Cardiac questions abound on the new 2015 TMC-RRT and clinical simulation exams. Fortunately, you don’t have to be a cardiologist to pass! However, familiarizing yourself with cardiac signs, symptoms, ECG, hemodynamics and pathophysiology will contribute to your success on the NBRC board exams.
While studying for the exams, remember to focus on what matters most. For example, don’t get sidetracked studying the intricacies of the parking fibers and wolf-parkinson white syndrome.
Instead, focusing on what the terminology means and what is normal will be of great help in finding the correct answers and passing the TMC and clinical simulations.
It is also important to be able to connect the dots between signs, symptoms, and disease processes. For example, pedal edema, diaphoresis, and orthopnea are associated with heart failure. Patients with heart failure may receive diuretics, which may cause electrolyte imbalances, which may lead to arrhythmias, etc. etc.
The following questions are a good start to get you familiar with some of the cardiac topics that are tested on the NBRC TMC-RRT board exams and clinical simulations.
Practice Question 1
What is the estimated heart rate of this ECG?
The correct answer is 75. In the example above, there are about 4 large boxes between each R wave. To estimate the heart rate divide 300 by 4 to get the answer 75 beats per minute.
RRT Exam Tip: Counting the number of large boxes between each R wave is an easy way to tell if the ECG is brady, tachy, or normal.
Normal rate = 3 to 5 large boxes between R waves
Tachycardia = < 3 large boxes between R waves
Bradycardia = > 5 large boxes between R waves
Practice Question 2
An elevated ST segment may indicate?
The correct answer is: Myocardial infarction. An ST elevation is associated with myocardial infarction. An ST depression is associated with myocardial ischemia.
Practice Question 3
Spiked or peaked T waves on an ECG may be due to?
The Correct answer is: Hyperkalemia
Hypokalemia (low potassium) may be caused by vomiting, diarrhea, and diuretics. Hypokalemia causes depressed or flat T waves on ECG.
Hyperkalemia (high potassium) causes peaked T waves on ECG. Kidney failure is a common cause of hyperkalemia.
Practice Question 4
A patient’s bed in the ICU is raised to provide routine care. The patient has a pulmonary artery catheter (PAC) in place and the transducer is attached to an IV pole next to the bed. What effect will this have on the patients CVP?
It will cause a false high reading
It will cause a false low reading
It will cause PVC’s
The correct answer is: It will cause a false low reading. The transducer must be level with the tip of the PAC catheter to be accurate.
Exam Tip: If the transducer is placed higher than the patient it will cause a false low reading. If the transducer is placed Lower than the patient it will cause a false high reading.
Practice Question 5
A patient in the cardiac ICU has a pulmonary artery catheter in place. The patient is edematous and has a CVP reading of 12. The patient most likely has?
This CVP is normal
The correct answer is: Hypervolemia. The normal CVP range is from 2 to 6 mm Hg. The respiratory therapist should recommend diuretics such as Lasix (Furosemide).
For more cardiac RRT board exam questions and review, check out our third book in the RRT board exam series below.