Test your basic knowledge |

NCLEX Cardiac

Subjects : nclex, health-sciences, nursing

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. How should you palpate the carotid arteries?
It is an elective procedure - where the client is awake - it is synchronized with 'QRS' - the patient is sedated - a consent form must be signed prior to - they are placed on an EKG monitor - and they are shocked with 50-200 Joules.
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.
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-
One at a time to assess the pulse amplitude and contour.

2. What should you tell a patient who developed a hematoma in the hospital and is being discharged?
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.
Aortic valve - Pulmonic valve - right ventricle - tricuspid valve - and apex or mitral valve.
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).

3. What should you suspect for someone who post cardiac cath and percutaneous coronary intervention reporting feeling a pop in her left groin followed by a saturated dressing - swelling around site - palpable 2 inch fullness - and a bruit is present?
One at a time to assess the pulse amplitude and contour.
A clinician will perform echocardiogram guided pericardiocentesis with a needle or catheter to remove excess fluid in the pericardial sac.
A hematoma= bleeding into the soft tissue surrounding the femoral artery access site.
Patient who are unable to tolerate exercise stress testing.

4. What is the treatments for hypertension?
It usually occurs when your heart is working harder (ex: exercising - eating large meal - or feeling stress. Also very hot or cold weather).
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.
Decrease in weight - diuretics (watch K loss) - aldactone (k sparing but check renal fx) - inderal (do Not give to asthma patients or diabetic patients) - more exercise - no smoking - and decreased Na intake.
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

5. Where is the pulmonic valve landmark on the chest?
No clearly defined or measurable P waves and an irregular - irregular ventricular response.
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.
NO TED HOSE - NO SHEETS/BLANKETS - NO COMPRESSION DEVICES - (TEACH NO OPEN TOES SHOES). Lambs wool is okay!
Second left intercostal space

6. What do calcium channel blockers do?
When they occur >6 per minute or occurring 2 or more in a row (bigeminy or trigeminy=on way out).
Open up blood vessels
CPR should be done. No defibrillation bc no rhythm to shock (heart already depolarized).
Gently insert the oropharyngeal airway by turning it upside down (into U shape) and slide it into the mouth. As continue to insert rotate it so the ends of the U turn downward into an arch shape after it transverses the oral cavity and approaches the

7. What is angina? Stable vs. unstable?

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183

8. What does an Allen's test determine?
Air answers (open junctions)
Whether the patients ulnar and radial arteries are patent.
It is a sterile procedure so both nurse and patient should wear a mask - arrange sterile field - remove dressing - assess the catheter insertion site for infection - put on sterile gloves - clean the site moving outwardly in a circular motion - apply
Lung disease

9. How is the arterial brachial index (ABI) calculated? Who should perform this? What is normal?
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.
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.
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
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).

10. What type of EKG change indicates MI?
ST segment elevation (STEMI)
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.
Check all junctions frequently to make sure secure - especially before patient gets out of bed - and always use tubing with twist lock connections.
A disease in which thrombi trap blood in the deep veins of the pelvis and legs.

11. What lab value is used to evaluate a patient on coumadin? What is the normal value?
Only for a few hours
Left sternal border
PT. Normal= 12 sec. If on anticoagulants it should be between 1 1/2 to 2 1/2 x the normal value. For PT= 18-30 sec.
Activity intolerance

12. What should you watch for with PICC lines that have been in place for 6 months?
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)
Right sided heart failure
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

13. What should happen if someone converts to asystole/flatline?
Iodine
CPR should be done. No defibrillation bc no rhythm to shock (heart already depolarized).
Pulmonary edema
Second Left intercostal space

14. How long is contrast media in the body?
Only for a few hours
Lowers BP and makes heart beat stronger. SE: flushed face.
A patient on sildenafil (Viagra) - Cealis - or Levitra bc these drugs together can cause very low blood pressure and heart attack.
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

15. How should you palpate the apical pulse?
When not visable - place the patient in the left lateral position - ask them to exhale fully and stop breathing for a few seconds.
Smoking - elevated cholesterol - diabetes - hypertension - old age - and family hx of coronary artery disease.
The damaged portion of the aorta is removed and is repaired with a synthetic graft.
Left sternal border

16. What causes essential/primary hypertension?
Hair loss - muscle mass loss - pallor when elevated - dependent rubor - and prolonged cap refill time.
D/C the med and call the doctor.
Pallor - diaphoresis - tachypnea - severe tearing chest pain radiating to back - PULSES In ARMS Are STRONG BUT LEG PULSES Are WEAK - low SP02.
Idiopathic

17. What should you teach your patient about a cardiac catheterization?
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
Left sternal border
If feel more than 3 shocks in a row or develop signs of infection at the site.
Decreased tissue perfusion. Tx: clot busting treatment must start within 6 hours.

18. What is the treatment for a patient in complete heart block?
Temporary or permanent transvenous PACEMAKER INSERTION - and if the client is symptomatic and showing S&S of decreased cardiac output - GIVE ATROPINE.
Aortic valve - Pulmonic valve - right ventricle - tricuspid valve - and apex or mitral valve.
INTERVENE: to control edema and decrease pain patient should be on bed rest with legs elevated six inches above heart level.
Vitamin K (aqua myphiton)

19. What should you teach your patient about an electrocardiogram (ECG)?
Air embolism
If you feel lightheaded - dizzy - or heart palpitations but feel no shock from the ICD.
It is a noninvasive test that takes 15 mins. Electrodes are applied to sites on your body. You must lie still - relax - and breathe normally and remain quiet. Talking or moving distorts the images
Diuretic & Digoxin (dig increases force of contraction and increases perfusion). Know working if client is peeing (kidney perfusion) and more alert!

20. What is an air embolism?
When a large air bubble blocks blood flow from the right ventricle into the pulmonary artery.
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.
Stroke - renal or heart failure - paraplegia secondary to compromised blood flow - or death from aortic rupture.
Lower left sternal border

21. Who would most likely have peripheral venous disease?
PTT. Normal= 30 sec. If on anticoagulants it should be between 1 1/2 to 2 1/2 x the normal value. For PTT= 45-75 sec.
Direct current cardioversion and digoxin/propranolol (inderal).
Stop the medication - address the factors that may have precipitated the event. If life threatening Digibind ay be indicated.
Old truck driver or someone on bed rest or with pelvic trauma.

22. What is the antidote for heparin?
Protamine Sulfate
Only for a few hours
An enlarged space indicates fluid accumulation in the pericardial sac.
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

23. What should you do if the PT value is 45 sec?
D/C the med and call the doctor.
Second Left intercostal space
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).
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.

24. 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.
Changing the way that you live is the first step. STOP SMOKING!!!! <30% FAT In DIET (don't avoid all fat) - lose weight - exercise - limit salt intake - nitro - Angioplasty (stent insertion) or CABG.
No clearly defined or measurable P waves and an irregular - irregular ventricular response.
The internal jugular veins (external are less reliable).

25. What are the proper steps to changing a central venous catheter dressing?
Stroke - renal or heart failure - paraplegia secondary to compromised blood flow - or death from aortic rupture.
It is a sterile procedure so both nurse and patient should wear a mask - arrange sterile field - remove dressing - assess the catheter insertion site for infection - put on sterile gloves - clean the site moving outwardly in a circular motion - apply
Nitrates - Beta blockers - and Calcium channel blockers
An inflammation of the pericardium. It may result in MI.

26. What are the steps for infant 1&2 rescuer CPR?
Include rest periods prior to any activity.
Smoking - elevated cholesterol - diabetes - hypertension - old age - and family hx of coronary artery disease.
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.
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

27. What should you do when applying a femoral artery compression device?
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
Direct current shock (defibrillation) and IV anti - arrhythmic drugs (lidocaine - Procainamide - and Bretylium).
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
Before

28. Where should you place your stethescope to find the pulmonic valve?
Idiopathic
4th left intercostal space lower sternal border
Second Left intercostal space
When not visable - place the patient in the left lateral position - ask them to exhale fully and stop breathing for a few seconds.

29. What will be the treatment for an acute episode of life threatening tamponade?
Spasms of the arterioles in finger/toes (digits of hands/feet may fall off). Tx: stop smoking - avoid stress & cold - use a vasodilator (calcium channel blocker). No skiing or butcher for career.
A clinician will perform echocardiogram guided pericardiocentesis with a needle or catheter to remove excess fluid in the pericardial sac.
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).
Close the open catheter lumen with the clamp - and place the pt on their left side in trendelenburg to move the air embolus away from the pulmonic valve. If you hear a churning sound in his chest (a classic sign of air embolus) and the patient starts

30. What would make someone more at risk for digoxin toxicity?
For the first month post op - do not lift more than 10 or 15 lbs. And avoid excessive pushing - pulling - or twisting.
Pneumothorax and will end up with chest tube to help reinflate lung.
MONA=Magnesium sulfate - O2 - Nitroglycerin - Aspirin (mona has a heart so EKG also if select all that apply).
Elderly - hypothyroidism - renal dysfunction - dehydration - HYPOKALEMIA - hypomagnesemia - or hypercalcemia. Patients with abnormal potassium levels have a higher risk because hypokalemia makes the heart more sensitive to digoxin.

31. What will the Transthoracic echocardiograph (TTE) show that will indicate cardiac tamponade?
Crushing chest pain that lasts 30 mins or longer and may radiate to the neck - shoulders - or jaw - diaphoresis - nausea - and SOB.
An enlarged space indicates fluid accumulation in the pericardial sac.
A nosebleed
Lowers BP and makes heart beat stronger. SE: flushed face.

32. What is a therapeutic digoxin level?
Chronic arteriosclerotic disease.
0.5-2.0 ng/ml
An inflammation of the pericardium. It may result in MI.
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.

33. What should you explain to the patient about an impedance cardiography test?
Cardiac tamponade (fluid in pericardial space) and thickening/scarring of the pericardial sac (constrictive pericarditis and possible RHF).
It will take 5 mins and he/she should remain quiet for about 1 minute without talking or moving.
It is a noninvasive test that takes 15 mins. Electrodes are applied to sites on your body. You must lie still - relax - and breathe normally and remain quiet. Talking or moving distorts the images
Vitamin K (aqua myphiton)

34. What is important to remember when removing a CVC from a patient?
Poorly controlled hypertension
Pericardial friction rub - chest pain (sharp and aggravated with breathing) - abnormal EKG findings - possible fever and tachycardia.
Have the patient use the val salva maneuver when the line is being removed (bear down/hold breath) to prevent air from entering where the line was and causing a PE.
Check for response - activate ERS and AED - open airway with head tilt chin lift - checking breathing (5-10 sec) - give 2 breaths (1 sec each) - check carotid pulse (5-10 sec) - locate CPR hand position - deliver first cycle of compressions (30 compr

35. What is defibrillation?
Used in an emergency (Vfib/defib) - used with Vfib or Vtach - NO CARDIAC OUTPUT - client is unconscious - EKG monitor - NO CONSENT NEEDED - begin with 200 Joules and up to 360.
An enlarged space indicates fluid accumulation in the pericardial sac.
When they occur >6 per minute or occurring 2 or more in a row (bigeminy or trigeminy=on way out).
PT. Normal= 12 sec. If on anticoagulants it should be between 1 1/2 to 2 1/2 x the normal value. For PT= 18-30 sec.

36. In What time period is the greatest risk of sudden death from an MI?
In the first 72 hours!!!!!
Protamine Sulfate
Left sternal border
Verapamil (calan) - diltiazem (cardizem) - nifedipine (procardia) - amlodipine (norvasc).

37. What are signs and symptoms of an MI?
Crushing chest pain that lasts 30 mins or longer and may radiate to the neck - shoulders - or jaw - diaphoresis - nausea - and SOB.
Iodine
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
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.

38. Where is the aortic valve landmark on the chest?
Second right intercostal space
GI - neuro - and cardiac. S&S= yellow/green vision - N&V - bradycardia - and anorexia.
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.
Feeling warm (fire) or tin can taste is expected and will pass.

39. What is a assessment finding with DVT?

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183

40. What should you remember while taking care of someone with a peripheral arterial occlusion?
NO TED HOSE - NO SHEETS/BLANKETS - NO COMPRESSION DEVICES - (TEACH NO OPEN TOES SHOES). Lambs wool is okay!
Clip the hair to allow good contact between the electrodes and the skin (DONT SHAVE).
A NON INVASIVE doppler exam of the heart via the thorax to detect cardiac tamponade.
In fatty areas or over major muscles - large breasts - or bony prominences.

41. When should bleeding precautions be implemented?
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
A complication from a venous access device or port. It is a blockage of the superior vena cava preventing superior blood flow from reaching the heart.
When: using anticoagulants - liver disease - decrease in platelets (less than 150 -000) - hemophilia - using thrombolytic meds - DIC - CA - HIV - chemo - bone marrow problems - and ASA/NSAIDS.
Having the patient supine is ideal but any position is acceptable so long as in same position for each monitoring session - locate clean and dry sensor sites on the neck (in line with earlobe) and thorax (midaxillary at xiphoid process) - connect lea

42. What is characteristic of atrial fibrillation?
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.
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.
No clearly defined or measurable P waves and an irregular - irregular ventricular response.
Awake and alert: IV lidocaine bolus and drip Unconscious - hypotensive - or S&S of angina/CHF: Direct current cardioversion and IV Lidocaine bolus and drip.

43. Test ending in Gram=?
Iodine
Diuretic & Digoxin (dig increases force of contraction and increases perfusion). Know working if client is peeing (kidney perfusion) and more alert!
Fat - Air - DVT - or Amniotic
Pericardial friction rub - chest pain (sharp and aggravated with breathing) - abnormal EKG findings - possible fever and tachycardia.

44. If you see a NA placing a patient with DVT in sitting position with legs dependent what should you do?
Gently insert the oropharyngeal airway by turning it upside down (into U shape) and slide it into the mouth. As continue to insert rotate it so the ends of the U turn downward into an arch shape after it transverses the oral cavity and approaches the
INTERVENE: to control edema and decrease pain patient should be on bed rest with legs elevated six inches above heart level.
Pallor - diaphoresis - tachypnea - severe tearing chest pain radiating to back - PULSES In ARMS Are STRONG BUT LEG PULSES Are WEAK - low SP02.
Protamine Sulfate

45. For which heart sounds should the bell be used?
A patient on sildenafil (Viagra) - Cealis - or Levitra bc these drugs together can cause very low blood pressure and heart attack.
Low pitched sounds such as S3 and S4 and the murmur of mitral stenosis. BEL(low)L
Old truck driver or someone on bed rest or with pelvic trauma.
Patient who are unable to tolerate exercise stress testing.

46. What should you always assume with a patient who has a central line placed and is experiencing SOB?
Air embolism
Low pitched sounds such as S3 and S4 and the murmur of mitral stenosis. BEL(low)L
Constipation or MAY CAUSE ANKLES TO SWELL (call healthcare provider).
Stop the medication - address the factors that may have precipitated the event. If life threatening Digibind ay be indicated.

47. What SE should you look for with calcium channel blocker use?
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
Constipation or MAY CAUSE ANKLES TO SWELL (call healthcare provider).
Decrease in weight - diuretics (watch K loss) - aldactone (k sparing but check renal fx) - inderal (do Not give to asthma patients or diabetic patients) - more exercise - no smoking - and decreased Na intake.
A fluid accumulation in the pericardial space that compromises cardiac function. It is considered a medical emergency and is a hemodynamic consequence of blood or excess fluid accumulation in the pericardial sac. Common causes are surgical or traumat

48. What should you do immediately for someone experiencing anticoagulant induced epistaxis?
A monitor with four dual electrodes that are applied to the patients neck and thorax.
Must be flushed 1x/month with heparin and between treatments.
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.
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

49. What are the S&S associated with right sided heart failure?
Elevated legs - anticoagulation therapy (aggressive: generally IV heparin) - Be alert for signs of PE.
D/C the med and call the doctor.
Fifth left intercostal space medial to the midclavicular line.
Fatigue - JVD - Increased peripheral venous pressure - ascites - anorexia/complaints of GI distress - cyanosis - and dependent edema.

50. What is Raynauds disease? Tx?
Lung disease
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!
Only for a few hours
Spasms of the arterioles in finger/toes (digits of hands/feet may fall off). Tx: stop smoking - avoid stress & cold - use a vasodilator (calcium channel blocker). No skiing or butcher for career.