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Exam (elaborations)

BARRON'S CCRN EXAM QUESTIONS AND ANSWERS

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BARRON'S CCRN EXAM QUESTIONS AND ANSWERS

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  • September 3, 2024
  • 17
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • CCRN
  • CCRN
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SUMMER2022
BARRON'S CCRN EXAM QUESTIONS AND ANSWERS
"high dose" dopamine causes vasoconstriction and

(C) Increase afterload - Answers -What is the primary hemodynamic effect of:

Dopamine >10 mcg/kg/min

(A) Increase preload

(B) Decrease preload

(C) Increase afterload

(D) Decreased afterload

(E) Increase contractility

(D) Decrease contractility

Pulmonary HTN and cor pulmonale;

Mitral, aortic, or tricuspid insufficiency - Answers -What causes the S3 sound?

during diastole - Answers -When are coronary arteries perfused?

S3 heart sound - Answers -What may you hear before crackles when a patient is going
into heart failure?

Variant or Prinzmetal's Angina - Answers -What is this called?

Unstable angina with transient ST segment elevation

Can occur at rest or may be cyclic (occurring at the same time daily)

troponin negative

Can be precipitated by nicotine, coke, or ETOH

RCA, inferior LV - Answers -There are changes in leads II, III, aVF....what type of MI?

LAD, anterior LV - Answers -There are changes in leads V1, V3 V3, V4

circumflex, lateral LV - Answers -There are changes in leads V5, V6, I, aVL

Low lateral LB - Answers -There are changes in leads V5, V6

,high lateral LB - Answers -There are changes in leads I aVL

RCA, posterior LV - Answers -There are changes in leads V1 and V2

RCA, right ventricular infarct - Answers -There are changes in leads V3R, V4R

Marked ELEVATION of troponin/CK-MB: due to miocardial stunning when vessel opens

reperfusion arrhythmias: VT, Vfib, accelerated idioventricular rhythm (due to stunning)

resolution of ST segment deviations

Chest pain relief - Answers -What are some signs of reperfusion following fibrinolytic
treatment of a STEMI?

contact the physician. Could be coronary artery re-occlusion/stent thrombosis. -
Answers -Your patient just had a percutaneous coronary intervention (PCI) (stenting)
less than 24 hours ago:

Inflates at dicrotic notch of the arterial waveform, beginning of diastole

Deflates before systole begins, determined by set trigger for deflation, R-wave of ECG
or upstroke of arterial pressure wave - Answers -IABP

tamponade

pericarditis

long CABG can increase bleeding risk due to increased heparin dose in surgery -
Answers -CABG (Coronary Artery Bypass Graft) complications

Narrowed pulse pressure (IE 82/68)
Pulsus paradoxus: excessive drop is SBP (>12mmgh during inspiration). Cardiac
muscle restriction due to tamponade with inspiration, intrathoracic pressure increases
thus decreasing venous return

Restlessness and agitation.
Distended neck veins (JVD), hypotension, diminished heart sounds (Beck's triad);
equalization of CVP: pulmonary artery diastolic and PAOP - Answers -Signs of cardiac
tamponade

4-12 mmHg - Answers -PAWP (pulmonary artery wedge pressure) (same as PAOP)
normal?

hypovolemia (low PAWP, low volume)

, normal is 4-12 - Answers -PAWP (same as PAOP) of 1-3 mmhg means?

Hypervolemia (high volume, high PAWP)

normal is 4-12 - Answers -PAWP(same as PAOP) of >12 mmhg means?

- Answers -https://www.youtube.com/watch?v=i1oJ-WyTvo8

Good video for swan ganz

nose to alveoli: Air within the trachea, pharynx, larynx, bronchi, and nasal passages -
Answers -Anatomic dead space is considered to be the:

PE. No blood flow past the PE, so all alveoli past it is dead space - Answers -what
causes alveolar dead space?

right side. good lung down! if the right lung is down, more blood flows to it, thus
increasing o2 - Answers -you have a patient with left-sided pneumonia, the right lung is
largely unaffected. Which position would you place them in to improve oxygenation?

0.8
=4 L ventilation/5L perfusion - Answers -normal VQ ratio

a pathologic shunt. Blood goes thru the lungs but does not get oxygenated resulting in
refractory hypoxemia - Answers -ARDS is an example of what?

0-5% normal

carbon monoxide clings to Hgb and O2 cannot attach when CO is already attached.
Pulse oximetry is unreliable because it just detects Hgb saturation. Thus if a patient has
a CO level of 40%, they cannot have more than 60% O2 sat.

Treatment is 100% fiO2 until CO is >10% or hyperbaric - Answers -what is the normal
level for carbon monoxide?

What should be considered when monitoring O2 sats?

What is the treatment for excess?

suspected pneumothorax
hemodynamic instability/life threatening arrhthmias
secretions/aspiration risks - Answers -contraindications to NIV (BiPAP/CPAP)?

Increased WOB/hypoxic respiratory failure.

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