TELE EXAM

Question 1

Patient has new onset chest pain. List 5 interventions from first to last

Answer 1

1. cycle VITALS every 5 mins
2. in-depth pain assessment (location, radiation)
3. EKG to confirm STEMI
4. Stay with patient
5. Notify provider

Question 2

What meds to administer for chest pain once the MD arrives (2)

Answer 2

1. SL nitroglycerin
2. morphine

Question 3

What cardiac enzyme labs should be drawn for a patient with chest pain (2)

Answer 3

1. CK-MB
2. Troponin

Question 4

What activity order should you expect for a patient s/p chest pain

Answer 4

Bedrest (prevent vasoconstriction)

Question 5

INR goal for patients with an LVAD

Answer 5

2-3

Question 6

What does an increased lactate indicate in patients with an LVAD?

Answer 6

Organ failure (indicates organ perfusion)

Question 7

What assessment is important for patients with an LVAD?

Answer 7

Neuro assessments (high risk for pump thrombosis = risk for hemorrhagic stroke)

Question 8

You walk into your patient’s room and they no longer know where they are or who you are, this morning they were alert and oriented during your assessment. What do you next? (6)

Answer 8

1. Check vitals and blood sugar check (hypoglycemia mimics stroke)
2. Notify charge nurse
3. Indicate when their last normal neuro status was (indicates the need for tPA treatment)
4. Call provider
5. Call BAT (brain aneurysm team)
6. CT to assess damage (quicker than MRI)

Question 9

What are 3 signs of of hypertensive crisis?

Answer 9

1. high BP (>180s SBP)
2. headache
3. numbness/tingling in extremities

Question 10

Your patient complains of a headache and numbness in their hands. You check their BP and see that it’s 198/97. What is your next intervention focused on?

Answer 10

Reducing BP and MAP (25% reduction in the first hour) using IV beta-blockers (ie: labetolol)

Question 11

Your patient just came back from an ablation. During your assessment, the monitor shoes VTACH. What do you do next? (5)

Answer 11

1. Vitals & assessment
2. Rerun an EKG
3. Notify the provider
4. Apply Zoll pads and prepare for Cardioversion
5. Push IV Adenosine

Question 12

The monitor shows VTACH but your patient is still speaking and has a pulse. What do you set up?

Answer 12

Zoll pads (front and back)

Question 13

What functions on the Zoll Tower are used for fast rhythms?

Answer 13

Defibrillation
Cardioversion (synchs to the patient’s natural rhythm)

Question 14

What function of the Zoll Tower is used for slow rhythm (bradycardia)?

Answer 14

Pacing

Question 15

How fast does adenosine need to be pushed?

Answer 15

Less than 1 min

Question 16

What steps need to be taken when cardioverting a patient?

Answer 16

1. Notify RRT
2. Premeditate with sedation (it’s painful!) like Fentanyl or Versed
3. If pulseless start quality CPR

Question 17

Your patient’s heart rate drops to the 40s and starts to feel dizzy and lightheaded. What do you do next? (4)

Answer 17

1. Get another set of vitals
2. Run an EKG
3. Call charge nurse
4. Notify provider

Question 18

What medication is used to treat bradycardia?

Answer 18

IV atRopine push

Question 19

Setting using on Zoll for bradycardia?

Answer 19

PACING which is transcutaneous (outside the body)

Question 20

What are symptoms of pericardial effusion?

Answer 20

• Beck’s Triad (JVD, hypotension, muffled heart sounds)
• SOB
• Pulsus Paradoxus (change in SBP during inhalation)

Question 21

You notice your patient’s neck is distended on one side and is SOB. You run vitals and see that their BP is 88/50. What invasive intervention do you expect for this patient?

Answer 21

Paracentesis (needle inserted into the pericardium to remove fluid)