Exam (elaborations)
Advanced vSIM Questions and Answers
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Exam of 5 pages for the course Carl Shapiro vsim at Carl Shapiro vsim (Advanced vSIM)
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Advanced vSIMMorphine - answerdecreases pain
decreases anxiety
decreases afterload
decreases preload
Which of the following are cardiac markers assessed in the patient experiencing angina
to determine potential myocardial injury?
a) hemoglobin
b)CK-MM
c) troponin
d) creatinine
e) CK-MB - answerCardiac enzymes and biomarkers, which include troponin, creatine
kinase (CK), and myoglobin, are used to diagnose an acute MI. Of these 3 CK
isoenzymes, CK-myocardial bound (MB) is specific to to the heart muscle. CK-MM is
specific to skeletal muscle and is not an indicator of MI. Hemoglobin is used to
determine the amount of oxygen in the blood. Creatinine is elevated in renal failure, not
in myocardial injury.
The nurse recognizes that an ST elevation on the 12-lead ECG typically indicates which
of the following?
a) myocardial ischemia
b) hyperkalemia
c) this is a normal finding
d) myocardial injury - answerd) myocardial injury
The 12-lead ECG should be obtained within 10 minutes from the time a patient reports
pain or arrives in the ED. The ECG changes expected with an MI include are T-wave
inversion, ST-segment elevation, and development of an abnormal Q wave.
Because infarction evolves over time, the ECG also changes over time. The first ECG
signs of an acute MI are usually seen in the T wave and ST segment.
As the area of injury becomes ischemic, myocardial repolarization is altered and
delayed, causing the T wave to invert.
Myocardial injury also causes ST-segment changes. The ST segment is normally flat on
the ECG tracing. The injured myocardial cells depolarize normally but repolarize more
rapidly than normal cells, causing the ST segment to rise at least 1 mm above the
isoelectric line (the area between the T wave and the next P wave is used as the
reference for the isoelectric line). An elevation in the ST segment in two contiguous
leads is a key diagnostic indicator for MI (i.e., STEMI).
, Metabolic syndrome diagnosis includes 3 of the following conditions: - answerinsulin
resistance
central obesity
dyslipidemia
BP persistently greater than 130/85mmHg
high levels of c-reactive protein
high fibrinogen level
Based on the following ECG waveform, the nurse recognizes that the patient is
experiencing which dysrhythmia?
a) ventricular flutter
b) atrial fibrillation
c) ventricular fibrillation
d) ventricular tachycardia - answerc) ventricular fibrillation
v-fib is characterized by a ventricular rate greater than 300bpm, and an extremely
irregular rhythm without a specific pattern, and irregular, undulating (having a smoothly
rising and falling form) waves without recognizable QRS complexes.
V-fib - answer
For adult CPR, what is the correct compression:ventilation ratio and rate per minute? -
answerThe correct compression: ventilation ratio and rate per minute is 30
compressions to 2 breaths with at least 100/minute.
True or false? According to AHA guidelines, epinephrine 1mg is administered for
ventricular fibrillation after the second defibrillation. - answerTrue. According to the
guidelines, epinephrine can be administered for ventricular fibrillation after the second
defibrillation.
When the patient is about to receive defibrillation, the nurse ensures that which of the
following safety measures are implemented?
a) not touching the bed or allowing any objects to touch the bed
b) chest compressions are not interrupted
c) removing the oxygen from the bed during fibrillation
d) clearing the bed at lease twice prior to defibrillation
e) ventilations are not interrupted - answera) not touching the bed or allowing any
objects to touch the bed
c) removing the oxygen from the bed during fibrillation
d) clearing the bed at lease twice prior to defibrillation
It's important during defibrillation that the bed be cleared at least twice prior to
discharging the paddles to prevent injury to any staff; that oxygen be removed from the
bed to prevent the danger of starting a fire; and that no person or object is touching the
bed, in order to prevent any conduction of electrical current that might injury the patient
or staff member. Compressions and ventilations would be interrupted during fibrillation.
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