1–10: Cardiovascular
1. A client with myocardial infarction reports chest
pain rated 8/10 despite nitroglycerin. Which action
is priority?
A. Increase IV morphine dose
B. Apply oxygen at 2 L/min via nasal cannula
C. Obtain a 12-lead ECG
D. Check vital signs
Answer: C
Rationale: A new or worsening MI requires immediate
ECG to assess for arrhythmias or extension of infarction
before other interventions.
2. Which lab value best indicates successful
thrombolytic therapy in MI?
A. CK-MB returning to normal
B. Troponin I decreasing to < 0.04 ng/mL
C. Myoglobin dropping below 90 ng/mL
D. LDH isoenzyme normalization
Answer: B
Rationale: Troponin I is the most specific and sensitive
marker for myocardial tissue injury.
3. The nurse monitors a client on heparin infusion.
Which lab result requires immediate action?
A. aPTT 60 sec (therapeutic 46–70)
B. Platelets 80,000/mm³
, C. Hematocrit 42%
D. PT 12 sec
Answer: B
Rationale: A drop in platelets to < 100,000 suggests
heparin-induced thrombocytopenia; infusion must stop.
4. Which symptom in left-sided heart failure is
earliest?
A. Dependent edema
B. Paroxysmal nocturnal dyspnea
C. Crackles at bases
D. Jugular venous distention
Answer: C
Rationale: Pulmonary congestion appears before
systemic signs like edema or JVD.
5. A client on digoxin has nausea, vomiting, and
blurred vision. The nurse’s priority?
A. Hold next dose and check digoxin level
B. Offer crackers and tea
C. Notify dietary for low-fat diet
D. Check apical pulse
Answer: A
Rationale: GI and visual disturbances suggest digoxin
toxicity; level must be checked and dose held.
6. Which teaching for a post-CABG client on
warfarin is most important?
A. Eat consistent amounts of leafy greens
, B. Use an electric razor only
C. Report any bruising or bleeding
D. Monitor INR weekly
Answer: C
Rationale: Early detection of bleeding is critical; all clients
should report bleeding signs.
7. Client with peripheral arterial disease complains
of foot pain at rest—what position helps?
A. Supine with legs elevated
B. Dangling over side of bed
C. Trendelenburg
D. Prone with pillow under abdomen
Answer: B
Rationale: Gravity-assisted perfusion reduces ischemic
pain.
8. Aortic stenosis murmur is best heard where?
A. Left sternal border, 5th ICS
B. Right second ICS, sternal border
C. Apex with bell
D. Left second ICS
Answer: B
Rationale: Systolic ejection murmur of aortic stenosis is
heard best at the right upper sternal border.
9. Which finding in cardiogenic shock is expected?
A. Warm, dry skin
B. High CVP
1. A client with myocardial infarction reports chest
pain rated 8/10 despite nitroglycerin. Which action
is priority?
A. Increase IV morphine dose
B. Apply oxygen at 2 L/min via nasal cannula
C. Obtain a 12-lead ECG
D. Check vital signs
Answer: C
Rationale: A new or worsening MI requires immediate
ECG to assess for arrhythmias or extension of infarction
before other interventions.
2. Which lab value best indicates successful
thrombolytic therapy in MI?
A. CK-MB returning to normal
B. Troponin I decreasing to < 0.04 ng/mL
C. Myoglobin dropping below 90 ng/mL
D. LDH isoenzyme normalization
Answer: B
Rationale: Troponin I is the most specific and sensitive
marker for myocardial tissue injury.
3. The nurse monitors a client on heparin infusion.
Which lab result requires immediate action?
A. aPTT 60 sec (therapeutic 46–70)
B. Platelets 80,000/mm³
, C. Hematocrit 42%
D. PT 12 sec
Answer: B
Rationale: A drop in platelets to < 100,000 suggests
heparin-induced thrombocytopenia; infusion must stop.
4. Which symptom in left-sided heart failure is
earliest?
A. Dependent edema
B. Paroxysmal nocturnal dyspnea
C. Crackles at bases
D. Jugular venous distention
Answer: C
Rationale: Pulmonary congestion appears before
systemic signs like edema or JVD.
5. A client on digoxin has nausea, vomiting, and
blurred vision. The nurse’s priority?
A. Hold next dose and check digoxin level
B. Offer crackers and tea
C. Notify dietary for low-fat diet
D. Check apical pulse
Answer: A
Rationale: GI and visual disturbances suggest digoxin
toxicity; level must be checked and dose held.
6. Which teaching for a post-CABG client on
warfarin is most important?
A. Eat consistent amounts of leafy greens
, B. Use an electric razor only
C. Report any bruising or bleeding
D. Monitor INR weekly
Answer: C
Rationale: Early detection of bleeding is critical; all clients
should report bleeding signs.
7. Client with peripheral arterial disease complains
of foot pain at rest—what position helps?
A. Supine with legs elevated
B. Dangling over side of bed
C. Trendelenburg
D. Prone with pillow under abdomen
Answer: B
Rationale: Gravity-assisted perfusion reduces ischemic
pain.
8. Aortic stenosis murmur is best heard where?
A. Left sternal border, 5th ICS
B. Right second ICS, sternal border
C. Apex with bell
D. Left second ICS
Answer: B
Rationale: Systolic ejection murmur of aortic stenosis is
heard best at the right upper sternal border.
9. Which finding in cardiogenic shock is expected?
A. Warm, dry skin
B. High CVP
