CARDIAC COMPLEX CARE EXAM SCRIPT
2026 QUESTIONS WITH COMPLETE
SOLUTIONS GRADED A+
◉ A client is at risk for pulmonary embolism and is on anticoagulant
therapy with warfarin (Coumadin). The client's prothrombin time is
20 seconds, with a control of 11 seconds. The nurse assesses that
this result is:
a. The same as the client's own baseline level
b. Lower than the needed therapeutic level
c. Within the therapeutic range
d. Higher than the therapeutic range. Answer: c. The therapeutic
range for prothrombin time is 1.5 to 2 times the control for clients at
risk for thrombus. Based on the client's control value, the
therapeutic range for this individual would be 16.5 to 22 seconds.
Therefore the result is within therapeutic range.
◉ A client who has been receiving heparin therapy also is started on
warfarin. The client asks a nurse why both medications are being
administered. In formulating a response, the nurse incorporates the
understanding that warfarin:
,a. Stimulates the breakdown of specific clotting factors by the liver,
and it takes 2-3 days for this to exert an anticoagulant effect.
b. Inhibits synthesis of specific clotting factors in the liver, and it
takes 3-4 days for this medication to exert an anticoagulant effect.
c. Stimulates production of the body's own thrombolytic substances,
but it takes 2-4 days for this to begin.
d. Has the same mechanism of action as Heparin, and the crossover
time is needed for the serum level of warfarin to be therapeutic..
Answer: b. Warfarin works in the liver and inhibits synthesis of four
vitamin K-dependent clotting factors (X, IX, VII, and II), but it takes 3
to 4 days before the therapeutic effect of warfarin is exhibited.
◉ A 60-year-old male client comes into the emergency department
with complaints of crushing chest pain that radiates to his shoulder
and left arm. The admitting diagnosis is acute myocardial infarction.
Immediate admission orders include oxygen by NC at 4L/minute,
blood work, chest x-ray, an ECG, and 2mg of morphine given
intravenously. The nurse should first:
a. Administer the morphine.
b. Obtain a 12-lead ECG.
c. Obtain the lab work.
d. Order the chest x-ray.. Answer: a. Although obtaining the ECG,
chest x-ray, and blood work are all important, the nurse's priority
action would be to relieve the crushing chest pain.
,◉ When administered a thrombolytic drug to the client experiencing
an MI, the nurse explains to him that the purpose of this drug is to:
a. Help keep him well hydrated.
b. Dissolve clots he may have.
c. Prevent kidney failure.
d. Treat potential cardiac arrhythmias.. Answer: b. Thrombolytic
drugs are administered within the first 6 hours after onset of a MI to
lyse clots and reduce the extent of myocardial damage.
◉ When interpreting an ECG, the nurse would keep in mind which of
the following about the P wave? Select all that apply.
a. Reflects electrical impulse beginning at the SA node.
b. Indicated electrical impulse beginning at the AV node.
c. Reflects atrial muscle depolarization.
d. Identifies ventricular muscle depolarization.
e. Has duration of normally 0.11 seconds or less.. Answer: a, c, e. In a
client who has had an ECG, the P wave represents the activation of
the electrical impulse in the SA node, which is then transmitted to
the AV node. In addition, the P wave represents atrial muscle
depolarization, not ventricular depolarization. The normal duration
, of the P wave is 0.11 seconds or less in duration and 2.5 mm or more
in height.
◉ A client has driven himself to the ER. He is 50 years old, has a
history of hypertension, and informs the nurse that his father died of
a heart attack at 60 years of age. The client is presently complaining
of indigestion. The nurse connects him to an ECG monitor and
begins administering oxygen at 2 L/minute per NC. The nurse's next
action would be to:
a. Call for the doctor.
b. Start an intravenous line.
c. Obtain a portable chest radiograph.
d. Draw blood for laboratory studies.. Answer: b. Advanced cardiac
life support recommends that at least one or two intravenous lines
be inserted in one or both of the antecubital spaces. Calling the
physician, obtaining a portable chest radiograph, and drawing blood
are important but secondary to starting the intravenous line.
◉ The nurse receives emergency laboratory results for a client with
chest pain and immediately informs the physician. An increased
myoglobin level suggests which of the following?
a. Cancer
b. Hypertension
2026 QUESTIONS WITH COMPLETE
SOLUTIONS GRADED A+
◉ A client is at risk for pulmonary embolism and is on anticoagulant
therapy with warfarin (Coumadin). The client's prothrombin time is
20 seconds, with a control of 11 seconds. The nurse assesses that
this result is:
a. The same as the client's own baseline level
b. Lower than the needed therapeutic level
c. Within the therapeutic range
d. Higher than the therapeutic range. Answer: c. The therapeutic
range for prothrombin time is 1.5 to 2 times the control for clients at
risk for thrombus. Based on the client's control value, the
therapeutic range for this individual would be 16.5 to 22 seconds.
Therefore the result is within therapeutic range.
◉ A client who has been receiving heparin therapy also is started on
warfarin. The client asks a nurse why both medications are being
administered. In formulating a response, the nurse incorporates the
understanding that warfarin:
,a. Stimulates the breakdown of specific clotting factors by the liver,
and it takes 2-3 days for this to exert an anticoagulant effect.
b. Inhibits synthesis of specific clotting factors in the liver, and it
takes 3-4 days for this medication to exert an anticoagulant effect.
c. Stimulates production of the body's own thrombolytic substances,
but it takes 2-4 days for this to begin.
d. Has the same mechanism of action as Heparin, and the crossover
time is needed for the serum level of warfarin to be therapeutic..
Answer: b. Warfarin works in the liver and inhibits synthesis of four
vitamin K-dependent clotting factors (X, IX, VII, and II), but it takes 3
to 4 days before the therapeutic effect of warfarin is exhibited.
◉ A 60-year-old male client comes into the emergency department
with complaints of crushing chest pain that radiates to his shoulder
and left arm. The admitting diagnosis is acute myocardial infarction.
Immediate admission orders include oxygen by NC at 4L/minute,
blood work, chest x-ray, an ECG, and 2mg of morphine given
intravenously. The nurse should first:
a. Administer the morphine.
b. Obtain a 12-lead ECG.
c. Obtain the lab work.
d. Order the chest x-ray.. Answer: a. Although obtaining the ECG,
chest x-ray, and blood work are all important, the nurse's priority
action would be to relieve the crushing chest pain.
,◉ When administered a thrombolytic drug to the client experiencing
an MI, the nurse explains to him that the purpose of this drug is to:
a. Help keep him well hydrated.
b. Dissolve clots he may have.
c. Prevent kidney failure.
d. Treat potential cardiac arrhythmias.. Answer: b. Thrombolytic
drugs are administered within the first 6 hours after onset of a MI to
lyse clots and reduce the extent of myocardial damage.
◉ When interpreting an ECG, the nurse would keep in mind which of
the following about the P wave? Select all that apply.
a. Reflects electrical impulse beginning at the SA node.
b. Indicated electrical impulse beginning at the AV node.
c. Reflects atrial muscle depolarization.
d. Identifies ventricular muscle depolarization.
e. Has duration of normally 0.11 seconds or less.. Answer: a, c, e. In a
client who has had an ECG, the P wave represents the activation of
the electrical impulse in the SA node, which is then transmitted to
the AV node. In addition, the P wave represents atrial muscle
depolarization, not ventricular depolarization. The normal duration
, of the P wave is 0.11 seconds or less in duration and 2.5 mm or more
in height.
◉ A client has driven himself to the ER. He is 50 years old, has a
history of hypertension, and informs the nurse that his father died of
a heart attack at 60 years of age. The client is presently complaining
of indigestion. The nurse connects him to an ECG monitor and
begins administering oxygen at 2 L/minute per NC. The nurse's next
action would be to:
a. Call for the doctor.
b. Start an intravenous line.
c. Obtain a portable chest radiograph.
d. Draw blood for laboratory studies.. Answer: b. Advanced cardiac
life support recommends that at least one or two intravenous lines
be inserted in one or both of the antecubital spaces. Calling the
physician, obtaining a portable chest radiograph, and drawing blood
are important but secondary to starting the intravenous line.
◉ The nurse receives emergency laboratory results for a client with
chest pain and immediately informs the physician. An increased
myoglobin level suggests which of the following?
a. Cancer
b. Hypertension
