RCIS CCI Practice Exam 4 (176 Questions) With 100% Correct Verified Answers, Exams of Advanced Education

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RCIS CCI Practice Exam 4 (176 Questions) With

100% Correct Verified Answers

Hypokalemia and which of the following might be considered contraindications for the pt to have a cardiac cath – ANS: anemia hyperkalemia electrolyte imbalance fever other systemic illnesses which might need stabilization In 1929, Dr Forssman performed which of the following - ANS: first cardiac cath (using a urinary cath inserted into his arm) The 4 major components of conscious sedation protocol should include all of the following except - ANS: cleaning the procedure room What are the 4 major components of conscious sedation protocol - ANS: 1. pre procedural baseline assessment

2. drug dosage and administration
3. monitoring the pt
4. monitoring of the pt post procedure (includes assessment and discharge criteria) Which of the following statements would not be considered correct regarding the scope of practice for the cardiac cath lab - ANS: the scope or practice for the Ccl is set by the federal government According to mallampati, which class would be considered when the visibility of the pts tonsils, uvula, and soft palate are clear - ANS: class 1 If the soft/hard palate and the bas of the uvula can be see what class of mallampati would that be - ANS: class 3 If only the hard palate is clearly visible what mallampati class would that be - ANS: class 4 If the hard/soft palate and the upper portion of the tonsils/uvula are visible what mallampati class would that be - ANS: class 2 All of the following is considered on of the 3 broad categoriesof tasks performed by the CCL staff except - ANS: office personnel What are the 3 broad categories of tasks performed by the CCL staff - ANS: scrub circulator monitor

Which of the following, which should be check by the nurse/tech once the pt has been transported to the CCL procedure room - ANS: if they have a signed consent on the chart if the pt has any allergies if their IV is patent Which of the following, which would be considered the second thing the cath lab nurse should do when meeting the pt for the first time - ANS: check the identity of the pt When talking with the pt regarding the cardiac cath, simple terms should be used. which of the following statements might be appropriate during this time - ANS: 1. we will look to see how well your heart muscles are working

2. we will look at your coronary arteries When the time out is being done, which of the following people must be included - ANS: the circulating nurse the lab operator anesthesia provider (time out should include the entire operative team and should be done out loud) One of the pre-procedure check the Ccl staff must complete is to check the pts IV access site. if their site is not working, which of the following would not be considered correct - ANS: the procedure should be continued with no IV access site A R heart cath typically entails which of the following - ANS: measures of pressures visualized cardiac and pulmonary structures All of the following would be considered critical for a safe ventriculography except - ANS: the cost of the procedure Which of the following would be considered a basic type of cardiac lead - ANS: unipolar bipolar What are your bipolar leads - ANS: I II III What are your unipolar leads - ANS: aVR aVL aVF V1-V

According to organizations such as the US veterans affair, the 5th vital sign would be considered which of the following - ANS: pain Which of the following contrast agents, which would be considered a low osmolar nonionic agent - ANS: loversol Which of the following would be considered correct for the purpose of the oil around a tube insert in an X-ray machine? - ANS: 1. to act as an insulator between the cathode and the anode supplies

2. to provide a medium for the effective heat dissipation The protocol in most hospitals for the pt admitted to the ER for chest pain is to administer aspirin. which of the following pts would this be contraindicated with - ANS: active/recent GI bleed allergy to aspirin According to the national commissions of radiologic protection and units, the typical amount of examinations that can be performed safely on a continuous basis in order to stay within their recommendations for a week would be considered - ANS: 25 Which of the following would not be considered a primary pt vital sign? - ANS: body mass index What are the 4 primary vital signs - ANS: temp HR respiratory rate BP The ___ ___ artery would be considered the target entry point for a femoral artery cardiac cath - ANS: common femoral This is designed as the portion of the femoral artery that is below the lowest margin of the inferior epigastric artery but above the bifurcations of the superficial and profound branches of the femoral art - ANS: common femoral art With a rotablator atherectomy which of the following would the pressure bag do - ANS: flushes the solution through the rotablator device What is the purpose of the flush solution for the rotablator device - ANS: allows lubrication and prevents oaverheating For the pt that is in pulseless Vtach, which of the following would be considered correct for the sequential defibrillation - ANS: 200J 200-300J 360J

During a cardiac cath, the pt experiences an air embolism. which of the following interventions would not be considered correct for treatment at this time - ANS: transfer the pt back to the floor immediately What are some interventions for the pt who experiences an air embolism during a cardiac cath - ANS: fluids start ACLS protocol if needed aspirate the air if possible start 100% O During a cardiac cath procedure, the pt sats to complain of not feeling right. which of the following might be considered signs and symptoms of a cardiovascular anaphylactic reaction to the contrast medium - ANS: arrhythmias What are the most common cadiovascular anaphylactic reactions to contrast - ANS: vasodilations arrhythmias hypotension (shock) With basic life support, which would be considered the correct compression rate for one?- ANS: person rescue for an adult - 30:2 at a rate of 100 compressions per min (same for a 2 person rescue) The LV pressure (supine resting press value for systolic press) would be considered ___ mmHg - ANS: 100-140 mmHg The RV pressure (supine resting press value for systolic press) would be considered ___ mmHg - ANS: 15-30 mmHg Which of the following, which would be considered the antidote for Versed - ANS: romazicon Which of the following, which would be considered the antidote for fentanyl - ANS: narcan If a pt is experiencing a MI, which of the following statements would be considered the most correct - ANS: 1. the chest pain typically last longer than angina pain

2. the pain is more intense than angina pain
3. rest doesn't help the pain Which of the following would be considered correct for the reason that Ergonovine is not manufactured in the US any longer? - ANS: it can induce coronary spasm The medical floor RN is assessing her newly admitted pt and he starts to complain of mid-sternal chest pain, becomes very anxious, complains of SOB, and becomes

diaphoretic. and EKG is performed and there are changes in leads I, aVL, and V2-V5. which of the following MIs would this be indicative of - ANS: anterior Which of the following statements would not be considered correct regarding tachycardia - ANS: it is a medical emergency ____ can be the earliest sign of a pt in distress and may be associated with conditions such as acute PE, hypoxemia, or hypoglycemia - ANS: tachycardia Which of the following which might be considered a preparation for an MRI - ANS: no preparation All of the following would be a type of calcium channel blocker except - ANS: aggregation inhibitors What are the 3 types of calcium channel blockers - ANS: 1. dihydroperidine (cardene)

2. phenylalkylamine (verapamil)
3. benzothiazepine (cardizem) Which of the following layers of the blood vessels is considered the protective outer layer? - ANS: adventitial Which of the following conditions would be contraindicated for the use of NTG for chest pain? - ANS: hypotension marked bradycardia of less than 50 bmp tachycardia allergy to NTG Which of the following which would be included in the 11-100 calcium score interpretation with a cardiac EBCT - ANS: mild plaque is present A calcium score of 0 with a cardiac EBCT would tell us what - ANS: no plaque is present A calcium score of 400+ with a cardiac EBCT would tell us what - ANS: a large amount of plaque is blocking at least one artery A calcium score of 1-10 with a cardiac EBCT would tell us what - ANS: very little plaque is present The safety policies for each CCL should include which of the following - ANS: 1. the requirements for protective equipment worn by all the personnel
4. routine monitoring of personnel radiation exposure
5. they need to have a program to make the personnel aware of the risks associated with radiation exposure

when analyzing the rate of an EKG strip, if the rhythm is irregular which of the following could be used to determine the pts HR - ANS: count the number of QRS complexes that appear in a 6 sec period and multiply by 10 when analyzing the rate of an EKG strip, if the rhythm is regular which of the following could be used to determine the pts HR - ANS: count the number of large boxes between P waves and then divide by 300 If the pts ACT is 100 seconds after the first dose of heparin, which intervention would be considered correct - ANS: administer an additional dose of heparin If the nurse in the cardiac cath lab assesses the pts lung sounds and determines there is a coarse, gravelly sound, which of the following terms would be considered correct

• ANS: Rhonchi This would be considered high pitched whistling expirations - wheezing This would be considered rattling or cracking sounds - ANS: crackles This would be considered harsh, high pitched inspirations - ANS: stridor Which of the following would be considered a low-osmolar nonionic contrast agent that is used in the CCL? - ANS: loversol Which of the following would be considered the normal range of heart rate for an adult pt? - ANS: 20-100 bpm What would be the normal HR for an infant of 1-28 days old - ANS: 120-160 bpm What would be the normal HR for a pediatric pt that is 1-12 months old - ANS: 100- 120 bpm What would be the normal HR for a pediatric pt that is 1-8 years old - ANS: 80- bpm The weight adjusted standard dose heparin bolus would be considered which of the following - ANS: 100 U/kg The weight adjusted low dose heparin bolus would be considered which of the following - ANS: 50-70 U/kg Which of the following, which might be considered a correct procedure for skin entry during a cardiac cath - ANS: 1. a small skin incision prior to inserting the seldlinger needle

2. nick the skin over the entry needle or guide wire post puncture

In what leads would you see changes on an EKG for an inferior MI - ANS: II, III, aVF Which of the following would be correct for the method of administering contrast medium in which the medium liquid is placed in a bowl on the table and then drawn up in a syringe? - ANS: open When there is a loss of properly timed atrial systole, it can cause which of the following - ANS: fatigue congestive heart failure getting worse dizziness hypotension SVR stands for which of the following - ANS: systemic vascular resistance What is the formula for determining SVR - SVR (mmHg/L/min) = [(MAP - ANS: RA press)/systemic CO] LV afterload is quantified with what - ANS: SVR Common signs and symptoms with cardizem would include all but which of the following - ANS: double vision What are the common signs and symptoms associated with cardizem - ANS: dizziness fatigue flushing asthenia ankle adema The normal HR range for ages 1-8 yrs old would be considered which of the following

• ANS: 80-100 bpm If a pt is suspected of having an inferolateral MI, which of the following leads would experience changes - ANS: II, III, aVF, V The fibrous connective tissue layer which covers the entire heart and the roots of the great vessels would be considered which of the following - ANS: pericardium A platelet can be referred to as which of the following - ANS: thrombocyte When interpreting an IVUS image, what color would the blood speckles be - ANS: grey (these speckles move around within the lumen with active blood flow) Which of the following, which would not be considered a contraindication for a cardiac cath - ANS: unstable angina

What would be contraindications for a cardiac cath - ANS: pregnancy infection medication toxicity electrolyte imbalance Which of the following would be considered correct for the lidocaine to a 3 yr old child in the cardiac cath lab, which percentage of lidocaine should be used? - ANS: 2% If the child is an infant under the age of 1 what percentage of lidocaine would you use

• ANS: 1% If the child is 1 year or older, which percentage of lidocaine would be used - ANS: 2% The calcium deposits on the intravascular ultrasound would appear as which of the following - ANS: very white echos Which of the following would be considered the most common complication of IVUS?
• ANS: coronary spasm (can administer IC NTG prior to help prevent this) (cardiac tamponade or coronary dissection can also occur) Which of the following types of catheters cannot be used safely for angiography in the pediatric pt? - ANS: end hole the ____ catheter can be used in the wedge position to measure pressures and determine O2 sats, but cannot be safely use for an angiography in the pediatric pt bc it has potential for myocardial injury bc of the concentrated jet of contrast dye that comes from it - ANS: end hole with the steps of removing the catheter from a venous puncture, which of the following would be correct for how long the puncture site should be compressed - ANS: 5 mins The arterial puncture site is usually compressed for - ANS: 10 minutes Which of the following, which access site would be used to perform a transeptal cath
• ANS: right femoral site An imaging technique that uses X-rays to take pictures of the pts blood vessels and heart chambers would be considered - ANS: angiography Which of the following, which of the lesion producing obstructions in pediatric pts is often caused by dysplasia or fusion of the valvular leaflets? - ANS: pulmonary valve stenosis

What is the most frequent lesion producing obstruction in the pediatric pt - ANS: pulmonary valve stenosis Which of the following would be considered the color that a card calcified lesions would appear by IVUS - ANS: white Which of the following which could cause a problem with a rotational atherectomy for the pt that has had a non-Q wave MI? - ANS: small embolytic particles How much saline flush is delivered every hr to the central lumen of the balloon catheter (IABP) - ANS: 3ml/hr The IABP would typically not be placed in which of the following areas - ANS: physical therapy Which of the following would be considered the correct description for a "distal filter device) - incorporates an umbrella on the distal end of a guide wire which expands when it is distal to the lesion catching any emboli in the blood Excimer laser catheters come in all but which of the following sizes - ANS: 8.5mm The excimer laser catheters come in which sizes - ANS: 1.4 mm 1.7 mm 2.0 mm All but which of the following tissues fuse to form the inter ventricular septum - ANS: subcutaneous tissues When inter ventricular septum is formed by the fusing of what - ANS: the muscular septum the bulbar ridges the aorticopulmonary system the endocardial cushions When sizing the balloon during the procedure for an atrial septal defect (ASD) which of the following would be considered correct - ANS: the technique of pulling an inflated balloon from the L to the R atrium of the pt until it fits snugly within the ASD (the actual device used to close the ASD will be double this size) Which of the following, which would not be considered a principle with radiation safety in the CCL - ANS: there is a permissible dose of ionizing radiation that is permissible of absolutely safe Which of the following would be considered correct for the sizes of the Inoue balloons available? - ANS: 26, 28, and 30 mm (the pts height determines the size of balloon that is needed)

With the use of the IVUS there has been an increase in the number of stents which are being placed. which other factor has also helped to increase this number - ANS: the stents have been improved over time If there is a foreign body in the pts blood vessel it can cause which of the following - ANS: neointimal hyperplasia During a cardiac cath the gauge of the peripheral IV should be at least - ANS: 18 300cm and which of the following would be considered the lengths of the guide wires that are used in the PCI procedures - ANS: 145 cm Which of the following procedures typically precedes a pericardiocentesis? - ANS: an echo to confirm pericardial fluid Which of the following catheters are typically used during a ventricular septal defect (VSD) procedure - judkins R catheter All of the following might be included as nursing interventions for the patient receiving an ICD expect - ANS: provide the pt with information about their insurance coverage One Pa would equal how many newtons per square meters - ANS: one [the standards international (SI) unit is the Pa (pascal)] Which of the following would not be considered a major timing error for an IABP? - ANS: late diffusion What are the 4 major timing errors with the IABP - ANS: early inflation early deflation late inflation late deflation The irrigation port and which of the following would be considered a part of the rotablator advancer - ANS: NTG gas delivery hose The rotablator advancer would consist of - ANS: irrigation port NTG gas delivery hose a fiberoptic tachometer cable The most common congenital cardiac abnormality would be considered which of the following - ANS: ventricular septal defects

____ is a defect in the wall dividing the L and R ventricles of the heart; small ones close on their own but if the opening is large open heart surgery may be needed to close it and prevent serious problems - ANS: VSD If the pt is administered streptokinase which of the following would not be considered adverse reactions of this medication - ANS: severe headache What are some of the adverse reactions of streptokinase - ANS: hypotension fever bleeding allergic reactions nonischemic DCM would be included in which of the classes for ICD - ANS: class IIa Class IIa for an ICD would include - ANS: sustained Vtach nonischemic DCM unexplained syncope significant LV dysfunction The pt that has had a cardiac stent placed is typically placed on clopidogrel (plavix) for which of the following periods of time - ANS: 1 yr If the pt is in the ER in third degree heart block and needs a pacemaker which of the following should be considered the ideal choice - ANS: external transcutaneous pacing The absorbed dose type of radiation dose measurements would best be described as which of the following - ANS: the energy that is absorbed by each unit of mass formula for grays (Gy): 1 Gy = 1 J/kg (SI unit) Which of the following would be considered a disadvantage of performing an angiography instead of an IVUS - ANS: plantar imaging During a cardiac procedure, when the radial or ulnar arteries need to be checked for occlusions which of the following test would be considered correct - ANS: allens test The 3 steps with insertion of the angio-seal would include all of the following except - ANS: sizing the seal What are the 3 steps to inserting an ago-seal - ANS: 1. locating the artery

2. deploying and setting the polymer anchor
3. deploying tha collagen sponge With pulseless Vtach which of the following would more than likely be the first medication administered - ANS: epinephrine 1mg IV bolus then repeated every 3-5 mins

The treatment for "flash" pulmonary edema would include all but which of the following - ANS: open heart surgery The treatments for "flash pulmonary edema would include - ANS: mechanical ventilation O vasodilator inotropic agents furosemide How long should occlusive press be held when removing cath sheaths after the procedure - ANS: 5 mins then slowly decrease press until a distal pulse can be palpated Which of the following best describes "thrombus"? - ANS: a solid fixed clot ____ would be considered a moving clot - ANS: embolism All but which of the following would be considered correct regarding the pt and a defibrillator during a cardiac cath - ANS: the defibrillator is of no benefit to the pt During the procedures in the CCL, _______ would be considered a major determinant for the survival of the pt and should be at the side of the pt and turned on and the pads or paddles prepared - ANS: successful defibrillation The ____ has the responsibility of reporting the medical procedure during a cardiac cath - ANS: operator/cardiologist Which of the following interventions, which might not be considered correct for the pt that is experiencing a retroperitoneal bleed during a cardiac cath - ANS: observe for hypertension