Practice 401 Exam 2- Test Bank-
Questions with Actual Detailed Answers
2026 Updated.
The nurse is caring for a client who has been diagnosed with an elevated cholesterol level. The
nurse is aware that plaque on the inner lumen of arteries is composed chiefly of what?
A. Lipids and fibrous tissue
B. White blood cells
C. Lipoproteins
D. High-density cholesterol - Answer A. Lipids and fibrous tissue
Rationale: As T-lymphocytes and monocytes infiltrate to ingest lipids on the arterial wall and
then die, a fibrous tissue develops. This causes plaques to form on the inner lumen of arterial
walls. These plaques do not consist of white cells, lipoproteins, or high-density cholesterol.
A client presents to the clinic reporting intermittent chest pain on exertion, which is eventually
attributed to angina. The nurse should inform the client that angina is most often attributable to
what cause?
A. Decreased cardiac output
B. Decreased cardiac contractility
C. Infarction of the myocardium
D. Coronary arteriosclerosis - Answer D. Coronary arteriosclerosis
Rationale: In most cases, angina pectoris is due to arteriosclerosis. The disease is not a result of
impaired cardiac output or contractility. Infarction may result from untreated angina, but it is
not a cause of the disease.
The nurse is caring for an adult client who had symptoms of unstable angina upon admission to
the hospital. What nursing diagnosis underlies the discomfort associated with angina?
A. Ineffective breathing pattern related to decreased cardiac output
B. Anxiety related to fear of death
C. Ineffective cardiopulmonary tissue perfusion related to coronary artery disease (CAD)
D. Impaired skin integrity related to CAD - Answer C. Ineffective cardiopulmonary tissue
perfusion related to coronary artery disease (CAD)
,Rationale: Ineffective cardiopulmonary tissue perfusion directly results in the symptoms of
discomfort associated with angina. Anxiety and ineffective breathing may result from angina
chest pain, but they are not the causes. Skin integrity is not impaired by the effects of angina.
The triage nurse in the ED assesses an adult client who presents with reports of midsternal
chest pain that has lasted for the last 5 hours. If the client's symptoms are due to an MI, what
will have happened to the myocardium?
A. It may have developed an increased area of infarction during the time without treatment.
B. It will probably not have more damage than if the client came in immediately.
C. It may be responsive to restoration of the area of dead cells with proper treatment.
D. It has been irreparably damaged, so immediate treatment is no longer necessary. - Answer
A. It may have developed an increased area of infarction during the time without treatment.
Rationale: When the client experiences lack of oxygen to myocardium cells during an MI, the
sooner treatment is initiated, the more likely the treatment will prevent or minimize myocardial
tissue necrosis. Delays in treatment equate with increased myocardial damage. Despite the
length of time the symptoms have been present, treatment needs to be initiated immediately to
minimize further damage. Dead cells cannot be restored by any means.
Family members bring a client to the ED with pale cool skin, sudden midsternal chest pain
unrelieved with rest, and a history of CAD. How should the nurse best interpret these initial
data?
A. The symptoms indicate angina and should be treated as such.
B. The symptoms indicate a pulmonary etiology rather than a cardiac etiology.
C. The symptoms indicate an acute coronary episode and should be treated as such.
D. Treatment should be determined pending the results of an exercise stress test. - Answer C.
The symptoms indicate an acute coronary episode and should be treated as such.
Rationale: Angina and MI have similar symptoms and are considered the same process but are
on different points along a continuum. That the client's symptoms are unrelieved by rest
suggests an acute coronary episode rather than angina. Pale, cool skin and sudden onset are
inconsistent with a pulmonary etiology. Treatment should be initiated immediately regardless of
diagnosis.
An OR nurse is preparing to assist with a coronary artery bypass graft (CABG). The OR nurse
knows that what vessel is most commonly used as source for a CABG?
,A. Brachial artery
B. Brachial vein
C. Femoral artery
D. Greater saphenous vein - Answer D. Greater saphenous vein
Rationale: The greater saphenous vein is the most commonly used graft site for CABG. The right
and left internal mammary arteries, radial arteries, and gastroepiploic artery are other graft
sites used, though not as frequently. The femoral artery, brachial artery, and brachial vein are
never harvested.
A client with an occluded coronary artery is admitted and has an emergency
percutaneous transluminal coronary angioplasty (PTCA). The client is admitted to the cardiac
critical care unit after the PTCA. The complications for which the nurse should monitor the client
include which of the following?
A. Peripheral edema
B. Bleeding at insertion site
C. Left ventricular hypertrophy
D. Pulmonary edema - Answer B. Bleeding at insertion site
Rationale: Complications of PTCA may include bleeding at the insertion site, abrupt closure of
the artery, arterial thrombosis, and perforation of the artery. Complications do not include left
ventricular hypertrophy because this problem takes an extended time to develop and is not
emergent. Bleeding is a more likely and more serious complication than edema.
A client with type 2 diabetes and hypertension (HTN) has a routine follow-up appointment after
a cardiac stent placement. On assessment the nurse notes the client weighs 250 lb/113.4 kg
with a waist circumference of 40 inches/101.6 cm, blood pressure is 162/84 mm Hg, and fasting
blood glucose is 220 mg/dl. Based on these findings, which syndrome should the nurse most
suspect?
A. Adams-Nance syndrome
B. Postpericardiotomy syndrome
C. Metabolic syndrome
D. Alagille syndrome - Answer C. Metabolic syndrome
Rationale: A cluster of metabolic abnormalities known as metabolic syndrome is a major risk
factor for cardiovascular disease. This diagnosis is made when the client has 3 of the 5 risk
factors. These factors include a waist circumference of greater than 35.4 inches/89.9 cm,
elevated triglycerides, reduced high-density lipoprotein cholesterol, HTN with a systolic blood
, pressure above 130 mm Hg, and fasting glucose greater than 100 mg/dL or drug treatment for
elevated glucose. Adams-Nance syndrome is an inherited disorder characterized by paroxysmal
tachycardia, arterial HTN, syncope, and seizures. Alagille syndrome is a rare genetic disorder
that can affect multiple organ systems including the liver, heart, skeleton, eyes, and kidneys.
Based on the information presented neither of the above syndromes is likely.
Postpericardiotomy syndrome may occur to clients days or weeks after surgery, so a possibility
exists, but the signs and symptoms are not presented. Postpericardiotomy is characterized by
fever, pericardial/pleural/joint pain, friction rub, and dyspnea.
The OR nurse is explaining to a client that cardiac surgery requires the absence of blood from
the surgical field. At the same time, it is imperative to maintain perfusion of body organs and
tissues. What technique for achieving these simultaneous goals should the nurse describe?
A. Coronary artery bypass graft (CABG)
B. Percutaneous transluminal coronary angioplasty (PTCA)
C. Atherectomy
D. Cardiopulmonary bypass - Answer D. Cardiopulmonary bypass
Rationale: Cardiopulmonary bypass is often used to circulate and oxygenate blood mechanically
while bypassing the heart and lungs. PTCA, atherectomy, and CABG are all surgical procedures,
none of which achieves the two goals listed.
The nurse has just admitted a client for cardiac surgery. The client tearfully describes feeling
afraid of dying while undergoing the surgery. What is the nurse's best response?
A. Explore the factors underlying the client's anxiety.
B. Teach the client guided imagery techniques.
C. Obtain an order for a PRN benzodiazepine.
D. Describe the procedure in greater detail. - Answer A. Explore the factors underlying the
client's anxiety.
Rationale: An assessment of anxiety levels is required in the client to assist the client in
identifying fears and developing coping mechanisms for those fears. The nurse must further
assess and explore the client's anxiety before providing interventions such as education or
medications.
A client with angina has been prescribed nitroglycerin. Before administering the drug, the nurse
should inform the client about what potential adverse effects?
A. Nervousness or paresthesia
Questions with Actual Detailed Answers
2026 Updated.
The nurse is caring for a client who has been diagnosed with an elevated cholesterol level. The
nurse is aware that plaque on the inner lumen of arteries is composed chiefly of what?
A. Lipids and fibrous tissue
B. White blood cells
C. Lipoproteins
D. High-density cholesterol - Answer A. Lipids and fibrous tissue
Rationale: As T-lymphocytes and monocytes infiltrate to ingest lipids on the arterial wall and
then die, a fibrous tissue develops. This causes plaques to form on the inner lumen of arterial
walls. These plaques do not consist of white cells, lipoproteins, or high-density cholesterol.
A client presents to the clinic reporting intermittent chest pain on exertion, which is eventually
attributed to angina. The nurse should inform the client that angina is most often attributable to
what cause?
A. Decreased cardiac output
B. Decreased cardiac contractility
C. Infarction of the myocardium
D. Coronary arteriosclerosis - Answer D. Coronary arteriosclerosis
Rationale: In most cases, angina pectoris is due to arteriosclerosis. The disease is not a result of
impaired cardiac output or contractility. Infarction may result from untreated angina, but it is
not a cause of the disease.
The nurse is caring for an adult client who had symptoms of unstable angina upon admission to
the hospital. What nursing diagnosis underlies the discomfort associated with angina?
A. Ineffective breathing pattern related to decreased cardiac output
B. Anxiety related to fear of death
C. Ineffective cardiopulmonary tissue perfusion related to coronary artery disease (CAD)
D. Impaired skin integrity related to CAD - Answer C. Ineffective cardiopulmonary tissue
perfusion related to coronary artery disease (CAD)
,Rationale: Ineffective cardiopulmonary tissue perfusion directly results in the symptoms of
discomfort associated with angina. Anxiety and ineffective breathing may result from angina
chest pain, but they are not the causes. Skin integrity is not impaired by the effects of angina.
The triage nurse in the ED assesses an adult client who presents with reports of midsternal
chest pain that has lasted for the last 5 hours. If the client's symptoms are due to an MI, what
will have happened to the myocardium?
A. It may have developed an increased area of infarction during the time without treatment.
B. It will probably not have more damage than if the client came in immediately.
C. It may be responsive to restoration of the area of dead cells with proper treatment.
D. It has been irreparably damaged, so immediate treatment is no longer necessary. - Answer
A. It may have developed an increased area of infarction during the time without treatment.
Rationale: When the client experiences lack of oxygen to myocardium cells during an MI, the
sooner treatment is initiated, the more likely the treatment will prevent or minimize myocardial
tissue necrosis. Delays in treatment equate with increased myocardial damage. Despite the
length of time the symptoms have been present, treatment needs to be initiated immediately to
minimize further damage. Dead cells cannot be restored by any means.
Family members bring a client to the ED with pale cool skin, sudden midsternal chest pain
unrelieved with rest, and a history of CAD. How should the nurse best interpret these initial
data?
A. The symptoms indicate angina and should be treated as such.
B. The symptoms indicate a pulmonary etiology rather than a cardiac etiology.
C. The symptoms indicate an acute coronary episode and should be treated as such.
D. Treatment should be determined pending the results of an exercise stress test. - Answer C.
The symptoms indicate an acute coronary episode and should be treated as such.
Rationale: Angina and MI have similar symptoms and are considered the same process but are
on different points along a continuum. That the client's symptoms are unrelieved by rest
suggests an acute coronary episode rather than angina. Pale, cool skin and sudden onset are
inconsistent with a pulmonary etiology. Treatment should be initiated immediately regardless of
diagnosis.
An OR nurse is preparing to assist with a coronary artery bypass graft (CABG). The OR nurse
knows that what vessel is most commonly used as source for a CABG?
,A. Brachial artery
B. Brachial vein
C. Femoral artery
D. Greater saphenous vein - Answer D. Greater saphenous vein
Rationale: The greater saphenous vein is the most commonly used graft site for CABG. The right
and left internal mammary arteries, radial arteries, and gastroepiploic artery are other graft
sites used, though not as frequently. The femoral artery, brachial artery, and brachial vein are
never harvested.
A client with an occluded coronary artery is admitted and has an emergency
percutaneous transluminal coronary angioplasty (PTCA). The client is admitted to the cardiac
critical care unit after the PTCA. The complications for which the nurse should monitor the client
include which of the following?
A. Peripheral edema
B. Bleeding at insertion site
C. Left ventricular hypertrophy
D. Pulmonary edema - Answer B. Bleeding at insertion site
Rationale: Complications of PTCA may include bleeding at the insertion site, abrupt closure of
the artery, arterial thrombosis, and perforation of the artery. Complications do not include left
ventricular hypertrophy because this problem takes an extended time to develop and is not
emergent. Bleeding is a more likely and more serious complication than edema.
A client with type 2 diabetes and hypertension (HTN) has a routine follow-up appointment after
a cardiac stent placement. On assessment the nurse notes the client weighs 250 lb/113.4 kg
with a waist circumference of 40 inches/101.6 cm, blood pressure is 162/84 mm Hg, and fasting
blood glucose is 220 mg/dl. Based on these findings, which syndrome should the nurse most
suspect?
A. Adams-Nance syndrome
B. Postpericardiotomy syndrome
C. Metabolic syndrome
D. Alagille syndrome - Answer C. Metabolic syndrome
Rationale: A cluster of metabolic abnormalities known as metabolic syndrome is a major risk
factor for cardiovascular disease. This diagnosis is made when the client has 3 of the 5 risk
factors. These factors include a waist circumference of greater than 35.4 inches/89.9 cm,
elevated triglycerides, reduced high-density lipoprotein cholesterol, HTN with a systolic blood
, pressure above 130 mm Hg, and fasting glucose greater than 100 mg/dL or drug treatment for
elevated glucose. Adams-Nance syndrome is an inherited disorder characterized by paroxysmal
tachycardia, arterial HTN, syncope, and seizures. Alagille syndrome is a rare genetic disorder
that can affect multiple organ systems including the liver, heart, skeleton, eyes, and kidneys.
Based on the information presented neither of the above syndromes is likely.
Postpericardiotomy syndrome may occur to clients days or weeks after surgery, so a possibility
exists, but the signs and symptoms are not presented. Postpericardiotomy is characterized by
fever, pericardial/pleural/joint pain, friction rub, and dyspnea.
The OR nurse is explaining to a client that cardiac surgery requires the absence of blood from
the surgical field. At the same time, it is imperative to maintain perfusion of body organs and
tissues. What technique for achieving these simultaneous goals should the nurse describe?
A. Coronary artery bypass graft (CABG)
B. Percutaneous transluminal coronary angioplasty (PTCA)
C. Atherectomy
D. Cardiopulmonary bypass - Answer D. Cardiopulmonary bypass
Rationale: Cardiopulmonary bypass is often used to circulate and oxygenate blood mechanically
while bypassing the heart and lungs. PTCA, atherectomy, and CABG are all surgical procedures,
none of which achieves the two goals listed.
The nurse has just admitted a client for cardiac surgery. The client tearfully describes feeling
afraid of dying while undergoing the surgery. What is the nurse's best response?
A. Explore the factors underlying the client's anxiety.
B. Teach the client guided imagery techniques.
C. Obtain an order for a PRN benzodiazepine.
D. Describe the procedure in greater detail. - Answer A. Explore the factors underlying the
client's anxiety.
Rationale: An assessment of anxiety levels is required in the client to assist the client in
identifying fears and developing coping mechanisms for those fears. The nurse must further
assess and explore the client's anxiety before providing interventions such as education or
medications.
A client with angina has been prescribed nitroglycerin. Before administering the drug, the nurse
should inform the client about what potential adverse effects?
A. Nervousness or paresthesia
