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?
,- 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
Angin
a 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? -
,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
, 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
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?
,- 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
Angin
a 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? -
,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
, 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
