position for a dyspneic patient 5

✔Central cyanosis is cyanosis in central areas such as mucous membranes and occurs when ____ g of hemoglobin is desaturated bronchophony ✔when a spoken word is heard clearly, distinctly, and loudly over an area of pneumonia during auscultation volutrauma ✔shearing of the alveoli caused by overly large tidal volumes barotrauma ✔pneumothorax associated with mechanical ventilation opening snap ✔sound occurring in early diastole caused by a rapid opening of a stenotic mitral valve dysrhythmias (trauma -> inflammation -> irritability) ✔most common complication of myocardial contusion pulmonic ✔On a pulmonary artery waveform, the dicrotic notch represents closure of which valve? diuretics and beta blockers ✔first-line therapy for chronic management of hypertension external respiration ✔the process of the movement of oxygen across the alveolar-capillary membrane internal respiration ✔the use of oxygen by the mitochondria to produce ATP catheter or radiofrequency ablation ✔definitive treatment for Wolff-Parkinson-White syndrome false aneurysm

✔an aneurysm that does not involve all layers of the artery. in essence, it is a pulsatile hematoma. bell ✔Murmurs of atrioventricular valve stenosis (i.e. mitral and tricuspid) are low-pitched and heard best with the ____________. left; right ✔Ventricular tachycardia is most likely to be _______ axis deviation of −30 or greater or indeterminate axis, whereas aberrancy is more likely to be normal axis or _______ axis deviation. 3 ✔The DeBakey system classifies aortic dissections into how many types? 2 ✔type ______ Aortic dissection only involves the ascending aorta 1 ✔type ______ Aortic dissection originates in the ascending aorta, then propagates at least into the aortic arch and often beyond it distally 3 ✔type _____ aortic dissection originates in the descending aorta and rarely extends proximally. Type A ✔type _____ aortic dissections are surgical emergencies and usually require an aortic valve replacement. includes DeBakey Types 1 and 2 and involve ascending aorta Type B ✔type ____ aortic dissections can often be medically managed. ascending aorta generally not involved, includes DeBakey type 3 TEE, CT, STAT EKG to r/o MI, MRI ✔diagnostics for acute aortic dissection bicarb

✔the lactate in LR is converted to __________ by the liver, which can result in metabolic alkalosis. 30% ✔Atrial fibrillation causes loss of atrial kick and reduces cardiac output by as much as _____% static compliance ✔___________ ____________________ is the compliance of the lung when no air is moving, so it reflects the compliance of the lung and the chest wall. coronary artery steal ✔Nitroprusside may cause what is called ______________ ______________ __________ as the vasodilation "steals" blood away from ischemic areas. It is contraindicated in pts w/ ischemic pain. VT (frequency of SVT w/ aberrancy is often overestimated). ✔most wide QRS complex tachycardias are what rhythm? The laryngectomy tube does not have a cuff. ✔what is the primary difference between a tracheostomy tube and a laryngectomy tube? mitral ✔a midsystolic click is associated with _________ valve prolapse ejection click ✔early systolic heart sound associated with aortic or pulmonic stenosis bowel sounds in the chest ✔finding most often is associated with a traumatic diaphragmatic rupture Legionella ✔Surprisingly, public water supplies frequently contain what pathogen? not visible ✔If a junctional impulse reaches the atria and the ventricles at the same time, how will the P wave appear?

Passive range of motion causes a decrease in SvO2 of approximately 18%; suctioning, 27%; turning, 31%; and weight, 36%. ✔Passive range of motion causes a decrease in SvO2 of approximately 18%; suctioning, 27%; turning, 31%; and weight, 36%. 50 and 150 ✔Cerebral perfusion pressure (CPP) must be maintained between ____ and ____ mm Hg to maintain autoregulation RBBB and left anterior hemiblock ✔most common form of bifascicular block vasoconstriction ✔what effect does hypoxemia have on the pulmonary vasculature? hypotension ✔High levels of magnesium cause smooth muscle relaxation, resulting in _________________. 1, ✔1 kg of body weight is equal to approximately _____mL of fluid loss being sexually aggressive behavior toward the nursing staff ✔What sexual behavior is common in patients early after an acute myocardial infarction (MI)? dehydration ✔most significant cause of prerenal acute kidney injury bronchophony ✔increased clarity of the spoken word when listening with a stethoscope over the area of lung consolidation egophony ✔when the patient says "e," and the examiner hears "a" when listening with a stethoscope over the area of lung consolidation whispered pectoriloquy

✔an increase in the clarity of whispering when listening with a stethoscope over the area of lung consolidation bronchial breath sounds ✔tubular breath sounds with a longer expiratory phase heard over an area of lung consolidation more ✔Carbon dioxide is 20 times (more/less) diffusible than oxygen. calcium channel blockers ✔class IV antidysrhythmic agents beta blockers ✔class II antidysrhythmic agents potassium blockers ✔class III antidysrhythmic agents 7 ✔Sodium bicarbonate generally is reserved for pH of ___ or less. 250 ✔Dextrose should be added to IV fluids in a DKA patient when the serum glucose is less than _____ mg/dL. acidotic ✔The serum potassium is normal when a patient is (acidotic/alkalotic) and potassium is shifted out of the cell and into the serum. drop ✔As soon as the pH is corrected in an acidotic, the potassium will shift back into the cell and the serum potassium will (rise/drop). dehydration ✔most significant cause of prerenal AKI prerenal ✔BUN/creatinine ratio of greater than 10:1 is seen in what type of AKI?

hypoxemic pulmonary vasoconstriction ✔most common cause of pulmonary HTN 2nd ICS MCL ✔Location where emergency decompression of a tension pneumothorax is performed indirect ✔An increase in (direct/indirect) bilirubin is associated with hepatic disease or excessive hemolysis direct, b/c direct bilirubin is conjugated ✔An increase in (direct/indirect) bilirubin is associated with biliary obstruction onstricted pupils, bradycardia, hypotension, and drooling -effects are due most likely to organophosphates, which act as anticholinesterase agents ✔s/s of cholinergic overdose adrenergic ✔sympathetic nervous system is (adrenergic/cholinergic) cholinergic ✔parasympathetic nervous system is (adrenergic/cholinergic). acute tubular necrosis (ATN) ✔Crush injuries cause muscle destruction and rhabdomyolysis, which liberates myoglobin into the blood. This heavy pigment potentially causes tubular occlusion and ________. increases ✔Hyperkalemia (increases/decreases) gastric motility. hyperkalemia ✔(hyperkalemia/hypokalemia) causes flaccid paralysis by partially depolarizing the muscle cell membrane, preventing further depolarization. 15

✔A BP variation of up to _____ mm Hg between the arms is normal aortic dissection ✔a variation of >15mmHg between arm BPs can be indicative of what fatal condition? 5 ✔The right atrial pressure (RAP) can be estimated by adding the ___ cm that the angle of Louis is above the right atrium (i.e. if JVD is 6 cm above the angle of louis, add this number to 6).

✔1 mm Hg is equal to _____ cm H2O hypernatremia ✔corticosteroid therapy in transplant patients can cause (hypo/hypernatremia). mild anxiety ✔level of anxiety characterized by a heightened awareness and increased problem- solving abilities severe anxiety ✔level of anxiety characterized by distorted perception, hyperventilation, tachycardia, urinary frequency, tremors, and pupil dilation panic ✔level of anxiety characterized by fear of dying, dyspnea, chest pain, vomiting, inability to speak, and distorted perception of the situation moderate anxiety ✔level of anxiety characterized by an increase in heart rate and respiratory rate, dry mouth, palpitations, rapid speech, frequent changes of topic, inappropriate humor, and jittering myasthenia gravis (MG) ✔autoimmune disorder with destruction of acetylcholine receptors which causes interference of neuromuscular transmission leading to muscle weakness and fatigability afib

✔most likely rhythm to demonstrate Ashman's phenomenon whether the needed organ will be available in time to prevent their death ✔primary concern of patients who are awaiting an organ transplant SaO2, hgb, CO ✔Components that make up oxygen delivery (DO2) prospective (predetermined) ✔Diagnosis-Related-Groups (DRGs) constitute a __________ payment program for Medicare patients early ✔tachycardia, tachypnea, and diaphoresis are (late/early) signs of hypoglycemia. DKA ✔what condition is Kussmaul's breathing associated with? advocate ✔primary role of a case manager internal thoracic artery (aka internal mammary) ✔artery used as a graft for MIDCABG Respiratory alkalosis (from hyperventilation) and metabolic acidosis (b/c aspirin is an acid) ✔What acid-base imbalances are likely to be seen in aspirin toxicity? decreases ✔a shift in the oxyhemoglobin dissociation curve to the right, i.e. in hyperthermia, (increases/decreases) the affinity between oxygen and hemoglobin. staff members are afraid of legal liability ✔most likely reason that an advance directive is ignored or overridden Hypokalemia, hypercalcemia, and hypomagnesemia ✔electrolyte imbalances that increase sensitivity to digitalis toxicity alpha- and noncardioselective beta blocker

✔carvedilol (coreg) is what type of drug? pain in left shoulder; indicates splenic rupture ✔What is Kehr's sign, and what does it indicate? S4 ✔heart sound a/w angina septic ✔Which type of shock is most likely to be iatrogenic? myoglobin (high sensitivity, low specificity... lots of false positives for MI) ✔earliest cardiac biomarker in the jejunum ✔where should the end of an enteral feeding tube be placed in a pt with acute pancreatitis? Oxygen concentration and barometric pressure ✔Driving pressure of oxygen is affected by which two factors? loss of the fear of death ✔what is often reported after a near-death experience? hypercoagulability ✔Polycythemia causes (hyper/hypo)coagulability. 2 to 3 days ✔how long do the kidneys take to compensate for respiratory acid-base imbalances? respiratory alkalosis ✔acid-base imbalance least likely to be compensated When the depth of the S wave in lead V1 or V2 plus the height of the R wave in lead V5 or V6 is 35 mm or greater, this constitutes voltage criteria for left ventricular hypertrophy.

✔When the depth of the S wave in lead V1 or V2 plus the height of the R wave in lead V5 or V6 is 35 mm or greater, this constitutes voltage criteria for left ventricular hypertrophy. bicarb (hence why LR is not fluid of choice in liver disease) ✔the liver converts lactate to __________ ACE inhibitors ✔what class of antihypertensives do african americans NOT respond well to? low fowler's (20-30 degrees) ✔best position for a dyspneic patient increases; decreases ✔High Fowler's position (increases/decreases) the pressure of the abdominal contents against the diaphragm, which (increases/decreases) diaphragmatic excursion. mitral and tricuspid (atrioventricular valves)...they're low-pitched ✔All murmurs are high pitched except the murmurs of ________ and ________ valve stenosis. family refusal ✔most common reason that organs of medically suitable potential donors are not recovered for donation hypoglycemia ✔Ethanol infusion may cause (hypo/hyper)glycemia. Saline, mannitol, and bicarbonate (flush out the pigment, alkalize the urine) ✔tx for myoglobinuria to prevent ATN and kidney injury RV MI ✔1/3 of all patients with inferior MI will have concurrent ___________ MI 10 ✔sleep deprivation may cause abnormalities in mental functioning for up to _____ days maintain hypoxemia but prevent hypoxia

✔appropriate guideline for oxygen therapy in a chronically hypercapnic patient Patients with chronic hypercapnia rely on secondary chemoreceptors to stimulate breathing. These chemoreceptors rely on low blood oxygen levels to stimulate breathing. therefore they must remain hypoxemic. ✔Patients with chronic hypercapnia rely on secondary chemoreceptors to stimulate breathing. These chemoreceptors rely on low blood oxygen levels to stimulate breathing. therefore they must remain hypoxemic. 40 minutes ✔MAP of less than 60 mm Hg for as short a period as _____ minutes may cause ATN and AKI. Anaphylactoid reaction is clinically indistinguishable from anaphylactic reaction but does not require previous exposure to the antigen ✔Anaphylactoid reaction is clinically indistinguishable from anaphylactic reaction but does not require previous exposure to the antigen increased ✔In septic shock the delivery of oxygen to the tissues is __________, and extraction and use of oxygen are impaired. at least 4-6 hours ✔how long will it take to see H&H changes after a blood transfusion? if the pt is still bleeding ✔what is the only thing that drawing a H&H immediately after giving blood will tell you? high urinary osmolality, low urinary sodium concentration (b/c the kidneys are holding onto sodium and water as a response) ✔what effect on osmolality and urine sodium will be seen in a hypo-perfused pt with normal kidneys, as a normal physiologic response? wide, notched P waves in lead II ✔manifestation of left atrial enlargement on an EKG RBBB and left anterior hemiblock ✔most common form of bifascicular block

✔How is the ankle-brachial index (ABI) calculated? ✔how does vasopressin help stop GI bleeding? ✔acid-base imbalance is seen in methanol intoxication venous, thus reduces preload (not afterload) ✔Morphine is a (venous/arterial) vasodilator by glucose causing an osmotic diuresis ✔how does DKA cause dehydration? 20-30mmHg ✔The systolic BP in the thigh is usually ____________ mm Hg higher than the BP in the arm, although the diastolic BP is usually the same. acts at the ascending limb of the loop of Henle to decrease sodium and water reabsorption ✔mechanism of furosemide (lasix) regarding diuresis two ✔The definition of MODS does not require complete cessation of function, but ________ or more organs must be involved large-bore, short peripheral catheter ✔preferred type of line for rapid IV fluid administration in severe shock microatelectasis ✔most common cause of hypoxemia in the surgical patient barorecptors ✔aka pressure receptors tachycardia