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

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

2. What is characteristic of ventricular fibrillation?
Thromboanglitis obliterans/ Buerger's disease= inflammatory process of arterial wall - veins - and nerves where they become blocked. It is associated with smoking/tobacco use.
SOB - dyspnea - anxiousness - diaphoresis - cool/clammy skin - distended neck veins - mental status changes - narrowed pulse pressure - hypotension - and faint or muffled heart sounds.
A disease in which thrombi trap blood in the deep veins of the pelvis and legs.
Totally disorganized - chaotic pattern - and no discernible waves or complexes.

3. During an Allen's test don't compress one artery _____ the other.
Vitamin K (aqua myphiton)
Stop What they are doing - sit down and rest - if prescribed nitroglycerin tablets place one under tongue - if it still remains take another tablet in 5 mins - and if still in pain take another after an additional 5 mins - if still pain after 3 table
Activity intolerance
Before

4. What is the treatment for premature ventricular contractions?
D/C the med and call the doctor.
Lowers BP and makes heart beat stronger. SE: flushed face.
NO TED HOSE - NO SHEETS/BLANKETS - NO COMPRESSION DEVICES - (TEACH NO OPEN TOES SHOES). Lambs wool is okay!
IV LIDOCAINE BOLUS (50-100 mg) followed by an IV lidocaine drip (suppresses ventricular activity).

5. What should you tell someone about taking nitroglycerin tablets (SE)?
The right and left ventricular pressures - cardiac output - arterial venous O2 difference - and pulmonary artery pressure.
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.
Lowers BP and makes heart beat stronger. SE: flushed face.
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.

6. What is an air embolism?
Before
Elevated legs - anticoagulation therapy (aggressive: generally IV heparin) - Be alert for signs of PE.
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.
When a large air bubble blocks blood flow from the right ventricle into the pulmonary artery.

7. Test ending in Gram=?
Steroid treatment or a pregnant woman who is retaining water.
No radial artery punctures if negative
(1st) Assess LOC - (2nd) if unconscious= begin CPR - and (3rd) Notify physician.
Iodine

8. What disease can cause right sided heart failure?
Lung disease
Direct current cardioversion and digoxin/propranolol (inderal).
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

9. Where should you place your stethescope to find the mitral (apex) valve?
Fifth left intercostal space medial to the midclavicular line.
The patient may suffer significant blood loss or femoral nerve compression.
If feel more than 3 shocks in a row or develop signs of infection at the site.
A central line placed that measures the right atrial pressure. Normal= 4-10 cm of H20.

10. What signals an elevated venous pressure based on the internal jugular veins?
International Normalized Ratio measures blood clotting time and compares it to normal values. 1.0=normal. Most people on anticoagulants are 2-3.
Right sided heart failure
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
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.

11. What should you not allow if a patient has a negative Allen's test?
Hematuria (tea or coca cola colored) - nosebleeds - gingival bleeding (no medicated mouth wash - flossing - or lemon glycerin swabs) - and bruising (assess for abuse w/o caregiver).
Only for a few hours
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
No radial artery punctures if negative

12. What is the proper way to access and implanted venous access port (IVAP) (Mediport)?

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

13. If you see a NA placing a patient with DVT in sitting position with legs dependent what should you do?
INTERVENE: to control edema and decrease pain patient should be on bed rest with legs elevated six inches above heart level.
Arterial pulse: 60-90 - Amplitude: 4+=strong and bounding - Edema: 0=none - Reflex 2+
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
Vitamin K (aqua myphiton)

14. What is more harmful a lot of little emboli or one large emboli?
Low pitched sounds such as S3 and S4 and the murmur of mitral stenosis. BEL(low)L
To reduce a patients risk of DVT and PE. They include graduated compression stockings - vena cava filters - and intermittent sequential external compression devices.
(1ST) BEGIN CARDIOPULMONARY RESUSCITATION (The PT. Is DYING) And NotIFY PHYSICIAN (2ND).
One large emboli (smaller=better)

15. 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.
Temporary or permanent transvenous PACEMAKER INSERTION - and if the client is symptomatic and showing S&S of decreased cardiac output - GIVE ATROPINE.
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
0.5-2.0 ng/ml

16. What are the steps to perform the heimlich maneuver?
Clip the hair to allow good contact between the electrodes and the skin (DONT SHAVE).
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.
Fifth left intercostal space medial to the midclavicular line.
Activity intolerance

17. What is Deep Vein Thrombosis (DVT)?
To inhibit thrombus and clot formation.
You need to maintain use of those devices continually except when the patient is ambulating - bathing - or during physical therapy or skin assessment.
INTERVENE: to control edema and decrease pain patient should be on bed rest with legs elevated six inches above heart level.
A disease in which thrombi trap blood in the deep veins of the pelvis and legs.

18. What is defibrillation?
Verapamil (calan) - diltiazem (cardizem) - nifedipine (procardia) - amlodipine (norvasc).
High pitched sounds like S1 and S2 (pericardial friction rubs - aortic/mitral regurgitation murmurs). DIAPH(high)ragm
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.
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 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?
Posterior nasal packing to stop the blood flow. The LPN CAN DO THIS!
Paroxysmal nocturnal dyspnea - elevated pulmonary capillary wedge pressure - BLOOD TINGED SPUTUM - cough - orthopnea - exertional dyspnea - cyanosis.
Idiopathic
A hematoma= bleeding into the soft tissue surrounding the femoral artery access site.

20. Which jugular veins give a more accurate estimate of the jugular vein pressure and pressure in the right atrium?
When they occur >6 per minute or occurring 2 or more in a row (bigeminy or trigeminy=on way out).
Pulse before and after giving.
The internal jugular veins (external are less reliable).
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

21. What should you teach your patient about a cardiac catheterization?
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.
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
Correct her and tell her that the (+) lead goes on the left and the (-) lead goes on the right side.
Poorly controlled hypertension

22. What type of EKG change indicates MI?
To reduce a patients risk of DVT and PE. They include graduated compression stockings - vena cava filters - and intermittent sequential external compression devices.
ST segment elevation (STEMI)
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
If feel more than 3 shocks in a row or develop signs of infection at the site.

23. What should you teach your patient about an abdominal ultrasonography?
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
Cannot
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
4th left intercostal space lower sternal border

24. What will the Transthoracic echocardiograph (TTE) show that will indicate cardiac tamponade?
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
To reduce a patients risk of DVT and PE. They include graduated compression stockings - vena cava filters - and intermittent sequential external compression devices.
An enlarged space indicates fluid accumulation in the pericardial sac.
4th left intercostal space lower sternal border

25. 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

26. What are the signs and symptoms of left sided HF?
Paroxysmal nocturnal dyspnea - elevated pulmonary capillary wedge pressure - BLOOD TINGED SPUTUM - cough - orthopnea - exertional dyspnea - cyanosis.
Lung disease
Idiopathic
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.

27. How does the blood flow through the heart? (valves?)
Pallor - diaphoresis - tachypnea - severe tearing chest pain radiating to back - PULSES In ARMS Are STRONG BUT LEG PULSES Are WEAK - low SP02.
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 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.
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!

28. Where is the right ventricle landmark on the chest?
Open up blood vessels
Second left intercostal space
Fifth left intercostal space medial to the midclavicular line.
Left sternal border

29. What should be checked in a patient on a beta blocker?
Pulse before and after giving.
Protamine Sulfate
Diuretic & Digoxin (dig increases force of contraction and increases perfusion). Know working if client is peeing (kidney perfusion) and more alert!
RAndI= Razor - electric - Aspirin - NO - Needles - small gauge - Decrease - needle sticks - and Injury- protect from. No percodan or NSAIDS - no open toed shoes.

30. How is the Allen's test done?
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
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
Crushing chest pain that lasts 30 mins or longer and may radiate to the neck - shoulders - or jaw - diaphoresis - nausea - and SOB.
Lowers BP and makes heart beat stronger. SE: flushed face.

31. What should you do frequently for someone with a central line to help prevent pulmonary emboli?
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.
When they occur >6 per minute or occurring 2 or more in a row (bigeminy or trigeminy=on way out).
It will take 5 mins and he/she should remain quiet for about 1 minute without talking or moving.
Check all junctions frequently to make sure secure - especially before patient gets out of bed - and always use tubing with twist lock connections.

32. What is the treatment for a pt. with ventricular tachycardia?
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.
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
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.
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.

33. What is the treatment for a patient in complete heart block?
Pericardial friction rub - chest pain (sharp and aggravated with breathing) - abnormal EKG findings - possible fever and tachycardia.
Idiopathic
Temporary or permanent transvenous PACEMAKER INSERTION - and if the client is symptomatic and showing S&S of decreased cardiac output - GIVE ATROPINE.
Chest pain or discomfort that occurs when your heart doesn't get enough blood and oxygen. Stable: the feeling comes and goes at expected times. Unstable: the pattern of your pain has changed (longer - hurts more - etc.)

34. What are the nursing interventions for a patient in atrial fibrillation?
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 NON INVASIVE doppler exam of the heart via the thorax to detect cardiac tamponade.
Verapamil (calan) - diltiazem (cardizem) - nifedipine (procardia) - amlodipine (norvasc).
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).

35. What is a therapeutic digoxin level?
An inflammation of the pericardium. It may result in MI.
GI - neuro - and cardiac. S&S= yellow/green vision - N&V - bradycardia - and anorexia.
0.5-2.0 ng/ml
4th left intercostal space lower sternal border

36. What is the treatments for hypertension?
Constipation or MAY CAUSE ANKLES TO SWELL (call healthcare provider).
Fatigue - JVD - Increased peripheral venous pressure - ascites - anorexia/complaints of GI distress - cyanosis - and dependent edema.
All People Enjoy Time Magazine= Aortic - Pulmonic - ERB's point - Tricuspid - and Mitral/Apex. P(2) E (3) T (4) MA (5) (locations)
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.

37. How should you palpate the apical pulse?
A NON INVASIVE doppler exam of the heart via the thorax to detect cardiac tamponade.
When not visable - place the patient in the left lateral position - ask them to exhale fully and stop breathing for a few seconds.
Stop What they are doing - sit down and rest - if prescribed nitroglycerin tablets place one under tongue - if it still remains take another tablet in 5 mins - and if still in pain take another after an additional 5 mins - if still pain after 3 table
Pulse before and after giving.

38. What should you do immediately if you suspect someone of developing a hematoma?
Pericardial friction rub - chest pain (sharp and aggravated with breathing) - abnormal EKG findings - possible fever and tachycardia.
Correct her and tell her that the (+) lead goes on the left and the (-) lead goes on the right side.
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.
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

39. What makes the symptoms of superior vena cava syndrome better? Worse?
The symptoms improve when the patient is sitting in upright position that promotes drainage but worsen with the client is lying down.
Temporary or permanent transvenous PACEMAKER INSERTION - and if the client is symptomatic and showing S&S of decreased cardiac output - GIVE ATROPINE.
Fat - Air - DVT - or Amniotic
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.

40. What things should you do to assess cardiovascular status?
Include rest periods prior to any activity.
D/C the med and call the doctor.
Inspect pulses on chest - inspect the internal jugular veins - palpate the apical pulse - palpate the carotid arteries - and auscultate the heart sounds.
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.

41. What should you explain to the patient about an impedance cardiography test?
Nitrates - Beta blockers - and Calcium channel blockers
Second Right intercostal space.
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.

42. What is the treatment for myocardial infarction?
Ventricular rate is regular at a rate of 40-60 bpm and there is no relationship of P waves to QRS complexes.
MONA=Magnesium sulfate - O2 - Nitroglycerin - Aspirin (mona has a heart so EKG also if select all that apply).
Second left intercostal space
Rapid ventricular rate with no relationship to atrial activity and QRS complex is wide and bizarre.

43. What is a major complication of central line placement?
Pneumothorax and will end up with chest tube to help reinflate lung.
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
When not visable - place the patient in the left lateral position - ask them to exhale fully and stop breathing for a few seconds.
Hair loss - muscle mass loss - pallor when elevated - dependent rubor - and prolonged cap refill time.

44. What should happen if someone converts to asystole/flatline?
CPR should be done. No defibrillation bc no rhythm to shock (heart already depolarized).
Fifth left intercostal space medial to the midclavicular line.
No radial artery punctures if negative
Elevated legs - anticoagulation therapy (aggressive: generally IV heparin) - Be alert for signs of PE.

45. What is the purpose of compression devices?
Nitrates - Beta blockers - and Calcium channel blockers
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
Lower left sternal border
To reduce a patients risk of DVT and PE. They include graduated compression stockings - vena cava filters - and intermittent sequential external compression devices.

46. What will a leg with arterial insufficiency look like?
CPR should be done. No defibrillation bc no rhythm to shock (heart already depolarized).
D/C the med and call the doctor.
Hair loss - muscle mass loss - pallor when elevated - dependent rubor - and prolonged cap refill time.
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-

47. What is the hallmark clinical finding associated with pericarditis?
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.
In the first 72 hours!!!!!
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

48. What should be done immediately if a pulmonary embolism is suspected?
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.
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.
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

49. 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.
One large emboli (smaller=better)
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.
Rapid ventricular rate with no relationship to atrial activity and QRS complex is wide and bizarre.

50. Where is the apex/mitral valve landmark on the chest?
Fourth or fifth intercostal space at or medial to the midclavicular line.
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
Correct her and tell her that the (+) lead goes on the left and the (-) lead goes on the right side.