RCIS 2024 Exam Study Guide With Complete Questions & Solutions, Exams of Nursing

Download RCIS 2024 Exam Study Guide With Complete Questions & Solutions and more Exams Nursing in PDF only on Docsity!

RCIS 2024 Exam Study Guide With Complete Questions

& Solutions

What determines the number of electrons generated by an x-ray tube? -Frame rate -Kilovoltage -Pulse width -Milliamperage - ANSWER - Kilovoltage What medication is cardiac glycoside? -Lasix -Digoxin -Hyperstat -Hydralazine - ANSWER - Digoxin What type of arterial puncture is associated with an increased risk of retroperitoneal bleeding? -Internal Femoral -External Femoral -Low common femoral -High common femoral - ANSWER - High common femoral What are the contraindications for rotational atherectomy? Choose three contraindications. 1.Ostial Lesion 2.Existing dissection 3.Unprotected LMCA

4. Saphenous vein graft lesion
5. Angiographic evidence of thrombus - ANSWER - 2,4, What type of balloon catheter should be used to treat fibrotic plaque and neo- intimal hyperplasia? -Scoring -Perfusion -Intra-aortic -Valvuloplasty - ANSWER - Scoring

What planes are represented in this image? Choose two planes. -AP -LAO -RAO -Caudal -Cranial -Lateral - ANSWER - LAO Caudal What devices are used to treat flow limiting dissections. Choose two devices. 1.Stent 2.Angioplast y 3.Atherecto my

4. Retractable coil - ANSWER - 1, Peg hydrogel plug closure device - ANSWER - Mynx Suture Mediated closure device - ANSWER - Perclose Collagen & suture mediated closure device - ANSWER - Angio-Seal Nitinol Clip closure device - ANSWER - StarClose During a diagnostic left heart cath, the following is observed on the hemodynamic monitor. What should be the next immediate action? -Flush the catheter -Pull back the catheter -Deliver 150 joules synchronized shock -Deliver 150 joules unsynchronized shock - ANSWER - Pull back the catheter

What INITIAL sign of retroperitoneal bleed may a patient exhibit? Choose three

1. Hypotension 2.Bradycardia 3.Lower back pain 4.A falling hematocrit
2. A falling respiratory rate - ANSWER - 1,3, What condition is associated with an elevated pulse pressure? -Hyperlipidemia -Arterial sclerosis -Aortic insufficiency -Hypertrophic cardiomyopathy - ANSWER - Aortic insufficiency What should be done to manage the rapid loss of balloon pressure during inflation? -Increase inflation pressure to the balloon -Decrease inflation pressure to the balloon -Inject the coronary before removing balloon -Aspirate the coronary before removing the balloon - ANSWER - Inject the coronary before removing balloon What valve has been replaced in the image? -Aortic -Mitral -Tricuspid -Pulmonic - ANSWER – Aortic

What type of imaging is MOST COMMONLY used during PFO closures? -OCT -ICE -MRI -IVUS - ANSWER - ICE What is an advantage to using a filter versus a balloon occlusion distal protection device? -Allows distal perfusion -Lower profile of the device -Ensures distal vessel occlusion -Allows small embolic particles to pass - ANSWER - Allows distal perfusion What medication is a calcium channel blocker? -Lisinopril -Warfarin -Metoprolol -Nifedipine - ANSWER - Nifedipine What actions SHOULD be completed when prepping the patient for a transradial procedure? Choose two responses. 1.Prep right groin 2.Administer antibiotics 3.Position wrist in prone position 4.Position wrist in supine position 5.Start IV on same arm as radial access - ANSWER - 1, Immediate treatment for a MI should include: -Aspirin, Lasix, nitroglycerin, and oxygen. -Aspirin, Lasix, morphine, and nitroglycerin. -Aspirin, morphine, nitroglycerin, and oxygen. -Aspirin, fibrinolytics, morphine, and nitroglycerin. - ANSWER - MONA What is the PRIMARY therapeutic reason for using rotational atherectomy as an adjunctive therapy for PCI? -Vaproizes plaque -Removes thrombus -Scores fibrotic plaque

-Debulks calcific plaque - ANSWER - Debulks What is represented by the circular tracings in this IVUS image? Calcium Stenosis Dissectio n Under expanded stent - ANSWER - Stenosis What hemodynamic waveform would be observed with mitral stenosis? -Large "a" wave in the left atrium -Large "v" wave in the left atrium -Left ventricular end diastolic pressure greater than left atrial mean -Left ventricular systolic pressure greater than aortic systolic pressure - ANSWER - Large a wave Where is the wire equalized when performing FFR? -In the wire hoop -On the procedure table -Advanced distal to the lesion -Advanced outside the guide catheter - ANSWER - Outside of the guide catheter What blood chemistry would be an indicator of renal function? -Sodium -Calcium -Creatinine

-Potassium - ANSWER - Creatinine MAP equation - ANSWER - (2 diastolic) + systolic/ 3 In preparation for a pericardiocentesis, the patient should be at a degree angle. -0 - 15 -30 - 45 -55 - 70 -75 - 90 - ANSWER - 30- A 1.66 mm diameter sheath is equivalent to what French size? 4 5 6 7 - ANSWER - 6 What findings are typically associated with hypertrophic cardiomyopathy? -Increased LV compliance; decreased EF -Decreased LV compliance; normal systolic function -Increased LV compliance; decreased systolic function -Decreased LV compliance; hyperdynamic LV function - ANSWER - Decreased LV compliance; hyperdynamic LV function When preparing a patient for a device implant what activities SHOULD be considered? Choose three activities.

1. Arms restrained
2. Oxygen mask on patient at 10 L/min 3.Cautery grounding pad attached to the patient 4.IV located on the ipsilateral side of the implant
3. IV located on the contralateral side of the implant - ANSWER - 1,3, What technique is being shown in this image?

Y stenting Crushing stent Kissing balloon dilatation PCI using distal protection - ANSWER - Kissing balloon What is an accurate interpretation of the ECG? Acute anterior MI Sinus bradycardia Ventricular tachycardia right bundle branch block - ANSWER - Acute anterior MI The highest risk of morbidity and mortality associated with coronary angiography occurs in patients with -Coronary spasm. -Coronary ectasia. -Left main coronary disease. -Three vessel coronary disease. - ANSWER - Left main coronary disease What equipment is used in peripheral interventions to steer across a lesion? Choose three items. 1.Balloon 2.Guidewire 3.Torque device 4.Diagnostic catheter 5.Atherectomy device - ANSWER - 2,3, When generating ionizing radiation, photons are emitted from the -Anode. -Cathode. -Focal spot. -Surface target. - ANSWER - Anode

What is the definition of the pacing threshold? -Maximum amount of time between discharge cycles -Minimum amount of mA required to elicit a response -Minimum amount of time to overdrive normal sinus rhythm -Maximum amount of mA necessary to block normal sinus rhythm - ANSWER - Minimum amount of mA required to elicit a response What is the desired physiologic effect of an IABP? -Increased preload -Increased afterload -Increased coronary blood flow -Increased myocardial oxygen demand - ANSWER - Increased coronary blood flow decreases afterload When does the IABP deflate? - ANSWER - Systole When does the IABP inflate? - ANSWER - Diastole What catheter could be used as an alternative to an IMA for a LIMA angiography? -AL -JL -JR -Pigtail - ANSWER - JR What temporary pacemaker setting would change the device from demand to asynchronous? -Increase voltage -Decrease sensitivity -Increase refractory period -Decrease refractory period - ANSWER - Decrease sensitivity Which atherectomy catheters shave and debulk plaque? -Orbital and directional -Vascular and intraspinal -Sculpting balloon and stent -Cutting balloon and infusion catheter - ANSWER - Orbital and directional What view exposes an operator standing on the patient's right side to the highest dose of radiation?

AP caudal LAO cranial RAO caudal RAO cranial - ANSWER - LAO Cranial What medication is a GP IIb/IIIa inhibitor? -Eptifibitide -Bivalirudin -Enoxaparin -Clopidogrel - ANSWER - Eptifibitide A pH greater than 7.45 is indicative of -Acidosis. -Alkalosis. -Hematuria. -Hyperkalemia. - ANSWER - Alkalosis Which artery MOST COMMONLY provides blood flow to the greatest portion of the myocardium? -Circumflex -Right coronary artery -Left anterior descending -Posterior descending artery - ANSWER - LAD The compliance chart for a balloon catheter has rated burst and -Shaft length. -Balloon length. -Minimal pressure. -Nominal pressure. - ANSWER - Nominal Pressure Post cardiac catheterization using femoral access, patients' instructions should include -Avoiding drinking liquids for 6 hours. -Elevating the head of the bed to 60 degrees. -Applying warm, moist compress to reduce swelling. -Holding pressure to access site when coughing or sneezing. - ANSWER - Holding pressure to access site when coughing or sneezing. What is a PRIMARY indication for the administration of sodium bicarbonate? -Metabolic acidosis

-Metabolic alkalosis -Respiratory acidosis -Respiratory alkalosis - ANSWER - Metabolic acidosis What vascular approach should be used to perform a transseptal left heart catheterization? -Right femoral vein -Right femoral artery -Right external jugular vein or the left axillary/subclavian vein -Right internal jugular artery - ANSWER - Right femoral vein What drug is MOST COMMONLY administered for sedation during a cardiac catheterization? -Ativan -Demerol -Morphine -Midazolam - ANSWER - Midazolam What is a common procoagulant used to obtain hemostasis when using vascular closure devices? -Fibrin -Collagen -Protamine -Procainamide - ANSWER - Protamine Critical limb ischemia can lead to which of the following? Choose three that apply. 1.Cellulitis 2.Wound infection 3.Decubitus ulcers 4.Excessive bruising 5.Amputation of affected limb - ANSWER - 3,4, Equalization of aortic and arterial pressures is associated with which procedural device? -CFR -FFR -OCT -IVUS - ANSWER - FFR What imaging modality is used to confirm proper stent apposition?

-DSA

-ICE

-TTE

-IVUS - ANSWER - IVUS

What signs or symptoms are associated with a vasovagal reaction? Choose three signs or symptoms. 1.Nausea 2.Bradycardi a 3.Hypotensi on 4.Tachycardi a 5.Hypertension - ANSWER - 1,2, What condition would invalidate FICK cardiac output results? -Atrial septal defect -Aortic regurgitation -Pulmonary stenosis -Systemic hypertension - ANSWER - ASD What pacing method requires the use of external pacing pads? -Transarterial -Transvenous -Transcutaneous -Transesophageal - ANSWER - Transcutaneous What is an absolute contraindication for intra-aortic balloon counterpulsation? Aortic stenosis Mitral stenosis Aortic regurgitation Mitral regurgitation - ANSWER - Aortic regurgitation In respiratory arrest, the rescuer should give one breath every seconds.

-6 - ANSWER - 6 Door to balloon time for STEMIs should occur within minutes.

-190 - ANSWER - 90

The term "standard precautions" refers to. -Informed consent -Aseptic technique -Advanced directives -Personal protective equipment - ANSWER - PPE What modality can be used to assure good stent apposition during PCI? -Coronary flow reserve -Fractional flow reserve -Intravascular ultrasound -Digital subtraction angiography - ANSWER - IVUS What medications are MOST COMMONLY used to pre-treat a patient with a history of contrast allergies? A.Aamrinone, diphenhydramine, epinephrine B.Famotidine, diphenhydramine, Solu-Medrol C.Cimetadine, Solu-Medrol, sodium bicarbonate D.Methyl-prednisolone, famotidine, sodium bicarbonate - ANSWER - B -Famotidine (Pepcid. Histamine-2 blocker that works by decreasing the amount of acid the stomach produces) -Diphenhydramine (Benadryl. Antihistamine) -Solu-Medrol (Methyl-prednisolone sodium succinate. A synthetic corticosteroid used for severe or incapacitating allergic conditions.) After obtaining radial artery hemostasis, the arterial flow should be monitored every minutes for the first hour.

-30 - ANSWER - 15 Post procedure bedside report handoff should include -Confirming the patient is no longer NPO. -Thanking the patient and cleaning the room. -Showing the patient's family member how to hold manual pressure.

-Assessing the puncture site with the receiving staff for questions and concerns. - ANSWER - Assessing the puncture site with the receiving staff for questions and concerns What type of angina usually occurs with activity and subsides with rest? -Stable -Unstable -Crescendo -Prinzmetal - ANSWER - Stable What French size is equal to a 1.5mm rotational atherectomy burr? -3. -3. -4. -6.00 - ANSWER - 6. Why is rapid ventricular pacing used for an aortic valvuloplasty procedure? -To increase oxygen demand for coronary perfusion -To increase cardiac output during the balloon inflation -To reduce the amount of balloon movement during inflation -To reduce the need for coronary perfusion during the inflation period - ANSWER - To reduce the amount of balloon movement during inflation DECREASES CARDIAC OUTPUT What vessel diameter would have the highest restenosis rate? -2.5mm -3.5mm -4.5mm -5.5mm - ANSWER - 2.5mm What tests are used to evaluate radial artery patency prior to obtaining access? Choose two tests. 1.Barbeau 2.Fluoroscopy 3.Tissue doppler 4.Modified Allen's 5.Cephalic venous doppler - ANSWER - 1, No perfusion -No antegrade flow beyond the point of occlusion - ANSWER - TIMI 0

Penetration without perfusion Faint antegrade coronary flow beyond the occlusion with incomplete filling of the distal coronary bed - ANSWER - TIMI 1 Partial perfusion Delayed or sluggish antegrade flow with complete filling of the distal territory

• ANSWER
• TIMI 2 Complete Perfusion Normal flow with complete filling of the distal territory - ANSWER - TIMI 3 What types of devices are used to macerate blood clots? Choose three devices. 1.Stent 2.Angiojet 3.Cleaner 4.Embolizati on

5. Balloon angioplasty
6. Thrombolytic infusion - ANSWER - 2,3, The dP/dt is a measure of the -Left ventricular contractility. -Pressure gradients in stenotic valves. -Ratio of atrial to ventricular muscle tension. -Ratio of pulmonary to total peripheral vascular resistance. - ANSWER - Left ventricular contractility A Fogarty balloon is commonly used to -Dilate a stenotic lesion. -Pull clot back into a vein. -Push plaque downstream. -Measure right heart pressures. - ANSWER - Pull clot back into a vein What are the most common access sites for an RV biopsy? Choose three sites. 1.Left femoral vein 2.Right axilary vein 3.Right brachial vein 4.Left subclavian vein 5.Right subclavian

vein

6.Right internal jugular vein - ANSWER - 1,5, The intrinsic pacemaker of the heart is the -AV node. -SA node. -Bundle of His. -Bachman's Bundle. - ANSWER - SA Node What is one advantage of using a left ventricular assist device? -Increases preload -Requires a smaller sheath -Eliminates the need to treat -Ischemic lesions -Provides perfusion regardless of intrinsic heart rate - ANSWER - Provides perfusion regardless of intrinsic heart rate What inotropic agent predominately stimulates beta 1 receptors? -Isuprel -Dopamine -Dobutamine -Epinephrine - ANSWER - Dobutamine What disease state could increase the amount of time necessary to achieve manual femoral artery hemostasis? -Aortic stenosis -Mitral stenosis -Aortic insufficiency -Mitral insufficiency - ANSWER - Aortic insufficiency What is the best wire when intervening in the lower extremities from a radial approach? -.038 x 150 cm -.035 x 180 cm -.038 x 180 cm -.035 x 260 cm - ANSWER - 0.35 x 260cm The Inferior LV wall is supplied by the - ANSWER - RCA The anterior LV wall is supplied by the - ANSWER - LAD Lateral LV wall is supplied by the - ANSWER - Cx

What complications are MOST FREQUENTLY associated with vascular closure devices? Choose three responses. 1.Infection 2.Thrombosis 3.Device failure 4.Delayed bleeding 5.Acute hemorrhage - ANSWER - 1,2, What is a complication associated with mechanical cardiac valves? -Aneurysm -Flail leaflet -Chordae rupture -Thrombus formation - ANSWER - Thrombus formation Which of the following hemostasis devices must be monitored frequently for possible misalignment over the femoral artery? -C-clamp -Perclose -StarClose -Angioseal - ANSWER - C clamp What cardiac structure is most posterior in the AP projection? -Left atrium -Aortic valve -Mitral valve -Left ventricle - ANSWER - left atrium What is the MOST COMMON complication while performing an endomyocardial biopsy? -Stroke -Perforation -Retroperitoneal bleed -Ruptured chordea tendineae - ANSWER - Perforation What type of catheter is used for a thrombectomy? -Ablation -Perfusion -Aspiration -Embolization - ANSWER - Aspiration

Activated clotting time is used to assess the effects of which medication? -Aaspirin -Heparin -Abciximab -Ticagrelor - ANSWER - Heparin What items should be on hand when performing atherectomy of the RCA? Choose three items. 1.Stiffer wire 2.Larger size burr 3.Vasodilator drug

4. Guide with side holes
5. Temporary pacing wire - ANSWER - 3,4, How long is informed consent for catheterization valid? -24 hours -48 hours -72 hours -Length of stay/30 days - ANSWER - Length of stay/30 days Systemic Vascular Resistance Equation - ANSWER - (MAP-RAP/ CO) 80 How many seconds should a cutting balloon be inflated at nominal pressure? -10 to 30 -40 to 50 -60 to 90 -100 to 120 - ANSWER - 60- Which abnormality may be effectively treated by increasing ventilation? -Metabolic acidosis -Metabolic alkalosis -Respiratory acidosis -Respiratory alkalosis - ANSWER - Respiratory acidosis What BEST describes a balloon's ability to yield to changes in pressure? -Flexibility -Pushability -Trackability -Compliance - ANSWER - Compliance

The ability to transmit force from the proximal end of the catheter to the distal end of the catheter. - ANSWER - Pushability The ability to navigate tortuous vasculature. - ANSWER - Trackability The ability to navigate the balloon catheter across narrow restrictions in the vasculature.

• ANSWER - Crossability What port is saline injected to calculate a thermal dilution cardiac output? -Distal -Dorsal -Medial -Proximal - ANSWER - Proximal What type of valvuloplasty requires a transseptal puncture? -Aortic -Mitral -Tricuspid -Pulmonary - ANSWER - Mitral Where is the cephalic vein located? -Anterior surface of the hand -Antecubital fossa of the center of the arm -Antecubital fossa of the lateral side of the arm -Antecubital fossa of the medial side of the arm - ANSWER - Antecubital fossa of the lateral side of the arm Anacrotic Notch - ANSWER - May indicate a critically high systolic pulmonary arterial pressure value. A secondary upstroke in the descending part of a pulse tracing corresponding to the closure of the aortic valve. - ANSWER - Diacroctic Notch May indicate a critically high systolic pulmonary arterial pressure value. - ANSWER - Anacrotic Notch DeBakey Classification Involves ascending and descending aorta - ANSWER - Type I/Stanford A REMEMBER BAD B: both ascending and descending aorta (type I) A: ascending aorta (type II) D: descending aorta (type III)

DeBakey Classification Involves ascending aorta only - ANSWER - Type II/Stanford A Debakey Classification Involves descending aorta only, commencing after the origin of the left subclavian artery

• ANSWER - Type III/Stanford B Stroke volume is related to/affected by - ANSWER - preload Preload is most impacted by - ANSWER - increased filling volumes A patient with chronic untreated hypertension would demonstrate - ANSWER - increased afterload Vascular resistance/pressure is most influenced by - ANSWER - radius of the vessel What component of a Pulmonary Capillary Wedge pressure indicates Mitral Insufficiency - ANSWER - V wave An elevated RVEDP is found in which pathology - ANSWER - RV Infarct If the RA waveform is 2x the normal value, where would this be demonstrated in the physical assessment - ANSWER - JVD What is the most common cause of Pulmonic stenosis? - ANSWER - congenital The Blue proximal port of the swan is located how far from the distal tip of the swan? - ANSWER - 30 cm When performing a thermodilution cardiac output, the operator injects 10 cc of saline into the and the temperature change is measured in the? - ANSWER RA,PA Equalization of RVEDP and LVEDP are found in? - ANSWER - restrictive pericarditis Signs of Right Sided heart failure include - ANSWER - JVD Based on the oxygen saturations on this image, what type of shunt is present? SVC= 67% IVC= 71% RA= 85%

RV= 85%

PA= 85%

LA= 98%

LV= 98%

AO= 98% - ANSWER - L to R ASD The type of ASD, located in the middle 1/3 of the atrial septum ( the former site of the fossa ovalis ) is called? - ANSWER - ostium secundum What are the four anomalies associated with Tertalogy of Fallot? a. ASD, VSD, LVH, RVH b. VVH, PS, over riding aorta, RVH c. over riding aorta, RVH, LVH, ASD d. pulmonic stenosis, over riding aorta, RVH, VSD - ANSWER - d Which fetal anomaly is characterized by a large VSD over which a large single great vessel arises? - ANSWER - truncas arteriosus Which component of the X-ray system converts light rays into images? - ANSWER - image intensifier What is the maximum annual dose of radiation one can receive annually? - ANSWER - 5 REM Lead protection should be at least how many millimeters of lead? - ANSWER - 0.5 Which view exposes the operator to the greatest amount of radiation? - ANSWER - Lateral What converts x-rays into an image? - ANSWER - image intensifier The contrast that is best for a patient is? - ANSWER - low osmolality ReoPro works on? - ANSWER - IIb/IIIa receptors Heparin potentiates (makes stronger) the action of: - ANSWER - antithrombin Fibrinogen is converted to Fibrin by the action of: - ANSWER - thrombin There are known pathways to imitate the clotting cascade. - ANSWER - 2 Aspirin inhibits the action of? - ANSWER - Arachidonic Acid Which agent is not an antiplatelet? a. ASA

b. hepari n c. plavix d. ReoPro - ANSWER - heparin If a patient has diabetes and renal failure with a creatinine of 2.0 what would you give? - ANSWER - fluids to hydrate If a patient is taking NPH insulin, Which medication should not be given? - ANSWER - protamine Which medication is most commonly given with SVT? a. NTG b. lidocain e c. dopamine d. adenosine - ANSWER - adenosine The best short acting medication/anxietolytic to sedate a patient is? - ANSWER - versed What medication is used as a preload and afterload reducer? - ANSWER - NTG An EKG demonstrates ST elevation in leads II, III, and AVF. What type of infarct would you suspect? (Which wall is affected) - ANSWER - inferior wall An EKG demonstrates ST elevation in leads V5, V6, Lead 1, and AVL. Which coronary artery is most likely occluded? - ANSWER - Cx Which cardiac output would be most accurate in a patient with tricuspid regurgitation? - ANSWER - FICK Which balloon is used for Valvuloplasty? - ANSWER - Inoue If a patient has a pulsatile mass below the sheath site, and a bruit is present, what should be suspected? - ANSWER - pseudoaneurysm An abdominal aortic pulsation greater than 3.0 cm can be a finding for what pathology?

• ANSWER - aortic aneurysm Back pain not relieved with NTG, morphine or oxygen and not associated with EKG changes can indicate? - ANSWER - aortic dissection Which stent is self expanding? a. cypher b. wall stent

c. vision - ANSWER - wall stent