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FCCN LEVEL 1 EXAM
QUESTIONS AND ANSWERS | CORRECT SOLUTIONS
"beta blockers - CORRECT ANSWER decrease heart rate and dilate arteries by blocking beta receptors
metoprolol, labetalol, atenolol"
"calcium channel blockers - CORRECT ANSWER inhibit the entry of calcium ions into heart muscle cells,
causing a slowing of the heart rate, a lessening of the demand for oxygen and nutrients, and a relaxing of vessels amlodipine, nifedipine, verapamil, diltiazem"
"function of kidney - CORRECT ANSWER -urine formation
-excretion of waste products -regulation of electrolytes -regulation of acid-base balance -control over water balance -control of blood pressure -vitamin D metabolism -regulation of RBC production"
"peritoneal dialysis - CORRECT ANSWER dialysis in which the peritoneal membrane (lining of the
abdominal cavity) acts as the filter to remove waste from the blood. dialysate is instilled through catheter into peritoneal cavity. after dwell phase, waste fluid is drained no needles or blood involved, can be done at home, at night"
"kidney transplant - CORRECT ANSWER replacement of a diseased kidney with one that is supplied by a
compatible donor. not a cure. possibility of rejection, infection, or original disease reoccurring"
"CKD no treatment - CORRECT ANSWER death occurs within days-weeks, wastes build up and pt usually
dies in their sleep"
"preload - CORRECT ANSWER the stretch before a contraction, when the ventricle fills. how wet or dry
the pt is"
"low preload - CORRECT ANSWER pt is dry, give fluids"
"high preload - CORRECT ANSWER pt is wet, give lasix, vasodilators, dialysis"
"contractility - CORRECT ANSWER how much squeeze the heart has"
"low contractility - CORRECT ANSWER give positive inotropes"
"positive inotropes - CORRECT ANSWER digoxin, dobutamine, dopamine, milrinone"
"NSTEMI - CORRECT ANSWER ST depression or T wave inversion, cardiac ischemia. thrombus is
intermittently occlusive, causes non full thickness infarction of myocardium"
"STEMI - CORRECT ANSWER ST elevation MI, real-time ongoing death of heart tissue due to cardiac
injury. thrombus is occlusive and causes full thickness infarction"
"ACS - CORRECT ANSWER unstable angina w/ normal troponin, NSTEMI w/ elevated troponin, STEMI
with elevated troponin"
"MI treatment - CORRECT ANSWER Notify physician, obtain 12 lead ECG within 10 minutes.
Morphine - pain relief, decreases workload of heart Oxygen if sats <92% - improve oxygenation Nitroglycerin - increase perfusion to heart Aspirin - stops platelets from forming Heparin - prevents formation of fibrin Beta blocker - slows heart, decreases O2 demand of heart Transfer to cath lab"
"how to measure ST elevation - CORRECT ANSWER 0.06 seconds (box and a half) after J point, count
boxes vertically up from isoelectric line"
"J point - CORRECT ANSWER Point where the QRS complex and ST segment meet"
"QT interval - CORRECT ANSWER ventricular depolarization and repolarization, beginning of QRS to end
of T wave"
"QTc - CORRECT ANSWER QT corrected for heart rate, prolonged >500"
"sodium - CORRECT ANSWER 135-145"
"hyponatremia - CORRECT ANSWER causes: dilutional or depletional
s/s: n/v, abd cramping, lethargy, weakness, headache, seizures, coma"
"hypernatremia - CORRECT ANSWER causes: water deficit or excessive sodium intake
"colloids - CORRECT ANSWER substances such as large protein molecules that do not readily dissolve
into true solutions. pulls fluids into the bloodstream"
"5% albumin - CORRECT ANSWER osmotically equivalent to plasma"
"25% albumin - CORRECT ANSWER draws 4X its volume into vascular compartment in 15 min of admin"
“V1 - CORRECT ANSWER 4th intercostal space, R sternal border. Use for dysrhythmias"
"V2 - CORRECT ANSWER 4th intercostal space, L sternal border."
"V4 - CORRECT ANSWER 5th intercostal space, left midclavicular line"
"V3 - CORRECT ANSWER Midway between V2 and V4. Use for normal rhythms with no arrhythmias"
"fluid maintenance therapy - CORRECT ANSWER replaces ongoing losses of water and electrolytes under
normal physiologic processes (urine, stool, sweat, respiration) goal is to preserve fluid and lyte balance in people who cannot eat and drink"
"fluid replacement therapy - CORRECT ANSWER corrects any existing fluid or lyte deficits. these can
result from high GI output, urinary or skin losses, bleeding, or third spacing. goal is to correct abnormalities"
"ACE inhibitors - CORRECT ANSWER antihypertensive. blocks conversion of angiotensin I to angiotensin
II
lisinopril, captopril, enalapril"
"anticoagulants - CORRECT ANSWER prevent blood clot formation
heparin, warfarin, lovenox, eloquis, plavix"
"diuretics - CORRECT ANSWER increase urine secretion in order to rid the body of excess water and salt
lasix, bumex, spironolactone, HCTZ, mannitol"
"nitrates - CORRECT ANSWER treatment of angina by dilating blood vessels, increasing blood flow and
oxygen to myocardial tissue nitroglycerin, nitroprusside, isosorbide"
"opioids - CORRECT ANSWER potent analgesics with sedative properties
fentanyl, oxycodone, morphine, hydromorphone"
"inotropes - CORRECT ANSWER affect strength of contraction"
"chronotropes - CORRECT ANSWER affect rate of contraction"
"AKI - CORRECT ANSWER abrupt decline in renal function as measured by sudden increased
BUN/creatinine and decreased UOP"
"RIFLE - CORRECT ANSWER Risk
Injury Failure Loss End-stage kidney disease"
"AKI stage 1 - CORRECT ANSWER SCr 1.5-1.9x baseline or >0.3 above baseline
UOP <0.5mL/kg/hr for 6-12 hours"
"AKI stage 2 - CORRECT ANSWER SCr 2-2.9x above baseline
UOP <0.5mL/kg/hr for >12 hours"
"AKI stage 3 - CORRECT ANSWER SCr >3x baseline or >
UOP <0.3 mL/kg/hr for >24 hours or anuria for >12 hours"
"AKI phases - CORRECT ANSWER onset, oliguric, diuretic, recovery"
"onset phase - CORRECT ANSWER onset of injury through cell death, hours-days"
"oliguric phase - CORRECT ANSWER obstruction of tubules, 8-14 days or can last months"
"diuretic phase - CORRECT ANSWER indicates return of tubular function, gradual increased urea
excretion and decreased Na loss, lasts 7-14 days"
"recovery phase - CORRECT ANSWER begins when diuresis stops, lasts up to 12 months, pts either reach
this stage or don't and progress to CKD"
"CKD - CORRECT ANSWER kidney damage for >3 months. characterized by one or more of the following:
proteinuria, urine sediment abnormalities, electrolyte abnormalities, abnormalities detected by histology, or GFR <60"
"GFR - CORRECT ANSWER best indicator of renal function, normal >125"
"CKD risk factors - CORRECT ANSWER -AKI
-DM
"tunneled dialysis catheter - CORRECT ANSWER used as long as needed, tunneled under skin"
"peritoneal dialysis catheter - CORRECT ANSWER surgically placed catheter into peritoneal cavity"
"renal diet - CORRECT ANSWER Normal protein
Low sodium Low potassium Low phosphate"
"high potassium foods - CORRECT ANSWER bananas, potatoes, orange, dairy, tomatoes"
"high phosphorus foods - CORRECT ANSWER dairy products, colas, beer, whole grains"
"high sodium foods - CORRECT ANSWER processed foods, pickles, chips"
"meds to give before dialysis - CORRECT ANSWER -insulin
-pain meds -phosphate binders -anti seizure -anti psychotic -HR control and long acting antihypertensives -heparin -anti rejection -meds given TID or more"
"meds to hold before dialysis - CORRECT ANSWER -antibiotics
-diuretics -short acting antihypertensives -once a day meds like vitamins and aspirin"
"fluid weight gain - CORRECT ANSWER 1L of fluid = 1 kg of weight gain"
"low afterload - CORRECT ANSWER dilated arteries. caused by sepsis, shock. transfer pt to ICU for
vasoconstrictors"
"high afterload - CORRECT ANSWER constricted arteries. can be caused by hypothermia, hypovolemia,
cardiogenic shock. treat the cause"
"afterload - CORRECT ANSWER the resistance the ventricle muscle has to go up against to pump out the
blood. how clamped down or dilated the pt is"
"stable angina - CORRECT ANSWER chest pain that occurs when a person is active or under severe stress.
caused by imbalance of O2 delivery and demand"
"unstable angina - CORRECT ANSWER chest pain that occurs while a person is at rest and not exerting
himself. caused by plaque rupture and thrombus formation"
"isotonic fluid - CORRECT ANSWER has tonicity that is equal to the plasma in the body. causes no fluid
shift into/out of cells. Given for dehydration LR, NS"
"hypotonic fluid - CORRECT ANSWER has lower tonicity than plasma in the body. causes fluids to shift
into the cell, and cells swell D5W, 0.45 NS"
"hypertonic fluid - CORRECT ANSWER has tonicity higher than body plasma. pulls fluid from cells and
into blood, cells shrink D5.45 NS, D5.9NS, D5LR, 3%, 7% and 23.4% sodium chloride"
"Angiotensin II Receptor Blockers (ARBs) - CORRECT ANSWER lower blood pressure by blocking the
angiotensin II enzyme from causing vasoconstriction losartan"
"antiarrhythmic drugs - CORRECT ANSWER used to prevent, alleviate, or correct an abnormal heart
rhythm amiodarone, lidocaine, flecainide, adenosine"
"prerenal AKI - CORRECT ANSWER cause is before kidney. decreased blood flow to kidneys leads to
decreased renal perfusion, resulting in decreased GFR. nephrons are functionally intact"
"prerenal AKI causes - CORRECT ANSWER -decreased intravascular volume (fluid loss or fluid shifts)
-ineffective arterial blood volume (decreased cardiac output, excess vasodilation) examples: hypotension, cardiogenic shock, sepsis, hypovolemia, blood loss"
"prerenal AKI treatment - CORRECT ANSWER restore cardiac output and perfusion
fluids, volume expanders, pressors"
"intrarenal AKI - CORRECT ANSWER direct damage to the kidneys"
"intrarenal AKI causes - CORRECT ANSWER -infection (glomerulonephritis)
-nephrotoxic drugs (NSAIDS, contrast, antibiotics, amphotericin B -toxins (pesticides, fungicides -vascular damage (hypertension, diabetes) -inflammation (ATN, swelling)"
