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. What is superior vena cava syndrome?
ST segment elevation (STEMI)
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
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 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

2. What is the antidote for coumadin?
Vitamin K (aqua myphiton)
Air embolism
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
For the first month post op - do not lift more than 10 or 15 lbs. And avoid excessive pushing - pulling - or twisting.

3. What should you teach your patient about an abdominal ultrasonography?
Air embolism
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
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.
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.

4. What should you teach your patient about MRI?
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
Varicose veins - elevate legs - weight reduction - brawny in color - ted hose - topical steroids - ulcers - and skin color changes.
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
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

5. What are the S&S of pulmonary embolism?
Anxiousness - restlessness - tachycardia - tachypneic - 90% SP02 - dyspnea - substernal pain - coughing - hemoptysis - and fever.
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.
Crushing chest pain that lasts 30 mins or longer and may radiate to the neck - shoulders - or jaw - diaphoresis - nausea - and SOB.
BP is elevated or decreased depending on activity.

6. What should you do when applying a femoral artery compression device?
In the first 72 hours!!!!!
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
One at a time to assess the pulse amplitude and contour.
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

7. What are signs and symptoms of an MI?
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.
Inspect pulses on chest - inspect the internal jugular veins - palpate the apical pulse - palpate the carotid arteries - and auscultate the heart sounds.
Decreased tissue perfusion. Tx: clot busting treatment must start within 6 hours.
Crushing chest pain that lasts 30 mins or longer and may radiate to the neck - shoulders - or jaw - diaphoresis - nausea - and SOB.

8. What should you watch for with PICC lines that have been in place for 6 months?
Air answers (open junctions)
Limit the size of the infarction is the goal. Treatment= thrombolytic therapy (tPA) initiated within 6 hours of the first symptoms= standard treatment.
Second Left intercostal space
Iodine

9. What condition can cause left sided heart failure?
Pallor - diaphoresis - tachypnea - severe tearing chest pain radiating to back - PULSES In ARMS Are STRONG BUT LEG PULSES Are WEAK - low SP02.
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.
IV LIDOCAINE BOLUS (50-100 mg) followed by an IV lidocaine drip (suppresses ventricular activity).
Vascular - artery disease causing fluid to back up into the lungs.

10. What are the treatments/ S&S of peripheral venous disease?
Deep in the sternomastoid muscle - so look for pulsations in the soft tissue surrounding that area.
A patient on sildenafil (Viagra) - Cealis - or Levitra bc these drugs together can cause very low blood pressure and heart attack.
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.
Varicose veins - elevate legs - weight reduction - brawny in color - ted hose - topical steroids - ulcers - and skin color changes.

11. What is the purpose of compression devices?
An inflammation of the pericardium. It may result in MI.
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
To reduce a patients risk of DVT and PE. They include graduated compression stockings - vena cava filters - and intermittent sequential external compression devices.
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

12. What are the steps to perform the heimlich maneuver?
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.
In fatty areas or over major muscles - large breasts - or bony prominences.
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.

13. What should you always assume with a patient who has a central line placed and is experiencing SOB?
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
A hematoma= bleeding into the soft tissue surrounding the femoral artery access site.
Air embolism
This noninvasive test takes 24 hours and causes no discomfort. Electrodes are applied to your body - you need to log your activities for a 24 hour period (walking - sleeping - urinating - physical symptoms - and medications). Don't tamper with the mo

14. What are the steps for adult 2 rescuer CPR?
Deep in the sternomastoid muscle - so look for pulsations in the soft tissue surrounding that area.
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
Must be flushed 1x/month with heparin and between treatments.
Left sternal border

15. If you see a NA placing a patient with DVT in sitting position with legs dependent what should you do?
After a sheath removal to apply consistent pressure and prevent bleeding. (Ex: after swan ganz removal).
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).
No clearly defined or measurable P waves and an irregular - irregular ventricular response.
INTERVENE: to control edema and decrease pain patient should be on bed rest with legs elevated six inches above heart level.

16. What should you do if you are going to ventilate someone with an ambu bag?
A patient on sildenafil (Viagra) - Cealis - or Levitra bc these drugs together can cause very low blood pressure and heart attack.
A monitor with four dual electrodes that are applied to the patients neck and thorax.
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
Correct her and tell her that the (+) lead goes on the left and the (-) lead goes on the right side.

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

18. What should you teach your patient about angiography (arteriography)?
Activity intolerance
Elevated legs - anticoagulation therapy (aggressive: generally IV heparin) - Be alert for signs of PE.
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
Anxiousness - restlessness - tachycardia - tachypneic - 90% SP02 - dyspnea - substernal pain - coughing - hemoptysis - and fever.

19. What should you tell someone about taking nitroglycerin tablets (SE)?
A clinician will perform echocardiogram guided pericardiocentesis with a needle or catheter to remove excess fluid in the pericardial sac.
Rapid ventricular rate with no relationship to atrial activity and QRS complex is wide and bizarre.
Verapamil (calan) - diltiazem (cardizem) - nifedipine (procardia) - amlodipine (norvasc).
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.

20. In what locations should you not place electrodes?
SOB - dyspnea - anxiousness - diaphoresis - cool/clammy skin - distended neck veins - mental status changes - narrowed pulse pressure - hypotension - and faint or muffled heart sounds.
In fatty areas or over major muscles - large breasts - or bony prominences.
Lowers BP and makes heart beat stronger. SE: flushed face.
Left sternal border

21. What needs to be held during the placement of a femoral artery compression device?
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.
Only for a few hours
NO NSAIDS or ASA.
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

22. What type of surgery is done for an aortic dissection?
Ventricular rate is regular at a rate of 40-60 bpm and there is no relationship of P waves to QRS complexes.
The damaged portion of the aorta is removed and is repaired with a synthetic graft.
An inflammation of the pericardium. It may result in MI.
A patient on sildenafil (Viagra) - Cealis - or Levitra bc these drugs together can cause very low blood pressure and heart attack.

23. 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
Iodine
Thromboanglitis obliterans/ Buerger's disease= inflammatory process of arterial wall - veins - and nerves where they become blocked. It is associated with smoking/tobacco use.
D/C the med and call the doctor.

24. What should be checked in a patient on a beta blocker?
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.
Activity intolerance
Stop the medication - address the factors that may have precipitated the event. If life threatening Digibind ay be indicated.
Pulse before and after giving.

25. What makes the symptoms of superior vena cava syndrome better? Worse?
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.
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.
Difficulty breathing - pain in midchest and shoulder - pale - nausea - and light headedness.
The symptoms improve when the patient is sitting in upright position that promotes drainage but worsen with the client is lying down.

26. What is the treatment for a patient in complete heart block?
Temporary or permanent transvenous PACEMAKER INSERTION - and if the client is symptomatic and showing S&S of decreased cardiac output - GIVE ATROPINE.
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.
INTERVENE: to control edema and decrease pain patient should be on bed rest with legs elevated six inches above heart level.
Direct current shock (defibrillation) and IV anti - arrhythmic drugs (lidocaine - Procainamide - and Bretylium).

27. What should be done immediately if a pulmonary embolism is suspected?
Activity intolerance
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
Fourth or fifth intercostal space at or medial to the midclavicular line.
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).

28. What is an air embolism?
A monitor with four dual electrodes that are applied to the patients neck and thorax.
Anxiousness - restlessness - tachycardia - tachypneic - 90% SP02 - dyspnea - substernal pain - coughing - hemoptysis - and fever.
Idiopathic
When a large air bubble blocks blood flow from the right ventricle into the pulmonary artery.

29. What is the treatment for myocardial infarction?
Varicose veins - elevate legs - weight reduction - brawny in color - ted hose - topical steroids - ulcers - and skin color changes.
Pulmonary edema
It will take 5 mins and he/she should remain quiet for about 1 minute without talking or moving.
MONA=Magnesium sulfate - O2 - Nitroglycerin - Aspirin (mona has a heart so EKG also if select all that apply).

30. What does the device for impedance cardiography consist of?
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).
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.
Aortic valve - Pulmonic valve - right ventricle - tricuspid valve - and apex or mitral valve.
A monitor with four dual electrodes that are applied to the patients neck and thorax.

31. What should you observe for in someone on bleeding precautions?
In fatty areas or over major muscles - large breasts - or bony prominences.
Cannot
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.
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).

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

33. For which heart sounds should the bell be used?
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
Low pitched sounds such as S3 and S4 and the murmur of mitral stenosis. BEL(low)L
Limit the size of the infarction is the goal. Treatment= thrombolytic therapy (tPA) initiated within 6 hours of the first symptoms= standard treatment.
GI - neuro - and cardiac. S&S= yellow/green vision - N&V - bradycardia - and anorexia.

34. What is an aortic dissection?

35. What will be the treatment for an acute episode of life threatening tamponade?
Clip the hair to allow good contact between the electrodes and the skin (DONT SHAVE).
A clinician will perform echocardiogram guided pericardiocentesis with a needle or catheter to remove excess fluid in the pericardial sac.
If feel more than 3 shocks in a row or develop signs of infection at the site.
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

36. What should you do if the PTT value is 80 for someone on heparin?
NO because it isn't sterile so keep out.
Chronic arteriosclerotic disease.
Elevated legs - anticoagulation therapy (aggressive: generally IV heparin) - Be alert for signs of PE.
D/C the med and call the doctor.

37. What is pulsus paradoxus?
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.
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.
Poorly controlled hypertension
A drop in systolic BP greater than 12 mm Hg during inspiration indicating a compromise.

38. What will the Transthoracic echocardiograph (TTE) show that will indicate cardiac tamponade?
Feeling warm (fire) or tin can taste is expected and will pass.
Open up blood vessels
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.
An enlarged space indicates fluid accumulation in the pericardial sac.

39. For which heart sounds should the diaphragm be used?
0.5-2.0 ng/ml
High pitched sounds like S1 and S2 (pericardial friction rubs - aortic/mitral regurgitation murmurs). DIAPH(high)ragm
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.
Vascular - artery disease causing fluid to back up into the lungs.

40. What should you not allow if a patient has a negative Allen's test?
Air embolism
Second left intercostal space
No radial artery punctures if negative
(1st) Assess the client for S&S of decreased cardiac output and Notify physician (2nd).

41. What do calcium channel blockers do?
Open up blood vessels
The right and left ventricular pressures - cardiac output - arterial venous O2 difference - and pulmonary artery pressure.
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
Anxiousness - restlessness - tachycardia - tachypneic - 90% SP02 - dyspnea - substernal pain - coughing - hemoptysis - and fever.

42. What does vasotec (Enalapril Maleate) do/SE?
Aortic valve - Pulmonic valve - right ventricle - tricuspid valve - and apex or mitral valve.
Fifth left intercostal space medial to the midclavicular line.
Limit the size of the infarction is the goal. Treatment= thrombolytic therapy (tPA) initiated within 6 hours of the first symptoms= standard treatment.
Lowers BP and makes heart beat stronger. SE: flushed face.

43. A femoral artery compression device ______be assigned to an NA?
Whether the patients ulnar and radial arteries are patent.
Cannot
In the first 72 hours!!!!!
The right and left ventricular pressures - cardiac output - arterial venous O2 difference - and pulmonary artery pressure.

44. What is characteristic of complete heart block?
Protamine Sulfate
Clip the hair to allow good contact between the electrodes and the skin (DONT SHAVE).
IV LIDOCAINE BOLUS (50-100 mg) followed by an IV lidocaine drip (suppresses ventricular activity).
Ventricular rate is regular at a rate of 40-60 bpm and there is no relationship of P waves to QRS complexes.

45. 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.
Administer 100% O2 - left trendelenburg position - heparin administered - and oral warfarin started (give heparin and warfarin together for at least 5 days).
Positive Homan's sign (calf tenderness on dorsiflexion of the foot).
A disease in which thrombi trap blood in the deep veins of the pelvis and legs.

46. What should you teach someone with arterial insufficiency?

47. What is CVP? Normal?
A hematoma= bleeding into the soft tissue surrounding the femoral artery access site.
A central line placed that measures the right atrial pressure. Normal= 4-10 cm of H20.
For the first month post op - do not lift more than 10 or 15 lbs. And avoid excessive pushing - pulling - or twisting.
RAndI= Razor - electric - Aspirin - NO - Needles - small gauge - Decrease - needle sticks - and Injury- protect from. No percodan or NSAIDS - no open toed shoes.

48. What is the correct way to insert an oropharyngeal airway?
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
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
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.
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

49. What are the signs and symptoms of left sided HF?
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.
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
Paroxysmal nocturnal dyspnea - elevated pulmonary capillary wedge pressure - BLOOD TINGED SPUTUM - cough - orthopnea - exertional dyspnea - cyanosis.
Clip the hair to allow good contact between the electrodes and the skin (DONT SHAVE).

50. What should you do frequently for someone with a central line to help prevent pulmonary emboli?
If feel more than 3 shocks in a row or develop signs of infection at the site.
Check all junctions frequently to make sure secure - especially before patient gets out of bed - and always use tubing with twist lock connections.
A clinician will perform echocardiogram guided pericardiocentesis with a needle or catheter to remove excess fluid in the pericardial sac.
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).