Cardiac Cath Lab RN A – New 2026 Relias Release
Comprehensive Practice Exam with -Correct Answer-s
and Rationales
Section 1: Pre-Procedure Assessment and Patient Preparation (Questions 1-20)
1. A patient is scheduled for a left heart catheterization. Which of the following
lab values is MOST critical to review prior to the procedure to prevent a
common complication?
A. White Blood Cell count
B. Hemoglobin A1c
C. Blood Urea Nitrogen (BUN) and Creatinine
D. Liver function tests (ALT, AST)
-Correct Answer-: C. Blood Urea Nitrogen (BUN) and Creatinine.
Rationale: Contrast-induced nephropathy (CIN) is a significant risk. Reviewing
BUN and creatinine to assess baseline renal function is critical for determining
contrast limits and implementing preventive hydration protocols.
2. During the pre-procedural time-out, which of the following elements must be
verified by the entire team?
A. The patient's insurance authorization
B. The correct patient, procedure, and site
,C. The patient's preferred language
D. The patient's discharge plan
-Correct Answer-: B. The correct patient, procedure, and site.
Rationale: The universal protocol requires verification of the correct patient,
correct procedure, and correct site/side to prevent wrong-site surgery. This is a
mandatory safety goal.
3. A patient with a history of shellfish allergy is scheduled for a cardiac
catheterization. What is the MOST appropriate nursing action?
A. Cancel the procedure immediately
B. Notify the physician to order prophylactic steroids and antihistamines
C. Assure the patient that modern contrast media does not contain shellfish
D. Prepare to administer epinephrine during the procedure
-Correct Answer-: B. Notify the physician to order prophylactic steroids and
antihistamines.
Rationale: While modern contrast is non-ionic, a history of shellfish or iodine
allergy necessitates premedication (e.g., diphenhydramine and corticosteroids) to
prevent a reaction. The procedure is not automatically cancelled.
4. What is the primary purpose of assessing distal pulses (DP/PT) before a
femoral cardiac catheterization?
A. To diagnose peripheral artery disease
B. To establish a baseline for post-procedure comparison
,C. To determine the patient's cardiac output
D. To fulfill a hospital admission requirement
-Correct Answer-: B. To establish a baseline for post-procedure comparison.
Rationale: Marking and assessing distal pulses (DP/PT) prior to the procedure
provides a baseline to compare against after the procedure. A decrease in pulse
quality could indicate a thrombotic complication or hematoma.
5. Which finding from the patient's history is an absolute contraindication for
femoral artery access?
A. Previous cardiac catheterization
B. Peripheral arterial disease
C. Active groin infection
D. Hypertension
-Correct Answer-: C. Active groin infection.
Rationale: Active infection at the puncture site is an absolute contraindication for
femoral access due to the risk of introducing bacteria into the bloodstream, which
could lead to sepsis or an infected pseudoaneurysm.
6. A patient's pre-procedure activated clotting time (ACT) is 90 seconds. For a
diagnostic catheterization, this result is:
A. Elevated; the patient is at risk for bleeding
B. Low; the patient is at risk for a thrombotic event
, C. Normal; no immediate action is needed
D. Critical; the procedure must be cancelled
-Correct Answer-: C. Normal; no immediate action is needed.
Rationale: A normal ACT range is typically 70-120 seconds. An ACT of 90 seconds
is within this normal range. Heparin is often given during the procedure to raise
the ACT to therapeutic levels (250-350 sec) for interventions.
7. What is the most important patient education point regarding lying flat after
a femoral artery catheterization?
A. "You can bend your knee if you have a pillow under it."
B. "You must keep your affected leg straight to prevent bleeding."
C. "You may sit up at a 45-degree angle after 2 hours."
D. "You can log roll onto your side as long as your leg is straight."
-Correct Answer-: B. "You must keep your affected leg straight to prevent
bleeding."
Rationale: Keeping the leg straight prevents flexion of the femoral artery, which
can dislodge the clot and cause bleeding or hematoma formation at the puncture
site.
8. The "ALARA" principle in the cardiac cath lab refers to:
A. Always Lower Activated Clotting Time
B. A specific type of contrast media
Comprehensive Practice Exam with -Correct Answer-s
and Rationales
Section 1: Pre-Procedure Assessment and Patient Preparation (Questions 1-20)
1. A patient is scheduled for a left heart catheterization. Which of the following
lab values is MOST critical to review prior to the procedure to prevent a
common complication?
A. White Blood Cell count
B. Hemoglobin A1c
C. Blood Urea Nitrogen (BUN) and Creatinine
D. Liver function tests (ALT, AST)
-Correct Answer-: C. Blood Urea Nitrogen (BUN) and Creatinine.
Rationale: Contrast-induced nephropathy (CIN) is a significant risk. Reviewing
BUN and creatinine to assess baseline renal function is critical for determining
contrast limits and implementing preventive hydration protocols.
2. During the pre-procedural time-out, which of the following elements must be
verified by the entire team?
A. The patient's insurance authorization
B. The correct patient, procedure, and site
,C. The patient's preferred language
D. The patient's discharge plan
-Correct Answer-: B. The correct patient, procedure, and site.
Rationale: The universal protocol requires verification of the correct patient,
correct procedure, and correct site/side to prevent wrong-site surgery. This is a
mandatory safety goal.
3. A patient with a history of shellfish allergy is scheduled for a cardiac
catheterization. What is the MOST appropriate nursing action?
A. Cancel the procedure immediately
B. Notify the physician to order prophylactic steroids and antihistamines
C. Assure the patient that modern contrast media does not contain shellfish
D. Prepare to administer epinephrine during the procedure
-Correct Answer-: B. Notify the physician to order prophylactic steroids and
antihistamines.
Rationale: While modern contrast is non-ionic, a history of shellfish or iodine
allergy necessitates premedication (e.g., diphenhydramine and corticosteroids) to
prevent a reaction. The procedure is not automatically cancelled.
4. What is the primary purpose of assessing distal pulses (DP/PT) before a
femoral cardiac catheterization?
A. To diagnose peripheral artery disease
B. To establish a baseline for post-procedure comparison
,C. To determine the patient's cardiac output
D. To fulfill a hospital admission requirement
-Correct Answer-: B. To establish a baseline for post-procedure comparison.
Rationale: Marking and assessing distal pulses (DP/PT) prior to the procedure
provides a baseline to compare against after the procedure. A decrease in pulse
quality could indicate a thrombotic complication or hematoma.
5. Which finding from the patient's history is an absolute contraindication for
femoral artery access?
A. Previous cardiac catheterization
B. Peripheral arterial disease
C. Active groin infection
D. Hypertension
-Correct Answer-: C. Active groin infection.
Rationale: Active infection at the puncture site is an absolute contraindication for
femoral access due to the risk of introducing bacteria into the bloodstream, which
could lead to sepsis or an infected pseudoaneurysm.
6. A patient's pre-procedure activated clotting time (ACT) is 90 seconds. For a
diagnostic catheterization, this result is:
A. Elevated; the patient is at risk for bleeding
B. Low; the patient is at risk for a thrombotic event
, C. Normal; no immediate action is needed
D. Critical; the procedure must be cancelled
-Correct Answer-: C. Normal; no immediate action is needed.
Rationale: A normal ACT range is typically 70-120 seconds. An ACT of 90 seconds
is within this normal range. Heparin is often given during the procedure to raise
the ACT to therapeutic levels (250-350 sec) for interventions.
7. What is the most important patient education point regarding lying flat after
a femoral artery catheterization?
A. "You can bend your knee if you have a pillow under it."
B. "You must keep your affected leg straight to prevent bleeding."
C. "You may sit up at a 45-degree angle after 2 hours."
D. "You can log roll onto your side as long as your leg is straight."
-Correct Answer-: B. "You must keep your affected leg straight to prevent
bleeding."
Rationale: Keeping the leg straight prevents flexion of the femoral artery, which
can dislodge the clot and cause bleeding or hematoma formation at the puncture
site.
8. The "ALARA" principle in the cardiac cath lab refers to:
A. Always Lower Activated Clotting Time
B. A specific type of contrast media
