NRSG430 Complex Care Final Exam
Questions and ANSWERS 2025\2026 update
Which two valves are open during ventricular systole? - ANS>>aortic and pulmonic
Which two valves are closed during ventricular systole? - ANS>>mitral and tricuspid
Amount of time systole takes in the cardiac cycle - ANS>>1/3 of cardiac cycle
Amount of time diastole takes in the cardiac cycle - ANS>>2/3 of cardiac cycle
How does activation of the RASS system affect both preload and after load? - ANS>>after load:
vasoconstriction
preload: sodium and water retention
Always use an armboard for patients with an ___________ - ANS>>arterial line
An arterial line should be leveled to - ANS>>the phlebostatic axis (4th intercostal space/halfway
point between anterior and posterior)
Causes of sinus tachycardia - ANS>>1. Stress
2. Dehydration
3. Pain
4. Fever
5. Hypoxia
Starlings Law - ANS>>There needs to be adequate volume for there to be adequate stretch and
contractility. This is why with hypovolemia, contractility will eventually go down
Determinants of preload - ANS>>1. Intravascular volume
2. Venous tone/pressure
3. Intra-pericardial pressure
4. Body position
5. Atrial Contraction
, Measures of contractility - ANS>>CO/CI, SV/SVI, EF
Normal ejection fraction - ANS>>60-65%
Determinants of contractility - ANS>>1. Preload/Afterload
2. Ventricular musculature
3. Neural control
4. Physiological depressants
5. Drug therapy
6. Intrinsic depression
7. Electrolytes
Normal SVR - ANS>>800-1200
Leads that look left main - ANS>>V1-V6, Lead 1, AVL
Leads that look at the left anterior descending - ANS>>V2-V4
Circumflex/CX - ANS>>Lead 1 & Avl, V5 & V6
The rate of cell death in an acute myocardial infarction is dependent on - ANS>>collateral
circulation
myocardial oxygen supply
restoration of blood flow
Contraindications for fibrinolytics - ANS>>Any prior ICH, known cerebral vascular lesion, known
malignant intracranial neoplasm, ischemic stroke within 3 months, suspected aortic dissection,
active bleeding, significant closed head or facial trauma within three months, severe or
uncontrolled hypertension (unresponsive to emergency therapy)
If fibrinolytic therapy is chosen as a primary reperfusion strategy, when should it be given? -
ANS>>within 30 minutes of hospital arrival
HFrEF - ANS>>EF of 40% or less accompanied by HF symptoms
HFpEF - ANS>>HF symptoms but and EF greater than 40%
Stage vs. Class of HF - ANS>>Stage represents the presence of disease. Class indicates the
presence of symptoms
Class 1 HF patient symptoms - ANS>>No limitation of physical activity. Ordinary physical activity
Questions and ANSWERS 2025\2026 update
Which two valves are open during ventricular systole? - ANS>>aortic and pulmonic
Which two valves are closed during ventricular systole? - ANS>>mitral and tricuspid
Amount of time systole takes in the cardiac cycle - ANS>>1/3 of cardiac cycle
Amount of time diastole takes in the cardiac cycle - ANS>>2/3 of cardiac cycle
How does activation of the RASS system affect both preload and after load? - ANS>>after load:
vasoconstriction
preload: sodium and water retention
Always use an armboard for patients with an ___________ - ANS>>arterial line
An arterial line should be leveled to - ANS>>the phlebostatic axis (4th intercostal space/halfway
point between anterior and posterior)
Causes of sinus tachycardia - ANS>>1. Stress
2. Dehydration
3. Pain
4. Fever
5. Hypoxia
Starlings Law - ANS>>There needs to be adequate volume for there to be adequate stretch and
contractility. This is why with hypovolemia, contractility will eventually go down
Determinants of preload - ANS>>1. Intravascular volume
2. Venous tone/pressure
3. Intra-pericardial pressure
4. Body position
5. Atrial Contraction
, Measures of contractility - ANS>>CO/CI, SV/SVI, EF
Normal ejection fraction - ANS>>60-65%
Determinants of contractility - ANS>>1. Preload/Afterload
2. Ventricular musculature
3. Neural control
4. Physiological depressants
5. Drug therapy
6. Intrinsic depression
7. Electrolytes
Normal SVR - ANS>>800-1200
Leads that look left main - ANS>>V1-V6, Lead 1, AVL
Leads that look at the left anterior descending - ANS>>V2-V4
Circumflex/CX - ANS>>Lead 1 & Avl, V5 & V6
The rate of cell death in an acute myocardial infarction is dependent on - ANS>>collateral
circulation
myocardial oxygen supply
restoration of blood flow
Contraindications for fibrinolytics - ANS>>Any prior ICH, known cerebral vascular lesion, known
malignant intracranial neoplasm, ischemic stroke within 3 months, suspected aortic dissection,
active bleeding, significant closed head or facial trauma within three months, severe or
uncontrolled hypertension (unresponsive to emergency therapy)
If fibrinolytic therapy is chosen as a primary reperfusion strategy, when should it be given? -
ANS>>within 30 minutes of hospital arrival
HFrEF - ANS>>EF of 40% or less accompanied by HF symptoms
HFpEF - ANS>>HF symptoms but and EF greater than 40%
Stage vs. Class of HF - ANS>>Stage represents the presence of disease. Class indicates the
presence of symptoms
Class 1 HF patient symptoms - ANS>>No limitation of physical activity. Ordinary physical activity
