Med-Surg Cardiovascular Review
Questions Updated Questions And
Answers With 100% Correct Answers
and Rationales
Graded A+
QUESTIONS AND ANSWERS
1. A client complains of crushing chest pain that radiates to his left arm. He should be
presented with the following treatment:
1. Aspirin, oxygen, nitroglycerin, and morphine
2. Aspirin, oxygen, nitroglycerin, and codeine
3. Oxygen, nitroglycerin, meperidine, and thrombolytics
4. Aspirin, oxygen, nitroprusside, and morphine. ANSWER - Answer: 1. Aspirin, oxygen,
nitroglycerin, and morphine
2. Which lifestyle changes should a client diagnosed with coronary artery disease consider?
1. Smoking cessation
2. Establishing a regular exercise routine
3. Weight reduction
4. All of the Above. ANSWER - Answer: 4. All of the Above
3. A client's cardiac monitor alarm sounds, indicating ventricular tachycardia. The nurse
should:
1. perform immediate defibrillation.
2. Assess the client.
3. Call the physician.
4. Administer a precordial thump.. ANSWER - Answer: 2. Assess the client.
4. A complication of peripheral vascular disease may be:
1. stasis ulcer.
2. Pressure ulcer.
,3. Gastric ulcer.
4. Duodenal ulcer.. ANSWER - Answer: 1. stasis ulcer.
5. A key diagnostic test for heart failure is:
1. serum potassium.
2. B-type natriuretic peptide.
3. Troponin I
4. cardiac enzymes.. ANSWER - Answer: 2. B-type natriuretic peptide.
6. While auscultating the heart sounds of a client with mitral insufficiency, the nurse hears
an extra heart sound immediately after the S2. The nurse should document this extra heart
sound as a:
1. S1.
2. S3.
3. S4.
4. mitral murmur.. ANSWER - Answer: 2. S3.
Rationale: An S3, is heard following an S2. This indicates that the client is experiencing
heart failure and results from increased filling pressures. An S1 is a normal heart sound
made by the closing of the mitral and tricuspid valves. An S4 is heard before S1 and is
caused by resistance to ventricular filling. A murmur of mitral insufficiency occurs during
systole and is heard when there's turbulent blood flow across the valve.
7. A nurse administers heparin to a client with deep vein thrombophlebitis. Which
laboratory value should the nurse monitor to determine the effectiveness of heparin?
1. PTT
2. HCT
3. CBC
4. PT. ANSWER - Answer: 1. PTT
Rationale: The therapeutic effectiveness of heparin is determined by monitoring the
patient's PTT, PT, HCT, and CBC don't monitor the therapeutic effectiveness of heparin.
Monitoring the PT determines warfarin's effectiveness.
8. A client has just returned from cardiac catheterization. Which nursing intervention
would be most appropriate?
1. Help the client ambulate to the bathroom.
2. Restrict fluids.
,3. Monitor peripheral pulses.
4. Insert an indwelling urinary catheter.. ANSWER - Answer. 3. Monitor peripheral
pulses.
Rationale: After cardiac catheterization, monitor peripheral pulses to assess peripheral
perfusion. Helping the client ambulate to the bathroom is incorrect because the client
should be on bed rest for 4 to 8 hours after the procedure to reduce the risk of bleeding at
the insertion site. Restricting fluids is incorrect because the client should be encouraged to
drink fluids after the procedure, unless contraindicated. Adequate hydration reduces the
risk of nephrotoxicity that can occur with the use of contrast dye. Although urine output is
monitored following cardiac catheterization, the insertion of a urinary catherter isn't
necessary.
9. A client is in the first postoperative day after left femoropopliteal revascularization.
Which position would be most appropriate for this client?
1. On his left-sided
2. In high Fowler's position
3. On his right side
4. In a left lateral decubitus position. ANSWER - Answer: 3. On his right side
Rationale: Following revascularization, avoid positioning the client on the surgical side.
Because this client had left femoropoliteal revascularization, he may be positioned on the
right side. Placing the client on the left side is incorrect because this would position the
client on the operative side. Positioning the client in high Fowler's position is incorrect
because the client should avoid flexion at the surgical site. Placing the client in a left lateral
decubitus position is incorrect because this would place the client on the surgical side and
cause flexion at the site.
10. A nurse is evaluating a client with left-sided heart failure. Which finding should the
nurse expect to assess?
1. Ascites
2. Dyspnea
3. Hepatomegaly
4. Jugular vein distention. ANSWER - Answer: 2. Dyspnea
Rationale: Dyspnea may occur in a client with left-sided heart failure. Ascites,
hepatomegaly, and jugular vein distention are assessment findings in right-sided heart
failure.
11. A client has developed acute pulmonary edema. Which test result should the nurse
expect?
1. Interstitial edema by chest X-ray
, 2. Metabolic alkalosis by ABG analysis
3. Bradycardia by ECG
4. Decreased PAWP by hemodynamic monitoring. ANSWER - Answer: 1. Interstitial
edema by chest X-ray
Rationale: The chest X-ray of a client with acute pulmonary edema shows interstitial edema
as a result of the heart's failure to pump adequately. Metabolic alkalosis is incorrect because
the ABG analysis of a client in acute pulmonary edema shows respiratory alkalosis or
acidosis. Bradycardia is incorrect because the ECG would most likely indicate tachycardia.
Decreased PAWP is incorrect because PAWP rises in the client with acute pulmonary
edema.
12. A nurse is performing discharge teaching for a client with PVD. The nurse should teach
the client to:
1. inspect his feet weekly
2. begin a daily walking program
3. wear constrictive clothing
4. stand rather than sit when possible. ANSWER - Answer: 2. begin a daily walking
program
Rationale: The nurse should encourage the client with PVD to follow a program of walking
and other leg exercises. Inspecting the feet weekly is incorrect because the nurse should
teach the client to inspect his feet daily. Wearing constrictive clothing is incorrect because
the client should wear loose clothing that doesn't restrict circulation. Standing when
possible—rather than sitting—is incorrect because the client should avoid standing for
long periods.
13. If a nurse knows a client's heart rate, what other value and formula does she need to
know to calculate CO?. ANSWER - Answer: Stroke Volume
Rationale: Cardiac output equals stroke volume (the amount of blood ejected with each
beat) times heart rate. [CO = SV X HR]
14. A client comes to the clinic and states he has a history of hypertension. Which type of
medication might the nurse expect the client to be taking to control his blood pressure?
1. Antilipemics
2. Antibiotics
3. ACE inhibitors
4. Antidiabetics. ANSWER - Answer: 3. ACE inhibitors
Rationale: ACE inhibitors may be prescribed to help control high blood pressure. Other
types of medications that may be prescribed include diuretics, calcium channel blockers,
Questions Updated Questions And
Answers With 100% Correct Answers
and Rationales
Graded A+
QUESTIONS AND ANSWERS
1. A client complains of crushing chest pain that radiates to his left arm. He should be
presented with the following treatment:
1. Aspirin, oxygen, nitroglycerin, and morphine
2. Aspirin, oxygen, nitroglycerin, and codeine
3. Oxygen, nitroglycerin, meperidine, and thrombolytics
4. Aspirin, oxygen, nitroprusside, and morphine. ANSWER - Answer: 1. Aspirin, oxygen,
nitroglycerin, and morphine
2. Which lifestyle changes should a client diagnosed with coronary artery disease consider?
1. Smoking cessation
2. Establishing a regular exercise routine
3. Weight reduction
4. All of the Above. ANSWER - Answer: 4. All of the Above
3. A client's cardiac monitor alarm sounds, indicating ventricular tachycardia. The nurse
should:
1. perform immediate defibrillation.
2. Assess the client.
3. Call the physician.
4. Administer a precordial thump.. ANSWER - Answer: 2. Assess the client.
4. A complication of peripheral vascular disease may be:
1. stasis ulcer.
2. Pressure ulcer.
,3. Gastric ulcer.
4. Duodenal ulcer.. ANSWER - Answer: 1. stasis ulcer.
5. A key diagnostic test for heart failure is:
1. serum potassium.
2. B-type natriuretic peptide.
3. Troponin I
4. cardiac enzymes.. ANSWER - Answer: 2. B-type natriuretic peptide.
6. While auscultating the heart sounds of a client with mitral insufficiency, the nurse hears
an extra heart sound immediately after the S2. The nurse should document this extra heart
sound as a:
1. S1.
2. S3.
3. S4.
4. mitral murmur.. ANSWER - Answer: 2. S3.
Rationale: An S3, is heard following an S2. This indicates that the client is experiencing
heart failure and results from increased filling pressures. An S1 is a normal heart sound
made by the closing of the mitral and tricuspid valves. An S4 is heard before S1 and is
caused by resistance to ventricular filling. A murmur of mitral insufficiency occurs during
systole and is heard when there's turbulent blood flow across the valve.
7. A nurse administers heparin to a client with deep vein thrombophlebitis. Which
laboratory value should the nurse monitor to determine the effectiveness of heparin?
1. PTT
2. HCT
3. CBC
4. PT. ANSWER - Answer: 1. PTT
Rationale: The therapeutic effectiveness of heparin is determined by monitoring the
patient's PTT, PT, HCT, and CBC don't monitor the therapeutic effectiveness of heparin.
Monitoring the PT determines warfarin's effectiveness.
8. A client has just returned from cardiac catheterization. Which nursing intervention
would be most appropriate?
1. Help the client ambulate to the bathroom.
2. Restrict fluids.
,3. Monitor peripheral pulses.
4. Insert an indwelling urinary catheter.. ANSWER - Answer. 3. Monitor peripheral
pulses.
Rationale: After cardiac catheterization, monitor peripheral pulses to assess peripheral
perfusion. Helping the client ambulate to the bathroom is incorrect because the client
should be on bed rest for 4 to 8 hours after the procedure to reduce the risk of bleeding at
the insertion site. Restricting fluids is incorrect because the client should be encouraged to
drink fluids after the procedure, unless contraindicated. Adequate hydration reduces the
risk of nephrotoxicity that can occur with the use of contrast dye. Although urine output is
monitored following cardiac catheterization, the insertion of a urinary catherter isn't
necessary.
9. A client is in the first postoperative day after left femoropopliteal revascularization.
Which position would be most appropriate for this client?
1. On his left-sided
2. In high Fowler's position
3. On his right side
4. In a left lateral decubitus position. ANSWER - Answer: 3. On his right side
Rationale: Following revascularization, avoid positioning the client on the surgical side.
Because this client had left femoropoliteal revascularization, he may be positioned on the
right side. Placing the client on the left side is incorrect because this would position the
client on the operative side. Positioning the client in high Fowler's position is incorrect
because the client should avoid flexion at the surgical site. Placing the client in a left lateral
decubitus position is incorrect because this would place the client on the surgical side and
cause flexion at the site.
10. A nurse is evaluating a client with left-sided heart failure. Which finding should the
nurse expect to assess?
1. Ascites
2. Dyspnea
3. Hepatomegaly
4. Jugular vein distention. ANSWER - Answer: 2. Dyspnea
Rationale: Dyspnea may occur in a client with left-sided heart failure. Ascites,
hepatomegaly, and jugular vein distention are assessment findings in right-sided heart
failure.
11. A client has developed acute pulmonary edema. Which test result should the nurse
expect?
1. Interstitial edema by chest X-ray
, 2. Metabolic alkalosis by ABG analysis
3. Bradycardia by ECG
4. Decreased PAWP by hemodynamic monitoring. ANSWER - Answer: 1. Interstitial
edema by chest X-ray
Rationale: The chest X-ray of a client with acute pulmonary edema shows interstitial edema
as a result of the heart's failure to pump adequately. Metabolic alkalosis is incorrect because
the ABG analysis of a client in acute pulmonary edema shows respiratory alkalosis or
acidosis. Bradycardia is incorrect because the ECG would most likely indicate tachycardia.
Decreased PAWP is incorrect because PAWP rises in the client with acute pulmonary
edema.
12. A nurse is performing discharge teaching for a client with PVD. The nurse should teach
the client to:
1. inspect his feet weekly
2. begin a daily walking program
3. wear constrictive clothing
4. stand rather than sit when possible. ANSWER - Answer: 2. begin a daily walking
program
Rationale: The nurse should encourage the client with PVD to follow a program of walking
and other leg exercises. Inspecting the feet weekly is incorrect because the nurse should
teach the client to inspect his feet daily. Wearing constrictive clothing is incorrect because
the client should wear loose clothing that doesn't restrict circulation. Standing when
possible—rather than sitting—is incorrect because the client should avoid standing for
long periods.
13. If a nurse knows a client's heart rate, what other value and formula does she need to
know to calculate CO?. ANSWER - Answer: Stroke Volume
Rationale: Cardiac output equals stroke volume (the amount of blood ejected with each
beat) times heart rate. [CO = SV X HR]
14. A client comes to the clinic and states he has a history of hypertension. Which type of
medication might the nurse expect the client to be taking to control his blood pressure?
1. Antilipemics
2. Antibiotics
3. ACE inhibitors
4. Antidiabetics. ANSWER - Answer: 3. ACE inhibitors
Rationale: ACE inhibitors may be prescribed to help control high blood pressure. Other
types of medications that may be prescribed include diuretics, calcium channel blockers,
