NRSG 3420 Exam 2 Cardiovascular PQ Part 1
Questions With Correct Answers
A nurse is assessing a patient post-cardiac catheterization via femoral artery.
Which finding requires immediate intervention?
A. Small ecchymosis at the site
B. Mild discomfort at the groin site
C. Bleeding at the insertion site
D. Pink, warm foot distal to site - ANSWER C. Active bleeding indicates potential
hemorrhage and requires immediate intervention to prevent hypovolemic shock.
A patient with pulmonary hypertension reports worsening dyspnea at rest. What
is the nurse's priority intervention?
A. Encourage rest periods
B. Elevate lower extremities
C. Apply oxygen as prescribed
D. Offer a low-sodium diet - ANSWER C. Hypoxia worsens pulmonary
hypertension. Oxygen therapy improves oxygenation and reduces cardiac
workload.
A patient presents with chest pain and ST elevations in two contiguous leads.
What is the priority nursing action?
A. Administer sublingual nitroglycerin
B. Notify provider and prepare for reperfusion therapy
C. Provide emotional support
D. Obtain a complete set of vital signs - ANSWER B. ST elevation suggests
STEMI. Priority is to initiate rapid reperfusion to prevent myocardial death.
A nurse is reviewing cardiac enzyme results for a patient with suspected MI.
Which finding is most indicative of an acute MI?
A. Elevated BNP
B. Decreased troponin
C. Elevated troponin
D. Normal CK-MB - ANSWER C. Troponin is the most sensitive and specific
marker for myocardial infarction.
A nurse notes peaked T waves on a cardiac monitor. Which electrolyte
imbalance is most likely responsible?
A. Hypokalemia
B. Hypernatremia
C. Hyperkalemia
D. Hypocalcemia - ANSWER C. Peaked T waves are a classic sign of
hyperkalemia, which affects cardiac conduction and can cause arrhythmias.
,A patient with atrial fibrillation is receiving warfarin. Which lab value indicates a
therapeutic effect?
A. aPTT of 45 seconds
B. INR of 2.5
C. PT of 8 seconds
D. INR of 1.1 - ANSWER B. An INR between 2-3 is therapeutic for atrial fibrillation
anticoagulation.
After a cardiac catheterization, a patient is found to have diminished pedal
pulses on the affected side. What is the nurse's priority?
A. Document findings
B. Reassess in 30 minutes
C. Notify the provider immediately
D. Apply a warm compress - ANSWER C. Diminished distal pulses suggest
compromised perfusion, possibly due to occlusion or hematoma formation.
A nurse caring for a patient in pulseless ventricular tachycardia prepares to
administer which first-line medication?
A. Epinephrine
B. Atropine
C. Amiodarone
D. Lidocaine - ANSWER A. Epinephrine is the first drug used in cardiac arrest to
increase perfusion and improve resuscitation outcomes.
A nurse is educating an older adult with HTN. What change in cardiac
physiology with aging should be considered?
A. Increased response to beta-adrenergic stimulation
B. Enhanced baroreceptor sensitivity
C. Decreased cardiac output and slower response to exercise
D. Thin, flexible vascular walls - ANSWER C. Older adults have diminished
cardiac output and decreased response to sympathetic stimulation, affecting
activity tolerance.
A patient is admitted with crackles, elevated JVD, and peripheral edema. What
is the most likely cause?
A. Dehydration
B. Right-sided heart failure
C. Pulmonary embolism
D. Myocardial ischemia - ANSWER B. These are classic signs of right-sided heart
failure due to fluid overload and venous congestion.
A patient with a STEMI is receiving sublingual nitroglycerin. Which assessment
indicates it is working?
A. Blood pressure increases
B. Pain score increases
, C. Chest pain resolves
D. Heart rate increases - ANSWER C. Nitroglycerin reduces myocardial oxygen
demand by vasodilation, relieving ischemic chest pain.
A nurse assesses a post-cardiac cath patient with back pain and a firm
abdomen. What should the nurse do first?
A. Administer prescribed analgesics
B. Notify the provider
C. Document findings
D. Encourage ambulation - ANSWER B. These signs suggest retroperitoneal
bleeding, a serious complication requiring immediate provider notification.
A nurse is caring for a patient with fluid volume overload. What is the most
important intervention?
A. Offer additional oral fluids
B. Monitor daily weight and lung sounds
C. Encourage high-sodium foods
D. Administer potassium supplements - ANSWER B. Monitoring for fluid status
and respiratory changes helps detect worsening overload and guide diuretic
use.
A nurse reviews labs for a heart failure patient. Which value indicates fluid
volume deficit?
A. Decreased hematocrit
B. Decreased BUN
C. Increased serum osmolality
D. Decreased urine specific gravity - ANSWER C. High serum osmolality
suggests concentrated blood due to volume depletion.
Which finding would be most concerning in a patient receiving a beta-blocker?
A. Heart rate of 58
B. Blood pressure of 110/70
C. Shortness of breath and crackles
D. Occasional fatigue - ANSWER C. SOB and crackles may indicate worsening
heart failure, a serious complication of beta-blockers in some patients.
A nurse finds a patient unresponsive with no pulse. What is the first priority
action?
A. Start chest compressions
B. Call for help
C. Check blood glucose
D. Administer atropine - ANSWER A. According to BLS, high-quality chest
compressions should be started immediately for pulseless patients.
A patient with heart failure reports weight gain of 3 pounds overnight and
dyspnea. What action should the nurse take?
Questions With Correct Answers
A nurse is assessing a patient post-cardiac catheterization via femoral artery.
Which finding requires immediate intervention?
A. Small ecchymosis at the site
B. Mild discomfort at the groin site
C. Bleeding at the insertion site
D. Pink, warm foot distal to site - ANSWER C. Active bleeding indicates potential
hemorrhage and requires immediate intervention to prevent hypovolemic shock.
A patient with pulmonary hypertension reports worsening dyspnea at rest. What
is the nurse's priority intervention?
A. Encourage rest periods
B. Elevate lower extremities
C. Apply oxygen as prescribed
D. Offer a low-sodium diet - ANSWER C. Hypoxia worsens pulmonary
hypertension. Oxygen therapy improves oxygenation and reduces cardiac
workload.
A patient presents with chest pain and ST elevations in two contiguous leads.
What is the priority nursing action?
A. Administer sublingual nitroglycerin
B. Notify provider and prepare for reperfusion therapy
C. Provide emotional support
D. Obtain a complete set of vital signs - ANSWER B. ST elevation suggests
STEMI. Priority is to initiate rapid reperfusion to prevent myocardial death.
A nurse is reviewing cardiac enzyme results for a patient with suspected MI.
Which finding is most indicative of an acute MI?
A. Elevated BNP
B. Decreased troponin
C. Elevated troponin
D. Normal CK-MB - ANSWER C. Troponin is the most sensitive and specific
marker for myocardial infarction.
A nurse notes peaked T waves on a cardiac monitor. Which electrolyte
imbalance is most likely responsible?
A. Hypokalemia
B. Hypernatremia
C. Hyperkalemia
D. Hypocalcemia - ANSWER C. Peaked T waves are a classic sign of
hyperkalemia, which affects cardiac conduction and can cause arrhythmias.
,A patient with atrial fibrillation is receiving warfarin. Which lab value indicates a
therapeutic effect?
A. aPTT of 45 seconds
B. INR of 2.5
C. PT of 8 seconds
D. INR of 1.1 - ANSWER B. An INR between 2-3 is therapeutic for atrial fibrillation
anticoagulation.
After a cardiac catheterization, a patient is found to have diminished pedal
pulses on the affected side. What is the nurse's priority?
A. Document findings
B. Reassess in 30 minutes
C. Notify the provider immediately
D. Apply a warm compress - ANSWER C. Diminished distal pulses suggest
compromised perfusion, possibly due to occlusion or hematoma formation.
A nurse caring for a patient in pulseless ventricular tachycardia prepares to
administer which first-line medication?
A. Epinephrine
B. Atropine
C. Amiodarone
D. Lidocaine - ANSWER A. Epinephrine is the first drug used in cardiac arrest to
increase perfusion and improve resuscitation outcomes.
A nurse is educating an older adult with HTN. What change in cardiac
physiology with aging should be considered?
A. Increased response to beta-adrenergic stimulation
B. Enhanced baroreceptor sensitivity
C. Decreased cardiac output and slower response to exercise
D. Thin, flexible vascular walls - ANSWER C. Older adults have diminished
cardiac output and decreased response to sympathetic stimulation, affecting
activity tolerance.
A patient is admitted with crackles, elevated JVD, and peripheral edema. What
is the most likely cause?
A. Dehydration
B. Right-sided heart failure
C. Pulmonary embolism
D. Myocardial ischemia - ANSWER B. These are classic signs of right-sided heart
failure due to fluid overload and venous congestion.
A patient with a STEMI is receiving sublingual nitroglycerin. Which assessment
indicates it is working?
A. Blood pressure increases
B. Pain score increases
, C. Chest pain resolves
D. Heart rate increases - ANSWER C. Nitroglycerin reduces myocardial oxygen
demand by vasodilation, relieving ischemic chest pain.
A nurse assesses a post-cardiac cath patient with back pain and a firm
abdomen. What should the nurse do first?
A. Administer prescribed analgesics
B. Notify the provider
C. Document findings
D. Encourage ambulation - ANSWER B. These signs suggest retroperitoneal
bleeding, a serious complication requiring immediate provider notification.
A nurse is caring for a patient with fluid volume overload. What is the most
important intervention?
A. Offer additional oral fluids
B. Monitor daily weight and lung sounds
C. Encourage high-sodium foods
D. Administer potassium supplements - ANSWER B. Monitoring for fluid status
and respiratory changes helps detect worsening overload and guide diuretic
use.
A nurse reviews labs for a heart failure patient. Which value indicates fluid
volume deficit?
A. Decreased hematocrit
B. Decreased BUN
C. Increased serum osmolality
D. Decreased urine specific gravity - ANSWER C. High serum osmolality
suggests concentrated blood due to volume depletion.
Which finding would be most concerning in a patient receiving a beta-blocker?
A. Heart rate of 58
B. Blood pressure of 110/70
C. Shortness of breath and crackles
D. Occasional fatigue - ANSWER C. SOB and crackles may indicate worsening
heart failure, a serious complication of beta-blockers in some patients.
A nurse finds a patient unresponsive with no pulse. What is the first priority
action?
A. Start chest compressions
B. Call for help
C. Check blood glucose
D. Administer atropine - ANSWER A. According to BLS, high-quality chest
compressions should be started immediately for pulseless patients.
A patient with heart failure reports weight gain of 3 pounds overnight and
dyspnea. What action should the nurse take?
