NR 341 EXAM COMPREHENSIVE QUESTIONS AND
VERIFIED ANSWERS (100% CORRECT) 2024 UPDATE
Why may a heart attack occur if Myocardial ischemia is left untreated?
- Because the oxygen supply may be cut off
What occurs to the ST segment during a myocardial injury?
- An elevation of 1mm above the baseline at the ST segment
What does a Myocardial injury look like?
If an Myocardial Injury occurs, what are the treatment options?
- You would treat this as a STEMI, since one is about to occur, and you would take
them to the HEART CATH LAB or START TPA immediately
What does the QT interval indicate?
- Depolarization
- Repolarization
- Refractory period
If a QT interval is prolonged, what are the patients at risk for?
- Ventricular dysrhythmias
- Sudden death
What does a prolonged QT interval look like?
What medication can cause Prolonged QT intervals?
- Amiodarone
- Procainamide
- Quinidine
What does ACLS stand for?
- Advanced Cardiac Life Support
What is the difference between a Rapid Response Team and a Code?
- Rapid Response still has a PULSE and RESPIRATORY RATE and is still alive but
DECLINING
- Code is no pulse, no respiratory rate, needing resuscitation
What occurs to the LOC that is a criterion for calling the Rapid Response Team?
- A change in LOC w/o any reason why
What occurs to the HR that is a criterion for calling the Rapid Response Team?
- A change in the HR w/o any reason why (but still has a pulse)
What occurs to the RR that is a criterion for calling the Rapid Response Team?
- A change in the RR w/o any reason why (but still breathing)
What might a nurse be asked first when a rapid response team arrives?
- What is going on or what the situation is
What should a Rapid Response Team assess for?
- IF the nurse started a new medication or a new medication was given
What should a rapid response acquire after asking about the patients situation?
- A fresh set of vital signs
- ABG
If the Rapid Response Team is called to the scene for a LOC change, what should
be assessed?
,- Blood Glucose levels (Especially on insulin)
What procedure or machine might be utilized by the rapid response team to
further assess the patient?
- CT Scan
What might a Rapid Response Team utilize a CT machine to assess for?
- A hemorrhagic Bleed
What type of units should not call the Rapid Response Team?
- ICU
- ED or ER
Why should a ICU or ED/ER not call a Rapid Response team?
- B/c they have ACLS certified nurses and certified docs
What type of doctors can be on a Rapid Response Team?
- Hospitalists
- Critical care docs
What type of certifications must a nurse have to be on the rapid response team?
- ACLS
What two criterion must me met with the patient in order for a code to be called?
- Apneic
- No pulse (Pulseless) or irregular pulses
What type of pulses can a code be called for?
- Pulseless
- Too Fast that it cannot be counted
- Too Slow that it can not be determined
If a nurse walks into the room and notices a patient that is unconscious what
should the nurse do?
- Wake the patient up
- Yell their name
- Vigorously shake their shoulders
If a nurse cannot wake a patient up, what should the nurse do after attempting to
wake the patient has failed?
- Check the pulse of the patient if the nurse cannot wake the patient up
What pulses should a nurse check on an unresponsive and unconscious patient?
- Carotid pulse is the golden standard
If the Carotid pulse cannot be detected by the nurse, what other location is
acceptable to check the pulse?
- Femoral pulse
What are the two types of central pulse locations?
- Carotid pulse
- Femoral pulse
If a nurse cannot detect a pulse on the patient at both central locations, what
should the nurse do initially?
- CALL A CODE / YELL FOR HELP!
After a nurse calls a code, what nursing action should the nurse take?
- Begin compressions
What position must a patient be in for a compressions to begin?
- A flat or supine position
, How does a nurse get a patient to lay in a flat/ supine position?
- Lower the bed
What should occur to the side rails in order to start compressions on a patient
during a code?
- Lower side rails
Where should the nurse be while performing compressions?
- On top of the bed
At what systolic BP does a femoral pulse stop being obtained by a nurse?
- at 60 systolic
At what Diastolic BP does a femoral pulse stop being obtained by a nurse?
- at 40 diastolic
What BP can a nurse start feeling a pulse at the femoral location?
- at or above 60/40
At what time requirement must a code be completed, and a patient be
resuscitated by, in order for a code to be considered effective?
- Less then (<) 10 minutes
What are the two shockable rhythms?
- Ventricular Tachycardia (V-Tach)
- Ventricular Fibrillation (V-Fib)
At what time requirement must IV medications be pushed DURING NORMAL
CIRCUMSTANCES in order to avoid various effects?
- over 2-5 minutes
During a code situation, how long should a nurse push medications over?
- AS QUICKLY AS POSSIBLE, DO NOT WAIT 2 MINUTES!
What should be established on all patients that ensures an effective code in case
there is a need for medication pushes?
- A patent IV
What are the two important reasons nurses should know heart rhythms for?
- To improve patient safety
- To Improve patient outcomes (optimize successful outcomes)
What does the P-wave represent?
- The Depolarization of the Right/ Left Atria (atrium)
What does the QRS complex represent?
- Depolarization of the right and Left Ventricles
What portion of the heart rhythm strip indicates the BEGINNING of ventricle
depolarization?
- Q-wave
How is the Q-wave impacted that indicates a Myocardial infarction is occurring?
- Q-Wave is BIG and LONG
What portion of the Heart Rhythm is elevated if a STEMI is occurring?
- ST- segment is elevated
What does an STEMI look like on an heart rhythm involving the ST segment?
If a patient has a EKG strip that indicates a STEMI is occurring, what are the two
treatment options?
- get to the Heart cath lab stat!
- Start patient of TPA immediately if Heart Cath lab is not open
VERIFIED ANSWERS (100% CORRECT) 2024 UPDATE
Why may a heart attack occur if Myocardial ischemia is left untreated?
- Because the oxygen supply may be cut off
What occurs to the ST segment during a myocardial injury?
- An elevation of 1mm above the baseline at the ST segment
What does a Myocardial injury look like?
If an Myocardial Injury occurs, what are the treatment options?
- You would treat this as a STEMI, since one is about to occur, and you would take
them to the HEART CATH LAB or START TPA immediately
What does the QT interval indicate?
- Depolarization
- Repolarization
- Refractory period
If a QT interval is prolonged, what are the patients at risk for?
- Ventricular dysrhythmias
- Sudden death
What does a prolonged QT interval look like?
What medication can cause Prolonged QT intervals?
- Amiodarone
- Procainamide
- Quinidine
What does ACLS stand for?
- Advanced Cardiac Life Support
What is the difference between a Rapid Response Team and a Code?
- Rapid Response still has a PULSE and RESPIRATORY RATE and is still alive but
DECLINING
- Code is no pulse, no respiratory rate, needing resuscitation
What occurs to the LOC that is a criterion for calling the Rapid Response Team?
- A change in LOC w/o any reason why
What occurs to the HR that is a criterion for calling the Rapid Response Team?
- A change in the HR w/o any reason why (but still has a pulse)
What occurs to the RR that is a criterion for calling the Rapid Response Team?
- A change in the RR w/o any reason why (but still breathing)
What might a nurse be asked first when a rapid response team arrives?
- What is going on or what the situation is
What should a Rapid Response Team assess for?
- IF the nurse started a new medication or a new medication was given
What should a rapid response acquire after asking about the patients situation?
- A fresh set of vital signs
- ABG
If the Rapid Response Team is called to the scene for a LOC change, what should
be assessed?
,- Blood Glucose levels (Especially on insulin)
What procedure or machine might be utilized by the rapid response team to
further assess the patient?
- CT Scan
What might a Rapid Response Team utilize a CT machine to assess for?
- A hemorrhagic Bleed
What type of units should not call the Rapid Response Team?
- ICU
- ED or ER
Why should a ICU or ED/ER not call a Rapid Response team?
- B/c they have ACLS certified nurses and certified docs
What type of doctors can be on a Rapid Response Team?
- Hospitalists
- Critical care docs
What type of certifications must a nurse have to be on the rapid response team?
- ACLS
What two criterion must me met with the patient in order for a code to be called?
- Apneic
- No pulse (Pulseless) or irregular pulses
What type of pulses can a code be called for?
- Pulseless
- Too Fast that it cannot be counted
- Too Slow that it can not be determined
If a nurse walks into the room and notices a patient that is unconscious what
should the nurse do?
- Wake the patient up
- Yell their name
- Vigorously shake their shoulders
If a nurse cannot wake a patient up, what should the nurse do after attempting to
wake the patient has failed?
- Check the pulse of the patient if the nurse cannot wake the patient up
What pulses should a nurse check on an unresponsive and unconscious patient?
- Carotid pulse is the golden standard
If the Carotid pulse cannot be detected by the nurse, what other location is
acceptable to check the pulse?
- Femoral pulse
What are the two types of central pulse locations?
- Carotid pulse
- Femoral pulse
If a nurse cannot detect a pulse on the patient at both central locations, what
should the nurse do initially?
- CALL A CODE / YELL FOR HELP!
After a nurse calls a code, what nursing action should the nurse take?
- Begin compressions
What position must a patient be in for a compressions to begin?
- A flat or supine position
, How does a nurse get a patient to lay in a flat/ supine position?
- Lower the bed
What should occur to the side rails in order to start compressions on a patient
during a code?
- Lower side rails
Where should the nurse be while performing compressions?
- On top of the bed
At what systolic BP does a femoral pulse stop being obtained by a nurse?
- at 60 systolic
At what Diastolic BP does a femoral pulse stop being obtained by a nurse?
- at 40 diastolic
What BP can a nurse start feeling a pulse at the femoral location?
- at or above 60/40
At what time requirement must a code be completed, and a patient be
resuscitated by, in order for a code to be considered effective?
- Less then (<) 10 minutes
What are the two shockable rhythms?
- Ventricular Tachycardia (V-Tach)
- Ventricular Fibrillation (V-Fib)
At what time requirement must IV medications be pushed DURING NORMAL
CIRCUMSTANCES in order to avoid various effects?
- over 2-5 minutes
During a code situation, how long should a nurse push medications over?
- AS QUICKLY AS POSSIBLE, DO NOT WAIT 2 MINUTES!
What should be established on all patients that ensures an effective code in case
there is a need for medication pushes?
- A patent IV
What are the two important reasons nurses should know heart rhythms for?
- To improve patient safety
- To Improve patient outcomes (optimize successful outcomes)
What does the P-wave represent?
- The Depolarization of the Right/ Left Atria (atrium)
What does the QRS complex represent?
- Depolarization of the right and Left Ventricles
What portion of the heart rhythm strip indicates the BEGINNING of ventricle
depolarization?
- Q-wave
How is the Q-wave impacted that indicates a Myocardial infarction is occurring?
- Q-Wave is BIG and LONG
What portion of the Heart Rhythm is elevated if a STEMI is occurring?
- ST- segment is elevated
What does an STEMI look like on an heart rhythm involving the ST segment?
If a patient has a EKG strip that indicates a STEMI is occurring, what are the two
treatment options?
- get to the Heart cath lab stat!
- Start patient of TPA immediately if Heart Cath lab is not open
