Cardiac Vascular Nursing Exam Diagnostic Testing & Interpretation Flashcards

On a Holter monitor report, the nurse identifies frequent multifocal premature ventricular contractions (PVCs) in a patient with known cardiomyopathy. What is the clinical significance?

Answer: Frequent multifocal PVCs in structural heart disease indicate increased risk of ventricular tachycardia and sudden cardiac death

In patients with structural heart disease, frequent or complex PVCs (multifocal, couplets, or runs) are associated with significantly increased risk of sustained VT and sudden cardiac death.

Which hemodynamic parameter obtained during right heart catheterization differentiates cardiogenic from distributive shock?

Answer: Cardiac output is low with high systemic vascular resistance in cardiogenic shock, while distributive shock has high CO with low SVR

Cardiogenic shock shows low CO, high SVR (compensatory), and elevated PCWP; distributive (septic) shock shows high CO, low SVR, and normal or low PCWP.

A patient undergoes exercise treadmill testing (ETT). Which response during the test is an absolute indication to stop exercise immediately?

Answer: Sustained ventricular tachycardia or ST elevation in leads without pathological Q waves

Sustained VT or ST elevation in leads without prior Q waves indicates severe ischemia or arrhythmia warranting immediate cessation to prevent hemodynamic collapse or ventricular fibrillation.

Which imaging characteristic on CT angiography (CTA) of the aorta best differentiates an aortic dissection from an intramural hematoma?

Answer: Dissection shows an intimal flap with true and false lumens; intramural hematoma shows crescentic wall thickening without a flap or false lumen

Classic aortic dissection creates an intimal tear with blood flowing in a false lumen creating a visible flap, while intramural hematoma is a contained bleed within the wall without a flap or false lumen.

During interpretation of a dobutamine stress echocardiogram, which finding indicates viable but hibernating myocardium?

Answer: Wall motion improves at low-dose dobutamine but worsens at high dose (biphasic response)

The biphasic response—improvement at low-dose dobutamine demonstrating contractile reserve, followed by worsening at higher doses from ischemia—identifies hibernating myocardium that will recover with revascularization.

Which waveform abnormality on the venous waveform (CVP tracing) is characteristic of cardiac tamponade?

Answer: Absence or blunting of the y descent with equalization of diastolic pressures across all cardiac chambers

Tamponade impairs ventricular filling throughout diastole; the y descent (tricuspid opening) is blunted because pericardial pressure prevents ventricular expansion after tricuspid valve opening.