NCLEX Tips

related to
Perfusion
NURN 236
For the treatment of
Myocardial Infarction, you can
think of the name MONA.

M~ morphine

O~ Oxygen

N~ Nitroglycerin

A~ Aspirin

T ~ Thrombolytics

A~ Anticoagulants

S ~ Stool softeners

S ~ Sedatives
For Endocarditis, you can remember FROM JANE.
F E V E R , R O T H ’ S S P O T S , O S L E R N O D E S , M U R M U R , J A N E WAY L E S I O N S , A N E M I A , N A I L B E D H E M O R R H A G E , E M B O L I = E N D O C A R D I T I S
To be able to
remember the cause of
heart Murmur, think
of SPAMS.

Stenosis of a valve

Partial obstruction

Aneurysm

Mitral

Septal defect
Remember D MAD DOG for the
treatment of congestive heart
failure.
•Digoxin

•Morphine

•Aminophylline

•Dopamine

•Diuretics

•Oxygen

•Gasses (gasses is for monitoring the arterial blood gasses)

Which individual is at the greatest risk for developing hypertension?

A. 45-year-old African-American attorney

B. 60-year-old Asian-American shop owner

C. 40-year-old Caucasian nurse

D. 55-year-old Hispanic teacher

 Correct Answer: A: 45-year-old
African American attorney

Option A: African-Americans develop high blood pressure at younger ages than other groups in the US.
Researchers have uncovered that African-Americans respond differently to hypertensive drugs than other groups of
people. They are also found out to be more sensitive to salt, which increases the risk of developing hypertension.
Option B: The incidence of hypertension in Asian-Americans does not appear to be significantly higher than the
general population, according to limited US data.
Option C: The racial disparity in hypertension and hypertension-related outcomes has been recognized for decades
with African-Americans with greater risks than Caucasians.
Option D: Hypertension prevalence rates in Hispanics may vary by gender and country of origin. Hispanic
Americans overall have relatively low levels of hypertension, despite elevated levels of diabetes and obesity.
Which complication of cardiac catheterization should the nurse monitor for in the initial 24 hours after
the procedure?

A. Angina at rest

B. Thrombus formation

C. Dizziness

D. Falling blood pressure

Correct Answer: B. Thrombus
formation

A thrombus formation may prevent blood from flowing normally through the circulatory system,
which may become an embolism, and block the flow of blood towards major organs in the body.

Option A: The reported incidence of myocardial infarction with angina at rest is less than 0.1%, and is
mostly influenced by patient-related factors like the extent and severity of underlying cardiovascular-
related diseases and technique-related factors.
Options C & D: A falling BP and dizziness occur along with hemorrhage of the insertion site which is
associated with the first 12 hours after the procedure.
At a community health fair, the blood pressure of a 62-year-old client is 160/96 mmHg. The client
states “My blood pressure is usually much lower.” The nurse should tell the client to:

A. Go get a blood pressure check within the next 15 minutes

B. Check blood pressure again in two (2) months

C. See the healthcare provider immediately

D. Visit the health care provider within one (1) week for a BP check
Correct Answer: A. Go get a blood pressure
check within the next 15 minutes

The blood pressure reading is moderately high with the need to have it rechecked after a few minutes
to verify. The client states it is ‘usually much lower.’ Thus a concern exists for complications such as
stroke.

 Options B & D: Waiting 2 months or a week for follow-up is too long.

 Option C: Immediate check by the provider of care is not warranted.

When teaching a client with coronary artery disease about nutrition, the nurse should emphasize:

A. Eating three (3) balanced meals a day

B. Adding complex carbohydrates

C. Avoiding very heavy meals

D. Limiting sodium to 7 gms per day

 Correct Answer: C. Avoiding very
heavy meals

Eating large, heavy meals can pull blood away from the heart for digestion and is dangerous for the client with
coronary artery disease. Too much plaque may accumulate in the arteries and block the delivery of blood and
oxygen in major organs of the body.

Option A: Eating a balanced diet should be a part of the management of a client with coronary artery disease.

Option B: Complex carbohydrates decrease inflammation and help decrease the risk of plaque build-up in the
arteries.
Option C: People with cardiovascular diseases should have a limit of less than 1.5 grams per day.
Question
Which clinical outcome best determines the effect of heparin?

A. Prothrombin time (PT) 25 seconds

B. Activated partial thromboplastin time (aPTT) 70 seconds

C. International Normalized Ratio (INR) of 2

D. Platelets 250,000
Answer
C. Activated partial thromboplastin time (aPTT) 70 seconds

Why?

A typical aPTT value is 30 to 40 seconds. If you get the test because you're taking heparin, you'd want
your PTT results to be more like 120 to 140 seconds, and your aPTT to be 60 to 80 seconds.
 SATA
Which of the following statements made by the nurse requires further teaching regarding the
administration of epinephrine? (Select all that apply.)

A. "This medication should be administered every time compressors are switched during CPR.“

B. "This medication should be given intravenously.“

C. "This medication should be administered every 3-5 minutes during a code.“

D. "This medication should be placed under the tongue to dissolve.“

E. "I will assess chest pain before and after administration.“

F. "This medication requires a witness when wasting."

 Answer
A. "This medication should be administered every time compressors are switched during CPR.“

B. "This medication should be given intravenously.“

C. "This medication should be administered every 3-5 minutes during a code.“

D. "This medication should be placed under the tongue to dissolve.“

E. "I will assess chest pain before and after administration.“

F. "This medication requires a witness when wasting."

SATA
Which of the following interventions are priority for a client receiving thrombolytic therapy? (Select all that
apply)

A. monitor vital signs 

B. assess for active bleeding

C. assess for reperfusion dysrhythmia

D. obtain basic metabolic panel 

E. obtain arterial blood gas

Answer
A. monitor vital signs 

B. assess for active bleeding

C. assess for reperfusion dysrhythmia

D. obtain basic metabolic panel 

E. obtain arterial blood gas

SATA
Which of the following can decrease risk of developing myocardial infarction? (Select all that apply.)

A. Consuming less than 2g sodium per day

B. Consuming 100g protein per day 

C. Walking 30 minutes per day

D. Maintaining glucose levels between 70-100 mg/dL

E. Maintaining BMI between 28-35

F. Maintaining cholesterol levels 150-180 mg/dL

Answer
A. Consuming less than 2g sodium per day

B. Consuming 100g protein per day 

C. Walking 30 minutes per day

D. Maintaining glucose levels between 70-100 mg/dL

E. Maintaining BMI between 28-35

F. Maintaining cholesterol levels 150-180 mg/dL

SATA
What nursing action(s) would be important for the nurse to assess post cardiac catheterization? (Select all
that apply)

A. Vital signs

B. Peripheral pulse checks

C. Check insertion site

D. Glucose checks

E. Obtain serum electrolytes

Answer
A. Vital signs

B. Peripheral pulse checks

C. Check insertion site

D. Glucose checks

E. Obtain serum electrolytes

Question
Which of the following medications will increase afterload?

A. Diltiazem
B. Metoprolol

C. Lisinopril

D. Norepinephrine
Answer
A. Diltiazem

B. Metoprolol

C. Lisinopril

D. Norepinephrine
SATA
Which of the following assessments would be a priority prior to administering IV Amiodarone? (Select all
that apply.)

A. Blood pressure

B. Heart rate

C. Respiratory rate

D. Temperature

E. O2 saturation 

F. Electrolytes
Answer
A. Blood pressure

B. Heart rate

C. Respiratory rate

D. Temperature

E. O2 saturation 

F. Electrolytes
Medications to Know
Adenosine
Aspirin
Norepinephrine
Atorvastatin
Nitroglycerin
Furosemide Amiodarone
Ticagrelor Diltiazem

Lisinopril Dopamine
Labetalol
Metoprolol

Epinephrine
Labs to know~ Know ranges
PT/INR Potassium

PTT WBCs

Troponin H&H

Platelet
 Electrolyte Values  
Calcium- ionized (Ca++) 4.64 – 5.28 mg/dL
Calcium- total 8.2 – 10.2 mg/dL
Chloride (Cl-) 97-107 mEq/L
Magnesium (Mg++) 1.6 – 2.6 mEq/L
Phosphate (P) 2.57 – 4.5 mg/dL
Potassium (K+) 3.5 - 5.3 mEq/L
Serum Glucose 60-100 mg/dL
Serum Osmolality 275-295 mOsm.kg
Sodium (Na+) 135 - 145 mEq/L
Urine Specific Gravity 1.001-1.029
 ABG VALUES  
pH 7.35 – 7.45 7.35 – 7.45
PaCO2 35 – 45 mmHg
HCO3- 22 – 26 mmol/L
PaO2 80 – 95 mmHg
 Complete Blood Count  
(CBC)
WBC 4.5 – 11.1 x 103/microL
RBC Men 5.21 – 5.81 x 106 microL
  Women 3.91 – 5.11 x 106/microL

Hgb Men 13.2 – 17.3 g/dL

  Women 11.7 – 15.5 g/dL
Hct Men 38 – 51%
  Women 33 – 45%
Platelet 150 – 450 x 103/microL
 Coagulation  
Prothrombin time (PT) 10-13 sec
Activated Partial 25-35 sec
Thromboplastin Time (APTT)
International Normalized < 2 sec
Ratio (INR)
Optimal Lipid Profile  
Total Cholesterol < 200 mg/dL
HDL > 60 mg/dL
LDL < 100 mg/dL
Triglycerides < 150 mg/dL
Diagnostic tests to review
Cardiac Catherization

CABG

PCTA

EKG

Cardioversion/Defibrillation
Telemetry strips
You will need to know how to interpret (not count or anything) but be able to identify then plan
interventions

Normal Sinus Rhythm/Sinus Brady/Sinus Tach

V-Tach / V-Fib / A-Fib

SVT

STEMI