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
, What should be done is a patient on anticoagulants suffers from epistaxis for more
than 15 mins? - ANSWER: Posterior nasal packing to stop the blood flow. THE LPN
CAN DO THIS!
What should you do immediately for someone experiencing anticoagulant induced
epistaxis? - ANSWER: 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 least 10 mins), apply ice packs to lips, back of neck, and forehead
to help stop bleeding.
What should you teach your patient about an abdominal ultrasonography? -
ANSWER: 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 into graphic images.
What should you teach your patient about angiography (arteriography)? - ANSWER:
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 unusual taste
will pass. They'll need to keep their arm or leg extended and immobile for
approximately 6 hours. Once able they should plenty of fluids. The nurse should
check pulses distal to the insertion site.
Test ending in Gram=? - ANSWER: Iodine
What should you teach someone about iodine? - ANSWER: Feeling warm (fire) or tin
can taste is expected and will pass.
How long is contrast media in the body? - ANSWER: Only for a few hours
What should you teach your patient about a cardiac catheterization? - ANSWER: 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 flushing, nausea,
or chest pain, they may be asked to COUGH OR DEEP BREATH for a better view of the
heart (and help aid catheter movement). They should keep their bandaged arm or
leg straight and still for up to 6 hours. Once they're allowed to resume their diet
drink plenty of fluids. (angioplasty can be done at the same time and stents can be
placed). Nurse should check pulses before and after.
What should you teach your patient about MRI? - ANSWER: 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, clips, valves, or pumps
containing metal you can't have the test. The scanner makes loud clicking, whirring,
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
, What should be done is a patient on anticoagulants suffers from epistaxis for more
than 15 mins? - ANSWER: Posterior nasal packing to stop the blood flow. THE LPN
CAN DO THIS!
What should you do immediately for someone experiencing anticoagulant induced
epistaxis? - ANSWER: 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 least 10 mins), apply ice packs to lips, back of neck, and forehead
to help stop bleeding.
What should you teach your patient about an abdominal ultrasonography? -
ANSWER: 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 into graphic images.
What should you teach your patient about angiography (arteriography)? - ANSWER:
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 unusual taste
will pass. They'll need to keep their arm or leg extended and immobile for
approximately 6 hours. Once able they should plenty of fluids. The nurse should
check pulses distal to the insertion site.
Test ending in Gram=? - ANSWER: Iodine
What should you teach someone about iodine? - ANSWER: Feeling warm (fire) or tin
can taste is expected and will pass.
How long is contrast media in the body? - ANSWER: Only for a few hours
What should you teach your patient about a cardiac catheterization? - ANSWER: 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 flushing, nausea,
or chest pain, they may be asked to COUGH OR DEEP BREATH for a better view of the
heart (and help aid catheter movement). They should keep their bandaged arm or
leg straight and still for up to 6 hours. Once they're allowed to resume their diet
drink plenty of fluids. (angioplasty can be done at the same time and stents can be
placed). Nurse should check pulses before and after.
What should you teach your patient about MRI? - ANSWER: 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, clips, valves, or pumps
containing metal you can't have the test. The scanner makes loud clicking, whirring,
