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 impedance cardiography?
ICG is a noninvasive way to collect hemodynamic data for assessing patients with heart failure - hypertension - or dyspnea.
Activity intolerance
Pulse before and after giving.
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.

2. What should you do to treat pulmonary edema?
Check all junctions frequently to make sure secure - especially before patient gets out of bed - and always use tubing with twist lock connections.
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
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
When a large air bubble blocks blood flow from the right ventricle into the pulmonary artery.

3. Where should you place your stethescope to find the tricuspid valve?
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
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
4th left intercostal space lower sternal border
Low pitched sounds such as S3 and S4 and the murmur of mitral stenosis. BEL(low)L

4. What are the S&S of pulmonary embolism?
Protamine Sulfate
0.5-2.0 ng/ml
Anxiousness - restlessness - tachycardia - tachypneic - 90% SP02 - dyspnea - substernal pain - coughing - hemoptysis - and fever.
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.

5. What is INR?
Vascular - artery disease causing fluid to back up into the lungs.
Pneumothorax and will end up with chest tube to help reinflate lung.
International Normalized Ratio measures blood clotting time and compares it to normal values. 1.0=normal. Most people on anticoagulants are 2-3.
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.

6. What is the treatment for premature ventricular contractions?
An inflammation of the pericardium. It may result in MI.
Fifth left intercostal space medial to the midclavicular line.
IV LIDOCAINE BOLUS (50-100 mg) followed by an IV lidocaine drip (suppresses ventricular activity).
Stop the medication - address the factors that may have precipitated the event. If life threatening Digibind ay be indicated.

7. What should you watch for with PICC lines that have been in place for 6 months?
Air answers (open junctions)
Fat - Air - DVT - or Amniotic
(1st) Assess LOC - (2nd) if unconscious= begin CPR - and (3rd) Notify physician.
Second Right intercostal space.

8. What is an air embolism?
When a large air bubble blocks blood flow from the right ventricle into the pulmonary artery.
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.
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).

9. What are the two common complications of pericarditis?
Fat - Air - DVT - or Amniotic
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
Cardiac tamponade (fluid in pericardial space) and thickening/scarring of the pericardial sac (constrictive pericarditis and possible RHF).
0.5-2.0 ng/ml

10. What usually triggers angina pain?
Low pitched sounds such as S3 and S4 and the murmur of mitral stenosis. BEL(low)L
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 usually occurs when your heart is working harder (ex: exercising - eating large meal - or feeling stress. Also very hot or cold weather).
Limit the size of the infarction is the goal. Treatment= thrombolytic therapy (tPA) initiated within 6 hours of the first symptoms= standard treatment.

11. When should a patient call their doctor after having an implantable cardioverter defibrillator (ICD) placed?
Diuretic & Digoxin (dig increases force of contraction and increases perfusion). Know working if client is peeing (kidney perfusion) and more alert!
Fourth or fifth intercostal space at or medial to the midclavicular line.
If feel more than 3 shocks in a row or develop signs of infection at the site.
Pulmonary edema

12. What are the S&S of aortic dissection?
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
Must be flushed 1x/month with heparin and between treatments.
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).
Pallor - diaphoresis - tachypnea - severe tearing chest pain radiating to back - PULSES In ARMS Are STRONG BUT LEG PULSES Are WEAK - low SP02.

13. What does a swan ganz measure?
The right and left ventricular pressures - cardiac output - arterial venous O2 difference - and pulmonary artery pressure.
Fourth or fifth intercostal space at or medial to the midclavicular line.
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.
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

14. What is the goal of treatment for an MI? Treatment?
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).
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.
To inhibit thrombus and clot formation.
Limit the size of the infarction is the goal. Treatment= thrombolytic therapy (tPA) initiated within 6 hours of the first symptoms= standard treatment.

15. What makes the symptoms of superior vena cava syndrome better? Worse?
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.
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 symptoms improve when the patient is sitting in upright position that promotes drainage but worsen with the client is lying down.
Steroid treatment or a pregnant woman who is retaining water.

16. What should be done for someone on bleeding precautions?
A central line placed that measures the right atrial pressure. Normal= 4-10 cm of H20.
RAndI= Razor - electric - Aspirin - NO - Needles - small gauge - Decrease - needle sticks - and Injury- protect from. No percodan or NSAIDS - no open toed shoes.
Steroid treatment or a pregnant woman who is retaining water.
Temporary or permanent transvenous PACEMAKER INSERTION - and if the client is symptomatic and showing S&S of decreased cardiac output - GIVE ATROPINE.

17. What can result from left sided heart failure if left untreated?
Pulmonary edema
No radial artery punctures if negative
Totally disorganized - chaotic pattern - and no discernible waves or complexes.
Protamine Sulfate

18. Where is the apex/mitral valve landmark on the chest?
The damaged portion of the aorta is removed and is repaired with a synthetic graft.
Fourth or fifth intercostal space at or medial to the midclavicular line.
Patient who are unable to tolerate exercise stress testing.
Clip the hair to allow good contact between the electrodes and the skin (DONT SHAVE).

19. How should you palpate the carotid arteries?
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.
NO because it isn't sterile so keep out.
Fat - Air - DVT - or Amniotic
One at a time to assess the pulse amplitude and contour.

20. What should you teach your patient about a cardiac catheterization?
4th left intercostal space lower sternal border
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
Verapamil (calan) - diltiazem (cardizem) - nifedipine (procardia) - amlodipine (norvasc).
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.

21. How does the blood flow through the heart? (valves?)
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!
Hair loss - muscle mass loss - pallor when elevated - dependent rubor - and prolonged cap refill time.
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).
Correct her and tell her that the (+) lead goes on the left and the (-) lead goes on the right side.

22. What are the steps to perform the heimlich maneuver?
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
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.
Whether the patients ulnar and radial arteries are patent.
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.

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

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

24. 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!
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.
Activity intolerance
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

25. What should you do when applying a femoral artery compression device?
Second Right intercostal space.
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
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).
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

26. What type of EKG change indicates MI?
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.
Trendelenburg position for insertion. Pt holds breath to prevent air from entering sinus tract.
If feel more than 3 shocks in a row or develop signs of infection at the site.
ST segment elevation (STEMI)

27. What should you suspect for someone who post cardiac cath and percutaneous coronary intervention reporting feeling a pop in her left groin followed by a saturated dressing - swelling around site - palpable 2 inch fullness - and a bruit is present?
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
Pulse before and after giving.
Smoking - elevated cholesterol - diabetes - hypertension - old age - and family hx of coronary artery disease.
A hematoma= bleeding into the soft tissue surrounding the femoral artery access site.

28. What is labile hypertension?
A patient on sildenafil (Viagra) - Cealis - or Levitra bc these drugs together can cause very low blood pressure and heart attack.
A hematoma= bleeding into the soft tissue surrounding the femoral artery access site.
To inhibit thrombus and clot formation.
BP is elevated or decreased depending on activity.

29. What are the nursing interventions for a patient in atrial fibrillation?
MONA=Magnesium sulfate - O2 - Nitroglycerin - Aspirin (mona has a heart so EKG also if select all that apply).
A patient on sildenafil (Viagra) - Cealis - or Levitra bc these drugs together can cause very low blood pressure and heart attack.
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.
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).

30. What condition can cause left sided heart failure?
Check all junctions frequently to make sure secure - especially before patient gets out of bed - and always use tubing with twist lock connections.
Vascular - artery disease causing fluid to back up into the lungs.
In fatty areas or over major muscles - large breasts - or bony prominences.
Trendelenburg position for insertion. Pt holds breath to prevent air from entering sinus tract.

31. What are the 2 types of pacemakers?
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.
A NON INVASIVE doppler exam of the heart via the thorax to detect cardiac tamponade.
Cardiac tamponade (fluid in pericardial space) and thickening/scarring of the pericardial sac (constrictive pericarditis and possible RHF).

32. What are the treatments/ S&S of peripheral venous disease?
D/C the med and call the doctor.
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).
Lower left sternal border

33. What should you do prior to placing cardiac monitor electrodes on the skin (4 things)?
Clip hair if necessary - abrade the skin (use abrader pads or fine sandpaper and lightly rub skin using 2 or 3 brisk strokes - improves tracings) - dry skin if necessary - and attach the lead wires to the electrodes before you apply them to the patie
Pulmonary edema
NO NSAIDS or ASA.
Constipation or MAY CAUSE ANKLES TO SWELL (call healthcare provider).

34. What should you teach someone about iodine?
Feeling warm (fire) or tin can taste is expected and will pass.
Check for response - activate ERS - open airway head tilt chin lift - check breathing (5-10 sec) - give 2 breaths (1 sec) with visible chest rise - checks brachial pulse (5-10 sec) - locates CPR finger position - deliver 1st cycle of compressions (30
International Normalized Ratio measures blood clotting time and compares it to normal values. 1.0=normal. Most people on anticoagulants are 2-3.
Decreased tissue perfusion. Tx: clot busting treatment must start within 6 hours.

35. What is characteristic of ventricular fibrillation?
(1ST) BEGIN CARDIOPULMONARY RESUSCITATION (The PT. Is DYING) And NotIFY PHYSICIAN (2ND).
The arteries have narrowed - decreased O2 to tissues= hypoxia to cells.
After a sheath removal to apply consistent pressure and prevent bleeding. (Ex: after swan ganz removal).
Totally disorganized - chaotic pattern - and no discernible waves or complexes.

36. Who would most likely have peripheral venous disease?
Lowers BP and makes heart beat stronger. SE: flushed face.
Maintain BED REST
Old truck driver or someone on bed rest or with pelvic trauma.
Diuretic & Digoxin (dig increases force of contraction and increases perfusion). Know working if client is peeing (kidney perfusion) and more alert!

37. What are the four types of pulmonary emboli?
To reduce a patients risk of DVT and PE. They include graduated compression stockings - vena cava filters - and intermittent sequential external compression devices.
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.
RAndI= Razor - electric - Aspirin - NO - Needles - small gauge - Decrease - needle sticks - and Injury- protect from. No percodan or NSAIDS - no open toed shoes.
Fat - Air - DVT - or Amniotic

38. What should you know about your recovery period after having an implantable cardioverter defibrillator (ICD)?
For the first month post op - do not lift more than 10 or 15 lbs. And avoid excessive pushing - pulling - or twisting.
BP is elevated or decreased depending on activity.
Second right intercostal space
Vitamin K (aqua myphiton)

39. What is the antidote for coumadin?
Right sided heart failure
Vitamin K (aqua myphiton)
Whether the patients ulnar and radial arteries are patent.
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

40. What should be done immediately if a pulmonary embolism is suspected?
Deep in the sternomastoid muscle - so look for pulsations in the soft tissue surrounding that area.
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.)
Anxiousness - restlessness - tachycardia - tachypneic - 90% SP02 - dyspnea - substernal pain - coughing - hemoptysis - and fever.
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

41. What is cardioversion?

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

42. What things should you do to assess cardiovascular status?
Fifth left intercostal space medial to the midclavicular line.
Inspect pulses on chest - inspect the internal jugular veins - palpate the apical pulse - palpate the carotid arteries - and auscultate the heart sounds.
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
Feeling warm (fire) or tin can taste is expected and will pass.

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

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

44. What is Deep Vein Thrombosis (DVT)?
A disease in which thrombi trap blood in the deep veins of the pelvis and legs.
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
Direct current shock (defibrillation) and IV anti - arrhythmic drugs (lidocaine - Procainamide - and Bretylium).
Idiopathic

45. What signals an elevated venous pressure based on the internal jugular veins?
A NON INVASIVE doppler exam of the heart via the thorax to detect cardiac tamponade.
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
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.

46. What should you do immediately if you suspect someone of developing a hematoma?
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.
Nitrates - Beta blockers - and Calcium channel blockers
Cannot
When not visable - place the patient in the left lateral position - ask them to exhale fully and stop breathing for a few seconds.

47. What is the treatments for hypertension?
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).
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.
CPR should be done. No defibrillation bc no rhythm to shock (heart already depolarized).
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

48. How is the arterial brachial index (ABI) calculated? Who should perform this? What is normal?
NO TED HOSE - NO SHEETS/BLANKETS - NO COMPRESSION DEVICES - (TEACH NO OPEN TOES SHOES). Lambs wool is okay!
Clip hair if necessary - abrade the skin (use abrader pads or fine sandpaper and lightly rub skin using 2 or 3 brisk strokes - improves tracings) - dry skin if necessary - and attach the lead wires to the electrodes before you apply them to the patie
It 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.
Maintain BED REST

49. What should be taught upon discharge for someone going home on coumadin as a result of a PE?
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.
A monitor with four dual electrodes that are applied to the patients neck and thorax.
Pericardial friction rub - chest pain (sharp and aggravated with breathing) - abnormal EKG findings - possible fever and tachycardia.
Difficulty breathing - pain in midchest and shoulder - pale - nausea - and light headedness.

50. 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