Cardiac/Vascular Nurse Exam Secrets Study Guide

Cardiac/Vascular Nurse Exam

Cardiac/Vascular Nurse Test Review for the

Cardiac/Vascular Nurse Exam

Copyright © 2015 by Mometrix Media LLC

All rights reserved. This product, or parts thereof, may not be reproduced, stored in a retrieval system, or transmitted in any form or by any means—electronic, mechanical, photocopy, recording, scanning, or other—except for brief quotations in critical reviews or articles, without the prior written permission of the publisher.

Written and edited by the Cardiac/Vascular Nurse Exam Secrets Test Prep Staff

Printed in the United States of America

This paper meets the requirements of ANSI/NISO Z39.48-1992 (Permanence of Paper).

Mometrix offers volume discount pricing to institutions. For more information or a price quote, please contact our sales department at [email protected] or 888-248-1219.

Mometrix Test Preparation is not affiliated with or endorsed by any official testing organization. All organizational and test names are trademarks of their respective owners.

ISBN 13: 978-1-60971-239-6

ISBN 10: 1-60971-239-0

Dear Future Exam Success Story:

Congratulations on your purchase of our study guide. Our goal in writing our study guide was to cover the content on the test, as well as provide insight into typical test taking mistakes and how to overcome them.

Standardized tests are a key component of being successful, which only increases the importance of doing well in the high-pressure high-stakes environment of test day. How well you do on this test will have a significant impact on your future, and we have the research and practical advice to help you execute on test day.

The product you’re reading now is designed to exploit weaknesses in the test itself, and help you avoid the most common errors test takers frequently make.

How to use this study guide

We don’t want to waste your time. Our study guide is fast-paced and fluff-free. We suggest going through it a number of times, as repetition is an important part of learning new information and concepts.

First, read through the study guide completely to get a feel for the content and organization. Read the general success strategies first, and then proceed to the content sections. Each tip has been carefully selected for its effectiveness.

Second, read through the study guide again, and take notes in the margins and highlight those sections where you may have a particular weakness.

Finally, bring the manual with you on test day and study it before the exam begins.

Your success is our success

We would be delighted to hear about your success. Send us an email and tell us your story. Thanks for your business and we wish you continued success.

Sincerely,

Mometrix Test Preparation Team

Need more help? Check out our flashcards at: http://MometrixFlashcards.com/CardiacVascular

TABLE OF CONTENTS

Top 20 Test Taking Tips

Assessment and Diagnosis

Planning and Implementation

Evaluation

Cardiac/Vascular Education for Patients, Families, or Groups

Professional Role Performance

Practice Test

Answer Key

Secret Key #1 - Time is Your Greatest Enemy

Secret Key #2 - Guessing is not Guesswork

Secret Key #3 - Practice Smarter, Not Harder

Secret Key #4 - Prepare, Don’t Procrastinate

Secret Key #5 - Test Yourself

General Strategies

Special Report: How to Overcome Test Anxiety

Additional Bonus Material

Top 20 Test Taking Tips

1. Carefully follow all the test registration procedures
   
2. Know the test directions, duration, topics, question types, how many questions
   
3. Setup a flexible study schedule at least 3-4 weeks before test day
   
4. Study during the time of day you are most alert, relaxed, and stress free
   
5. Maximize your learning style; visual learner use visual study aids, auditory learner use auditory study aids
   
6. Focus on your weakest knowledge base
   
7. Find a study partner to review with and help clarify questions
   
8. Practice, practice, practice
   
9. Get a good night’s sleep; don’t try to cram the night before the test
   
10. Eat a well balanced meal
    
11. Know the exact physical location of the testing site; drive the route to the site prior to test day
    
12. Bring a set of ear plugs; the testing center could be noisy
    
13. Wear comfortable, loose fitting, layered clothing to the testing center; prepare for it to be either cold or hot during the test
    
14. Bring at least 2 current forms of ID to the testing center
    
15. Arrive to the test early; be prepared to wait and be patient
    
16. Eliminate the obviously wrong answer choices, then guess the first remaining choice
    
17. Pace yourself; don’t rush, but keep working and move on if you get stuck
    
18. Maintain a positive attitude even if the test is going poorly
    
19. Keep your first answer unless you are positive it is wrong
    
20. Check your work, don’t make a careless mistake
    

Assessment and Diagnosis

Methods of questioning that encourage the patient to give an accurate, in-depth personal history

Open discussion: Promotes patient comfort by encouraging questions and feedback during the interview.

Ask leading questions: Ask questions that require more than a “yes” or “no” answer and give clear permission for the patient to speak freely about his/her health.

Restate and summarize provided information in another way: Allows you to verify that your understanding of given information is correct.

Focus: Assist the patient to concentrate on identifying his/her highest healthcare needs or make connections between healthcare behavior and larger priorities.

Order and sequence: Verify cause and effect and timing of the events given in a patient history.

Encourage self-evaluation: Allow the patient to draw his/her own conclusions regarding information. Do not judge or try to educate at this point.

Make observations: Provide commentary on the patient’s physical, mental and emotional demeanor to help him/her focus and give permission to discuss further aspects of his/her health or immediate needs.

Comprehensive cardiovascular patient assessment

1. Patient history: The best source of information about the history of his/her condition is the patient. Other resources might include past medical records and involved family members.
   
2. Physical exam: Execute a full, head-to-toe symmetrical exam including inspection, palpation, percussion and auscultation methods as appropriate.
   
3. Laboratory results: Typical laboratory tests include cardiac enzymes, clotting function, cholesterol levels and therapeutic medication levels.
   
4. Diagnostic tests: Diagnostic tests can include X-ray, computed tomography (CT) scan, magnetic resonance imaging (MRI), electrocardiogram (ECG), echocardiography (ECHO), myocardial perfusion imaging and cardiac catheterization.
   

General order of procedure for a physical examination

• Inspection: visual inspection with the naked eye and specialized equipment such as an ophthalmoscope to view physical features such as height, body mass, skin condition and color, breath frequency and quality, hair distribution, balance, gait and presence of tremors or physical injuries.
  
• Palpation: examination by touch for pulses, organ size and location, pain response, temperature, distinguishable masses.
  
• Percussion: further touch intervention utilizing the fingers to create sound.
  
• Auscultation: auditory assessment with and without the assistance of a stethoscope generally focusing on the cardiac, respiratory and digestive systems. Other useful tools might include the use of Doppler to locate pulses that were difficult to palpate.
  

This general procedure varies slightly during assessment of the abdomen, placing auscultation before palpation and percussion. Other systems may not require the use of all four examination elements.

Physical examination in patients with known or suspected peripheral artery disease (PAD)

• Blood pressure results taken from both arms as well as notations regarding hypertension and medications used to treat it.
  
• Carotid, femoral and extremity pulses assessed for presence, intensity and bruit.
  
• Abdominal auscultation and palpation for bruits or pulsation.
  
• Thorough skin examination, including bare feet, assessing color, temperature, perfusion, integrity, nail changes, hair distribution.
  
• Subjective history should include smoking, diabetes, extremity pain, numbness, exertion fatigue, reports of past slow-healing wounds, abdominal pain after eating, and family history of PAD or abdominal aortic aneurysm.
  
• Gather laboratory values for cholesterol levels and clotting times. Anticipate ultrasound evaluation of any abnormalities.
  

Risk factors associated with cardiovascular disease

Risk factors that the patient and his/her healthcare provider can exercise some control over are identified as modifiable. These can include smoking, excess weight, alcohol use, cholesterol levels, blood pressure, active management of diabetes, stress and the amount of exercise the patient engages in.

Risk factors beyond the patient’s control include: age, male gender and genetic tendencies including race (Caucasian, black or Native American) and family history.

The greatest risk is to those who have already experienced a cardiovascular event or have been previously diagnosed with a cardiovascular disease such as peripheral vascular disease, aortic aneurysm or carotid artery disease. Others with high risk include those who have at least two of the modifiable or non-modifiable risk factors or type II diabetes.

Chronic obstructive pulmonary disease (COPD)

COPD and chronic heart disease (CHD) share a common causative factor: smoking. Priority preventive care and education would focus on smoking cessation for the patient presenting with COPD; this will in turn lower his/her risk of CHD.

The patient presenting with COPD is at a greater risk for cardiac and vascular problems such as pulmonary hypertension and right ventricular heart failure (cor pulmonale). Likewise, the patient with both cardiovascular problems and COPD is faced with a higher mortality rate than the patient with only one condition. COPD also complicates and slows recovery from chronic heart disease and surgical procedures that might be used in the treatment of CHD.

Diabetes

Diabetes mellitus is a significant risk factor for cardiovascular disease. The patient with diabetes should be treated as if he or she already has cardiovascular disease when addressing treatment and risk factor reduction. Approximately ⅔ of all individuals diagnosed with diabetes will die as a result of cardiovascular disease. This is particularly alarming when considering the rapid growth trends for newly diagnosed diabetics. Highest priority is given to maintaining an HbA1c level at or below 7. Complications such as retinopathy, microalbuminuria, neuropathy and elevated cholesterol levels can be reduced with tight blood sugar control. Careful blood sugar maintenance is also required after surgical procedures to reduce the risks of infection and delayed healing.

Cerebrovascular disease

Cardiovascular disease and cerebrovascular disease, most commonly chronic heart disease and carotid artery occlusive disease, are often coexisting because of their overlapping risk factors. Cardiovascular accident (CVA) is the third leading cause of death in the United States and can be directly linked to atherosclerosis. The patient experiencing dysrhythmia, MI or cardiopulmonary arrest is at increased risk for subsequent acute cerebrovascular injury. Cardiac and vascular surgeries can also result in CVAs. On the other end of the spectrum, the patient experiencing a CVA is less likely to survive if he/she also has chronic heart disease.

Pain that should be assessed in a thorough patient history

• Quality: Have the patient describe the quality of the pain using words such as dull, stabbing, sharp, aching, throbbing and burning.
  
• Severity: Pain can be rated on a scale of 1–10 or other assessment tool.
  
• Location: Where on the body is the pain located? Does it radiate or shift?
  
• Timing: When did the pain begin? Is it constant or does it come and go with a predictable or random frequency?
  
• Causative factors: Ask whether or not the patient is able to pinpoint a precipitating event prior to the onset of pain.
  
• Aggravating factors: Does the quality or severity of pain change with activity, position, stress level or other varying conditions?
  
• Alleviating factors: What effect do medication, position or other noninvasive treatment interventions have on the amount of pain?
  
• Related symptoms: Is the pain accompanied by nausea, dizziness, shortness of breath or other closely related symptoms?