CMSRN – Cardiac(Med-Ed Study Guide for Certified-
Med Surg RN Test) Qs & As
Heart valves on the right side of the heart Correct-Tricuspid Valve, Pulmonary Valve
How does blood flow through the tricuspid valve? Correct-Blood flows from the right
atrium, to the right ventricle
How does blood flow through the pulmonary valve? Correct-Blood flows from the right
ventricle, to the pulmonary arteries
Heart valves on the left side of the heart Correct-Aortic valve, mitral valve
How does blood flow through the mitral valve? Correct-Blood flows from the left atrium,
to the left ventricle
How does blood flow through the aortic valve? Correct-Blood flows from the left ventricle,
into the aortic arch
, CMSRN – Cardiac(Med-Ed Study Guide for Certified-
Med Surg RN Test) Qs & As
What does S1 sounds like? What is happening in heart? Correct-S1 is the first heart sound
heard (the "lub" in "lub-dub"). The sound is caused by the closure of the mitral and triscupid
valves at the start of systole
What does S2 sound like? What is happening in the heart? Correct-S2 is the second heart
sound heard (the "dub" in "lub-dub"). The sound is caused by the closure of the aortic and
pulmonic valves - representing the end of systole
What does S3 sound like? What is happening in the heart? Correct-S3 is an extra heart
sound, called a gallop. It happens right after S2, and signifies atrial or mitral regurgitation, left
ventricular heart failure, or volume overload.
What does S4 sound like? What is happening in the heart? Correct-S4 is an extra heart
sound, called a gallop. It happens before S1, and signifies HTN, acute MI, aortic stenosis,
pulmonary stenosis, pulmonary HTN
What are the types of coronary ischemia? Correct-Stable angina, unstable angina, and AMI
, CMSRN – Cardiac(Med-Ed Study Guide for Certified-
Med Surg RN Test) Qs & As
What interventions are needed for coronary ischemia? Correct-Stress echo, nuclear
perfusion imaging or cardiac catheterization
What is stable angina? Correct-Exercise-induced chest pain relieved by rest or nitroglycerin
What is unstable angina? Correct-Angina that is either new in onset or differs from a
patient's typical stable angina pattern. Pain at rest does not respond to nitroglycerin.
Precursor to MI.
What causes unstable angina? Correct-Rupture of plaque with w/thrombus and
incomplete occlusion of coronary artery
What EKG changes are seen with unstable angina? Correct-T-wave inversion, or ST
depression, occasionally ST elevation.
What are AHA core measures for chest pain? Correct-EKG within 10 minutes, thrombolytic
within 30 minutes, cath-lab within 90 minutes
, CMSRN – Cardiac(Med-Ed Study Guide for Certified-
Med Surg RN Test) Qs & As
Classic signs/symptoms of MI Correct-Chest pressure/pain, radiates to jaw/left arm, not
relieved by sublingual nitro, SOB, diaphoretic, pallor, anxiety, nausea/vomiting
Atypical MI symptoms Correct-Fatigue, palpitations, dizziness, acute CHF, pulmonary
edema, silent myocardial ischemia, sudden cardiac arrest
Who is at risk for atypical MI presentation? Correct-Women, eldery, diabetics
What does t-wave inversion indicate? Correct-Ischemia
Pathologic q-wave Correct-is wider than 0.04 seconds and indicates that a myocardial
infarction occurred in the past, and/or necrosis
Lab work for chest pain Correct-CBC, PT/PTT, Chemistry panel, Troponin I, CK total and CK-
MB
CK-MB Correct-Creatine Kinase-Muscle Breakdown
