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QR Challenge: CEN Review: May 2021

Created using the ClassTools QR Treasure Hunt Generator

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Teacher Notes

A. Prior to the lesson:

1. Arrange students into groups. Each group needs at least ONE person who has a mobile device.

2. If their phone camera doesn't automatically detect and decode QR codes, ask students to

3. Print out the QR codes.

4. Cut them out and place them around your class / school.

B. The lesson:

1. Give each group a clipboard and a piece of paper so they can write down the decoded questions and their answers to them.

2. Explain to the students that the codes are hidden around the school. Each team will get ONE point for each question they correctly decode and copy down onto their sheet, and a further TWO points if they can then provide the correct answer and write this down underneath the question.

3. Away they go! The winner is the first team to return with the most correct answers in the time available. This could be within a lesson, or during a lunchbreak, or even over several days!

C. TIPS / OTHER IDEAS

4. A detailed case study in how to set up a successful QR Scavenger Hunt using this tool can be found here.

Questions / Answers (teacher reference)

Question

Answer

1. Q1. Sudden onset of retrosternal chest pain exacerbated by inspiration, activity, and supine position; and relieved by leaning forward or sitting up; pericardial friction rub; tachycardia and tachypnea; low grade fever are all signs of what?Pericarditis
2. Q2. Jugular venous distention, hypotension, and muffled or distant heart sounds are commonly referred to as this triad.Becks Triad
3. Q3. Sudden onset of tearing, ripping pain to chest, shoulders, flank, or back not relieved by analgesics; difference of 20mmHg in systolic blood pressure between arms; potentially stroke-like symptoms, Horner’s Syndrome, or loss of distal pulses, lower extremity weakness, and decreased urinary output are signs and symptoms of what life-threatening emergency?Aortic dissection
4. Q4. Cardiac medications such as Sotalol or Procainamide, antibiotics such as Erythromycin, Levofloxacin, and Ciprofloxacin, and psychiatric medications such as Haldol, Lithium, and tricyclic antidepressants (ex. Elavil, Tofranil) can all cause what EKG changes?Prolonged QT interval
5. Q5. What medication will be ineffective for bradycardia caused by high-degree heart block or heart transplant?Atropine
6. Q6. Pericardial tamponade causes which type of shock?Obstructive shock
7. Q7. What is the most common cause of pediatric cardiac arrest?Respiratory arrest
8. Q8. This disorder causes pallor of the digits, ears, or nose, and is more common in women, especially those with Lupus and scleroderma.Raynaud’s disease
9. Q9. Fever, pleuritic chest pain, new onset heart murmur, Janeway lesions, and Roth spots, especially in drug users or those with tattoos or piercings, are signs and symptoms of what disorder?Endocarditis
10. Q10. Peaked T waves are indicative of which metabolic disorder?Hyperkalemia
11. Q11. What are the shockable cardiac rhythms?Ventricular tachycardia and ventricular fibrillation
12. Q12. Connective tissue diseases such as Marfan’s Syndrome and Ehlers Danlos make a patient more susceptible to what cardiac emergency?Aortic dissection
13. Q13. What is the goal from door to needle when a patient requires percutaneous catheterization intervention (PCI)?90 minutes
14. Q14. What are the missing H’s and T’s from this list: Hypovolemia, Hypoxemia, _________, Hyper- or Hypokalemia, ________, Toxins, ________, Tension pneumothorax, _________, and Thrombosis?Hydrogen ions, hypothermia, trauma, tamponade
15. Q15. Post cardiac arrest, what is the goal for targeted temperature management? ______ degrees for at least ______ hours.32-36C/89.6-95F; 24 hours
16. Q16. What heart block does this describe: consistent R to R intervals, consistent P to P intervals, but there is not an association between the P wave and the QRS?3rd Degree Heart Block
17. Q17. What heart block does this describe: prolonged PR interval (>0.20 sec), consistent PR and R to R intervals?First degree heart block
18. Q18. Diffuse ST segment elevation in most leads without reciprocal changes could be indicative of what?Pericarditis
19. Q19. Which of the following characterizes chronic arterial insufficiency of the lower extremities: a. pitting edema; b. bounding pedal pulses; c. dilated tortuous veins; or d. intermittent claudication?D. Intermittent claudication
20. Q20. A patient arrives in the emergency department with complaints of sudden onset of chest pain and shortness of breath. The EKG reveals a normal sinus rhythm with ST-segment elevation in leads V2, V3, and V4. What area of the heart has sustained injury?Anterior
21. Q21. Which cardiac syndrome displays T-wave changes plus a history of anginal chest pain without serum marker abnormalities?Wellens’ Syndrome
22. Q22. Of the following labs, if elevated, which supports the diagnosis of congestive heart failure: lactic acid, troponin, B-type natriuretic peptide (BNP), or creatine kinase (CK)?B-type natriuretic peptide
23. Q23. In right ventricular myocardial infarction (RVMI), right ventricular dilation and decreased contractility lead to what complication, especially in if nitrates are administered?Decreased preload and cardiac output
24. Q24. Which medication would be indicated for an emergency department patient with a plasma digoxin (Lanoxin) level of 5.2ng/mL?Digoxin immune fab (Digibind)
25. Q25. A patient presents with a chief complaint of chest palpitations and shortness of breath. The cardiac monitor displays a narrow-complex rhythm with visible P waves and regular R to R intervals at a a rate of 170 beats per minute. What is the cardiac rhythm?SVT
26. Q26. A 4-month-old infant presents to the ED for irritability and poor feeding. The infant is lethargic and has circumoral cyanosis. Capillary refill is 4 to 5 seconds. The EKG shows a regular, narrow-complex rhythm with a rate of 230 beats per minute. Is it more appropriate to: a. insert an IO needle and administer adenosine at 0.1mg/kg, or b. estimate the infant’s weight using a length-based system and perform immediate synchronized cardioversion at 0.5 joules/kg?B. estimate the infant’s weight using a length-based system and perform immediate synchronized cardioversion at 0.5 joules/kg
27. Q27. This laboratory test is used to evaluate for the presence of clots in the body; if it is negative (level is within normal limits), the patient is not suffering from a pulmonary embolism.D-dimer
28. Q28. Will heart transplant patients experience chest pain during an acute myocardial infarction? Yes or no?No – the pain receptors are interrupted during transplantation
29. Q29. Transcutaneous pacing has been initiated at a rate of 70 bpeats per minute for a patient in a complete heart block. The nurse notes there is a wide-complex beat after each pacer spike. How does the nurse know that the patient is being successfully paced?There is mechanical capture, a palpable central pulse at 70 beats/minute
30. Q30. What syndrome is characterized by a shortened PR interval and widened QRS complex with a delta wave?Wolff-Parkinson-White (WPW)

 


CEN Review: May 2021: QR Challenge

https://www.classtools.net/QR/decode.php?text=Q1.-Sudden-onset-of-retrosternal-chest-pain-exacerbated-by-inspiration,-activity,-and-supine-position;-and-relieved-by-leaning-forward-or-sitting-up;-pericardial-friction-rub;-tachycardia-and-tachypnea;-low-grade-fever-are-all-signs-of-what?

Question 1 (of 30)

 


CEN Review: May 2021: QR Challenge

https://www.classtools.net/QR/decode.php?text=Q2.-Jugular-venous-distention,-hypotension,-and-muffled-or-distant-heart-sounds-are-commonly-referred-to-as-this-triad.

Question 2 (of 30)

 


CEN Review: May 2021: QR Challenge

https://www.classtools.net/QR/decode.php?text=Q3.-Sudden-onset-of-tearing,-ripping-pain-to-chest,-shoulders,-flank,-or-back-not-relieved-by-analgesics;-difference-of-20mmHg-in-systolic-blood-pressure-between-arms;-potentially-stroke-like-symptoms,-Horner’s-Syndrome,-or-loss-of-distal-pulses,-lower-extremity-weakness,-and-decreased-urinary-output-are-signs-and-symptoms-of-what-life-threatening-emergency?

Question 3 (of 30)

 


CEN Review: May 2021: QR Challenge

https://www.classtools.net/QR/decode.php?text=Q4.-Cardiac-medications-such-as-Sotalol-or-Procainamide,-antibiotics-such-as-Erythromycin,-Levofloxacin,-and-Ciprofloxacin,-and-psychiatric-medications-such-as-Haldol,-Lithium,-and-tricyclic-antidepressants-(ex.-Elavil,-Tofranil)-can-all-cause-what-EKG-changes?

Question 4 (of 30)

 


CEN Review: May 2021: QR Challenge

https://www.classtools.net/QR/decode.php?text=Q5.-What-medication-will-be-ineffective-for-bradycardia-caused-by-high-degree-heart-block-or-heart-transplant?

Question 5 (of 30)

 


CEN Review: May 2021: QR Challenge

https://www.classtools.net/QR/decode.php?text=Q6.-Pericardial-tamponade-causes-which-type-of-shock?

Question 6 (of 30)

 


CEN Review: May 2021: QR Challenge

https://www.classtools.net/QR/decode.php?text=Q7.-What-is-the-most-common-cause-of-pediatric-cardiac-arrest?

Question 7 (of 30)

 


CEN Review: May 2021: QR Challenge

https://www.classtools.net/QR/decode.php?text=Q8.-This-disorder-causes-pallor-of-the-digits,-ears,-or-nose,-and-is-more-common-in-women,-especially-those-with-Lupus-and-scleroderma.

Question 8 (of 30)

 


CEN Review: May 2021: QR Challenge

https://www.classtools.net/QR/decode.php?text=Q9.-Fever,-pleuritic-chest-pain,-new-onset-heart-murmur,-Janeway-lesions,-and-Roth-spots,-especially-in-drug-users-or-those-with-tattoos-or-piercings,-are-signs-and-symptoms-of-what-disorder?

Question 9 (of 30)

 


CEN Review: May 2021: QR Challenge

https://www.classtools.net/QR/decode.php?text=Q10.-Peaked-T-waves-are-indicative-of-which-metabolic-disorder?

Question 10 (of 30)

 


CEN Review: May 2021: QR Challenge

https://www.classtools.net/QR/decode.php?text=Q11.-What-are-the-shockable-cardiac-rhythms?

Question 11 (of 30)

 


CEN Review: May 2021: QR Challenge

https://www.classtools.net/QR/decode.php?text=Q12.-Connective-tissue-diseases-such-as-Marfan’s-Syndrome-and-Ehlers-Danlos-make-a-patient-more-susceptible-to-what-cardiac-emergency?

Question 12 (of 30)

 


CEN Review: May 2021: QR Challenge

https://www.classtools.net/QR/decode.php?text=Q13.-What-is-the-goal-from-door-to-needle-when-a-patient-requires-percutaneous-catheterization-intervention-(PCI)?

Question 13 (of 30)

 


CEN Review: May 2021: QR Challenge

https://www.classtools.net/QR/decode.php?text=Q14.-What-are-the-missing-H’s-and-T’s-from-this-list:-Hypovolemia,-Hypoxemia,-_________,-Hyper--or-Hypokalemia,-________,-Toxins,-________,-Tension-pneumothorax,-_________,-and-Thrombosis?

Question 14 (of 30)

 


CEN Review: May 2021: QR Challenge

https://www.classtools.net/QR/decode.php?text=Q15.-Post-cardiac-arrest,-what-is-the-goal-for-targeted-temperature-management?-______-degrees-for-at-least-______-hours.

Question 15 (of 30)

 


CEN Review: May 2021: QR Challenge

https://www.classtools.net/QR/decode.php?text=Q16.-What-heart-block-does-this-describe:-consistent-R-to-R-intervals,-consistent-P-to-P-intervals,-but-there-is-not-an-association-between-the-P-wave-and-the-QRS?

Question 16 (of 30)

 


CEN Review: May 2021: QR Challenge

https://www.classtools.net/QR/decode.php?text=Q17.-What-heart-block-does-this-describe:-prolonged-PR-interval-(>0.20-sec),-consistent-PR-and-R-to-R-intervals?

Question 17 (of 30)

 


CEN Review: May 2021: QR Challenge

https://www.classtools.net/QR/decode.php?text=Q18.-Diffuse-ST-segment-elevation-in-most-leads-without-reciprocal-changes-could-be-indicative-of-what?

Question 18 (of 30)

 


CEN Review: May 2021: QR Challenge

https://www.classtools.net/QR/decode.php?text=Q19.-Which-of-the-following-characterizes-chronic-arterial-insufficiency-of-the-lower-extremities:-a.-pitting-edema;-b.-bounding-pedal-pulses;-c.-dilated-tortuous-veins;-or-d.-intermittent-claudication?

Question 19 (of 30)

 


CEN Review: May 2021: QR Challenge

https://www.classtools.net/QR/decode.php?text=Q20.-A-patient-arrives-in-the-emergency-department-with-complaints-of-sudden-onset-of-chest-pain-and-shortness-of-breath.-The-EKG-reveals-a-normal-sinus-rhythm-with-ST-segment-elevation-in-leads-V2,-V3,-and-V4.-What-area-of-the-heart-has-sustained-injury?

Question 20 (of 30)

 


CEN Review: May 2021: QR Challenge

https://www.classtools.net/QR/decode.php?text=Q21.-Which-cardiac-syndrome-displays-T-wave-changes-plus-a-history-of-anginal-chest-pain-without-serum-marker-abnormalities?

Question 21 (of 30)

 


CEN Review: May 2021: QR Challenge

https://www.classtools.net/QR/decode.php?text=Q22.-Of-the-following-labs,-if-elevated,-which-supports-the-diagnosis-of-congestive-heart-failure:-lactic-acid,-troponin,-B-type-natriuretic-peptide-(BNP),-or-creatine-kinase-(CK)?

Question 22 (of 30)

 


CEN Review: May 2021: QR Challenge

https://www.classtools.net/QR/decode.php?text=Q23.-In-right-ventricular-myocardial-infarction-(RVMI),-right-ventricular-dilation-and-decreased-contractility-lead-to-what-complication,-especially-in-if-nitrates-are-administered?

Question 23 (of 30)

 


CEN Review: May 2021: QR Challenge

https://www.classtools.net/QR/decode.php?text=Q24.-Which-medication-would-be-indicated-for-an-emergency-department-patient-with-a-plasma-digoxin-(Lanoxin)-level-of-5.2ng/mL?

Question 24 (of 30)

 


CEN Review: May 2021: QR Challenge

https://www.classtools.net/QR/decode.php?text=Q25.-A-patient-presents-with-a-chief-complaint-of-chest-palpitations-and-shortness-of-breath.-The-cardiac-monitor-displays-a-narrow-complex-rhythm-with-visible-P-waves-and-regular-R-to-R-intervals-at-a-a-rate-of-170-beats-per-minute.--What-is-the-cardiac-rhythm?

Question 25 (of 30)

 


CEN Review: May 2021: QR Challenge

https://www.classtools.net/QR/decode.php?text=Q26.-A-4-month-old-infant-presents-to-the-ED-for-irritability-and-poor-feeding.--The-infant-is-lethargic-and-has-circumoral-cyanosis.--Capillary-refill-is-4-to-5-seconds.--The-EKG-shows-a-regular,-narrow-complex-rhythm-with-a-rate-of-230-beats-per-minute.--Is-it-more-appropriate-to:-a.-insert-an-IO-needle-and-administer-adenosine-at-0.1mg/kg,-or-b.-estimate-the-infant’s-weight-using-a-length-based-system-and-perform-immediate-synchronized-cardioversion-at-0.5-joules/kg?

Question 26 (of 30)

 


CEN Review: May 2021: QR Challenge

https://www.classtools.net/QR/decode.php?text=Q27.-This-laboratory-test-is-used-to-evaluate-for-the-presence-of-clots-in-the-body;-if-it-is-negative-(level-is-within-normal-limits),-the-patient-is-not-suffering-from-a-pulmonary-embolism.

Question 27 (of 30)

 


CEN Review: May 2021: QR Challenge

https://www.classtools.net/QR/decode.php?text=Q28.-Will-heart-transplant-patients-experience-chest-pain-during-an-acute-myocardial-infarction?-Yes-or-no?

Question 28 (of 30)

 


CEN Review: May 2021: QR Challenge

https://www.classtools.net/QR/decode.php?text=Q29.-Transcutaneous-pacing-has-been-initiated-at-a-rate-of-70-bpeats-per-minute-for-a-patient-in-a-complete-heart-block.--The-nurse-notes-there-is-a-wide-complex-beat-after-each-pacer-spike.--How-does-the-nurse-know-that-the-patient-is-being-successfully-paced?

Question 29 (of 30)

 


CEN Review: May 2021: QR Challenge

https://www.classtools.net/QR/decode.php?text=Q30.-What-syndrome-is-characterized-by-a-shortened-PR-interval-and-widened-QRS-complex-with-a-delta-wave?

Question 30 (of 30)