Perfusion and Protection Practice Test

These questions are part of the practice quiz. Start practicing

• Which lab value best indicates therapeutic anticoagulation for a client on warfarin?
• A client with atrial fibrillation is receiving heparin. Which of the following findings is the nurse priority?
• Why are filters and bubble detectors included in CPB?
• How is intraoperative pharmacology dosing, such as antifibrinolytics, administered and adjusted?
• How does temperature management influence endothelial activation during CPB?
• What is the key difference between alpha-stat and pH-stat acid-base strategies during CPB?
• What is the role of transesophageal echocardiography (TEE) during CPB in perfusion practice?
• Which statement best describes perfusion considerations for on-pump vs off-pump CABG?
• During neonatal CPB, what is the typical temperature target?
• What issues arise with venous reservoir collapse or suction during CPB?
• A nurse caring for a client with a delayed hypersensitivity reaction should expect which manifestation?
• Discharge teaching for a client with systemic lupus erythematosus should include which hair care instruction?
• What is the function of the heat exchanger in CPB?
• When teaching a client with rheumatoid arthritis to rest to reduce joint stress, which outcome should be documented as a goal?
• St. Thomas II cardioplegia is typically delivered in what manner?
• A client with heart palpitations is diagnosed with ventricular tachycardia. What action should be taken first?
• Pharmacologic adjunct in cardioplegia?
• A client with rheumatoid arthritis has a new prescription for methotrexate. Which instruction should the nurse include?
• How do you interpret an arterial blood gas with elevated lactate and hypoxemia during CPB, and what actions should be taken?
• A nurse in a provider's office is assessing a client who has rheumatoid arthritis. Which finding is a late manifestation?
• A nurse is assessing a client who is to have IV urography. Which of the following data should indicate to the nurse that this procedure is contraindicated for this client?
• Perfusionists have which professional responsibilities regarding patient safety and error reporting?
• A client who takes digoxin reports toxicity. Which symptom would indicate toxicity?
• Imaging for cannula placement?
• During cardiac surgery, what is the role of transesophageal echocardiography (TOE) in the perfusionist workflow?
• After a positive ELISA test, which confirmatory test is used to diagnose HIV?
• How does CPB contribute to SIRS, and what strategies mitigate it?
• A provider's office receives a call from a client who has nausea and unrelieved chest pain after taking a nitroglycerin tablet 5 minutes ago. Which is an appropriate response?
• Which risk is commonly monitored during protamine reversal after heparinization?
• In a client with heart failure who is receiving a dobutamine infusion, which finding indicates the medication is effective?
• A nurse teaching a client who has rheumatoid arthritis about self-care. Which activity should be included?
• Why do troponin levels rise in myocardial injury?
• The nurse should recognize the need for further teaching when the client identifies which factor as a trigger for lupus flare?
• A nurse is caring for a client who has HIV. Which of the following laboratory values is the nurse's priority?
• What is the role of the venous cannulas in CPB?
• Explain the potential consequences of potassium disturbances during CPB and general management.
• A client is admitted with acute heart failure following a myocardial infarction. The provider's prescription that requires clarification is:
• Recruitment maneuvers during weaning?
• Which inotropes and vasopressors are commonly used during CPB and weaning, and what are their general goals?
• Intraoperative blood conservation strategy reduces fluid overload and hemodilution?
• A nurse is assessing a toddler with heart failure. Which finding should the nurse expect?
• Which population is most closely associated with Kaposi's sarcoma?
• What is a key consideration for neonatal CPB to ensure adequate perfusion and oxygenation?
• Before administering digoxin to a client with heart failure, which laboratory value requires priority review?
• What are typical arterial blood gas targets during CPB?
• Which instruction should the nurse include when teaching a client started on bumetanide?
• Hematocrit during CPB?
• What is the role of the reservoir in CPB?
• In pediatric CPB, which cannulation strategy is commonly used due to smaller vessel size?
• A client who received an injection of penicillin G procaine begins to experience dyspnea and tongue swelling. Which action should the nurse perform first?
• In neonatal cardiopulmonary bypass, what is a primary consideration due to extremely small patient size?
• A nurse evaluating a client with systemic lupus erythematosus should report which finding as the highest priority?
• Discharge teaching for a client with an implantable cardioverter/defibrillator (ICD) should include which instruction?
• A client with atrial fibrillation is taking warfarin. Which laboratory result should prompt the nurse to notify the provider?
• In a child with suspected heart failure, orthopnea would be most evident when the child is in which position?
• How does prime composition influence hemodilution and electrolyte balance during CPB?
• Which hair-care recommendation is appropriate for a client with SLE?
• What is the role of leukocyte filtration during CPB?
• In left-sided heart failure, which finding is most directly related to pulmonary congestion?
• Which instruction is essential when a patient starts methotrexate therapy?
• A nurse is caring for a client who has had myocardial infarction. Upon his first visit to cardiac rehabilitation, he tells the nurse that he doesn't understand why he needs to be there because there is nothing more to do, as the damage is done. Which of the following is the correct nursing response?
• What is the purpose of the pump in a CPB circuit?
• Which pulmonary protection strategies are used during CPB?
• If air enters the CPB circuit, what is an immediate action?
• A nurse is evaluating medication safety prior to imaging and notes a patient is taking metformin. Which medication should be held before the procedure to reduce the risk of kidney injury?
• Which CPB circuit component is responsible for performing gas exchange?
• In the emergency department, a client reports chest pressure and shortness of breath. Which laboratory test should the clinician anticipate ordering first?
• A client with congestive heart failure on digoxin refuses breakfast and reports nausea and weakness. What action should the nurse take first?
• Which diagnostic tool is commonly used to guide management of postoperative coagulopathy after CPB?
• A nurse is caring for a client who has heart failure and a potassium level of 2.4 mEq/L. The nurse should identify which of the following medications as the cause of the client's low potassium level?
• In pediatric CPB, how do alpha-stat and pH-stat strategies affect cerebral perfusion?
• Why is thorough de-airing important before initiating bypass?
• Hematocrit optimization during CPB when using DO2 targets?
• How does cross-clamp time relate to myocardial protection strategies and risk of myocardial dysfunction?
• Why is gradual rewarming during CPB important?
• Which cardioplegia solution is crystalloid and used as a single dose with potassium, magnesium, lidocaine, and mannitol?
• What specific adjustments are made for neonatal CPB to ensure adequate perfusion and oxygenation?
• How does hemodilution affect oxygen delivery during CPB, and what strategies help maintain DO2?
• Where are core temperature measurements typically taken during CPB, and why is the location important?
• A discharge teaching for a client with systemic lupus erythematosus should include which hair care instruction?
• A nurse is assessing a client prior to administering atenolol. Which finding should prompt withholding?
• In pediatric CPB, which measures are used to reduce the inflammatory response and risk of SIRS?
• Excessive suction in the CPB circuit can reduce venous return and cause hypotension. Which management steps are appropriate?
• Which sign indicates potential fluid overload during an RBC transfusion?
• What is the general goal for systemic perfusion pressure and flows during CPB?
• Which oxygenator type is most commonly used in modern CPB, and what is its key feature?
• A nurse is collecting a medication history from a client who will undergo cardiac catheterization. Which medication interacts with contrast and increases the risk of acute kidney injury?
• Which strategy helps mitigate ischemia-reperfusion injury during CPB?
• Which monitoring modality directly reflects renal perfusion during CPB?
• A client taking digoxin states, \'I feel nauseated and have no appetite.\' This statement most likely indicates which of the following?
• For a child with acute rheumatic fever, which assessment should be performed promptly upon admission to monitor cardiac involvement?
• Protamine-induced hypotension and pulmonary hypertension present with?
• During auscultation, turbulence between S1 and S2 is heard. This finding should be documented as what?
• Which cardioplegia temperature is used to slow myocardial metabolism during CPB?
• Which step involves pausing to verify critical information and enable team communication before bypass?
• A nurse on a medical-surgical unit cares for a client with chest pain, jaw pain, shortness of breath, and nausea. Which action is most appropriate?
• DO2i formula?
• How does cross-clamp time affect myocardial protection, and what strategies are used to manage prolonged cross-clamp periods?
• A client with AIDS has multiple raised, purplish-brown skin lesions. This finding indicates which condition?
• A nurse caring for a client prescribed diphenhydramine to relieve pruritus. To minimize daytime sedation, how should the client take the medication?
• A nurse remains with a client to observe for any adverse reactions after initiating a transfusion of packed red blood cells. The client becomes apprehensive and tachycardic, reporting headache and low back pain. The nurse should recognize that these findings indicate which type of transfusion reaction?
• In anaphylaxis after penicillin administration, which action should the nurse perform first?
• Vacuum-assisted venous drainage carries risk of which complication?
• Why is temperature management important during CPB?
• Which combination best indicates adequate tissue oxygen delivery during CPB?
• Which finding is a manifestation of digoxin toxicity?
• What are risk factors and signs of a protamine reaction, and how is it managed intraoperatively?
• Which laboratory test is used to monitor inflammation in rheumatoid arthritis?
• Which of the following changes is an early manifestation of rheumatoid arthritis?
• In pediatric CPB, how should priming volume be managed and why?
• Which diagnostic test is designed to confirm HIV infection after a positive ELISA result?
• Which infection control practice is critical in CPB environments?
• In an 8-year-old child with acute rheumatic fever, which assessment should be prioritized immediately after admission?
• How is heparin reversal achieved after CPB?
• What is the impact of hemodilution on CPB oxygen delivery, and what hematocrit targets are typical for adults and pediatrics?
• How is prime volume for a CPB circuit calculated?
• A nurse is teaching a female client with a new diagnosis of systemic lupus erythematosus (SLE). The nurse should recognize the need for further teaching when the client identifies which factor as a trigger that can exacerbate SLE?
• Role of leukocyte-depleted or coated CPB circuits?
• Which finding indicates a late-stage progression of rheumatoid arthritis?
• Which neuro-monitoring modalities are used during CPB to assess cerebral perfusion and oxygenation?
• Lung protection strategy?
• During CPB, which parameter is most directly used to gauge systemic oxygen delivery?
• Which antifibrinolytics are commonly used in CPB and what is a typical dosing approach?
• Intraoperative heparin resistance is best managed by?
• Which of the following is a typical postoperative hemodynamic target after CPB separation?
• A client presents with dyspnea and fatigue, tachycardia, and weak peripheral pulses. The nurse should recognize these findings as manifestations of which condition?
• Which client statement indicates discharge teaching for congestive heart failure was effective?
• A clinic nurse is assessing a client with systemic lupus erythematosus. Which finding should be expected?
• Which hygiene instruction would be appropriate for a client with systemic lupus erythematosus to protect hair integrity?
• If hypotension occurs during CPB, what actions should be taken to restore perfusion?
• During CPB, what is the purpose of the Perfusion Safety Checklist and how does it improve outcomes?
• Which statement about centrifugal and roller pumps in CPB is accurate?
• During pediatric CPB, which statement best describes cannulation practices, prime volume, and hematocrit targets?
• Which mechanism contributes to post-CPB organ dysfunction such as renal and myocardial injury?
• What are cerebral protection strategies during DHCA and selective cerebral perfusion?
• Which renal protection strategy is used during CPB?
• Which is an indication for ECMO in the perioperative/perfusion setting?
• A code scenario: The emergency response team will administer which medication if the restored rhythm is symptomatic bradycardia?
• During CPB, where should temperature be monitored?
• What is the typical hemoglobin threshold to guide transfusion during CPB in adults?
• What is the rationale for considering pulsatile flow during CPB?
• What are the primary monitoring concerns during ECMO in the perioperative setting?
• In adult CPB, arterial cannulation is most commonly performed via which site?
• The appearance of raised purplish-brown skin lesions in an immunocompromised patient is most characteristic of which condition?
• Temperature gradients management
• What is the role of protamine and how should you monitor for reactions?
• Which is a key readiness criterion for weaning from CPB?
• What are the benefits and limitations of cell saver use during CPB?
• What is the purpose of monitoring lines in CPB?
• If the oxygenator's gas exchange performance appears poor during CPB, what is the recommended action?
• Which statement best describes the impact of biocompatible circuits and priming volume on inflammation during CPB?
• Which medication is a known cause of hypokalemia in heart failure patients?
• Which CPB component is primarily responsible for removing debris from circulating blood?
• Embolic risk with suction devices?
• During CPB, if there is a sudden rise in transmembrane pressure and reduced gas exchange, what is the likely cause and management?
• What are the risks associated with vacuum-assisted venous drainage and how are they mitigated?
• Why is circuit surveillance and alarm management important for safety in CPB?
• Which lung-protective strategy is used during weaning from CPB and protective ventilation?
• Which temperature management strategy helps reduce inflammatory response during CPB?
• Antegrade cardioplegia is typically delivered through which route?
• What is the primary goal of antifibrinolytics during CPB?
• What is a key difference between CPB and ECMO in terms of support duration?
• What items should be reviewed during a post-CPB debrief?
• What are major physiological risks associated with deep hypothermic circulatory arrest and a common mitigation strategy?
• What are common post-CPB complications and their perfusion-related etiologies?
• Which electrolyte imbalance increases the risk of digoxin toxicity?
• Which facial region is affected by the malar rash often seen in systemic lupus erythematosus?
• In neonatal CPB, what is the purpose of delicate coagulation balance?
• What is one key purpose of ultrafiltration during CPB?
• Which cerebral protection strategies may be used during CPB?
• A nurse in a coronary care unit explains that lidocaine given IV after CPR has which action?
• Which factors influence gas transfer efficiency in modern oxygenators?
• In transfusion decisions during CPB, which patients might require a higher Hb threshold than 7 g/dL?
• Which statement correctly describes neonatal CPB circuit design relative to pediatric circuits?
• For a patient receiving dobutamine, which finding indicates improved renal perfusion?
• A client who develops a ventricular fibrillation rhythm is unresponsive, pulseless, and apneic. Which action is the nurse's priority?
• In right-sided heart failure, which finding is expected?
• When SvO2 is low during CPB, which adjustments might be considered to improve oxygen delivery?
• What is the function of the arterial cannula in a cardiopulmonary bypass circuit?
• Preparing to administer a transfusion of red blood cells to a client with heart failure. Which manifestation indicates potential fluid volume overload?
• What does DO2i represent?
• While awaiting troponin results for suspected myocardial infarction, which explanation should the nurse provide to the patient about what troponin indicates?
• After the initial acute phase of a myocardial infarction, which medication should the nurse plan to administer to relieve pain and anxiety?
• Which strategy is used to conserve blood during CPB?
• Which laboratory value is commonly used to assess tissue perfusion during CPB?
• Describe the inflammatory response in CPB and a primary strategy to mitigate it.
• If a patient on digoxin reports nausea and decreased appetite, what is the appropriate nursing action?
• What is a key step to prevent air entrainment in the CPB circuit?
• How should mixed venous oxygen saturation (SvO2) and lactate levels be interpreted during CPB?
• What planning steps are important to assess and prepare for potential reoperation during the initial CPB setup?
• Which finding is most consistent with right-sided heart failure?
• Rising lactate during CPB should prompt which approach?
• What are typical intraoperative anticoagulation monitoring protocols (ACT, heparin, protamine) and interpretation?
• CaO2 determinants?
• Which statement best describes the pulse finding in a client with atrial fibrillation?
• What is controlled reperfusion during CPB, and why is it used in pulmonary protection?
• What is the key difference in ECMO cannulation strategies between VA and VV configurations?
• What steps are taken to ensure safe decannulation and CPB withdrawal?
• Which is a typical component of a CPB safety checklist before starting bypass?
• To assess the safety of digoxin therapy in an infant, which assessment should the nurse perform before administration?
• A systolic click heard on auscultation is most consistent with which condition?
• Which symptom is most characteristic of left-sided heart failure?
• What is the role of temperature management in CPB with respect to inflammation and myocardial protection?
• What are signs of air embolism during CPB, and how are they managed?
• A client with right ventricular failure is likely to present with which finding?
• What is the target ACT during CPB?
• What is the recommended practice for antibiotic prophylaxis and sterile technique in the CPB environment?
• Which strategies help protect the endothelium during CPB?
• In systemic lupus erythematosus, which laboratory value best reflects renal function?
• What is the typical ACT target during CPB with unfractionated heparin?
• Which symptom is commonly reported early in rheumatoid arthritis?
• Which aspect characterizes lung-protective ventilation strategies during CPB?
• What anticoagulant is standard for CPB?
• Cardiac enzyme studies are used to determine which of the following?
• Which pulse characteristic should the nurse expect in a client who has atrial fibrillation?
• Which step is used to validate circuit performance before initiating bypass?
• An older adult with rheumatoid arthritis is taking aspirin 650 mg every 4 hours. Which diagnostic test should the nurse monitor to evaluate the medication's effectiveness?
• A nurse assessing an older adult who is taking digoxin should recognize which finding as a manifestation of digoxin toxicity?
• What immediate action should be taken if oxygenator failure is suspected?
• In the emergency department, a client presents with manifestations of myocardial infarction. Which prescription should the nurse take first?
• What is a primary lactate management goal during CPB?
• Which option best represents essential safety practices to protect patients during CPB?
• An older adult with left-sided heart failure is assessed. Which finding should the nurse expect?
• What does the oxygenator in CPB do?
• Which item is not typically part of a CPB safety checklist?
• When might intraoperative ECMO be considered during surgery?
• What is the principal difference between membrane and bubble oxygenators?
• What is the purpose of ultrafiltration during CPB?
• Which manifestation should the nurse expect in a client experiencing an acute myocardial infarction?
• Prior to administering digoxin to a 6-month-old infant, the apical pulse rate is checked. The nurse should withhold the dose if the heart rate is less than which value?
• In left-sided heart failure, which finding is expected?
• What is the function of an arterial line filter, and when is it particularly important?
• What precaution accompanies temperature management during rewarming on CPB?
• Which symptom is commonly associated with heart failure?
• What are common causes and management of air entering the CPB oxygenator or circuit?
• Reviewing laboratory values in a client with systemic lupus erythematosus. Which value best indicates renal function?
• Which information from TEE is most useful to guide deairing and weaning decisions from CPB?
• Which intervention is a strategy to minimize renal injury during CPB?
• RAP indications
• What is the purpose of topical myocardial cooling during CPB?