Barron/Elsevier CCRN practice test
questions
ADH - ansPhenytoin inhibits _______ secretion
Right - ansMost episodes of aspiration result in (right/left) lung infiltrates.
urine creatinine clearance - ansBest indicator of GFR
Auto-PEEP - ansIn a vented patient with status asthmaticus, check for _______________
Air trapping - ansAn increase in auto-PEEP is a sign of _________________.
obstructive pulmonary disease - ansA patient with a flattened diaphragm on a Chest X-ray
and decreased expiratory flow rate most likely has what type of disease?
II and V1 - ans____ and ______ are the two best P wave leads.
wide, notched P waves - ansWhat is a manifestation of left atrial enlargement on an EKG in
lead II?
normal - ansDiphasic P waves in lead V1 on 12-lead EKG are abnormal/normal.
myoglobin - ans_________ is the earliest cardiac biomarker for a MI (elevated within 3hrs
s/p MI) and is nonspecific.
pleurodesis - ansinjection of a sclerosing agent into the pleural space and is used for pleural
effusion
LAD - ansThe__________ coronary artery supplies the bundle of His and bundle branches
anterior (LAD affected) - ans_____________ MIs may cause blocks of the bundle of His or
bundle branches
Right Coronary Artery (RCA)... LCA in 10% of ppl - ansType I AV block, also called
Wenckebach, is a block at the AV node, and the AV node is supplied by the
___________________ (in 90% of people)
sinus - ansthe ____________ node is supplied by the RCA in 55% of ppl and LCA in 45%
pale and shiny - ansThe skin changes associated with chronic peripheral arterial disease
pain, pallor, pulselessness, paresthesia, paralysis, and polar (cold) - answhat are the 6 Ps of
acute arterial occlusion?
less - ansThere is (more/less) risk of burning of the skin with biphasic waveform
defibrillation than with monophasic.
,necrosis - ansadding too much air to a ETT cuff can cause overinflation and tracheal
______________.
myocardial infarction (MI) - ansWhat is the most common cause of death after vascular
surgery?
CAD - ansBecause atherosclerosis does not occur in one vessel, patients requiring vascular
surgery are likely also to have ___________________________.
dissecting aortic aneurysm - ansThe first diagnostic test should be a CXR film for probable
diagnosis. The film would reveal a widening mediastinum. An additional, more indicative
finding would be calcified aortic knob with extension of the aortic wall.
left - ansA wide, notched P wave is an indication of ________ atrial enlargement.
P mitrale - ansLeft atrial enlargement causes the P wave to be wide (greater than 0.1 second)
and notched. This sometimes is referred to as ___ __________.
mitral - ans___________ valve stenosis causes LA enlargement and wide, notched P Waves
RCA (as seen in inferior wall MIs) - ansSA blocks, second-degree AV block type I, and
third-degree AV heart block at the level of the AV node would occur in _______________
occlusion
left - ansThe anterolateral heart wall is supplied by the ______ coronary artery
right - ansThe SA node and the atrioventricular (AV) node are supplied by the ________
coronary artery in most hearts.
AV - anssecond degree Type I AV block is located anatomically at the _____ node
Bundle of His - ansSecond degree AV block Type II is located anatomically at the
________________.
junctional escape - ansA third-degree AV heart block would have to be blocked above the
bundle of His to have what kind of rhythm?
erythropoietin (EPO) - ansThe hypoxemia that results from COPD causes release of
_______________ from the kidney, which stimulates release of red blood cells from the bone
marrow and polycythemia
COPD causes pulmonary hypertension, right ventricular hypertrophy, and right atrial
enlargement. The right atrial enlargement causes stretching of the atrial tissue and frequently
results in atrial dysrhythmias. - ansHow does COPD result in atrial fibrillation and
predisposition to PEs?
Nitrates - ans___________ are used primarily as antispasmodics in cath lab patients.
widened - ans(Widened/narrowed) pulse pressure is associated with aortic regurgitation
, narrowed - ans(Widened/narrowed) pulse pressure is associated with mitral regurgitation
diastolic - ansmitral stenosis causes a (systolic/diastolic) murmur.
mitral stenosis - ans_____________ stenosis results in pinkish discoloration of the cheeks,
aka "malar blush."
programmability - ans_____________________ is the ability to noninvasively change one of
several aspects of the function of a pacemaker, using a device placed over the pulse
generator.
Pressure-controlled inverse ratio ventilation - ans______________________________
ventilation, which flips the normal inspiration/expiration ratio to make inspiration longer than
expiration, allows trapping of air in the lungs. This inadvertent PEEP is called auto-PEEP.
hypokalemia, hypercalcemia, and hypomagnesemia - answhich electrolyte imbalances
increase sensitivity to digitalis toxicity?
decreases; decreases - ansPositive pressure ventilation (increases/decreases) venous return to
the heart and (increases/decreases) cardiac output and perfusion to the kidney.
increase (because of heart failure) - ansStunned myocardium and intraoperative myocardial
infarction more likely would cause an (increase/decrease) in PAOP.
30 - ansIdeally, fibrinolytic therapy should be initiated within ____ minutes of the patient's
arrival in the emergency department.
heart, brain, kidney, and retina - ansThe target organs of hypertension (most susceptible to
changes in pressure and perfusion)
alveolar dead space - ans______________________________ is ventilation without
perfusion (also referred to as high ventilation/perfusion [V/Q] ratio).
intrapulmonary shunt - ans______________________________ is perfusion without
ventilation (also referred to as low V/Q ratio).
beta blockers (BBs) - ansWhich drug category is used to block the maladaptive sympathetic
nervous system (SNS) innervation in heart failure?
increased CO; increased SvO2 - anshemodynamic parameters in a ventricular septal rupture
(VSR) will include (increased/decreased) CO and (increased/decreased) SvO2.
15-20mmHg
(Although 8-12 mm Hg is considered normal this does not cause optimal stretch, esp in a pt
with a dilated LV. The theoretical optimal PAOP is 15-20 mm Hg). - ansA patient is in
cardiogenic shock and requires careful volume titration to enhance contractility. What is an
optimal pulmonary artery occlusive pressure (PAOP) in this patient?
RV (it is the most directly anterior chamber, located directly beneath the sternum). -
ansWhich heart chamber is at greatest risk for trauma in myocardial contusion?
questions
ADH - ansPhenytoin inhibits _______ secretion
Right - ansMost episodes of aspiration result in (right/left) lung infiltrates.
urine creatinine clearance - ansBest indicator of GFR
Auto-PEEP - ansIn a vented patient with status asthmaticus, check for _______________
Air trapping - ansAn increase in auto-PEEP is a sign of _________________.
obstructive pulmonary disease - ansA patient with a flattened diaphragm on a Chest X-ray
and decreased expiratory flow rate most likely has what type of disease?
II and V1 - ans____ and ______ are the two best P wave leads.
wide, notched P waves - ansWhat is a manifestation of left atrial enlargement on an EKG in
lead II?
normal - ansDiphasic P waves in lead V1 on 12-lead EKG are abnormal/normal.
myoglobin - ans_________ is the earliest cardiac biomarker for a MI (elevated within 3hrs
s/p MI) and is nonspecific.
pleurodesis - ansinjection of a sclerosing agent into the pleural space and is used for pleural
effusion
LAD - ansThe__________ coronary artery supplies the bundle of His and bundle branches
anterior (LAD affected) - ans_____________ MIs may cause blocks of the bundle of His or
bundle branches
Right Coronary Artery (RCA)... LCA in 10% of ppl - ansType I AV block, also called
Wenckebach, is a block at the AV node, and the AV node is supplied by the
___________________ (in 90% of people)
sinus - ansthe ____________ node is supplied by the RCA in 55% of ppl and LCA in 45%
pale and shiny - ansThe skin changes associated with chronic peripheral arterial disease
pain, pallor, pulselessness, paresthesia, paralysis, and polar (cold) - answhat are the 6 Ps of
acute arterial occlusion?
less - ansThere is (more/less) risk of burning of the skin with biphasic waveform
defibrillation than with monophasic.
,necrosis - ansadding too much air to a ETT cuff can cause overinflation and tracheal
______________.
myocardial infarction (MI) - ansWhat is the most common cause of death after vascular
surgery?
CAD - ansBecause atherosclerosis does not occur in one vessel, patients requiring vascular
surgery are likely also to have ___________________________.
dissecting aortic aneurysm - ansThe first diagnostic test should be a CXR film for probable
diagnosis. The film would reveal a widening mediastinum. An additional, more indicative
finding would be calcified aortic knob with extension of the aortic wall.
left - ansA wide, notched P wave is an indication of ________ atrial enlargement.
P mitrale - ansLeft atrial enlargement causes the P wave to be wide (greater than 0.1 second)
and notched. This sometimes is referred to as ___ __________.
mitral - ans___________ valve stenosis causes LA enlargement and wide, notched P Waves
RCA (as seen in inferior wall MIs) - ansSA blocks, second-degree AV block type I, and
third-degree AV heart block at the level of the AV node would occur in _______________
occlusion
left - ansThe anterolateral heart wall is supplied by the ______ coronary artery
right - ansThe SA node and the atrioventricular (AV) node are supplied by the ________
coronary artery in most hearts.
AV - anssecond degree Type I AV block is located anatomically at the _____ node
Bundle of His - ansSecond degree AV block Type II is located anatomically at the
________________.
junctional escape - ansA third-degree AV heart block would have to be blocked above the
bundle of His to have what kind of rhythm?
erythropoietin (EPO) - ansThe hypoxemia that results from COPD causes release of
_______________ from the kidney, which stimulates release of red blood cells from the bone
marrow and polycythemia
COPD causes pulmonary hypertension, right ventricular hypertrophy, and right atrial
enlargement. The right atrial enlargement causes stretching of the atrial tissue and frequently
results in atrial dysrhythmias. - ansHow does COPD result in atrial fibrillation and
predisposition to PEs?
Nitrates - ans___________ are used primarily as antispasmodics in cath lab patients.
widened - ans(Widened/narrowed) pulse pressure is associated with aortic regurgitation
, narrowed - ans(Widened/narrowed) pulse pressure is associated with mitral regurgitation
diastolic - ansmitral stenosis causes a (systolic/diastolic) murmur.
mitral stenosis - ans_____________ stenosis results in pinkish discoloration of the cheeks,
aka "malar blush."
programmability - ans_____________________ is the ability to noninvasively change one of
several aspects of the function of a pacemaker, using a device placed over the pulse
generator.
Pressure-controlled inverse ratio ventilation - ans______________________________
ventilation, which flips the normal inspiration/expiration ratio to make inspiration longer than
expiration, allows trapping of air in the lungs. This inadvertent PEEP is called auto-PEEP.
hypokalemia, hypercalcemia, and hypomagnesemia - answhich electrolyte imbalances
increase sensitivity to digitalis toxicity?
decreases; decreases - ansPositive pressure ventilation (increases/decreases) venous return to
the heart and (increases/decreases) cardiac output and perfusion to the kidney.
increase (because of heart failure) - ansStunned myocardium and intraoperative myocardial
infarction more likely would cause an (increase/decrease) in PAOP.
30 - ansIdeally, fibrinolytic therapy should be initiated within ____ minutes of the patient's
arrival in the emergency department.
heart, brain, kidney, and retina - ansThe target organs of hypertension (most susceptible to
changes in pressure and perfusion)
alveolar dead space - ans______________________________ is ventilation without
perfusion (also referred to as high ventilation/perfusion [V/Q] ratio).
intrapulmonary shunt - ans______________________________ is perfusion without
ventilation (also referred to as low V/Q ratio).
beta blockers (BBs) - ansWhich drug category is used to block the maladaptive sympathetic
nervous system (SNS) innervation in heart failure?
increased CO; increased SvO2 - anshemodynamic parameters in a ventricular septal rupture
(VSR) will include (increased/decreased) CO and (increased/decreased) SvO2.
15-20mmHg
(Although 8-12 mm Hg is considered normal this does not cause optimal stretch, esp in a pt
with a dilated LV. The theoretical optimal PAOP is 15-20 mm Hg). - ansA patient is in
cardiogenic shock and requires careful volume titration to enhance contractility. What is an
optimal pulmonary artery occlusive pressure (PAOP) in this patient?
RV (it is the most directly anterior chamber, located directly beneath the sternum). -
ansWhich heart chamber is at greatest risk for trauma in myocardial contusion?
