Instructions:

• Answer 50 questions in 15 minutes.
• If you are not ready to take this test, you can study here.
• Match each statement with the correct term.
• Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. What should you do if the PTT value is 80 for someone on heparin?
Inspect pulses on chest - inspect the internal jugular veins - palpate the apical pulse - palpate the carotid arteries - and auscultate the heart sounds.
D/C the med and call the doctor.
Assess and mark the location of the dorsalis pedis and posterior tibial pulses in affected leg - wash hands and put on sterile gloves - gown - and mask - position device - check circulation and make sure good pedal pulse is present - IMMEDIATELY REPO
Fifth left intercostal space medial to the midclavicular line.


2. Which type of patient shouldn't take nitrates?
A clinician will perform echocardiogram guided pericardiocentesis with a needle or catheter to remove excess fluid in the pericardial sac.
Pulse before and after giving.
A patient on sildenafil (Viagra) - Cealis - or Levitra bc these drugs together can cause very low blood pressure and heart attack.
It is noninvasive. You must not eat - smoke - or drink alcohol for 3 hours before the test. WEAR COMFORTABLE SHOES And LOOSE LIGHTWEIGHT SHORTS OR SLACKS - YOU MAY GET AN INJECTION of THAllIUM - after your blood pressure and ECG are monitored for 10-


3. What condition can cause left sided heart failure?
Second right intercostal space
ICG is a noninvasive way to collect hemodynamic data for assessing patients with heart failure - hypertension - or dyspnea.
SOB - dyspnea - anxiousness - diaphoresis - cool/clammy skin - distended neck veins - mental status changes - narrowed pulse pressure - hypotension - and faint or muffled heart sounds.
Vascular - artery disease causing fluid to back up into the lungs.


4. What should you tell someone about taking nitroglycerin tablets (SE)?
Feeling warm (fire) or tin can taste is expected and will pass.
No clearly defined or measurable P waves and an irregular - irregular ventricular response.
Left sternal border
They may feel a slight stinging under there tongue when they are dissolving - and they should get a HA (if no HA may not be good bc the pills only last for 6 months). Keep with you at all times.


5. What is more harmful a lot of little emboli or one large emboli?
MRI is painless - you must remain still inside a small/noisy space. If you are claustrophobic you may need sedation. Remove all jewelry and other metal objects. If you have any shrapnel - a pacemaker - or any surgically implanted joints - pins - clip
One large emboli (smaller=better)
Feeling warm (fire) or tin can taste is expected and will pass.
Demand: Works PRN (when HR goes below predetermined rate) or Fixed: beats constantly at predetermined rate so no matter what heart does still beats at same rate.


6. What is epistaxis?
A nosebleed
This noninvasive test takes 24 hours and causes no discomfort. Electrodes are applied to your body - you need to log your activities for a 24 hour period (walking - sleeping - urinating - physical symptoms - and medications). Don't tamper with the mo
To report to her healthcare provider if she feels a large bump in her groin - if she has groin pain unrelieved by acetaminophen - or if she develops numbness - tingling - etc. in the affected leg.
CPR should be done. No defibrillation bc no rhythm to shock (heart already depolarized).


7. Where is the pulmonic valve landmark on the chest?
Crushing chest pain that lasts 30 mins or longer and may radiate to the neck - shoulders - or jaw - diaphoresis - nausea - and SOB.
A drop in systolic BP greater than 12 mm Hg during inspiration indicating a compromise.
Second left intercostal space
Whether the patients ulnar and radial arteries are patent.


8. What should you know about your recovery period after having an implantable cardioverter defibrillator (ICD)?
Steroid treatment or a pregnant woman who is retaining water.
In fatty areas or over major muscles - large breasts - or bony prominences.
For the first month post op - do not lift more than 10 or 15 lbs. And avoid excessive pushing - pulling - or twisting.
Second left intercostal space


9. What are all the S&S of pericarditis?
Pericardial friction rub - chest pain (sharp and aggravated with breathing) - abnormal EKG findings - possible fever and tachycardia.
The physician injects a local anesthetic into the site - inserts a catheter - and threads it through the artery into the left side of the heart or through a vein into the right side of the heart to your lungs. Next - a dye is injected which may cause
Right sided heart failure
Need for follow up blood tests - Need to take oral warfarin for at least 3 months - and to reduce current risk encourage weight loss - smoking cessation - and regular exercise.


10. What will a leg with arterial insufficiency look like?
Ventricular rate is regular at a rate of 40-60 bpm and there is no relationship of P waves to QRS complexes.
Hair loss - muscle mass loss - pallor when elevated - dependent rubor - and prolonged cap refill time.
A nosebleed
IV LIDOCAINE BOLUS (50-100 mg) followed by an IV lidocaine drip (suppresses ventricular activity).


11. What does vasotec (Enalapril Maleate) do/SE?
All People Enjoy Time Magazine= Aortic - Pulmonic - ERB's point - Tricuspid - and Mitral/Apex. P(2) E (3) T (4) MA (5) (locations)
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).
Vitamin K (aqua myphiton)
Lowers BP and makes heart beat stronger. SE: flushed face.


12. For what disease should you do the Allen's test?

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13. What is a chemical stress test (persantine stress test)?
(S1 - S2) Third left intercostal space
In fatty areas or over major muscles - large breasts - or bony prominences.
Clip the hair to allow good contact between the electrodes and the skin (DONT SHAVE).
It is a test that examines the hearts response to being stressed by a pharmacologic agent. Persantine and adenosine vasodilate the coronary arteries and cause blood to shunt away from partially occluded coronary vessels. Then dobutamine stresses the


14. What should be done is a patient on anticoagulants suffers from epistaxis for more than 15 mins?
Posterior nasal packing to stop the blood flow. The LPN CAN DO THIS!
Exercise and use graduated compression devices as directed - don't stand for long period of time - to avoid dislodging blood clots don't rub or massage your legs.
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).
A central line placed that measures the right atrial pressure. Normal= 4-10 cm of H20.


15. What should you teach your patient about angiography (arteriography)?
GI - neuro - and cardiac. S&S= yellow/green vision - N&V - bradycardia - and anorexia.
Used to look at vessels. A local anesthetic is injected and a catheter is inserted into a vessel in the area and advanced as necessary. A contrast medium is injected into the vessel than a series of xrays follow. Any flushing sensation/nausea/ or unu
Leg pain that is brought on by exercise and relieved by rest. It is characteristic of peripheral artery occlusion/ arterial insufficiency. It is dull or cramp like and consistently occurs in the same area of the leg and with same amount of distance.
Using both gloved hands - apply firm pressure just above the skin puncture site and over the hematoma to compress the area. Wait at least 15 mins before removing pressure and reassessing the site. Then notify the health care provider.


16. What should you do if the PT value is 45 sec?
All People Enjoy Time Magazine= Aortic - Pulmonic - ERB's point - Tricuspid - and Mitral/Apex. P(2) E (3) T (4) MA (5) (locations)
D/C the med and call the doctor.
An enlarged space indicates fluid accumulation in the pericardial sac.
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).


17. What should happen if someone converts to asystole/flatline?
Difficulty breathing - pain in midchest and shoulder - pale - nausea - and light headedness.
CPR should be done. No defibrillation bc no rhythm to shock (heart already depolarized).
Open up blood vessels
To inhibit thrombus and clot formation.


18. What causes essential/primary hypertension?
Idiopathic
Used to look at vessels. A local anesthetic is injected and a catheter is inserted into a vessel in the area and advanced as necessary. A contrast medium is injected into the vessel than a series of xrays follow. Any flushing sensation/nausea/ or unu
The physician injects a local anesthetic into the site - inserts a catheter - and threads it through the artery into the left side of the heart or through a vein into the right side of the heart to your lungs. Next - a dye is injected which may cause
Lung disease


19. What are the 2 types of pacemakers?
For the first month post op - do not lift more than 10 or 15 lbs. And avoid excessive pushing - pulling - or twisting.
Direct current shock (defibrillation) and IV anti - arrhythmic drugs (lidocaine - Procainamide - and Bretylium).
Demand: Works PRN (when HR goes below predetermined rate) or Fixed: beats constantly at predetermined rate so no matter what heart does still beats at same rate.
All People Enjoy Time Magazine= Aortic - Pulmonic - ERB's point - Tricuspid - and Mitral/Apex. P(2) E (3) T (4) MA (5) (locations)


20. What is the hallmark clinical finding associated with pericarditis?
Paroxysmal nocturnal dyspnea - elevated pulmonary capillary wedge pressure - BLOOD TINGED SPUTUM - cough - orthopnea - exertional dyspnea - cyanosis.
Right atrium - TRICUSPID VALVE (tissue) - right ventricle - PULMONIC VALVE (paper) - lungs - left atrium - MITRAL VALVE (My) - left ventricle - AORTIC VALVE (Assets). Tissue PAPER MY ASSETS!
Pericardial friction rub: A high pitched squeaking or grating sound during cardiac contraction. It is typically best heard when the patient sits - leans forward - and breaths out.
The internal jugular veins (external are less reliable).


21. What should you watch for with PICC lines that have been in place for 6 months?
Used to detect an abdominal aortic aneurysm. This noninvasive test takes 15 to 30 mins. They apply conductive gel to your abdomen and move a transducer over abdomen to scan blood vessels. Sound waves bouncing off anatomic structures are translated in
RAndI= Razor - electric - Aspirin - NO - Needles - small gauge - Decrease - needle sticks - and Injury- protect from. No percodan or NSAIDS - no open toed shoes.
Air answers (open junctions)
Exercise and use graduated compression devices as directed - don't stand for long period of time - to avoid dislodging blood clots don't rub or massage your legs.


22. How is the arterial brachial index (ABI) calculated? Who should perform this? What is normal?
Varicose veins - elevate legs - weight reduction - brawny in color - ted hose - topical steroids - ulcers - and skin color changes.
It will take 5 mins and he/she should remain quiet for about 1 minute without talking or moving.
It is calculated by checking the brachial BP and the ankle BP. The ankle systolic pressure is divided by the brachial systolic. The NA can perform. 0.97-1 is normal anything below indicates ischemia.
The right and left ventricular pressures - cardiac output - arterial venous O2 difference - and pulmonary artery pressure.


23. During an Allen's test don't compress one artery _____ the other.
INTERVENE: to control edema and decrease pain patient should be on bed rest with legs elevated six inches above heart level.
Air answers (open junctions)
Must be flushed 1x/month with heparin and between treatments.
Before


24. What should you teach your patient about MRI?
Maintain BED REST
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).
(1st) Assess the client for S&S of decreased cardiac output and Notify physician (2nd).
MRI is painless - you must remain still inside a small/noisy space. If you are claustrophobic you may need sedation. Remove all jewelry and other metal objects. If you have any shrapnel - a pacemaker - or any surgically implanted joints - pins - clip


25. What activity should a patient with pericarditis - who is undergoing treatment - be allowed?
(1ST) BEGIN CARDIOPULMONARY RESUSCITATION (The PT. Is DYING) And NotIFY PHYSICIAN (2ND).
Maintain BED REST
RAndI= Razor - electric - Aspirin - NO - Needles - small gauge - Decrease - needle sticks - and Injury- protect from. No percodan or NSAIDS - no open toed shoes.
Demand: Works PRN (when HR goes below predetermined rate) or Fixed: beats constantly at predetermined rate so no matter what heart does still beats at same rate.


26. What is pulsus paradoxus?
A drop in systolic BP greater than 12 mm Hg during inspiration indicating a compromise.
Nitrates - Beta blockers - and Calcium channel blockers
The internal jugular veins (external are less reliable).
An enlarged space indicates fluid accumulation in the pericardial sac.


27. What should you teach your patient about a holter monitor?

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28. If 2 liters of fluid is left in the pericardial sac (cardiac tamponade) and goes untreated what could it cause?
Patient who are unable to tolerate exercise stress testing.
INTERVENE: to control edema and decrease pain patient should be on bed rest with legs elevated six inches above heart level.
Right sided heart failure
Direct current shock (defibrillation) and IV anti - arrhythmic drugs (lidocaine - Procainamide - and Bretylium).


29. What type of EKG change indicates MI?
When they occur >6 per minute or occurring 2 or more in a row (bigeminy or trigeminy=on way out).
High pitched sounds like S1 and S2 (pericardial friction rubs - aortic/mitral regurgitation murmurs). DIAPH(high)ragm
ST segment elevation (STEMI)
One large emboli (smaller=better)


30. What is pericarditis?
Don't interfere!
An inflammation of the pericardium. It may result in MI.
A life threatening emergency that involves a tear in the aorta's intimal layer allowing blood to flow through a false lumen creating a hematoma or false aneurysm.
Check all junctions frequently to make sure secure - especially before patient gets out of bed - and always use tubing with twist lock connections.


31. What disease can cause right sided heart failure?
One at a time to assess the pulse amplitude and contour.
Lung disease
Smoking - elevated cholesterol - diabetes - hypertension - old age - and family hx of coronary artery disease.
Pulse before and after giving.


32. How is the Allen's test done?
ST segment elevation (STEMI)
Ask patient to make a tight fist - using your index and middle fingers compress both the radial and ulnar arteries to obstruct blood flow to hand - ask pt to relax hand (hand and palm should appear blanched bc flow stopped) - release pressure on ulna
A clinician will perform echocardiogram guided pericardiocentesis with a needle or catheter to remove excess fluid in the pericardial sac.
Check for response - activate ERS - open airway head tilt chin lift - check breathing (5-10 sec) - give 2 breaths (1 sec) with visible chest rise - checks brachial pulse (5-10 sec) - locates CPR finger position - deliver 1st cycle of compressions (30


33. If a victim is choking but can cough - speak - or breath what should you do?

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34. What are the steps to perform the heimlich maneuver?
Stand behind the victim - wrap arms around waist (IF PREGNANT WRAP ABOVE The BABy) - make a fist with one had and place thumb against abdomen midline - grasp fist with other hand - press into victims abdomen with quick upward thrusts.
Patient who are unable to tolerate exercise stress testing.
The damaged portion of the aorta is removed and is repaired with a synthetic graft.
Chronic arteriosclerotic disease.


35. For which heart sounds should the diaphragm be used?
High pitched sounds like S1 and S2 (pericardial friction rubs - aortic/mitral regurgitation murmurs). DIAPH(high)ragm
4th left intercostal space lower sternal border
Used to look at vessels. A local anesthetic is injected and a catheter is inserted into a vessel in the area and advanced as necessary. A contrast medium is injected into the vessel than a series of xrays follow. Any flushing sensation/nausea/ or unu
Only for a few hours


36. Where is the aortic valve landmark on the chest?
Second right intercostal space
Air answers (open junctions)
Assess and mark the location of the dorsalis pedis and posterior tibial pulses in affected leg - wash hands and put on sterile gloves - gown - and mask - position device - check circulation and make sure good pedal pulse is present - IMMEDIATELY REPO
Rescuer arrives with AED - turn AED on - select proper pads and apply - clear victim to analyze - clear victim to shock/press shock - resume chest compressions after 1 shock - delivers cycle of compressions at correct rate - pause to allow other resc


37. What should you do prior to placing cardiac monitor electrodes on the skin (4 things)?
A drop in systolic BP greater than 12 mm Hg during inspiration indicating a compromise.
Steroid treatment or a pregnant woman who is retaining water.
Patient who are unable to tolerate exercise stress testing.
Clip hair if necessary - abrade the skin (use abrader pads or fine sandpaper and lightly rub skin using 2 or 3 brisk strokes - improves tracings) - dry skin if necessary - and attach the lead wires to the electrodes before you apply them to the patie


38. What type of surgery is done for an aortic dissection?
You need to maintain use of those devices continually except when the patient is ambulating - bathing - or during physical therapy or skin assessment.
The damaged portion of the aorta is removed and is repaired with a synthetic graft.
Right sided heart failure
Low pitched sounds such as S3 and S4 and the murmur of mitral stenosis. BEL(low)L


39. Who would most likely have peripheral venous disease?
When they occur >6 per minute or occurring 2 or more in a row (bigeminy or trigeminy=on way out).
Old truck driver or someone on bed rest or with pelvic trauma.
File toe nails - if have new shoes only wear 2 hrs/day d/t neuropathy can't feel if problem. To decrease pain of claudication massage legs to increase circulation.
A drop in systolic BP greater than 12 mm Hg during inspiration indicating a compromise.


40. What should you do immediately for someone experiencing anticoagulant induced epistaxis?
Don a protective gown - gloves - and goggles - call Dr - hand pt. emesis basin and raise the HOB 45* (at this angle he can spit out blood and prevent N&V/aspiration - have another nurse firmly press on his nose just below bony part (apply pressure at
Rapid ventricular rate with no relationship to atrial activity and QRS complex is wide and bizarre.
Lung disease
Pulmonary edema


41. What should you teach a patient regarding discharge after a DVT?

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42. What should you do if the patient you are applying cardiac monitor electrodes to is hairy?
Fatigue - JVD - Increased peripheral venous pressure - ascites - anorexia/complaints of GI distress - cyanosis - and dependent edema.
(1st) Assess LOC - (2nd) if unconscious= begin CPR - and (3rd) Notify physician.
Second Right intercostal space.
Clip the hair to allow good contact between the electrodes and the skin (DONT SHAVE).


43. What should you do if you are going to ventilate someone with an ambu bag?
The patient may suffer significant blood loss or femoral nerve compression.
If you feel lightheaded - dizzy - or heart palpitations but feel no shock from the ICD.
Lower HOB - place patient supine - assess LOC - open airway - assess breathing - get ambu bag - put on gloves - connect tubing from O2 source - adjust flow to 10 to 15 liters. First RESCUER: PLACE APEX of MASK OVER BRIDGE of NOSE And BASE BETWEEN LOW
Fourth or fifth intercostal space at or medial to the midclavicular line.


44. What should you go when applying nitroglycerin ointment for angina?
BIRTH CONTROL PILL (LEADING CAUSE of HTN In YOUNG WOMEN-45=STILL YOUNG) - BLACK Male (then white male - than black female - then white female) - obesity - smoking - stress - high Na diet - lack of exercise - age - sex - race - or noncompliance.
Pulse before and after giving.
Put on gloves - remove the previous application paper and use a tissue to remove all ointment from the site to prevent overdose - squeeze the prescribed ointment in a thin layer onto a clean ruled application paper - choose an unused site on the ches
Paroxysmal nocturnal dyspnea - elevated pulmonary capillary wedge pressure - BLOOD TINGED SPUTUM - cough - orthopnea - exertional dyspnea - cyanosis.


45. What is cardioversion?

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46. What are the steps for adult 2 rescuer CPR?
Rescuer arrives with AED - turn AED on - select proper pads and apply - clear victim to analyze - clear victim to shock/press shock - resume chest compressions after 1 shock - delivers cycle of compressions at correct rate - pause to allow other resc
Limit the size of the infarction is the goal. Treatment= thrombolytic therapy (tPA) initiated within 6 hours of the first symptoms= standard treatment.
Decreased tissue perfusion. Tx: clot busting treatment must start within 6 hours.
Used to detect an abdominal aortic aneurysm. This noninvasive test takes 15 to 30 mins. They apply conductive gel to your abdomen and move a transducer over abdomen to scan blood vessels. Sound waves bouncing off anatomic structures are translated in


47. What is a nursing diagnosis for arterial occlusion? Tx
International Normalized Ratio measures blood clotting time and compares it to normal values. 1.0=normal. Most people on anticoagulants are 2-3.
Decreased tissue perfusion. Tx: clot busting treatment must start within 6 hours.
Demand: Works PRN (when HR goes below predetermined rate) or Fixed: beats constantly at predetermined rate so no matter what heart does still beats at same rate.
Anxiousness - restlessness - tachycardia - tachypneic - 90% SP02 - dyspnea - substernal pain - coughing - hemoptysis - and fever.


48. When should a patient call 911 after having an implantable cardioverter defibrillator (ICD) placed?
A life threatening emergency that involves a tear in the aorta's intimal layer allowing blood to flow through a false lumen creating a hematoma or false aneurysm.
Include rest periods prior to any activity.
If you feel lightheaded - dizzy - or heart palpitations but feel no shock from the ICD.
Chronic arteriosclerotic disease.


49. What does plan of care include?
Elevated legs - anticoagulation therapy (aggressive: generally IV heparin) - Be alert for signs of PE.
Left sternal border
Use sterile gloves and aseptic technique - clean skin over port with alcohol or iodine - insert a 21 or 22 gauge HUBER needle (noncoring - won't break apart) attached to syringe or tubing into the middle of the port until rigid back of port is palpab
Limit the size of the infarction is the goal. Treatment= thrombolytic therapy (tPA) initiated within 6 hours of the first symptoms= standard treatment.


50. What are the treatments/ S&S of peripheral venous disease?
INTERVENE: to control edema and decrease pain patient should be on bed rest with legs elevated six inches above heart level.
Pericardial friction rub: A high pitched squeaking or grating sound during cardiac contraction. It is typically best heard when the patient sits - leans forward - and breaths out.
Varicose veins - elevate legs - weight reduction - brawny in color - ted hose - topical steroids - ulcers - and skin color changes.
After a sheath removal to apply consistent pressure and prevent bleeding. (Ex: after swan ganz removal).