Critical Care Midterm Exam – Questions And Answers
(Guaranteed Pass!)
Heart rate on an ECG - ANSWER number of complexes in 6 seconds x 10
evaluating the heart rhythm - ANSWER regular or irregular; look at R-R intervals
PR interval - ANSWER 0.12-0.20; top of P wave to top of R wave - determine if
consistent or not
QRS complex - ANSWER <0.12 seconds
NSR - ANSWER seen in majority of patients, 60-100
SB - ANSWER HR<60
ST - ANSWER HR > 100
A-fib - ANSWER most frequent dysrhythmia; irregular R-R; lack of P waves
A-fib - ANSWER
PVCs - ANSWER large, bizarre, complexes that come early, followed by a pause;
associated with hypokalemia, drug toxicity, hypoxia, myocardial ischemia, acidosis,
cardiomyopathy
PVCs - ANSWER
VT - ANSWER wide complex, tachycardia, associated with structural heart disease and
electrolyte imbalance; poorly tolerated, low CO b/c no time to fill ventricles
VT - ANSWER
V-fib - ANSWER
V-fib - ANSWER chaotic, electrical activity ventricles shaking, no pulse, no CO; ECG
wavy line
Symptomatic bradycardia - ANSWER Will usually not be treated unless the patient
displays symptoms of hypoperfusion (hypotension, dizziness, chest pain, changes in
level of consciousness); decreased CO due to fewer ejections
, Sinus tachycardia - ANSWER treat the cause - CCB, BB; needs close examination of
the cause of the tachycardia; decreases diastolic filling time and EF
A-fib - ANSWER control the rate to enable filling and keep CO up - CCB, BB,
anticoagulants (aspirin, coumadin, xarelto); convert to NSR - not an option for most
people (amiodarone, diltiazem, cardioversion, ablation)
PVCs - ANSWER look for a cause and treat it - oxygen
VT - ANSWER check on the patient to ensure VT is real; if responsive = "stable" -
amiodarone, call a code; if unresponsive = "stable" - immediate defibrillation and code
VF - ANSWER immediate defibrillation per ACLS; no such thing as a stable patient, will
progress to asystole if no interventions
70-100 - ANSWER Map: most accurate indicator of organ perfusion
PVC arterial curve change - ANSWER poor perfusion w/ this dysrhythmia; single, non-
perfused beat; waveform drops off
A-fib arterial curve change - ANSWER variable arterial pressure b/c of the differences in
stroke volume between each beat; irregular atrial pulsations
CVP - ANSWER reflects mean right atrial pressure - right heart preload indicator and
volume status; subclavian or jugular insertion; can see if patient is fluid overloaded or
fluid depleted
Low CVP intervention - ANSWER decreased blood returning to the heart = fluid
deficient, give fluids, vasoconstrictor
High CVP intervention - ANSWER seen with heart failure - fluid overload = give
diuretics, fluid restriction, vasodilator to decrease preload and increase SV (means
preload is high)
Pulmonary artery catheter - ANSWER tells you about afterload; monitor R and L heart
function; indirect measurement of LAP across capillary bed
high PA pressures - ANSWER pulmonary HTN, blood clots in lungs, illicit drug use, lung
disease (emphysema, chronic bronchitis)
PCWP measurement - ANSWER balloon at the end of the catheter that adds to the
pressure measurement; left ventricular preload (volume status)
CO - ANSWER HR x SV
(Guaranteed Pass!)
Heart rate on an ECG - ANSWER number of complexes in 6 seconds x 10
evaluating the heart rhythm - ANSWER regular or irregular; look at R-R intervals
PR interval - ANSWER 0.12-0.20; top of P wave to top of R wave - determine if
consistent or not
QRS complex - ANSWER <0.12 seconds
NSR - ANSWER seen in majority of patients, 60-100
SB - ANSWER HR<60
ST - ANSWER HR > 100
A-fib - ANSWER most frequent dysrhythmia; irregular R-R; lack of P waves
A-fib - ANSWER
PVCs - ANSWER large, bizarre, complexes that come early, followed by a pause;
associated with hypokalemia, drug toxicity, hypoxia, myocardial ischemia, acidosis,
cardiomyopathy
PVCs - ANSWER
VT - ANSWER wide complex, tachycardia, associated with structural heart disease and
electrolyte imbalance; poorly tolerated, low CO b/c no time to fill ventricles
VT - ANSWER
V-fib - ANSWER
V-fib - ANSWER chaotic, electrical activity ventricles shaking, no pulse, no CO; ECG
wavy line
Symptomatic bradycardia - ANSWER Will usually not be treated unless the patient
displays symptoms of hypoperfusion (hypotension, dizziness, chest pain, changes in
level of consciousness); decreased CO due to fewer ejections
, Sinus tachycardia - ANSWER treat the cause - CCB, BB; needs close examination of
the cause of the tachycardia; decreases diastolic filling time and EF
A-fib - ANSWER control the rate to enable filling and keep CO up - CCB, BB,
anticoagulants (aspirin, coumadin, xarelto); convert to NSR - not an option for most
people (amiodarone, diltiazem, cardioversion, ablation)
PVCs - ANSWER look for a cause and treat it - oxygen
VT - ANSWER check on the patient to ensure VT is real; if responsive = "stable" -
amiodarone, call a code; if unresponsive = "stable" - immediate defibrillation and code
VF - ANSWER immediate defibrillation per ACLS; no such thing as a stable patient, will
progress to asystole if no interventions
70-100 - ANSWER Map: most accurate indicator of organ perfusion
PVC arterial curve change - ANSWER poor perfusion w/ this dysrhythmia; single, non-
perfused beat; waveform drops off
A-fib arterial curve change - ANSWER variable arterial pressure b/c of the differences in
stroke volume between each beat; irregular atrial pulsations
CVP - ANSWER reflects mean right atrial pressure - right heart preload indicator and
volume status; subclavian or jugular insertion; can see if patient is fluid overloaded or
fluid depleted
Low CVP intervention - ANSWER decreased blood returning to the heart = fluid
deficient, give fluids, vasoconstrictor
High CVP intervention - ANSWER seen with heart failure - fluid overload = give
diuretics, fluid restriction, vasodilator to decrease preload and increase SV (means
preload is high)
Pulmonary artery catheter - ANSWER tells you about afterload; monitor R and L heart
function; indirect measurement of LAP across capillary bed
high PA pressures - ANSWER pulmonary HTN, blood clots in lungs, illicit drug use, lung
disease (emphysema, chronic bronchitis)
PCWP measurement - ANSWER balloon at the end of the catheter that adds to the
pressure measurement; left ventricular preload (volume status)
CO - ANSWER HR x SV
