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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. A femoral artery compression device ______be assigned to an NA?
Cannot
You need to maintain use of those devices continually except when the patient is ambulating - bathing - or during physical therapy or skin assessment.
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
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.

2. What should you do if the patient you are applying cardiac monitor electrodes to is hairy?
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
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).
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
Clip the hair to allow good contact between the electrodes and the skin (DONT SHAVE).

3. What usually triggers angina pain?
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
A disease in which thrombi trap blood in the deep veins of the pelvis and legs.
Air embolism
It usually occurs when your heart is working harder (ex: exercising - eating large meal - or feeling stress. Also very hot or cold weather).

4. What is the goal of treatment for an MI? Treatment?
Limit the size of the infarction is the goal. Treatment= thrombolytic therapy (tPA) initiated within 6 hours of the first symptoms= standard treatment.
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
Varicose veins - elevate legs - weight reduction - brawny in color - ted hose - topical steroids - ulcers - and skin color changes.
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.

5. What should you teach your patient about MRI?
Varicose veins - elevate legs - weight reduction - brawny in color - ted hose - topical steroids - ulcers - and skin color changes.
Smoking - elevated cholesterol - diabetes - hypertension - old age - and family hx of coronary artery disease.
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
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

6. What do calcium channel blockers do?
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
Second Right intercostal space.
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
Open up blood vessels

7. What does vasotec (Enalapril Maleate) do/SE?
NO TED HOSE - NO SHEETS/BLANKETS - NO COMPRESSION DEVICES - (TEACH NO OPEN TOES SHOES). Lambs wool is okay!
After a sheath removal to apply consistent pressure and prevent bleeding. (Ex: after swan ganz removal).
Lowers BP and makes heart beat stronger. SE: flushed face.
Limit the size of the infarction is the goal. Treatment= thrombolytic therapy (tPA) initiated within 6 hours of the first symptoms= standard treatment.

8. What should you always assume with a patient who has a central line placed and is experiencing SOB?
An enlarged space indicates fluid accumulation in the pericardial sac.
Air embolism
Nitrates - Beta blockers - and Calcium channel blockers
No clearly defined or measurable P waves and an irregular - irregular ventricular response.

9. How long is contrast media in the body?
Only for a few hours
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
Totally disorganized - chaotic pattern - and no discernible waves or complexes.
Poorly controlled hypertension

10. During an Allen's test don't compress one artery _____ the other.
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.
Feeling warm (fire) or tin can taste is expected and will pass.
Before
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).

11. What are the indications for a chemical stress test (persantine stress test)?
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
The symptoms improve when the patient is sitting in upright position that promotes drainage but worsen with the client is lying down.
Patient who are unable to tolerate exercise stress testing.
Elevated legs - anticoagulation therapy (aggressive: generally IV heparin) - Be alert for signs of PE.

12. What are the S&S of aortic dissection?
No radial artery punctures if negative
The right and left ventricular pressures - cardiac output - arterial venous O2 difference - and pulmonary artery pressure.
(1st) Assess LOC - (2nd) if unconscious= begin CPR - and (3rd) Notify physician.
Pallor - diaphoresis - tachypnea - severe tearing chest pain radiating to back - PULSES In ARMS Are STRONG BUT LEG PULSES Are WEAK - low SP02.

13. What is characteristic of ventricular tachycardia?
Rapid ventricular rate with no relationship to atrial activity and QRS complex is wide and bizarre.
Maintain BED REST
Inspect pulses on chest - inspect the internal jugular veins - palpate the apical pulse - palpate the carotid arteries - and auscultate the heart sounds.
One at a time to assess the pulse amplitude and contour.

14. What things should you do to assess cardiovascular status?
Inspect pulses on chest - inspect the internal jugular veins - palpate the apical pulse - palpate the carotid arteries - and auscultate the heart sounds.
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
No clearly defined or measurable P waves and an irregular - irregular ventricular response.
0.5-2.0 ng/ml

15. What should you do frequently for someone with a central line to help prevent pulmonary emboli?
GI - neuro - and cardiac. S&S= yellow/green vision - N&V - bradycardia - and anorexia.
The right and left ventricular pressures - cardiac output - arterial venous O2 difference - and pulmonary artery pressure.
Right sided heart failure
Check all junctions frequently to make sure secure - especially before patient gets out of bed - and always use tubing with twist lock connections.

16. What is impedance cardiography?
ICG is a noninvasive way to collect hemodynamic data for assessing patients with heart failure - hypertension - or dyspnea.
Verapamil (calan) - diltiazem (cardizem) - nifedipine (procardia) - amlodipine (norvasc).
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.
Steroid treatment or a pregnant woman who is retaining water.

17. What should you teach your patient about an abdominal ultrasonography?
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
D/C the med and call the doctor.
IV LIDOCAINE BOLUS (50-100 mg) followed by an IV lidocaine drip (suppresses ventricular activity).
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

18. What should you teach your patient about an exercise ECG (stress test)?
Pallor - diaphoresis - tachypnea - severe tearing chest pain radiating to back - PULSES In ARMS Are STRONG BUT LEG PULSES Are WEAK - low SP02.
Include rest periods prior to any activity.
GI - neuro - and cardiac. S&S= yellow/green vision - N&V - bradycardia - and anorexia.
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-

19. Where should you place your stethescope to find the mitral (apex) valve?
Lower left sternal border
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
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.
Fifth left intercostal space medial to the midclavicular line.

20. What are the nursing interventions for a pt. with ventricular tachycardia?
Direct current shock (defibrillation) and IV anti - arrhythmic drugs (lidocaine - Procainamide - and Bretylium).
When a large air bubble blocks blood flow from the right ventricle into the pulmonary artery.
A disease in which thrombi trap blood in the deep veins of the pelvis and legs.
(1st) Assess LOC - (2nd) if unconscious= begin CPR - and (3rd) Notify physician.

21. What are the steps to perform the heimlich maneuver?
Maintain BED REST
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.
Diuretic & Digoxin (dig increases force of contraction and increases perfusion). Know working if client is peeing (kidney perfusion) and more alert!
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.

22. What is a assessment finding with DVT?

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23. Where should you place your stethescope to find the pulmonic valve?
The right and left ventricular pressures - cardiac output - arterial venous O2 difference - and pulmonary artery pressure.
Right sided heart failure
Second Left intercostal space
Idiopathic

24. What is characteristic of premature ventricular contractions?
Limit the size of the infarction is the goal. Treatment= thrombolytic therapy (tPA) initiated within 6 hours of the first symptoms= standard treatment.
RAndI= Razor - electric - Aspirin - NO - Needles - small gauge - Decrease - needle sticks - and Injury- protect from. No percodan or NSAIDS - no open toed shoes.
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.
When they occur >6 per minute or occurring 2 or more in a row (bigeminy or trigeminy=on way out).

25. Without prompt surgery for an aortic dissection What is someone at risk for developing?
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.
BP is elevated or decreased depending on activity.
Hair loss - muscle mass loss - pallor when elevated - dependent rubor - and prolonged cap refill time.
Stroke - renal or heart failure - paraplegia secondary to compromised blood flow - or death from aortic rupture.

26. What should you go when applying nitroglycerin ointment for angina?
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
Thromboanglitis obliterans/ Buerger's disease= inflammatory process of arterial wall - veins - and nerves where they become blocked. It is associated with smoking/tobacco use.
Cardiac tamponade (fluid in pericardial space) and thickening/scarring of the pericardial sac (constrictive pericarditis and possible RHF).
Pallor - diaphoresis - tachypnea - severe tearing chest pain radiating to back - PULSES In ARMS Are STRONG BUT LEG PULSES Are WEAK - low SP02.

27. What does an Allen's test determine?
Vitamin K (aqua myphiton)
IV LIDOCAINE BOLUS (50-100 mg) followed by an IV lidocaine drip (suppresses ventricular activity).
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.
Whether the patients ulnar and radial arteries are patent.

28. What should be immediately done for a patient experiencing digoxin toxicity?
The right and left ventricular pressures - cardiac output - arterial venous O2 difference - and pulmonary artery pressure.
A clinician will perform echocardiogram guided pericardiocentesis with a needle or catheter to remove excess fluid in the pericardial sac.
Stop the medication - address the factors that may have precipitated the event. If life threatening Digibind ay be indicated.
Cardiac tamponade (fluid in pericardial space) and thickening/scarring of the pericardial sac (constrictive pericarditis and possible RHF).

29. What factors place you at risk for HTN?
Pallor - diaphoresis - tachypnea - severe tearing chest pain radiating to back - PULSES In ARMS Are STRONG BUT LEG PULSES Are WEAK - low SP02.
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.
One large emboli (smaller=better)
An enlarged space indicates fluid accumulation in the pericardial sac.

30. Which jugular veins give a more accurate estimate of the jugular vein pressure and pressure in the right atrium?
The patient may suffer significant blood loss or femoral nerve compression.
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 internal jugular veins (external are less reliable).
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.

31. What should you do immediately for someone experiencing anticoagulant induced epistaxis?
0.5-2.0 ng/ml
Cardiac tamponade (fluid in pericardial space) and thickening/scarring of the pericardial sac (constrictive pericarditis and possible RHF).
It usually occurs when your heart is working harder (ex: exercising - eating large meal - or feeling stress. Also very hot or cold weather).
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

32. What does the device for impedance cardiography consist of?
A monitor with four dual electrodes that are applied to the patients neck and thorax.
Cardiac tamponade (fluid in pericardial space) and thickening/scarring of the pericardial sac (constrictive pericarditis and possible RHF).
Hair loss - muscle mass loss - pallor when elevated - dependent rubor - and prolonged cap refill time.
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.

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

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34. What should you not allow if a patient has a negative Allen's test?
It will take 5 mins and he/she should remain quiet for about 1 minute without talking or moving.
Chronic arteriosclerotic disease.
No radial artery punctures if negative
Arterial pulse: 60-90 - Amplitude: 4+=strong and bounding - Edema: 0=none - Reflex 2+

35. In what locations should you not place electrodes?
An inflammation of the pericardium. It may result in MI.
Rapid ventricular rate with no relationship to atrial activity and QRS complex is wide and bizarre.
(1st) Assess the client for S&S of decreased cardiac output and Notify physician (2nd).
In fatty areas or over major muscles - large breasts - or bony prominences.

36. Which type of patient shouldn't take nitrates?
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).
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
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.
A patient on sildenafil (Viagra) - Cealis - or Levitra bc these drugs together can cause very low blood pressure and heart attack.

37. What is important to remember when removing a CVC from a patient?
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.
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.
Pneumothorax and will end up with chest tube to help reinflate lung.

38. 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
Cardiac tamponade (fluid in pericardial space) and thickening/scarring of the pericardial sac (constrictive pericarditis and possible RHF).
Direct current shock (defibrillation) and IV anti - arrhythmic drugs (lidocaine - Procainamide - and Bretylium).
Hair loss - muscle mass loss - pallor when elevated - dependent rubor - and prolonged cap refill time.

39. How is the arterial brachial index (ABI) calculated? Who should perform this? What is normal?
Vitamin K (aqua myphiton)
Elevated legs - anticoagulation therapy (aggressive: generally IV heparin) - Be alert for signs of PE.
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.
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.

40. What is the hallmark clinical finding associated with pericarditis?
Totally disorganized - chaotic pattern - and no discernible waves or complexes.
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.
(1st) Assess LOC - (2nd) if unconscious= begin CPR - and (3rd) Notify physician.
Crushing chest pain that lasts 30 mins or longer and may radiate to the neck - shoulders - or jaw - diaphoresis - nausea - and SOB.

41. If you see a NA placing a patient with DVT in sitting position with legs dependent what should you do?
A drop in systolic BP greater than 12 mm Hg during inspiration indicating a compromise.
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
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.
INTERVENE: to control edema and decrease pain patient should be on bed rest with legs elevated six inches above heart level.

42. What are the treatments/ S&S of peripheral venous disease?
The damaged portion of the aorta is removed and is repaired with a synthetic graft.
Varicose veins - elevate legs - weight reduction - brawny in color - ted hose - topical steroids - ulcers - and skin color changes.
A disease in which thrombi trap blood in the deep veins of the pelvis and legs.
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

43. What are the four types of pulmonary emboli?
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
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.
Fat - Air - DVT - or Amniotic
Administer 100% O2 - left trendelenburg position - heparin administered - and oral warfarin started (give heparin and warfarin together for at least 5 days).

44. What places someone at risk for an aortic dissection?
Poorly controlled hypertension
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.)
One large emboli (smaller=better)
Protamine Sulfate

45. What does a swan ganz measure?
Activity intolerance
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.
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
The right and left ventricular pressures - cardiac output - arterial venous O2 difference - and pulmonary artery pressure.

46. What disease can cause right sided heart failure?
The patient may suffer significant blood loss or femoral nerve compression.
Poorly controlled hypertension
The arteries have narrowed - decreased O2 to tissues= hypoxia to cells.
Lung disease

47. What is an acute peripheral arterial occlusion?
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
Stroke - renal or heart failure - paraplegia secondary to compromised blood flow - or death from aortic rupture.
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.
The arteries have narrowed - decreased O2 to tissues= hypoxia to cells.

48. What should be checked in a patient on a beta blocker?
Open up blood vessels
Hair loss - muscle mass loss - pallor when elevated - dependent rubor - and prolonged cap refill time.
Pulse before and after giving.
Right sided heart failure

49. What is cardioversion?

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50. What is an air embolism?
When a large air bubble blocks blood flow from the right ventricle into the pulmonary artery.
Clip the hair to allow good contact between the electrodes and the skin (DONT SHAVE).
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.
Vascular - artery disease causing fluid to back up into the lungs.

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NCLEX Cardiac

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