PCCN Exam questions with correct answers, Exams of Nursing

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The nurse observes that the patient's jugular veins distend in the semi- upright position to more than 5 cm above the sternal angle. This is an indication of: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ fluid volume overload. what is normal Pulmonary artery occlusion pressure (PAOP)? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ 5-12 mmHg The resistance against which the left ventricle must pump to eject its volume is: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ systemic vascular resistance. When the tricuspid valve is open, central venous pressure reflects the filling pressure in the: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ right ventricle. Tachycardia is dangerous for the patient with ischemic heart disease because of: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ compromised cardiac output. During initial examination of a critical care patient, the nurse observes wide and convex nails and bulbous fingertips. This is evidence of: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ central cyanosis. Priorities for palpation of the patient with cardiovascular disease include: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ estimating edema. checking capillary refill checking for DVT arterial pulses

By blocking the conversion of angiotensin I to angiotensin II, angiotensin- converting enzyme inhibitors produce: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ b. vasodilation. The nurse has read that the cardiologist recommends the use of class IV drugs to depress sinus and atrioventricular node conduction and terminate supraventricular tachycardias in the patient at this time. The nurse will anticipate orders for which medications? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ a. Verapamil, diltiazem, or amlodipine The nurse has administered a drug that stimulates β1-adrenergic sites. Following administration of the drug, the nurse will assess for: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ a. increased heart rate. The nurse is observing the patient's electrocardiographic monitor after insertion of a temporary pacemaker. Seeing a P-wave after the pacing artifact, the nurse knows that the: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ c. atrium is being paced. The possibility of microshock when handling a temporary pacemaker can be minimized by: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ b. insulating the ends of the wires. and wearing gloves when handling the pacing wires In the postoperative cardiovascular patient, the most frequent cause of a decreased cardiac output is: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ a. reduced preload. A patient is being monitored by continuous electrocardiogram (ECG) after placement of a transvenous pacemaker. "Loss of capture" is seen on the ECG. Which nursing intervention may correct this situation? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ a. Position the patient on the left side. or reposition the leads

In analyzing the ECG strip, the nurse notices a spike before each QRS complex. The patient's heart rate is 70 beats/min. This phenomenon is reflective of - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ b. pacing artifact; the pacemaker is sensing and capturing. Calculate the cerebral perfusion pressure (CPP) for a patient with a mean arterial pressure (MAP) = 95 mm Hg and an intracranial pressure (ICP) = 15 mm Hg. - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ b. 80 mm Hg What procedure secures an arteriovenous malformation when a pt's condition is too unstable for surgery? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ embolization that can be done to secure the lesion without surgery. When the condition is more stable, an operation might be considered if needed. Knowing that a patient has hypoxemia and ischemia in his brain, the nurse anticipates which of the following? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ a. Cerebrovascular dilation The nurse's priority in eye care for the patient in a coma will be: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ c. keeping the eyes moist to prevent corneal ulceration. The patient has markedly deep, rapid respirations with a fruity breath odor. Based on the patient's history, the nurse will: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ perform a blood glucose measurement. The patient with the syndrome of inappropriate antidiuretic hormone (SIADH) secretion will need to have the imbalance of which electrolyte corrected as soon as possible? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ Sodium Which of the following conditions occurs when the renal tubules are unable to reabsorb excess glucose? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ Glycosuria

The patient has a waist measurement of 52 inches. His triglyceride level is 175 mg/dL, his high-density lipoprotein (HDL) cholesterol level is 32 mg/dL, and his fasting plasma glucose level is 224 mg/dL. His blood pressure readings are usually approximately 140/90 mm Hg. The nurse recognizes the characteristics of: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ metabolic syndrome. To reverse the hyperglycemic hyperosmolar state, the nurse will first prepare to administer: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ fluids The nurse is caring for a patient with central diabetes insipidus (DI). The nurse should anticipate orders for the administration of: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ vasopressin In the syndrome of inappropriate antidiuretic hormone (SIADH), the physiological effect is: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ dilutional hyponatremia, reducing sodium concentration to critically low levels. Which assessment findings would indicate fluid volume excess? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ edema, auscultation of a third heart sound, crackles in lungs, bounding pulses, AMS, olguria, HTN The report of a renal patient's laboratory results shows that the blood urea nitrogen (BUN) level is less than 25 mg/dL. To fully understand the patient's renal status, the nurse must consider this value along with: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ c. creatinine level. To determine whether edema in a patient's hands is due to circulatory compromise or another cause, the nurse might: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ elevate the patient's extremities for 1 hour and observe the degree of edema still present.

Hypovolemia causes tachycardia and : - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ hypotension. To avoid the complications that can result from administering furosemide (Lasix) to stimulate urinary output, the nurse will carefully monitor: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ levels of electrolytes, especially potassium. Which dialysis method would be most appropriate for the hemodynamically stable patient in the anuric phase of acute kidney injury (AKI)? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ Intermittent hemodialysis What are complications of continuous renal replacement therapy (CRRT)? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ Air embolism, decreased inflow pressure, electrolyte imbalance Which electrolytes pose the most potential hazard if not within normal limits for the person with acute kidney failure? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ Potassium and calcium peaked T-waves and a widening of the QRS interval in a pt with AKI are indicative of: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ d. hyperkalemia. A patient presents with the following: HR, 120 beats/min; BP, 80/44 mm Hg; urine output averaging 20 mL/hr over the last 4 hours; afebrile; moist rales in the lungs bilaterally; BUN, 84 mg/dL; creatinine, 3.4 mg/dL. What is the probable cause of this patient's acute kidney injury (AKI)? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ Left ventricular failure causing prerenal AKI An elderly patient is in a motor vehicle accident and incurs a significant internal hemorrhage. He is at greatest risk for which category of acute kidney injury (AKI)? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ Prerenal

A patient is admitted to the unit with the following laboratory values: urine specific gravity, 1.010; urine osmolality, 210 mOsm/kg; BUN/Cr ratio 10:1; urine sodium, 96 mEq/L. The urine output has been 60 mL since admission 2 hours ago. These values are most consistent with which of the following types of acute kidney injury (AKI)? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ Intrarenal Percussing the patient's stomach produces a tympanic sound is a sign that:

• ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ the patient's stomach is empty. The nurse is unable to hear bowel sounds in any of the four quadrants of the patient's abdomen. This may indicate the presence of: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ ban ileus. Auscultation of the abdomen reveals a bruit over the left renal artery. This is an indication of: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ renal hypertension. The nurse observes that striae on the patient's abdomen are pink and purple. This may be a sign of: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ Cushing's syndrome. During auscultation of the patient's abdomen, the nurse hears frequent high-pitched, tinkling sounds. This is probably evidence of: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ normal bowel sounds. The nurse has been unable to hear any bowel sounds during examination of the patient's abdomen. The minimum interval for listening before concluding that bowel sounds are absent is ____ minute(s). - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ 5 During palpation of the patient's abdomen, rebound tenderness indicates: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ inflammation of the peritoneum, such as with appenticitis and Chrohn's dz

Elevated alkaline phosphatase level and increasing nausea and abdominal pain indicate: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ gallbladder disease. The patient's serum transferrin level is higher than 300 mcg/dL. The nurse will review other laboratory results to evaluate for the possible presence of:

• ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ iron deficiency anemia. The patient's alpha fetoprotein level is 200 ng/mL. This can indicate the presence of ____ cancer. - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ liver Knowing that the patient has advanced liver disease, the nurse expects his partial thromboplastin time (PTT) to be in the range of ____ seconds. - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ 50 to 75 The patient has advanced cirrhosis. Her serum albumin level is anticipated to be: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ decreased. A vasopressin drip for a patient with bleeding esophagogastric varices would be contraindicated if the patient has a history of: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ coronary artery disease What type of formula would be most appropriate for a patient with acute pancreatitis? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ Low fat A person with a body mass index (BMI) of 32 would be considered: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ obese Diet therapy for a hypertensive person 1 day after a myocardial infarction would include all the following except: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ a fluid-restricted diet.

Kwashiorkor malnutrition results in: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ low levels of serum proteins, low lymphocyte count, and hair loss. Significant laboratory and clinical findings in the nutritional assessment of patient with cardiovascular disease include: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ b. elevated low-density lipoprotein (LDL) cholesterol and decreased subcutaneous fat. Serum proteins serve the function of: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ maintaining osmotic pressure. A patient on mechanical ventilation is receiving total parenteral nutrition (TPN). Why is appropriate caloric intake important? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ Excessive calorie intake can cause an increase in PaCO2. A primary nutritional intervention for hypertension is: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ limiting sodium An effect of malnutrition on respiratory function is: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ decreased surfactant. What is the rationale for careful intake and output for the patient with pulmonary alterations? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ Fluid volume excess can lead to right-sided heart failure. To decrease portal hypertension, an interventional radiologist can: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ perform a transjugular intrahepatic portosystemic shunt procedure. To decompress an obstructed gastrointestinal (GI) tract, the nurse will prepare to: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ insert a nasogastric tube.

When inserting a small-diameter feeding tube, the nurse will evaluate the placement into the: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ stomach. The appropriate method of checking placement of a feeding tube is to: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ use a portable x-ray device. Following surgery for liver transplantation, the nurse will recognize signs of hypovolemia, tachypnea, tachycardia, and poor peripheral oxygenation as evidence of: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ blood loss. Accumulation of ammonia and other toxins normally detoxified by the liver can produce: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ Hepatic encephalopathy Elevations in which lab test results to establish a diagnosis of acute liver failure? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ Serum bilirubin and alkaline phosphatase levels The most useful test to evaluate the coagulation status of a patient with acute liver failure is prothrombin time. This is because prothrombin is: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ markedly increased in the condition. The patient with spinal cord injury is at risk for disruption of the sympathetic nervous system. The nurse will be prepared to apply interventions for _____ shock. - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ neurogenic Shock syndrome can best be described as a: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ generalized systemic response to inadequate tissue perfusion. The initial priority action in managing the patient in shock is to: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ establish and maintain an airway.

The nursing measure that can best enhance large volumes of fluid replacement in hypovolemic shock is: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ insertion of a large-bore peripheral intravenous catheter. The main cause of cardiogenic shock is: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ an inability of the heart to pump blood forward. With anaphylactic shock, which mechanism results in a decreased cardiac output? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ Peripheral vasodilation The gastrointestinal system is a common target organ for MODS following septic shock due to: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ disruption of the mucosal barrier from hypoperfusion. Clinical manifestations of ischemic hepatitis show up 1 to 2 days after the insult. Which symptom is indicative of hepatic insufficiency? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ Jaundice The difference between primary and secondary multiple organ dysfunction syndrome (MODS) is that primary MODS is the result of: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ direct organ injury. The patient is hypovolemic, has decreased breath sounds, and shows dullness to percussion on the injured side. This is suspicious of: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ Hemothorax A patient with a cervical spinal cord injury becomes hypotensive and bradycardic. The nurse will notify the physician and prepare to administer: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ ephedrine To prevent respiratory complications, such as pneumonia and atelectasis, in the patient with fractured ribs, the nurse will carefully monitor the patient's need for: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ analgesia

The patient has experienced a deceleration trauma injury to the chest, and there is a significant difference in the blood pressures in the left and right upper extremities. The nurse's priority action is to: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ measure blood pressure in both lower extremities. Nutritional support of the trauma patient is especially important because: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ a post-traumatic hypermetabolic response occurs after injury In addition to having the usual host susceptibility to pathogens, the trauma patient is at risk for infection because of: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ adverse effects of trauma on the immune system. How do you open the airway of an unresponsive trauma patient in the emergency department? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ Chin lift/jaw thrust maneuver should be used. Tension pneumothorax is characterized by mediastinal shift that often results in? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ Lung collapse on the injured side a. Verapamil Class and uses - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ Antidysrhythmic used for angina, hypertension, supraventricular arrhythmia and atrial fibrillation or flutter, tardive dyskinesia diltiazem Class and uses - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ Antidysrhythmic

used for angina, hypertension, supraventricular arrhythmia and atrial fibrillation or flutter, tardive dyskinesia amlodipine class and uses - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ Calcium channel blocker HTN, angina more ____ ion resides in ICF and more ____ ion resides in ECF - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ potassium, sodium electrical potential across membrane = ____ - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ -90mV on an EKG, this portion shows atrial depolarization - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ P wave on an EKG, this portion shows ventricular depolarization - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ QRS complex on an EKG, this portion shows ventricular repolarization - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ T wave beginning of P -> beginning of QRS - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ PR interval: beginning of QRS -> end of T - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ QT interval:

end of QRS -> beginning of T - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ ST segment: the delay in the __ region of the AV node allows the ventricle to fill - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ N each thick block on an EKG is ___ seconds - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ 0. each little block on an EKG is __ seconds - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ 0. 15 little blocks = __ seconds - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ 3 hash marks at top of EKG = ___second intervals - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ 3 QRS vector points away from area of ____ - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ infarction QRS vector points toward area of ____ - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ hypertrophy normal range for vector: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ 0-90 degrees ST elevation is a sign of ___ injury - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ acute (recent) a larger than normal Q wave is a sign of ___ - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ infarction

normal P-R interval is ______ seconds - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ <0. normal QRS interval is ____ seconds - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ <0. number of P waves per minute - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ atrial rate number of QRS complexes per minute - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ ventricular rate calculated QTc = - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ QT interval/square root of RR interval normal QTc = ______ seconds - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ 0.36-0. seconds a rhythm disturbance that is organized and has F waves - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ atrial flutter a rhythm disturbance that is not organized and has irregular R-R intervals - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ atrial fibrillation when the PR interval is lengthened beyond the normal interval, it is called a __ ___ ___ block - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ first degree AV when there is progressive prolongation of PR interval until QRS complex is dropped, this is called __ ___ ___ block (type ___) aka ____ phenomenon or ____ - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ second degree AV, I, wenchybock, mobitz (type I) when there is no correlation between what's happening in the atrium and the ventricle, nothing is getting through the AV node and the atrium and

ventricle are firing on their own, this is called a ___ ___ ___ block - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ third degree AV as you double creatinine, you cut in half ____ - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ GFR normal BUN range - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ 8-20 mg/dl azotemia - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ increased BUN normal SCr range - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ 0.7-1.5 mg/dl normal sodium range - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ 136-145 meq/L normal osmolality range - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ 270-290 meq/L normal glucose range - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ 80-120 mg/dl normal serum potassium range - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ 3.5-5 meq/L intracellular potassium concentration - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ 140 meq/L normal magnesium range - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ 1.4-1.8 meq/L normal calcium range - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ 8.5-10.5 mg/dl normal phosphate range - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ 2.6-4.5 mg/dl

anion gap calculation: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ Na - (Cl + HCO3) total osmolality calculation: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ (2xNa) + (glucose x10)/180 + (BUN x 10)/ total effective osmolality calculation - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ (2xNa)

• (glucose x 10)/ normal anion gap range - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ 3-11 meq/L a patient w/significant Q waves and ST elevation present in leads V1-V4 is said to have: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ acute anterior infarction a patient w/significant Q waves and ST elevation present in leads I and AVL is said to have: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ acute lateral infarction a patient w/significant Q waves and ST elevation present in leads II, III and AVF is said to have: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ acute inferior infarction Automaticity of cells in the SA node is a function of which phase of the action potential? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ 4 the ___ node is located in the junctional tissue between atria and ventricles - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ AV diarrhea can most likely lead to hypotonicity by causing volume ____ with subsequent ___ in ADH effect and water intake - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ depletion, increase

Pre-renal azotemia is more likely to be present in ____ - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ hypovolemia if a patient has a a decrease in pH, decrease in bicarb, and decrease in pCO2, they have: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ metabolic acidosis if a patient has an increase in pH, increase in bicarb, and increase in pCO2, they have: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ metabolic alkalosis if a patient has a decrease in pH, increase in bicarb, and increase in pCO2, they have: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ respiratory acidosis if a patient has an increase in pH, decrease in bicarb, and decrease in pCO2, they have: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ respiratory alkalosis normal bicarb range: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ 22-26 meq/L normal pCO2 range: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ 35-45 mm Hg normal pH range: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ 7.35-7. an increased anion gap suggests a possible __ ___ - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ metabolic acidosis In the presence of an acidosis, the ionized portion of serum calcium is - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ increased a loss of 1 L of a fluid that is _____ would result in the greatest decrease in the effective circulating volume - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ isotonic

fluid losses from the body could lead to either - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ hypertonicity or hypotonicity ST segment elevation indicates ____ injury - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ acute in the presence of an alkalosis, the ionized portion of serum calcium: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ decreased the ______________ compartment will provide a disproportionately greater share of a hypotonic fluid loss from the body - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ extracellular Calculate the cardiac output for a pt with a HR of 70 and a SV of 65 ml. - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ HR X SV=CO 70 X 65= 4550 4.6 L/min Calculate the cardiac output for a pt with a HR of 70 and a SV of 65 ml. HR X SV=CO - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ HR X SV=CO 70 X 65= 4550 4.6 L/min What % of the cardiac cycle is provided by the atrial kick? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ 20% What is Atrial Kick? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ Atrial kick is a term that represents the amount of the total CO that is supplied via atrial contraction. If the pt has a condition or dysrhythmia that impairs or eliminates the atrial contraction, the pt may be compromised.

A normal value for an EF would be? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ The EF should be more than 50%. It represents the amount of blood ejected from the left ventricle compared to the total amount available, expressed as a %. An EF of 35% or less indicates a problem with contractility, outflow or filling. EXA: If the ventricle contains 90ml of blood and 50mls are ejected, the amount would be expressed as a %, in this case 55%. A pt presenting with chest pain that is more frequent, severe and prolonged than before has _____ angina. - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ UNSTABLE ANGINA The change in quality, frequency, and duration indicates UNSTABLE ANGINA and may indicate that the pt is at increased risk for an MI. This pt should be closely monitored for EKG changes and rhythm disturbances. Pt/ family teaching should begin on how to identify an MI and basic CPR. Stroke Volume is comprised of which factors? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ Contractility, preload and afterload A reflex tachycardia caused by the stretch of the right atrial receptors is known as the ____ - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ BAINBRIDGE REFLEX It is believed that this reflex exists to speed up the HR if the right side becomes overloaded, thereby helping equalize pressures on both sides Diastole comprises what portion of time of the cardiac cycle? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ 2/ The heart is virtually static during diastole.

During this period, the cardiac vessels and chambers fill—a process that takes up 2/3s of the time necessary to complete the cardiac cycle What is the MAP (mean arterial pressure) for pt: BP 120/ HR 80 - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ MAP=2(DBP) + (SBP)/ MAP=2(70) + 120/ MAP=260/ MAP=86. Pts should maintain a MAP of at least 60 to ensure adequate perfusion to the brain and kidneys. What is the MAP (mean arterial pressure) for pt: BP 120/ HR 80 MAP=2(DBP) + (SBP)/3 - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ MAP=2(70) + 120/ MAP=260/ MAP=86. Pts should maintain a MAP of at least 60 to ensure adequate perfusion to the brain and kidneys. Calculate CI (cardiac index) HR 80 BP 110/ SV 60 BSA 2.0 m Expressed in L/min/m2 - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ CI=CO/BSA CO=HR X SV

CO=80 X 60

CI=4800/2.0

CI=2400

CI=2.4 L/min/m2 Calculate CI (cardiac index) HR 80 BP 110/70 SV 60 BSA 2.0 m2 Expressed in L/min/m2 CI=CO/BSA - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ CI=CO/BSA CO=HR X SV CO=80 X 60 CI=4800/2.0 CI=2400 CI=2.4 L/min/m2 The resistance against which the right ventricle must work to eject its volume is known as: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ Pulmonary Vascular Resistance This pressure represents a mean pressure in the systemic vasculature. The higher the resistance, the harder the heart has to work against it. EXA: Colder temperatures will cause vasoconstriction; the heart then has to pump harder to deliver blood through the narrowed vasculature.

Approximately what % of coronary artery blockage is needed to cause angina? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ 75% Anginal pain usually occurs when approximately 75% of the artery's diameter becomes occluded. Pain is usually more pronounced with exertion or emotional distress, when O2 demand by cardiac tissue cannot be met by O2 supply via the occluded arteries. The severity of the pain may be compounded with vasospams that further restrict blood flow through the coronary arteries. A heart murmur associated with acute valvular regurg would be? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ S4 S1 and S2 are normal heart sounds S3 is associated with fluid status S4 is associated with compliance. Which is the best lead to monitor a RBBB? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ Lead V1 Tall, peaked T waves on an EKG may be indicative of? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ HYPERKALEMIA The PR interval may become prolonged. Also, if the K is greater than 8, a wide-complex tachycardia may occur. Keep in mind that low levels of calcium or sodium may potentiate the cardiac effects, as can a low pH. Administering vecuronium during theraputic hypothermic measures prevents: - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ PREVENT SHIVERING Vecuronium is a paralytic and will prevent shivering. If a pt shivers, her temperature will rise.

Your pt was admitted for malaise, severe dyspnea and had a syncopal episode at work. He states he has a midline burning sensation in his chest that worsens when he is supine. You suspect? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ MYOCARDITIS It can also present as inspiratory pain. The pain when supine is a cardinal sign of myocarditis. Other findings may include respiratory infection and an S3, S4, and pericardial friction rub. A definitive diagnosis of myocarditis can be made via? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ ENDOMYOCARDIAL BIOPSY A biopsy is the ONLY definitive way to diagnose myocarditis. The volume of fluid required to cause a pericardial tamponade is? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ 50-75 ml of blood Although 50-75 mls is a small amount, the pressure in the intrapericardial space may equal or exceed atrial and vertricular pressures causing an acute tamponade. Beck's triad is a combination of symptoms useful in diagnosing cardiac tamponade. They are? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ Distended neck veins Muffled heart sounds Hypotension Tachycardia is an early sign of tamponade. A narrowed pulse pressure occurs, and fluid cannot be ejected from the heart. The muffled heart sounds occur because the fluid in the sac minimized the transmission of sound waves.

Which of the following hemodynamic changes will occur with cardiac tamponade?

• Increased cardiac output
• Stroke volume decrease
• Contractility increases
• Decreased heart rate - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ STROKE VOLUME DECREASE Because the heart cannot adequately fill or eject its contents, stroke volume (SV) decreases and causes a decreased cardiac output (CO). Contractility decreases because the muscles cannot stretch and, therefore, cannot contract effectively. If your pt had a cardiac tamponade, what you expect to see on a CXR? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ A DILATED SUPERIOR VENA CAVA The vena cava is dilated because blood couldn't flow into the right atrium. JVD would not be visible on a CXR. The mediastinum would be widened. Delineation of the pericardium or epicardium would not be visible on a CXR. Your pt was admitted for severe dyspnea, dysphagia, palpitations and an intractable cough. On auscultation, you hear a loud S1 and a right sided S3 and S4. This pt probably has? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ MITRAL STENOSIS These symptoms could be caused by mitral stenosis, an ischemic left ventricle, or failure of a left ventricle. The S3 and S4 sounds suggest both a fluid problem and a pressure problem.

Quincke's sign is usually seen in what condition? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ AORTIC INSUFFICIENCY Quincke's sign is elicited by pressing down on he finger top; a visible pulsation is seen in the nail bed. The sign results from a pulse with a rapid, initial hard pulsation, followed by a sudden collapse as blood flows back through the incompetent valve. In pts with aortic insufficiency, the popliteal BP is often higher than the brachial BP by at least 40 mm HG. This discrepancy between the measurements is known as? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ HILL'S SIGN Hills's sign reflects the rapid rise in pulsation. DeMusset's sign is also found in aortic insufficiency; it consists of the bobbing of the head in time with the forceful pulse. Holmes' and Rochelle's signs are not diagnostic signs. In stable angina, which of the following is true about CK-MB isoenzymes and troponins? - ** 🔰 VERIFIED ANSWERS 🔰 ✔✔ CK-MB ISOENZYMES AND TROPONINS WILL NOT INCREASE A positive treadmill test may not be positive for CAD. LV dysfunction may be diagnosed with a thallium test (myocardial scintigraphy). Treadmill stress tests miss as many as 40% of cases of single-vessel disease. If the inferior wall of the heart is infracted, the leads that will most directly reflect the injury are?

• II, aVF
• I, aVL
• V1 - V2