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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. What places someone at risk for an aortic dissection?
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
Poorly controlled hypertension
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.
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.

2. In What time period is the greatest risk of sudden death from an MI?
Anxiousness - restlessness - tachycardia - tachypneic - 90% SP02 - dyspnea - substernal pain - coughing - hemoptysis - and fever.
A clinician will perform echocardiogram guided pericardiocentesis with a needle or catheter to remove excess fluid in the pericardial sac.
A disease in which thrombi trap blood in the deep veins of the pelvis and legs.
In the first 72 hours!!!!!

3. What should you explain to the patient about an impedance cardiography test?
It will take 5 mins and he/she should remain quiet for about 1 minute without talking or moving.
The internal jugular veins (external are less reliable).
All People Enjoy Time Magazine= Aortic - Pulmonic - ERB's point - Tricuspid - and Mitral/Apex. P(2) E (3) T (4) MA (5) (locations)
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

4. What type of surgery is done for an aortic dissection?
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.
Stop the medication - address the factors that may have precipitated the event. If life threatening Digibind ay be indicated.
The damaged portion of the aorta is removed and is repaired with a synthetic graft.
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

5. What should you know about your recovery period after having an implantable cardioverter defibrillator (ICD)?
Arterial pulse: 60-90 - Amplitude: 4+=strong and bounding - Edema: 0=none - Reflex 2+
For the first month post op - do not lift more than 10 or 15 lbs. And avoid excessive pushing - pulling - or twisting.
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
Pallor - diaphoresis - tachypnea - severe tearing chest pain radiating to back - PULSES In ARMS Are STRONG BUT LEG PULSES Are WEAK - low SP02.

6. What should you do if you are going to ventilate someone with an ambu bag?
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.
When a large air bubble blocks blood flow from the right ventricle into the pulmonary artery.
Limit the size of the infarction is the goal. Treatment= thrombolytic therapy (tPA) initiated within 6 hours of the first symptoms= standard treatment.
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

7. How long is contrast media in the body?
Pulmonary edema
Only for a few hours
Gently insert the oropharyngeal airway by turning it upside down (into U shape) and slide it into the mouth. As continue to insert rotate it so the ends of the U turn downward into an arch shape after it transverses the oral cavity and approaches the
MONA=Magnesium sulfate - O2 - Nitroglycerin - Aspirin (mona has a heart so EKG also if select all that apply).

8. What is characteristic of atrial fibrillation?
A hematoma= bleeding into the soft tissue surrounding the femoral artery access site.
Trendelenburg position for insertion. Pt holds breath to prevent air from entering sinus tract.
No clearly defined or measurable P waves and an irregular - irregular ventricular response.
Pneumothorax and will end up with chest tube to help reinflate lung.

9. What should you do prior to placing cardiac monitor electrodes on the skin (4 things)?
Chronic arteriosclerotic disease.
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
Cardiac tamponade (fluid in pericardial space) and thickening/scarring of the pericardial sac (constrictive pericarditis and possible RHF).
One at a time to assess the pulse amplitude and contour.

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

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11. What SE should you look for with calcium channel blocker use?
Hair loss - muscle mass loss - pallor when elevated - dependent rubor - and prolonged cap refill time.
Crushing chest pain that lasts 30 mins or longer and may radiate to the neck - shoulders - or jaw - diaphoresis - nausea - and SOB.
Constipation or MAY CAUSE ANKLES TO SWELL (call healthcare provider).
Chronic arteriosclerotic disease.

12. What nursing interventions are associated with a pt. experiencing ventricular fibrillation?
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
Chronic arteriosclerotic disease.
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).
(1ST) BEGIN CARDIOPULMONARY RESUSCITATION (The PT. Is DYING) And NotIFY PHYSICIAN (2ND).

13. What are the treatments/ S&S of peripheral venous disease?
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
(1ST) BEGIN CARDIOPULMONARY RESUSCITATION (The PT. Is DYING) And NotIFY PHYSICIAN (2ND).
Varicose veins - elevate legs - weight reduction - brawny in color - ted hose - topical steroids - ulcers - and skin color changes.
It usually occurs when your heart is working harder (ex: exercising - eating large meal - or feeling stress. Also very hot or cold weather).

14. What should be done is a patient on anticoagulants suffers from epistaxis for more than 15 mins?
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.
Vascular - artery disease causing fluid to back up into the lungs.
Temporary or permanent transvenous PACEMAKER INSERTION - and if the client is symptomatic and showing S&S of decreased cardiac output - GIVE ATROPINE.
Posterior nasal packing to stop the blood flow. The LPN CAN DO THIS!

15. What should you tell a patient who developed a hematoma in the hospital and is being discharged?
Steroid treatment or a pregnant woman who is retaining water.
Give furosemide (lasix) 40-60 mg IV - O2 administration - morphine sulfate 3-5 mg IV - have patient sit up with feet lowered (decreases venous return to the heart) - nitroglycerin given sublingual or IV - and rotating tourniquets (can reduce intratho
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
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.

16. What is you see an NA placing cardiac monitor electrodes on a patient. She is placing (-) on the left and (+) on the right what should you do?
Check all junctions frequently to make sure secure - especially before patient gets out of bed - and always use tubing with twist lock connections.
Stroke - renal or heart failure - paraplegia secondary to compromised blood flow - or death from aortic rupture.
Constipation or MAY CAUSE ANKLES TO SWELL (call healthcare provider).
Correct her and tell her that the (+) lead goes on the left and the (-) lead goes on the right side.

17. Which jugular veins give a more accurate estimate of the jugular vein pressure and pressure in the right atrium?
RAndI= Razor - electric - Aspirin - NO - Needles - small gauge - Decrease - needle sticks - and Injury- protect from. No percodan or NSAIDS - no open toed shoes.
Varicose veins - elevate legs - weight reduction - brawny in color - ted hose - topical steroids - ulcers - and skin color changes.
The internal jugular veins (external are less reliable).
Temporary or permanent transvenous PACEMAKER INSERTION - and if the client is symptomatic and showing S&S of decreased cardiac output - GIVE ATROPINE.

18. What is INR?
International Normalized Ratio measures blood clotting time and compares it to normal values. 1.0=normal. Most people on anticoagulants are 2-3.
Old truck driver or someone on bed rest or with pelvic trauma.
One large emboli (smaller=better)
If you feel lightheaded - dizzy - or heart palpitations but feel no shock from the ICD.

19. When should a patient call 911 after having an implantable cardioverter defibrillator (ICD) placed?
Thromboanglitis obliterans/ Buerger's disease= inflammatory process of arterial wall - veins - and nerves where they become blocked. It is associated with smoking/tobacco use.
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
A patient on sildenafil (Viagra) - Cealis - or Levitra bc these drugs together can cause very low blood pressure and heart attack.
If you feel lightheaded - dizzy - or heart palpitations but feel no shock from the ICD.

20. What is characteristic of premature ventricular contractions?
Air answers (open junctions)
Stroke - renal or heart failure - paraplegia secondary to compromised blood flow - or death from aortic rupture.
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: 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.

21. Where do the internal jugular veins lie?
International Normalized Ratio measures blood clotting time and compares it to normal values. 1.0=normal. Most people on anticoagulants are 2-3.
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
Cardiac tamponade (fluid in pericardial space) and thickening/scarring of the pericardial sac (constrictive pericarditis and possible RHF).
Deep in the sternomastoid muscle - so look for pulsations in the soft tissue surrounding that area.

22. What are the four types of pulmonary emboli?
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.
Fat - Air - DVT - or Amniotic
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
RAndI= Razor - electric - Aspirin - NO - Needles - small gauge - Decrease - needle sticks - and Injury- protect from. No percodan or NSAIDS - no open toed shoes.

23. What should be done during the insertion of both a CVP catheter and a swan ganz catheter?
Trendelenburg position for insertion. Pt holds breath to prevent air from entering sinus tract.
NO NSAIDS or ASA.
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 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.

24. What is impedance cardiography?
A drop in systolic BP greater than 12 mm Hg during inspiration indicating a compromise.
ICG is a noninvasive way to collect hemodynamic data for assessing patients with heart failure - hypertension - or dyspnea.
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.
Pneumothorax and will end up with chest tube to help reinflate lung.

25. How should you palpate the carotid arteries?
One at a time to assess the pulse amplitude and contour.
Elevated legs - anticoagulation therapy (aggressive: generally IV heparin) - Be alert for signs of PE.
The patient may suffer significant blood loss or femoral nerve compression.
Pallor - diaphoresis - tachypnea - severe tearing chest pain radiating to back - PULSES In ARMS Are STRONG BUT LEG PULSES Are WEAK - low SP02.

26. 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.
After a sheath removal to apply consistent pressure and prevent bleeding. (Ex: after swan ganz removal).
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
It will take 5 mins and he/she should remain quiet for about 1 minute without talking or moving.

27. 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
Air embolism
Totally disorganized - chaotic pattern - and no discernible waves or complexes.
In the first 72 hours!!!!!

28. What are the nursing interventions for a patient with premature ventricular contractions?
In fatty areas or over major muscles - large breasts - or bony prominences.
For the first month post op - do not lift more than 10 or 15 lbs. And avoid excessive pushing - pulling - or twisting.
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).
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 drugs are most commonly used for angina?
Nitrates - Beta blockers - and Calcium channel blockers
ST segment elevation (STEMI)
For the first month post op - do not lift more than 10 or 15 lbs. And avoid excessive pushing - pulling - or twisting.
NO NSAIDS or ASA.

30. What should you observe for in someone on bleeding precautions?
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
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).
Left sternal border
Fat - Air - DVT - or Amniotic

31. What is the treatment for someone in ventricular fibrillation?
Deep in the sternomastoid muscle - so look for pulsations in the soft tissue surrounding that area.
Direct current shock (defibrillation) and IV anti - arrhythmic drugs (lidocaine - Procainamide - and Bretylium).
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.
Include rest periods prior to any activity.

32. What type of EKG change indicates MI?
GI - neuro - and cardiac. S&S= yellow/green vision - N&V - bradycardia - and anorexia.
ST segment elevation (STEMI)
Air answers (open junctions)
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

33. What should you teach someone with arterial insufficiency?

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34. What body systems are affected by digoxin toxicity? S&S?
A patient on sildenafil (Viagra) - Cealis - or Levitra bc these drugs together can cause very low blood pressure and heart attack.
International Normalized Ratio measures blood clotting time and compares it to normal values. 1.0=normal. Most people on anticoagulants are 2-3.
GI - neuro - and cardiac. S&S= yellow/green vision - N&V - bradycardia - and anorexia.
Trendelenburg position for insertion. Pt holds breath to prevent air from entering sinus tract.

35. What is the treatment for a patient in complete heart block?
Activity intolerance
Temporary or permanent transvenous PACEMAKER INSERTION - and if the client is symptomatic and showing S&S of decreased cardiac output - GIVE ATROPINE.
It will take 5 mins and he/she should remain quiet for about 1 minute without talking or moving.
In fatty areas or over major muscles - large breasts - or bony prominences.

36. What usually triggers angina pain?
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
Fourth or fifth intercostal space at or medial to the midclavicular line.
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.
It usually occurs when your heart is working harder (ex: exercising - eating large meal - or feeling stress. Also very hot or cold weather).

37. What is a major complication of central line placement?
Pneumothorax and will end up with chest tube to help reinflate lung.
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.
All People Enjoy Time Magazine= Aortic - Pulmonic - ERB's point - Tricuspid - and Mitral/Apex. P(2) E (3) T (4) MA (5) (locations)
Inspect pulses on chest - inspect the internal jugular veins - palpate the apical pulse - palpate the carotid arteries - and auscultate the heart sounds.

38. What lab value is used to evaluate a patient on coumadin? What is the normal value?
PT. Normal= 12 sec. If on anticoagulants it should be between 1 1/2 to 2 1/2 x the normal value. For PT= 18-30 sec.
NO because it isn't sterile so keep out.
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
(1st) Assess the client for S&S of decreased cardiac output and Notify physician (2nd).

39. What is the antidote for coumadin?
Vitamin K (aqua myphiton)
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.
Don't interfere!
One large emboli (smaller=better)

40. Where is the aortic valve landmark on the chest?
An inflammation of the pericardium. It may result in MI.
Second right intercostal space
Clip the hair to allow good contact between the electrodes and the skin (DONT SHAVE).
Rapid ventricular rate with no relationship to atrial activity and QRS complex is wide and bizarre.

41. What condition can cause left sided heart failure?
Vascular - artery disease causing fluid to back up into the lungs.
Iodine
Only for a few hours
Low pitched sounds such as S3 and S4 and the murmur of mitral stenosis. BEL(low)L

42. When should bleeding precautions be implemented?
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
Diuretic & Digoxin (dig increases force of contraction and increases perfusion). Know working if client is peeing (kidney perfusion) and more alert!
Smoking - elevated cholesterol - diabetes - hypertension - old age - and family hx of coronary artery disease.
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.

43. What are the steps to perform the heimlich maneuver?
D/C the med and call the doctor.
Trendelenburg position for insertion. Pt holds breath to prevent air from entering sinus tract.
NO NSAIDS or ASA.
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.

44. What can result from left sided heart failure if left untreated?
(1st) Assess the client for S&S of decreased cardiac output and Notify physician (2nd).
Old truck driver or someone on bed rest or with pelvic trauma.
Protamine Sulfate
Pulmonary edema

45. What is a transthoracic echocardiograph (TTE)?
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.
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
GI - neuro - and cardiac. S&S= yellow/green vision - N&V - bradycardia - and anorexia.

46. What are the indications for a chemical stress test (persantine stress test)?
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.
Second Left intercostal space
Clip the hair to allow good contact between the electrodes and the skin (DONT SHAVE).
Patient who are unable to tolerate exercise stress testing.

47. What is cardioversion?

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48. How is the arterial brachial index (ABI) calculated? Who should perform this? What is normal?
Right sided heart failure
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
Administer 100% O2 - left trendelenburg position - heparin administered - and oral warfarin started (give heparin and warfarin together for at least 5 days).
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.

49. What is a chemical stress test (persantine stress test)?
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
(1st) Assess the client for S&S of decreased cardiac output and Notify physician (2nd).
Anxiousness - restlessness - tachycardia - tachypneic - 90% SP02 - dyspnea - substernal pain - coughing - hemoptysis - and fever.
Poorly controlled hypertension

50. What should be immediately done for a patient experiencing digoxin toxicity?
The internal jugular veins (external are less reliable).
Stop the medication - address the factors that may have precipitated the event. If life threatening Digibind ay be indicated.
Steroid treatment or a pregnant woman who is retaining water.
Lung disease