NR 575 Final exam with 100% correct answers + rationales 2026

Blood Flow Cycle

Deoxygenated blood > right atrium > right ventricle > lungs (oxygenated blood) > left atrium > left ventricle > body

Functional Heart Class

Subjective data of severity of heart failure

Functional Heart Class 1

Asymptomatic

Functional Heart Class 2

Symptoms with exertion

Functional Heart Class 3

Symptoms with ADLs

Functional Heart Class 4

Symptoms at rest

Reduced ejection fraction (HFeEF) is...

EF less than 40%, indicating poor heart function.

How to prescribe medication to help with compliance?

Once a day

Educate on side effects

Leading causes of medication non-compliance

side effects

What is the guidelines to HTN

JCN8

What is the first step in suspected heart failure

2d Echo

Preserved ejection fraction (HFpEF) is .....

>40%

Helps reduce remodeling (elasticity) and causes you to lose volume (urine)

ACEI and ARBs

When do you not prescribed ACE/ARBs?

AKI, but can have with CKD

ACEI/ARBs side effects

hyperkalemia

cough

Angioedema (worst case)

Naturesis is what?

lose urine with sodium (Na)

Kauresis is what?

Lose urine with potassium (K)

ARNI medication is

Entresto

Entresto alter what serum test? and what do you order instead?

Alters BNP, will need to order pro-BNP

How long do wait in between switching from ACEi to ARBs?

wait 36 hours in between medication

What test for Cardiac ischemia?

Angio (coronary angiography) performed via cardiac catheterization

What do you not prescribed beta blockers for?

HTN management

What is a beta blocker used for?

for low EF

Which diuretic is used most due to being more aggressive in heart failure?

Loop diurectics

Furosemide (Lasix, Furoscix)

Bumetanide (Bumex, Enbumyst)

Torsemide (Demadex, Soaanz)

What weight gain would be concerning?

Daily wt >3lbs

Weekly wt > 5lbs

What does epinephrine do?

Shunts blood from the skin to the cells/circulation, making CPR more effective

What class is amodarone?

Class 3 drug

What does chronic Afib cause?

enlarged atrium and increased risk for blood clots

What should you do prior to cardioverting an Afib pt?

Anticoagulate

What medication should you give if your Afib pt is hypotensive?

digoxin

What is polymorphic ventricular tachycardia?

Torsades

What medication do you give for Torsades?

Magnesium

What is a 1st degree heart block?

PR interval is long

What is a 2nd degree heart block type 1?

Wenkebach (PR interval gets longer and longer until the P wave drops)

What is a 2nd degree heart bloack type 2?

QRS complex drops

What is a 3rd degree heart block?

( P wave and QRS complex are separate) 3rd degree heart block is complete heart block whereby atrial contraction is normal but no beats are contracted to the ventricles

What to do for PEA?

ABG

consider H/Ts

When do you need a life vest?

EF

What is the most common cause of PACs (ectopic beats)?

hypoxia and electrolytes

*hypokalemia

What to do if potassium keeps dropping when having PACs?

Check magnesium

What are the high intensity lipid management with dosage?

Atorvastatin 40-80 mg

Rosuvastatin 20-40mg

When do you take statins?

night time (when your body is making cholesterol)

Worse side affect of statins?

Rhabdo

Most common side affect of statins?

myalgia

What is the secondary lipid treatment and where does it absorb?

ezetimibe (zetia), absorbs in the small intestine

What is PCSK9s?

For HLD but in severe cases and secondary treatment must have been tried first. VERY EXPENSIVE but VERY effective.

q2wk injection

What is familial homozygous?

extremely high lipids, hereditary

What is the LDL target goal with HDL?

What is the risk score screening called for HLD?

ASCVD

What is HTN defined as?

140/90

130 with comorbidities

What is HTN defines as for someone >60?

150/90

What should you prescribe for HTN to protect kidneys and for people with DM?

ACEI/ARBS

For a black hypertensive pt what medication should you prescribe?

calcium channel blockers, unless they have CHF

diapuredine/norvasc

When should you not prescribe a calcium channel blocker (diapuredine/norvasc)?

it the patient has CHF, due causing peripheral edema, wt gain and constipation

What do you prescribed for coronary disease (plaque build up)?

Lopressor (metoprolol)

What electrolyte does HCTZ increase?

Calcium

Blood pressure greater than what can be a sign of kidney failure?

>130

What is aortic stenosis?

narrowing due to Ca buildup, reduced flow

may cause syncopy or near syncopy

symptoms similar to CAD

How to diagnose structural heart disease? (ex stenosis, regugitation)

echo

Most common valve to have problems with IV drug users and/or dialysis pt?

Tricuspid valve- 1st valve it passes

What causes a pulsatile CVP?

Tricupsid regurgiation will cause IJ pulse

What can a carcinoma tumor in bowel cause?

Cardiovascular disease

Aortic sounds radiates where?

neck

Mitral valve sound radiates where?

lateral chest

If you have a vascular concern what type of CT should you order?

CT with contrast

What are the 2 types of aortic aneurysms?

Stanford A

Stanford B

Where is a standord A aneurysm?

Above (ascending) the left subclavian, EMERGENT

Where is a standord B aneurysm locaseted?

below (descending) the left subclavian

Fluroquinolones should never be prescribed when?

levaquin/ciprofloxacin

A history or current aneurysm

detached retina

How long is PE treatment?

3 months

How is PAD/intermitten claudication dx?

Ankle-brachial index (ABI)

Treatment or PAD/intermitten claudication?

MOVE, if hurts to walk> walk more

What are the symptoms of acute tamponade?

BECKS TRIAD

1. narrow pulse pressure

2. tachycardia

3. muffled heart tones

What is Becks triad?

narrow pulse pressure

tachycardia

muffled heart tones

Recurrence of acute tampondae treatment?

Pericardial window

colchicine

NSAID

Risk factors for percardial effusion/tamponade?

cancer pt

post cath

trauma

hypothyroidism

What type of anticoagulant for a pt with valve problems?

Warfarin

Does DOACs need to be bridged?

No they are quick acting

apixaban=eliquis

What anticoagulant should a renal pt take?

apixaban=eliquis

How to bridge warfarin?

heparin iv to bridge, until PT >2

What is the therapeutic dose for lovenox?

1mg/kg BID

What is the reversal for Warfarin?

Vitamin K or/and FFP

Which leads are inferior MI?

II, III, aVF

Which leads for septal MI?

V1, V2

Which leads for anterior MI?

V3, V4

Whch leads for lateral MI?

V5, V6

CT angiogram

contrast used with CT, must be timed

What is the dual antiplatelet therapy?

aspirin

plavix

taken for 1 yr if for MI

taken for 6 months with stent

Normal heart rate

60-100

Normal cardiac output (CO)

4-8

normal cardiac index (CI)

2-4

normal MAP

65-100

normal systemic vascular resistance (SVR)

800-1200

Normal Central Venous Pressure (CVP)

2-10

What is an contraindication for Intra Aortic Balloon pump (IABP) placement?

plaque

aortic valve incompetence

aortic dissection or aneurysm

At what age are you at an increased risk for cardiac disease?

Men 55

Women 65

Which race has highest risk for HTN?

African americans

At risk populations for cardiac disease?

Men over women until menopause (estrogen protects)

African Americans (due to HTN)

Mexican-American, American Indians, Hawaiians, Asian Americans- due to obesity and DM

It is considered DM at what level of A1C?

>6.5

What is the target A1c for DM?