NUR 254 MIDTERM ASSESSMENT Test Latest Review 2026

NUR 254 MIDTERM ASSESSMENT Test Latest Review 2026 Initial dose of amiodarone bolus IV - -300mg The med is administrated rapid IV push resulting in a brief flat line, used for SVT, code cart must be at bedside - -adenosine What are the doses for adenosine? - -6mg, 12 mg, 12mg rapid IV push Medication used PRN for angina - -Nitro- warn of HA, low BP Each large box on the Ecg paper represents how many seconds - -20 seconds What is serum lab tests that would be elevated with MI - -CK (CREATININE KINASE) and Troponin What complication of CABG presents with manifestations of decreased urinary output, crackles, jvd, s3 gallop - -pump failure (heart failure) Most carbohydrates in the diet should be complex such as whole grains. Name 2 foods that would be considered complex carbs - -whole grain breads/pasta, legumes, potatoes What would a high CVP reading indicate (normal readings are 3-12mmhg)(dehydrated means 2-3mmhg)(20-22mmhg hypervolemia) - -hypervolemia what would you see on an EKG with a patient with Hyperkalemia? - -peaked T waves A PATIENT WITH HIGH LDL SHOULD BE ADVISED TO REPLACE FOODS HIGH IN SATURATED FAT WITH FOODS HIGHER IN UNSATURATED FAT. NAME THREE (3) FOODS THE PATIENT SHOULD AVOID THAT ARE HIGH IN SATURATED FAT. - BUTTER, CHEESE, MILK, CREAM, ICE CREAM, COCONUT OIL AND FATTY MEATS ASIDE FROM PACER SPIKES WITH SUBSEQUENT P WAVES OR QRS COMPLEXES, HOW WOULD A NURSE ASSESS THE INTENDED OUTCOMES OF A PACEMAKER? (THERE ARE SEVERAL, NAME AT LEAST ONE CORRECTLY) - HEART RATE 60, NORMOTENSIVE, SKIN COLOR APPROPRIATE WHICH CLASS OF ANTIHYPERTENSIVE MEDICATIONS HAS COMMON SIDE EFFECTS OF COUGH, HYPERKALEMIA (TOO HIGH) AND HYPOTENSION? - ANGIOTENSION CONVERTING ENZYME (ACE) INHIBITORS NURS 254 NURS 254 THIS ANTICHOLINERGIC MEDICATION IS ADMINISTERED 0.5 MG TO 1 MG IV PUSH FOR SYMPTOMATIC BRADYCARDIA - -ATROPINE CHEST PAIN RELIEVED BY REST IS REFERRED TO AS - -STABLE ANGINA NAME THREE (3) MODIFIABLE RISK FACTORS FOR CAD - -HYPERLIPIDEMIA CIGARETTE SMOKING/TOBACCO USE HTN DM OBESITY ATHEROGENIC DIET ORAL CONTRACEPTIVES (HRT) PHYSICAL INACTIVITY METABOLIC SYNDROME ULTIMATELY THE RECOMMENDED GOAL FOR PHYSICAL ACTIVITY FOR CORONARY ARTERY DISEASE IS: - -30 minutes per day most days (5-6 days a week) MOST CARBOHYDRATES IN THE DIET SHOULD BE COMPLEX SUCH AS WHOLE GRAINS. NAME TWO (2) FOODS THAT WOULD BE CONSIDERED COMPLEX CARBOHYDRATES. - -WHOLE GRAIN BREADS/PASTA, LEGUMES, POTATOES, RICE, STARCHY VEGETABLES. USED TO INCREASE CARDIAC OUTPUT WHILE AWAITING A HEART TRANSPLANT - -ventricular assistive device THIS IS THE UMBRELLA TERM FOR UNSTABLE ANGINA, THAT IS WORSE THAN TYPICAL ANGINA, LASTS GREATER THAN 15 MINUTES, INDICATES MYOCARDIAL INJURY, AND IS OFTEN A PRECURSOR TO MYOCARDIAL INFARCTION? - -ACS- acute coronary syndrome CHEST PAIN WITH MI IS TYPICALLY DESCRIBED AS (NAME AT LEAST 3): - UNRELIEVED BY REST/NITROGLYCERIN, OCCURS AT REST, RADIATING, CRUSHING/SQUEEZING, ASSOCIATED FACTORS (DYSPNEA, DIAPHORESIS) WHICH COMPLICATION OF CABG HAS MANIFESTATIONS OF MUFFLED HEART TONES, CT DRAINAGE ABRUPTLY SUBSIDING, HYPOTENSION AND TACHYCARDIA? - -cardiac tamponade WHAT IS THE NORMAL MEASUREMENT IN SECONDS FOR THE PR INTERVAL? - 0.12- 0.20 seconds WHAT IS THE NORMAL MEASURMENT IN SECONDS FOR THE QRS COMPLEX? - 0.6-0.10 seconds NURS 254 NURS 254 THESE TWO (2) ABNORMALITIES ARE SEEN WITH MYOCARDIAL INFARCTION. - ST ELEVATION AND PATHOLOGIC Q WAVES*** A PATIENT SECOND DEGREE TYPE 2 HEART BLOCK THAT HAS PROGRESSED TO THIRD DEGREE (COMPLETE) HEART BLOCK. WHAT IS THE PRIORITY INTERVENTION? - -pacemaker WHAT ARE THE COMMON CAUSES OF SINUS TACHYCARDIA? - -FEVER, HYPOXIA, ANEMIA, HYPOVOLEMIA, PAIN/ANXIETY WHAT IS THE PRIORITY INTERVENTION FOR VENTRICULAR FIBRILLATION, THAT HAS THE GREATEST IMPACT ON SURVIVAL RATE? - -defib A PATIENT DEVELOPS PSVT AND IS SYMPTOMATIC. PRIOR TO ADENOSINE OR CARDIOVERSION, WHAT IS A NONPHARMACOLOGIC INTERVENTION FOR PSVT? - -ELICIT VAGAL RESPONSE/VALSALVA MANEUVER WHAT DIAGNOSTIC TEST IS ESSENTIAL IN THE DIAGNOSIS OF STEMI (ST ELEVATION MYOCARDIAL INFARCTION)? - -EKG WHAT DIAGNOSTIC TEST IS ESSENTIAL IN THE DIAGNOSIS OF STEMI (ST ELEVATION MYOCARDIAL INFARCTION)? - -echocardiogram WHAT IS THE MOST LIKELY IMMEDIATE COMPLICATION FOLLOWING CARDIAC CATHETERIZATION SHEATH REMOVAL? - -bleeding Shock is a SYNDROME resulting from a decrease in a. ____________ that causes inadequate b. __________ resulting in ischemic organs/tissues that cannot carry out cellular metabolism. - -a. blood flow b. oxygenation When monitoring for effectiveness of treatment, which value is often used to titrate medications such as norepinepherine, as it is an indicator of tissue perfusion. - -MAP Which findings indicates progression from early (I) to intermediate (II)? 1. decreased U/O 2. increased lactic acid/ hyperkalemia 3. fluid shift from interstitial space INTO capillaries 4. MAP drop 12 mmHg - -2. increased lactic acid/ hyperkalemia NURS 254 NURS 254 if norepinephrine, dobutamine or dopamine infiltrates in a peripheral site which medication should be used as an antidote? - -Phentolamine Four factors necessary to maintain cellular metabolism. When one of these is disrupted, shock occurs. - -1. Cardiac output 2. Vessel diameter and tone 3. Blood volume 4. Tissues ability to extract and use O2 All of the manifestations of shock can be directly related to the body's attempts to maintain __________. - -Perfusion of vital organs (heart and brain) In stage I of shock, compensatory mechanisms begin when there is a volume loss of approximately 1000 mL which causes a MAP drop of __________ mmHg - -10-15 mmhg A patient is involved in a MVC. Which finding would indicate neruogenic shock as opposed to hypovolvemic shock? 1. Decreased hgb and hct 2. Bradycardia 3. Tachycardia 4. Hypotension 5. Hypertension - -2. bradycardia What test might be used to diagnose septic shock (as opposed to cardiogenic shock)? 1. lactic acid level 2. BNP 3. blood cultures 4. EKG - -blood cultures When administering norepinepherine to a patient in shock the expected outcome (goal) is often: - -MAP 65 or SBP 80-100 What are the three (3) components of Virchow's Triad? - -1. Endothelial damage (smoking, HTN) 2. Hypercoagulability (obesity, hormones) 3. Stasis (immobility, polycythemia) Which of the following is NOT a clinical manifestation of PE? Dyspnea, anxiety, tachycardia, low grade fever, syncope, ischemic chest pain. - -ischemic chest pain is not a manifestation of PE. Pleuritic chest pain is characteristic of PE NURS 254 NURS 254 A patient with a known DVT (deep vein thrombosis) may have a surgical procedure to place this, which would "catch" any clots that may dislodge - -Inferior Vena Cava (IVC) filter How will the nurse quantify the expected outcome of a heparin drip? - -Titrate Heparin with a partial thromboplastin time (PTT) of 2 - 3 times the baseline When taking an anticoagulant name 3 necessary interventions for "bleeding precautions"? - -longer pressure to puncture sites No IM injections avoid tissue trauma soft bristle tooth brush electric shaver (no razors) What is the antidote for heparin? - -protamine sulfate Which nursing intervention is necessary for a patient diagnosed with PE? a. Ambulate frequently b. Administer heparin therapy c. Administer all medications intramuscularly (IM) for quicker absorption. - -b. administer heparin therapy When administering warfarin therapy what laboratory data would reflect the expected outcome? - -international Normalized Ratio (INR) between 2 to 3 (normal for warafrin) less than 1.1 in normal healthy pts What is the reversal agent for Coumadin (warfarin)? - -vitamin k The p wave signifies - -Atrial depolarization and contraction In order to measure the PR interval the nurse would place the calipers: - -At the beginning of the P wave to the beginning of the QRS complex The ST segment should be: - -on the same plane as the isoelectric line Inversion of the T wave signifies: - -Myocardial injury (NOT INFARCTION) Which of the following ECG changes signifies myocardial infarction? - -ST elevation Pathologic Q waves NURS 254 NURS 254 In order for cells to "do their work" (cellular metabolism), which of the following physiologic components must be working appropriately? - -Adequate cardiac output Tissues must be able to extract and use oxygen Blood vessel diameter and tone must be adequate Blood volume must be adequate a sign/symptom of early/Stage I shock? - -Tachycardia Which of the following are signs/symptoms of the intermediate/Stage II of shock? - Lactic acidosis Third spacing edema Oliguria Profound hypotension tachypnea What are effects of shock on the GI system? - -Stress ulcers and possible hemorrhage Paralytic ileus When administering crystalloid solutions to a patient in hypovolemic shock the nurse understands that __________ type of solution would result in fluid staying in the vascular space and therefore helping most with hypovolemia? - -isotonic (NS 0.9%) When administering a colloid/volume expander such as albumin 5% IV to a patient with hypovolemic shock, the nurse would be astute to which of the following unexpected outcomes of this therapy? - -Decreased platelet function/coagulation