NCLEX Cardiac

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. 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.
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.
Pneumothorax and will end up with chest tube to help reinflate lung.
Posterior nasal packing to stop the blood flow. The LPN CAN DO THIS!


2. 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


3. What is an air embolism?
File toe nails - if have new shoes only wear 2 hrs/day d/t neuropathy can't feel if problem. To decrease pain of claudication massage legs to increase circulation.
When a large air bubble blocks blood flow from the right ventricle into the pulmonary artery.
Nitrates - Beta blockers - and Calcium channel blockers
Ventricular rate is regular at a rate of 40-60 bpm and there is no relationship of P waves to QRS complexes.


4. Where is the right ventricle landmark on the chest?
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
Left sternal border
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.
An enlarged space indicates fluid accumulation in the pericardial sac.


5. What should be immediately done for a patient experiencing digoxin toxicity?
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
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.
Stop the medication - address the factors that may have precipitated the event. If life threatening Digibind ay be indicated.
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.


6. What are the treatments/ S&S of peripheral venous disease?
Varicose veins - elevate legs - weight reduction - brawny in color - ted hose - topical steroids - ulcers - and skin color changes.
Diuretic & Digoxin (dig increases force of contraction and increases perfusion). Know working if client is peeing (kidney perfusion) and more alert!
Lowers BP and makes heart beat stronger. SE: flushed face.
ICG is a noninvasive way to collect hemodynamic data for assessing patients with heart failure - hypertension - or dyspnea.


7. What drugs are most commonly used for angina?
Thromboanglitis obliterans/ Buerger's disease= inflammatory process of arterial wall - veins - and nerves where they become blocked. It is associated with smoking/tobacco use.
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
Nitrates - Beta blockers - and Calcium channel blockers
A patient on sildenafil (Viagra) - Cealis - or Levitra bc these drugs together can cause very low blood pressure and heart attack.


8. What are all the S&S of pericarditis?
Trendelenburg position for insertion. Pt holds breath to prevent air from entering sinus tract.
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.
Pericardial friction rub - chest pain (sharp and aggravated with breathing) - abnormal EKG findings - possible fever and tachycardia.
(S1 - S2) Third left intercostal space


9. What does the device for impedance cardiography consist of?
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.
Difficulty breathing - pain in midchest and shoulder - pale - nausea - and light headedness.
A monitor with four dual electrodes that are applied to the patients neck and thorax.
Aortic valve - Pulmonic valve - right ventricle - tricuspid valve - and apex or mitral valve.


10. During an Allen's test don't compress one artery _____ the other.
Before
The internal jugular veins (external are less reliable).
To inhibit thrombus and clot formation.
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.


11. What should you teach someone with arterial insufficiency?

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


12. What nursing interventions are associated with a pt. experiencing ventricular fibrillation?
(1ST) BEGIN CARDIOPULMONARY RESUSCITATION (The PT. Is DYING) And NotIFY PHYSICIAN (2ND).
0.5-2.0 ng/ml
A patient on sildenafil (Viagra) - Cealis - or Levitra bc these drugs together can cause very low blood pressure and heart attack.
Before


13. What condition can cause left sided heart failure?
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.
Positive Homan's sign (calf tenderness on dorsiflexion of the foot).
Vascular - artery disease causing fluid to back up into the lungs.
You need to maintain use of those devices continually except when the patient is ambulating - bathing - or during physical therapy or skin assessment.


14. What does an Allen's test determine?
CPR should be done. No defibrillation bc no rhythm to shock (heart already depolarized).
An inflammation of the pericardium. It may result in MI.
One at a time to assess the pulse amplitude and contour.
Whether the patients ulnar and radial arteries are patent.


15. What is pulsus paradoxus?
To inhibit thrombus and clot formation.
Positive Homan's sign (calf tenderness on dorsiflexion of the foot).
Limit the size of the infarction is the goal. Treatment= thrombolytic therapy (tPA) initiated within 6 hours of the first symptoms= standard treatment.
A drop in systolic BP greater than 12 mm Hg during inspiration indicating a compromise.


16. What should be done is a patient on anticoagulants suffers from epistaxis for more than 15 mins?
ICG is a noninvasive way to collect hemodynamic data for assessing patients with heart failure - hypertension - or dyspnea.
Posterior nasal packing to stop the blood flow. The LPN CAN DO THIS!
Lung disease
Don't interfere!


17. What should you do prior to placing cardiac monitor electrodes on the skin (4 things)?
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
It usually occurs when your heart is working harder (ex: exercising - eating large meal - or feeling stress. Also very hot or cold weather).
Pallor - diaphoresis - tachypnea - severe tearing chest pain radiating to back - PULSES In ARMS Are STRONG BUT LEG PULSES Are WEAK - low SP02.
Elevated legs - anticoagulation therapy (aggressive: generally IV heparin) - Be alert for signs of PE.


18. What will a leg with arterial insufficiency look like?
D/C the med and call the doctor.
To reduce a patients risk of DVT and PE. They include graduated compression stockings - vena cava filters - and intermittent sequential external compression devices.
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
Hair loss - muscle mass loss - pallor when elevated - dependent rubor - and prolonged cap refill time.


19. When should you be concerned about premature ventricular contraction?
All People Enjoy Time Magazine= Aortic - Pulmonic - ERB's point - Tricuspid - and Mitral/Apex. P(2) E (3) T (4) MA (5) (locations)
Vitamin K (aqua myphiton)
When they occur >6 per minute or occurring 2 or more in a row (bigeminy or trigeminy=on way out).
A clinician will perform echocardiogram guided pericardiocentesis with a needle or catheter to remove excess fluid in the pericardial sac.


20. What should you tell someone about taking nitroglycerin tablets (SE)?
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.
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
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
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.


21. What are the steps to perform the heimlich maneuver?
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!
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.
D/C the med and call the doctor.


22. How should you palpate the carotid arteries?
A NON INVASIVE doppler exam of the heart via the thorax to detect cardiac tamponade.
One at a time to assess the pulse amplitude and contour.
Arterial pulse: 60-90 - Amplitude: 4+=strong and bounding - Edema: 0=none - Reflex 2+
Pulse before and after giving.


23. What should you teach your patient about an abdominal ultrasonography?
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
(S1 - S2) Third left intercostal space
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
International Normalized Ratio measures blood clotting time and compares it to normal values. 1.0=normal. Most people on anticoagulants are 2-3.


24. What lab value is used to evaluate a patient on coumadin? What is the normal value?
IV LIDOCAINE BOLUS (50-100 mg) followed by an IV lidocaine drip (suppresses ventricular activity).
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
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.


25. When should a patient call 911 after having an implantable cardioverter defibrillator (ICD) placed?
Direct current cardioversion and digoxin/propranolol (inderal).
If you feel lightheaded - dizzy - or heart palpitations but feel no shock from the ICD.
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
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


26. What SE should you look for with calcium channel blocker use?
Protamine Sulfate
An inflammation of the pericardium. It may result in MI.
Constipation or MAY CAUSE ANKLES TO SWELL (call healthcare provider).
After a sheath removal to apply consistent pressure and prevent bleeding. (Ex: after swan ganz removal).


27. What is pericarditis?
An inflammation of the pericardium. It may result in MI.
To report to her healthcare provider if she feels a large bump in her groin - if she has groin pain unrelieved by acetaminophen - or if she develops numbness - tingling - etc. in the affected leg.
CPR should be done. No defibrillation bc no rhythm to shock (heart already depolarized).
Vascular - artery disease causing fluid to back up into the lungs.


28. What are the S&S of cardiac tamponade?
No clearly defined or measurable P waves and an irregular - irregular ventricular response.
0.5-2.0 ng/ml
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
SOB - dyspnea - anxiousness - diaphoresis - cool/clammy skin - distended neck veins - mental status changes - narrowed pulse pressure - hypotension - and faint or muffled heart sounds.


29. What is the treatment for someone in ventricular fibrillation?
For the first month post op - do not lift more than 10 or 15 lbs. And avoid excessive pushing - pulling - or twisting.
Direct current cardioversion and digoxin/propranolol (inderal).
Direct current shock (defibrillation) and IV anti - arrhythmic drugs (lidocaine - Procainamide - and Bretylium).
Constipation or MAY CAUSE ANKLES TO SWELL (call healthcare provider).


30. What should you teach someone about iodine?
NO TED HOSE - NO SHEETS/BLANKETS - NO COMPRESSION DEVICES - (TEACH NO OPEN TOES SHOES). Lambs wool is okay!
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.
Feeling warm (fire) or tin can taste is expected and will pass.
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


31. What should you watch for with PICC lines that have been in place for 6 months?
(S1 - S2) Third left intercostal space
Air answers (open junctions)
Fourth or fifth intercostal space at or medial to the midclavicular line.
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.


32. What are the S&S of aortic dissection?
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
When a large air bubble blocks blood flow from the right ventricle into the pulmonary artery.
Pallor - diaphoresis - tachypnea - severe tearing chest pain radiating to back - PULSES In ARMS Are STRONG BUT LEG PULSES Are WEAK - low SP02.
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


33. What is a therapeutic digoxin level?
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.
(1st) Assess the client for S&S of decreased cardiac output and Notify physician (2nd).
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.
0.5-2.0 ng/ml


34. What is the normal value for arterial pulse? Pulse amplitude? Edema? Reflex?
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.
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
Arterial pulse: 60-90 - Amplitude: 4+=strong and bounding - Edema: 0=none - Reflex 2+
Varicose veins - elevate legs - weight reduction - brawny in color - ted hose - topical steroids - ulcers - and skin color changes.


35. What are signs and symptoms of an MI?
GI - neuro - and cardiac. S&S= yellow/green vision - N&V - bradycardia - and anorexia.
Maintain BED REST
Pneumothorax and will end up with chest tube to help reinflate lung.
Crushing chest pain that lasts 30 mins or longer and may radiate to the neck - shoulders - or jaw - diaphoresis - nausea - and SOB.


36. When would a nurse use an external femoral artery compression device?
The arteries have narrowed - decreased O2 to tissues= hypoxia to cells.
International Normalized Ratio measures blood clotting time and compares it to normal values. 1.0=normal. Most people on anticoagulants are 2-3.
After a sheath removal to apply consistent pressure and prevent bleeding. (Ex: after swan ganz removal).
Anxiousness - restlessness - tachycardia - tachypneic - 90% SP02 - dyspnea - substernal pain - coughing - hemoptysis - and fever.


37. What should you teach someone after they have had a pacemaker placed?

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


38. What are the signs and symptoms of left sided HF?
Don't interfere!
Paroxysmal nocturnal dyspnea - elevated pulmonary capillary wedge pressure - BLOOD TINGED SPUTUM - cough - orthopnea - exertional dyspnea - cyanosis.
Whether the patients ulnar and radial arteries are patent.
Poorly controlled hypertension


39. What are the S&S of superior vena cava syndrome?
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).
The internal jugular veins (external are less reliable).
Steroid treatment or a pregnant woman who is retaining water.
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


40. What is the antidote for coumadin?
Pneumothorax and will end up with chest tube to help reinflate lung.
Vitamin K (aqua myphiton)
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.
4th left intercostal space lower sternal border


41. What is a assessment finding with DVT?

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


42. What should be done during the insertion of both a CVP catheter and a swan ganz catheter?
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
Trendelenburg position for insertion. Pt holds breath to prevent air from entering sinus tract.
(1st) Assess LOC - (2nd) if unconscious= begin CPR - and (3rd) Notify physician.
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


43. What should be taught upon discharge for someone going home on coumadin as a result of a PE?
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
Decreased tissue perfusion. Tx: clot busting treatment must start within 6 hours.
A nosebleed
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.


44. What is epistaxis?
It usually occurs when your heart is working harder (ex: exercising - eating large meal - or feeling stress. Also very hot or cold weather).
Maintain BED REST
A nosebleed
A hematoma= bleeding into the soft tissue surrounding the femoral artery access site.


45. What type of EKG change indicates MI?
ST segment elevation (STEMI)
A nosebleed
Vitamin K (aqua myphiton)
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


46. What body systems are affected by digoxin toxicity? S&S?
Fourth or fifth intercostal space at or medial to the midclavicular line.
Patient who are unable to tolerate exercise stress testing.
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
GI - neuro - and cardiac. S&S= yellow/green vision - N&V - bradycardia - and anorexia.


47. What is angina? Stable vs. unstable?

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


48. 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


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

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


50. What are the five areas for listening to the heart?

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