The nurse would evaluate that the client For a neurologically injured client, the

understands his home care instructions nurse would best assess motor strength
after scleral buckling for a detached retina by:
if he says his activity should include:
A. Comparing equality of hand grasps
A. Avoiding abrupt movements of the head B. Observing spontaneous movements
B. Exercising the eye muscles each day C. Observing the client feed himself
C. Turning the entire head rather than just D. Asking him to signal if he feels pressure
the eyes for sight applied to his feet
D. Avoiding activities requiring good depth
perception Morphine 8 mg IM has been ordered for a
client. The ampule label reads 15 mg/mL.
Lomotil has been prescribed to treat a How many milliliters will the nurse give?
client’s diarrhea. The nurse should teach
the client to report which of the following A. 0.45 mL
common side effects? B. 0.53 mL
C. 0.66 mL
A. Urinary retention D. 0.75 mL
B. Diaphoresis
C. Hypotension Which of the following would be an
D. Lethargy appropriate nursing diagnosis for a
hospitalized client with bacterial
Nitroglycerin is also available in ointment pneumonia and shortness of breath?
or paste form. Before applying
nitroglycerin ointment, the nurse should: A. Ineffective cardiopulmonary tissue
perfusion related to myocardial damage
A. Cleanse the skin with alcohol where the B. Risk for self-care deficit related to
ointment will be placed. fatigue
B. Obtain the client’s pulse rate and C. Deficient fluid volume related to nausea
rhythm and vomiting
C. Remove the ointment previously D. Disturbed thought processes related to
applied inadequate relief of chest pain
D. Instruct the client to expect pain relief in
the next 15 minutes Theophylline ethylenediamide is
administered to a client with COPD to:
While a client with hypertension is being
assessed, he says to the nurse, “I really A. Reduce bronchial secretions
don’t know why I am here. I feel fine and B. Relax bronchial smooth muscle
haven’t had any symptoms.” The nurse C. Strengthen myocardial contractions
would explain to the client that symptoms D. Decrease alveolar elasticity
of hypertension:
Which of the following lab results would be
A. Are often not present unexpected in a client with chronic renal
B. Signify a high risk of stroke failure?
C. Occur only with malignant hypertension
D. Appear after irreversible kidney A. Serum potassium 6.0 mEq/L
damage has occurred B. Serum creatinine 9 mg/dL
C. BUN 15 mg/dL
D. Serum phosphate 5.2 mg/dL. the client understands measures to avoid
problems with reflux while sleeping?
Which of the following criteria are
acceptable for a rescuer to discontinue A. I can elevate the foot of the bed 4 to 6
CPR? inches
B. I can sleep on my stomach with my
A. When it is obvious that the victim will head turned to the left
not survive C. I can sleep on my back without a pillow
B. When the rescuer is exhausted under my head
C. After 30 minutes of CPR without a D. I can elevate the head of the bed 4 to 6
pulse rate inches
D. When the family requests
discontinuation A nurse should interpret which of the
following as an early sign of a tension
The correct procedure for auscultating the pneumothorax in a client with chest
client’s abdomen for bowel sounds would trauma?
include:
A. Diminished bilateral breath sounds
A. Palpating the abdomen first to B. Muffled heart sounds
determine correct stethoscope placement C. Respiratory distress
B. Encouraging the client to cough to D. Tracheal deviation
stimulate movement of fluid and air
through the abdomen A nurse is to administer 10 mg of
C. Placing the client on the left side to aid morphine sulfate to a client with three
auscultation fractures ribs. The available concentration
D. Listening for 5minutes in all four for this drug is 15mg/mL. How many
quadrants to confirm absence of bowel milliliters should the nurse administer?
sound Round to one decimal point. Answer:
_________ mL's.
A client is admitted to the hospital with a
diagnosis of a right hip fracture. She A client with rib fractures and a
complains of right hip pain and cannot pneumothorax has a chest tube inserted
move her right leg. Which of the following that is connected to water-seal drainage.
assessments made by the nurse indicates The nurse notes that the fluid in the
that the client has a typical sign of hip water-seal column is fluctuating with each
fracture? The client’s right leg is: breath that the client takes. What is the
significance of this fluctuation?
A. Rotated internally
B. Held in a flexed positio A. An obstruction is present in the chest
C. Adducted tube
D. Shorter than the leg on the unaffected B. The client is developing subcutaneous
side emphysema
C. The chest tube system is functioning
The nurse assesses the client’s properly
understanding of the relationship between D. There is a leak in the chest tube system
body position and gastroesophageal
reflux. Which response would indicate that
A client who is recovering from chest D. Pa02 of 70 mm Hg
trauma is to be discharged home with a
chest tube drainage system intact. The A client undergoes surgery to repair lung
nurse should instruct the client to call the injuries. Postop orders include the
physician for which of the following? transfusion of one unit of packed red
blood cells at a rate of 60 mL/hour. How
A. Respiratory rate greater than 16 long would this transfusion take?
breaths/minute
B. Continuous bubbling in the water-seal A. 2 hours
chamber B. 4 hours
C. Fluid in the chest tube C. 6 hours
D. Fluctuation of fluid in the water-seal D. 8 hours
chamber
The primary reason for infusing blood at a
Which of the following findings would rate of 60 mL/hour is to help prevent which
suggest pneumothorax in a trauma victim? of the following complications?

A. Pronounced crackles A. Emboli formation

B. Inspiratory wheezing B. Fluid volume overload
C. Dullness on percussion C. Red blood cell hemolysis
D. Absent breath sounds D. Allergic reaction

A 21-year old male is transported by A client's chest tube is to be removed by

ambulance to the emergency department the physician. Which of the following
after a serious automobile accident. He items should the nurse have ready to be
complains of severe pain in his right chest placed directly over the wound when the
where he struck the steering wheel. chest tube is removed?
Which is the primary client goal at this
time? A. Butterfly dressing
B. Montgomery strap
A. Reduce the client's anxiety C. Fine-mesh gauze dressing
B. Maintain adequate oxygenation D. Petroleum gauze dressing
C. Decrease chest pain
D. Maintain adequate circulating volume A client has been in a car accident and the
nurse is assessing for possible
For a client with rub fractures and a pneumothorax. The nurse should assess
pneumothorax, the physician prescribes for:
morphine sulfate, 1 to 2 mg/hour, given IV
as needed for pain. The nursing care goal A. Sudden, sharp chest pain
is to provide adequate pain control so that B. Wheezing breath sounds over affected
the client can breathe effectively. Which side
of the following outcomes would indicate C. Hemoptysis
successful achievement of this goal? D. Cyanosis

A. Pain rating of 0 on a scale of 0-10 by The physician has inserted a chest tube in
the client a client with a pneumothorax. The nurse
B. Decreased client anxiety should evaluate the effectiveness of the
C. Respiratory rate of 26 breaths/minute chest tube:
A. For administration of oxygen Which of the following interventions would
B. To promote formation of lung scar be most likely to prevent the development
tissue of ARDS?
C. To insert antibiotics into the pleural
space A. Teaching cigarette smoking cessation
D. To remove air and fluid B. Maintaining adequate serum potassium
levels
The nurse has placed the intubated client C. Monitoring clients for signs of
with ARDS in prone position for 30 hypercapnia
minutes. Which of the following would D. Replacing fluids adequately during
require the nurse to discontinue prone hypovolemic states
positioning and return the client to the
supine position? Select all that apply. The nurse interprets which of the following
as an early sign of ARDS?
A. The family is coming in to visit
B. The client has increased secretions A. Elevated carbon dioxide level
requiring frequent suctioning B. Hypoxia not responsive to oxygen
C. The Sp02 and P02 have decreased therapy
D. The client is tachycardic with drop in C. Metabolic acidosis
blood pressure D. Severe, unexplained electrolyte
E. The face has increased skin breakdown imbalance
and edema
A client with ARDS is showing signs of
The nurse has calculated a low P/F ratio < increased dyspnea. The nurse reviews a
150 for a client with ARDS. The nurse report of ABGs that recently arrived:pH
should place the client in which position to 7.35PaC02 25 mm HgHC03 22
improve oxygenation, ventilation mEq/LPa02 95 mm HgWhich finding
distribution, and drainage of secretions? should the nurse report to the physician?

A. Supine A. PH
B. Semi-fowlers B. PaC02
C. Lateral side C. HC03
D. Prone D. Pa02

A client with ARDS has fine crackles at the A client with ARDS is on a ventilator. The
lung bases and the respirations are client's peak inspiratory pressure and
shallow at a rate of 28 breaths/minute. spontaneous respiratory rate are
The client is restless and anxious. In increasing, and the P02 is not improving.
addition to monitoring the arterial blood Using the SBAR technique, the nurse calls
gas results, the nurse should do which of the physician with the recommendation
the following? Select all that apply. for:

A. Monitor serum creatinine and BUN A. Initiating IV sedation

levels B. Starting a high protein diet
B. Administer a sedative C. Providing pain medication
C. Keep the head of the bed flat D. Increasing the ventilator rate
D. Administer humidified oxygen
E. Auscultate the lungs
A client has the following ABG values:pH C. Verifying the amount of cuff inflation
7.52Pa02 50 mm HgPaC02 28 mm D. Auscultating breath sounds bilaterally
HgHC03 24 mEq/LBased on the client's
Pa02, which of these conclusions would Which of the following nursing
be accurate? interventions would promote effective
airway clearance in a client with ARDS?
A. The client is severely hypoxic
B. The oxygen level is low but poses no A. Administering oxygen every 2 hours
risk for the client B. Turning the client every 4 hours
C. The client's Pa02 level is within normal C. Administering sedatives to promote rest
range D. Suctioning if cough is ineffective
D. The client requires oxygen therapy with
very low oxygen concentrations A client has these arterial blood gas
values: pH, 7.30; PaO2, 89 mm Hg;
A client has the following ABG values:pH PaCO2, 50 mm Hg; and HCO3-, 26
7.52Pa02 50 mm HgPaC02 28 mm mEq/L. Based on these values, the nurse
HgHC03 24 mEq/LThe nurse determines should suspect which condition?
that which of the following is a possible respiratory acidosis
cause for these findings?
A client is receiving supplemental oxygen.
A. COPD When determining the effectiveness of
B. DKA with Kussmaul's respirations oxygen therapy, which arterial blood gas
C. Myocardial infarction value is most important? partial
D. Pulmonary embolus pressure of arterial oxygen (PaO2)

Which of the following interventions should A client admitted with acute anxiety has
the nurse anticipate in a client who has the following arterial blood gas (ABG)
been diagnosed with ARDS? values: pH, 7.55; partial pressure of
arterial oxygen (PaO2), 90 mm Hg; partial
A. Tracheostomy pressure of arterial carbon dioxide
B. Use of a nasal cannula (PaCO2), 27 mm Hg; and bicarbonate
C. Mechanical ventilation (HCO3-), 24 mEq/L. Based on these
D. Insertion of a chest tube values, the nurse suspects respiratory
alkalosis.
Which of the following conditions can
place a client at risk for ARDS? In chronic obstructive pulmonary disease
(COPD), decreased carbon dioxide
A. Septic shock elimination results in increased carbon
B. COPD dioxide tension in arterial blood, leading to
C. Asthma what acid-base imbalance? respiratory
D. Heart failure acidosis

Which one of the following assessments is A client with Guillain-Barré syndrome

most appropriate for determining the develops respiratory acidosis as a result of
correct placement of an endotracheal tube reduced alveolar ventilation. Which
in a mechanically ventilated client? combination of arterial blood gas (ABG)
A. Assessing the client's skin color values confirms respiratory acidosis? pH,
B. Monitoring the respiratory rate 7.25; PaCO2 50 mm Hg
 recognize the risk of what complication?
A client's arterial blood gas values are metabolic alkalosis
shown. The nurse should develop a care
plan based on the fact the client is For the child experiencing excessive
experiencing which clinical situation? vomiting secondary to pyloric stenosis, the
metabolic acidosis nurse should assess the child for which
acid-base imbalance? metabolic
Which of these ions plays an important alkalosis
role in pH homeostasis? bicarbonate
A client has the following arterial blood
A nurse is reviewing a client's arterial gas (ABG) values: pH, 7.12; partial
blood gas (ABG) report. Which ABG value pressure of arterial carbon dioxide
reflects the acid concentration in the (PaCO2), 40 mm Hg; and bicarbonate
client's blood? pH (HCO3-), 15 mEq/L. These ABG values
suggest which disorder? metabolic
A client with a suspected overdose of an acidosis
unknown drug is admitted to the
emergency department. Arterial blood gas Which intervention is most appropriate for
values indicate respiratory acidosis. What a client with an arterial blood gas (ABG) of
should the nurse do first? Prepare to pH 7.5, a partial pressure of arterial
assist with ventilation. carbon dioxide (PaCO2) of 26 mm Hg,
oxygen (O2) saturation of 96%,
When evaluating a client's arterial blood bicarbonate (HCO3-) of 24 mEq/L, and a
gases (ABGs), which value is consistent PaO2 of 94 mm Hg? Instruct the client
with metabolic alkalosis? pH 7.48 to breathe into a paper bag.

The nurse is caring for a client with The nurse on a surgical unit is caring for a
chronic obstructive pulmonary disease. client recovering from recent surgery with
The client reports that he is having the placement of a nasogastric tube on
difficulty breathing and is feeling fatigued. low continuous suction. Which acid-base
The nurse realizes that this client is at high imbalance is most likely to occur?
risk for which condition? Respiratory metabolic alkalosis
acidosis
A neonate weighing 1,870 g with a
A nurse is reviewing arterial blood gas respiratory rate of 46 breaths/minute, a
results on an assigned client. The pH is pulse rate of 175 bpm, and a serum pH of
7.32 with PCO2 of 49 mm Hg and a 7.11 has received sodium bicarbonate
HCO3−of 28 mEq/L. The nurse reports to intravenously. The drug has been effective
the physician which finding? respiratory if the neonate exhibits which finding?
acidosis resolves the metabolic acidosis

A client has been diagnosed with A client with emphysema is at a greater

metabolic alkalosis. The nurse should risk for developing what acid-base
anticipate what finding from the client's imbalance? chronic respiratory
arterial blood gases? serum bicarbonate acidosis
of 28 mEq/L
A client has vomited several times over The nurse is caring for a client with
the past 12 hours. The nurse should multiple organ failure who is in metabolic
acidosis. Which pair of organs is blood pressure, increased respiratory rate
responsible for regulatory processes and and depth, drowsiness, and confusion.
compensation? lungs and kidneys The client reports headache and nausea.
Based on the serum laboratory results,
The nurse is caring for a client who has a how would the nurse interpret the client's
compromised cardiopulmonary system acid-base balance? metabolic acidosis
and needs to assess the client's tissue
oxygenation. The nurse would use which An adolescent is admitted for treatment of
appropriate method to assess this client's bulimia nervosa. When developing the
oxygenation? Arterial blood gas care plan, the nurse anticipates including
interventions that address which metabolic
A client has been diagnosed with an disorder? metabolic alkalosis
intestinal obstruction and has a
nasogastric tube set to low continuous A client presents to the emergency
suction. Which acid-base disturbance is department, reporting that they have been
this client at risk for developing? vomiting every 30 to 40 minutes for the
metabolic alkalosis past 8 hours. Frequent vomiting puts this
client at risk for which imbalances?
A nurse assesses arterial blood gas metabolic alkalosis and hypokalemia
results for a client in acute respiratory
failure (ARF). Which result is consistent On admission, a client has the following
with this disorder? pH 7.28, PaO2 50 arterial blood gas (ABG) values: PaO2, 50
mm Hg mm Hg; PaCO2, 70 mm Hg; pH, 7.20;
HCO3-, 28 mEq/L. Based on these values,
A client's arterial blood gas analysis the nurse should prioritize which nursing
reveals an excess of carbon dioxide. The diagnosis for this client? Impaired
nurse should recognize that this is gas exchange
consistent with which condition?
respiratory acidosis A patient presents to the Emergency
Department experiencing a severe anxiety
The nurse is caring for a client diagnosed attack and is hyperventilating. The nurse
with chronic obstructive pulmonary would expect the patient's pH value to be
disease (COPD) and experiencing which of the following? 7.50
respiratory acidosis. The decrease in pH
exists because the client's lungs: are Which of the following would be a
unable to blow off carbon dioxide. potential cause of respiratory acidosis?
Hypoventilation
A client has the following arterial blood
gas values: pH, 7.52; PaO2, 50 mm Hg As status asthmaticus worsens, the nurse
(6.7 kPa); PaCO2, 28 mm Hg (3.72 kPa); would expect which acid-base imbalance?
HCO3- 24 mEq/L (24 mmol/L). Based respiratory acidosis
upon the client's PaO2, which nursing
clinical judgment should the nurse make? The nurse is analyzing the arterial blood
The client is severely hypoxic. gas (AGB) results of a client diagnosed
with severe pneumonia. What ABG results
The nurse is admitting a client with newly are most consistent with this diagnosis?
diagnosed diabetes mellitus and left-sided pH: 7.20, PaCO2: 65 mm Hg, HCO3-: 26
heart failure. Assessment reveals low mEq/L
As status asthmaticus worsens, the nurse The nurse is caring for a client with
would expect the client to experience end-stage kidney disease. What arterial
which acid-base imbalance? respiratory blood gas results are most closely
acidosis associated with this disorder? pH
7.20, PaCO2 36, HCO3 14-
Before seeing a newly assigned client with
respiratory alkalosis, a nurse quickly What function does the kidney perform to
reviews the client's medical history. Which assist in maintaining acid-base balance
condition is a predisposing factor for within the necessary normal range?
respiratory alkalosis? extreme anxiety Return bicarbonate to the body's
circulation
The nurse is caring for a client with severe
diarrhea. The nurse recognizes that the Arterial blood gas analysis would reveal
client is at risk for developing which of the which finding related to acute respiratory
following acid-base imbalances? failure? pH 7.24
metabolic acidosis
A client with respiratory acidosis is
A client has a respiratory rate of 38 admitted to the intensive care unit for
breaths/min. What effect does breathing close observation. The nurse should stay
faster have on arterial pH level? alert for which complication associated
Increases arterial pH with respiratory acidosis? shock

The nurse is caring for a 12-month-old The nurse observes a client with an onset
infant with dehydration and metabolic of heart failure having rapid, shallow
acidosis. What symptom does the nurse breathing at a rate of 32 breaths/minute.
document as congruent with dehydration What blood gas analysis does the nurse
and metabolic acidosis? Tachypnea. anticipate finding initially? respiratory
alkalosis
A male client tells the nurse that he takes
antacid tablets several times each day. The nurse is caring for a client with acute
Knowing that the brand of antacid he uses respiratory distress syndrome. What
contains calcium carbonate, the nurse portion of arterial blood gas results does
cautions the client that overuse could the nurse find most concerning, requiring
place him at risk for: metabolic intervention? partial pressure of arterial
alkalosis. oxygen (PaO2) of 69 mm Hg

Trousseau's sign is elicited by which of the Which finding would be expected in a

following? Carpopedal spasm is client with chest trauma, rib fractures, and
induced by occluding the blood flow to respiratory acidosis?" hypoventilation
the arm for 3 minutes with the use of a due to inability to take deep breaths
blood pressure cuff. because of pain

Which of the following arterial blood gas During shift report, the nurse learns the
(ABG) results would the nurse anticipate following laboratory values: pH, 7.44;
for a client with a 3-day history of PCO2, 30mmHg; and HCO3,21 mEq/L for
vomiting? pH: 7.55, PaCO2: 60 mm a client with noted acid-base disturbances.
Hg, HCO3-: 28 Which acid-base imbalance is the client
most likely experiencing? vomiting. The nurse should assess the
compensated respiratory alkalosis client specifically for which symptom?
irritability
For the child diagnosed with an asthma
attack, which manifestation would best In a patient who loses bicarbonate from
correlate with the child's arterial blood gas the body, how does it get replaced?
results, which include pH of 7.46, Renal tubular cells generate new
bicarbonate of 21 mEq/L (21 mmol/L), and bicarbonate.
a partial pressure of carbon dioxide
(PCO2) of 33 mm Hg (4.4 kPa)? A client has just been diagnosed as being
tingling sensation in the fingertips in status asthmaticus. The nurse
understands that this client will likely
A client with a pulmonary embolus has the initially exhibit symptoms of: respiratory
following arterial blood gas (ABG) values: alkalosis.
pH, 7.49; partial pressure of arterial
oxygen (PaO2), 60 mm Hg; partial A client has the following arterial blood
pressure of arterial carbon dioxide gas values: pH, 7.52; PaO2, 50 mm Hg
(PaCO2), 30 mm Hg; bicarbonate (6.7 kPa); PaCO2, 28 mm Hg (3.7 kPa);
(HCO3-) 25 mEq/L. What should the nurse HCO3-, 24 mEq/L (24 mmol/l). The nurse
do first? Administer oxygen by determines that which of the following is a
nasal cannula as ordered. possible cause for these findings?
Pulmonary embolus.
The body of a critically ill client may use
which of the following mechanisms to Upon analysis of a client's arterial blood
maintain normal pH? The lungs gas results, the nurse determines that the
eliminate carbonic acid by blowing off concentration of carbon dioxide and
more CO2. hydrogen ions are elevated and the
oxygen in the arterial blood is decreased.
Arterial blood gases should be obtained at What respiratory assessment findings
which timeframe following the initiation of would the nurse anticipate in a client with
continuous mechanical ventilation? 20 these arterial blood gas results?
minutes increase in rate and depth of
respirations
Which finding may occur with respiratory
acidosis? Increased intracranial A nurse working in the emergency
pressure (ICP) department (ED) reviews arterial blood
gas (ABG) values for a client diagnosed
Bicarbonate is stored in which structure with heatstroke. Blood gas values are pH
when the body needs a buffer? 7.48, pCO2 34, pO2 95, CO2 23, HCO3
Renal tubule 22, and SO2 98%. What nursing
interventions demonstrate the nurse's
Which of the following may be the first understanding of the patient's ABG's and
sign of respiratory acidosis in an knowledge of Maslow's hierarchy of needs
anesthetized client? ventricular when providing care for this patient? The
fibrillation nurse prepares for endotracheal
intubation and mechanical ventilation
A client is at risk for development of for the client.
metabolic alkalosis because of persistent
The nurse is reviewing the results of a What labs are called for if Chronic Stable
patient's arterial blood gas and pH Angina is diagnosed? Check fasting
analysis. Normal findings include: (Select Lipid Panel, serum Glucose/HgbA1c,
all that apply.) pH 7.45, PCO2 40 mm Hg, Renal Function, Resting ECG.
Base excess or deficit +2 mmol/L
What is the Alternative to a Treadmill
Define Acute Coronary Syndrome. An Stress Test if, for example, the patient
Acute expression of Ischemic Heart cannot exercise? Imaging and
Disease, implying a lack of Oxygen to Pharmacological Intervention.
the Myocardium and associated with
some general symptoms. What are we looking for in a Treadmill
Stress Test, and when must it be stopped?
What disorders fall under the Category of We are looking for an Ischemic
Acute Coronary Syndrome? Unstable Response, visualized by ST depression
Angina, MI. in more than one Lead. We stop if the
patient feels dizzy, short of breath, or
pain.
What Disorders fall under the Category of
more Chronic Ischemic Syndromes? What are the options for Pharmacological
(versus Acute) Chronic Stable Angina, Treatment of Stable Angina?
Variant Angina, Silent Ischemia. 1. Aspirin or Clopidogrel for
Antiplatelet.
What is the single most frequent symptom 2. Sublingual Nitroglycerin for
of Intermittent Myocardial Ischemia? Symptoms
Angina Pectoris. 3. Beta-Blocker
4. Calcium Channel Blockers
What is NSTEMI? It is Non-ST 5. Lipid Lowering Agents
Segment Elevation Myocardial 6. Ace Inhibitors
Infarction. It is caused Not by a full
Occlusive Thrombus but from a Mural What Lifestyle Changes are advised in
Thrombus with potential to Embolize. Stable Angina?
Smoking cessation.
What is STEMI? ST-Elevated Treatment of hypertension.
Myocardial Infarction. It results from Optimize weight & exercise.
Occlusive Thrombi. The ST segment on Treatment of diabetes.
the EKG is quite literally elevated Reduce stress.
above the normal Zero value that it What is Variant, aka Prinzmetal Angina?
should be at. Accounting for 2-3% of Angina
Pectoris, it is caused by defective NO
What is a TMST? Treadmill Stress production yielding a Dysfunctional
Test. Stable Angina is reproduced in Epithelium, causing Focal Coronary
the lab via a treadmill, while EKG is Artery Vasospasm.
attached. This test is indicated for
Stable Angina if the Patient can What is Asymptomatic, aka Silent,
Exercise and has a normal ECG. Ischemia? A Painless event of
Ischemia which could actually even be
an MI. Best detected on Treadmill
Stress Test.
Ischemia of the papillary muscles can lead Contrast Systolic and Diastolic
to a High Pitched, Blowing Holosystolic Dysfunctions. Systolic Dysfunctions are
Murmur. What are you hearing? caused by reduced Contractility,
Mitral Regurgitation. Diastolic Dysfunction is caused by

Give five possible Molecular markers of a What is the Technical name for a
Myocardial Infarction. Ventricular Gallop? S3. Sounds like a
1. Aspartate Aminotransferase (AST) running horse, 2 fast beats during the
2. Lactate Dehydrogenase (LDH) Second heart sound.
3. Myoglobin
4. Creatine Kinase MB (CKMB) This indicates a Failing Left Ventricle.
5. Troponin I and Troponin T What is the Technical Name for an Atrial
Gallop? S4. Sounds like a running
Myoglobin is not a very good test to prove horse, 2 fast beats during the First
an MI just happened. What is it good for? heart sound. This is caused by a Stiff
It can rule out that an MI happened if it Ventricular wall, into which the Atrium
is negative. is slamming.

Which used to be the best marker of MI, Contrast PCI and CABG. (pronounced
until Troponins? CKMB, Creatine Cabbage I guess) Percutaneous
Kinase MB. Coronary Intervention is the insertion
of a Stint into an Atherosclerotic
What is the most Common Pathology of Coronary Artery. Coronary Artery
ACS? (MI and unstable Angina) Bypass Graft is using another vessel to
Rupture of Atherosclerotic Plaque. give perfusion to the Distal Vessel
beyond the Clot.
Is Unstable Angina more closely related to
STEMI or NSTEMI? NSTEMI. These Pateints may be discharged as early as 5
both result from Partial Occlusion of days after an Acute MI. What is the most
Coronary Arteries rather than Full important factor to predict a longer stay?
Occlusion which gives STEMI. The extent of dysfunction in the
Ventricular Wall.
When do most Heart Attacks occur? Early
Morning. Perhaps caused by the Stress What are reciprocal Changes on 12-Lead
of getting to work. ECG? Areas of ST depression that
occur while ST is elevated elsewhere.
What does ST Elevation give rise to in the Yellow is Elevation, Blue is Reciprocal
Long Run? Q-Waves. These are deep Changes (Depressions) in the picture.
spikes of the normally short Q area.

What are Signs and Symptoms of Acute

MI? Note that it can be quite Variable.
Again, can be quite Variable, especially
in Women. Instead of pain it could be
'Elephant on the Chest' Pressure or
referred Pain to Jaw, Arm, Shoulders.