IBHRE PRACTICE TEST QUESTIONS AND ANSWERS 100% VERIFIED ANSWERS 2024/2025 CORRECT STUDY, Exams of Nursing

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IBHRE PRACTICE TEST

QUESTIONS AND ANSWERS

100% VERIFIED ANSWERS

2024/2025 CORRECT STUDY

SET

What current ICD capacitor technologies provide the highest energy density and does not require reformation? Tantalum Electrolytic 1.67 Hz would equal how many bpm? 100 bpm 1 bpm = 0.0166667 Hz Which pace/sense lead designs would one expect the highest current density w/ a bipolar impedance reading of 1100 ohms? Brady lead w/ anode of 4.2 mm2 and cathode 5.2 mm What is the voltage measurement of a pacing system w/ impedance of 500 ohms, current of 5. milliamp and pulse width of 0.4 ms and rate of 60 bpm? V = 2.5 V V=I x R = 5.0 milliamps x 500 ohms = 2,500 millivolts =2,500/

What condition is shown to have an increase stimulation threshold, wide QRS, latency, or under sensing? Hyperkalemia (high potassium) What is the estimated battery longevity of a pacemaker with 1.0 amp-hour battery and 20 microamp drain? Longevity = 114 x (amp-hours/microamp drain) = 114 x (1.0/20) = 5.7 years Which sensing related parameter represents the maximal rate of change of the electrical potential between the sensing electrode and is the first derivative of the electrogram? Slew rate The isovolumetric time from electrical depolarization of the heart to mechanical systole describes what term? Pre-ejection interval What test is typically performed during exercise with HR around 105-115 and was shown to have a negative predictive value in MADIT II and SCD-HeFT? Micro volt t-wave alternans Which battery chemistry is now incorporated into pacemakers? Lithium silver vanadium & lithium carbon mono fluoride What test is performed over 10-20 beats following a PVC and whose absence is a predictor of cardiac mortality following an MI? Micro volt t-wave alternans Fluoroquinolones, a new gen antibiotic is known for which cardiac effect? Prolonging QT What would decrease stim thresholds and current drain?

Reducing electrode surface area Ex: from 12mm to 8mm Match the units: watt-second Power Defibrillation energies exceed pacing energies by a factor of? 1,000, A band-pass filter modifies incoming signals according to which of the following units of measure? Hertz AV block occurs in what percentage of congenital open heart surgeries? 1 - 3% In order to have a pacing system automatically assess capture and thresholds, the essential electrode characteristics would be? Minimal electrode diameter size In a normal person, stroke volume increases by what % when exercising? 50% In pacing, capacitors are: Charged in parallel and discharged in series In a circuit with resistance of 500 ohms and 600 ohms in the parallel circuit the resistance would be? R total = R1 x R ———— (R1 + R2) = (500 x 600) ——————-

(500 + 600)

= 272.7 ohms Battery capacity of a pacemaker is given in which parameter? Current Most commonly utilized battery in current ICDs? Lithium silver vanadium oxide What does one French size equal in mm? 0.3mm What drug will increase DFT within 2 days? Flecainide What drug might be given to reduce pacing thresholds? Isoproterenol IV Which pacing indication would most likely use Rate drop response, sudden Brady response or rate hysteresis? Carotid sinus hypersensitivity What was a secondary endpoint finding CTOPP and MOST studies comparing atrial vs ventricle pacing? Reduced onset of AF Patient with long QT getting ICD. What drug should be avoided due to increased risk of Torsades De Pointes Erythromycin What drug may reduce digoxin clearance by 30% resulting in the need to reduce digoxin dose and retitrate based on serum levels? Amiodarone

What drug may significantly lower myocardial stimulation thresholds? Verapamil Proper lead position in a child who has undergone a Fontan procedure? Epicardial V lead, with subsequent transvenous A lead What causes cardiac C fibers in patients exhibiting vasodepressor syncope? Vigorous squeezing of relatively empty ventricles Approximate infection rate of CRTD implant in a normal healthy male? 2 - 4% Lead extraction morbidity and mortality rate? 1 - 3% What is the normal range of PCWP? 4 - 12 mm/Hg What is the most dangerous interaction between RF ablation and pacemakers? Runaway pacing Most common reason for ICD classify false VT/VF? EMI Which of the following is a Class III indication for ICD implant?

• VT not due to reversible cause
• severely symptomatic VT while patient awaits transplant
• Incessant VT
• NSVT, previous MI, positive EP Study VT not due to reversible cause

An EP takes a retrospective look at 360 consecutive ICD patients to gather data one his patient survival statistic. It uncovers one pharmacological factor was linked to better patient survival, what is it? Beta blocker therapy What may likely occur as a result of reversing the distal and proximal shock coils in the header of an integrated defibrillator system? May result in change of therapy efficacy and oversensing What is the goal of optimizing via echo for AV delay and ventricular synchrony? E and A waves separating with the end of diastole coinciding with beginning of systole What lab finding indicates HF exasperation? Elevated BMP What heart failure approved drugs have shown an increase in survival and EF? Carvedilol and metoprolol Which study demonstrated a clear mortality benefit from CRT pacing alone? SCD-HeFT Approximately what percentage of CRT patients are non responders? 30% A function of pacemaker circuitry that allows the pacemaker output to be dissipated quickly maximizing both the output and sensing capability? Charge dump AV sequential paced patients with frequent ventricular ectopic should have the the following parameters to decrease chance of competition: Short blanking periods

Low threshold electrode materials include each of the following EXCEPT:

• iridium oxide
• Elgiloy
• Platinized platinum
• Titanium nitride Elgiloy The strength duration curve resulting in a parabolic shape is described by which of the following formulas? I x V x t What has NOT been used as ERI magnet response? Abrupt decrease in rate What has NOT been used as an indicator of battery depletion? Pulse width stretching The term virtual electrode describes? The lead electrode and surrounding myocardium The energy delivered by an icd is based on the relationship between what? Initial voltage and final voltage on a capacitor The horizontal asymptote of a strength duration curve is termed: Rheobase Over time, the battery cell impedance of a lithium iodine powered pacemaker does what? Remains constant Tapping on a pulse generator with which type of sensor will increase the pacing rate? Piezoelectric activity

A MDT style 3.2mm low profile lead with no sealing rings and a long pin fits appropriately with which header? VS-1 B (sealing rings in header) DBS (Drawn Brazed Strand) is a term associated with: Silver & nickel alloy conductor material A likely benefit but possible concern of a ventricular detection enhancement such as "stability" would be best described as what? Increase the specificity but decrease the sensitivity In order to charge a capacitor, and ICD must provide current of approximately: 2 amps The cardioinhibitory response to carotid massage may be manifested by? Advanced AV block Sinus Brady PR prolongation What type of patient would benefit most from a feature like rate drop response? Carotid sinus hypersensitivity Trifasicular block is what class of indication? Class I Quinidine is associated with which side effect? Prolongation of QT What is the approximate number of sudden cardiac death episodes which occur in the US each year? 400, Infection from microorganisms within the patient would be termed?

Endogenous Diastolic dysfunction is characterized by: Increased ventricular wall stiffness Way at is considered first line drug therapy for treatment of malignant vasovagal syncope? Metoprolol What were the 3 inclusion criteria for MADIT I Prior MI Low EF Nonsustained VT A patient who undergoes revascularization for CAD who has sustained VT should be managed with: Post or perisurgical ICD implamt An idiopathic dilated cardiomyopathy patient was implanted with an ICD due to aborted SCD. Patient was placed on amio to decrease frequency of VT. As a result of the amio the patient experienced thyrotoxicosis which manifests itself by? Polymorphic VT Arrythmogenic RV dysplasia differs from brugada syndrome by presenting with? Monomorphic VT What has NOT been linked as a trigger mechanism for Torsades de Pointes? Adenosine The most common cause of a pacemaker to failure to output is? Oveersensing The time between heart beats would be described as : Cycle length

A patient is scheduled to receive radiation therapy for lung cancer in a location very close to an implanted generator. What should be done? Relocate the pacemaker before the radiation treatment Early results have shown which of the following categories of CHF patients to benefit from BiV pacing? NYHA class III with BBB What potential pacemaker/defibrillator interaction can result in defibrillator inhibition in a patient implanted with both? Pacemaker failure to sense VF When defibrillating a pacemaker patient, the defibrillator pass should be positioned how? Anterior/ posterior What drug is known to increase chronic pacing thresholds and decrease chronic defibrillation thresholds? Sotalol What drug increases DFT thresholds but decrease action potential duration and refractory periods? Lidocaine Which of the following is NOT a class I or II indication for ICD implantation?

• VT not due to reversible cause
• severe symptoms,attributed to VT while waiting for transplant
• incessant VT
• nonsustained VT, prior MI, +EP stufy Nonsustained VT, prior MI, +EP study On the radiodensity scale what would appear the most radiolicent? Air

If one doubles the distance away from the radiation source, the exposure level is ____ compared to original? 1/4 less