PCCN Review Cardiac Review Questions For The
Progressive Care Certification Test As Given By
The AACN.
Calculate the cardiac output for a pt with a HR of 70 and a SV of 65 ml. Correct Answers: HR X
SV=CO
70 X 65= 4550
4.6 L/min
Calculate the cardiac output for a pt with a HR of 70 and a SV of 65 ml.
HR X SV=CO Correct Answers: HR X SV=CO
70 X 65= 4550
4.6 L/min
What % of the cardiac cycle is provided by the atrial kick?
• 15%
• 20%
• 30%
• 35% Correct Answers: 20%
Atrial kick is a term that represents the amount of the total CO that is supplied via atrial contraction.
If the pt has a condition or dysrhythmia that impairs or eliminates the atrial contraction, the pt may be
compromised.
Atrial Kick Correct Answers: Atrial kick is a term that represents the amount of the total CO that is
supplied via atrial contraction.
A normal value for an EF would be?
• 65%
• 40%
• 30%
• 25% Correct Answers: 65%
The EF should be more than 50%. It represents the amount of blood ejected from the left ventricle
compared to the total amount available, expressed as a %. An EF of 35% or less indicates a problem
with contractility, outflow or filling.
EXA: If the ventricle contains 90ml of blood and 50mls are ejected, the amount would be expressed
as a %, in this case 55%.
A 67 year old male is admitted with chest pain after collapsing at home. He is arguing with his wife
that he should not be admitted because he "just over did it" while working in the world. Lee's wife
states to you that his chest pain is more frequent, severe and prolonged than before. You should
anticipate what diagnosis?
• Exertional angina
• Unstable angina
• Variant angina
• Stable angina Correct Answers: UNSTABLE ANGINA
,The change in quality, frequency, and duration indicates UNSTABLE ANGINA and may indicate that
the pt is at increased risk for an MI. This pt should be closely monitored for EKG changes and rhythm
disturbances. Pt/ family teaching should begin on how to identify an MI and basic CPR.
Stroke Volume is comprised of which of the following factors?
• Blood volume, viscosity, impedance
• Cardiac output, HR, compliance
• Contractility, preload, afterload
• Compliance, impedance, HR Correct Answers: Contractility, preload and afterload
A reflex tachycardia caused by the stretch of the right atrial receptors is known as the ____
• Herring-Sines law
• Renin-angiotensin system
• Starling's law
• Bainbridge reflex Correct Answers: BAINBRIDGE REFLEX
It is believed that this reflex exists to speed up the HR if the right side becomes overloaded, thereby
helping equalize pressures on both sides
Diastole comprises what & of the cardiac cycle?
•½
• 2/3
•¼
• 1/3 Correct Answers: 2/3
Some people that the heart is virtually static during diastole.
During this period, the cardiac vessels and chambers fill—a process that takes up 2/3s of the time
necessary to complete the cardiac cycle
What is the MAP (mean arterial pressure) for pt:
BP 120/70
HR 80 Correct Answers: MAP=2(DBP) + (SBP)/3
MAP=2(70) + 120/3
MAP=260/3
MAP=86.6
Pts should maintain a MAP of at least 60 to ensure adequate perfusion to the brain and kidneys.
What is the MAP (mean arterial pressure) for pt:
BP 120/70
HR 80
MAP=2(DBP) + (SBP)/3 Correct Answers: MAP=2(70) + 120/3
MAP=260/3
MAP=86.6
Pts should maintain a MAP of at least 60 to ensure adequate perfusion to the brain and kidneys.
Calculate CI (cardiac index)
HR 80
BP 110/70
SV 60
,BSA 2.0 m2
Expressed in L/min/m2 Correct Answers: CI=CO/BSA
CO=HR X SV
CO=80 X 60
CI=4800/2.0
CI=2400
CI=2.4 L/min/m2
Calculate CI (cardiac index)
HR 80
BP 110/70
SV 60
BSA 2.0 m2
Expressed in L/min/m2
CI=CO/BSA Correct Answers: CI=CO/BSA
CO=HR X SV
CO=80 X 60
CI=4800/2.0
CI=2400
CI=2.4 L/min/m2
The resistance against which the right ventricle must work to eject its volume is known as
• Resting heart pressure
• Systemic vascular pressure
• Central venous pressure
• Pulmonary vascular resistance Correct Answers: Pulmonary Vascular Resistance
This pressure represents a mean pressure in the systemic vasculature. The higher the resistance, the
harder the heart has to work against it.
EXA: Colder temperatures will cause vasoconstriction; the heart then has to pump harder to deliver
blood through the narrowed vasculature.
Mr. Ironclaw lives on a nearby Indian Reservation. He is retired and on a fixed income with no
insurance. He is being discharged today after an observational stay for Chest Pain. In planning his
discharge care, which of the following should be considered FIRST to increase compliance with plan
of care once home?
• Arrange for Home Health 1X/week
• Ask doc to consider an OTC antiplatelet medication
• Schedule his follow-up appt with the cardiologist in 3 months
• Suggest a gym membership Correct Answers: ASK DOC TO CONSIDER AN OTC ANTIPLATELET
MEDICATION
Although he may wish to be compliant with plan of care at home, financial limitations may prohibit him
from expensive treatments, meds, and support services.
William was diagnosed with unstable angina. He is scheduled for an exercise stress test. He tells you
he has a "bad hip" and an old knee injury that makes it difficult for him to walk or stand for more than
20 minutes. You tell him:
, • You only need to walk for 10 minutes
• You can ride a bike for 20 minutes instead
• I will call the doc and ask for the Weight-life test instead
• I will call the doc and ask for a stress echocardiography test instead Correct Answers: I WILL CALL
THE DOC AND ASK FOR A STRESS ECHOCARDIOGRAPHY TEST INSTEAD
The exercise stress test requires the pt to walk on a treadmill or stationary bike for 30-60 minutes.
The Stress Echocardiography test uses Dobutamine to stress the cardiac tissues without requiring
the pt to walk or ride.
The Weight lift test does not exist.
Approximately what % of coronary artery blockage is needed to cause angina?
• 45%
• 60%
• 75%
• 90% Correct Answers: 75%
Anginal pain usually occurs when approximately 75% of the artery's diameter becomes occluded.
Pain is usually more pronounced with exertion or emotional distress, when O2 demand by cardiac
tissue cannot be met by O2 supply via the occluded arteries. The severity of the pain may be
compounded with vasospams that further restrict blood flow through the coronary arteries.
A heart murmur associated with acute valvular regurg would be?
• S3
• S2
• S1
• S4 Correct Answers: S4
S1 and S2 are normal heart sounds
S3 is associated with fluid status
S4 is associated with compliance.
Which is the best lead to monitor a RBBB?
• Lead II
Lead I
• Lead V1
• Lead V6 Correct Answers: Lead V1
Tall, peaked T waves on an EKG may be indicative of?
• Hypocalcemia
• A non-STEMI
• Hyperkalemia
• A LBBB Correct Answers: HYPERKALEMIA
The PR interval may become prolonged. Also, if the K is greater than 8, a wide-complex tachycardia
may occur. Keep in mind that low levels of calcium or sodium may potentiate the cardiac effects, as
can a low pH.
Mrs. P suffered a cardiac arrest at home. The family did not perform CPR and paramedics arrived 6
minutes after the arrest. The pt was found in pulseless V-tach. Defib and continuous CPR were
Progressive Care Certification Test As Given By
The AACN.
Calculate the cardiac output for a pt with a HR of 70 and a SV of 65 ml. Correct Answers: HR X
SV=CO
70 X 65= 4550
4.6 L/min
Calculate the cardiac output for a pt with a HR of 70 and a SV of 65 ml.
HR X SV=CO Correct Answers: HR X SV=CO
70 X 65= 4550
4.6 L/min
What % of the cardiac cycle is provided by the atrial kick?
• 15%
• 20%
• 30%
• 35% Correct Answers: 20%
Atrial kick is a term that represents the amount of the total CO that is supplied via atrial contraction.
If the pt has a condition or dysrhythmia that impairs or eliminates the atrial contraction, the pt may be
compromised.
Atrial Kick Correct Answers: Atrial kick is a term that represents the amount of the total CO that is
supplied via atrial contraction.
A normal value for an EF would be?
• 65%
• 40%
• 30%
• 25% Correct Answers: 65%
The EF should be more than 50%. It represents the amount of blood ejected from the left ventricle
compared to the total amount available, expressed as a %. An EF of 35% or less indicates a problem
with contractility, outflow or filling.
EXA: If the ventricle contains 90ml of blood and 50mls are ejected, the amount would be expressed
as a %, in this case 55%.
A 67 year old male is admitted with chest pain after collapsing at home. He is arguing with his wife
that he should not be admitted because he "just over did it" while working in the world. Lee's wife
states to you that his chest pain is more frequent, severe and prolonged than before. You should
anticipate what diagnosis?
• Exertional angina
• Unstable angina
• Variant angina
• Stable angina Correct Answers: UNSTABLE ANGINA
,The change in quality, frequency, and duration indicates UNSTABLE ANGINA and may indicate that
the pt is at increased risk for an MI. This pt should be closely monitored for EKG changes and rhythm
disturbances. Pt/ family teaching should begin on how to identify an MI and basic CPR.
Stroke Volume is comprised of which of the following factors?
• Blood volume, viscosity, impedance
• Cardiac output, HR, compliance
• Contractility, preload, afterload
• Compliance, impedance, HR Correct Answers: Contractility, preload and afterload
A reflex tachycardia caused by the stretch of the right atrial receptors is known as the ____
• Herring-Sines law
• Renin-angiotensin system
• Starling's law
• Bainbridge reflex Correct Answers: BAINBRIDGE REFLEX
It is believed that this reflex exists to speed up the HR if the right side becomes overloaded, thereby
helping equalize pressures on both sides
Diastole comprises what & of the cardiac cycle?
•½
• 2/3
•¼
• 1/3 Correct Answers: 2/3
Some people that the heart is virtually static during diastole.
During this period, the cardiac vessels and chambers fill—a process that takes up 2/3s of the time
necessary to complete the cardiac cycle
What is the MAP (mean arterial pressure) for pt:
BP 120/70
HR 80 Correct Answers: MAP=2(DBP) + (SBP)/3
MAP=2(70) + 120/3
MAP=260/3
MAP=86.6
Pts should maintain a MAP of at least 60 to ensure adequate perfusion to the brain and kidneys.
What is the MAP (mean arterial pressure) for pt:
BP 120/70
HR 80
MAP=2(DBP) + (SBP)/3 Correct Answers: MAP=2(70) + 120/3
MAP=260/3
MAP=86.6
Pts should maintain a MAP of at least 60 to ensure adequate perfusion to the brain and kidneys.
Calculate CI (cardiac index)
HR 80
BP 110/70
SV 60
,BSA 2.0 m2
Expressed in L/min/m2 Correct Answers: CI=CO/BSA
CO=HR X SV
CO=80 X 60
CI=4800/2.0
CI=2400
CI=2.4 L/min/m2
Calculate CI (cardiac index)
HR 80
BP 110/70
SV 60
BSA 2.0 m2
Expressed in L/min/m2
CI=CO/BSA Correct Answers: CI=CO/BSA
CO=HR X SV
CO=80 X 60
CI=4800/2.0
CI=2400
CI=2.4 L/min/m2
The resistance against which the right ventricle must work to eject its volume is known as
• Resting heart pressure
• Systemic vascular pressure
• Central venous pressure
• Pulmonary vascular resistance Correct Answers: Pulmonary Vascular Resistance
This pressure represents a mean pressure in the systemic vasculature. The higher the resistance, the
harder the heart has to work against it.
EXA: Colder temperatures will cause vasoconstriction; the heart then has to pump harder to deliver
blood through the narrowed vasculature.
Mr. Ironclaw lives on a nearby Indian Reservation. He is retired and on a fixed income with no
insurance. He is being discharged today after an observational stay for Chest Pain. In planning his
discharge care, which of the following should be considered FIRST to increase compliance with plan
of care once home?
• Arrange for Home Health 1X/week
• Ask doc to consider an OTC antiplatelet medication
• Schedule his follow-up appt with the cardiologist in 3 months
• Suggest a gym membership Correct Answers: ASK DOC TO CONSIDER AN OTC ANTIPLATELET
MEDICATION
Although he may wish to be compliant with plan of care at home, financial limitations may prohibit him
from expensive treatments, meds, and support services.
William was diagnosed with unstable angina. He is scheduled for an exercise stress test. He tells you
he has a "bad hip" and an old knee injury that makes it difficult for him to walk or stand for more than
20 minutes. You tell him:
, • You only need to walk for 10 minutes
• You can ride a bike for 20 minutes instead
• I will call the doc and ask for the Weight-life test instead
• I will call the doc and ask for a stress echocardiography test instead Correct Answers: I WILL CALL
THE DOC AND ASK FOR A STRESS ECHOCARDIOGRAPHY TEST INSTEAD
The exercise stress test requires the pt to walk on a treadmill or stationary bike for 30-60 minutes.
The Stress Echocardiography test uses Dobutamine to stress the cardiac tissues without requiring
the pt to walk or ride.
The Weight lift test does not exist.
Approximately what % of coronary artery blockage is needed to cause angina?
• 45%
• 60%
• 75%
• 90% Correct Answers: 75%
Anginal pain usually occurs when approximately 75% of the artery's diameter becomes occluded.
Pain is usually more pronounced with exertion or emotional distress, when O2 demand by cardiac
tissue cannot be met by O2 supply via the occluded arteries. The severity of the pain may be
compounded with vasospams that further restrict blood flow through the coronary arteries.
A heart murmur associated with acute valvular regurg would be?
• S3
• S2
• S1
• S4 Correct Answers: S4
S1 and S2 are normal heart sounds
S3 is associated with fluid status
S4 is associated with compliance.
Which is the best lead to monitor a RBBB?
• Lead II
Lead I
• Lead V1
• Lead V6 Correct Answers: Lead V1
Tall, peaked T waves on an EKG may be indicative of?
• Hypocalcemia
• A non-STEMI
• Hyperkalemia
• A LBBB Correct Answers: HYPERKALEMIA
The PR interval may become prolonged. Also, if the K is greater than 8, a wide-complex tachycardia
may occur. Keep in mind that low levels of calcium or sodium may potentiate the cardiac effects, as
can a low pH.
Mrs. P suffered a cardiac arrest at home. The family did not perform CPR and paramedics arrived 6
minutes after the arrest. The pt was found in pulseless V-tach. Defib and continuous CPR were
