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if a pt is experiencing hyperkalemia, which of the following might be seen on the 12 lead ekg - ✔✔a sharply pointed T wave this is generated by the last phase or the depolarization - ✔✔T wave ____ is upright in leads I, II, V3-V6 - ✔✔T wave the T wave is inverted in which lead - ✔✔aVR which of the following might NOT be considered a side effect of cardizem - ✔✔joint pain ____ is considered a calcium channel blocker - ✔✔Cardizem what are some of the side effects of cardizem - ✔✔asthenia (muscle weakness) ankle edema dizziness flushing which of the following would be considered classifications of aortic dissections according to DeBakey - ✔✔Type 1 (just above the AO valve and is most common) Type II (just above the AO valve but stop in the ascending AO not progressing into the AO arch) Type III (begins past the AO arch and distal to the L subclavian art) what is the great vessel that carries deoxygenated blood from the lower extremities back into the R atrium - ✔✔IVC which of the following might be considered a typical loading dose for clopidrogrel (plavix) - ✔✔150mg- 600mg
what kind of drug is clopidrogrel (plavix) - ✔✔ADP inhibitor what is the daily dose for clopidrogrel (plavix) - ✔✔75mg which of the following devices uses a diamond dust-tipped burr that spins at 150,000-200,000 rpm within the art to pulverize the calcified plaque - ✔✔rotablator rotational atherectomy device this device selectively ablates the nonelastic diseased tissue and the normal healthy tissue is pushed out of the way and not touched - ✔✔rotablator during a cardiac cath which of the following is not done by the monitor - ✔✔performs a direct assessment of the pt who would perform the direct assessment of the pt - ✔✔circulating nurse the primary objective of the ___ is to monitor the pts vital signs, enter hemodynamic data, pt demographic information, and documents all pertinent data from the procedure into the database - ✔✔monitor if the cardiac cath procedure is being performed on a newborn infant, which of the vessels would be considered the typical one used - ✔✔umbilical using this vessel for a cath on a newborn infant allows for easy access to the arterial and the venous circulation of the pt - ✔✔umbilical equipment that might be used in the pediatric cardiac cath lab could include all of the following EXCEPT - ✔✔bladder scanner what are some of the equipment that might be used in the pediatric cardiac cath lab - ✔✔resuscitation equipment defibrillator ECG
when performing this, there should be at least 2 staff members present in addition to the physician. one staff member will assist the physician while the other connects the device, initiates, and monitors the pt
- ✔✔placing an IABP at bedside the most common congenital cardiac abnormality would be considered - ✔✔atrial septal defect (ASD) what is considered the most effective treatment for ASD - ✔✔surgical closure when the pt is transferred to the CCL for a PCI, which of the following would not typically need to be assessed - ✔✔medication history when the pt arrives in the CCL, they should be assessed for - ✔✔baseline ECG O2 sat lab values BP if a pt is in need of temporary pacing, which would be considered the ideal choice for treatment of the emergency pt - ✔✔external transcutaneous pacing this type of pacer works by delivering a timed electrical impulse to the chest wall of the pt by the use of pacing electrode patches - ✔✔external transcutaneous pacer clinical evaluation for a mitral stenosis would include all of the following except - ✔✔liver enzymes clinical evaluation for mitral stenosis would include - ✔✔medical history in depth physical assessment transesophageal assessment (TEE) 2D echo with doppler study chest radiography
if the pt has a temporary pacemaker in place, which of the following would not be considered correct - ✔✔if the temporary pacing is prolonged, the transesophageal method should be considered the V wave in the PCWP would indicated which of the following - ✔✔the rise in the pressure that is brought on by the filling of the L atrium with oxygenated blood from the lungs this represents the contraction of the L atrium when you are looking at a PCWP tracing - ✔✔A wave this shows the relaxation of the atrium when you are looking at a PCWP tracing - ✔✔x descent which of the following might be considered a cardinal symptom of mitral regurg - ✔✔orthopnea paroxysmal nocturnal dyspnea pulmonary congestion exertional dyspnea pulmonary edema (all the above) if the temp pacer is failing to pace due to output, all of the following interventions would be considered correct except - ✔✔disconnect the pacer and hope the pt does well if the temp pacer is failing to pace due to output what are some of the interventions that might take place - ✔✔1. prepare for transcutaneous pacing
- check the battery, power, and connections
- prepare to administer chronotropic meds
- increase the output to max (20mA atrial and 25mA ventricular)
- consider switching to an asynchronous mode in the attempt to prevent oversensing
- prepare to do CPR where is the pulmonic valve located - ✔✔between the RV and the pulm art
- the muscular wall of the RV is thicker than normal
- pulmonary stenosis
- the AO valves are enlarged and open from both ventricles all but which of the following might be considered potential complications of an ICD procedure - ✔✔hypercalcemia what are some of the potential complications that might occur during an ICD procedure - ✔✔vein thrombosis MI blood loss infection hematoma air embolism cardiac tamponade stroked which of the following would be considered the most common mechanism for Vtach - ✔✔reentry _____ depends on a functional circuit - ✔✔reentry hen performing a transeptal cath, the R fem vein is used. once introduced, the wire is advanced into which area - ✔✔SVC to measure L arterial press which of the following would be considered the lowest PSI NTG level that is acceptable to start a procedure with a rotablator system - ✔✔500 PSI when prophylactic antibiotics are ordered for the ICD pt preoperatively, when should their infusion typically be completed - ✔✔approx 30 mins prior to the incision being made of the following, which would be considered a factor for the increase in the number of stents that are being done - ✔✔IVUS results
recovery time is reduced average age of the population is increasing (all of the above) a high speed device that is designed to pulverize plaque into minute particles would be considered which of the following types - ✔✔rotational which of the following would be considered post procedural care for the atherectomy pt - ✔✔perform a 12 lead EKG cardiac enzymes admit to cardiac tele step down unit to CCU monitor vital signs assessment of pedal pulses groin site checks oral pain meds (all the above) the most common mitral regurg is caused by which of the following - ✔✔cardiomyopathy what are some other causes of mitral regurg - ✔✔degenerative rheumatic inflammation the 4 major timing errors with the IABP would not include - ✔✔primary deflation what are the 4 timing errors with the IABP - ✔✔early deflation early inflation late deflation late inflation of the following, which would NOT be considered a lateral lead - ✔✔aVF
interventions that would be appropriate for a pt that has developed a retroperitoneal bleed would include which of the following - ✔✔transfusion surgical consultation reversal of anticoagulation CT scan observe for hypotension avoid high femoral artery punctures volume replacement if a topical agent is used with manual compression when removing cardiac sheaths, it would help to do which of the following - ✔✔hasten clotting if amiodarone needs to be administered during a high risk cardiac cath, which of the following might be considered the correct dose - ✔✔300 mg rapid IV infusion (diluted in 20-30 ml of fluid) or 150 mg over 10 mins followed by an infusion rate of 1 mg/min which of the following would be considered the best description for an allens test - ✔✔test done for occlusion of the ulnar or radial arteries for this test, the pt makes a tight fist and the nurse makes a digital compression of either the radial or the ulnar art. when the pt opens their hand if there is a failure of the blood to return to the palm and fingers it can be an indication that there is an obstruction to the blood flow in the artery that has not been compresses; this test should be performed prior to any cath that will be using the radial approach - ✔✔allens test atrial fib and SVT can be caused by which of the following - ✔✔vigorous stretching of the R atrium what are some of the typical arrhythmias which can be caused by vigorous stretching go the R atrium - ✔✔SVT Afib atrial arrhythmias
the pt that is scheduled for a cardiac cath is taking furosemide 40 mg daily. they are told not to take this medication the morning of the procedure. which of the following would be the most correct statement regarding holding the furosemide - ✔✔1. could cause dehydration decreasing renal flow
- could increase the risk of contrast nephropathy
- could cause hypotension ____ would be considered the correct benzodiazepine antidote that could be used for a versed or valium overdose - ✔✔flumazenil (romazicon) (GABA receptor antagonist) which of the following would be considered one of the 4 areas the physicians role in pt education should include - ✔✔1. the possible risks and potential complications of the procedure
- the clear reasons for having the procedure
- the information the cath will provide
- treatment options what will be available when a diagnosis has been made information regarding the CCL standards and which of the following would be considered standards mandated by OSHA - ✔✔explanation as to the modes of transmission according to OSHA standards, the CCL should provide the following - ✔✔1. explanation as to the modes of transmission
- info regarding the CCL standards
- explanation of blood born diseases
- info on hep B vaccine
- info regarding the OSHA standards
- explanation of environmental controls (benefits and limitations)
- explanation as to how to report an exposure incident
- explanation of proper follow up procedure
- rational for the selection of protective equipment that is used in the CCL the narcotic antagonist for morphine would be considered which of the following - ✔✔naloxone (evzio or narcan)
pulmonary congestion when analyzing the pts cardiac rhythm which of the following would be considered correct for a normal rhythm - ✔✔there should be a P wave before each QRS in a normal cardiac rhythm what would the ratio of P:QRS be - ✔✔1: sinus tachycardia occurs when the heart beats at a rate of ____ or more beats per min - ✔✔ 100 if the heart beats at a rate of ____ or less beats per min it would be considered sinus bradycardia - ✔✔ 60 which of the following does the central venous press (CVP) reflect - ✔✔1. the ability of the heart to be able to pump blood into the material system
- the amount of blood returning to the heart the ____ measures the SVC just outside the RA and tells us the amount of venous blood that is returning to the heart and also how well the heart pumps the blood back into the arterial system - ✔✔CVP (central venous press) synchronized cardioversion would be used for which of the following rhythms - ✔✔sustained Vtach this type of defibrillation uses the R waves - ✔✔synchronized cardioversion this type of defibrillation would be used if there is not a distinguishable QRS complex - ✔✔unsynchronized cardioversion which of the following could be considered an advantage for the use of a power injector during a cath procedure - ✔✔1. ensures the amount of contrast medium that is injected would be at a constant press
- ensures the amount of contrast medium that is injected would be the correct volume
- ensures the automatic recording of the injection
- ensures the recording of the total calculated
(all of the above) if a 9F guide cath is used in the cardiac cath lab for a procedure, which of the following would be considered the correct burr of rotablator - ✔✔2.25-2.38 mm burr which size rotablator burr would you use if you have a 10F guide cath - ✔✔2.5 mm burr which size rotablator burr would you use if you have an 8F guide cath - ✔✔2.0 mm burr which size rotablator burr would you use if you have an 6F guide cath - ✔✔1.25-1.5 mm burr metrology of ballot has all of the following characteristics except - ✔✔a congenital narrowing in the descending AO a congenital narrowing in the descending AO would be a characteristic of which anomaly - ✔✔coarctation of the aorta with TFO ____ would be present because of the venous blood from the R ventricle flowing into the AO - ✔✔cyanosis fentanyl (sublimaze) is considered to be ____ times more potent as morphine - ✔✔ 100 ____ is a synthetic opioid with a quicker onset, and a shorter duration of action - ✔✔fentanyl (sublimaze) during a high risk cardiac cath, a pt develops stable Vtach. Which of the following would be considered correct for the initial dosage of Lidocaine that might be ordered for this pt - ✔✔lidocaine 1-1.5 mg/kg IV bolus (another medication that might be ordered would be amiodarone) how would the CO be determined - ✔✔multiply HR by SV
a recommended routine for vital signs post cardiac cath would be considered which of the following - ✔✔Q 15 mins x 4, Q 30 mins x 2, Q 1 hr x 2 if an adult pts respirations are 32 which of the following would be considered correct - ✔✔the pts respiratory rate is too fast what is the normal respiratory rate for an adult pt - ✔✔ 12 - 20 breaths per min which of the following would not be considered a classification of shunts - ✔✔side to side what are the classifications for shunts - ✔✔R to L L to R bidirectional which of these heart rhythms is characterized by periods of tachycardia and bradycardia - ✔✔sick sinus syndrome what would the HR be for someone who is in SVT - ✔✔160 beats/min or more a main method for administering contrast medium during a procedure in the CCL would be considered which of the following - ✔✔closed what are the 2 main methods for administering contrast medium - ✔✔open closed which of the following would be seen in a pts labs that would indicate coagulation abnormalities - ✔✔1. a bleeding time greater than 10 mins
- a platelet count of less than 80,000 mm
- a prothrombin time (PT) greater than 1.2 sec
- a partial thromboplastin time (PTT) greater than 1.2 secs (all of the above)
the volume of blood that is left in the ventricle at the end of diastole is considered which of the following
- ✔✔preload ____ is quantified by measuring the LVEDP. bc of the fact that the LVEDP and the PCWP approximately equilibrates, the PCWP is often used to quantify this - ✔✔preload if the cardiac cat pt is experiencing pulseless Vtach which of the following would be appropriate for sequential defibrillation - ✔✔200J 200J-300J 360J the mean press and which of the following would be considered correct for the pressures that are considered the most important with the PAWP - ✔✔peak if the V wave what are the 2 pressures that are considered to be the most important with the PAWP - ✔✔peak of the V wave mean press how is the mean PAWP pressure figured - ✔✔by taking the point halfway between the peak of the A wave and the lowest point of the x descent in which of the following conditions could a high RVEDP be seen - ✔✔endocardial fibrosis cardiac tamponade pulmonic valve insufficiency restrictive myocardial disease constrictive pericarditis which of the following statements would be considered correct regarding the CCL and how output is measured - ✔✔1. by a digital signal that is displayed on a computer screen or lines on a paper
- the press measurement system is made up of an input signal and an output signal
- the press of the pt is exerted on the blood which is transmitted through the fluid in a catheter
which of the following would be considered on of the 13 factors which should be analyzed when interpreting an ECG - ✔✔QRS duration what are the 13 features that should be analyzed when interpreting an ECG - ✔✔PR interval QRS duration QRS voltage QRS axis U wave T wave QT interval HR ST segment the morphology/amplitude of the P wave abnormal Q waves R wave progression in the precordial leads origin of the rhythm blood and which of the following might be considered a part of the persons cardiovascular system - ✔✔vascular bed the cardiovascular system has 3 parts, what are they - ✔✔blood vascular bed heart when preparing the pt for transfer to the ICU after a cardiac cath, which of the following information should be reported to the receiving nurse - ✔✔vital signs procedure done site of procedure results of the test cardiac rhythm
the last ACT the oximetry level the urine output post cath orders if the physician is using a femoral approach to perform an endomyocardial biopsy, once the local anesthetic has been administered, which would be the next step to be done - ✔✔puncture the L or R fem vein using the Seldlinger technique, then the guide wire will be advanced into the femoral vein if a pt is experiencing hyperkalemia, which of the following might be seen on the 12 lead EKG - ✔✔a sharply pointed T wave ____ is generated by the last phase or the repolarization - ✔✔T wave the normal T wave is upright in leads - ✔✔I, II, V3-V the T wave is inverted in - ✔✔aVR the nurse is caring for a cariogenic shock pt in the IABP and their rhythm changes from sinus tach to A fib. which of the following might be considered the intervention for the pt at this time - ✔✔change the trigger on the pump to A fib if there is one which of the following does a calcium channel blocker have - ✔✔dilates vascular smooth muscle _____ help to reduce the peripheral conduction. they also help to decrease BP, increase coronary blood flow, and block coronary spasm. - ✔✔calcium channel blockers what are the actions of calcium channel blockers - ✔✔dilates vascular smooth muscle decreases the heart muscle contractility some block atrioventricular nodal conditions
