1
NEW 2022 WORKING UPDATE SOLUTION FOR ATI MED SURG FINAL
EXAM ALL PRACICE QUESTIONS AND ANSWERS
What is normal range for cholesterol, HDL, LDL
- CORRECT ANSWER Less than 200, above 40, less than 130
What is the desired INR range for people taking warfarin
- CORRECT ANSWER 2.0-3.0
What is an indicator of cardiac tamponade
- CORRECT ANSWER Blood pressure is 10 MM HG or higher on expiration then on inspiration
Patients scheduled for a coronary artery bypass graft should not take anticoagulants for at least
blank prior to the surgery to prevent excessive bleeding
- CORRECT ANSWER A week
A patient is admitted with a diagnosis of Bradydysrhythmia. What assessment finding requires
immediate intervention?
- CORRECT ANSWER The patient reports weakness and fatigue
Following insertion of a permanent pacemaker, a patient states they cannot get rid of these
hiccups. Why is this potentially a problem?
- CORRECT ANSWER Hiccups may indicate that the pacemaker is stimulating the chest wall
or diaphragm. This could indicate a complication such as lead wire perforation
Chapter 27 - CORRECT ANSWER
What is the normal range for creatine kinase? When are elevated levels first detectable after
myocardial injury and what is expected duration of the elevated levels?
- CORRECT ANSWER 30 to 170 units/L, 4 to 6 hours, 3 days
What is the normal range for troponin T? When are elevated levels first detectable after
myocardial injury and what is expected duration of the elevated levels?
,2
- CORRECT ANSWER Less than 0.2 ng/L, 3 to 5 hours, 14 to 21 days
What is normal range for troponin I? When are elevated levels first detectable after myocardial
injury and what is expected duration of the elevated levels? - CORRECT ANSWER Less than
0.03, three hours, 7 to 10 days
What is normal range for myoglobin? When are elevated levels first detectable after myocardial
injury and what is expected duration of the elevated levels? - CORRECT ANSWER Less than
90 mcg/L, two hours, 24 hours
While an echocardiogram is being performed what side should the patient lie on? - CORRECT
ANSWER Left side and remain still
What are indications for an echocardiogram - CORRECT ANSWER Cardiomyopathy
Heart failure
Angina
Myocardial infarction
What are indications for stress test - CORRECT ANSWER Dysrhythmias
HF
Angina
MI
What are two medications that are prescribed for pharmacological stress test - CORRECT
ANSWER Dobutamine
Adenosine
What do you instruct the patient to do 2 to 4 hours before a stress test - CORRECT ANSWER
Avoid tobacco, alcohol and caffeine
Hemodynamic monitoring involves special indwelling catheters that provide information about
blood volume and perfusion, fluid status and how well the heart is pumping. Arterial lines are
placed in the radial (most common), brachial or femoral artery. What should you Monitor for? -
,3
CORRECT ANSWER Monitor circulation in the limb with the arterial line. Such as capillary refill,
temperature, color. Arterial lines are not used for IV fluid administration
The pulmonary artery (PA) catheter is inserted into a large vein (internal jugular, femoral,
subclavian, brachial) and threaded through the right atria and ventricles into a branch of the
pulmonary artery. PA catheters have multiple lumens, ports and components that allow for
various hemodynamic measurements, blood sampling and - CORRECT ANSWER Infusion of IV
fluids
What are the different lumens used for? - CORRECT ANSWER
What is the expected reference range for CVP (Central venous pressure) - CORRECT
ANSWER 1 to 8 MM HG
What is the expected reference range for pulmonary artery systolic (PAS) - CORRECT
ANSWER 15 to 26
What is the expected range for pulmonary artery diastolic (PAD) - CORRECT ANSWER 5 to 15
What is expected range for pulmonary artery wedge pressure (PAWP)? - CORRECT ANSWER
4 to 12
What is the expected range for cardiac output - CORRECT ANSWER 4 to 7 L/minute
What is expected range for mixed venous oxygen saturation - CORRECT ANSWER 60% to
80%
When should a nurse anticipate lower hemodynamic values? - CORRECT ANSWER In older
patients especially if dehydration is a complication
What position should the patient be in with hemodynamic monitoring - CORRECT ANSWER
Supine or Trendelenburg
, 4
What are post procedure nursing interventions for hemodynamic monitoring - CORRECT
ANSWER 1. Obtain chest x-ray to confirm catheter placement
2. Continually monitor vitals
3. Compare NIBP to arterial blood pressure
4. Observe and document waveforms. Report changes in waveforms to the provider
5. Document catheter placement each shift and as needed
6. Place the patient in supine position prior to recording hemodynamic values ( HOB can be
elevated 15° to 30°)
What are complications of hemodynamic monitoring - CORRECT ANSWER
What are nursing actions preprocedure before an angiography - CORRECT ANSWER 1.
Patient is NPO for at least eight hours before
2. Assess for iodine/shellfish allergy
3. Assess renal function
4. Teach the client that the affected leg must remain straight after the procedure
5. The other normal stuff like ensure informed consent blah blah
What are post procedure nursing interventions for an angiography - CORRECT ANSWER 1.
Assess vitals every 15 minutes for One hour, every 30 minutes for one hour, every hour for four
hours and then every four hours
2. Assess the site for bleeding and hematoma with every vital sign check
3. Maintain bed rest for 4 to 6 hours after the procedure
4. Monitor urine output and administer IV fluids for hydration (contrast media acts as an osmotic
diuretic)
How long do patients receive anticoagulation therapy that have stent placement - CORRECT
ANSWER 6 to 8 weeks
What is cardiac tamponade - CORRECT ANSWER Fluid accumulation in the pericardial sac
What are manifestations of cardiac tamponade - CORRECT ANSWER hypotension
NEW 2022 WORKING UPDATE SOLUTION FOR ATI MED SURG FINAL
EXAM ALL PRACICE QUESTIONS AND ANSWERS
What is normal range for cholesterol, HDL, LDL
- CORRECT ANSWER Less than 200, above 40, less than 130
What is the desired INR range for people taking warfarin
- CORRECT ANSWER 2.0-3.0
What is an indicator of cardiac tamponade
- CORRECT ANSWER Blood pressure is 10 MM HG or higher on expiration then on inspiration
Patients scheduled for a coronary artery bypass graft should not take anticoagulants for at least
blank prior to the surgery to prevent excessive bleeding
- CORRECT ANSWER A week
A patient is admitted with a diagnosis of Bradydysrhythmia. What assessment finding requires
immediate intervention?
- CORRECT ANSWER The patient reports weakness and fatigue
Following insertion of a permanent pacemaker, a patient states they cannot get rid of these
hiccups. Why is this potentially a problem?
- CORRECT ANSWER Hiccups may indicate that the pacemaker is stimulating the chest wall
or diaphragm. This could indicate a complication such as lead wire perforation
Chapter 27 - CORRECT ANSWER
What is the normal range for creatine kinase? When are elevated levels first detectable after
myocardial injury and what is expected duration of the elevated levels?
- CORRECT ANSWER 30 to 170 units/L, 4 to 6 hours, 3 days
What is the normal range for troponin T? When are elevated levels first detectable after
myocardial injury and what is expected duration of the elevated levels?
,2
- CORRECT ANSWER Less than 0.2 ng/L, 3 to 5 hours, 14 to 21 days
What is normal range for troponin I? When are elevated levels first detectable after myocardial
injury and what is expected duration of the elevated levels? - CORRECT ANSWER Less than
0.03, three hours, 7 to 10 days
What is normal range for myoglobin? When are elevated levels first detectable after myocardial
injury and what is expected duration of the elevated levels? - CORRECT ANSWER Less than
90 mcg/L, two hours, 24 hours
While an echocardiogram is being performed what side should the patient lie on? - CORRECT
ANSWER Left side and remain still
What are indications for an echocardiogram - CORRECT ANSWER Cardiomyopathy
Heart failure
Angina
Myocardial infarction
What are indications for stress test - CORRECT ANSWER Dysrhythmias
HF
Angina
MI
What are two medications that are prescribed for pharmacological stress test - CORRECT
ANSWER Dobutamine
Adenosine
What do you instruct the patient to do 2 to 4 hours before a stress test - CORRECT ANSWER
Avoid tobacco, alcohol and caffeine
Hemodynamic monitoring involves special indwelling catheters that provide information about
blood volume and perfusion, fluid status and how well the heart is pumping. Arterial lines are
placed in the radial (most common), brachial or femoral artery. What should you Monitor for? -
,3
CORRECT ANSWER Monitor circulation in the limb with the arterial line. Such as capillary refill,
temperature, color. Arterial lines are not used for IV fluid administration
The pulmonary artery (PA) catheter is inserted into a large vein (internal jugular, femoral,
subclavian, brachial) and threaded through the right atria and ventricles into a branch of the
pulmonary artery. PA catheters have multiple lumens, ports and components that allow for
various hemodynamic measurements, blood sampling and - CORRECT ANSWER Infusion of IV
fluids
What are the different lumens used for? - CORRECT ANSWER
What is the expected reference range for CVP (Central venous pressure) - CORRECT
ANSWER 1 to 8 MM HG
What is the expected reference range for pulmonary artery systolic (PAS) - CORRECT
ANSWER 15 to 26
What is the expected range for pulmonary artery diastolic (PAD) - CORRECT ANSWER 5 to 15
What is expected range for pulmonary artery wedge pressure (PAWP)? - CORRECT ANSWER
4 to 12
What is the expected range for cardiac output - CORRECT ANSWER 4 to 7 L/minute
What is expected range for mixed venous oxygen saturation - CORRECT ANSWER 60% to
80%
When should a nurse anticipate lower hemodynamic values? - CORRECT ANSWER In older
patients especially if dehydration is a complication
What position should the patient be in with hemodynamic monitoring - CORRECT ANSWER
Supine or Trendelenburg
, 4
What are post procedure nursing interventions for hemodynamic monitoring - CORRECT
ANSWER 1. Obtain chest x-ray to confirm catheter placement
2. Continually monitor vitals
3. Compare NIBP to arterial blood pressure
4. Observe and document waveforms. Report changes in waveforms to the provider
5. Document catheter placement each shift and as needed
6. Place the patient in supine position prior to recording hemodynamic values ( HOB can be
elevated 15° to 30°)
What are complications of hemodynamic monitoring - CORRECT ANSWER
What are nursing actions preprocedure before an angiography - CORRECT ANSWER 1.
Patient is NPO for at least eight hours before
2. Assess for iodine/shellfish allergy
3. Assess renal function
4. Teach the client that the affected leg must remain straight after the procedure
5. The other normal stuff like ensure informed consent blah blah
What are post procedure nursing interventions for an angiography - CORRECT ANSWER 1.
Assess vitals every 15 minutes for One hour, every 30 minutes for one hour, every hour for four
hours and then every four hours
2. Assess the site for bleeding and hematoma with every vital sign check
3. Maintain bed rest for 4 to 6 hours after the procedure
4. Monitor urine output and administer IV fluids for hydration (contrast media acts as an osmotic
diuretic)
How long do patients receive anticoagulation therapy that have stent placement - CORRECT
ANSWER 6 to 8 weeks
What is cardiac tamponade - CORRECT ANSWER Fluid accumulation in the pericardial sac
What are manifestations of cardiac tamponade - CORRECT ANSWER hypotension
