CCRN PRACTICE TEST QUESTIONS
1. is ventilation without perfusion (also
referred to as high ventilation/perfusion [V/Q] ratio).: alveolar dead space
2. is perfusion without ventilation (also
referred to as low V/Q ratio).: intrapulmonary shunt
3. Which drug category is used to block the maladaptive sympathetic nervous system (SNS)
innervation in heart failure?: beta blockers (BBs)
4. hemodynamic parameters in a ventricular septal rupture (VSR) will include
(increased/decreased) CO and (increased/decreased) SvO2.: increased CO; increased SvO2
5. A 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?:
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).
6. Which heart chamber is at greatest risk for trauma in myocardial contu-sion?: RV (it is
the most directly anterior chamber, located directly beneath the sternum).
7. The best indicator of intravascular volume is .: pulmonary
arteryocclusion pressure (PAOP)
8. Why is BNP correlated with PAOP and LVEDV?: because it is released inresponse to
increased intravascular volume
9. is an expiratory maneuver that slows ex-
piration, prevents airway collapse, and decreases air trapping. This methodis a complementary
therapy used by patients with obstructive pulmonary disease.: Pursed lip breathing
10. in temporary pacemakers, increase sensitivity for
malfunction.Increase the voltage for malfunction.: sensing; capture
11. What is the purpose of a higher PEEP in treating a pt with ARDS?: To de-crease
intrapulmonary shunt by re-opening collapsed alveoli (alveolar recruitment)
12. What are the 3 main purposes of PEEP?: to increase the driving pressure ofoxygen, to
decrease surface tension and the work of breathing, and to decrease shunt by reopening
collapsed alveoli
13. The loss of the a wave in a PAOP waveform equals the loss of atrial con-traction, which is
certain in .: atrial
fibrillation.
14. Submassive or massive pulmonary embolism causes obstruction in the pulmonary circuit,
which results in impairment in left ventricular filling, oftencalled what?: forward failure of the
left ventricle
15. carbon dioxide is times more diffusible than oxygen: 20
,16. Impaired perfusion equals impaired diffusion equals
.: hypox-emia
17. receptors are stimulated by an increase in interstitial fluid volume. Stimulation of
these receptors may cause laryngeal constriction, hypotension,bradycardia, mucous production,
and dyspnea.: J receptors
18. are sensory nerve endings located within the alveo-lar walls
in juxtaposition to the pulmonary capillaries of the lung and are inner-vated by fibers of the
vagus nerve.: J (juxtacapillary) receptors, aka pulmonary C-fiber receptors
19. Inflation of a balloon to dilate the coronary artery,
suchas in a balloon angioplasty, could result in potentially fatal ischemia or infarc-tion of the
left ventricle. can only do this if this vessel is "protected," aka a bypass graft already placed
around it.: left main coronary artery
20. Where do most abdominal aortic aneurysms (AAAs) occur?: infrarenal(90%)
21. When a pt has likely developed an air embolism s/p TLC removal, placept immediately in
a head-down position on left side. This prevents the air embolus from entering the right
ventricular outflow tract & allows time forthe air embolism to be absorbed. What is this
maneuver called?: Durant's maneuver
22. PAOP is an indirect evaluation of
pressure.: -
left atrial pressure (LAP)
23. is decreased oxygen in the blood: hypoxemia
24. is decreased oxygen in the tissues: hypoxia
25. Alkalosis (i.e. respiratory alkalosis from hyperventilation) causes an in- crease in the
binding between and albumin.: calcium (which will
cause hypocalcemia)
26. Rhonchi indicate in the airway and indicate that a patientshould
be helped to cough or that secretions should be suctioned: fluid or mucus
27. A significantly elevated LDH, such as in acute respiratory syndrome, isassociated with
involvement.: multisystem
28. Which are the two most common dysrhythmias associated withWolff-Parkinson-White
syndrome?: Afib and SVT
29. LBBB causes a paradoxical splitting of the (S1/S2) heart sound. This means that it is split
on expiration but not on inspiration. (split on inspirationis normal): S2
30. When the depth of the S wave in lead V1 or V2 plus the height of the R wave in lead V5
or V6 is 35 mm or greater, this constitutes voltage criteria for(left/right) ventricular
hypertrophy.: left
31. The first drug for a wide QRS complex tachycardia: amiodarone
, 32. Verapamil and adenosine typically are used for what type of tachycardia?-
: narrow QRS complex (such as in SVT)
33. Isometric exercises, such as weight lifting, cause
maneuver andshould be avoided in pts w/ stable angina.: Valsalva
34. Morphine is a venous vaso(constrictor/dilator). does not cause a signifi-cant effect on the
arteries, meaning it doesn't really affect afterload.: dilator
35. What is the leading cause of ARDS?: shock; blood is shunted away from lungs(remember
that the SNS shunts blood to the brain and heart when it redistributes blood from nonessential
to essential...damage to type 2 pneumocytes occurs)
36. what do type 2 pneumocytes produce?: surfactant
37. shock triggers SIRS, which (increases/decreases) the permeability of thealveolar-
capillary membrane... which can lead to ARDS: increases permeability
38. Drug that frequently is used in vascular surgery patients to inhibit plateletaggregation at
the site of intimal trauma: Dextran 40
39. The PAOP/PAWP should be (higher/lower) than the PAD.: lower (normally2-5mmHg
lower)
40. the majority of myocardial oxygen consumption occurs during whichphase of the cardiac
cycle?: isovolumetric contraction
41. During this phase of the cardiac cycle, the valves are closed and contrac-tion occurs
without a change in volume, in order to generate a pressure high
enough to overcome the resistance in the arterial (pulmonary or systemic) circulation, to open
the semilunar valves (pulmonic or aortic), and to propel blood into the great vessels
(pulmonary artery or aorta): isovolumetric contrac-tion
42. Nesiritide is a vasodilator with diuretic effects. What is the most commonside effect?:
Hypotension
43. Mitral stenosis causes large waves on the PAOP waveform: a waves
44. Cardiac tamponade and left ventricular failure cause high pressures andlarge and
waves on a PAOP waveform: a and v waves
45. Mitral regurgitation causes large waves on a PAOP waveform: v waves
46. The PAOP waveform is a reflection of the (right/left) atrium.: left
47. Normal PaO2/FiO2 ratio is greater than mm Hg.: 300
48. The PaO2/FiO2 (sometimes simply called the P/F) ratio of less than or equalto 200 mm Hg
is an international criterion for .: ARDS
49. Hypoperfusion of which organ activates the renin-angiotensin-aldos-terone system
(RAAS)?: kidney
50. At which point in the ventilatory cycle should the pulmonary artery occlu-sive pressure be
1. is ventilation without perfusion (also
referred to as high ventilation/perfusion [V/Q] ratio).: alveolar dead space
2. is perfusion without ventilation (also
referred to as low V/Q ratio).: intrapulmonary shunt
3. Which drug category is used to block the maladaptive sympathetic nervous system (SNS)
innervation in heart failure?: beta blockers (BBs)
4. hemodynamic parameters in a ventricular septal rupture (VSR) will include
(increased/decreased) CO and (increased/decreased) SvO2.: increased CO; increased SvO2
5. A 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?:
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).
6. Which heart chamber is at greatest risk for trauma in myocardial contu-sion?: RV (it is
the most directly anterior chamber, located directly beneath the sternum).
7. The best indicator of intravascular volume is .: pulmonary
arteryocclusion pressure (PAOP)
8. Why is BNP correlated with PAOP and LVEDV?: because it is released inresponse to
increased intravascular volume
9. is an expiratory maneuver that slows ex-
piration, prevents airway collapse, and decreases air trapping. This methodis a complementary
therapy used by patients with obstructive pulmonary disease.: Pursed lip breathing
10. in temporary pacemakers, increase sensitivity for
malfunction.Increase the voltage for malfunction.: sensing; capture
11. What is the purpose of a higher PEEP in treating a pt with ARDS?: To de-crease
intrapulmonary shunt by re-opening collapsed alveoli (alveolar recruitment)
12. What are the 3 main purposes of PEEP?: to increase the driving pressure ofoxygen, to
decrease surface tension and the work of breathing, and to decrease shunt by reopening
collapsed alveoli
13. The loss of the a wave in a PAOP waveform equals the loss of atrial con-traction, which is
certain in .: atrial
fibrillation.
14. Submassive or massive pulmonary embolism causes obstruction in the pulmonary circuit,
which results in impairment in left ventricular filling, oftencalled what?: forward failure of the
left ventricle
15. carbon dioxide is times more diffusible than oxygen: 20
,16. Impaired perfusion equals impaired diffusion equals
.: hypox-emia
17. receptors are stimulated by an increase in interstitial fluid volume. Stimulation of
these receptors may cause laryngeal constriction, hypotension,bradycardia, mucous production,
and dyspnea.: J receptors
18. are sensory nerve endings located within the alveo-lar walls
in juxtaposition to the pulmonary capillaries of the lung and are inner-vated by fibers of the
vagus nerve.: J (juxtacapillary) receptors, aka pulmonary C-fiber receptors
19. Inflation of a balloon to dilate the coronary artery,
suchas in a balloon angioplasty, could result in potentially fatal ischemia or infarc-tion of the
left ventricle. can only do this if this vessel is "protected," aka a bypass graft already placed
around it.: left main coronary artery
20. Where do most abdominal aortic aneurysms (AAAs) occur?: infrarenal(90%)
21. When a pt has likely developed an air embolism s/p TLC removal, placept immediately in
a head-down position on left side. This prevents the air embolus from entering the right
ventricular outflow tract & allows time forthe air embolism to be absorbed. What is this
maneuver called?: Durant's maneuver
22. PAOP is an indirect evaluation of
pressure.: -
left atrial pressure (LAP)
23. is decreased oxygen in the blood: hypoxemia
24. is decreased oxygen in the tissues: hypoxia
25. Alkalosis (i.e. respiratory alkalosis from hyperventilation) causes an in- crease in the
binding between and albumin.: calcium (which will
cause hypocalcemia)
26. Rhonchi indicate in the airway and indicate that a patientshould
be helped to cough or that secretions should be suctioned: fluid or mucus
27. A significantly elevated LDH, such as in acute respiratory syndrome, isassociated with
involvement.: multisystem
28. Which are the two most common dysrhythmias associated withWolff-Parkinson-White
syndrome?: Afib and SVT
29. LBBB causes a paradoxical splitting of the (S1/S2) heart sound. This means that it is split
on expiration but not on inspiration. (split on inspirationis normal): S2
30. When the depth of the S wave in lead V1 or V2 plus the height of the R wave in lead V5
or V6 is 35 mm or greater, this constitutes voltage criteria for(left/right) ventricular
hypertrophy.: left
31. The first drug for a wide QRS complex tachycardia: amiodarone
, 32. Verapamil and adenosine typically are used for what type of tachycardia?-
: narrow QRS complex (such as in SVT)
33. Isometric exercises, such as weight lifting, cause
maneuver andshould be avoided in pts w/ stable angina.: Valsalva
34. Morphine is a venous vaso(constrictor/dilator). does not cause a signifi-cant effect on the
arteries, meaning it doesn't really affect afterload.: dilator
35. What is the leading cause of ARDS?: shock; blood is shunted away from lungs(remember
that the SNS shunts blood to the brain and heart when it redistributes blood from nonessential
to essential...damage to type 2 pneumocytes occurs)
36. what do type 2 pneumocytes produce?: surfactant
37. shock triggers SIRS, which (increases/decreases) the permeability of thealveolar-
capillary membrane... which can lead to ARDS: increases permeability
38. Drug that frequently is used in vascular surgery patients to inhibit plateletaggregation at
the site of intimal trauma: Dextran 40
39. The PAOP/PAWP should be (higher/lower) than the PAD.: lower (normally2-5mmHg
lower)
40. the majority of myocardial oxygen consumption occurs during whichphase of the cardiac
cycle?: isovolumetric contraction
41. During this phase of the cardiac cycle, the valves are closed and contrac-tion occurs
without a change in volume, in order to generate a pressure high
enough to overcome the resistance in the arterial (pulmonary or systemic) circulation, to open
the semilunar valves (pulmonic or aortic), and to propel blood into the great vessels
(pulmonary artery or aorta): isovolumetric contrac-tion
42. Nesiritide is a vasodilator with diuretic effects. What is the most commonside effect?:
Hypotension
43. Mitral stenosis causes large waves on the PAOP waveform: a waves
44. Cardiac tamponade and left ventricular failure cause high pressures andlarge and
waves on a PAOP waveform: a and v waves
45. Mitral regurgitation causes large waves on a PAOP waveform: v waves
46. The PAOP waveform is a reflection of the (right/left) atrium.: left
47. Normal PaO2/FiO2 ratio is greater than mm Hg.: 300
48. The PaO2/FiO2 (sometimes simply called the P/F) ratio of less than or equalto 200 mm Hg
is an international criterion for .: ARDS
49. Hypoperfusion of which organ activates the renin-angiotensin-aldos-terone system
(RAAS)?: kidney
50. At which point in the ventilatory cycle should the pulmonary artery occlu-sive pressure be
