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 the treatment for someone in ventricular fibrillation?
Direct current shock (defibrillation) and IV anti - arrhythmic drugs (lidocaine - Procainamide - and Bretylium).
Decreased tissue perfusion. Tx: clot busting treatment must start within 6 hours.
Pulse before and after giving.
It will take 5 mins and he/she should remain quiet for about 1 minute without talking or moving.

2. What are the S&S of air embolism?
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.
BP is elevated or decreased depending on activity.
A drop in systolic BP greater than 12 mm Hg during inspiration indicating a compromise.

3. What drugs are most commonly used for angina?
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.
Clip the hair to allow good contact between the electrodes and the skin (DONT SHAVE).
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. What is defibrillation?
Check all junctions frequently to make sure secure - especially before patient gets out of bed - and always use tubing with twist lock connections.
If feel more than 3 shocks in a row or develop signs of infection at the site.
Used in an emergency (Vfib/defib) - used with Vfib or Vtach - NO CARDIAC OUTPUT - client is unconscious - EKG monitor - NO CONSENT NEEDED - begin with 200 Joules and up to 360.
Chronic arteriosclerotic disease.

5. What SE should you look for with calcium channel blocker use?
Vitamin K (aqua myphiton)
Constipation or MAY CAUSE ANKLES TO SWELL (call healthcare provider).
Idiopathic
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.

6. Where should you place your stethescope to find the tricuspid valve?
To reduce a patients risk of DVT and PE. They include graduated compression stockings - vena cava filters - and intermittent sequential external compression devices.
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.
For the first month post op - do not lift more than 10 or 15 lbs. And avoid excessive pushing - pulling - or twisting.
4th left intercostal space lower sternal border

7. What should be done immediately for someone with PE?
Diuretic & Digoxin (dig increases force of contraction and increases perfusion). Know working if client is peeing (kidney perfusion) and more alert!
Administer 100% O2 - left trendelenburg position - heparin administered - and oral warfarin started (give heparin and warfarin together for at least 5 days).
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.
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

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

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

9. Where is the apex/mitral valve landmark on the chest?
Fourth or fifth intercostal space at or medial to the midclavicular line.
The internal jugular veins (external are less reliable).
Poorly controlled hypertension
An inflammation of the pericardium. It may result in MI.

10. What does an Allen's test determine?
Whether the patients ulnar and radial arteries are patent.
Left sternal border
(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).

11. What are the signs and symptoms of left sided HF?
Poorly controlled hypertension
Paroxysmal nocturnal dyspnea - elevated pulmonary capillary wedge pressure - BLOOD TINGED SPUTUM - cough - orthopnea - exertional dyspnea - cyanosis.
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.
It will take 5 mins and he/she should remain quiet for about 1 minute without talking or moving.

12. What should you teach your patient about an electrocardiogram (ECG)?
Include rest periods prior to any 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
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.
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

13. What should you do if the patient you are applying cardiac monitor electrodes to is hairy?
It usually occurs when your heart is working harder (ex: exercising - eating large meal - or feeling stress. Also very hot or cold weather).
Second Left intercostal space
Iodine
Clip the hair to allow good contact between the electrodes and the skin (DONT SHAVE).

14. What are the proper steps to changing a central venous catheter dressing?
Pneumothorax and will end up with chest tube to help reinflate lung.
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.
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.
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

15. What is characteristic of ventricular fibrillation?
Totally disorganized - chaotic pattern - and no discernible waves or complexes.
A hematoma= bleeding into the soft tissue surrounding the femoral artery access site.
Idiopathic
ST segment elevation (STEMI)

16. What should you do if the PT value is 45 sec?
Aortic valve - Pulmonic valve - right ventricle - tricuspid valve - and apex or mitral valve.
IV LIDOCAINE BOLUS (50-100 mg) followed by an IV lidocaine drip (suppresses ventricular activity).
The internal jugular veins (external are less reliable).
D/C the med and call the doctor.

17. 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

18. What is an air embolism?
D/C the med and call the doctor.
Deep in the sternomastoid muscle - so look for pulsations in the soft tissue surrounding that area.
When a large air bubble blocks blood flow from the right ventricle into the pulmonary artery.
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

19. What is a nursing diagnosis for arterial occlusion? Tx
NO because it isn't sterile so keep out.
Decreased tissue perfusion. Tx: clot busting treatment must start within 6 hours.
Aortic valve - Pulmonic valve - right ventricle - tricuspid valve - and apex or mitral valve.
Second Left intercostal space

20. Where should you place your stethescope to find the pulmonic valve?
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
Second Left intercostal space
Rapid ventricular rate with no relationship to atrial activity and QRS complex is wide and bizarre.
Posterior nasal packing to stop the blood flow. The LPN CAN DO THIS!

21. For which heart sounds should the diaphragm be used?
RAndI= Razor - electric - Aspirin - NO - Needles - small gauge - Decrease - needle sticks - and Injury- protect from. No percodan or NSAIDS - no open toed shoes.
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
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.
High pitched sounds like S1 and S2 (pericardial friction rubs - aortic/mitral regurgitation murmurs). DIAPH(high)ragm

22. What are the S&S of cardiac tamponade?
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.
Direct current shock (defibrillation) and IV anti - arrhythmic drugs (lidocaine - Procainamide - and Bretylium).
SOB - dyspnea - anxiousness - diaphoresis - cool/clammy skin - distended neck veins - mental status changes - narrowed pulse pressure - hypotension - and faint or muffled heart sounds.
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

23. If 2 liters of fluid is left in the pericardial sac (cardiac tamponade) and goes untreated what could it cause?
Deep in the sternomastoid muscle - so look for pulsations in the soft tissue surrounding that area.
Right sided heart failure
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.
International Normalized Ratio measures blood clotting time and compares it to normal values. 1.0=normal. Most people on anticoagulants are 2-3.

24. How long is contrast media in the body?
Only for a few hours
In the first 72 hours!!!!!
NO TED HOSE - NO SHEETS/BLANKETS - NO COMPRESSION DEVICES - (TEACH NO OPEN TOES SHOES). Lambs wool is okay!
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

25. What could happen without immediate intervention for a hematoma?
It is noninvasive. You must not eat - smoke - or drink alcohol for 3 hours before the test. WEAR COMFORTABLE SHOES And LOOSE LIGHTWEIGHT SHORTS OR SLACKS - YOU MAY GET AN INJECTION of THAllIUM - after your blood pressure and ECG are monitored for 10-
The patient may suffer significant blood loss or femoral nerve compression.
Protamine Sulfate
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.

26. What are the S&S of superior vena cava syndrome?
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
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
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
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.

27. What causes essential/primary hypertension?
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
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.
Idiopathic
The patient may suffer significant blood loss or femoral nerve compression.

28. What is the treatment for myocardial infarction?
MONA=Magnesium sulfate - O2 - Nitroglycerin - Aspirin (mona has a heart so EKG also if select all that apply).
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
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
Maintain BED REST

29. What is the treatment for premature ventricular contractions?
IV LIDOCAINE BOLUS (50-100 mg) followed by an IV lidocaine drip (suppresses ventricular activity).
Maintain BED REST
It is noninvasive. You must not eat - smoke - or drink alcohol for 3 hours before the test. WEAR COMFORTABLE SHOES And LOOSE LIGHTWEIGHT SHORTS OR SLACKS - YOU MAY GET AN INJECTION of THAllIUM - after your blood pressure and ECG are monitored for 10-
In the first 72 hours!!!!!

30. What are the treatments/ S&S of peripheral venous disease?
Low pitched sounds such as S3 and S4 and the murmur of mitral stenosis. BEL(low)L
Varicose veins - elevate legs - weight reduction - brawny in color - ted hose - topical steroids - ulcers - and skin color changes.
Check all junctions frequently to make sure secure - especially before patient gets out of bed - and always use tubing with twist lock connections.
Don't interfere!

31. What is labile hypertension?
Deep in the sternomastoid muscle - so look for pulsations in the soft tissue surrounding that area.
BP is elevated or decreased depending on activity.
Used to detect an abdominal aortic aneurysm. This noninvasive test takes 15 to 30 mins. They apply conductive gel to your abdomen and move a transducer over abdomen to scan blood vessels. Sound waves bouncing off anatomic structures are translated in
Pulse before and after giving.

32. When should a patient call 911 after having an implantable cardioverter defibrillator (ICD) placed?
A monitor with four dual electrodes that are applied to the patients neck and thorax.
BP is elevated or decreased depending on activity.
Whether the patients ulnar and radial arteries are patent.
If you feel lightheaded - dizzy - or heart palpitations but feel no shock from the ICD.

33. What is angina? Stable vs. unstable?

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

34. What is Deep Vein Thrombosis (DVT)?
Open up blood vessels
Pulse before and after giving.
A disease in which thrombi trap blood in the deep veins of the pelvis and legs.
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.

35. 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.
When not visable - place the patient in the left lateral position - ask them to exhale fully and stop breathing for a few seconds.
Chronic arteriosclerotic disease.
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.

36. What are examples of calcium channel blockers?
Varicose veins - elevate legs - weight reduction - brawny in color - ted hose - topical steroids - ulcers - and skin color changes.
To reduce a patients risk of DVT and PE. They include graduated compression stockings - vena cava filters - and intermittent sequential external compression devices.
Verapamil (calan) - diltiazem (cardizem) - nifedipine (procardia) - amlodipine (norvasc).
(1st) Assess LOC - (2nd) if unconscious= begin CPR - and (3rd) Notify physician.

37. What does the device for impedance cardiography consist of?
A monitor with four dual electrodes that are applied to the patients neck and thorax.
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).
NO NSAIDS or ASA.
ICG is a noninvasive way to collect hemodynamic data for assessing patients with heart failure - hypertension - or dyspnea.

38. Who would most likely have peripheral venous disease?
One at a time to assess the pulse amplitude and contour.
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.
Air embolism
Old truck driver or someone on bed rest or with pelvic trauma.

39. What should be done is a patient on anticoagulants suffers from epistaxis for more than 15 mins?
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.)
NO because it isn't sterile so keep out.
Posterior nasal packing to stop the blood flow. The LPN CAN DO THIS!
IV LIDOCAINE BOLUS (50-100 mg) followed by an IV lidocaine drip (suppresses ventricular activity).

40. In what locations should you not place electrodes?
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
It will take 5 mins and he/she should remain quiet for about 1 minute without talking or moving.
Cardiac tamponade (fluid in pericardial space) and thickening/scarring of the pericardial sac (constrictive pericarditis and possible RHF).
In fatty areas or over major muscles - large breasts - or bony prominences.

41. What is cardioversion?

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

42. What are the steps for adult/child 1 rescuer CPR?
No clearly defined or measurable P waves and an irregular - irregular ventricular response.
NO TED HOSE - NO SHEETS/BLANKETS - NO COMPRESSION DEVICES - (TEACH NO OPEN TOES SHOES). Lambs wool is okay!
Low pitched sounds such as S3 and S4 and the murmur of mitral stenosis. BEL(low)L
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

43. What is a good diagnosis for someone with right sided HF?
A NON INVASIVE doppler exam of the heart via the thorax to detect cardiac tamponade.
Pallor - diaphoresis - tachypnea - severe tearing chest pain radiating to back - PULSES In ARMS Are STRONG BUT LEG PULSES Are WEAK - low SP02.
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.
Activity intolerance

44. How should you palpate the apical pulse?
(1ST) BEGIN CARDIOPULMONARY RESUSCITATION (The PT. Is DYING) And NotIFY PHYSICIAN (2ND).
When not visable - place the patient in the left lateral position - ask them to exhale fully and stop breathing for a few seconds.
Used to look at vessels. A local anesthetic is injected and a catheter is inserted into a vessel in the area and advanced as necessary. A contrast medium is injected into the vessel than a series of xrays follow. Any flushing sensation/nausea/ or unu
The damaged portion of the aorta is removed and is repaired with a synthetic graft.

45. What is superior vena cava syndrome?
Vitamin K (aqua myphiton)
Idiopathic
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.
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.

46. What is an acute peripheral arterial occlusion?
CPR should be done. No defibrillation bc no rhythm to shock (heart already depolarized).
To reduce a patients risk of DVT and PE. They include graduated compression stockings - vena cava filters - and intermittent sequential external compression devices.
The physician injects a local anesthetic into the site - inserts a catheter - and threads it through the artery into the left side of the heart or through a vein into the right side of the heart to your lungs. Next - a dye is injected which may cause
The arteries have narrowed - decreased O2 to tissues= hypoxia to cells.

47. What factors place you at risk for HTN?
Rapid ventricular rate with no relationship to atrial activity and QRS complex is wide and bizarre.
To reduce a patients risk of DVT and PE. They include graduated compression stockings - vena cava filters - and intermittent sequential external compression devices.
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.
A central line placed that measures the right atrial pressure. Normal= 4-10 cm of H20.

48. What is the treatments for hypertension?
Hair loss - muscle mass loss - pallor when elevated - dependent rubor - and prolonged cap refill time.
Open up blood vessels
Pallor - diaphoresis - tachypnea - severe tearing chest pain radiating to back - PULSES In ARMS Are STRONG BUT LEG PULSES Are WEAK - low SP02.
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.

49. What should you do prior to placing cardiac monitor electrodes on the skin (4 things)?
A nosebleed
4th left intercostal space lower sternal border
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
Low pitched sounds such as S3 and S4 and the murmur of mitral stenosis. BEL(low)L

50. What is Raynauds disease? Tx?
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.
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.
Paroxysmal nocturnal dyspnea - elevated pulmonary capillary wedge pressure - BLOOD TINGED SPUTUM - cough - orthopnea - exertional dyspnea - cyanosis.
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.