ADVANCED MED SURG FINAL EXAM
QUESTIONS AND ANSWERS 100% PASS
2026/2027
A Fib -
A Flutter -
V Tach
V Fib -
3rd Degree Heart Block - ANS No transmission of electrical pulses between the AV node and
the ventricles. No relation between P and QRS waves
Treatment: temporary pacing (can be used to cardiovert), Epi, discontinuing harmful meds. Then
permanent pacemaker
Will be very slow HR
Atrial Fibrillation - ANS Most common atrial arrhythmia, leads to a low CO
Risk for blood clots which can lead to stroke
Diagnosis: ECG
@2026 ALLRIGHTS RESERVED 1
,Treatment: *anticoagulation* is 1st step like warfarin (INR 2-3x normal limit, 2-3 is normal
level). Then think about cardioversion, 48 hours is limit. Beta blockers, calcium channel blockers,
cardiac glycosides
Ventricular Tachycardia - ANS Can be stable (has a pulse), or unstable (pulseless)
Sustained: severely decreases CO when it lasts longer than 30 seconds.
S/S: Hypotension, Pulmonary edema, Decreased cerebral blood flow, Cardiopulmonary arrest
Treatment: must be rapid to prevent v fib. Asymptomatic - drugs. Symptomatic but alert -
cardioversion. Pulseless - defib, CPR, code, then Epi if defib doesn't work
*1st step is to check pulse*
Ventricular Fibrillation - ANS Risk Factors/Causes: MI, CAD, cardiac catheterization,,
hyperkalemia, hypoxia, drugs
Treatment: immediate CPR, code, defib, Epi + amiodarone
PVC (Premature Ventricular Contraction) - ANS Considered life-threatening because of
decreased CO and the possibility of deterioration to ventricular fibrillation (no CO)
Can be caused by stimulants, *electrolyte imbalances*, MI, HF, a set of over 3 in a row =
Ventricular tachycardia
PEA (Pulseless Electrical Activity) - ANS Electrical activity observed but no pulse
5 H Causes: hypovolemia, hypothermia, hypoxia, hypo/hyperkalemia, acidosis (H+)
5 T Causes: cardiac Tamponade, Toxins, Tension pneumothorax, pulmonary Thrombosis,
cornoary Thrombosis
Very dangerous and often fatal
Asytole - ANS No electrical activity, CO, or pulse
Can be from long QT interval
@2026 ALLRIGHTS RESERVED 2
, Treatment: CPR, intubation, pacemaker, epi, atropine
Bradycardia - ANS Symptomatic: fatigue, dizzy, chest pain, syncope, pale, cool skin,
hypotension, SOB
Treatment: IV atropine. If this doesn't work, transcutaneous pacing or dopamine/Epi.
Permanent pacemaker
Tachycardia - ANS Heart rate above 100 with regular rhythm, treat the cause
Symptoms can include chest pain, palpitations, light-headedness
Tx: pain meds, beta blocker, disease management, etc
Abdominal Aortic Aneurysm - ANS Dilation right before the aorta splits. Risk Factor: HTN
S/S: often asymptomatic, can mimic pain associated with abdominal/back disorders. Physical
exam shows pulsatile mass in periumbilical area, bruit may be auscultated.
Spontaneous plaque embolization can cause "blue toe syndrome": patchy motting of feet/toes
with palpable pedal pulses, back pain. If dissects, most likely to be fatal
Tx: surgery if 5.5+ cm diameter (hydrate). Conservative tx for less than 5.5 cm includes statins &
ACE inhibitors, and monitoring q 6-12 months. HTN/hyperlipidemia meds
Teaching: no smoking, control BP, exercise. Contact HCP if back pain + headache. Go to ED if you
feel tear.
Heparin - ANS Indication: *atrial fib* (high clot risk), prevention/treatment of DVT (esp w/
bedrest), DIC, surgery (prevent clot formation)
Interventions: monitor effects by checking aPTT or ACT. Titrate dosage by checking CBC
(platelets). Protamine sulfate is the antidote, consider stopping if platelets fall below 150,000 or
drop by 50%
Teaching: report any bruises, be very careful not to hurt yourself as healing is significantly
delayed. They need regular blood draws to check PTT. Limit leafy greens, soft tooth brush. No
aspirin/nitro
@2026 ALLRIGHTS RESERVED 3
QUESTIONS AND ANSWERS 100% PASS
2026/2027
A Fib -
A Flutter -
V Tach
V Fib -
3rd Degree Heart Block - ANS No transmission of electrical pulses between the AV node and
the ventricles. No relation between P and QRS waves
Treatment: temporary pacing (can be used to cardiovert), Epi, discontinuing harmful meds. Then
permanent pacemaker
Will be very slow HR
Atrial Fibrillation - ANS Most common atrial arrhythmia, leads to a low CO
Risk for blood clots which can lead to stroke
Diagnosis: ECG
@2026 ALLRIGHTS RESERVED 1
,Treatment: *anticoagulation* is 1st step like warfarin (INR 2-3x normal limit, 2-3 is normal
level). Then think about cardioversion, 48 hours is limit. Beta blockers, calcium channel blockers,
cardiac glycosides
Ventricular Tachycardia - ANS Can be stable (has a pulse), or unstable (pulseless)
Sustained: severely decreases CO when it lasts longer than 30 seconds.
S/S: Hypotension, Pulmonary edema, Decreased cerebral blood flow, Cardiopulmonary arrest
Treatment: must be rapid to prevent v fib. Asymptomatic - drugs. Symptomatic but alert -
cardioversion. Pulseless - defib, CPR, code, then Epi if defib doesn't work
*1st step is to check pulse*
Ventricular Fibrillation - ANS Risk Factors/Causes: MI, CAD, cardiac catheterization,,
hyperkalemia, hypoxia, drugs
Treatment: immediate CPR, code, defib, Epi + amiodarone
PVC (Premature Ventricular Contraction) - ANS Considered life-threatening because of
decreased CO and the possibility of deterioration to ventricular fibrillation (no CO)
Can be caused by stimulants, *electrolyte imbalances*, MI, HF, a set of over 3 in a row =
Ventricular tachycardia
PEA (Pulseless Electrical Activity) - ANS Electrical activity observed but no pulse
5 H Causes: hypovolemia, hypothermia, hypoxia, hypo/hyperkalemia, acidosis (H+)
5 T Causes: cardiac Tamponade, Toxins, Tension pneumothorax, pulmonary Thrombosis,
cornoary Thrombosis
Very dangerous and often fatal
Asytole - ANS No electrical activity, CO, or pulse
Can be from long QT interval
@2026 ALLRIGHTS RESERVED 2
, Treatment: CPR, intubation, pacemaker, epi, atropine
Bradycardia - ANS Symptomatic: fatigue, dizzy, chest pain, syncope, pale, cool skin,
hypotension, SOB
Treatment: IV atropine. If this doesn't work, transcutaneous pacing or dopamine/Epi.
Permanent pacemaker
Tachycardia - ANS Heart rate above 100 with regular rhythm, treat the cause
Symptoms can include chest pain, palpitations, light-headedness
Tx: pain meds, beta blocker, disease management, etc
Abdominal Aortic Aneurysm - ANS Dilation right before the aorta splits. Risk Factor: HTN
S/S: often asymptomatic, can mimic pain associated with abdominal/back disorders. Physical
exam shows pulsatile mass in periumbilical area, bruit may be auscultated.
Spontaneous plaque embolization can cause "blue toe syndrome": patchy motting of feet/toes
with palpable pedal pulses, back pain. If dissects, most likely to be fatal
Tx: surgery if 5.5+ cm diameter (hydrate). Conservative tx for less than 5.5 cm includes statins &
ACE inhibitors, and monitoring q 6-12 months. HTN/hyperlipidemia meds
Teaching: no smoking, control BP, exercise. Contact HCP if back pain + headache. Go to ED if you
feel tear.
Heparin - ANS Indication: *atrial fib* (high clot risk), prevention/treatment of DVT (esp w/
bedrest), DIC, surgery (prevent clot formation)
Interventions: monitor effects by checking aPTT or ACT. Titrate dosage by checking CBC
(platelets). Protamine sulfate is the antidote, consider stopping if platelets fall below 150,000 or
drop by 50%
Teaching: report any bruises, be very careful not to hurt yourself as healing is significantly
delayed. They need regular blood draws to check PTT. Limit leafy greens, soft tooth brush. No
aspirin/nitro
@2026 ALLRIGHTS RESERVED 3
