← Scrub Notes · Reference library
Audited-content ledger
Audit status: preliminary — not commercially certified.
This register inventories the actual learning items and lists potential source references, rights, and clinical-review issues. A topical source match does not prove an item was individually checked against its linked source. Original replacement graphics are marked separately. There has not been a professional per-medication or per-rhythm clinical signoff.
Contents: 17 chapters; 102 knowledge checks; 180 exam questions; 96 flashcards; 24 replaced original diagrams; 300 pharmacology profiles; 22 interaction examples.
Questions and flashcards — item-by-item
All choices are checked for a four-option structure, duplicates, and high-risk wording. Clinical interpretation and provenance still require subject-matter review.
| ID | Chapter | Prompt | Expected answer | Reading sources | Screen flags |
|---|---|---|---|---|---|
| CHECK-resp-1-01 | resp-1 | A chest tube is placed for a pneumothorax. What is the tube intended to remove? | Air from the pleural space | OR-SK OR-ADV OR-RSP | No heuristic flags |
| CHECK-resp-1-02 | resp-1 | Continuous bubbling is observed in a chest drain's WATER-SEAL chamber. What should the nurse consider? | An ongoing air leak in the patient or drainage circuit | OR-SK OR-ADV OR-RSP | No heuristic flags |
| CHECK-resp-1-03 | resp-1 | A patient with a chest tube suddenly becomes hypotensive and severely dyspneic. What takes priority? | Assess ABCs and urgently escalate for possible tension physiology | OR-SK OR-ADV OR-RSP | No heuristic flags |
| CHECK-resp-1-04 | resp-1 | Which setup best supports effective chest drainage? | Keep the collection device upright below the insertion site | OR-SK OR-ADV OR-RSP | No heuristic flags |
| CHECK-resp-1-05 | resp-1 | A chest tube has suddenly drained brisk bright-red blood. What is the safest nursing response? | Reassess vitals and perfusion and notify the treating team urgently | OR-SK OR-ADV OR-RSP | No heuristic flags |
| CHECK-resp-1-06 | resp-1 | Why should a bubbling chest tube not be clamped routinely? | Trapped pleural air can cause tension pneumothorax | OR-SK OR-ADV OR-RSP | No heuristic flags |
| CHECK-resp-2-01 | resp-2 | An ABG shows pH 7.29, PaCO₂ 56, HCO₃⁻ 25. What is the primary disturbance? | Respiratory acidosis | OR-HA OR-RSP OR-ADV | No heuristic flags |
| CHECK-resp-2-02 | resp-2 | Which ABG variable best represents the metabolic BASE component? | HCO₃⁻ | OR-HA OR-RSP OR-ADV | No heuristic flags |
| CHECK-resp-2-03 | resp-2 | A patient on supplemental oxygen has a PaO₂ of 145 mmHg. What does this mean? | The oxygen tension can exceed 100 mmHg when FiO₂ is increased | OR-HA OR-RSP OR-ADV | No heuristic flags |
| CHECK-resp-2-04 | resp-2 | A patient has HCO₃⁻ 12 mEq/L during metabolic acidosis. Winter's formula predicts which PaCO₂ range? | About 24–28 mmHg | OR-HA OR-RSP OR-ADV | numerical-clinical-specificity-check |
| CHECK-resp-2-05 | resp-2 | Which statement about a near-normal pH with abnormal PaCO₂ and HCO₃⁻ is safest? | It may represent compensation OR a mixed disorder requiring further assessment | OR-HA OR-RSP OR-ADV | non-generic-legacy-wording |
| CHECK-resp-2-06 | resp-2 | Which equation calculates the anion gap WITHOUT potassium? | Na⁺ − (Cl⁻ + HCO₃⁻) | OR-HA OR-RSP OR-ADV | No heuristic flags |
| CHECK-resp-3-01 | resp-3 | After opioid exposure, a patient becomes somnolent and hypoventilates. Which primary acid–base problem is most likely? | Respiratory acidosis from CO₂ retention | OR-HA OR-ADV | No heuristic flags |
| CHECK-resp-3-02 | resp-3 | A patient with sudden tachypnea and perioral tingling has a low PaCO₂. What condition should be considered without assuming anxiety? | Respiratory alkalosis associated with causes such as PE or hypoxemia | OR-HA OR-ADV | No heuristic flags |
| CHECK-resp-3-03 | resp-3 | A patient with DKA has pH 7.24, HCO₃⁻ 12, and rapid deep breaths. Why is the respiratory rate elevated? | Compensation lowers PaCO₂ to offset metabolic acidosis | OR-HA OR-ADV | No heuristic flags |
| CHECK-resp-3-04 | resp-3 | After persistent vomiting and gastric suction, HCO₃⁻ rises to 36. What disorder best matches? | Metabolic alkalosis due to acid loss | OR-HA OR-ADV | No heuristic flags |
| CHECK-resp-3-05 | resp-3 | An ABG is pH 7.50, PaCO₂ 47, HCO₃⁻ 35. Which interpretation best fits the guide? | Metabolic alkalosis with respiratory compensation | OR-HA OR-ADV | non-generic-legacy-wording |
| CHECK-resp-3-06 | resp-3 | Which response is most appropriate to severe metabolic acidosis caused by shock? | Treat the cause and restore perfusion while monitoring ventilation and electrolytes | OR-HA OR-ADV | No heuristic flags |
| CHECK-resp-4-01 | resp-4 | Why can a large pulmonary embolism cause acute right-sided heart strain? | It blocks pulmonary vessels, raising right ventricular afterload | PE26 OR-HA | No heuristic flags |
| CHECK-resp-4-02 | resp-4 | A recently immobilized patient develops sudden pleuritic pain, dyspnea and tachycardia. What should the nurse do first? | Assess stability and promptly escalate suspected PE | PE26 OR-HA | No heuristic flags |
| CHECK-resp-4-03 | resp-4 | A low-probability patient has an appropriately selected NEGATIVE D-dimer test. How is the result generally used? | It can help exclude PE when paired with suitable pretest probability | PE26 OR-HA | No heuristic flags |
| CHECK-resp-4-04 | resp-4 | What imaging is commonly used to confirm PE when appropriate? | CT pulmonary angiography | PE26 OR-HA | No heuristic flags |
| CHECK-resp-4-05 | resp-4 | A patient with suspected high-risk PE becomes hypotensive and confused. Which priority is most appropriate? | Activate urgent response while supporting oxygenation and circulation | PE26 OR-HA | No heuristic flags |
| CHECK-resp-4-06 | resp-4 | A patient receiving heparin for PE needs monitoring. Which statement is accurate? | Use the ordered aPTT or anti-Xa protocol and monitor for bleeding | PE26 OR-HA | drug-guidance-check |
| CHECK-resp-5-01 | resp-5 | An ABG shows PaO₂ 54 mmHg on room air with pulmonary edema. What failure pattern is most directly suggested? | Type 1 hypoxemic respiratory failure | OR-RSP ATS-ARDS | No heuristic flags |
| CHECK-resp-5-02 | resp-5 | A COPD patient has pH 7.26 and PaCO₂ 68 with fatigue. Which dysfunction is central? | Inadequate alveolar ventilation causing hypercapnia | OR-RSP ATS-ARDS | No heuristic flags |
| CHECK-resp-5-03 | resp-5 | Which change is especially concerning in a struggling respiratory patient? | Increasing exhaustion and inability to protect the airway | OR-RSP ATS-ARDS | No heuristic flags |
| CHECK-resp-5-04 | resp-5 | Which oxygen strategy is commonly used initially for COPD patients at risk of CO₂ retention, pending ABGs? | Controlled oxygen with an SpO₂ target around 88–92% | OR-RSP ATS-ARDS | non-generic-legacy-wording, absolute-claim-check |
| CHECK-resp-5-05 | resp-5 | Pneumonia causes poor oxygen transfer, while opioid overdose causes hypoventilation. Which matching is correct? | Pneumonia commonly causes Type 1; opioid overdose commonly causes Type 2 | OR-RSP ATS-ARDS | No heuristic flags |
| CHECK-resp-5-06 | resp-5 | When choosing respiratory support for acute failure, what besides SpO₂ must be assessed? | Work of breathing, mental status, ventilation, and hemodynamics | OR-RSP ATS-ARDS | No heuristic flags |
| CHECK-resp-6-01 | resp-6 | A chest-drain patient develops sudden distress. Which first sequence is appropriate? | Assess ABCs, inspect the system, consider tension physiology, and escalate | OR-RSP PE26 OR-SK | No heuristic flags |
| CHECK-resp-6-02 | resp-6 | An ABG shows severe acidemia in an unstable ICU patient. Which associated issues need immediate assessment? | Ventilation, perfusion, cause, and electrolytes | OR-RSP PE26 OR-SK | No heuristic flags |
| CHECK-resp-6-03 | resp-6 | A suspected PE patient becomes hypotensive. What is the priority? | Activate emergency response and support breathing/circulation | OR-RSP PE26 OR-SK | No heuristic flags |
| CHECK-resp-6-04 | resp-6 | Chest tube output suddenly increases and becomes very bloody. What should be done? | Reassess vitals and hemodynamics and report the change promptly | OR-RSP PE26 OR-SK | No heuristic flags |
| CHECK-resp-6-05 | resp-6 | A patient has low PaO₂ despite oxygen equipment in place. Which assessment is most useful initially? | Confirm delivery equipment and evaluate lung/ventilation–perfusion problems | OR-RSP PE26 OR-SK | No heuristic flags |
| CHECK-resp-6-06 | resp-6 | What is the safest general priority when several monitor numbers are abnormal? | Address the immediately threatening airway, breathing, and perfusion issue first | OR-RSP PE26 OR-SK | No heuristic flags |
| CHECK-vent-1-01 | vent-1 | A patient develops stridor and facial swelling. Which ABCDE element requires immediate attention? | Airway patency | OR-ADV OR-SK | No heuristic flags |
| CHECK-vent-1-02 | vent-1 | A restless patient becomes severely fatigued while breathing rapidly. How should this trend be interpreted? | Possible respiratory deterioration requiring rapid reassessment | OR-ADV OR-SK | No heuristic flags |
| CHECK-vent-1-03 | vent-1 | SpO₂ is 98%, but the patient is cool and poorly perfused. What is the key distinction? | Blood oxygen saturation can look normal despite inadequate tissue perfusion | OR-ADV OR-SK | No heuristic flags |
| CHECK-vent-1-04 | vent-1 | What belongs in the Disability step of ABCDE? | Neurologic status and blood glucose | OR-ADV OR-SK | No heuristic flags |
| CHECK-vent-1-05 | vent-1 | What best defines a ventilation–perfusion mismatch? | Airflow and pulmonary blood flow are poorly matched | OR-ADV OR-SK | No heuristic flags |
| CHECK-vent-1-06 | vent-1 | What is the correct first principle when monitors disagree with the bedside appearance? | Assess the patient and verify airway, breathing and perfusion | OR-ADV OR-SK | No heuristic flags |
| CHECK-vent-2-01 | vent-2 | Which oxygen device is designed to deliver a controlled FiO₂ using a specified adapter? | Venturi mask | OR-ADV OR-RSP | No heuristic flags |
| CHECK-vent-2-02 | vent-2 | A non-rebreather is set to an appropriate high flow. Which statement is most accurate? | It provides high oxygen concentration but not a guaranteed 100% FiO₂ | OR-ADV OR-RSP | absolute-claim-check |
| CHECK-vent-2-03 | vent-2 | A patient fails conventional oxygen and becomes more somnolent with worsening work of breathing. What is the priority? | Urgent reassessment and escalation of respiratory support | OR-ADV OR-RSP | No heuristic flags |
| CHECK-vent-2-04 | vent-2 | What is the preferred ongoing bedside method to confirm a placed endotracheal tube remains tracheal? | Sustained waveform capnography with clinical reassessment | OR-ADV OR-RSP | No heuristic flags |
| CHECK-vent-2-05 | vent-2 | Why must a paralyzed intubated patient still receive appropriate sedation and analgesia? | Neuromuscular blockade prevents movement but does not relieve pain or ensure unconsciousness | OR-ADV OR-RSP | No heuristic flags |
| CHECK-vent-2-06 | vent-2 | Which ETT detail should the nurse trend after repositioning? | Depth marking at lips/teeth and bilateral chest movement | OR-ADV OR-RSP | No heuristic flags |
| CHECK-vent-3-01 | vent-3 | A ventilator's PEEP setting is increased. What is the intended oxygenation benefit? | Improved alveolar recruitment at end expiration | ATS-ARDS OR-ADV | No heuristic flags |
| CHECK-vent-3-02 | vent-3 | A patient becomes hypotensive after a large increase in positive-pressure support. What mechanism may explain this? | Higher intrathoracic pressure reduces venous return and cardiac output | ATS-ARDS OR-ADV | No heuristic flags |
| CHECK-vent-3-03 | vent-3 | A ventilator displays a new HIGH airway pressure alarm. What problem should be assessed? | Kinked tubing, secretions, biting, or reduced compliance | ATS-ARDS OR-ADV | No heuristic flags |
| CHECK-vent-3-04 | vent-3 | A LOW-pressure/low-volume alarm occurs. What is a likely initial cause to check? | Disconnected circuit, leak or cuff problem | ATS-ARDS OR-ADV | No heuristic flags |
| CHECK-vent-3-05 | vent-3 | Which statement distinguishes Assist-Control (AC) from SIMV? | AC supports mandatory breaths triggered by time or patient; SIMV schedules mandatory breaths with spontaneous breaths between | ATS-ARDS OR-ADV | No heuristic flags |
| CHECK-vent-3-06 | vent-3 | For lung-protective ventilation, tidal volume is commonly calculated using which weight? | Predicted body weight, often around 4–8 mL/kg depending on context | ATS-ARDS OR-ADV | numerical-clinical-specificity-check |
| CHECK-vent-4-01 | vent-4 | During an SBT, a patient develops increasing work of breathing and obvious respiratory fatigue. What does this indicate? | SBT intolerance requiring reassessment | AARC24 OR-ADV | No heuristic flags |
| CHECK-vent-4-02 | vent-4 | Which group of findings supports SBT TOLERANCE? | Comfortable breathing, stable vitals, acceptable oxygenation, and mentation | AARC24 OR-ADV | No heuristic flags |
| CHECK-vent-4-03 | vent-4 | During a trial, respiratory rate rises sharply and tidal volume falls. What is the best interpretation? | The patient may be tiring and failing the trial | AARC24 OR-ADV | No heuristic flags |
| CHECK-vent-4-04 | vent-4 | A patient maintains SpO₂ 96% during an SBT but is unable to cough or clear secretions. What is the key concern? | Adequate oxygenation alone does not establish safe extubation readiness | AARC24 OR-ADV | No heuristic flags |
| CHECK-vent-4-05 | vent-4 | Why are spontaneous awakening and breathing trials considered together in liberation planning? | Sedation level can obscure respiratory drive and readiness; both require assessment | AARC24 OR-ADV | No heuristic flags |
| CHECK-vent-4-06 | vent-4 | Which development during an SBT calls for closer evaluation rather than automatic extubation? | New hemodynamic instability or arrhythmia | AARC24 OR-ADV | No heuristic flags |
| CHECK-vent-5-01 | vent-5 | What is the approximate MAP for a blood pressure of 90/60 mmHg? | 70 mmHg | OR-ADV OR-SK | No heuristic flags |
| CHECK-vent-5-02 | vent-5 | An arterial line waveform becomes damped after the transducer is moved. What should be checked? | Leveling/zeroing, air, clot, tubing and waveform quality | OR-ADV OR-SK | No heuristic flags |
| CHECK-vent-5-03 | vent-5 | What event creates the dicrotic notch in an arterial pressure waveform? | Aortic valve closure | OR-ADV OR-SK | No heuristic flags |
| CHECK-vent-5-04 | vent-5 | Why isn't one CVP value a reliable standalone measure of fluid responsiveness? | CVP is influenced by right-heart function and intrathoracic pressure, not simply preload need | OR-ADV OR-SK | No heuristic flags |
| CHECK-vent-5-05 | vent-5 | A patient with shock has MAP near 65, but urine output falls and mentation worsens. What should the nurse recognize? | Perfusion may still be inadequate despite one acceptable MAP | OR-ADV OR-SK | No heuristic flags |
| CHECK-vent-5-06 | vent-5 | Why might a pulmonary artery catheter be used in selected complex shock cases? | To measure advanced right-sided and pulmonary pressures and cardiac output | OR-ADV OR-SK | No heuristic flags |
| CHECK-vent-6-01 | vent-6 | Which bundled actions help lower ventilator-associated pneumonia risk? | Head elevation when feasible, oral hygiene, aspiration precautions, and liberation readiness | OR-SK OR-ADV AHA25 | No heuristic flags |
| CHECK-vent-6-02 | vent-6 | A critically ill patient's urine output is 0.4 mL/kg/h for six hours. What is the concern? | It meets a commonly used urine-output criterion for possible AKI | OR-SK OR-ADV AHA25 | numerical-clinical-specificity-check |
| CHECK-vent-6-03 | vent-6 | An ICU patient becomes disoriented after poor sleep and escalating sedatives. What prevention strategy fits the guide? | Review pain, medications, sleep, orientation and mobility | OR-SK OR-ADV AHA25 | non-generic-legacy-wording |
| CHECK-vent-6-04 | vent-6 | During an arrest, the team leader requests epinephrine. Which communication demonstrates closed-loop practice? | The nurse repeats the order and confirms when it is completed | OR-SK OR-ADV AHA25 | No heuristic flags |
| CHECK-vent-6-05 | vent-6 | A patient has SpO₂ 97% but rising lactate, cool skin, and confusion. What is the main concern? | Inadequate tissue perfusion or oxygen delivery despite acceptable saturation | OR-SK OR-ADV AHA25 | No heuristic flags |
| CHECK-vent-6-06 | vent-6 | What is an appropriate prevention priority for an immobile critically ill patient? | Assess VTE prevention and skin protection while promoting safe mobility | OR-SK OR-ADV AHA25 | non-generic-legacy-wording |
| CHECK-ecg-1-01 | ecg-1 | On a normal ECG, what electrical event is represented by the P wave? | Atrial depolarization | OR-HA AHA25 | No heuristic flags |
| CHECK-ecg-1-02 | ecg-1 | A six-second strip contains eight QRS complexes. What is the estimated rate? | 80 beats/min | OR-HA AHA25 | No heuristic flags |
| CHECK-ecg-1-03 | ecg-1 | At paper speed 25 mm/s, one SMALL box represents how much time? | 0.04 seconds | OR-HA AHA25 | No heuristic flags |
| CHECK-ecg-1-04 | ecg-1 | What PR interval is typically within the adult reference range? | 0.12–0.20 seconds | OR-HA AHA25 | No heuristic flags |
| CHECK-ecg-1-05 | ecg-1 | A wide, fast QRS rhythm appears while the patient is unstable. What is the safest interpretation strategy? | Consider ventricular tachycardia until expertly assessed while checking pulse/perfusion | OR-HA AHA25 | non-generic-legacy-wording |
| CHECK-ecg-1-06 | ecg-1 | The ECG monitor shows organized complexes, but the patient has no pulse. What does this prove? | Electrical complexes do not guarantee mechanical cardiac output | OR-HA AHA25 | absolute-claim-check |
| CHECK-ecg-2-01 | ecg-2 | A rhythm is regular at 125 bpm with a consistent P before each narrow QRS. What is it? | Sinus tachycardia | AHA25 OR-HA | No heuristic flags |
| CHECK-ecg-2-02 | ecg-2 | A stable patient has a sudden-onset regular narrow tachycardia with P waves obscured. What is an appropriate initial rhythm-specific approach? | Vagal maneuvers, then adenosine when indicated | AHA25 OR-HA | drug-guidance-check |
| CHECK-ecg-2-03 | ecg-2 | The rhythm is irregularly irregular with no identifiable consistent P waves. What does this suggest? | Atrial fibrillation | AHA25 OR-HA | No heuristic flags |
| CHECK-ecg-2-04 | ecg-2 | A tracing has organized sawtooth atrial activity. What is the most likely rhythm? | Atrial flutter | AHA25 OR-HA | No heuristic flags |
| CHECK-ecg-2-05 | ecg-2 | An early narrow QRS is preceded by a different-shaped P wave. What is the best identification? | Premature atrial contraction (PAC) | AHA25 OR-HA | No heuristic flags |
| CHECK-ecg-2-06 | ecg-2 | What clinical consideration matters before cardioversion for atrial fibrillation? | Onset/duration, anticoagulation and hemodynamic urgency | AHA25 OR-HA | No heuristic flags |
| CHECK-ecg-3-01 | ecg-3 | A wide early beat has no related preceding P and is followed by a pause. Which rhythm feature is present? | Premature ventricular complex (PVC) | AHA25 OR-HA | No heuristic flags |
| CHECK-ecg-3-02 | ecg-3 | A patient has monomorphic VT with a pulse but hypotension and altered mental status. Which response is appropriate? | Urgent synchronized cardioversion | AHA25 OR-HA | No heuristic flags |
| CHECK-ecg-3-03 | ecg-3 | A patient has VF on the monitor and no pulse. What takes priority? | High-quality CPR and rapid defibrillation | AHA25 OR-HA | No heuristic flags |
| CHECK-ecg-3-04 | ecg-3 | The monitor shows organized complexes but the patient has no pulse. What is the correct classification and action? | PEA: CPR, epinephrine, and reversible-cause assessment | AHA25 OR-HA | No heuristic flags |
| CHECK-ecg-3-05 | ecg-3 | Which feature most specifically supports torsades de pointes? | Polymorphic VT associated with prolonged QT | AHA25 OR-HA | drug-guidance-check |
| CHECK-ecg-3-06 | ecg-3 | When is a shock unsynchronized rather than R-wave synchronized? | VF, pulseless VT, or unstable sustained polymorphic VT | AHA25 OR-HA | No heuristic flags |
| CHECK-ecg-4-01 | ecg-4 | Each P wave leads to a QRS, but PR is consistently 0.26 seconds. What conduction pattern is present? | First-degree AV block | AHA25 OR-HA | No heuristic flags |
| CHECK-ecg-4-02 | ecg-4 | The PR interval gets progressively longer until a P wave is not followed by a QRS. What is this? | Second-degree AV block, Mobitz I | AHA25 OR-HA | No heuristic flags |
| CHECK-ecg-4-03 | ecg-4 | A rhythm has identical PR intervals on conducted beats, then an on-time P wave fails to conduct. What is it? | Second-degree AV block, Mobitz II | AHA25 OR-HA | No heuristic flags |
| CHECK-ecg-4-04 | ecg-4 | P waves and QRS complexes march independently at separate regular rates. What does this demonstrate? | Third-degree AV block (AV dissociation) | AHA25 OR-HA | No heuristic flags |
| CHECK-ecg-4-05 | ecg-4 | Why is Mobitz II usually more urgent than first-degree AV block? | It can progress abruptly to high-grade or complete block and may need pacing | AHA25 OR-HA | No heuristic flags |
| CHECK-ecg-4-06 | ecg-4 | A 2:1 AV block shows every second P wave blocked. What interpretation caution applies? | It may not be possible to distinguish Mobitz I from II using that strip alone | AHA25 OR-HA | absolute-claim-check |
| CHECK-ecg-5-01 | ecg-5 | Pacing spikes are visible, but some ventricular spikes are NOT followed by QRS complexes. What malfunction is suspected? | Failure to capture | AHA25 OR-PH | No heuristic flags |
| CHECK-ecg-5-02 | ecg-5 | A pacing device should fire during a prolonged pause, but no spike appears. What problem is suggested? | Failure to output (failure to pace) | AHA25 OR-PH | No heuristic flags |
| CHECK-ecg-5-03 | ecg-5 | Pacing spikes appear despite well-timed intrinsic beats, sometimes near their QRS or T waves. Which malfunction is suspected? | Failure to sense (undersensing) | AHA25 OR-PH | No heuristic flags |
| CHECK-ecg-5-04 | ecg-5 | Which change is commonly associated with severe hyperkalemia? | Peaked T waves with possible PR prolongation and QRS widening | AHA25 OR-PH | No heuristic flags |
| CHECK-ecg-5-05 | ecg-5 | A patient has prolonged QT and torsades risk in the setting of low magnesium. Which treatment principle belongs in the guide? | Magnesium sulfate and correction of contributing electrolytes/causes | AHA25 OR-PH | non-generic-legacy-wording, drug-guidance-check |
| CHECK-ecg-5-06 | ecg-5 | IV calcium is ordered for severe hyperkalemia with ECG changes. What is its primary immediate purpose? | Stabilize cardiac membranes, not directly lower serum potassium | AHA25 OR-PH | drug-guidance-check |
| EXAM-1-01 | vent-4 | During an SBT, a patient develops increasing work of breathing and obvious respiratory fatigue. What does this indicate? | SBT intolerance requiring reassessment | AARC24 OR-ADV | No heuristic flags |
| EXAM-1-02 | vent-6 | How should vascular access infection risk be reduced? | Aseptic line care and removing unnecessary devices | OR-SK OR-ADV AHA25 | No heuristic flags |
| EXAM-1-03 | ecg-2 | For junctional rhythm, which reversible contributor should be evaluated? | Digoxin toxicity or myocardial ischemia | AHA25 OR-HA | No heuristic flags |
| EXAM-1-04 | vent-6 | What reduces ICU delirium risk in supportive care? | Address pain, sleep, orientation, medication burden and mobility | OR-SK OR-ADV AHA25 | No heuristic flags |
| EXAM-1-05 | vent-5 | What complication must be considered with PA catheter use? | Dysrhythmia, infection, thrombosis or PA injury | OR-ADV OR-SK | No heuristic flags |
| EXAM-1-06 | resp-1 | A chest tube is placed for a pneumothorax. What is the tube intended to remove? | Air from the pleural space | OR-SK OR-ADV OR-RSP | No heuristic flags |
| EXAM-1-07 | resp-1 | Which pleural problem requires emergency decompression when tension physiology develops? | Trapped pleural air under pressure | OR-SK OR-ADV OR-RSP | No heuristic flags |
| EXAM-1-08 | resp-4 | Why can a PE increase right ventricular strain? | It obstructs pulmonary arterial flow | PE26 OR-HA | No heuristic flags |
| EXAM-1-09 | resp-5 | An ABG shows PaO₂ 54 mmHg on room air with pulmonary edema. What failure pattern is most directly suggested? | Type 1 hypoxemic respiratory failure | OR-RSP ATS-ARDS | No heuristic flags |
| EXAM-1-10 | resp-1 | Which bedside finding after chest tube placement merits urgent escalation? | New respiratory distress and crepitus | OR-SK OR-ADV OR-RSP | No heuristic flags |
| EXAM-1-11 | ecg-4 | What does 2:1 AV conduction prevent in some cases? | Reliable subtyping as Mobitz I versus II from strip alone | AHA25 OR-HA | No heuristic flags |
| EXAM-1-12 | vent-1 | What does the C in ABCDE include? | Pulse, BP, skin perfusion, mentation and urine output | OR-ADV OR-SK | No heuristic flags |
| EXAM-1-13 | vent-2 | Which oxygen device is designed to deliver a controlled FiO₂ using a specified adapter? | Venturi mask | OR-ADV OR-RSP | No heuristic flags |
| EXAM-1-14 | resp-4 | Which symptom cluster raises concern for PE? | Sudden dyspnea and pleuritic chest pain | PE26 OR-HA | No heuristic flags |
| EXAM-1-15 | ecg-1 | What must be assessed before acting on an ECG finding? | Pulse and patient perfusion/stability | OR-HA AHA25 | No heuristic flags |
| EXAM-1-16 | vent-2 | A non-rebreather is set to an appropriate high flow. Which statement is most accurate? | It provides high oxygen concentration but not a guaranteed 100% FiO₂ | OR-ADV OR-RSP | absolute-claim-check |
| EXAM-1-17 | vent-4 | Which group of findings supports SBT TOLERANCE? | Comfortable breathing, stable vitals, acceptable oxygenation, and mentation | AARC24 OR-ADV | No heuristic flags |
| EXAM-1-18 | vent-3 | A ventilator's PEEP setting is increased. What is the intended oxygenation benefit? | Improved alveolar recruitment at end expiration | ATS-ARDS OR-ADV | No heuristic flags |
| EXAM-1-19 | vent-1 | Which sign can be an early indicator of critical respiratory deterioration? | Restlessness and tachypnea | OR-ADV OR-SK | No heuristic flags |
| EXAM-1-20 | ecg-5 | What ECG finding is associated with hyperkalemia? | Peaked T waves and possible QRS widening | AHA25 OR-PH | No heuristic flags |
| EXAM-1-21 | resp-5 | Which finding indicates worsening respiratory failure and urgent escalation? | Unable to protect airway or worsening consciousness | OR-RSP ATS-ARDS | No heuristic flags |
| EXAM-1-22 | resp-2 | An ABG shows pH 7.29, PaCO₂ 56, HCO₃⁻ 25. What is the primary disturbance? | Respiratory acidosis | OR-HA OR-RSP OR-ADV | No heuristic flags |
| EXAM-1-23 | ecg-1 | On a normal ECG, what electrical event is represented by the P wave? | Atrial depolarization | OR-HA AHA25 | No heuristic flags |
| EXAM-1-24 | ecg-3 | What is first priority for VF arrest? | Immediate CPR and defibrillation | AHA25 OR-HA | No heuristic flags |
| EXAM-1-25 | resp-2 | Which ABG variable best represents the metabolic BASE component? | HCO₃⁻ | OR-HA OR-RSP OR-ADV | No heuristic flags |
| EXAM-1-26 | ecg-5 | Pacing spikes are visible, but some ventricular spikes are NOT followed by QRS complexes. What malfunction is suspected? | Failure to capture | AHA25 OR-PH | No heuristic flags |
| EXAM-1-27 | vent-2 | A patient fails conventional oxygen and becomes more somnolent with worsening work of breathing. What is the priority? | Urgent reassessment and escalation of respiratory support | OR-ADV OR-RSP | No heuristic flags |
| EXAM-1-28 | resp-4 | How is a warfarin effect generally monitored? | INR | PE26 OR-HA | No heuristic flags |
| EXAM-1-29 | vent-5 | What can cause a damped arterial pressure waveform? | Air bubbles, clot, or line mechanics | OR-ADV OR-SK | No heuristic flags |
| EXAM-1-30 | ecg-5 | How does hypercalcemia often affect QT? | Shortens QT | AHA25 OR-PH | drug-guidance-check |
| EXAM-1-31 | vent-6 | Which bundled actions help lower ventilator-associated pneumonia risk? | Head elevation when feasible, oral hygiene, aspiration precautions, and liberation readiness | OR-SK OR-ADV AHA25 | No heuristic flags |
| EXAM-1-32 | ecg-2 | Which rhythm has sawtooth F waves? | Atrial flutter | AHA25 OR-HA | No heuristic flags |
| EXAM-1-33 | resp-1 | Continuous bubbling is observed in a chest drain's WATER-SEAL chamber. What should the nurse consider? | An ongoing air leak in the patient or drainage circuit | OR-SK OR-ADV OR-RSP | No heuristic flags |
| EXAM-1-34 | ecg-4 | Which AV block often needs no intervention when stable? | First-degree AV block | AHA25 OR-HA | No heuristic flags |
| EXAM-1-35 | vent-3 | A patient becomes hypotensive after a large increase in positive-pressure support. What mechanism may explain this? | Higher intrathoracic pressure reduces venous return and cardiac output | ATS-ARDS OR-ADV | No heuristic flags |
| EXAM-1-36 | vent-3 | A ventilator displays a new HIGH airway pressure alarm. What problem should be assessed? | Kinked tubing, secretions, biting, or reduced compliance | ATS-ARDS OR-ADV | No heuristic flags |
| EXAM-1-37 | vent-1 | In the ABCDE assessment, what does D represent? | Disability: neurologic status and glucose | OR-ADV OR-SK | No heuristic flags |
| EXAM-1-38 | ecg-1 | A six-second strip contains eight QRS complexes. What is the estimated rate? | 80 beats/min | OR-HA AHA25 | No heuristic flags |
| EXAM-1-39 | ecg-3 | What is correct for asystole? | Verify rhythm/leads, begin CPR and epinephrine, do not shock | AHA25 OR-HA | No heuristic flags |
| EXAM-1-40 | ecg-2 | What treatment is needed for a hemodynamically stable normal sinus rhythm? | No rhythm-specific treatment | AHA25 OR-HA | No heuristic flags |
| EXAM-1-41 | ecg-5 | A pacing device should fire during a prolonged pause, but no spike appears. What problem is suggested? | Failure to output (failure to pace) | AHA25 OR-PH | No heuristic flags |
| EXAM-1-42 | ecg-4 | What is first-degree AV block? | Every P conducts but PR is greater than 0.20 s | AHA25 OR-HA | No heuristic flags |
| EXAM-1-43 | vent-5 | Which target is commonly used as a starting MAP goal in shock, subject to individualization? | About 65 mmHg | OR-ADV OR-SK | No heuristic flags |
| EXAM-1-44 | vent-1 | What is a later concerning sign of respiratory deterioration? | Exhaustion and decreased consciousness | OR-ADV OR-SK | No heuristic flags |
| EXAM-1-45 | resp-6 | A chest-drain patient develops sudden distress. Which first sequence is appropriate? | Assess ABCs, inspect the system, consider tension physiology, and escalate | OR-RSP PE26 OR-SK | No heuristic flags |
| EXAM-1-46 | resp-3 | After opioid exposure, a patient becomes somnolent and hypoventilates. Which primary acid–base problem is most likely? | Respiratory acidosis from CO₂ retention | OR-HA OR-ADV | No heuristic flags |
| EXAM-1-47 | resp-4 | Which imaging study commonly confirms PE when appropriate? | CT pulmonary angiography | PE26 OR-HA | No heuristic flags |
| EXAM-1-48 | ecg-3 | What electrolyte issue is linked to torsades? | Low magnesium, often low potassium | AHA25 OR-HA | drug-guidance-check |
| EXAM-1-49 | vent-4 | During a trial, respiratory rate rises sharply and tidal volume falls. What is the best interpretation? | The patient may be tiring and failing the trial | AARC24 OR-ADV | No heuristic flags |
| EXAM-1-50 | ecg-3 | What defines a PVC? | Premature wide QRS without a related preceding P | AHA25 OR-HA | No heuristic flags |
| EXAM-1-51 | resp-6 | A low PaO₂ persists despite indicated oxygen support. What do you assess? | Oxygen delivery and pulmonary/VQ causes | OR-RSP PE26 OR-SK | No heuristic flags |
| EXAM-1-52 | vent-4 | A patient maintains SpO₂ 96% during an SBT but is unable to cough or clear secretions. What is the key concern? | Adequate oxygenation alone does not establish safe extubation readiness | AARC24 OR-ADV | No heuristic flags |
| EXAM-1-53 | ecg-2 | Which concern guides decisions about anticoagulation in atrial fibrillation? | Stroke risk | AHA25 OR-HA | non-generic-legacy-wording |
| EXAM-1-54 | resp-3 | A patient with sudden tachypnea and perioral tingling has a low PaCO₂. What condition should be considered without assuming anxiety? | Respiratory alkalosis associated with causes such as PE or hypoxemia | OR-HA OR-ADV | No heuristic flags |
| EXAM-1-55 | ecg-1 | What is the usual SA-node intrinsic rate range? | 60–100 bpm | OR-HA AHA25 | non-generic-legacy-wording |
| EXAM-1-56 | resp-5 | A COPD patient has pH 7.26 and PaCO₂ 68 with fatigue. Which dysfunction is central? | Inadequate alveolar ventilation causing hypercapnia | OR-RSP ATS-ARDS | No heuristic flags |
| EXAM-1-57 | ecg-4 | How are atrial and ventricular rhythms related in complete heart block? | They beat independently | AHA25 OR-HA | No heuristic flags |
| EXAM-1-58 | resp-2 | What is the expected PaCO₂ for HCO₃⁻ = 12 using Winter’s formula? | About 26 mmHg (±2) | OR-HA OR-RSP OR-ADV | No heuristic flags |
| EXAM-1-59 | resp-6 | An ABG shows severe acidemia in an unstable ICU patient. Which associated issues need immediate assessment? | Ventilation, perfusion, cause, and electrolytes | OR-RSP PE26 OR-SK | No heuristic flags |
| EXAM-1-60 | resp-3 | A patient with DKA has pH 7.24, HCO₃⁻ 12, and rapid deep breaths. Why is the respiratory rate elevated? | Compensation lowers PaCO₂ to offset metabolic acidosis | OR-HA OR-ADV | No heuristic flags |
| EXAM-2-01 | vent-4 | What neurologic finding may make extubation unsafe? | Inability to protect the airway | AARC24 OR-ADV | No heuristic flags |
| EXAM-2-02 | resp-2 | A patient on supplemental oxygen has a PaO₂ of 145 mmHg. What does this mean? | The oxygen tension can exceed 100 mmHg when FiO₂ is increased | OR-HA OR-RSP OR-ADV | No heuristic flags |
| EXAM-2-03 | ecg-3 | Which intervention is needed for pulseless monomorphic VT? | CPR and defibrillation | AHA25 OR-HA | No heuristic flags |
| EXAM-2-04 | resp-2 | A patient has HCO₃⁻ 12 mEq/L during metabolic acidosis. Winter's formula predicts which PaCO₂ range? | About 24–28 mmHg | OR-HA OR-RSP OR-ADV | numerical-clinical-specificity-check |
| EXAM-2-05 | ecg-1 | At paper speed 25 mm/s, one SMALL box represents how much time? | 0.04 seconds | OR-HA AHA25 | No heuristic flags |
| EXAM-2-06 | ecg-5 | Pacing spikes appear despite well-timed intrinsic beats, sometimes near their QRS or T waves. Which malfunction is suspected? | Failure to sense (undersensing) | AHA25 OR-PH | No heuristic flags |
| EXAM-2-07 | vent-3 | Which variable best indicates the minimum mandatory breaths set by the ventilator? | Set respiratory rate | ATS-ARDS OR-ADV | No heuristic flags |
| EXAM-2-08 | vent-2 | Why might sustained capnography suddenly disappear after intubation? | Displacement or airway/circuit failure warrants urgent evaluation | OR-ADV OR-RSP | No heuristic flags |
| EXAM-2-09 | ecg-2 | Which treatment principle applies to sinus tachycardia? | Treat fever, hypovolemia, pain or other cause | AHA25 OR-HA | No heuristic flags |
| EXAM-2-10 | resp-3 | After persistent vomiting and gastric suction, HCO₃⁻ rises to 36. What disorder best matches? | Metabolic alkalosis due to acid loss | OR-HA OR-ADV | No heuristic flags |
| EXAM-2-11 | ecg-2 | How does sinus tachycardia differ from many SVTs? | Sinus P waves precede QRS and a cause may be present | AHA25 OR-HA | No heuristic flags |
| EXAM-2-12 | ecg-2 | What is the first stable regular narrow SVT intervention to consider? | Vagal maneuvers and adenosine when appropriate | AHA25 OR-HA | drug-guidance-check |
| EXAM-2-13 | vent-3 | A LOW-pressure/low-volume alarm occurs. What is a likely initial cause to check? | Disconnected circuit, leak or cuff problem | ATS-ARDS OR-ADV | No heuristic flags |
| EXAM-2-14 | resp-3 | An ABG is pH 7.50, PaCO₂ 47, HCO₃⁻ 35. Which interpretation best fits the guide? | Metabolic alkalosis with respiratory compensation | OR-HA OR-ADV | non-generic-legacy-wording |
| EXAM-2-15 | resp-4 | Which condition is a risk factor for pulmonary embolism? | Recent surgery with immobility | PE26 OR-HA | No heuristic flags |
| EXAM-2-16 | vent-6 | Which data support assessment of kidney injury? | Urine output, creatinine, fluid balance and perfusion | OR-SK OR-ADV AHA25 | No heuristic flags |
| EXAM-2-17 | vent-6 | Which nutrient route is generally preferred when feasible in critical care? | Enteral nutrition | OR-SK OR-ADV AHA25 | No heuristic flags |
| EXAM-2-18 | ecg-3 | Which antiarrhythmic may be considered for shock-refractory VF/pulseless VT per algorithm? | Amiodarone or lidocaine | AHA25 OR-HA | drug-guidance-check |
| EXAM-2-19 | vent-5 | Why evaluate lactate and urine output alongside MAP? | They add information about organ perfusion | OR-ADV OR-SK | No heuristic flags |
| EXAM-2-20 | resp-1 | A patient with a chest tube suddenly becomes hypotensive and severely dyspneic. What takes priority? | Assess ABCs and urgently escalate for possible tension physiology | OR-SK OR-ADV OR-RSP | No heuristic flags |
| EXAM-2-21 | resp-6 | A suspected PE patient becomes hypotensive. What is the priority? | Activate emergency response and support breathing/circulation | OR-RSP PE26 OR-SK | No heuristic flags |
| EXAM-2-22 | resp-6 | Chest tube output suddenly increases and becomes very bloody. What should be done? | Reassess vitals and hemodynamics and report the change promptly | OR-RSP PE26 OR-SK | No heuristic flags |
| EXAM-2-23 | ecg-1 | What does the QRS complex represent? | Ventricular depolarization | OR-HA AHA25 | No heuristic flags |
| EXAM-2-24 | vent-2 | What is the preferred ongoing bedside method to confirm a placed endotracheal tube remains tracheal? | Sustained waveform capnography with clinical reassessment | OR-ADV OR-RSP | No heuristic flags |
| EXAM-2-25 | vent-4 | Can an SBT be performed with some pressure support? | Yes, standardized approaches can use support or not | AARC24 OR-ADV | non-generic-legacy-wording |
| EXAM-2-26 | ecg-5 | Which reversible arrest cause belongs to the Hs and Ts? | Tension pneumothorax | AHA25 OR-PH | No heuristic flags |
| EXAM-2-27 | resp-3 | What is the key initial treatment principle for metabolic acidosis? | Identify and address its cause | OR-HA OR-ADV | No heuristic flags |
| EXAM-2-28 | resp-2 | Which statement about a near-normal pH with abnormal PaCO₂ and HCO₃⁻ is safest? | It may represent compensation OR a mixed disorder requiring further assessment | OR-HA OR-RSP OR-ADV | non-generic-legacy-wording |
| EXAM-2-29 | ecg-5 | Which change is commonly associated with severe hyperkalemia? | Peaked T waves with possible PR prolongation and QRS widening | AHA25 OR-PH | No heuristic flags |
| EXAM-2-30 | resp-5 | Which factor may cause hypercapnic respiratory failure? | Opioid-associated hypoventilation | OR-RSP ATS-ARDS | No heuristic flags |
| EXAM-2-31 | resp-5 | Which change distinguishes hypercapnic from hypoxemic failure? | High PaCO₂ versus primarily low PaO₂ | OR-RSP ATS-ARDS | No heuristic flags |
| EXAM-2-32 | resp-2 | Which equation calculates the anion gap WITHOUT potassium? | Na⁺ − (Cl⁻ + HCO₃⁻) | OR-HA OR-RSP OR-ADV | No heuristic flags |
| EXAM-2-33 | vent-5 | What must be checked with an arterial-line transducer? | Leveling, zeroing, and waveform quality | OR-ADV OR-SK | No heuristic flags |
| EXAM-2-34 | vent-5 | Which parameter does CVP approximate? | Right atrial pressure | OR-ADV OR-SK | No heuristic flags |
| EXAM-2-35 | vent-1 | What is the distinction between oxygenation and perfusion? | Oxygenation loads blood with O₂; perfusion delivers it to tissue | OR-ADV OR-SK | absolute-claim-check |
| EXAM-2-36 | ecg-4 | What defines third-degree block? | Independent P and QRS rhythms without fixed PR | AHA25 OR-HA | No heuristic flags |
| EXAM-2-37 | resp-6 | A patient develops severe respiratory distress with a chest drain. What first? | Assess ABCs and check drain/system while escalating | OR-RSP PE26 OR-SK | No heuristic flags |
| EXAM-2-38 | resp-4 | What can a positive D-dimer alone establish? | It does not diagnose PE | PE26 OR-HA | No heuristic flags |
| EXAM-2-39 | vent-2 | Which statement about neuromuscular blockade is correct? | Paralysis never replaces sedation | OR-ADV OR-RSP | absolute-claim-check |
| EXAM-2-40 | ecg-5 | A patient has prolonged QT and torsades risk in the setting of low magnesium. Which treatment principle belongs in the guide? | Magnesium sulfate and correction of contributing electrolytes/causes | AHA25 OR-PH | non-generic-legacy-wording, drug-guidance-check |
| EXAM-2-41 | resp-5 | How should respiratory failure treatment be selected? | Support oxygenation or ventilation according to the mechanism | OR-RSP ATS-ARDS | No heuristic flags |
| EXAM-2-42 | ecg-1 | At 25 mm/s, what does one small ECG square represent? | 0.04 seconds | OR-HA AHA25 | No heuristic flags |
| EXAM-2-43 | resp-5 | In some COPD patients at risk of CO₂ retention, what usual initial SpO₂ target is described? | 88–92% pending ABG assessment | OR-RSP ATS-ARDS | No heuristic flags |
| EXAM-2-44 | resp-4 | Which treatment is standard for most confirmed PE if bleeding risk allows? | Anticoagulation | PE26 OR-HA | No heuristic flags |
| EXAM-2-45 | vent-3 | Which problem may cause a high-pressure ventilator alarm? | Kinked tube or thick secretions | ATS-ARDS OR-ADV | No heuristic flags |
| EXAM-2-46 | resp-1 | Which setup best supports effective chest drainage? | Keep the collection device upright below the insertion site | OR-SK OR-ADV OR-RSP | No heuristic flags |
| EXAM-2-47 | vent-1 | Why might normal SpO₂ coexist with shock? | Cardiac output and tissue delivery can still be inadequate | OR-ADV OR-SK | No heuristic flags |
| EXAM-2-48 | ecg-4 | What should be checked first when block is associated with symptoms? | Perfusion and hemodynamic compromise | AHA25 OR-HA | No heuristic flags |
| EXAM-2-49 | ecg-4 | Why might atropine be ineffective in complete heart block? | Block can be infranodal, requiring pacing | AHA25 OR-HA | drug-guidance-check |
| EXAM-2-50 | ecg-3 | Which condition calls for unsynchronized defibrillation rather than synchronized cardioversion? | Unstable sustained polymorphic VT | AHA25 OR-HA | No heuristic flags |
| EXAM-2-51 | vent-4 | Why are spontaneous awakening and breathing trials considered together in liberation planning? | Sedation level can obscure respiratory drive and readiness; both require assessment | AARC24 OR-ADV | No heuristic flags |
| EXAM-2-52 | ecg-4 | When Mobitz II is suspected, what should be prepared? | Urgent pacing readiness and evaluation | AHA25 OR-HA | No heuristic flags |
| EXAM-2-53 | ecg-3 | What treatment is used for unstable monomorphic VT with a pulse? | Synchronized cardioversion | AHA25 OR-HA | No heuristic flags |
| EXAM-2-54 | ecg-2 | What defines atrial fibrillation on ECG? | Irregularly irregular R–R and no consistent P | AHA25 OR-HA | No heuristic flags |
| EXAM-2-55 | ecg-1 | What PR interval is typically within the adult reference range? | 0.12–0.20 seconds | OR-HA AHA25 | No heuristic flags |
| EXAM-2-56 | vent-1 | What is hypoxemia? | Low oxygen in arterial blood | OR-ADV OR-SK | No heuristic flags |
| EXAM-2-57 | vent-5 | What can a pulmonary artery catheter measure in selected cases? | PA pressures, wedge pressure and cardiac output | OR-ADV OR-SK | No heuristic flags |
| EXAM-2-58 | vent-2 | What should be documented about endotracheal tube position? | Mark at lips/teeth and tube inner diameter | OR-ADV OR-RSP | No heuristic flags |
| EXAM-2-59 | vent-6 | Which actions reduce ventilator-associated pneumonia risk? | Head elevation when feasible and oral hygiene | OR-SK OR-ADV AHA25 | No heuristic flags |
| EXAM-2-60 | resp-1 | A chest tube has suddenly drained brisk bright-red blood. What is the safest nursing response? | Reassess vitals and perfusion and notify the treating team urgently | OR-SK OR-ADV OR-RSP | No heuristic flags |
| EXAM-3-01 | vent-1 | What does E in ABCDE prompt? | Inspect for bleeding, injuries, fever, and skin abnormalities | OR-ADV OR-SK | No heuristic flags |
| EXAM-3-02 | vent-6 | A critically ill patient's urine output is 0.4 mL/kg/h for six hours. What is the concern? | It meets a commonly used urine-output criterion for possible AKI | OR-SK OR-ADV AHA25 | numerical-clinical-specificity-check |
| EXAM-3-03 | vent-4 | Which finding favors SBT tolerance? | Stable heart rate, blood pressure, and comfortable effort | AARC24 OR-ADV | No heuristic flags |
| EXAM-3-04 | resp-3 | What should be assessed during treatment of metabolic alkalosis? | Chloride, volume status, and potassium | OR-HA OR-ADV | No heuristic flags |
| EXAM-3-05 | ecg-1 | What does the T wave represent? | Ventricular repolarization | OR-HA AHA25 | No heuristic flags |
| EXAM-3-06 | vent-3 | How does assist-control differ from SIMV? | AC supports triggered mandatory breaths; SIMV allows spontaneous breaths between scheduled ones | ATS-ARDS OR-ADV | No heuristic flags |
| EXAM-3-07 | ecg-1 | What does the P wave represent? | Atrial depolarization | OR-HA AHA25 | No heuristic flags |
| EXAM-3-08 | ecg-4 | What is a nonconducted P wave? | Atrial depolarization with no following QRS | AHA25 OR-HA | No heuristic flags |
| EXAM-3-09 | vent-5 | Approximate MAP for BP 90/60 mmHg using (SBP + 2DBP)/3? | 70 mmHg | OR-ADV OR-SK | No heuristic flags |
| EXAM-3-10 | vent-2 | Why must a paralyzed intubated patient still receive appropriate sedation and analgesia? | Neuromuscular blockade prevents movement but does not relieve pain or ensure unconsciousness | OR-ADV OR-RSP | No heuristic flags |
| EXAM-3-11 | resp-4 | What is the initial nursing priority for hemodynamically unstable suspected PE? | Activate emergency response and support oxygenation/circulation | PE26 OR-HA | No heuristic flags |
| EXAM-3-12 | resp-4 | What lab approach may monitor a heparin infusion depending on protocol? | aPTT or anti-Xa | PE26 OR-HA | drug-guidance-check |
| EXAM-3-13 | vent-1 | What is V/Q mismatch? | Pulmonary airflow and blood flow are poorly matched | OR-ADV OR-SK | No heuristic flags |
| EXAM-3-14 | ecg-3 | Why does R-on-T PVC merit concern? | It may provoke a malignant ventricular arrhythmia | AHA25 OR-HA | No heuristic flags |
| EXAM-3-15 | resp-3 | Which condition commonly causes metabolic acidosis? | Diabetic ketoacidosis | OR-HA OR-ADV | No heuristic flags |
| EXAM-3-16 | vent-6 | An ICU patient becomes disoriented after poor sleep and escalating sedatives. What prevention strategy fits the guide? | Review pain, medications, sleep, orientation and mobility | OR-SK OR-ADV AHA25 | non-generic-legacy-wording |
| EXAM-3-17 | vent-6 | During an arrest, the team leader requests epinephrine. Which communication demonstrates closed-loop practice? | The nurse repeats the order and confirms when it is completed | OR-SK OR-ADV AHA25 | No heuristic flags |
| EXAM-3-18 | vent-5 | Why is a CVP reading insufficient by itself to select IV fluids? | It does not reliably predict fluid responsiveness | OR-ADV OR-SK | No heuristic flags |
| EXAM-3-19 | ecg-2 | What characterizes a PAC? | Early abnormal P wave with usually narrow QRS | AHA25 OR-HA | No heuristic flags |
| EXAM-3-20 | vent-4 | Which development during an SBT calls for closer evaluation rather than automatic extubation? | New hemodynamic instability or arrhythmia | AARC24 OR-ADV | No heuristic flags |
| EXAM-3-21 | ecg-4 | What defines Mobitz I? | PR grows longer until a P does not conduct | AHA25 OR-HA | No heuristic flags |
| EXAM-3-22 | vent-2 | What does the guide emphasize about a non-rebreather? | High oxygen concentration, not reliably 100% | OR-ADV OR-RSP | non-generic-legacy-wording, absolute-claim-check |
| EXAM-3-23 | ecg-2 | What is the unstable regular SVT treatment described? | Synchronized cardioversion | AHA25 OR-HA | No heuristic flags |
| EXAM-3-24 | resp-3 | In respiratory acidosis, which primary change is expected? | Elevated PaCO₂ | OR-HA OR-ADV | No heuristic flags |
| EXAM-3-25 | vent-1 | What should take priority over routine abnormalities in critical care? | Immediate ABC threats | OR-ADV OR-SK | No heuristic flags |
| EXAM-3-26 | ecg-1 | A wide, fast QRS rhythm appears while the patient is unstable. What is the safest interpretation strategy? | Consider ventricular tachycardia until expertly assessed while checking pulse/perfusion | OR-HA AHA25 | non-generic-legacy-wording |
| EXAM-3-27 | ecg-5 | IV calcium is ordered for severe hyperkalemia with ECG changes. What is its primary immediate purpose? | Stabilize cardiac membranes, not directly lower serum potassium | AHA25 OR-PH | drug-guidance-check |
| EXAM-3-28 | resp-1 | Why should a bubbling chest tube not be clamped routinely? | Trapped pleural air can cause tension pneumothorax | OR-SK OR-ADV OR-RSP | No heuristic flags |
| EXAM-3-29 | resp-6 | A critical ABG shows severe acidemia. What should you prioritize? | Ventilation, perfusion, cause, electrolytes and escalation | OR-RSP PE26 OR-SK | No heuristic flags |
| EXAM-3-30 | vent-2 | Which ETT detail should the nurse trend after repositioning? | Depth marking at lips/teeth and bilateral chest movement | OR-ADV OR-RSP | No heuristic flags |
| EXAM-3-31 | resp-5 | What early sign may precede severe respiratory fatigue? | Restlessness and tachypnea | OR-RSP ATS-ARDS | No heuristic flags |
| EXAM-3-32 | resp-1 | Why must a chest drainage unit stay below insertion level? | To reduce backflow and keep drainage functional | OR-SK OR-ADV OR-RSP | No heuristic flags |
| EXAM-3-33 | ecg-5 | A prolonged QT is found in a patient with low calcium. Which association fits the guide? | Hypocalcemia can prolong QT | AHA25 OR-PH | non-generic-legacy-wording, drug-guidance-check |
| EXAM-3-34 | vent-3 | Which statement distinguishes Assist-Control (AC) from SIMV? | AC supports mandatory breaths triggered by time or patient; SIMV schedules mandatory breaths with spontaneous breaths between | ATS-ARDS OR-ADV | No heuristic flags |
| EXAM-3-35 | ecg-3 | What does torsades de pointes imply? | Polymorphic VT associated with prolonged QT | AHA25 OR-HA | No heuristic flags |
| EXAM-3-36 | ecg-2 | What might an inverted retrograde P near a narrow QRS suggest? | Junctional rhythm | AHA25 OR-HA | No heuristic flags |
| EXAM-3-37 | vent-5 | What does the dicrotic notch on arterial waveform relate to? | Aortic valve closure | OR-ADV OR-SK | No heuristic flags |
| EXAM-3-38 | resp-5 | Which change is especially concerning in a struggling respiratory patient? | Increasing exhaustion and inability to protect the airway | OR-RSP ATS-ARDS | No heuristic flags |
| EXAM-3-39 | ecg-5 | What does IV calcium do in severe hyperkalemia when indicated? | Stabilizes cardiac membranes without lowering serum potassium | AHA25 OR-PH | drug-guidance-check |
| EXAM-3-40 | vent-6 | A patient has SpO₂ 97% but rising lactate, cool skin, and confusion. What is the main concern? | Inadequate tissue perfusion or oxygen delivery despite acceptable saturation | OR-SK OR-ADV AHA25 | No heuristic flags |
| EXAM-3-41 | ecg-4 | Why is Mobitz II concerning? | Can progress to complete block and need pacing | AHA25 OR-HA | No heuristic flags |
| EXAM-3-42 | resp-2 | In chronic respiratory acidosis, which renal response helps compensate over time? | Retention of bicarbonate (HCO₃⁻) | OR-HA OR-RSP OR-ADV | No heuristic flags |
| EXAM-3-43 | ecg-5 | Which drug is typically used for selected regular AV-node-dependent SVT instead of symptomatic bradycardia? | Adenosine | AHA25 OR-PH | drug-guidance-check |
| EXAM-3-44 | ecg-2 | How do you recognize normal sinus rhythm? | P before each narrow QRS, regular 60–100 bpm | AHA25 OR-HA | No heuristic flags |
| EXAM-3-45 | vent-4 | Which change suggests failure of an SBT? | Increasing respiratory fatigue and severe tachypnea | AARC24 OR-ADV | No heuristic flags |
| EXAM-3-46 | ecg-1 | The ECG monitor shows organized complexes, but the patient has no pulse. What does this prove? | Electrical complexes do not guarantee mechanical cardiac output | OR-HA AHA25 | absolute-claim-check |
| EXAM-3-47 | ecg-3 | What characterizes ventricular fibrillation? | Chaotic activity without organized QRS | AHA25 OR-HA | No heuristic flags |
| EXAM-3-48 | resp-4 | What can a normal oxygen saturation tell you about PE? | It does not exclude PE | PE26 OR-HA | No heuristic flags |
| EXAM-3-49 | resp-3 | Which response is most appropriate to severe metabolic acidosis caused by shock? | Treat the cause and restore perfusion while monitoring ventilation and electrolytes | OR-HA OR-ADV | No heuristic flags |
| EXAM-3-50 | ecg-4 | What defines Mobitz II? | Fixed PR on conducted beats with sudden dropped QRS | AHA25 OR-HA | No heuristic flags |
| EXAM-3-51 | resp-2 | Which oxygenation measurement is obtained noninvasively by a pulse oximeter? | SpO₂ | OR-HA OR-RSP OR-ADV | No heuristic flags |
| EXAM-3-52 | ecg-3 | What is PEA? | Organized electrical activity without a palpable pulse | AHA25 OR-HA | absolute-claim-check |
| EXAM-3-53 | resp-6 | Suspected PE causes hypotension and altered mentation. What now? | Rapid response and circulatory/respiratory support | OR-RSP PE26 OR-SK | No heuristic flags |
| EXAM-3-54 | resp-5 | Which oxygen strategy is commonly used initially for COPD patients at risk of CO₂ retention, pending ABGs? | Controlled oxygen with an SpO₂ target around 88–92% | OR-RSP ATS-ARDS | non-generic-legacy-wording, absolute-claim-check |
| EXAM-3-55 | vent-3 | Why can increasing PEEP lower blood pressure? | Increased intrathoracic pressure reduces venous return | ATS-ARDS OR-ADV | No heuristic flags |
| EXAM-3-56 | resp-1 | Which practice is discouraged for routine chest-tube care? | Aggressively stripping the tubing | OR-SK OR-ADV OR-RSP | No heuristic flags |
| EXAM-3-57 | resp-6 | A patient has low PaO₂ despite oxygen equipment in place. Which assessment is most useful initially? | Confirm delivery equipment and evaluate lung/ventilation–perfusion problems | OR-RSP PE26 OR-SK | No heuristic flags |
| EXAM-3-58 | resp-2 | An ABG shows alkalemia and an elevated HCO₃⁻. Which primary process should be evaluated first? | Metabolic alkalosis | OR-HA OR-RSP OR-ADV | No heuristic flags |
| EXAM-3-59 | resp-6 | What is the safest general priority when several monitor numbers are abnormal? | Address the immediately threatening airway, breathing, and perfusion issue first | OR-RSP PE26 OR-SK | No heuristic flags |
| EXAM-3-60 | vent-3 | What is a major concern with high airway pressures or excessive tidal volumes? | Ventilator-associated lung injury | ATS-ARDS OR-ADV | No heuristic flags |
| FLASH-f0 | resp-1 | What accumulates in the pleural space during a pneumothorax? | Air. | OR-SK OR-ADV OR-RSP | No heuristic flags |
| FLASH-f1 | resp-1 | Why is tension pneumothorax life-threatening? | Trapped pressurized air can cause obstructive shock. | OR-SK OR-ADV OR-RSP | No heuristic flags |
| FLASH-f2 | resp-1 | What accumulates in a hemothorax? | Blood in the pleural space. | OR-SK OR-ADV OR-RSP | No heuristic flags |
| FLASH-f3 | resp-1 | What is a pleural effusion? | Excess fluid in the pleural space. | OR-SK OR-ADV OR-RSP | No heuristic flags |
| FLASH-f4 | resp-1 | What is an empyema? | Infected pleural fluid or pus. | OR-SK OR-ADV OR-RSP | No heuristic flags |
| FLASH-f5 | resp-1 | What is a chylothorax? | Chyle (lymphatic fluid) in the pleural space. | OR-SK OR-ADV OR-RSP | No heuristic flags |
| FLASH-f6 | resp-2 | What is the normal adult arterial pH range? | 7.35–7.45. | OR-HA OR-RSP OR-ADV | No heuristic flags |
| FLASH-f7 | resp-2 | What is the usual adult PaCO₂ range? | 35–45 mmHg. | OR-HA OR-RSP OR-ADV | No heuristic flags |
| FLASH-f8 | resp-2 | What is the usual adult HCO₃⁻ range? | 22–26 mEq/L (lab-dependent). | OR-HA OR-RSP OR-ADV | numerical-clinical-specificity-check |
| FLASH-f9 | resp-2 | What is a typical PaO₂ on room air in a healthy adult? | About 80–100 mmHg; varies with age. | OR-HA OR-RSP OR-ADV | No heuristic flags |
| FLASH-f10 | resp-2 | What is typical healthy-adult arterial O₂ saturation (SaO₂)? | About 95–100%. | OR-HA OR-RSP OR-ADV | absolute-claim-check |
| FLASH-f11 | resp-2 | What does SpO₂ measure? | Pulse-oximeter estimate of oxygen saturation. | OR-HA OR-RSP OR-ADV | No heuristic flags |
| FLASH-f12 | resp-3 | Interpret pH 7.28 / PaCO₂ 55 / HCO₃⁻ 25. | Acute/uncompensated respiratory acidosis. | OR-HA OR-ADV | No heuristic flags |
| FLASH-f13 | resp-3 | Interpret pH 7.49 / PaCO₂ 29 / HCO₃⁻ 23. | Respiratory alkalosis. | OR-HA OR-ADV | No heuristic flags |
| FLASH-f14 | resp-3 | Interpret pH 7.25 / PaCO₂ 27 / HCO₃⁻ 12. | Metabolic acidosis with expected respiratory compensation. | OR-HA OR-ADV | No heuristic flags |
| FLASH-f15 | resp-3 | Interpret pH 7.50 / PaCO₂ 47 / HCO₃⁻ 35. | Metabolic alkalosis with respiratory compensation. | OR-HA OR-ADV | No heuristic flags |
| FLASH-f16 | resp-3 | Interpret pH 7.36 / PaCO₂ 60 / HCO₃⁻ 33. | Compensated chronic respiratory acidosis pattern. | OR-HA OR-ADV | No heuristic flags |
| FLASH-f17 | resp-3 | What breathing pattern may occur in severe metabolic acidosis? | Deep, rapid Kussmaul respirations. | OR-HA OR-ADV | No heuristic flags |
| FLASH-f18 | resp-4 | Why can pulmonary embolism strain the right ventricle? | Blocked pulmonary blood flow raises RV afterload. | PE26 OR-HA | No heuristic flags |
| FLASH-f19 | resp-4 | What symptoms should raise concern for pulmonary embolism? | Sudden dyspnea, pleuritic chest pain, and tachycardia. | PE26 OR-HA | No heuristic flags |
| FLASH-f20 | resp-4 | What recent history increases risk for pulmonary embolism? | Surgery or prolonged immobility. | PE26 OR-HA | No heuristic flags |
| FLASH-f21 | resp-4 | Does a positive D-dimer confirm pulmonary embolism? | No. It is nonspecific. | PE26 OR-HA | No heuristic flags |
| FLASH-f22 | resp-4 | What imaging study commonly confirms suspected PE? | CT pulmonary angiography (CTPA). | PE26 OR-HA | No heuristic flags |
| FLASH-f23 | resp-4 | Can normal SpO₂ rule out pulmonary embolism? | No. | PE26 OR-HA | No heuristic flags |
| FLASH-f24 | resp-5 | What physiological problem defines type 1 respiratory failure? | Impaired oxygen transfer (hypoxemia). | OR-RSP ATS-ARDS | No heuristic flags |
| FLASH-f25 | resp-5 | Name common causes of type 1 respiratory failure. | Pneumonia, pulmonary edema, ARDS, or PE. | OR-RSP ATS-ARDS | No heuristic flags |
| FLASH-f26 | resp-5 | What ABG finding strongly suggests type 1 respiratory failure? | Low PaO₂, often <60 mmHg on room air. | OR-RSP ATS-ARDS | No heuristic flags |
| FLASH-f27 | resp-5 | What are first priorities in type 1 respiratory failure? | Support oxygenation and treat the cause. | OR-RSP ATS-ARDS | No heuristic flags |
| FLASH-f28 | resp-5 | How do type 1 and type 2 respiratory failure differ? | Type 1: low PaO₂. Type 2: elevated PaCO₂. | OR-RSP ATS-ARDS | No heuristic flags |
| FLASH-f29 | resp-5 | What is the main mechanism of type 2 respiratory failure? | Inadequate alveolar ventilation with CO₂ retention. | OR-RSP ATS-ARDS | No heuristic flags |
| FLASH-f30 | vent-1 | How do oxygenation and perfusion differ? | Oxygenation loads O₂ into blood; perfusion delivers blood to tissue. | OR-ADV OR-SK | absolute-claim-check |
| FLASH-f31 | vent-1 | What early signs suggest respiratory deterioration? | Restlessness, tachypnea, or increased breathing effort. | OR-ADV OR-SK | No heuristic flags |
| FLASH-f32 | vent-1 | What does V/Q mismatch mean? | Airflow and blood flow are poorly matched in the lungs. | OR-ADV OR-SK | No heuristic flags |
| FLASH-f33 | vent-1 | What is checked under C (circulation) in ABCDE? | Pulse, BP, skin perfusion, mentation, and urine output. | OR-ADV OR-SK | No heuristic flags |
| FLASH-f34 | vent-1 | What is the difference between hypoxemia and hypoxia? | Hypoxemia: low arterial O₂; hypoxia: inadequate tissue O₂. | OR-ADV OR-SK | No heuristic flags |
| FLASH-f35 | vent-1 | What does E (exposure) assess in ABCDE? | Bleeding, injury, temperature, and skin abnormalities. | OR-ADV OR-SK | No heuristic flags |
| FLASH-f36 | vent-2 | What percentage of inspired oxygen is in room air? | 21%. | OR-ADV OR-RSP | No heuristic flags |
| FLASH-f37 | vent-2 | Which oxygen device delivers a controlled FiO₂? | Venturi mask. | OR-ADV OR-RSP | No heuristic flags |
| FLASH-f38 | vent-2 | What oxygen range can a non-rebreather provide? | High FiO₂, often roughly 60–90%; not reliably 100%. | OR-ADV OR-RSP | absolute-claim-check |
| FLASH-f39 | vent-2 | Does neuromuscular paralysis replace sedation? | No. Paralysis never replaces sedation. | OR-ADV OR-RSP | absolute-claim-check |
| FLASH-f40 | vent-2 | What ETT position details should nurses document? | Tube size and depth marking at lips or teeth. | OR-ADV OR-RSP | No heuristic flags |
| FLASH-f41 | vent-2 | Why is right-mainstem intubation dangerous? | It can preferentially ventilate one lung. | OR-ADV OR-RSP | No heuristic flags |
| FLASH-f42 | vent-3 | What does FiO₂ mean on a ventilator? | Fraction of inspired oxygen. | ATS-ARDS OR-ADV | No heuristic flags |
| FLASH-f43 | vent-3 | What does the ventilator's set rate represent? | Minimum mandatory breaths per minute. | ATS-ARDS OR-ADV | No heuristic flags |
| FLASH-f44 | vent-3 | What does total respiratory rate include? | Mandatory plus patient-triggered/spontaneous breaths. | ATS-ARDS OR-ADV | No heuristic flags |
| FLASH-f45 | vent-3 | What is pressure support on a ventilator? | Inspiratory assistance for spontaneous breaths. | ATS-ARDS OR-ADV | No heuristic flags |
| FLASH-f46 | vent-3 | Why monitor plateau pressure? | It helps assess lung-distending pressure. | ATS-ARDS OR-ADV | No heuristic flags |
| FLASH-f47 | vent-3 | What does PEEP do for oxygenation? | Helps keep alveoli recruited at end expiration. | ATS-ARDS OR-ADV | No heuristic flags |
| FLASH-f48 | vent-4 | What breathing signs suggest SBT intolerance? | Severe tachypnea, very low tidal volume, or rising effort. | AARC24 OR-ADV | No heuristic flags |
| FLASH-f49 | vent-4 | What cardiac signs suggest SBT intolerance? | Hemodynamic instability or new arrhythmias. | AARC24 OR-ADV | No heuristic flags |
| FLASH-f50 | vent-4 | What mental-status signs threaten safe ventilator liberation? | Agitation or inability to protect the airway. | AARC24 OR-ADV | No heuristic flags |
| FLASH-f51 | vent-4 | What does a spontaneous breathing trial assess? | Ability to breathe with reduced ventilator support. | AARC24 OR-ADV | No heuristic flags |
| FLASH-f52 | vent-4 | What should the nurse do if an SBT causes marked fatigue? | Stop/reassess the trial and alert the care team. | AARC24 OR-ADV | No heuristic flags |
| FLASH-f53 | vent-4 | Beyond SpO₂, what must be assessed before extubation? | Airway protection, cough, mentation and secretion control. | AARC24 OR-ADV | No heuristic flags |
| FLASH-f54 | vent-5 | Can one CVP reading predict fluid responsiveness? | No. | OR-ADV OR-SK | No heuristic flags |
| FLASH-f55 | vent-5 | What mechanical event produces the arterial dicrotic notch? | Aortic valve closure. | OR-ADV OR-SK | No heuristic flags |
| FLASH-f56 | vent-5 | What setup checks matter for arterial-line BP accuracy? | Transducer leveling, zeroing, and waveform quality. | OR-ADV OR-SK | No heuristic flags |
| FLASH-f57 | vent-5 | What can a pulmonary artery catheter measure? | PA pressures, wedge pressure, and cardiac output. | OR-ADV OR-SK | No heuristic flags |
| FLASH-f58 | vent-5 | What MAP is a common initial target during shock care? | Approximately 65 mmHg, individualized. | OR-ADV OR-SK | No heuristic flags |
| FLASH-f59 | vent-5 | What can dampen an arterial-line waveform? | Air bubbles, clot, or tubing/line problems. | OR-ADV OR-SK | No heuristic flags |
| FLASH-f60 | vent-6 | What routine care helps prevent pressure injury in ICU patients? | Repositioning, device checks, and pressure relief. | OR-SK OR-ADV AHA25 | No heuristic flags |
| FLASH-f61 | vent-6 | Which trends help assess evolving acute kidney injury? | Urine output, creatinine, fluid balance, and perfusion. | OR-SK OR-ADV AHA25 | No heuristic flags |
| FLASH-f62 | vent-6 | What basic measures lower VAP risk? | Head elevation when feasible and oral hygiene. | OR-SK OR-ADV AHA25 | No heuristic flags |
| FLASH-f63 | vent-6 | What sustained urine output can meet an AKI criterion? | <0.5 mL/kg/hr for at least 6 hours. | OR-SK OR-ADV AHA25 | numerical-clinical-specificity-check |
| FLASH-f64 | vent-6 | How can ICU nurses help prevent VTE? | Early mobility and indicated mechanical/drug prophylaxis. | OR-SK OR-ADV AHA25 | No heuristic flags |
| FLASH-f65 | vent-6 | What helps prevent ICU delirium? | Manage pain, sleep, orientation, medications, and mobility. | OR-SK OR-ADV AHA25 | No heuristic flags |
| FLASH-f66 | ecg-1 | How should sinus P waves typically look in lead II? | Upright, with one P before each QRS. | OR-HA AHA25 | No heuristic flags |
| FLASH-f67 | ecg-1 | What is the normal adult PR interval? | 0.12–0.20 seconds. | OR-HA AHA25 | No heuristic flags |
| FLASH-f68 | ecg-1 | How wide is a normal QRS complex? | <0.12 seconds. | OR-HA AHA25 | No heuristic flags |
| FLASH-f69 | ecg-1 | What are the approximate intrinsic pacemaker rates? | SA 60–100; junction 40–60; ventricular escape 20–40 bpm. | OR-HA AHA25 | No heuristic flags |
| FLASH-f70 | ecg-1 | What electrical event creates the P wave? | Atrial depolarization. | OR-HA AHA25 | No heuristic flags |
| FLASH-f71 | ecg-1 | What electrical event creates the QRS complex? | Ventricular depolarization. | OR-HA AHA25 | No heuristic flags |
| FLASH-f72 | ecg-2 | How do you recognize normal sinus rhythm? | Regular 60–100; P before every narrow QRS. | AHA25 OR-HA | No heuristic flags |
| FLASH-f73 | ecg-2 | Does stable normal sinus rhythm need a rhythm treatment? | No rhythm-specific treatment. | AHA25 OR-HA | No heuristic flags |
| FLASH-f74 | ecg-2 | What tracing clue helps distinguish sinus tachycardia from SVT? | Distinct sinus P waves before QRS complexes. | AHA25 OR-HA | No heuristic flags |
| FLASH-f75 | ecg-2 | What is the priority in sinus tachycardia management? | Treat the underlying cause. | AHA25 OR-HA | No heuristic flags |
| FLASH-f76 | ecg-2 | What identifies a premature atrial contraction (PAC)? | An early, often different-looking P with a usually narrow QRS. | AHA25 OR-HA | No heuristic flags |
| FLASH-f77 | ecg-2 | What's a typical first approach to stable regular narrow SVT? | Vagal maneuver; adenosine when appropriate. | AHA25 OR-HA | drug-guidance-check |
| FLASH-f78 | ecg-3 | What ECG feature identifies a PVC? | An early wide QRS without a related preceding P. | AHA25 OR-HA | No heuristic flags |
| FLASH-f79 | ecg-3 | What is the priority for pulseless monomorphic VT? | CPR and defibrillation. | AHA25 OR-HA | No heuristic flags |
| FLASH-f80 | ecg-3 | What treatment is indicated for unstable VT with a pulse? | Synchronized cardioversion for monomorphic VT. | AHA25 OR-HA | No heuristic flags |
| FLASH-f81 | ecg-3 | What is torsades de pointes? | Polymorphic VT associated with prolonged QT. | AHA25 OR-HA | No heuristic flags |
| FLASH-f82 | ecg-3 | Which electrolyte deficits increase torsades risk? | Low magnesium and often low potassium. | AHA25 OR-HA | drug-guidance-check |
| FLASH-f83 | ecg-3 | What does ventricular fibrillation look like? | Chaotic activity with no organized QRS complexes. | AHA25 OR-HA | No heuristic flags |
| FLASH-f84 | ecg-4 | What is the ECG criterion for first-degree AV block? | PR >0.20 seconds; every P still conducts. | AHA25 OR-HA | No heuristic flags |
| FLASH-f85 | ecg-4 | How do you recognize Mobitz I (Wenckebach)? | PR progressively lengthens, then a QRS drops. | AHA25 OR-HA | No heuristic flags |
| FLASH-f86 | ecg-4 | How do you recognize Mobitz II? | Fixed PR on conducted beats with sudden dropped QRS. | AHA25 OR-HA | No heuristic flags |
| FLASH-f87 | ecg-4 | Why should nurses prepare for pacing in Mobitz II? | It may progress abruptly to complete AV block. | AHA25 OR-HA | No heuristic flags |
| FLASH-f88 | ecg-4 | What defines third-degree AV block? | Atrial P waves and QRS complexes occur independently. | AHA25 OR-HA | No heuristic flags |
| FLASH-f89 | ecg-4 | Why may atropine fail in complete heart block? | The block may be infranodal; pacing may be needed. | AHA25 OR-HA | drug-guidance-check |
| FLASH-f90 | ecg-5 | How does low calcium affect the ECG's QT interval? | Prolongs the QT interval. | AHA25 OR-PH | drug-guidance-check |
| FLASH-f91 | ecg-5 | How does high calcium affect the QT interval? | Shortens the QT interval. | AHA25 OR-PH | drug-guidance-check |
| FLASH-f92 | ecg-5 | How does low magnesium affect ventricular rhythm risk? | Prolonged QT and increased torsades risk. | AHA25 OR-PH | drug-guidance-check |
| FLASH-f93 | ecg-5 | How can excess magnesium affect cardiac conduction? | Bradycardia and AV-conduction depression. | AHA25 OR-PH | drug-guidance-check |
| FLASH-f94 | ecg-5 | When is adenosine commonly considered? | Selected stable regular AV-node-dependent SVT. | AHA25 OR-PH | drug-guidance-check |
| FLASH-f95 | ecg-5 | When may atropine be used in an adult with a pulse? | Symptomatic bradycardia with poor perfusion. | AHA25 OR-PH | drug-guidance-check |
Original replacement illustrations
All 24 formerly embedded figures were replaced with independently drawn SVG schematics, including 16 ECG examples. They are for concepts, not clinical diagnosis. The live ECG simulator was retained separately.
| Chapter | Graphic | File | Notes |
|---|---|---|---|
| resp-1 | Three-part chest drain | Original SVG | Created in this rebuild, source code available; clinical schematic review still recommended |
| resp-2 | ABG interpretation | Original SVG | Created in this rebuild, source code available; clinical schematic review still recommended |
| resp-4 | Pulmonary embolism | Original SVG | Created in this rebuild, source code available; clinical schematic review still recommended |
| resp-5 | Acute respiratory failure | Original SVG | Created in this rebuild, source code available; clinical schematic review still recommended |
| vent-1 | Oxygen transport | Original SVG | Created in this rebuild, source code available; clinical schematic review still recommended |
| vent-3 | Ventilator physiology | Original SVG | Created in this rebuild, source code available; clinical schematic review still recommended |
| vent-5 | Determinants of cardiac output | Original SVG | Created in this rebuild, source code available; clinical schematic review still recommended |
| ecg-1 | Conduction pathway | Original SVG | Created in this rebuild, source code available; clinical schematic review still recommended |
| ecg-2 | Normal sinus rhythm | Original SVG | Created in this rebuild, source code available; clinical schematic review still recommended |
| ecg-2 | Sinus bradycardia | Original SVG | Created in this rebuild, source code available; clinical schematic review still recommended |
| ecg-2 | Sinus tachycardia | Original SVG | Created in this rebuild, source code available; clinical schematic review still recommended |
| ecg-2 | Premature atrial contraction | Original SVG | Created in this rebuild, source code available; clinical schematic review still recommended |
| ecg-2 | Regular supraventricular tachycardia | Original SVG | Created in this rebuild, source code available; clinical schematic review still recommended |
| ecg-2 | Atrial flutter | Original SVG | Created in this rebuild, source code available; clinical schematic review still recommended |
| ecg-2 | Atrial fibrillation | Original SVG | Created in this rebuild, source code available; clinical schematic review still recommended |
| ecg-2 | Junctional rhythm | Original SVG | Created in this rebuild, source code available; clinical schematic review still recommended |
| ecg-3 | Premature ventricular contraction | Original SVG | Created in this rebuild, source code available; clinical schematic review still recommended |
| ecg-3 | Monomorphic ventricular tachycardia | Original SVG | Created in this rebuild, source code available; clinical schematic review still recommended |
| ecg-3 | Ventricular fibrillation | Original SVG | Created in this rebuild, source code available; clinical schematic review still recommended |
| ecg-3 | Asystole | Original SVG | Created in this rebuild, source code available; clinical schematic review still recommended |
| ecg-4 | First-degree atrioventricular block | Original SVG | Created in this rebuild, source code available; clinical schematic review still recommended |
| ecg-4 | Second-degree AV block, Mobitz I | Original SVG | Created in this rebuild, source code available; clinical schematic review still recommended |
| ecg-4 | Second-degree AV block, Mobitz II | Original SVG | Created in this rebuild, source code available; clinical schematic review still recommended |
| ecg-4 | Third-degree complete AV block | Original SVG | Created in this rebuild, source code available; clinical schematic review still recommended |
Medication Mastery — 300 individual profiles
Every entry has a label-search link. The 48 expanded cards are not represented as freshly verified labels; medication dose and route details must be checked against indication-specific and current labeling.
| Rank | Drug | Class | Editorial status | Label lookup |
|---|---|---|---|---|
| 1 | Atorvastatin | Statin | Expanded study example — unverified | Search label |
| 2 | Levothyroxine | Thyroid hormone | Expanded study example — unverified | Search label |
| 3 | Metformin | Biguanide | Expanded study example — unverified | Search label |
| 4 | Amlodipine | Calcium-channel blocker | Expanded study example — unverified | Search label |
| 5 | Lisinopril | ACE inhibitor | Expanded study example — unverified | Search label |
| 6 | Albuterol | Beta-2 bronchodilator | Expanded study example — unverified | Search label |
| 7 | Losartan | ARB | Expanded study example — unverified | Search label |
| 8 | Metoprolol | Beta blocker | Expanded study example — unverified | Search label |
| 9 | Rosuvastatin | Statin | Expanded study example — unverified | Search label |
| 10 | Omeprazole | Proton pump inhibitor | Expanded study example — unverified | Search label |
| 11 | Gabapentin | Anticonvulsant | Expanded study example — unverified | Search label |
| 12 | Sertraline | SSRI | Expanded study example — unverified | Search label |
| 13 | Escitalopram | SSRI | Expanded study example — unverified | Search label |
| 14 | Semaglutide | GLP-1 / incretin therapy | Expanded study example — unverified | Search label |
| 15 | Mixed amphetamine salts | Drug-specific class—review required | Class-level overview — unverified | Search label |
| 16 | Pantoprazole | Proton pump inhibitor | Expanded study example — unverified | Search label |
| 17 | Bupropion | Antidepressant / other | Expanded study example — unverified | Search label |
| 18 | Hydrochlorothiazide | Thiazide diuretic | Expanded study example — unverified | Search label |
| 19 | Fluoxetine | SSRI | Expanded study example — unverified | Search label |
| 20 | Trazodone | Antidepressant / other | Expanded study example — unverified | Search label |
| 21 | Montelukast | Other prescription | Expanded study example — unverified | Search label |
| 22 | Amoxicillin | Antibiotic | Expanded study example — unverified | Search label |
| 23 | Fluticasone | Corticosteroid | Class-level overview — unverified | Search label |
| 24 | Tamsulosin | Alpha-1 antagonist | Expanded study example — unverified | Search label |
| 25 | Apixaban | Anticoagulant | Expanded study example — unverified | Search label |
| 26 | Simvastatin | Statin | Expanded study example — unverified | Search label |
| 27 | Insulin glargine | Insulin | Expanded study example — unverified | Search label |
| 28 | Empagliflozin | SGLT2 inhibitor | Expanded study example — unverified | Search label |
| 29 | Furosemide | Loop diuretic | Expanded study example — unverified | Search label |
| 30 | Meloxicam | NSAID | Expanded study example — unverified | Search label |
| 31 | Hydrocodone/acetaminophen | Combination product | Class-level overview — unverified | Search label |
| 32 | Tirzepatide | GLP-1 / incretin therapy | Expanded study example — unverified | Search label |
| 33 | Methylphenidate | CNS stimulant | Class-level overview — unverified | Search label |
| 34 | Duloxetine | SNRI | Expanded study example — unverified | Search label |
| 35 | Prednisone | Corticosteroid | Expanded study example — unverified | Search label |
| 36 | Carvedilol | Beta blocker | Expanded study example — unverified | Search label |
| 37 | Famotidine | GI agent | Expanded study example — unverified | Search label |
| 38 | Ibuprofen | NSAID | Expanded study example — unverified | Search label |
| 39 | Buspirone | Drug-specific class—review required | Class-level overview — unverified | Search label |
| 40 | Venlafaxine | SNRI | Expanded study example — unverified | Search label |
| 41 | Tramadol | Opioid analgesic | Class-level overview — unverified | Search label |
| 42 | Potassium chloride | Electrolyte replacement | Expanded study example — unverified | Search label |
| 43 | Hydroxyzine | H1 antihistamine | Class-level overview — unverified | Search label |
| 44 | Allopurinol | Other prescription | Class-level overview — unverified | Search label |
| 45 | Clopidogrel | Antiplatelet | Class-level overview — unverified | Search label |
| 46 | Ergocalciferol | Vitamin / mineral | Class-level overview — unverified | Search label |
| 47 | Cetirizine | H1 antihistamine | Class-level overview — unverified | Search label |
| 48 | Ondansetron | 5-HT3 antagonist | Expanded study example — unverified | Search label |
| 49 | Cyclobenzaprine | Muscle relaxant | Class-level overview — unverified | Search label |
| 50 | Spironolactone | Potassium-sparing diuretic | Expanded study example — unverified | Search label |
| 51 | Oxycodone | Opioid analgesic | Class-level overview — unverified | Search label |
| 52 | Estradiol | Hormonal therapy | Class-level overview — unverified | Search label |
| 53 | Aspirin | NSAID | Expanded study example — unverified | Search label |
| 54 | Glipizide | Antidiabetic sulfonylurea | Class-level overview — unverified | Search label |
| 55 | Zolpidem | Drug-specific class—review required | Class-level overview — unverified | Search label |
| 56 | Lamotrigine | Anticonvulsant | Class-level overview — unverified | Search label |
| 57 | Alprazolam | Benzodiazepine | Class-level overview — unverified | Search label |
| 58 | Citalopram | SSRI | Class-level overview — unverified | Search label |
| 59 | Pregabalin | Anticonvulsant | Class-level overview — unverified | Search label |
| 60 | Cholecalciferol | Vitamin / mineral | Class-level overview — unverified | Search label |
| 61 | Clonazepam | Benzodiazepine | Class-level overview — unverified | Search label |
| 62 | Azithromycin | Antibiotic | Class-level overview — unverified | Search label |
| 63 | Pravastatin | Statin | Class-level overview — unverified | Search label |
| 64 | Valsartan | ARB | Class-level overview — unverified | Search label |
| 65 | Ezetimibe | Other prescription | Class-level overview — unverified | Search label |
| 66 | Diclofenac | NSAID | Class-level overview — unverified | Search label |
| 67 | Insulin lispro | Insulin | Expanded study example — unverified | Search label |
| 68 | Ethinyl estradiol/norethindrone | Hormonal contraception | Class-level overview — unverified | Search label |
| 69 | Propranolol | Beta blocker | Class-level overview — unverified | Search label |
| 70 | Latanoprost | Ophthalmic agent | Class-level overview — unverified | Search label |
| 71 | Atenolol | Beta blocker | Class-level overview — unverified | Search label |
| 72 | Lisdexamfetamine | CNS stimulant | Class-level overview — unverified | Search label |
| 73 | Doxycycline | Antibiotic | Class-level overview — unverified | Search label |
| 74 | Amoxicillin/clavulanate | Combination product | Class-level overview — unverified | Search label |
| 75 | Dulaglutide | GLP-1 / incretin therapy | Class-level overview — unverified | Search label |
| 76 | Lisinopril/hydrochlorothiazide | Combination cardiovascular agent | Class-level overview — unverified | Search label |
| 77 | Lorazepam | Benzodiazepine | Class-level overview — unverified | Search label |
| 78 | Fluticasone/salmeterol | ICS + LABA | Class-level overview — unverified | Search label |
| 79 | Insulin aspart | Insulin | Expanded study example — unverified | Search label |
| 80 | Celecoxib | NSAID | Class-level overview — unverified | Search label |
| 81 | Finasteride | Other prescription | Class-level overview — unverified | Search label |
| 82 | Quetiapine | Antipsychotic | Class-level overview — unverified | Search label |
| 83 | Clonidine | Other cardiovascular | Class-level overview — unverified | Search label |
| 84 | Aripiprazole | Antipsychotic | Class-level overview — unverified | Search label |
| 85 | Cephalexin | Antibiotic | Class-level overview — unverified | Search label |
| 86 | Alendronate | Drug-specific class—review required | Class-level overview — unverified | Search label |
| 87 | Topiramate | Anticonvulsant | Class-level overview — unverified | Search label |
| 88 | Tizanidine | Muscle relaxant | Class-level overview — unverified | Search label |
| 89 | Dapagliflozin | SGLT2 inhibitor | Class-level overview — unverified | Search label |
| 90 | Oxycodone/acetaminophen | Combination product | Class-level overview — unverified | Search label |
| 91 | Losartan/hydrochlorothiazide | Combination cardiovascular agent | Class-level overview — unverified | Search label |
| 92 | Olmesartan | ARB | Class-level overview — unverified | Search label |
| 93 | Testosterone | Hormonal therapy | Class-level overview — unverified | Search label |
| 94 | Amitriptyline | Antidepressant / other | Class-level overview — unverified | Search label |
| 95 | Folic acid | Vitamin / mineral | Class-level overview — unverified | Search label |
| 96 | Rivaroxaban | Anticoagulant | Class-level overview — unverified | Search label |
| 97 | Fenofibrate | Other prescription | Class-level overview — unverified | Search label |
| 98 | Triamcinolone | Corticosteroid | Class-level overview — unverified | Search label |
| 99 | Paroxetine | SSRI | Class-level overview — unverified | Search label |
| 100 | Ferrous sulfate | Vitamin / mineral | Class-level overview — unverified | Search label |
| 101 | Loratadine | H1 antihistamine | Class-level overview — unverified | Search label |
| 102 | Warfarin | Anticoagulant | Expanded study example — unverified | Search label |
| 103 | Valacyclovir | Antiviral | Class-level overview — unverified | Search label |
| 104 | Budesonide/formoterol | ICS + LABA | Class-level overview — unverified | Search label |
| 105 | Ethinyl estradiol/norgestimate | Hormonal contraception | Class-level overview — unverified | Search label |
| 106 | Fluticasone/umeclidinium/vilanterol | ICS + LAMA + LABA | Class-level overview — unverified | Search label |
| 107 | Methocarbamol | Muscle relaxant | Class-level overview — unverified | Search label |
| 108 | Acetaminophen | Analgesic / antipyretic | Expanded study example — unverified | Search label |
| 109 | Diltiazem | Calcium-channel blocker | Class-level overview — unverified | Search label |
| 110 | Desiccated thyroid | Drug-specific class—review required | Class-level overview — unverified | Search label |
| 111 | Baclofen | Muscle relaxant | Class-level overview — unverified | Search label |
| 112 | Naproxen | NSAID | Class-level overview — unverified | Search label |
| 113 | Sumatriptan | Migraine medication | Class-level overview — unverified | Search label |
| 114 | Prednisolone | Corticosteroid | Class-level overview — unverified | Search label |
| 115 | Esomeprazole | Proton pump inhibitor | Class-level overview — unverified | Search label |
| 116 | Mirtazapine | Antidepressant / other | Class-level overview — unverified | Search label |
| 117 | Levetiracetam | Anticonvulsant | Class-level overview — unverified | Search label |
| 118 | Norethindrone | Hormonal therapy | Class-level overview — unverified | Search label |
| 119 | Tadalafil | PDE5 inhibitor | Class-level overview — unverified | Search label |
| 120 | Nifedipine | Calcium-channel blocker | Class-level overview — unverified | Search label |
| 121 | Progesterone | Hormonal therapy | Class-level overview — unverified | Search label |
| 122 | Insulin degludec | Insulin | Class-level overview — unverified | Search label |
| 123 | Cyanocobalamin | Vitamin / mineral | Class-level overview — unverified | Search label |
| 124 | Hydralazine | Other cardiovascular | Class-level overview — unverified | Search label |
| 125 | Adalimumab | Immunomodulator | Class-level overview — unverified | Search label |
| 126 | Azelastine | H1 antihistamine | Class-level overview — unverified | Search label |
| 127 | Sitagliptin | Antidiabetic DPP-4 inhibitor | Class-level overview — unverified | Search label |
| 128 | Glimepiride | Antidiabetic sulfonylurea | Class-level overview — unverified | Search label |
| 129 | Chlorthalidone | Thiazide diuretic | Class-level overview — unverified | Search label |
| 130 | Oxybutynin | Drug-specific class—review required | Class-level overview — unverified | Search label |
| 131 | Pioglitazone | Antidiabetic TZD | Class-level overview — unverified | Search label |
| 132 | Ketoconazole | Antifungal | Class-level overview — unverified | Search label |
| 133 | Irbesartan | ARB | Class-level overview — unverified | Search label |
| 134 | Hydroxychloroquine | Immunomodulator | Class-level overview — unverified | Search label |
| 135 | Sulfamethoxazole/trimethoprim | Combination product | Class-level overview — unverified | Search label |
| 136 | Benzonatate | Other prescription | Class-level overview — unverified | Search label |
| 137 | Nitrofurantoin | Antibiotic | Class-level overview — unverified | Search label |
| 138 | Isosorbide mononitrate | Other cardiovascular | Class-level overview — unverified | Search label |
| 139 | Methylprednisolone | Corticosteroid | Class-level overview — unverified | Search label |
| 140 | Triamterene/hydrochlorothiazide | Combination cardiovascular agent | Class-level overview — unverified | Search label |
| 141 | Levocetirizine | H1 antihistamine | Class-level overview — unverified | Search label |
| 142 | Clindamycin | Antibiotic | Class-level overview — unverified | Search label |
| 143 | Atomoxetine | Drug-specific class—review required | Class-level overview — unverified | Search label |
| 144 | Dexmethylphenidate | CNS stimulant | Class-level overview — unverified | Search label |
| 145 | Methotrexate | Antimetabolite / DMARD | Expanded study example — unverified | Search label |
| 146 | Donepezil | Other neurologic | Class-level overview — unverified | Search label |
| 147 | Desvenlafaxine | SNRI | Class-level overview — unverified | Search label |
| 148 | Ropinirole | Other neurologic | Class-level overview — unverified | Search label |
| 149 | Clobetasol | Corticosteroid | Class-level overview — unverified | Search label |
| 150 | Fluticasone/vilanterol | ICS + LABA | Class-level overview — unverified | Search label |
| 151 | Albuterol/ipratropium | SABA + SAMA | Class-level overview — unverified | Search label |
| 152 | Phentermine | CNS stimulant | Class-level overview — unverified | Search label |
| 153 | Ofloxacin | Antibiotic | Class-level overview — unverified | Search label |
| 154 | Mupirocin | Antibiotic | Class-level overview — unverified | Search label |
| 155 | Verapamil | Calcium-channel blocker | Class-level overview — unverified | Search label |
| 156 | Olanzapine | Antipsychotic | Class-level overview — unverified | Search label |
| 157 | Metronidazole | Antibiotic | Class-level overview — unverified | Search label |
| 158 | Prazosin | Alpha-1 antagonist | Class-level overview — unverified | Search label |
| 159 | Ciprofloxacin | Antibiotic | Class-level overview — unverified | Search label |
| 160 | Sildenafil | PDE5 inhibitor | Class-level overview — unverified | Search label |
| 161 | Ethinyl estradiol/levonorgestrel | Hormonal contraception | Class-level overview — unverified | Search label |
| 162 | Evolocumab | Drug-specific class—review required | Class-level overview — unverified | Search label |
| 163 | Mesalamine | GI agent | Class-level overview — unverified | Search label |
| 164 | Memantine | Other neurologic | Class-level overview — unverified | Search label |
| 165 | Ethinyl estradiol/etonogestrel | Hormonal contraception | Class-level overview — unverified | Search label |
| 166 | Diazepam | Benzodiazepine | Class-level overview — unverified | Search label |
| 167 | Lithium | Mood stabilizer | Class-level overview — unverified | Search label |
| 168 | Nortriptyline | Antidepressant / other | Class-level overview — unverified | Search label |
| 169 | Timolol | Beta blocker | Class-level overview — unverified | Search label |
| 170 | Cefdinir | Antibiotic | Class-level overview — unverified | Search label |
| 171 | Magnesium salts | Drug-specific class—review required | Class-level overview — unverified | Search label |
| 172 | Meclizine | H1 antihistamine | Class-level overview — unverified | Search label |
| 173 | Cyclosporine | Immunomodulator | Class-level overview — unverified | Search label |
| 174 | Fluconazole | Antifungal | Class-level overview — unverified | Search label |
| 175 | Rimegepant | Migraine medication | Class-level overview — unverified | Search label |
| 176 | Tretinoin | Dermatologic | Class-level overview — unverified | Search label |
| 177 | Lovastatin | Statin | Class-level overview — unverified | Search label |
| 178 | Drospirenone/ethinyl estradiol | Hormonal contraception | Class-level overview — unverified | Search label |
| 179 | Tiotropium | Anticholinergic bronchodilator | Class-level overview — unverified | Search label |
| 180 | Docusate | GI agent | Class-level overview — unverified | Search label |
| 181 | Temazepam | Benzodiazepine | Class-level overview — unverified | Search label |
| 182 | Benazepril | ACE inhibitor | Class-level overview — unverified | Search label |
| 183 | Brimonidine | Ophthalmic agent | Class-level overview — unverified | Search label |
| 184 | Sacubitril/valsartan | Combination cardiovascular agent | Class-level overview — unverified | Search label |
| 185 | Valproate | Anticonvulsant | Class-level overview — unverified | Search label |
| 186 | Nebivolol | Beta blocker | Class-level overview — unverified | Search label |
| 187 | Acyclovir | Antiviral | Class-level overview — unverified | Search label |
| 188 | Morphine | Opioid analgesic | Class-level overview — unverified | Search label |
| 189 | Doxazosin | Alpha-1 antagonist | Class-level overview — unverified | Search label |
| 190 | Amlodipine/benazepril | Combination cardiovascular agent | Class-level overview — unverified | Search label |
| 191 | Nirmatrelvir/ritonavir | Combination product | Class-level overview — unverified | Search label |
| 192 | Emtricitabine/tenofovir | Combination product | Class-level overview — unverified | Search label |
| 193 | Budesonide | Corticosteroid | Class-level overview — unverified | Search label |
| 194 | Tacrolimus | Immunomodulator | Class-level overview — unverified | Search label |
| 195 | Dupilumab | Immunomodulator | Class-level overview — unverified | Search label |
| 196 | Enalapril | ACE inhibitor | Class-level overview — unverified | Search label |
| 197 | Anastrozole | Drug-specific class—review required | Class-level overview — unverified | Search label |
| 198 | Melatonin | Drug-specific class—review required | Class-level overview — unverified | Search label |
| 199 | Torsemide | Loop diuretic | Class-level overview — unverified | Search label |
| 200 | Polyethylene glycol 3350 | Drug-specific class—review required | Class-level overview — unverified | Search label |
| 201 | Nitroglycerin | Nitrate vasodilator | Expanded study example — unverified | Search label |
| 202 | Ketorolac | NSAID | Class-level overview — unverified | Search label |
| 203 | Flecainide | Other cardiovascular | Class-level overview — unverified | Search label |
| 204 | Liothyronine | Drug-specific class—review required | Class-level overview — unverified | Search label |
| 205 | Telmisartan | ARB | Class-level overview — unverified | Search label |
| 206 | Risperidone | Antipsychotic | Class-level overview — unverified | Search label |
| 207 | Colchicine | Other prescription | Class-level overview — unverified | Search label |
| 208 | Lansoprazole | Proton pump inhibitor | Class-level overview — unverified | Search label |
| 209 | Regular/NPH insulin mixture | Insulin | Class-level overview — unverified | Search label |
| 210 | Oxcarbazepine | Anticonvulsant | Class-level overview — unverified | Search label |
| 211 | Promethazine | Drug-specific class—review required | Class-level overview — unverified | Search label |
| 212 | Dicyclomine | GI agent | Class-level overview — unverified | Search label |
| 213 | Calcium | Vitamin / mineral | Class-level overview — unverified | Search label |
| 214 | Minoxidil | Other cardiovascular | Class-level overview — unverified | Search label |
| 215 | Linaclotide | GI agent | Class-level overview — unverified | Search label |
| 216 | Metoclopramide | GI agent | Class-level overview — unverified | Search label |
| 217 | Rizatriptan | Migraine medication | Class-level overview — unverified | Search label |
| 218 | Oseltamivir | Antiviral | Class-level overview — unverified | Search label |
| 219 | Nystatin | Antifungal | Class-level overview — unverified | Search label |
| 220 | Dorzolamide/timolol | Combination product | Class-level overview — unverified | Search label |
| 221 | Budesonide/glycopyrrolate/formoterol | ICS + LAMA + LABA | Class-level overview — unverified | Search label |
| 222 | Terazosin | Alpha-1 antagonist | Class-level overview — unverified | Search label |
| 223 | Dexlansoprazole | Proton pump inhibitor | Class-level overview — unverified | Search label |
| 224 | Acetaminophen/codeine | Combination product | Class-level overview — unverified | Search label |
| 225 | Erythromycin | Antibiotic | Class-level overview — unverified | Search label |
| 226 | Dorzolamide | Ophthalmic agent | Class-level overview — unverified | Search label |
| 227 | Hydrocortisone | Corticosteroid | Class-level overview — unverified | Search label |
| 228 | Bisoprolol | Beta blocker | Class-level overview — unverified | Search label |
| 229 | Solifenacin | Drug-specific class—review required | Class-level overview — unverified | Search label |
| 230 | Carbamazepine | Anticonvulsant | Class-level overview — unverified | Search label |
| 231 | Betamethasone/clotrimazole | Combination product | Class-level overview — unverified | Search label |
| 232 | Dextroamphetamine | CNS stimulant | Class-level overview — unverified | Search label |
| 233 | Omega-3-acid ethyl esters | Drug-specific class—review required | Class-level overview — unverified | Search label |
| 234 | Epinephrine | Nonselective adrenergic agonist | Expanded study example — unverified | Search label |
| 235 | Levofloxacin | Antibiotic | Class-level overview — unverified | Search label |
| 236 | Promethazine/dextromethorphan | Combination product | Class-level overview — unverified | Search label |
| 237 | Ramipril | ACE inhibitor | Class-level overview — unverified | Search label |
| 238 | Loperamide | GI agent | Class-level overview — unverified | Search label |
| 239 | Mirabegron | Drug-specific class—review required | Class-level overview — unverified | Search label |
| 240 | Medroxyprogesterone | Hormonal therapy | Class-level overview — unverified | Search label |
| 241 | Dexamethasone | Corticosteroid | Class-level overview — unverified | Search label |
| 242 | Sucralfate | GI agent | Class-level overview — unverified | Search label |
| 243 | Ubrogepant | Migraine medication | Class-level overview — unverified | Search label |
| 244 | Pramipexole | Other neurologic | Class-level overview — unverified | Search label |
| 245 | Calcitriol | Vitamin / mineral | Class-level overview — unverified | Search label |
| 246 | Ipratropium | Anticholinergic bronchodilator | Class-level overview — unverified | Search label |
| 247 | Ticagrelor | Antiplatelet | Class-level overview — unverified | Search label |
| 248 | Fexofenadine | H1 antihistamine | Class-level overview — unverified | Search label |
| 249 | Pancrelipase | Other prescription | Class-level overview — unverified | Search label |
| 250 | Polymyxin B/trimethoprim | Combination product | Class-level overview — unverified | Search label |
| 251 | Bumetanide | Loop diuretic | Class-level overview — unverified | Search label |
| 252 | Labetalol | Beta blocker | Class-level overview — unverified | Search label |
| 253 | Sodium salts | Drug-specific class—review required | Class-level overview — unverified | Search label |
| 254 | Alfuzosin | Alpha-1 antagonist | Class-level overview — unverified | Search label |
| 255 | Senna/docusate | Combination product | Class-level overview — unverified | Search label |
| 256 | Moxifloxacin | Antibiotic | Class-level overview — unverified | Search label |
| 257 | Clotrimazole | Antifungal | Class-level overview — unverified | Search label |
| 258 | Terbinafine | Antifungal | Class-level overview — unverified | Search label |
| 259 | Isotretinoin | Dermatologic | Class-level overview — unverified | Search label |
| 260 | NPH insulin | Insulin | Class-level overview — unverified | Search label |
| 261 | Calcium phosphate/cholecalciferol | Combination product | Class-level overview — unverified | Search label |
| 262 | Insulin detemir | Insulin | Class-level overview — unverified | Search label |
| 263 | Letrozole | Drug-specific class—review required | Class-level overview — unverified | Search label |
| 264 | Sodium fluoride | Drug-specific class—review required | Class-level overview — unverified | Search label |
| 265 | Acetaminophen/butalbital/caffeine | Combination product | Class-level overview — unverified | Search label |
| 266 | Ciclopirox | Antifungal | Class-level overview — unverified | Search label |
| 267 | Cyproheptadine | H1 antihistamine | Class-level overview — unverified | Search label |
| 268 | Amiodarone | Class III antiarrhythmic | Expanded study example — unverified | Search label |
| 269 | Ethinyl estradiol/norelgestromin | Hormonal contraception | Class-level overview — unverified | Search label |
| 270 | Desogestrel/ethinyl estradiol | Hormonal contraception | Class-level overview — unverified | Search label |
| 271 | Chlorhexidine | Drug-specific class—review required | Class-level overview — unverified | Search label |
| 272 | Nabumetone | NSAID | Class-level overview — unverified | Search label |
| 273 | Lidocaine | Local anesthetic / class Ib antiarrhythmic | Expanded study example — unverified | Search label |
| 274 | Hydroquinone | Dermatologic | Class-level overview — unverified | Search label |
| 275 | Codeine/guaifenesin | Combination product | Class-level overview — unverified | Search label |
| 276 | Dexamethasone/neomycin/polymyxin B | Combination product | Class-level overview — unverified | Search label |
| 277 | PEG-electrolyte bowel preparation | Drug-specific class—review required | Class-level overview — unverified | Search label |
| 278 | Penicillin V | Drug-specific class—review required | Class-level overview — unverified | Search label |
| 279 | Diphenhydramine | H1 antihistamine | Class-level overview — unverified | Search label |
| 280 | Levalbuterol | Beta-2 bronchodilator | Class-level overview — unverified | Search label |
| 281 | Lactate salts | Drug-specific class—review required | Class-level overview — unverified | Search label |
| 282 | Liraglutide | GLP-1 / incretin therapy | Class-level overview — unverified | Search label |
| 283 | Guanfacine | Drug-specific class—review required | Class-level overview — unverified | Search label |
| 284 | Betamethasone | Corticosteroid | Class-level overview — unverified | Search label |
| 285 | Mometasone | Corticosteroid | Class-level overview — unverified | Search label |
| 286 | Fluorouracil | Dermatologic | Class-level overview — unverified | Search label |
| 287 | Beclomethasone | Corticosteroid | Class-level overview — unverified | Search label |
| 288 | Loratadine/pseudoephedrine | Combination product | Class-level overview — unverified | Search label |
| 289 | Ascorbic acid | Vitamin / mineral | Class-level overview — unverified | Search label |
| 290 | Mycophenolate mofetil | Immunomodulator | Class-level overview — unverified | Search label |
| 291 | Olopatadine | H1 antihistamine | Class-level overview — unverified | Search label |
| 292 | Indomethacin | NSAID | Class-level overview — unverified | Search label |
| 293 | Brompheniramine/dextromethorphan/pseudoephedrine | Combination product | Class-level overview — unverified | Search label |
| 294 | Benzoyl peroxide | Drug-specific class—review required | Class-level overview — unverified | Search label |
| 295 | Ciprofloxacin/dexamethasone | Combination product | Class-level overview — unverified | Search label |
| 296 | Phenazopyridine | Drug-specific class—review required | Class-level overview — unverified | Search label |
| 297 | Cefuroxime | Antibiotic | Class-level overview — unverified | Search label |
| 298 | Thiamine | Vitamin / mineral | Class-level overview — unverified | Search label |
| 299 | Ethinyl estradiol/norgestrel | Hormonal contraception | Class-level overview — unverified | Search label |
| 300 | Sulfacetamide/sulfur | Combination product | Class-level overview — unverified | Search label |
Interaction practice — 22 paired rules
Rule existence does not establish an exhaustive clinical interaction checker. Empty or unknown results must not be interpreted as evidence of safety.
| ID | Pair | App severity | App rationale | Label status |
|---|---|---|---|---|
| INTERACTION-001 | Warfarin + Ibuprofen | Major | Increased bleeding risk with warfarin and an NSAID. Avoid unsupervised combination; check INR/bleeding and prescriber plan. | FDA label reconciliation pending |
| INTERACTION-002 | Warfarin + Naproxen | Major | Warfarin plus NSAID increases bleeding risk; discuss alternative analgesia and monitor. | FDA label reconciliation pending |
| INTERACTION-003 | Warfarin + Aspirin | Major | Additive antithrombotic effect increases bleeding; combinations require a specific indication and monitoring. | FDA label reconciliation pending |
| INTERACTION-004 | Apixaban + Ibuprofen | Major | DOAC plus NSAID increases GI and other bleeding risk. | FDA label reconciliation pending |
| INTERACTION-005 | Apixaban + Aspirin | Major | Additive bleeding risk; dual therapy requires a documented indication. | FDA label reconciliation pending |
| INTERACTION-006 | Rivaroxaban + Ibuprofen | Major | DOAC plus NSAID increases bleeding risk. | FDA label reconciliation pending |
| INTERACTION-007 | Rivaroxaban + Aspirin | Major | Additive bleeding risk; verify reason for combination. | FDA label reconciliation pending |
| INTERACTION-008 | Clopidogrel + Omeprazole | Significant | Omeprazole inhibits CYP2C19 and may reduce clopidogrel activation; label guidance favors avoiding this combination. | FDA label reconciliation pending |
| INTERACTION-009 | Clopidogrel + Esomeprazole | Significant | Esomeprazole inhibits CYP2C19 and may reduce clopidogrel antiplatelet activation. | FDA label reconciliation pending |
| INTERACTION-010 | Lisinopril + Spironolactone | Significant | ACE inhibitor plus potassium-sparing diuretic can cause hyperkalemia; monitor potassium and kidney function. | FDA label reconciliation pending |
| INTERACTION-011 | Losartan + Spironolactone | Significant | ARB plus potassium-sparing diuretic increases hyperkalemia risk. | FDA label reconciliation pending |
| INTERACTION-012 | Lisinopril + Losartan | Avoid combination | Dual renin-angiotensin blockade raises renal injury, hypotension and hyperkalemia risk with limited benefit. | FDA label reconciliation pending |
| INTERACTION-013 | Sildenafil + Nitroglycerin | Contraindicated | PDE5 inhibitor plus nitrate can cause severe hypotension. Never coadminister; check timing and local emergency protocols. | FDA label reconciliation pending |
| INTERACTION-014 | Tadalafil + Nitroglycerin | Contraindicated | PDE5 inhibitor plus nitrate can cause profound hypotension; tadalafil has a prolonged effect. | FDA label reconciliation pending |
| INTERACTION-015 | Oxycodone + Alprazolam | Major | Opioid plus benzodiazepine: additive sedation and respiratory depression. | FDA label reconciliation pending |
| INTERACTION-016 | Morphine + Lorazepam | Major | Opioid plus benzodiazepine increases sedation and respiratory-depression risk. | FDA label reconciliation pending |
| INTERACTION-017 | Tramadol + Sertraline | Significant | Serotonergic activity raises serotonin-syndrome and seizure concerns. | FDA label reconciliation pending |
| INTERACTION-018 | Tramadol + Fluoxetine | Significant | Serotonin syndrome/seizure risk; fluoxetine CYP2D6 effects may change tramadol metabolism. | FDA label reconciliation pending |
| INTERACTION-019 | Metoprolol + Verapamil | Significant | Combined AV-nodal suppression can produce severe bradycardia, AV block or hypotension. | FDA label reconciliation pending |
| INTERACTION-020 | Metoprolol + Diltiazem | Significant | Combined AV-nodal blockade increases bradycardia and hypotension risk. | FDA label reconciliation pending |
| INTERACTION-021 | Lithium + Ibuprofen | Significant | NSAIDs may decrease lithium renal clearance, increasing toxicity risk. | FDA label reconciliation pending |
| INTERACTION-022 | Lithium + Hydrochlorothiazide | Significant | Thiazides can raise lithium concentrations and toxicity risk. | FDA label reconciliation pending |
Source reuse permissions
| Reference | Permissions | Permitted workflow |
|---|---|---|
| Open RN Health Alterations (2024) | CC BY 4.0, check embedded third-party items | Reusable text subject to specific embedded exclusions, with credit |
| Open RN Health Alterations: Respiratory Alterations | CC BY 4.0; embedded NC exceptions | Educational framework; avoid reuse of separately credited NC items |
| Open RN Nursing Skills 2e | CC BY 4.0, check embedded rights | Clinical skills and safety background |
| Open RN Nursing Pharmacology 2e | CC BY 4.0, check embedded rights | Drug class background; not dose formulary |
| Open RN OER textbook collection (Advanced Skills available) | CC BY 4.0 at collection level; embedded rights may differ | Open nursing skills and critical-care fundamentals |
| MedlinePlus: Public domain vs third-party content policy | Public domain only for listed original US federal sections | Facts/reference; exclude A.D.A.M., ASHP drug monographs and uncredited images |
| AHA 2025 Adult Advanced Life Support Guideline | Copyrighted reference; link/cite only | Resuscitation and rhythm decisions; no copyrighted artwork or passages reproduced |
| 2026 AHA/ACC multi-society acute pulmonary embolism guideline | Copyrighted reference; link/cite only | Diagnostic/treatment reference; original authoring required |
| 2024 AARC spontaneous breathing trial clinical practice guideline | Publicly readable; reuse rights need separate check | Reference findings; do not lift wording, graphics or tables |
| ATS/ESICM/SCCM mechanical ventilation guideline | Copyrighted reference; link/cite only | Lung-protective ventilation concepts |
| ACOG 2025 Intrapartum FHR Monitoring, CPG 10 | Copyrighted and partly member-only | Reference only; no charts/tables/algorithms copied |
| DailyMed: NIH/NLM label access | Label-by-label rights not blanket CC grant | FDA-submitted drug labeling reference; verify per medication |
| Creative Commons Attribution 4.0 | License instrument | Attribution/license/changes must accompany adapted content |
Remaining clinical and legal verification
Requires a qualified clinical editor to confirm each learning item's answer/explanation and the labeling of each medication and interaction, particularly where current dosing, contraindications, resuscitation algorithms or diagnostic decisions appear. Verify the original authorship of remaining inherited lesson text, terms and ranking data before representing the full site as cleared for commercial reuse. This is an editorial traceability register, not legal advice.
Report produced October 26, 2026. See AUDIT_INDEX_ITEM_BY_ITEM.json and AUDIT_MEDICATIONS_INTERACTIONS.json in the private archive for machine-readable records.