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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 are the steps for infant 1&2 rescuer CPR?
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
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
Second Right intercostal space.
(1ST) BEGIN CARDIOPULMONARY RESUSCITATION (The PT. Is DYING) And NotIFY PHYSICIAN (2ND).

2. What are the S&S of air embolism?
Air answers (open junctions)
Open up blood vessels
Difficulty breathing - pain in midchest and shoulder - pale - nausea - and light headedness.
Pericardial friction rub - chest pain (sharp and aggravated with breathing) - abnormal EKG findings - possible fever and tachycardia.

3. What will be the treatment for an acute episode of life threatening tamponade?
Maintain BED REST
Fat - Air - DVT - or Amniotic
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
A clinician will perform echocardiogram guided pericardiocentesis with a needle or catheter to remove excess fluid in the pericardial sac.

4. What is the treatment for someone with right sided HF? How do you know working?
Diuretic & Digoxin (dig increases force of contraction and increases perfusion). Know working if client is peeing (kidney perfusion) and more alert!
Pulmonary edema
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
Right sided heart failure

5. What is impedance cardiography?
Posterior nasal packing to stop the blood flow. The LPN CAN DO THIS!
ST segment elevation (STEMI)
ICG is a noninvasive way to collect hemodynamic data for assessing patients with heart failure - hypertension - or dyspnea.
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

6. What should you do immediately if you suspect someone of developing a hematoma?
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
A disease in which thrombi trap blood in the deep veins of the pelvis and legs.
(S1 - S2) Third left intercostal space
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.

7. What is the normal value for arterial pulse? Pulse amplitude? Edema? Reflex?
If feel more than 3 shocks in a row or develop signs of infection at the 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.
Stop the medication - address the factors that may have precipitated the event. If life threatening Digibind ay be indicated.
Arterial pulse: 60-90 - Amplitude: 4+=strong and bounding - Edema: 0=none - Reflex 2+

8. What should you observe for in someone on bleeding precautions?
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
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).
BP is elevated or decreased depending on activity.
Old truck driver or someone on bed rest or with pelvic trauma.

9. In What time period is the greatest risk of sudden death from an MI?
An inflammation of the pericardium. It may result in MI.
Right atrium - TRICUSPID VALVE (tissue) - right ventricle - PULMONIC VALVE (paper) - lungs - left atrium - MITRAL VALVE (My) - left ventricle - AORTIC VALVE (Assets). Tissue PAPER MY ASSETS!
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
In the first 72 hours!!!!!

10. Where should you place your stethescope to find the ERB's Point?
Temporary or permanent transvenous PACEMAKER INSERTION - and if the client is symptomatic and showing S&S of decreased cardiac output - GIVE ATROPINE.
(S1 - S2) Third left intercostal space
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
Paroxysmal nocturnal dyspnea - elevated pulmonary capillary wedge pressure - BLOOD TINGED SPUTUM - cough - orthopnea - exertional dyspnea - cyanosis.

11. What should you know about your recovery period after having an implantable cardioverter defibrillator (ICD)?
A fluid accumulation in the pericardial space that compromises cardiac function. It is considered a medical emergency and is a hemodynamic consequence of blood or excess fluid accumulation in the pericardial sac. Common causes are surgical or traumat
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.
For the first month post op - do not lift more than 10 or 15 lbs. And avoid excessive pushing - pulling - or twisting.
Totally disorganized - chaotic pattern - and no discernible waves or complexes.

12. Where should you place your stethescope to find the pulmonic valve?
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
Second Left intercostal space
Patient who are unable to tolerate exercise stress testing.
A NON INVASIVE doppler exam of the heart via the thorax to detect cardiac tamponade.

13. What should you do to treat pulmonary edema?
Diuretic & Digoxin (dig increases force of contraction and increases perfusion). Know working if client is peeing (kidney perfusion) and more alert!
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
Constipation or MAY CAUSE ANKLES TO SWELL (call healthcare provider).

14. How is the Allen's test done?
Clip the hair to allow good contact between the electrodes and the skin (DONT SHAVE).
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
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 fluid accumulation in the pericardial space that compromises cardiac function. It is considered a medical emergency and is a hemodynamic consequence of blood or excess fluid accumulation in the pericardial sac. Common causes are surgical or traumat

15. What are the nursing interventions for a patient in atrial fibrillation?
BP is elevated or decreased depending on activity.
Fatigue - JVD - Increased peripheral venous pressure - ascites - anorexia/complaints of GI distress - cyanosis - and dependent edema.
ICG is a noninvasive way to collect hemodynamic data for assessing patients with heart failure - hypertension - or dyspnea.
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).

16. What can result from left sided heart failure if left untreated?
Difficulty breathing - pain in midchest and shoulder - pale - nausea - and light headedness.
Cannot
Right sided heart failure
Pulmonary edema

17. What are the two common complications of pericarditis?
Cardiac tamponade (fluid in pericardial space) and thickening/scarring of the pericardial sac (constrictive pericarditis and possible RHF).
The right and left ventricular pressures - cardiac output - arterial venous O2 difference - and pulmonary artery pressure.
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.
Arterial pulse: 60-90 - Amplitude: 4+=strong and bounding - Edema: 0=none - Reflex 2+

18. Where should you place your stethescope to find the tricuspid valve?
A drop in systolic BP greater than 12 mm Hg during inspiration indicating a compromise.
Anxiousness - restlessness - tachycardia - tachypneic - 90% SP02 - dyspnea - substernal pain - coughing - hemoptysis - and fever.
4th left intercostal space lower sternal border
An enlarged space indicates fluid accumulation in the pericardial sac.

19. What is a assessment finding with DVT?

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20. What does a swan ganz measure?
The right and left ventricular pressures - cardiac output - arterial venous O2 difference - and pulmonary artery pressure.
Open up blood vessels
Elevated legs - anticoagulation therapy (aggressive: generally IV heparin) - Be alert for signs of PE.
(1st) Assess the client for S&S of decreased cardiac output and Notify physician (2nd).

21. What causes essential/primary hypertension?
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.
Idiopathic
Before
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.

22. What should you explain to the patient about an impedance cardiography test?
No radial artery punctures if negative
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
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.

23. A femoral artery compression device ______be assigned to an NA?
Cannot
A fluid accumulation in the pericardial space that compromises cardiac function. It is considered a medical emergency and is a hemodynamic consequence of blood or excess fluid accumulation in the pericardial sac. Common causes are surgical or traumat
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.
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.

24. What factors place you at risk for HTN?
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.
Clip the hair to allow good contact between the electrodes and the skin (DONT SHAVE).
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
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.

25. What is a transthoracic echocardiograph (TTE)?
The internal jugular veins (external are less reliable).
Right sided heart failure
A NON INVASIVE doppler exam of the heart via the thorax to detect cardiac tamponade.
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.

26. What should you teach your patient about angiography (arteriography)?
Temporary or permanent transvenous PACEMAKER INSERTION - and if the client is symptomatic and showing S&S of decreased cardiac output - GIVE ATROPINE.
Low pitched sounds such as S3 and S4 and the murmur of mitral stenosis. BEL(low)L
Lower left sternal border
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

27. What is more harmful a lot of little emboli or one large emboli?
(S1 - S2) Third left intercostal space
NO TED HOSE - NO SHEETS/BLANKETS - NO COMPRESSION DEVICES - (TEACH NO OPEN TOES SHOES). Lambs wool is okay!
One large emboli (smaller=better)
Smoking - elevated cholesterol - diabetes - hypertension - old age - and family hx of coronary artery disease.

28. What type of EKG change indicates MI?
Smoking - elevated cholesterol - diabetes - hypertension - old age - and family hx of coronary artery disease.
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
ST segment elevation (STEMI)
When they occur >6 per minute or occurring 2 or more in a row (bigeminy or trigeminy=on way out).

29. What is the treatment for atrial fibrillation?
After a sheath removal to apply consistent pressure and prevent bleeding. (Ex: after swan ganz removal).
Direct current cardioversion and digoxin/propranolol (inderal).
NO TED HOSE - NO SHEETS/BLANKETS - NO COMPRESSION DEVICES - (TEACH NO OPEN TOES SHOES). Lambs wool is okay!
ICG is a noninvasive way to collect hemodynamic data for assessing patients with heart failure - hypertension - or dyspnea.

30. What is an acute peripheral arterial occlusion?
The arteries have narrowed - decreased O2 to tissues= hypoxia to cells.
Feeling warm (fire) or tin can taste is expected and will pass.
A hematoma= bleeding into the soft tissue surrounding the femoral artery access site.
Anxiousness - restlessness - tachycardia - tachypneic - 90% SP02 - dyspnea - substernal pain - coughing - hemoptysis - and fever.

31. What are the 2 types of pacemakers?
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-
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.
Fourth or fifth intercostal space at or medial to the midclavicular line.
Pneumothorax and will end up with chest tube to help reinflate lung.

32. What should be done is a patient on anticoagulants suffers from epistaxis for more than 15 mins?
Posterior nasal packing to stop the blood flow. The LPN CAN DO THIS!
Only for a few hours
No clearly defined or measurable P waves and an irregular - irregular ventricular response.
All People Enjoy Time Magazine= Aortic - Pulmonic - ERB's point - Tricuspid - and Mitral/Apex. P(2) E (3) T (4) MA (5) (locations)

33. What are the indications for a chemical stress test (persantine stress test)?
International Normalized Ratio measures blood clotting time and compares it to normal values. 1.0=normal. Most people on anticoagulants are 2-3.
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
Patient who are unable to tolerate exercise stress testing.
One at a time to assess the pulse amplitude and contour.

34. What things should you do to assess cardiovascular status?
Whether the patients ulnar and radial arteries are patent.
Open up blood vessels
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
Inspect pulses on chest - inspect the internal jugular veins - palpate the apical pulse - palpate the carotid arteries - and auscultate the heart sounds.

35. 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
(S1 - S2) Third left intercostal space
Left sternal border
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

36. What is the most common cause of arterial insufficiency?
Fifth left intercostal space medial to the midclavicular line.
SOB - dyspnea - anxiousness - diaphoresis - cool/clammy skin - distended neck veins - mental status changes - narrowed pulse pressure - hypotension - and faint or muffled heart sounds.
Chronic arteriosclerotic disease.
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

37. What is the treatment for a pt. with ventricular tachycardia?
Awake and alert: IV lidocaine bolus and drip Unconscious - hypotensive - or S&S of angina/CHF: Direct current cardioversion and IV Lidocaine bolus and drip.
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.
One large emboli (smaller=better)
A hematoma= bleeding into the soft tissue surrounding the femoral artery access site.

38. What is the necessary lab value to evaluate while a patient is on heparin? What is the normal value?
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
A patient on sildenafil (Viagra) - Cealis - or Levitra bc these drugs together can cause very low blood pressure and heart attack.
A NON INVASIVE doppler exam of the heart via the thorax to detect 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.

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

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

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

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42. What is the treatments for hypertension?
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).
High pitched sounds like S1 and S2 (pericardial friction rubs - aortic/mitral regurgitation murmurs). DIAPH(high)ragm
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.
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.

43. What should be done immediately for someone with 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
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.
(1st) Assess LOC - (2nd) if unconscious= begin CPR - and (3rd) Notify physician.
Administer 100% O2 - left trendelenburg position - heparin administered - and oral warfarin started (give heparin and warfarin together for at least 5 days).

44. What could happen without immediate intervention for a hematoma?
The internal jugular veins (external are less reliable).
Left sternal border
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.
The patient may suffer significant blood loss or femoral nerve compression.

45. What is Raynauds disease? Tx?
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.
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
If feel more than 3 shocks in a row or develop signs of infection at the site.
All People Enjoy Time Magazine= Aortic - Pulmonic - ERB's point - Tricuspid - and Mitral/Apex. P(2) E (3) T (4) MA (5) (locations)

46. What should be done during the insertion of both a CVP catheter and a swan ganz catheter?
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.
Paroxysmal nocturnal dyspnea - elevated pulmonary capillary wedge pressure - BLOOD TINGED SPUTUM - cough - orthopnea - exertional dyspnea - cyanosis.
Rapid ventricular rate with no relationship to atrial activity and QRS complex is wide and bizarre.

47. What should you do if the PTT value is 80 for someone on heparin?
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.
(1st) Assess the client for S&S of decreased cardiac output and Notify physician (2nd).
D/C the med and call the doctor.
NO TED HOSE - NO SHEETS/BLANKETS - NO COMPRESSION DEVICES - (TEACH NO OPEN TOES SHOES). Lambs wool is okay!

48. Where should you place your stethescope to find the mitral (apex) valve?
Fifth left intercostal space medial to the midclavicular line.
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
When not visable - place the patient in the left lateral position - ask them to exhale fully and stop breathing for a few seconds.
NO because it isn't sterile so keep out.

49. What is a therapeutic digoxin level?
A nosebleed
Cannot
Left sternal border
0.5-2.0 ng/ml

50. What nursing interventions are associated with a pt. experiencing ventricular fibrillation?
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.
(1ST) BEGIN CARDIOPULMONARY RESUSCITATION (The PT. Is DYING) And NotIFY PHYSICIAN (2ND).
Vitamin K (aqua myphiton)
Lung disease

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NCLEX Cardiac

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