CARDIAC NCLEX EXAM /NCLEX CARDIAC EXAM
ACTUAL EXAM 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).
What is the treatment for someone in ventricular fibrillation? - ✔✔ANSWER✔✔>>Direct
current shock (defibrillation) and IV anti-arrhythmic drugs (lidocaine, Procainamide, and
Bretylium).
What is characteristic of complete heart block? - ✔✔ANSWER✔✔>>Ventricular rate is
regular at a rate of 40-60 bpm and there is no relationship of P waves to QRS
complexes.
What are the nursing interventions for a patient in complete heart block? -
✔✔ANSWER✔✔>>(1st) Assess the client for S&S of decreased cardiac output and
Notify physician (2nd).
What is the treatment for a patient in complete heart block? -
✔✔ANSWER✔✔>>Temporary or permanent transvenous PACEMAKER INSERTION,
, and if the client is symptomatic and showing S&S of decreased cardiac output, GIVE
ATROPINE.
What is characteristic of ventricular tachycardia? - ✔✔ANSWER✔✔>>Rapid ventricular
rate with no relationship to atrial activity and QRS complex is wide and bizarre.
What are the nursing interventions for a pt. with ventricular tachycardia? -
✔✔ANSWER✔✔>>(1st) Assess LOC, (2nd) if unconscious= begin CPR, and (3rd)
Notify physician.
What is the treatment for a pt. with ventricular tachycardia? - ✔✔ANSWER✔✔>>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.
What should happen if someone converts to asystole/flatline? - ✔✔ANSWER✔✔>>CPR
should be done. No defibrillation bc no rhythm to shock (heart already depolarized).
What are the steps for adult/child 1 rescuer CPR? - ✔✔ANSWER✔✔>>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 compression <23 sec, 1 1/2-2"
DEEP), give 2 breaths (1 sec each), deliver second cycle of compressions, give 2
breaths.
What are the steps for infant 1&2 rescuer CPR? - ✔✔ANSWER✔✔>>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 compression <23 sec, 1/3-1/2"
DEEP), 2 breaths, (2nd rescuer arrives) 1st rescuer deliver 2nd cycle of compression,
2nd rescuer gives 2 breaths, (after 2 cycles they switch positions).
What are the steps for adult 2 rescuer CPR? - ✔✔ANSWER✔✔>>Rescuer arrives with
AED, turn AED on, select proper pads and apply, clear victim to analyze, clear victim to
shock/press shock, resume chest compressions after 1 shock, delivers cycle of
compressions at correct rate, pause to allow other rescuer to give 2 breaths, delivers
cycle of compressions, pauses for 2 more breaths, switches places after 2 cycles.
What are the steps to perform the heimlich maneuver? - ✔✔ANSWER✔✔>>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.
If a victim is choking but can cough, speak, or breath what should you do? -
✔✔ANSWER✔✔>>Don't interfere!
ACTUAL EXAM 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).
What is the treatment for someone in ventricular fibrillation? - ✔✔ANSWER✔✔>>Direct
current shock (defibrillation) and IV anti-arrhythmic drugs (lidocaine, Procainamide, and
Bretylium).
What is characteristic of complete heart block? - ✔✔ANSWER✔✔>>Ventricular rate is
regular at a rate of 40-60 bpm and there is no relationship of P waves to QRS
complexes.
What are the nursing interventions for a patient in complete heart block? -
✔✔ANSWER✔✔>>(1st) Assess the client for S&S of decreased cardiac output and
Notify physician (2nd).
What is the treatment for a patient in complete heart block? -
✔✔ANSWER✔✔>>Temporary or permanent transvenous PACEMAKER INSERTION,
, and if the client is symptomatic and showing S&S of decreased cardiac output, GIVE
ATROPINE.
What is characteristic of ventricular tachycardia? - ✔✔ANSWER✔✔>>Rapid ventricular
rate with no relationship to atrial activity and QRS complex is wide and bizarre.
What are the nursing interventions for a pt. with ventricular tachycardia? -
✔✔ANSWER✔✔>>(1st) Assess LOC, (2nd) if unconscious= begin CPR, and (3rd)
Notify physician.
What is the treatment for a pt. with ventricular tachycardia? - ✔✔ANSWER✔✔>>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.
What should happen if someone converts to asystole/flatline? - ✔✔ANSWER✔✔>>CPR
should be done. No defibrillation bc no rhythm to shock (heart already depolarized).
What are the steps for adult/child 1 rescuer CPR? - ✔✔ANSWER✔✔>>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 compression <23 sec, 1 1/2-2"
DEEP), give 2 breaths (1 sec each), deliver second cycle of compressions, give 2
breaths.
What are the steps for infant 1&2 rescuer CPR? - ✔✔ANSWER✔✔>>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 compression <23 sec, 1/3-1/2"
DEEP), 2 breaths, (2nd rescuer arrives) 1st rescuer deliver 2nd cycle of compression,
2nd rescuer gives 2 breaths, (after 2 cycles they switch positions).
What are the steps for adult 2 rescuer CPR? - ✔✔ANSWER✔✔>>Rescuer arrives with
AED, turn AED on, select proper pads and apply, clear victim to analyze, clear victim to
shock/press shock, resume chest compressions after 1 shock, delivers cycle of
compressions at correct rate, pause to allow other rescuer to give 2 breaths, delivers
cycle of compressions, pauses for 2 more breaths, switches places after 2 cycles.
What are the steps to perform the heimlich maneuver? - ✔✔ANSWER✔✔>>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.
If a victim is choking but can cough, speak, or breath what should you do? -
✔✔ANSWER✔✔>>Don't interfere!
