CARDIAC NCLEX EXAM /NCLEX CARDIAC
EXAM ACTUAL EXAM 300 QUESTIONS AND
CORRECT DETAILED ANSWERS
What are coumadin and heparin used for? -ANSWER->>>>To inhibit thrombus and clot
formation.
What is the necessary lab value to evaluate while a patient is on heparin? What is the normal
value? -ANSWER->>>>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.
What is the antidote for heparin? -ANSWER->>>>Protamine Sulfate
What should you do if the PTT value is 80 for someone on heparin? -ANSWER->>>>D/C the med
and call the doctor.
What is the antidote for coumadin? -ANSWER->>>>Vitamin K (aqua myphiton)
What lab value is used to evaluate a patient on coumadin? What is the normal value? -ANSWER-
>>>>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.
What should you do if the PT value is 45 sec? -ANSWER->>>>D/C the med and call the doctor.
,What is INR? -ANSWER->>>>International Normalized Ratio measures blood clotting time and
compares it to normal values. 1.0=normal. Most people on anticoagulants are 2-3.
What should be done for someone on bleeding precautions? -ANSWER->>>>RANDI= Razor-
electric, Aspirin- NO, Needles- small gauge, Decrease-needle sticks, and Injury- protect from. No
percodan or NSAIDS, no open toed shoes.
What should you observe for in someone on bleeding precautions? -ANSWER->>>>Hematuria
(tea or coca cola colored), nosebleeds, gingival bleeding (no medicated mouth wash, flossing, or
lemon glycerin swabs), and bruising (assess for abuse w/o caregiver).
When should bleeding precautions be implemented? -ANSWER->>>>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.
What landmarks should you be looking for on someone's chest? -ANSWER->>>>Aortic valve,
Pulmonic valve, right ventricle, tricuspid valve, and apex or mitral valve.
Where is the aortic valve landmark on the chest? -ANSWER->>>>Second right intercostal space
Where is the pulmonic valve landmark on the chest? -ANSWER->>>>Second left intercostal
space
Where is the right ventricle landmark on the chest? -ANSWER->>>>Left sternal border
Where is the tricuspid valve landmark on the chest? -ANSWER->>>>Lower left sternal border
Where is the apex/mitral valve landmark on the chest? -ANSWER->>>>Fourth or fifth intercostal
space at or medial to the midclavicular line.
, Which jugular veins give a more accurate estimate of the jugular vein pressure and pressure in
the right atrium? -ANSWER->>>>The internal jugular veins (external are less reliable).
Where do the internal jugular veins lie? -ANSWER->>>>Deep in the sternomastoid muscle, so
look for pulsations in the soft tissue surrounding that area.
What signals an elevated venous pressure based on the internal jugular veins? -ANSWER-
>>>>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.
How should you palpate the apical pulse? -ANSWER->>>>When not visable, place the patient in
the left lateral position, ask them to exhale fully and stop breathing for a few seconds.
How should you palpate the carotid arteries? -ANSWER->>>>One at a time to assess the pulse
amplitude and contour.
For which heart sounds should the diaphragm be used? -ANSWER->>>>High pitched sounds like
S1 and S2 (pericardial friction rubs, aortic/mitral regurgitation murmurs). DIAPH(high)ragm
For which heart sounds should the bell be used? -ANSWER->>>>Low pitched sounds such as S3
and S4 and the murmur of mitral stenosis. BEL(low)L
What things should you do to assess cardiovascular status? -ANSWER->>>>Inspect pulses on
chest, inspect the internal jugular veins, palpate the apical pulse, palpate the carotid arteries,
and auscultate the heart sounds.
What is epistaxis? -ANSWER->>>>A nosebleed
EXAM ACTUAL EXAM 300 QUESTIONS AND
CORRECT DETAILED ANSWERS
What are coumadin and heparin used for? -ANSWER->>>>To inhibit thrombus and clot
formation.
What is the necessary lab value to evaluate while a patient is on heparin? What is the normal
value? -ANSWER->>>>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.
What is the antidote for heparin? -ANSWER->>>>Protamine Sulfate
What should you do if the PTT value is 80 for someone on heparin? -ANSWER->>>>D/C the med
and call the doctor.
What is the antidote for coumadin? -ANSWER->>>>Vitamin K (aqua myphiton)
What lab value is used to evaluate a patient on coumadin? What is the normal value? -ANSWER-
>>>>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.
What should you do if the PT value is 45 sec? -ANSWER->>>>D/C the med and call the doctor.
,What is INR? -ANSWER->>>>International Normalized Ratio measures blood clotting time and
compares it to normal values. 1.0=normal. Most people on anticoagulants are 2-3.
What should be done for someone on bleeding precautions? -ANSWER->>>>RANDI= Razor-
electric, Aspirin- NO, Needles- small gauge, Decrease-needle sticks, and Injury- protect from. No
percodan or NSAIDS, no open toed shoes.
What should you observe for in someone on bleeding precautions? -ANSWER->>>>Hematuria
(tea or coca cola colored), nosebleeds, gingival bleeding (no medicated mouth wash, flossing, or
lemon glycerin swabs), and bruising (assess for abuse w/o caregiver).
When should bleeding precautions be implemented? -ANSWER->>>>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.
What landmarks should you be looking for on someone's chest? -ANSWER->>>>Aortic valve,
Pulmonic valve, right ventricle, tricuspid valve, and apex or mitral valve.
Where is the aortic valve landmark on the chest? -ANSWER->>>>Second right intercostal space
Where is the pulmonic valve landmark on the chest? -ANSWER->>>>Second left intercostal
space
Where is the right ventricle landmark on the chest? -ANSWER->>>>Left sternal border
Where is the tricuspid valve landmark on the chest? -ANSWER->>>>Lower left sternal border
Where is the apex/mitral valve landmark on the chest? -ANSWER->>>>Fourth or fifth intercostal
space at or medial to the midclavicular line.
, Which jugular veins give a more accurate estimate of the jugular vein pressure and pressure in
the right atrium? -ANSWER->>>>The internal jugular veins (external are less reliable).
Where do the internal jugular veins lie? -ANSWER->>>>Deep in the sternomastoid muscle, so
look for pulsations in the soft tissue surrounding that area.
What signals an elevated venous pressure based on the internal jugular veins? -ANSWER-
>>>>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.
How should you palpate the apical pulse? -ANSWER->>>>When not visable, place the patient in
the left lateral position, ask them to exhale fully and stop breathing for a few seconds.
How should you palpate the carotid arteries? -ANSWER->>>>One at a time to assess the pulse
amplitude and contour.
For which heart sounds should the diaphragm be used? -ANSWER->>>>High pitched sounds like
S1 and S2 (pericardial friction rubs, aortic/mitral regurgitation murmurs). DIAPH(high)ragm
For which heart sounds should the bell be used? -ANSWER->>>>Low pitched sounds such as S3
and S4 and the murmur of mitral stenosis. BEL(low)L
What things should you do to assess cardiovascular status? -ANSWER->>>>Inspect pulses on
chest, inspect the internal jugular veins, palpate the apical pulse, palpate the carotid arteries,
and auscultate the heart sounds.
What is epistaxis? -ANSWER->>>>A nosebleed
