Exam (elaborations)
CEN Review: Questions & Answers (Detailed)
CEN Review: Questions & Answers (Detailed)
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CEN Review: Questions & Answers (Detailed)What is a pericardial friction rub? Correct Ans - often heard over the
sternal border. The inflammation causes a grating, scraping or leather-
rubbing sound
Is pericarditis more common in adults or children? Correct Ans -
Adults
What positions aggravate pericarditis? Correct Ans - lying flat on the
left side, coughing and deep inspiration
How is pericardial pain relieved? Correct Ans - NSAIDs because this
type of pain is not related to ischemia
How to characterize a HTN crisis? Correct Ans - An uncontrolled rise
in BP with end organ damage. Diastolic normally >130. Neuro sx are common
as well as papilledema. This condition requires rapid management
What can cause a HTN crisis? Correct Ans - Malignant HTN defined as
a BP > 180/120
How is malignant HTN different from HTN emergency? Correct Ans -
Malignant HTN will have papilloedema
How to calculate MAP? Correct Ans - [(2 x DBP) + SBP] divided by 3
How fast do you tx an HTN ER? Correct Ans - decrease between 20-
30% over 2-3 hours
How fast do you tx an HTN urgency? Correct Ans - reduce BP gradually
over 24-48 hours
What can dig toxicity manifest as? Correct Ans - acute onset =
hyperkalemia
chronic = hypokalemia, hypomag and bradycardia r/t hypokalemia
,Who is more likely to have an aortic dissection? Correct Ans - Males,
HTN pts, and those with Marfans (which is connective tissue weakness)
What drug is recommended for wide complex tachycardia in a stable pt?
Correct Ans - Amidodarone
What joule setting is recommended for emergent cardioversion? Correct
Ans - starting at 50-75 in biphasic and 100 in monophasic
What drug is rec for SVT? Correct Ans - Adenosine
How does hyperkalemia manifest on an EKG? Correct Ans - peaked T-
waves in V1-V5, widened QRS that can turn into sin wave --> asytole
How does hypokalemia manifest on an EKG? Correct Ans - flat T-
waves in V1-V5
Define US Angina Correct Ans - CP that occurs with activity and
become worse with each episode. 1/2 pts with UA have total or near total
occlusion of a coronary artery
Define Ludwigs angina Correct Ans - an expansion of an existing untx
dental infection/cellulitis to the submandibular/lingual/mental mandibular
spaces
Define Stable Angina Correct Ans - predictable event after activites
and exercise
Define Prinzmetals angia Correct Ans - (variant angina) occurs when
the pt is at rest, usually the same time each day. Prognosis is poor and 50%
die w/in first year
How to tx emergent pericardiditis Correct Ans - aka cardiac
tamponade = pericardialcentesis
What is characteristic of AA on CXR? Correct Ans - widened
mediastinum
,What is done for an unstable pt w/tachy rhythm? Correct Ans -
synchronized cardioversion vs adenosine is for stable pts
Who is at risk for a silent MI? Correct Ans - Diabetics r/t muscular
neuropathy
What does a STEMI in 2, 3 AVF indicate? Correct Ans - RCA occlusion
leading to an inferior MI
Where will an anterior MI occur? Correct Ans - Leads V1-V4
How does hypocalcemia present on an EKG? Correct Ans - peaked T-
waves; think of the signs, neuromusclar irritability
What cardiac dz are SLE pts at r/f? Correct Ans - pericarditis
What cardiac dz does an exposure to environment toxins lead to? Correct
Ans - myocarditis
What are 2 forms of PVD? Correct Ans - Raynauds and Buergers
What is Raynauds dz? Correct Ans - chronic peripheral vascular dz
that involves episodic vasospasm of the blood vessels to the skin, mostly the
hands resulting in pain/pallor/dec fxn ppt by cold/stress; no pulse loss
Describe an arterial occlusion Correct Ans - sudden occlusion of
arterial blood flow mainly caused by an embolus. severe pain at rest r/t tissue
ischemia --> dec perfusion --> possible necrosis
What are tarry stools indicative of? Correct Ans - peptic ulcers
What are bloody stools indicative of? Correct Ans - ulcerative colitis
What are frequent stools indicative of? Correct Ans - more than 20 are
suggestive of IBS
What e- abnl do you see in pancreatitis? Correct Ans - INC
amylase/glucose/bili (or nL)
DEC in calcium
, Why give a pt with cholecysitis NG tube? Correct Ans - to relieve
colicky pain
What relationship does black licorice have on dig? Correct Ans - it
increases it's activity
What is the best indicator of renal trauma? Correct Ans - Hematuria
Whats a common cause of prerenal failure? Correct Ans - hypovolemia
vs intrarenal ( rhabdo/glomerularnephitis) and post renal (urethral
obstruction)
What is common for a preggers in an MVC? Correct Ans - premature
labor contractions r/t cells releasing prostaglandins; sometimes Tocolysis is
needed (a drug used to stop premature contractions)
What are sx of a detached retina? Correct Ans - flashes of lights,
floaters in peripheral vision, and a feeling of looking through cobwebs
a nurse would want to shield the eyes b/c light will make worse
What sx are common w/Meniere's dz? Correct Ans - sudden onset of
vertigo assoc w/ unilateral hearing loss and n/v. the sx are episodic and come
and go lasting from 20 min to 12 hours
What are common sx of meningiomas? Correct Ans - gradual onset of
vertigo and hearing loss which is an 8th nerve lesion
What are sx of vestibular neuronitis Correct Ans - it does not recur and
sx are persisten
How to properly irrigate eyes? Correct Ans - With 0.9% NS or LR to a
ocular pH of 7-7.4 and continue until pH maintained for 30 min
What should be monitored when admin diamox? Correct Ans -
potassium r/t possibility for hypokalemia because K+ is excreted more in the
kidneys
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