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critical care (Week 7+8)

Total questions: 163

Worksheet time: 2hrs 38mins

Name
Class
Date
1.

Heart is Composed of 3 layers (outer, covers heart)

a)

Epicardium

b)

Myocardium

c)

Endocardium

2.

Heart is Composed of 3 layers (muscle)

a)

Epicardium

b)

Myocardium

c)

Endocardium

3.

Heart is Composed of 3 layers (covers heart valves)

a)

Epicardium

b)

Myocardium

c)

Endocardium

4.

–Releases norepinephrine

a)

Sympathetic nervous system

b)

Parasympathetic nervous system

5.

–Releases acetylcholine

a)

Sympathetic nervous system

b)

Parasympathetic nervous system

6.

→ arterial vasoconstriction

a)

Alpha-adrenergic effects (α):

b)

Beta-adrenergic effects (β)

7.

→ Positive chronotropic – sinus node discharge

a)

Alpha-adrenergic effects (α):

b)

Beta-adrenergic effects (β)

8.

→ Positive inotropic - ↑ force of contraction

a)

Alpha-adrenergic effects (α):

b)

Beta-adrenergic effects (β)

9.

→ Positive dromotropic – ↑ AV conduction time

a)

Alpha-adrenergic effects (α):

b)

Beta-adrenergic effects (β)

10.

Alpha-adrenergic effects (α):

a)

Arterial vasoconstriction

b)

Positive chronotropic

c)

Positive inotropic

d)

Positive dromotropic

11.

Beta-adrenergic effects (β)

a)

Arterial vasoconstriction

b)

Positive chronotropic

c)

Positive inotropic

d)

Positive dromotropic

12.

Beta-adrenergic effects (β)

( Positive chronotropic )

a)

sinus node discharge

b)

↑ force of contraction

c)

↑ AV conduction time

13.

Beta-adrenergic effects (β)

( Positive inotropic )

a)

sinus node discharge

b)

↑ force of contraction

c)

↑ AV conduction time

14.

Beta-adrenergic effects (β)

( Positive dromotropic )

a)

sinus node discharge

b)

↑ force of contraction

c)

↑ AV conduction time

15.

Sympathetic nervous system: Releases norepinephrine

a)

Alpha-adrenergic effects (α):

b)

Beta-adrenergic effects (β)

c)

Stimulate the vagal nerve

16.

Parasympathetic nervous system: Releases acetylcholine

a)

Alpha-adrenergic effects (α):

b)

Beta-adrenergic effects (β)

c)

Stimulate the vagal nerve

17.

•Parasympathetic nervous system, Releases acetylcholine

(Stimulate the vagal nerve)

a)

↓ sinus node discharge

b)

↓ conduction through the AV node

c)

↑ force of contraction

18.

Sensitive to changes in PaO2 & PaCO2

a)

Chemoreceptors

b)

Baroreceptors

19.

Stimulate vasomotor centre in medulla:

-  vasoconstriction and vasodilatation 

a)

Chemoreceptors

b)

Baroreceptors

20.

Sensitive to stretch and pressure

a)

Chemoreceptors

b)

Baroreceptors

21.

if BP ↑ the ________ cause Heart Rate to ↓

a)

Chemoreceptors

b)

Baroreceptors

22.

Cardiac Function

a)

Coronary circulation

b)

Conduction system

c)

Hemodynamics

d)

Neurotransmitter 

e)

N

23.

•Pulse site & estimate BP (Carotid)

a)

60 mmHg

b)

70 mmHg

c)

80 mmHg

24.

•Pulse site & estimate BP (Femoral)

a)

60 mmHg

b)

70 mmHg

c)

80 mmHg

25.

•Pulse site & estimate BP (Radial)

a)

60 mmHg

b)

70 mmHg

c)

80 mmHg

26.

–Turbulent blood flow through valves

a)

Heart sound

b)

Heart murmur

27.

–S1, S2, S3, and S4

a)

Heart sound

b)

Heart murmur

28.

LUB

a)

S1

b)

S2

c)

S3

d)

S4

29.

DUB

a)

S1

b)

S2

c)

S3

d)

S4

30.

associated with closure of the tricuspid & mitral valves

a)

LUB or S₁

b)

DUB or S₂

31.

associated with closure of the pulmonic & aortic valves

a)

LUB or S₁

b)

DUB or S₂

32.

Extra heart sounds

(Third heart sound (S3))

a)

extra, protodiastole (rapid filling of ventricle)

b)

immediately after s₂

c)

with heart failure & volume overload

d)

extra, end of diastole at presystole

33.

Fourth heart sound (S4)

a)

extra, end of diastole at presystole

b)

just before S₁ (atrial contraction)

c)

when ventricle is resistant to filling

d)

associated with coronary artery disease

e)

with heart failure & volume overload

34.

Heart murmur

a)

Pile of stones

b)

Sharp turn in a stream that causes a noisy water flow

c)

Gently, wooshing sound

d)

LUB, DUB

35.

Graded on a scale of I – VI

I - soft, faint         

VI - heard without a stethoscope

a)

Heart murmur

b)

Heart sound

36.

Graded on a scale of I – VI

I

a)

soft, faint         

b)

heard without a stethoscope

37.

Graded on a scale of I – VI

VI

a)

soft, faint         

b)

heard without a stethoscope

38.

Record the timing, location, pitch, characteristics:

Associated with valve disorders or abnormal blood flow patterns (exercise / anemia) 

a)

Heart sound

b)

Heart murmur

39.

Coronary artery disease (CAD)

•Progressive narrowing of coronary arteries by atherosclerosis

a)

Coronary heart disease

b)

Atherosclerotic heart disease

c)

Congenital heart disease

40.

•inflammatory disease

a)

Atherosclerosis

b)

Coronary artery disease

41.

-Progress from endothelial injury  → fatty streak → plaque → complex lesion

a)

Atherosclerosis

b)

Coronary artery disease

42.

-Due to cardiac risk factors i.e smoking, hypertension

a)

Atherosclerosis

b)

Coronary artery disease

43.

Coronary Artery Disease (CAD): Pathophysiology:

Injury to epithelial cells in intima

a)

–Platelet aggregation

b)

–Migration (relocation) of monocytes

c)

–Lipoproteins enter  the intima

d)

–Monocytes develop into macrophages

44.

Coronary Artery Disease (CAD): Pathophysiology:

Fatty streak

a)

–Migration (relocation) of monocytes

b)

–Lipid-rich "foam cells” develop

c)

–Monocytes develop into macrophages

45.

Coronary Artery Disease (CAD): Pathophysiology:

Atheroma

a)

•Damage to intima

–Liberates platelet-derived growth factor

b)

–Lipid-rich "foam cells” develop

c)

–Monocytes develop into macrophages

46.

Coronary Artery Disease (CAD): Pathophysiology:

Fibrous cap forms

a)

•Damage to intima

–Liberates platelet-derived growth factor

b)

–From connective tissue and low-density lipoprotein (LDL)

c)

–Monocytes develop into macrophages

47.

Coronary Artery Disease (CAD): Pathophysiology:

•Fibrous cap often ruptures

a)

–Clotting cascade initiated

b)

–From connective tissue and low-density lipoprotein (LDL)

c)

–Thrombus

48.

Coronary Artery Disease (CAD): Pathophysiology:

•Fibrous cap often ruptures

a)

–Clotting cascade initiated

b)

–From connective tissue and low-density lipoprotein (LDL)

c)

–Thrombus

49.

Coronary Artery Disease (CAD): Pathophysiology:

•Activation: platelets change shape and activate receptors

a)

–Release: thromboxane A2 and serotonin

b)

–Glycoprotein IIb/IIIa inhibitors

c)

–Activate glycoprotein IIb/IIIa receptors

50.

Coronary Artery Disease (CAD): Pathophysiology:

Aggregation

a)

–Release: thromboxane A2 and serotonin

b)

-Platelet clump together 

c)

–Activate glycoprotein IIb/IIIa receptors

51.

Coronary Artery Disease (CAD): Pathophysiology:

Drugs administered to stop the process

a)

thromboxane A2 and serotonin

b)

aspirin

c)

glycoprotein IIb/IIIa inhibitors

52.

Coronary artery disease (CAD): Pathology =

Risk factors

a)

Age and family history

b)

Cholesterol and overweight

c)

Gender and lifestyle

d)

Smoking and hypertension

e)

Inactivity and diabetes

53.

Coronary artery disease (CAD) HISTORY

a)

Risk factors and Prior hospitalizations

b)

Shortness of breath, chest pain

c)

Medication: Erectile dysfunction meds if considering nitroglycerin

d)

Psychosocial history

–Include stressors

e)

Exercise tolerance test (stress test)

54.

Laboratory Tests :

(Hemoglobin - males)

a)

13-18gm/dL

b)

12-16gm/dL

55.

Laboratory Tests :

(Hemoglobin - female)

a)

13-18gm/dL

b)

12-16gm/dL

56.

Laboratory Tests :

(Hematocrit - males)

a)

42-52%

b)

35-47%

57.

Laboratory Tests :

(Hematocrit - female)

a)

42-52%

b)

35-47%

58.

Laboratory Tests :

3.5-5mEq/l

a)

Potassium

b)

Magnesium

c)

Calcium

d)

Sodium

e)

3

59.

Laboratory Tests :

1.3-2.3 mg/dL

a)

Potassium

b)

Magnesium

c)

Calcium

d)

Sodium

e)

3

60.

Laboratory Tests :

8.6-10.2mg/dL

a)

Potassium

b)

Magnesium

c)

Calcium

d)

Sodium

61.

Laboratory Tests :

135-145mEq/L

a)

Potassium

b)

Magnesium

c)

Calcium

d)

Sodium

62.

Laboratory Tests : Cardiac enzymes :

22-198 U/l

a)

CK (total)

b)

CK-M(cardiac specific)

63.

Laboratory Tests : Cardiac enzymes :

3-5 U/l

a)

CK (total)

b)

CK-M(cardiac specific)

64.

Laboratory Tests : Cardiac enzymes :

2 to 6 hours; peak 18 to 36 hours

a)

CK (total)

b)

CK-M(cardiac specific)

65.

Laboratory Tests : Cardiac enzymes :

4 to 8 hours; peak 18 to 24 hours

a)

CK (total)

b)

CK-M(cardiac specific)

66.

Laboratory Tests : Cardiac enzymes :

Troponin I and T

a)

As early as 1 hour after injury

b)

As early as 4 hour after injury

67.

Laboratory Tests : Cardiac enzymes :

Troponin I and T

a)

As early as 1 hour after injury

b)

As early as 4 hour after injury

68.

Laboratory Tests : Cardiac enzymes :

Myoglobin

a)

30 to 60 minutes after injury

b)

20 to 40 minutes after injury

69.

◦Normal values less than 0.5 mcg/L for ?

a)

Troponin I

b)

Troponin T

70.

◦Normal values less than 0.1 mcg/L for ?

a)

Troponin I

b)

Troponin T

71.

◦Normal values less than 0.1 mcg/L for ?

a)

Troponin I

b)

Troponin T

72.

Cholesterol in CAD (HDL is considered good)

male

a)

35-70mg/dl

b)

35-85mg/dl

73.

Cholesterol in CAD (HDL is considered good)

female

a)

35-70mg/dl

b)

35-85mg/dl

74.

LDL – Target levels

(No CHD and 0 – 1  risk factors)

a)

160mg/dL

b)

130mg/dL

c)

<100mg/dL

75.

LDL – Target levels

(No CHD and 2 or more risk factors)

a)

160mg/dL

b)

130mg/dL

c)

<100mg/dL

76.

LDL – Target levels

(CAD)

a)

160mg/dL

b)

130mg/dL

c)

<100mg/dL

77.

Diagnostic Studies for CAD

a)

12-lead electrocardiogram (ECG)

b)

Holter monitor – to detect suspected dysrythmias – 24 to 48 hrs

c)

Exercise tolerance test (stress test)

d)

Chest x-ray and echocardiography

e)

Liver enzyme test

78.

in the Mediastinal space, Covered by pericardium.

a)

Heart

b)

Lungs

c)

stomach

d)

kidney

79.

Ultrasound to visualize cardiac structures

a)

Echocardiography

b)

Exercise tolerance test (stress test)

c)

Holter monitor

d)

Chest x-ray

80.

cardiomegaly,  cardiac position, pulmonary effusions

a)

Echocardiography

b)

Exercise tolerance test (stress test)

c)

Holter monitor

d)

Chest x-ray

81.

Ultrasonic imaging of heart – view behind the heart

a)

Transesophageal echocardiography

b)

Diagnostic heart scans

c)

Magnetic resonance imaging (MRI)

d)

Electrophysiology study

e)

Cardiac catheterization and angiography

82.

Multigated blood pool study – to assess LV function

a)

Transesophageal echocardiography

b)

Diagnostic heart scans

c)

Magnetic resonance imaging (MRI)

d)

Electrophysiology study

e)

Cardiac catheterization and angiography

83.

Evaluate tissues, structures and blood flow

a)

Transesophageal echocardiography

b)

Diagnostic heart scans

c)

Magnetic resonance imaging (MRI)

d)

Electrophysiology study

e)

Cardiac catheterization and angiography

84.

Record intracardiac ECG etc

a)

Transesophageal echocardiography

b)

Diagnostic heart scans

c)

Magnetic resonance imaging (MRI)

d)

Electrophysiology study

e)

Cardiac catheterization and angiography

85.

Catheter (right or left)

a)

Heart pressures (similar to PA catheter)

b)

Cardiac output

c)

Visualize blood vessels

86.

Arteriography

a)

Heart pressures (similar to PA catheter)

b)

Cardiac output

c)

Visualize blood vessels

87.

Post-Catheterization Care

a)

Bed rest

b)

Head of bed no higher than 60 º

c)

Monitor bleeding; newer collagen agents for hemostasis may be used

88.

Post-Catheterization Care

a)

Monitor pulses

b)

Anticoagulant drug after the procedure (usually after PCI)

c)

May be discharged in 6-8 hr; depends on diagnosis and procedures done in catheterization laboratory

89.

Treatment for CAD (Diet)

a)

Low cholesterol, low salt

b)

High cholesterol, low salt

c)

Low cholesterol, low fiber

d)

High cholesterol, high fiber

90.

Treatment for CAD (Exercise)

a)

Aeroic

b)

Weight loss

c)

Management of hypotension and diabetes if present

d)

aneroic 

91.

Treatment for CAD (Exercise)

a)

lipid lowering agents

b)

high lipid agents

c)

Management of hypotension and diabetes if present

d)

aneroic 

92.

Medications for Hyperlipidemia

a)

HMG CoA reductase inhibitors

b)

Bile acid resins

c)

Nicotinic acid

d)

Fibric acid derivatives

e)

Anticoagulant 

93.

slow production: most effective (statins)

a)

HMG CoA reductase inhibitors

b)

Bile acid resins

c)

Nicotinic acid

d)

Fibric acid derivatives

e)

Anticoagulant 

94.

bind and excreted via bowel (Cholestyramine + Colestipol)

a)

HMG CoA reductase inhibitors

b)

Bile acid resins

c)

Nicotinic acid

d)

Fibric acid derivatives

e)

Anticoagulant 

95.

inhibits LDL synthesis and increases HDL; many side effects

a)

HMG CoA reductase inhibitors

b)

Bile acid resins

c)

Nicotinic acid

d)

Fibric acid derivatives

e)

Anticoagulant 

96.

ncrease VLDL clearance

(Gemfibrozil)

a)

HMG CoA reductase inhibitors

b)

Bile acid resins

c)

Nicotinic acid

d)

Fibric acid derivatives

e)

Anticoagulant 

97.

-inhibits Thromboxane A2 production

a)

ASA (acetylsalicylic acid ) = Aspirin 

b)

Dipyridamole  (Persantine)

c)

Ticlopidine (Ticlid)

d)

Clopidogrel (Plavix)

98.

stimulates activation of new platelets as well as increases platelet aggregation

a)

Thromboxane A2 

b)

Anticoagulant

c)

Ticlopidine

d)

Clopidogrel

99.

Nursing Diagnosis for CAD

a)

Hemodynamic instability related to increase cardiac output

b)

Pain related to ↓ coronary artery tissue perfusion

c)

Anxiety / fear related to  treatments and invasive procedures used for diagnostic testing

d)

Knowledge deficit  related to understanding of anatomy and pathophysiology of the heart and its functions, complexity of treatment, new condition, emotional state

e)

Health-seeking behaviors related to desire for information with regard to altered health status or a disease process or condition

100.

the heart’s demand for oxygen is higher than the supply

a)

Myocardial ischemia

b)

Myocardial injury

101.

Myocardial ischemia: the heart’s demand for oxygen is higher than the supply

a)

Pulmonary effusion

b)

Angina

102.

Angina (chest pain)

a)

Classic symptoms

b)

Often midsternal

c)

May radiate to arms, jaw, or back

d)

start with back pain 

103.

Stable (chronic, exertional)

a)

Effort, classic

b)

More often and severe, less relief

c)

Vasospasms

104.

Unstable (crescendo)

a)

Effort, classic

b)

More often and severe, less relief

c)

Vasospasms

105.

Variant = Prinzmetal’s

a)

Effort, classic

b)

More often and severe, less relief

c)

Vasospasms

106.

T-wave inversion on ECG

a)

Stable (chronic, exertional)

b)

Unstable (crescendo)

c)

Variant = Prinzmetal’s

107.

May see ST elevation on ECG

a)

Stable (chronic, exertional)

b)

Unstable (crescendo)

c)

Variant = Prinzmetal’s

108.

ST elevation during pain episodes

a)

Stable (chronic, exertional)

b)

Unstable (crescendo)

c)

Variant = Prinzmetal’s

109.

Treatment: for unstale (crescendo)

a)

rest

b)

nitroglycerin

c)

calcium channel blockers

d)

drugs affecting platelets

e)

revascularization

110.

Treatment: for variant (Prinzmetal's) vasospasms

a)

rest

b)

nitroglycerin

c)

calcium channel blockers

d)

drugs affecting platelets

e)

revascularization

111.

Treatment: for stale (chronic, exertional) (2)

a)

rest

b)

nitroglycerin

c)

calcium channel blockers

d)

drugs affecting platelets

e)

revascularization

112.

Nursing management of the patient with angina is directed toward

a)

immediate administration of nitrates.

b)

assessment of history of previous anginal episodes.

c)

assessment and documentation of chest pain episodes.

d)

administration of prophylactic lidocaine for ventricular ectopy.

113.

Acute Coronary Syndrome (ACS)

a)

Ischemia with myocardial cell death

b)

Ischemia with myocardial cell death

c)

Includes stable angina, unstable angina or acute myocardial infarction

d)

Imbalance of oxygen supply and demand

e)

Ischemia with myocardial cell death

114.

Acute Coronary Syndrome (ACS) causes :

a)

Atherosclerosis

b)

Emboli

c)

Blunt trauma

d)

Spasm

e)

Pneumothorax

115.

Acute Coronary Syndrome (ACS) causes :

a)

Atherosclerosis

b)

Emboli

c)

Blunt trauma

d)

Spasm

e)

Pneumothorax

116.

• Ischemia with myocardial cell death

a)

ACS

b)

AMI

c)

CAD

117.

•) includes the diagnoses of stable angine, unstable angina (UA) and acute myocardial infarction (AMI).

a)

ACS

b)

KPI

c)

CAD

118.

• Ischemia with myocardial cell death

a)

Acute myocardial infarction (AMI)

b)

Acute myocardial injury (AMI)

c)

Chronic myocardial infarction (CMI)

d)

Acute myocardial injury (CMI)

119.

Causes of Acute myocardial infarction (AMI)

a)

Atherosclerosis

b)

Emboli

c)

Blunt trauma

d)

Spasm

e)

Arterioles

120.

Types of acute myocardial infarction (AMI) (2 answers)

a)

Q wave

b)

Non Q wave

c)

T wave

d)

Non t wave

121.

Types of acute myocardial infarction (AMI):

Total occlusion of coronary artery with thrombus

a)

Q wave

b)

Non Q wave

122.

Types of acute myocardial infarction (AMI):

Partial occlusion of coronary artery

a)

Q wave

b)

Non Q wave

123.

Assessment of AMI (acute myocardial infarction)

a)

•Midsternal chest pain, Severe, crushing, and squeezing pressure, May radiate (spread out), Unrelieved with nitrates

b)

Pale and diaphoretic

c)

Dysrhythmias and syncope

d)

Nausea and vomiting

e)

Sever headache

124.

Diagnosis of AMI

a)

Signs and symptoms: –Often atypical symptoms in women                                                 

b)

•12-lead:

–ST elevation followed by Q wave                                  (Q-wave myocardial infarction)

–ST depression (non–Q-wave myocardial infarction)

c)

•Elevated cardiac enzymes

–CPK-MB

d)

•Elevated serum troponin I/T, myoglobin

e)

•Elevated serum potassium

125.

Which finding on the ECG is most conclusive for infarction :

a)

Q waves

b)

Inverted T waves

c)

Tall, peaked T waves

d)

St segment

126.

Medical Management: AMI

a)

Pain relief: morphine, nitroglycerin

b)

Prevention of platelet aggregation

c)

Percutaneous Coronary Intervention (PCI)

d)

Oxygen

e)

CABG for all AMI patients

127.

Medical Management: AMI

a)

Fibrinolytic therapy

b)

Medications (nitrates, beta blockers, angiotensin-converting enzyme inhibitors

c)

Autologous bone marrow stem cell treatment to the damaged myocardium.

d)

Amidrone and penicillin

128.

Thrombolytic therapy •Time is muscle; ---hour window

(a)  

129.

•Several thrombolytic agents available, such as:

a)

Tissue plasminogen activator (t-PA)

b)

Streptokinase

c)

Reteplase

d)

Thrombosis AX2

130.

•Heparin and glycoprotein IIb/IIIainhibitors

a)

Thrombolytic therapy

b)

anticoagulant agent

c)

Anti platelet

131.

medical procedure where access to inner organs or other tissue is done via needle-puncture of the skin

a)

PCI

b)

CABG

132.

Primary Angioplasty

a)

Percutaneous transluminal coronary angioplasty (PTCA)

b)

Intracoronary stenting (Drug-eluting stents)

c)

Coronary artery bypass graft

133.

•Better outcomes than thrombolytics

a)

Primary angioplasty

b)

Secondary angioplasty

c)

Coronary artery bypass graft

134.

Goal to increase blood flow to myocardium

a)

PTCA

b)

Intracoronary stents

135.

Criteria of PTCA

a)

Uncompromised collateral flow

b)

Noncalcified lesions

c)

Lesions not on bifurcation of vessels

d)

Help prevent the restenosis associated with angioplasty

136.

Balloon catheter is inflated

a)

PTCA

b)

Intracoronary stents

137.

Tubes placed in conjunction with angioplasty to keep vessel patent

a)

PTCA

b)

Intracoronary stents

138.

Help prevent the restenosis associated with angioplasty

a)

PTCA

b)

Intracoronary stents

139.

• Similar procedure as PTCA

a)

PTCA

b)

Intracoronary stents

140.

• Anticoagulation therapy

a)

PTCA

b)

Intracoronary stents

141.

New Interventional Techniques

a)

Excimer laser angioplasty

b)

Radiation therapy

c)

Chemotherapy

142.

New Interventional Techniques (Excimer laser angioplasty)

a)

Xenon chloride laser

b)

Beta or gamma radiation

143.

New Interventional Techniques (Radiation therapy)

a)

Xenon chloride laser

b)

Beta or gamma radiation

144.

Surgical Revascularization

a)

Coronary artery bypass graft (CABG) surgery

b)

Minimally invasive direct coronary artery bypass surgery (MIDCAB)

c)

Transmyocardial revascularization (TMR)

d)

Percutaneous transluminal coronary angioplasty (PTCA)

145.

CABG surgery (Provides additional conduits for blood flow)

a)

Saphenous vein

b)

Internal mammary artery

c)

Radial artery

d)

Femoral artery

146.

CABG surgery

a)

Arteries longer patency

b)

Vein longer patency

147.

Indication for CABG

a)

Unstable angina

b)

Coronary artery disease

c)

Acute myocardial infarction

d)

Failure of percutaneous interventions

148.

Goals for CABG surgery

a)

Increase blood flow to myocardium

b)

Relieve symptoms

c)

Prolong survival

d)

Improve quality of life

e)

Decrease tissue perfusion

149.

Risks Associated With CABG: (Increased mortality associated with:)

a)

Right ventricle dysfunction

b)

Emergency surgery

c)

Age and sex

d)

Number of diseased vessels

e)

Decreased ejection fraction with congestive heart failure

150.

Traditional CABG

a)

Median sternotomy or sternum split

b)

Excision of pericardium

c)

Cardiopulmonary bypass

d)

Myocardial preservation or cardioplegia

e)

Respiratory insufficiency

151.

Traditional CABG

a)

Grafts / Wire sternum

b)

Wean bypass; defibrillate if needed

c)

Mediastinal and chest tubes

d)

Epicardial pacing wires

e)

Pericardial tamponade

152.

Port-access coronary artery bypass

a)

Cardiopulmonary bypass

b)

Incisions (ports)

c)

No cardiopulmonary bypass

153.

Minimally invasive direct coronary artery bypass surgery

a)

Cardiopulmonary bypass

b)

Heart still beating

c)

No cardiopulmonary bypass

d)

One or two bypasses

154.

Cardiac Surgery Complications

a)

Low cardiac output

b)

Mediastinal bleeding

c)

Atrial dysrhythmias

d)

Hypovolemia

e)

Hypertension 

155.

Cardiac Surgery Complications: (Low cardiac output)

a)

Renal impairment

b)

Gastrointestinal dysfunction

c)

Impaired peripheral circulation

d)

Infection: very serious if sternal

156.

Cardiac Surgery Complications: (Mediastinal bleeding)

a)

Renal impairment

b)

Gastrointestinal dysfunction

c)

Impaired peripheral circulation

d)

Infection: very serious if sternal

157.

Complications of CABG

a)

Dysrhythmias

b)

Impaired contractility; low cardiac output

c)

Intraoperative MI

d)

Pericardial tamponade

e)

Mediastinal and chest tubes

158.

Complications of CABG

a)

Respiratory insufficiency

b)

Pain

c)

Emboli; stroke

d)

Death

e)

Wire sternum

159.

Transmyocardial Revascularization

a)

Laser channels into ventricle

b)

Goal is to decrease perfusion of heart muscle

c)

Relief of symptoms occurs over time

d)

Poor candidates for CABG

e)

Mixed results from clinical trials

160.

Dysrhythmias

a)

Radiofrequency catheter ablation (procedure to correct)

b)

Permanent pacemakers

c)

Implantable cardioverter-defibrillator

d)

Temporary pacemakers

161.

Which finding on the ECG is most conclusive for infarction?

a)

Q waves

b)

Inverted T waves

c)

Tall, peaked T waves

d)

ST segment depression

162.

Which finding on the ECG is most conclusive for infarction?

a)

Q waves

b)

Inverted T waves

c)

Tall, peaked T waves

d)

ST segment depression

163.

•Exercise tolerance test (stress test)

a)

–Exercise to increase demand on heart

b)

–Stressed via drugs if patient cannot tolerate exercise, e.g., adenosine

c)

–Monitoring vital signs, ECG

d)

–Checking orthostatic hypotension during stress test