Instructions:

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

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

1. What should you teach your patient about an electrocardiogram (ECG)?
The right and left ventricular pressures - cardiac output - arterial venous O2 difference - and pulmonary artery pressure.
In the first 72 hours!!!!!
Steroid treatment or a pregnant woman who is retaining water.
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


2. How is the arterial brachial index (ABI) calculated? Who should perform this? What is normal?
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
Pneumothorax and will end up with chest tube to help reinflate lung.
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
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.


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

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4. During an Allen's test don't compress one artery _____ the other.
Administer 100% O2 - left trendelenburg position - heparin administered - and oral warfarin started (give heparin and warfarin together for at least 5 days).
Before
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.)
In fatty areas or over major muscles - large breasts - or bony prominences.


5. What is the most common cause of arterial insufficiency?
Chronic arteriosclerotic disease.
Pneumothorax and will end up with chest tube to help reinflate lung.
Vitamin K (aqua myphiton)
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.


6. What is cardioversion?

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7. What is a major complication of central line placement?
If you feel lightheaded - dizzy - or heart palpitations but feel no shock from the ICD.
Pneumothorax and will end up with chest tube to help reinflate lung.
Clip the hair to allow good contact between the electrodes and the skin (DONT SHAVE).
Pulse before and after giving.


8. What is the maintenance for venous access port that isn't being regularly used?
Pneumothorax and will end up with chest tube to help reinflate lung.
Vascular - artery disease causing fluid to back up into the lungs.
In fatty areas or over major muscles - large breasts - or bony prominences.
Must be flushed 1x/month with heparin and between treatments.


9. What should you teach someone with arterial insufficiency?

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10. What are the S&S of superior vena cava syndrome?
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.
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
Vascular - artery disease causing fluid to back up into the lungs.
Vitamin K (aqua myphiton)


11. Where do the internal jugular veins lie?
An enlarged space indicates fluid accumulation in the pericardial sac.
RAndI= Razor - electric - Aspirin - NO - Needles - small gauge - Decrease - needle sticks - and Injury- protect from. No percodan or NSAIDS - no open toed shoes.
Deep in the sternomastoid muscle - so look for pulsations in the soft tissue surrounding that area.
A hematoma= bleeding into the soft tissue surrounding the femoral artery access site.


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

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13. Where is the right ventricle landmark on the chest?
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.
Left sternal border
Cannot
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.


14. What is Raynauds disease? Tx?
Only for a few hours
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
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.
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


15. Should the tubing for a venous access port be included under the dressing site?

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16. When would a nurse use an external femoral artery compression device?
When they occur >6 per minute or occurring 2 or more in a row (bigeminy or trigeminy=on way out).
Second left intercostal space
An inflammation of the pericardium. It may result in MI.
After a sheath removal to apply consistent pressure and prevent bleeding. (Ex: after swan ganz removal).


17. What should you remember while taking care of someone with a peripheral arterial occlusion?
For the first month post op - do not lift more than 10 or 15 lbs. And avoid excessive pushing - pulling - or twisting.
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.
Whether the patients ulnar and radial arteries are patent.
NO TED HOSE - NO SHEETS/BLANKETS - NO COMPRESSION DEVICES - (TEACH NO OPEN TOES SHOES). Lambs wool is okay!


18. What should you teach your patient about MRI?
Second Left intercostal space
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.
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
Vascular - artery disease causing fluid to back up into the lungs.


19. What should you tell a patient who developed a hematoma in the hospital and is being discharged?
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.
The symptoms improve when the patient is sitting in upright position that promotes drainage but worsen with the client is lying down.
Aortic valve - Pulmonic valve - right ventricle - tricuspid valve - and apex or mitral valve.
(S1 - S2) Third left intercostal space


20. What are the steps for infant 1&2 rescuer CPR?
Check all junctions frequently to make sure secure - especially before patient gets out of bed - and always use tubing with twist lock connections.
Must be flushed 1x/month with heparin and between treatments.
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
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!


21. What are common risk factors for an MI?
Smoking - elevated cholesterol - diabetes - hypertension - old age - and family hx of coronary artery disease.
(1st) Assess the client for S&S of decreased cardiac output and Notify physician (2nd).
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).
MRI is painless - you must remain still inside a small/noisy space. If you are claustrophobic you may need sedation. Remove all jewelry and other metal objects. If you have any shrapnel - a pacemaker - or any surgically implanted joints - pins - clip


22. What are the proper steps to changing a central venous catheter dressing?
A disease in which thrombi trap blood in the deep veins of the pelvis and legs.
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
Rapid ventricular rate with no relationship to atrial activity and QRS complex is wide and bizarre.
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.


23. What is angina? Stable vs. unstable?

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

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25. What does the device for impedance cardiography consist of?
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.
A monitor with four dual electrodes that are applied to the patients neck and thorax.
Pneumothorax and will end up with chest tube to help reinflate lung.
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


26. What should a patient do if they feel chest pain or discomfort?
A nosebleed
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
Deep in the sternomastoid muscle - so look for pulsations in the soft tissue surrounding that area.
Trendelenburg position for insertion. Pt holds breath to prevent air from entering sinus tract.


27. What is more harmful a lot of little emboli or one large emboli?
A monitor with four dual electrodes that are applied to the patients neck and thorax.
Right sided heart failure
One large emboli (smaller=better)
Totally disorganized - chaotic pattern - and no discernible waves or complexes.


28. What is a good diagnosis for someone with right sided HF?
ST segment elevation (STEMI)
Activity intolerance
(S1 - S2) Third left intercostal space
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.


29. 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.
Verapamil (calan) - diltiazem (cardizem) - nifedipine (procardia) - amlodipine (norvasc).
When a large air bubble blocks blood flow from the right ventricle into the pulmonary artery.
Second Right intercostal space.


30. What would make someone more at risk for digoxin toxicity?
Steroid treatment or a pregnant woman who is retaining water.
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.
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.
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.


31. What is INR?
Chronic arteriosclerotic disease.
International Normalized Ratio measures blood clotting time and compares it to normal values. 1.0=normal. Most people on anticoagulants are 2-3.
A clinician will perform echocardiogram guided pericardiocentesis with a needle or catheter to remove excess fluid in the pericardial sac.
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.


32. What should you go when applying nitroglycerin ointment for angina?
When they occur >6 per minute or occurring 2 or more in a row (bigeminy or trigeminy=on way out).
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
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
Administer 100% O2 - left trendelenburg position - heparin administered - and oral warfarin started (give heparin and warfarin together for at least 5 days).


33. What should you teach your patient about a cardiac catheterization?
Poorly controlled hypertension
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
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
MONA=Magnesium sulfate - O2 - Nitroglycerin - Aspirin (mona has a heart so EKG also if select all that apply).


34. What is the nursing care associated with chemical stress tests (persantine stress test)?
High pitched sounds like S1 and S2 (pericardial friction rubs - aortic/mitral regurgitation murmurs). DIAPH(high)ragm
Low pitched sounds such as S3 and S4 and the murmur of mitral stenosis. BEL(low)L
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
The arteries have narrowed - decreased O2 to tissues= hypoxia to cells.


35. What should happen if someone converts to asystole/flatline?
Trendelenburg position for insertion. Pt holds breath to prevent air from entering sinus tract.
Smoking - elevated cholesterol - diabetes - hypertension - old age - and family hx of coronary artery disease.
CPR should be done. No defibrillation bc no rhythm to shock (heart already depolarized).
Pneumothorax and will end up with chest tube to help reinflate lung.


36. What are the nursing interventions for a patient with premature ventricular contractions?
(1ST) BEGIN CARDIOPULMONARY RESUSCITATION (The PT. Is DYING) And NotIFY PHYSICIAN (2ND).
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.
Cardiac tamponade (fluid in pericardial space) and thickening/scarring of the pericardial sac (constrictive pericarditis and possible RHF).
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).


37. For which heart sounds should the diaphragm be used?
CPR should be done. No defibrillation bc no rhythm to shock (heart already depolarized).
High pitched sounds like S1 and S2 (pericardial friction rubs - aortic/mitral regurgitation murmurs). DIAPH(high)ragm
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
Smoking - elevated cholesterol - diabetes - hypertension - old age - and family hx of coronary artery disease.


38. What is epistaxis?
Second Left intercostal space
Vascular - artery disease causing fluid to back up into the lungs.
Crushing chest pain that lasts 30 mins or longer and may radiate to the neck - shoulders - or jaw - diaphoresis - nausea - and SOB.
A nosebleed


39. What is intermittent claudication?
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.
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.
Fourth or fifth intercostal space at or medial to the midclavicular line.
Pulmonary edema


40. What is the treatment for a pt. with ventricular tachycardia?
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.
Whether the patients ulnar and radial arteries are patent.
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.
An inflammation of the pericardium. It may result in MI.


41. 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.
Check all junctions frequently to make sure secure - especially before patient gets out of bed - and always use tubing with twist lock connections.
NO NSAIDS or ASA.
Left sternal border


42. If you see a NA placing a patient with DVT in sitting position with legs dependent what should you do?
Totally disorganized - chaotic pattern - and no discernible waves or complexes.
INTERVENE: to control edema and decrease pain patient should be on bed rest with legs elevated six inches above heart level.
0.5-2.0 ng/ml
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.


43. What things should you do to assess cardiovascular status?
An inflammation of the pericardium. It may result in MI.
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.
A disease in which thrombi trap blood in the deep veins of the pelvis and legs.
Inspect pulses on chest - inspect the internal jugular veins - palpate the apical pulse - palpate the carotid arteries - and auscultate the heart sounds.


44. Which jugular veins give a more accurate estimate of the jugular vein pressure and pressure in the right atrium?
The internal jugular veins (external are less reliable).
INTERVENE: to control edema and decrease pain patient should be on bed rest with legs elevated six inches above heart level.
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
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.


45. What places someone at risk for an aortic dissection?
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.
A clinician will perform echocardiogram guided pericardiocentesis with a needle or catheter to remove excess fluid in the pericardial sac.
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.
Poorly controlled hypertension


46. In What time period is the greatest risk of sudden death from an MI?
Steroid treatment or a pregnant woman who is retaining water.
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.
No radial artery punctures if negative
In the first 72 hours!!!!!


47. What is characteristic of ventricular tachycardia?
Lung disease
Rapid ventricular rate with no relationship to atrial activity and QRS complex is wide and bizarre.
The right and left ventricular pressures - cardiac output - arterial venous O2 difference - and pulmonary artery pressure.
Include rest periods prior to any activity.


48. Where is the tricuspid valve landmark on the chest?
A clinician will perform echocardiogram guided pericardiocentesis with a needle or catheter to remove excess fluid in the pericardial sac.
Lower left sternal border
Lung disease
If feel more than 3 shocks in a row or develop signs of infection at the site.


49. What should be done for someone on bleeding precautions?
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.
RAndI= Razor - electric - Aspirin - NO - Needles - small gauge - Decrease - needle sticks - and Injury- protect from. No percodan or NSAIDS - no open toed shoes.
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
Pneumothorax and will end up with chest tube to help reinflate lung.


50. What is superior vena cava syndrome?
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.
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.
GI - neuro - and cardiac. S&S= yellow/green vision - N&V - bradycardia - and anorexia.