104 Practice Test 1 CCRN (Pass CCRN) Exam Review Questions With Answers|21 Pages
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Course
CCRN
Institution
CCRN
What is Wolff-Parkinson-White syndrome and how is it treated? - ️️There is an extra pathway between your hearts upper and lower chambers causing a rapid heartbeat. Lidocain and amiodarone may be used in treatment, as well as adenosine if experiencing SVT. DON't give verapamil because it slows c...
What is Wolff-Parkinson-White syndrome and how is it treated? - ✔
✔ There is an extra pathway between your hearts upper and lower
chambers causing a rapid heartbeat. Lidocain and amiodarone may be
used in treatment, as well as adenosine if experiencing SVT. DON't give
verapamil because it slows conduction through the AV node which
could lead to severe tachycardias
How can you differentiate the cause of jaundice? - ✔ ✔ An increase
in direct bilirubin is associated with biliary obstruction because direct
bilirubin is conjugated. An increase in indirect bilirubin is associated
with hepatic disease or excessive hemolysis because indirect bilirubin is
unconjugated
How do you manage fluid status in a patient with a subarachnoid
hemorrhage? - ✔ ✔ You keep the patient hypervolemic with a PAOP
(LV preload) greater than 12mmHg (normal is 8-12). Keeping them
hypervolemic aids in the prevention and treatment of vasospam, which
increases the morbidity
How do you treat oversensing - ✔ ✔ Decrease the sensitivity if
causing failure to fire
How does hypoxemia affect pulmonary vascular pressures? - ✔ ✔ It
causes the vasculature to constrict, which can lead to pulmonary
hypertension
,How does Milrinone work? - ✔ ✔ Inotropic agent, has arterial and
venous vasodilating qualities- decreases preload and lessens the filling
of the left side of the heart. Is indicated for chronic LV failure.
How does Nifedipine (Procardia) work? - ✔ ✔ Nifedipine decreases
myocardial oxygen consumption by dilating veins and arteries, thereby
decreasing preload and afterload. Nifedipine also decreases vasospasm
and potential for vasospasm. Unlike diltiazem and verapamil, nifedipine
does not significantly decrease contractility
How does positive pressure ventilation affect ICP - ✔ ✔ It increases
intrathoracic pressure, which leads to increased ICP
Hyperkalemia can cause what? - ✔ ✔ Diarrhea-increases gastric
motility
Flaccid paralysis- partially depolarizes muscle cells, prevents further
depolarization
Hyperthermia cause what change on the oxyhemoglobin dissociation
curve? - ✔ ✔ It causes it to shift to the right, which decreases
hemoglobin's affinity for oxygen (doesn't like it so it doesn't hold on to
it). So your O2 sats would be lower than normal
ex: Pa02 of 60 normally gives you an SaO2 of 90%, but if your
hyperthermic it would be closer to 86%
If the ventricles are depolarized before the atria in a junctional rhythm
you would expect to find the P wave where? - ✔ ✔ After the QRS
, What lead changes are associated with left ventricle hyperthrophy? - ✔
✔ Strain pattern in V5 and V6 (asymmetric T wave inversion)
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
What lead changes are associated with right ventricle hypertrophy? - ✔
✔ strain pattern in V1 and V2. Prominent R wave in V1 reverse
progression of the R wave across the precordium.
What murmur is associated with narrowed pulse pressure? - ✔ ✔
Mitral regurg
What murmur is associated with widened pulse pressure? - ✔ ✔
Aortic regurg
What is the difference between an anaphylactic and anaphylactoid
reaction? - ✔ ✔ Anaphylactoid reaction is clinically indistinguishable
from anaphylactic reaction but does not require previous exposure to
the antigen. Anaphylactoid reaction is not IgE mediated, and direct
activation and degranulation of mast cells are thought to be triggered
by the complement system. Anaphylactic reaction requires previous
exposure to the antigen and is IgE mediated
What is the earliest sign of hepatic failure in MODS? - ✔ ✔
Hypoglycemia- liver helps form and breakdown glycogen. Ascites,
increased serum bilirubin and increased ammonia levels take time to
develop
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