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Free CCRN PDF with 30 questions
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Q1Premature termination of the curve, cardiac arrhythmias, and marked variation in pulmonary artery baseline temperature can all cause problems with thermodilution cardiac output measurement. What type of problem do these factors produce?
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✓ Correct answer: Irregular downslope of the CO curve
An irregular downslope of the cardiac output curve can result from cardiac arrhythmias, catheter tip movement, premature termination of the curve, right-to-left shunt, and marked variation in pulmonary artery baseline temperature.
Q2Which settings must be configured on an intra-aortic balloon pump (IABP) to achieve optimal support?
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✓ Correct answer: Both the ECG signal to trigger the balloon and the arterial pressure to coordinate timing of counterpulsation
Optimal IABP support requires two waveforms: the ECG to trigger balloon inflation and the arterial pressure waveform to coordinate counterpulsation timing. Settings are typically 1:1 or 1:2; 1:3 is used only for weaning prior to removal due to increased thrombus risk. The balloon should not be stationary for more than 20 minutes while in place.
Q3A student nurse overhears a physician explain the cardiac conduction system to a patient. Where does the heart's electrical impulse originate?
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✓ Correct answer: Sinoatrial node
The electrical impulse originates in the sinoatrial (SA) node, the natural pacemaker of the heart, which coordinates normal sinus rhythm. The SA node is located near the opening of the superior vena cava in the right atrium.
Q4A patient on an ACE inhibitor for hypertension complains of general malaise, low energy, muscle weakness, and rapid, shallow breathing. This patient should be further evaluated for which condition?
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✓ Correct answer: Hyperkalemia
Hyperkalemia occurs when blood potassium levels are elevated. ACE inhibitors can impair potassium excretion and contribute to hyperkalemia, especially in the setting of renal insufficiency. The condition can be life-threatening.
Q5A neonatologist auscultates a defect in the mitral valve of a 28-hour-old infant. By what other name is the mitral valve also known?
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✓ Correct answer: Atrioventricular valve
The mitral valve is also known as the left atrioventricular valve. It is a bicuspid valve consisting of two leaflets surrounded by the mitral valve annulus, located between the left atrium and left ventricle.
Q6Which of the following is a valid rating in the peripheral pulse assessment scale?
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✓ Correct answer: +3 Full
The peripheral pulse rating scale uses the following grading: 0 = absent pulse, +1 = palpable but thready, +3 = full, and +4 = full and bounding.
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