Anatomy/
Physiology
Physiology
Diagnostics
CAD/ACS
HF
PVD/PAD
Cardio
myopathy
myopathy
Pericarditis
Effusion
Tamponade
Effusion
Tamponade
Aortic/Mitral
Valves
Valves
EKGs/Rhythm
100
The right atrium (RA) receives deoxygenated blood from?
The SVC/IVC
100
The precordial leads on an EKG include which leads?
Leads V1-V6
100
What are the non-modifiable risk factors for CAD/ACS?
Smoking, HTN , DM, HLD, obesity, sedentary lifestyle, poor diet, CKD, OSA
100
What are some of the signs and symptoms of right-sided heart failure?
Peripheral edema, ascites, hepato/splenomegaly, JVD, weight gain
100
A patient develops a DVT from having chronic venous disease. What is the #1 complication?
PE
100
Which cardiomyopathy is closely related to heart failure?
Dilated cardiomyopathy
100
What is the hallmark sign on an EKG representing pericarditis?
Diffuse ST-segment elevation in all leads
100
What is seen on an EKG w/ aortic valve disease?
LVH
100
What is this rhythm?
NSR
200
What is the formula for cardiac output (CO)?
Heart rate (HR) x stroke volume (SV)
200
Which of the following are cardiac biomarkers used to diagnosis a MI? Troponin, CKMB, BNP, and myoglobin
All except BNP
200
A patient comes into the ED w/ c/o chest pain that radiates to the left arm. The EKG shows a STEMI in leads V1-V4. What kind of STEMI is the patient having and and which coronary artery is affected?
Anterior and LAD
200
A patient has the following s/s: DOE, PND, pink frothy sputum, crackles bilaterally, cool and pale extremities, and low UOP. What is the diagnosis?
Left-sided HF
200
What are the 6 P's of PAD?
Pain, pallor, pulselessness, paresthesia, paralysis, poikilothermia
200
What is the key treatment for restrictive cardiomyopathy?
Treat the underlying cause (HF, amyloidosis, hemochromatosis, sarcoidosis)
200
What is included in Beck's Triad?
Hypotension, muffled heart sounds, JVD
200
What is the most common etiology for mitral valve disease?
Rheumatic heart disease
200
A patient starts complaining of lightheadedness and dizziness. The nurse sees the following rhythm on the monitor. What is the first action the nurse should expect to take?
Give atropine
300
True or False. The pulmonary vein carries deoxygenated blood towards the heart.
False
300
What is the key difference between a TTE and TEE?
TTE is noninvasive and outside the body while a TEE is invasive and goes down esophagus
300
The STEMI patient needs a PCI placed. What is the door-to-balloon time?
</= 90 minutes
300
A patient is prescribed a medication to increase the squeeze/contractility of the heart. What class of medication will they be put on and give an example?
Inotropic agents (DBA, milrinone, dopamine, digoxin)
300
What is the mainstay diagnostic for peripheral vascular disease?
Duplex US
300
The Hallmark diagnostic for HOCM is a TTE which shows SAM physiology. We know that we cannot administer what class of medications because it increases obstruction?
Inotropes
300
What is the mainstay treatment for pericarditis?
Anti-inflammatories (NSAIDs and colchicine)
300
What is the classic triad seen in aortic stenosis (AS)?
Angina, syncope, and dyspnea
300
The patient's EKG shows that their HR is 35 and they are in a 2nd degree Type II rhythm. They become symptomatic. What should the nurse be expected to do?
Pace the patient (transcutaneous)
400
Which valve lies between the left atrium (LA) and the left ventricle (LV)?
Mitral valve
400
What two medications are used during a chemical stress test?
Dobutamine and adenosine
400
What is the nitro rule of 3?
1 tablet under tongue. If pain persists after 5 min, call 911 and may repeat every 5 min up to 3 doses
400
A HF patient is prescribed HCTZ. What is the primary action of this drug in HF patients?
To reduce preload
400
What are the differences between venous and arterial ulcers?
Venous - shallow, irregular margins, exudative (drainage)
Arterial - Pale, painful, dry, neat circular, shiny/scaly
400
A patient with HOCM says they take their sublingual NTG when they start having chest pain. How should the nurse responds?
Do NOT take your NTG because it can make HOCM s/s worse.
400
Why would one expect an elevated lactate when the patient has a massive pericardial effusion?
Hypoperfusion and hypoxia
400
The nurse auscultates a blowing, holosystolic murmur at the apex. The nurse knows that the patient has what?
Mitral regurgitation
400
A patient goes into SVT w/ a HR of 200. The nurse is asked to administer adenosine. How should the nurse administer it? (3 steps)
1. Set up a three-way stopcock (one to patient, one to adenosine, one to NS flush).
2. Give 6mg of adenosine followed by 20mL of NS (rapidly).
3. If not out of adenosine, can redose w/ 12mg adenosine followed by another 20mL (rapidly).
500
What is the key difference between cardiac output (CO) and cardiac index (CI)? What is the formula for CI?
CI takes into account the patient's BSA, so it is more tailored to that specific person. The formula is CO/BSA.
500
The patient had an EKG that showed an acute MI, so they went to the cath lab for an angiography. After the procedure was done and the patient was in the monitoring area, the nurse noted the patient was acutely hypotensive and had bruising around their flanks and umbilical area. What complication of the cath is this patient most likely experiencing?
Retroperitoneal bleed
500
What are the four classifications of medicines that a CAD patient will be prescribed? (Give one example of each)
1. Antiplatelet (ASA/Clopidogrel)
2. Anticoagulation (Heparin/Bival)
3. Anti-ischemic/adjunct (NTG/BB/ACE-I/ARB)
4. Lipids (Statins, Atorvastatin)
500
What are the 4 core GDMT for HF? (Give name of 1 medication for each)
1. ARNI (sacubitril/valsartan [Entresto])
2. Beta-Blocker (Metoprolol, Carvedilol)
3. MRA (Spironolactone)
4. SGLT2-Inhibitor (Empagliflozin [Jardiance])
500
A patient is educated on the pharmacologic treatment for their chronic PAD. What class of medications does this entail? (Give examples of each)
1. Antiplatelet therapy (ASA or Clopidogrel [Plavix])
2. Anticoagulation (Rivaroxaban [Xarelto] or Apixaban [Eliquis] and ASA)
3. Lipid lowering (Atorvastatin [Lipitor] or Rosuvastatin [Crestor])
500
A patient with dilated cardiomyopathy reports feeling more short of breath today and says his legs look “more swollen than usual.” This morning, the nurse notes the patient has gained 3 pounds since yesterday. What would the nurse think is the cause of this?
Fluid retention/overload
500
The physicians are preparing to perform an emergent pericardiocentesis. What should the nurse be running through the IV pump as a short-term bridge treatment until the procedure can be done?
IV fluids (LR or albumin)
500
The patient had a congenital bicuspid aortic valve and is now s/p a mechanical AVR. What is the priority teaching point the nurse must discuss with the patient?
Lifelong anticoagulation (Coumadin) w/ follow-up appts to check PT/INR levels.
500
A patient is found to be unresponsive and pulseless by the PCT. They grab the nurse and the nurse notes the following rhythm on the monitor. What is the priority nursing action to take first?
Call a code and start CPR immediately.