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 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.
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.
Give furosemide (lasix) 40-60 mg IV - O2 administration - morphine sulfate 3-5 mg IV - have patient sit up with feet lowered (decreases venous return to the heart) - nitroglycerin given sublingual or IV - and rotating tourniquets (can reduce intratho
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.

2. What is intermittent claudication?
A disease in which thrombi trap blood in the deep veins of the pelvis and legs.
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.
The symptoms improve when the patient is sitting in upright position that promotes drainage but worsen with the client is lying down.
Second right intercostal space

3. What is more harmful a lot of little emboli or one large emboli?
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.
Elevated legs - anticoagulation therapy (aggressive: generally IV heparin) - Be alert for signs of PE.
One large emboli (smaller=better)
Vascular - artery disease causing fluid to back up into the lungs.

4. What is important to remember when taking care of patients with compression devices?
You need to maintain use of those devices continually except when the patient is ambulating - bathing - or during physical therapy or skin assessment.
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).
A nosebleed
In fatty areas or over major muscles - large breasts - or bony prominences.

5. What does the device for impedance cardiography consist of?
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
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
A monitor with four dual electrodes that are applied to the patients neck and thorax.
Decreased tissue perfusion. Tx: clot busting treatment must start within 6 hours.

6. Where should you place your stethescope to find the pulmonic valve?
To inhibit thrombus and clot formation.
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.
Second Left intercostal space
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

7. What is the maintenance for venous access port that isn't being regularly used?
Must be flushed 1x/month with heparin and between treatments.
(1st) Assess the client for S&S of decreased cardiac output and Notify physician (2nd).
You need to maintain use of those devices continually except when the patient is ambulating - bathing - or during physical therapy or skin assessment.
Poorly controlled hypertension

8. Without prompt surgery for an aortic dissection What is someone at risk for developing?
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
If feel more than 3 shocks in a row or develop signs of infection at the site.
When a large air bubble blocks blood flow from the right ventricle into the pulmonary artery.
Stroke - renal or heart failure - paraplegia secondary to compromised blood flow - or death from aortic rupture.

9. What should you do frequently for someone with a central line to help prevent pulmonary emboli?
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.
No radial artery punctures if negative
GI - neuro - and cardiac. S&S= yellow/green vision - N&V - bradycardia - and anorexia.
Check all junctions frequently to make sure secure - especially before patient gets out of bed - and always use tubing with twist lock connections.

10. What is a therapeutic digoxin level?
0.5-2.0 ng/ml
Second left intercostal space
Give furosemide (lasix) 40-60 mg IV - O2 administration - morphine sulfate 3-5 mg IV - have patient sit up with feet lowered (decreases venous return to the heart) - nitroglycerin given sublingual or IV - and rotating tourniquets (can reduce intratho
The internal jugular veins (external are less reliable).

11. What lab value is used to evaluate a patient on coumadin? What is the normal value?
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.
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
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
The right and left ventricular pressures - cardiac output - arterial venous O2 difference - and pulmonary artery pressure.

12. What causes essential/primary hypertension?
Direct current cardioversion and digoxin/propranolol (inderal).
Idiopathic
Cardiac tamponade (fluid in pericardial space) and thickening/scarring of the pericardial sac (constrictive pericarditis and possible RHF).
Crushing chest pain that lasts 30 mins or longer and may radiate to the neck - shoulders - or jaw - diaphoresis - nausea - and SOB.

13. For which heart sounds should the bell be used?
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
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.
Lung disease
Low pitched sounds such as S3 and S4 and the murmur of mitral stenosis. BEL(low)L

14. What are the 2 types of pacemakers?
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.
Before
In the first 72 hours!!!!!
Diuretic & Digoxin (dig increases force of contraction and increases perfusion). Know working if client is peeing (kidney perfusion) and more alert!

15. What does vasotec (Enalapril Maleate) do/SE?
Identify the highest point of pulsation and measure from this point to the sternal angle. A measurement of greater than 3 cm= an elevated venous pressure.
Varicose veins - elevate legs - weight reduction - brawny in color - ted hose - topical steroids - ulcers - and skin color changes.
MONA=Magnesium sulfate - O2 - Nitroglycerin - Aspirin (mona has a heart so EKG also if select all that apply).
Lowers BP and makes heart beat stronger. SE: flushed face.

16. Where do the internal jugular veins lie?
GI - neuro - and cardiac. S&S= yellow/green vision - N&V - bradycardia - and anorexia.
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.
Difficulty breathing - pain in midchest and shoulder - pale - nausea - and light headedness.
Deep in the sternomastoid muscle - so look for pulsations in the soft tissue surrounding that area.

17. What is the treatment for myocardial infarction?
MONA=Magnesium sulfate - O2 - Nitroglycerin - Aspirin (mona has a heart so EKG also if select all that apply).
Varicose veins - elevate legs - weight reduction - brawny in color - ted hose - topical steroids - ulcers - and skin color changes.
Temporary or permanent transvenous PACEMAKER INSERTION - and if the client is symptomatic and showing S&S of decreased cardiac output - GIVE ATROPINE.
Posterior nasal packing to stop the blood flow. The LPN CAN DO THIS!

18. What will be the treatment for an acute episode of life threatening tamponade?
A disease in which thrombi trap blood in the deep veins of the pelvis and legs.
A clinician will perform echocardiogram guided pericardiocentesis with a needle or catheter to remove excess fluid in the pericardial sac.
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.
No magnets (cell phone 6 inches away from) - DO Not DRINK CAFFEINATED BEVERAGES - DO Not ENGAGE In ROUGH ACTIVITIES (FOOTBAll OR WRESTLING) - and no tight clothing over site.

19. What is the treatment for a pt. with ventricular tachycardia?
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.
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.
Crushing chest pain that lasts 30 mins or longer and may radiate to the neck - shoulders - or jaw - diaphoresis - nausea - and SOB.
0.5-2.0 ng/ml

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

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

21. What SE should you look for with calcium channel blocker use?
Fifth left intercostal space medial to the midclavicular line.
Constipation or MAY CAUSE ANKLES TO SWELL (call healthcare provider).
Administer 100% O2 - left trendelenburg position - heparin administered - and oral warfarin started (give heparin and warfarin together for at least 5 days).
(1st) Assess the client for S&S of decreased cardiac output and Notify physician (2nd).

22. What should be done during the insertion of both a CVP catheter and a swan ganz catheter?
Vitamin K (aqua myphiton)
Trendelenburg position for insertion. Pt holds breath to prevent air from entering sinus tract.
D/C the med and call the doctor.
An enlarged space indicates fluid accumulation in the pericardial sac.

23. What should you do if you are going to ventilate someone with an ambu bag?
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
Feeling of fullness in head - tightness around shirt collar - or rings/jewelry that suddenly seem tight - swelling in face - hands - arms - and swollen/cyanotic lips - dyspnea - coughing - hoarseness - chest pain - hemotysis - visable collateral ches
Left sternal border
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

24. What could happen without immediate intervention for a hematoma?
GI - neuro - and cardiac. S&S= yellow/green vision - N&V - bradycardia - and anorexia.
The patient may suffer significant blood loss or femoral nerve compression.
Pulse before and after giving.
Correct her and tell her that the (+) lead goes on the left and the (-) lead goes on the right side.

25. What is the nursing care associated with chemical stress tests (persantine stress test)?
Explain procedure - stress importance of reporting symptoms. INSTRUCT The PATIENT NO TO EAT DRINK OR SMOKE AT LEAST 1 HOUR BEFORE The TEST. EVALUATE PATIENTS HISTORY FOR ANY CARDIAC CONDITIONS OR MEDICATIONS THAT MAY INTERFERE WITH The TEST!!! (No va
Elevated legs - anticoagulation therapy (aggressive: generally IV heparin) - Be alert for signs of PE.
Keep clean and dry for 72 hours - DON'T LIFT The ELBOW OR ARM ON The INCISION SIDE FOR FOUR WEEKS (CAN'T BRUSH HAIR OR TEECH BC PULLS CAN ROLL MARBLES) - DON'T LIFT PUSH OR PULL MORE THAN 10 LBS FOR FOUR WEEKS - take pulse and wt each day - CAll CARD
NO because it isn't sterile so keep out.

26. What is characteristic of premature ventricular contractions?
Left sternal border
Premature beats that are not preceded by a P- wave - QRS is wide and bizarre - and the T wave of the premature beat is generally large and in the opposite direction of the QRS.
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
A disease in which thrombi trap blood in the deep veins of the pelvis and legs.

27. What is a transthoracic echocardiograph (TTE)?
Feeling warm (fire) or tin can taste is expected and will pass.
Second right intercostal space
One large emboli (smaller=better)
A NON INVASIVE doppler exam of the heart via the thorax to detect cardiac tamponade.

28. What is a nursing diagnosis for arterial occlusion? Tx
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!
Ventricular rate is regular at a rate of 40-60 bpm and there is no relationship of P waves to QRS complexes.
Decreased tissue perfusion. Tx: clot busting treatment must start within 6 hours.
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.

29. What is CVP? Normal?
A central line placed that measures the right atrial pressure. Normal= 4-10 cm of H20.
Cannot
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
Cardiac tamponade (fluid in pericardial space) and thickening/scarring of the pericardial sac (constrictive pericarditis and possible RHF).

30. What should you watch for with PICC lines that have been in place for 6 months?
Air answers (open junctions)
A disease in which thrombi trap blood in the deep veins of the pelvis and legs.
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.

31. What are the nursing interventions for a patient in atrial fibrillation?
CPR should be done. No defibrillation bc no rhythm to shock (heart already depolarized).
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.
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).
Pericardial friction rub - chest pain (sharp and aggravated with breathing) - abnormal EKG findings - possible fever and tachycardia.

32. 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
You need to maintain use of those devices continually except when the patient is ambulating - bathing - or during physical therapy or skin assessment.
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.
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.

33. What is characteristic of ventricular fibrillation?
Air embolism
Totally disorganized - chaotic pattern - and no discernible waves or complexes.
Vascular - artery disease causing fluid to back up into the lungs.
Maintain BED REST

34. What do calcium channel blockers do?
Steroid treatment or a pregnant woman who is retaining water.
If feel more than 3 shocks in a row or develop signs of infection at the site.
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
Open up blood vessels

35. What are the nursing interventions for a patient with premature ventricular contractions?
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).
To reduce a patients risk of DVT and PE. They include graduated compression stockings - vena cava filters - and intermittent sequential external compression devices.
Trendelenburg position for insertion. Pt holds breath to prevent air from entering sinus tract.
For the first month post op - do not lift more than 10 or 15 lbs. And avoid excessive pushing - pulling - or twisting.

36. In What time period is the greatest risk of sudden death from an MI?
Chronic arteriosclerotic disease.
In the first 72 hours!!!!!
Protamine Sulfate
To inhibit thrombus and clot formation.

37. What usually triggers angina pain?
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
It usually occurs when your heart is working harder (ex: exercising - eating large meal - or feeling stress. Also very hot or cold weather).
Old truck driver or someone on bed rest or with pelvic trauma.
Vitamin K (aqua myphiton)

38. Where should you place your stethescope to find the aortic valve?
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
Hair loss - muscle mass loss - pallor when elevated - dependent rubor - and prolonged cap refill time.
Second Right intercostal space.
Direct current cardioversion and digoxin/propranolol (inderal).

39. What body systems are affected by digoxin toxicity? S&S?
Air answers (open junctions)
GI - neuro - and cardiac. S&S= yellow/green vision - N&V - bradycardia - and anorexia.
Low pitched sounds such as S3 and S4 and the murmur of mitral stenosis. BEL(low)L
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

40. What is the normal value for arterial pulse? Pulse amplitude? Edema? Reflex?
Verapamil (calan) - diltiazem (cardizem) - nifedipine (procardia) - amlodipine (norvasc).
Left sternal border
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
Arterial pulse: 60-90 - Amplitude: 4+=strong and bounding - Edema: 0=none - Reflex 2+

41. Who would most likely have peripheral venous disease?
Second right intercostal space
Old truck driver or someone on bed rest or with pelvic trauma.
The internal jugular veins (external are less reliable).
High pitched sounds like S1 and S2 (pericardial friction rubs - aortic/mitral regurgitation murmurs). DIAPH(high)ragm

42. A femoral artery compression device ______be assigned to an NA?
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
Cannot
ST segment elevation (STEMI)
The patient may suffer significant blood loss or femoral nerve compression.

43. What is a good diagnosis for someone with right sided HF?
(1st) Assess LOC - (2nd) if unconscious= begin CPR - and (3rd) Notify physician.
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
Pulmonary edema
Activity intolerance

44. What is Deep Vein Thrombosis (DVT)?
Iodine
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
Pulse before and after giving.
A disease in which thrombi trap blood in the deep veins of the pelvis and legs.

45. What is INR?
(1ST) BEGIN CARDIOPULMONARY RESUSCITATION (The PT. Is DYING) And NotIFY PHYSICIAN (2ND).
International Normalized Ratio measures blood clotting time and compares it to normal values. 1.0=normal. Most people on anticoagulants are 2-3.
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
Left sternal border

46. What will the Transthoracic echocardiograph (TTE) show that will indicate cardiac tamponade?
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
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.
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.
An enlarged space indicates fluid accumulation in the pericardial sac.

47. How should you palpate the carotid arteries?
One at a time to assess the pulse amplitude and contour.
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
Give furosemide (lasix) 40-60 mg IV - O2 administration - morphine sulfate 3-5 mg IV - have patient sit up with feet lowered (decreases venous return to the heart) - nitroglycerin given sublingual or IV - and rotating tourniquets (can reduce intratho
One large emboli (smaller=better)

48. What should be taught upon discharge for someone going home on coumadin as a result of a PE?
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.
Direct current shock (defibrillation) and IV anti - arrhythmic drugs (lidocaine - Procainamide - and Bretylium).
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.
In the first 72 hours!!!!!

49. 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
To inhibit thrombus and clot formation.
The right and left ventricular pressures - cardiac output - arterial venous O2 difference - and pulmonary artery pressure.
Second right intercostal space

50. What signals an elevated venous pressure based on the internal jugular veins?
A patient on sildenafil (Viagra) - Cealis - or Levitra bc these drugs together can cause very low blood pressure and heart attack.
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
Low pitched sounds such as S3 and S4 and the murmur of mitral stenosis. BEL(low)L
Identify the highest point of pulsation and measure from this point to the sternal angle. A measurement of greater than 3 cm= an elevated venous pressure.