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Cardiac Catheterization Procedures and Standard Precautions, Exams of Advanced Education

Harvard UniversityAdvanced Education

Various aspects of cardiac catheterization procedures, including normal co, lv and rv co, calcium channel blockers, diagnostic cath procedures, lab values indicating coagulation abnormalities, ventricular fibrillation, ventriculography, high rv edp, heart location, act, major vascular complications, vasodilators, radial artery catheterization, endomyocardial biopsy, radial sheath removal, and post-procedure discharge education. It also mentions standard precautions in healthcare settings.

Typology: Exams

2023/2024

Available from 07/31/2024

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RCIS CCI Practice Exam 5 Questions and
Answers
The urinary catheter drainage bag should be placed in which of the following
positions – ANS: below the pts bladder
Equipment that would be needed by the CCL nurse to start an IV access could include
which of the following - ANS: IV catheter
gloves
non-latex tourniquet
medical tape
guaze
sharps container
sterile pad
sterile dressing
bag of IV fluids
Which of the following would be considered a minor/other complication which can
occur during a cardiac cath? - ANS: vascular injury
Which of the following would be considered an infection control technique that
considered all blood and body fluids as being contaminated? - ANS: universal
precautions
____ helps to decrease the risk of the transmission of microorganisms from both
recognized and unrecognized paths - ANS: standard precautions
Which of the following would be considered the normal CO? - ANS: 4-8 L/min
The blood that is ejected from the LV into the aorta would be considered the persons
____ - ANS: CO
CO would be be described as which of the following - ANS: the blood that is ejected
from the LV into the aorta
During the process of setting up the sterile table, it is L alone for 10 mins. which of
the following statements would be considered correct regarding the use of the table
for the procedure - ANS: the sterility of the table cannot be guaranteed
The measuring of press in the pts heart would be referred to as which of the
following - ANS: hemodynamics
____ would be considered pictures of the heart that were taken during the cardiac
cath - ANS: angiography
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RCIS CCI Practice Exam 5 Questions and

Answers

The urinary catheter drainage bag should be placed in which of the following positions – ANS: below the pts bladder Equipment that would be needed by the CCL nurse to start an IV access could include which of the following - ANS: IV catheter gloves non-latex tourniquet medical tape guaze sharps container sterile pad sterile dressing bag of IV fluids Which of the following would be considered a minor/other complication which can occur during a cardiac cath? - ANS: vascular injury Which of the following would be considered an infection control technique that considered all blood and body fluids as being contaminated? - ANS: universal precautions ____ helps to decrease the risk of the transmission of microorganisms from both recognized and unrecognized paths - ANS: standard precautions Which of the following would be considered the normal CO? - ANS: 4-8 L/min The blood that is ejected from the LV into the aorta would be considered the persons ____ - ANS: CO CO would be be described as which of the following - ANS: the blood that is ejected from the LV into the aorta During the process of setting up the sterile table, it is L alone for 10 mins. which of the following statements would be considered correct regarding the use of the table for the procedure - ANS: the sterility of the table cannot be guaranteed The measuring of press in the pts heart would be referred to as which of the following - ANS: hemodynamics ____ would be considered pictures of the heart that were taken during the cardiac cath - ANS: angiography

All but which of the following would be considered an area that the physician would include in their role as a pt educator - ANS: cost of the procedure What are the 4 areas which should be included in the physicians role in pt education

  • ANS: 1. info that would be obtained from the procedure
  1. potential treatment options
  2. clear reasons for the procedure
  3. potential risks and complications of the procedure All but which of the following ppl would not be included in the "time-out" process in the CCL - ANS: physical thereapist Which of the following, which would be considered basic equipment on the sterile table for the cardiac cath procedure - ANS: 1. a bowl of 1% or 2% lidocaine
  4. a needle for cannulating the artery
  5. a container of 500 ml of saline solution/5000 units of hep that has been added to the solution
  6. a container/bowl for betadine
  7. sheaths and catheters
  8. sterile drapes
  9. sterile swabs or prep sticks
  10. manifold SVR stands for which of the following - ANS: systemic vascular resistance ____ quantifies the LV afterload - ANS: SVR The formula: CO = VO2 would be considered which of the following (CaO2-CvO2) x 10 - ANS: fick formula Which of the following would be considered a typical ejection press limit setting for a Vgram? - ANS: 900-1200 psi The myocardial O2 supply should _____ the myocardial O2 demand - ANS: equal If the myocardial O2 supply is not equal to the demand, it can cause such problems as
  • ANS: infarctions or ischemia Safety is considered extremely important in the CCL. All of the following might be considered safety policies except - ANS: policies for the staffs break times The RV CO could best be described as which of the following - ANS: the vol of blood that is delivered to the pulmonic circulations per unit of time
  1. with Vfib, there is a decrease in the persons Co
  2. with Vfib, defibrillation would be needed immediately to attempt to resolve it When preparing for ventriculography, what would be considered the most important step of the setup for the staff - ANS: to make certain that all the air and bubbles are cleared from the transparent pressure injection syringe and tubing A high RV EDP might be see with all of the following conditions except - ANS: kidney failure A high RV EDP would be seen with all of the following conditions - ANS: cardiac tamponade restrictive myocardial disease endocardial fibrosis pulmonic valve insufficiency constrictive pericarditis The normal HR for a child age 1-8 would be considered which of the following - ANS: 80-100 bpm _____ would be the normal HR for ages 1-28 days - ANS: 120-160 bpm _____ would be the normal HR for an adult - ANS: 60-100 bpm _____ would be the normal HR for age 1-12 months - ANS: 100- according to the society for cardiac angiography and interventions, an acceptable intervention that could be used for urticaria with an anaphylactic reaction in the CCL would be considered which of the following - ANS: diphenhydramine 25-50 mg IV The human heart is typically the size of which of the following - ANS: clenched fist Where is the heart located - ANS: behind the sternum and slightly to the L the acceptable range for the ACT before it is considered safe for the team in the CCL to proceed with a procedure would be considered - ANS: 250-350 secs RAD stands for which of the following - ANS: radiation absorbed dose All but which of the following would be considered a major vascular complication in the CCL - ANS: cerebral bleed Some of the major vascular complications would include - ANS: local obstructions from flaps dissection thrombosis

subintimal hemorrhage Which of the following which would be considered a vasodilator that can be used in a radial art cath to help minimize vessel spasm - ANS: papaverine verapamil adenosine diltiazem A single, large dose of a medication would be considered a ____ - ANS: bolus Stenosis in the AO valve can cause which of the following problems - ANS: an increased press overload on the LV causing a reduction in CO and pulmonary congestion When converting pounds to kg, which of the following would be correct for converting 298 lbs to kg - ANS: 298 divided by 2.2 = 135.45 kg ACT is a mnemonic for - ANS: activated clotting time When placing a transcutaneous pacer on a pt, the electrodes are placed on the chest and the pacer is turned on. which of the following should be considered the next step

  • ANS: set the demand rate to approx 60/min (then set the current mA output to 2 mA above the dose at which there is consistent capture) The main pumping chamber of the heart would be considered the _____ - ANS: LV Ischemia in the absence of a MI would be characterized by which of the following - ANS: symmetrical changes in the T wave Which of the following which should the CCL nurse check if the pts EKG suddenly goes flat - ANS: check the pt check the press curve on the monitor A high pulmonary art press could be seen with all of the following conditions except - ANS: constrictive pericarditis High pulmonary art press could be seen in which conditions - ANS: LV failure mitral valve stenosis pulmonary emboli chronic obstructive pulm disease pulmonary hypertension peripheral PA stenosis the press that is exerted will be the same at the pro end of the cath tubing as the tip of the tubing would be considered which of the following laws (the belief is that the

Which of the following would be considered correct for the most commonly used locations for stents in congenital heart pts? - ANS: AO coarctation and conduits after surgery as in metrology of fallot With a bilateral heart cath which would the PA press provide - ANS: the (PA) systolic, diastolic, and mean press are measured Which of the following would be considered the most common indication for measuring coronary press and FFR? - ANS: evaluating a mild to moderate stenosis In the neonate that is having a cardiac cath procedure, which of the vessels is typically used for access - ANS: umbilical If a pt has a normal renal profile, which of the following would be considered a procedural limit for contrast medium that should be administered during an angiography - ANS: 3-4 ml/kg Which of the types of IVUS catheter based ultrasound images require only minimal pre involving only one step - ANS: electronic multi-element phased array transducers The mnemonic IVUS would be considered - ANS: intravascular ultrasound Which of the following should be done prior to removing the percutaneous vascular sheaths from the cardiac cath pt? - ANS: 1. assess the dorsalis pedis and post tibial pulses of the pt

  1. assess the insertion sites for any existing hematomas When positioning a pediatric pt for a cardiac cath which of the following statements are correct - ANS: 1. the pts elbows should be flexed at a 90 degree angle
  2. the pts hands should be positioned near the ears
  3. the elbows should be passed and internally rotated toward their midline
  4. soft restraints on the pts writs and ankles to be released as soon as the procedure is over The press guide wire units for the FFR consists of - ANS: connections a monitor a guide wire High RV EDP would be seen in which conditions - ANS: cardiac tamponade pulmonic valve insufficiency restrictive myocardial disease endocardial fibrosis constrictive pericarditis

The 2 lengths of guide wires which are used for a PVI procedure would include - ANS: 300 cm 145 cm Which of the following can be triggered by a foreign body (stent) in a persons blood vessel - ANS: neointimal hyperplasia If a cardiac pt has an ICD which of the following would be considered the typical shock energy of the device - ANS: 0.1-41 J which of the following would be considered the most important step for the staff to take when setting up for a ventriculography - ANS: to ensure that all the air and air bubbles are cleared from the transparent press injection syringe and tubings Which of the following which might be considered a potential complication after an ICD - ANS: infection blood loss hematoma air embolism cardiac tamponade stroke vein thrombosis MI Which of the 4 main methods of performing temp pacing, which would be considered an ideal choice for treatment of the emergency pt - ANS: external transcutaneous pacing ____ works by the delivery of a timed electrical impulse to the chest wall of the pt by the use of pacing electrode patches - ANS: external transcutaneous pacing Which of the following which would be considered a common complaint of the pt with chronic atherosclerotic obstructions? - ANS: exercised induced pain in the calf A unique balloon cath for the dilation of the fused mitral valve commissures would be considered - Inoue (invented in 1982) The rotational atherectomy is considered to have a higher risk for the pt to experience a non-Q wave MI. which i=of the following could be the cause for this - ANS: small embolic particles The surgical procedure for implantation of a pacemaker includes which of the following - ANS: making an incision creation of a pocket to accommodate the device

When performing a R heart cath which should be measured in the IVC and SVC - ANS: O2 sat When performing a R heart cath, the O2 sat should be measured in the - ANS: IVC SVC PA RA RV PCWP AO Discharge education for the pt with post sheath removal would include all of the following - ANS: 1. watch for increased swelling

  1. mottling/discoloration
  2. any discharge
  3. increased warmth or redness
  4. numbness or tingling
  5. dull aching
  6. limb that is cool to the touch Which of the following which would be considered a relative contraindication? - ANS:
  7. pregnancy
  8. electrolyte imbalance
  9. infection
  10. fever
  11. acute GI bleed or anemia
  12. medication toxicity
  13. recent cerebrovascular accident
  14. renal failure
  15. uncontrolled CHF
  16. hypertension
  17. arrhythmias
  18. uncooperative pt
  19. unknown uncontrolled bleeding diathesis What bpm is the internal trigger on the IABP typically set at? - ANS: 80 Regarding the defibrillator during a cardiac cath procedure, which of the following would be correct - ANS: 1. successful defibrillation is a major determinant for the pts survival
  20. the defibrillator should be near the pt and turned on prior to the procedure
  21. the appropriate conductive source should be available for immediate use The initial dose of amiodarone that would be administered during a cardiac cath would be considered which of the following ANS: - 150 mg over 10 mins

(followed by an infusion rate of 1 mg/min) (or 300 mg rapid IV infusion diluted in 20-30 ml of fluid) If the cardiac cath pt is experiencing urticaria, which of the following might be considered part of the potential treatment - ANS: diphenhydramine 25-50 mg IV All of the following might be considered an intervention that would be used if the pt experiences a retroperitoneal bleed during a cardiac cath procedure - ANS: 1. vol replacement

  1. reversal of anticoagulation
  2. avoid high fem art punctures
  3. transfusion
  4. CT scan
  5. surgical consult During a cardiac cath the pt goes into Vfib. which of the following interventions would be considered correct treatment - ANS: defibrillate the pt Interventions which might potentially help prevent the development of an air embolism with the cardiac cath pt would include - ANS: careful flushing of all connections make certain that all of the connections are tight very careful back bleeding of the lines The following complications during a cardiac cath could require a vascular surgeon consult - ANS: a large dissection a thrombotic occlusion enlarging hematoma Assessment of the post procedure cardiac cath access site would include checking for all of the following - ANS: oozing swelling character of the site hematoma redness