BKAT MED-SURG CERTIFICATION
SCRIPT 2026 QUESTIONS WITH
SOLUTIONS GRADED A+
◍ Troponin T.
Answer: <0.2 ng/mLelevation detectable after MI 3-5 hrs
◍ Troponin I.
Answer: <0.03 ng/mLelevation detectable after MI 3 hrs
◍ Indications for CAB(G) surgery.
Answer: Coronary heart disease (CHD)
◍ Anesthesia used for CAB(G) surgery.
Answer: General
◍ Myoglobin.
Answer: <90 mcg/Lelevation detectable after MI 2 hrs
◍ Echocardiogram.
Answer: ultrasound of the heartindications:cardiomyopathyheart
failureanginaMIlay on LEFT side during procedure, takes 1 hr
◍ Entry incisions used for CAB(G) surgery.
Answer: 1. Median sternotomy 2. Minimally invasive direct, MID (variety
of incision types - limited candidates) 3. Port access, PA (keyhole incisions
for scope & instrument - limited candidates)
◍ Median sternotomy incisions.
Answer: Through center of the sternum
◍ MID incisions.
Answer: Minimally invasive direct - variety of options for incisions
,◍ Stress Testing.
Answer: measures workload of the heart and how it tolerates
"stress"indications:anginaheart failureMIdysrhythmiasMAY use drugs
(adenosine, dobutamine)FAST 2-4 hrs beforeECG nursing test
◍ Hemodynamic Monitoring.
Answer: the use of pressure monitoring devices to directly measure
cardiovascular functionindications:serious/critical illnessheart failurepost
coronary artery bypass graft patientsARDSacute kidney injuryburn
injurytrauma injurylay SUPINE or TRENDELENBURGplace at
phlebostatic axis (4th intercostal space, midaxillary line)
◍ Port access incisions.
Answer: 3 small keyhole incisions for scope & instruments or through
femoral artery access
◍ Hemodynamic Monitoring Findings.
Answer: central venous pressure = 1-8pulmonary artery systolic =
15-25pulmonary artery diastolic = 5-15pulmonary artery wedge pressure =
4-12mixed venous oxygen saturation = 60-80%
◍ Hemodynamic Monitoring Complications.
Answer: infection/sepsis -surgical asepsis when changing dressing (mask,
sterile globes, maintain sterile fiedl)embolism0.9% sodium chloride for
flushing (NO heparin)
◍ What procedures can port access be used for?.
Answer: Valve replacements, LAD procedures
◍ Angiography.
Answer: a radiographic study of the blood vessels after the injection of a
contrast mediumindications:unstable anginaECG changesNPO for at least 8
hrswatch for iodine/shellfish ALLERGYassess RENAL functionAFTER:
maintain bed rest, keep extremity STRAIGHT
◍ Intra-operative circulation for CAB(G) surgery.
Answer: - Cardiopulmonary bypass machine (heart can stop beating) -
, Off-pump (beating heart - stabilize portions) - "Mini" bypass machine (less
contact w/artificial surfaces)
◍ Angiography Teaching.
Answer: no strenous exercisereport bleedingrestrict lifting (<10
lb)anticoagulation therapy (those who have stent placement)
◍ How does a cardiopulmonary bypass machine work?.
Answer: Withdraws blood from the vena cava & returned to the aorta (after
the clamp)
◍ Major issues with cardiopulmonary bypass machine.
Answer: Clamping the aorta can cause tissue irritation & clotting Contact
with artificial surfaces can cause clotting
◍ Angiography Complications.
Answer: cardiac tamponadehematoma formationrestenosis of treated
vesselretroperitoneal bleeding
◍ Benefits of a mini bypass machine.
Answer: - Closer to the pt - Less volume loading needed - Less
tubing/contact with artificial surfaces (lower risk of clots)
◍ Vascular Access.
Answer: central catheters:- nontunneled percutaneous central catheter
-(chemotherapy, blood, antibiotics, TPN)LONG TERM- peripherally
inserted central catheter -use up to 12 months(blood, chemotherapy,
antibiotics, TPN)assess site q 8 hrschange tube and positive pressure cap at
least q 3 days10 mL or larger syringe to flushflush with 10 mL of 0.9%
sodium chloridetransparent dressingdo NOT immerse in waterNO blood
pressure on PICC arm- tunneled percutaneous central catheter -long term
useNO dressing needed- implanted port -long term (> 1 yr)access with a
noncoring (Huber) needle
◍ Vessels that are used for a CAB(G).
Answer: L internal mammary a. R internal mammary a. Saphenous v. Radial
aa. Etc
SCRIPT 2026 QUESTIONS WITH
SOLUTIONS GRADED A+
◍ Troponin T.
Answer: <0.2 ng/mLelevation detectable after MI 3-5 hrs
◍ Troponin I.
Answer: <0.03 ng/mLelevation detectable after MI 3 hrs
◍ Indications for CAB(G) surgery.
Answer: Coronary heart disease (CHD)
◍ Anesthesia used for CAB(G) surgery.
Answer: General
◍ Myoglobin.
Answer: <90 mcg/Lelevation detectable after MI 2 hrs
◍ Echocardiogram.
Answer: ultrasound of the heartindications:cardiomyopathyheart
failureanginaMIlay on LEFT side during procedure, takes 1 hr
◍ Entry incisions used for CAB(G) surgery.
Answer: 1. Median sternotomy 2. Minimally invasive direct, MID (variety
of incision types - limited candidates) 3. Port access, PA (keyhole incisions
for scope & instrument - limited candidates)
◍ Median sternotomy incisions.
Answer: Through center of the sternum
◍ MID incisions.
Answer: Minimally invasive direct - variety of options for incisions
,◍ Stress Testing.
Answer: measures workload of the heart and how it tolerates
"stress"indications:anginaheart failureMIdysrhythmiasMAY use drugs
(adenosine, dobutamine)FAST 2-4 hrs beforeECG nursing test
◍ Hemodynamic Monitoring.
Answer: the use of pressure monitoring devices to directly measure
cardiovascular functionindications:serious/critical illnessheart failurepost
coronary artery bypass graft patientsARDSacute kidney injuryburn
injurytrauma injurylay SUPINE or TRENDELENBURGplace at
phlebostatic axis (4th intercostal space, midaxillary line)
◍ Port access incisions.
Answer: 3 small keyhole incisions for scope & instruments or through
femoral artery access
◍ Hemodynamic Monitoring Findings.
Answer: central venous pressure = 1-8pulmonary artery systolic =
15-25pulmonary artery diastolic = 5-15pulmonary artery wedge pressure =
4-12mixed venous oxygen saturation = 60-80%
◍ Hemodynamic Monitoring Complications.
Answer: infection/sepsis -surgical asepsis when changing dressing (mask,
sterile globes, maintain sterile fiedl)embolism0.9% sodium chloride for
flushing (NO heparin)
◍ What procedures can port access be used for?.
Answer: Valve replacements, LAD procedures
◍ Angiography.
Answer: a radiographic study of the blood vessels after the injection of a
contrast mediumindications:unstable anginaECG changesNPO for at least 8
hrswatch for iodine/shellfish ALLERGYassess RENAL functionAFTER:
maintain bed rest, keep extremity STRAIGHT
◍ Intra-operative circulation for CAB(G) surgery.
Answer: - Cardiopulmonary bypass machine (heart can stop beating) -
, Off-pump (beating heart - stabilize portions) - "Mini" bypass machine (less
contact w/artificial surfaces)
◍ Angiography Teaching.
Answer: no strenous exercisereport bleedingrestrict lifting (<10
lb)anticoagulation therapy (those who have stent placement)
◍ How does a cardiopulmonary bypass machine work?.
Answer: Withdraws blood from the vena cava & returned to the aorta (after
the clamp)
◍ Major issues with cardiopulmonary bypass machine.
Answer: Clamping the aorta can cause tissue irritation & clotting Contact
with artificial surfaces can cause clotting
◍ Angiography Complications.
Answer: cardiac tamponadehematoma formationrestenosis of treated
vesselretroperitoneal bleeding
◍ Benefits of a mini bypass machine.
Answer: - Closer to the pt - Less volume loading needed - Less
tubing/contact with artificial surfaces (lower risk of clots)
◍ Vascular Access.
Answer: central catheters:- nontunneled percutaneous central catheter
-(chemotherapy, blood, antibiotics, TPN)LONG TERM- peripherally
inserted central catheter -use up to 12 months(blood, chemotherapy,
antibiotics, TPN)assess site q 8 hrschange tube and positive pressure cap at
least q 3 days10 mL or larger syringe to flushflush with 10 mL of 0.9%
sodium chloridetransparent dressingdo NOT immerse in waterNO blood
pressure on PICC arm- tunneled percutaneous central catheter -long term
useNO dressing needed- implanted port -long term (> 1 yr)access with a
noncoring (Huber) needle
◍ Vessels that are used for a CAB(G).
Answer: L internal mammary a. R internal mammary a. Saphenous v. Radial
aa. Etc
