CARDIAC LEWIS TEST BANK
QUESTIONS AND ANSWERS WITH
SOLUTIONS 2024
After noting a pulse deficit when assessing a 74-year-old patient who has just arrived in the emergency
department, the nurse will anticipate that the patient may require
a. emergent cardioversion.
b. a cardiac catheterization.
c. hourly blood pressure (BP) checks.
d. electrocardiographic (ECG) monitoring. - ANSWER d. electrocardiographic (ECG) monitoring
Pulse deficit indicates that there may be a cardiac dysrhythmia that would best be detected with ECG
monitoring
When reviewing the 12-lead electrocardiograph (ECG) for a healthy 79 year old patient who is having an
annual physical exam, what would be most concern to the nurse?
a. The PR interval is 0.21 seconds
b. The QRS duration is 0.13 seconds
c. There is a right bundle branch block
d. The HR is 42 beats/minute - ANSWER d. The HR is 42 beats/minute
The HR does not change with aging, so the decrease in HR requires further investigation.
During the physical examination of a 74 year old patient, the nurse palpates the point of maximal
impulse (PMI) in the sixth intercostal space lateral to the left midclavicular line. The most appropriate
action for the nurse to take next will be to
a. ask the patient about risk factors for atherosclerosis
b. document that the PMI is in the normal anatomic location
,c. auscultate both the cardiac arteries for the presence of a bruit
d. assess the patient for symptoms of left ventricular hypertrophy - ANSWER d. asses the patient for
symptoms of left ventricular hypertrophy assess
The PMI should be felt at the intersection of the fifth intercostal space and the left midclavicular line. A
PMI outside of that would indicate possible cardiac enlargement, such as left ventricular hypertrophy.
A patient is scheduled for cardiac catheterization with coronary angiography. Before the test, the nurse
informs the patient that
a. it will be important to lie completely still during the procedure
b. a flushed feeling may be noted when the contrast dye is injected
c. monitored anesthesia care will be provided during the procedure during the procedure
d. arterial pressure will be required for 24 hours after the test - ANSWER b. a flushed feeling may be
noted when the contrast dye is injected
A sensation of warmth or flushing is common when the contrast material is injected, which can be
anxiety producing procedure unless it has been discussed with the patient, anxiety-producing
While assessing a patient who was admitted with heart failure, the nurse notes that the patient has JVD
when lying flat in bed. Which action should the nurse take next?
a. Document the finding in the patient's record
b. Obtain vital signs, including oxygen saturation
c. Have the patient perform the Valsalva maneuver
d. Observe for JVD with the patient upright at 45 degrees - ANSWER d. Observe for JVD with the patient
upright at 45 degrees
When a patient is lying flat, the jugular vein is at the level of the right atrium, so JVD is common. JVD
that persists when the patient is sitting at a 30 to 45-degree angle or greater is significant.
, The nurse received the laboratory results for a patient who developed chest pain 4 hours ago and may
have myocardial infarction. The most important laboratory result will review will be
a. myoglobin
b. low-density lipoprotein (LDL)
c. troponins T and L
d. creatine kinase-MB (CK-MB) - ANSWER c. troponins T and L
cardiac troponins start to elevate 4 to 6 hours after myocardial injury and are highly specific to the
myocardium. They are the preferred diagnostic marker for myocardial infarction.
When the nurse is monitoring a patient who is undergoing exercise (stress) testing on a treadmill, which
assessment finding requires the most rapid action by the nurse?
a. Patient complaint of feeling tired
b. Pulse change from 87 to 101 beats/minute
c. Blood pressure (BP) increase from 134/68 to 150/80 mm Hg
d. Newly inverted T waves on the electrocardiogram - ANSWER d. Newly inverted T waves on the
electrocardiogram
ECG changes associated with coronary ischemia indicate that the myocardium is not getting adequate
oxygen delivery and that the exercise test should be terminated immediately
When admitting a patient for a cardiac cath and coronary angiogram, which information about the
patient is most important for the nurse to communicate to the HCP
a. The patient's pedal pulses are +1
b. The patient is allergic shellfish
c. The patient had a heart attack a year ago
d. The patient has not eaten anything today - ANSWER b. the patient is allergic shellfish
QUESTIONS AND ANSWERS WITH
SOLUTIONS 2024
After noting a pulse deficit when assessing a 74-year-old patient who has just arrived in the emergency
department, the nurse will anticipate that the patient may require
a. emergent cardioversion.
b. a cardiac catheterization.
c. hourly blood pressure (BP) checks.
d. electrocardiographic (ECG) monitoring. - ANSWER d. electrocardiographic (ECG) monitoring
Pulse deficit indicates that there may be a cardiac dysrhythmia that would best be detected with ECG
monitoring
When reviewing the 12-lead electrocardiograph (ECG) for a healthy 79 year old patient who is having an
annual physical exam, what would be most concern to the nurse?
a. The PR interval is 0.21 seconds
b. The QRS duration is 0.13 seconds
c. There is a right bundle branch block
d. The HR is 42 beats/minute - ANSWER d. The HR is 42 beats/minute
The HR does not change with aging, so the decrease in HR requires further investigation.
During the physical examination of a 74 year old patient, the nurse palpates the point of maximal
impulse (PMI) in the sixth intercostal space lateral to the left midclavicular line. The most appropriate
action for the nurse to take next will be to
a. ask the patient about risk factors for atherosclerosis
b. document that the PMI is in the normal anatomic location
,c. auscultate both the cardiac arteries for the presence of a bruit
d. assess the patient for symptoms of left ventricular hypertrophy - ANSWER d. asses the patient for
symptoms of left ventricular hypertrophy assess
The PMI should be felt at the intersection of the fifth intercostal space and the left midclavicular line. A
PMI outside of that would indicate possible cardiac enlargement, such as left ventricular hypertrophy.
A patient is scheduled for cardiac catheterization with coronary angiography. Before the test, the nurse
informs the patient that
a. it will be important to lie completely still during the procedure
b. a flushed feeling may be noted when the contrast dye is injected
c. monitored anesthesia care will be provided during the procedure during the procedure
d. arterial pressure will be required for 24 hours after the test - ANSWER b. a flushed feeling may be
noted when the contrast dye is injected
A sensation of warmth or flushing is common when the contrast material is injected, which can be
anxiety producing procedure unless it has been discussed with the patient, anxiety-producing
While assessing a patient who was admitted with heart failure, the nurse notes that the patient has JVD
when lying flat in bed. Which action should the nurse take next?
a. Document the finding in the patient's record
b. Obtain vital signs, including oxygen saturation
c. Have the patient perform the Valsalva maneuver
d. Observe for JVD with the patient upright at 45 degrees - ANSWER d. Observe for JVD with the patient
upright at 45 degrees
When a patient is lying flat, the jugular vein is at the level of the right atrium, so JVD is common. JVD
that persists when the patient is sitting at a 30 to 45-degree angle or greater is significant.
, The nurse received the laboratory results for a patient who developed chest pain 4 hours ago and may
have myocardial infarction. The most important laboratory result will review will be
a. myoglobin
b. low-density lipoprotein (LDL)
c. troponins T and L
d. creatine kinase-MB (CK-MB) - ANSWER c. troponins T and L
cardiac troponins start to elevate 4 to 6 hours after myocardial injury and are highly specific to the
myocardium. They are the preferred diagnostic marker for myocardial infarction.
When the nurse is monitoring a patient who is undergoing exercise (stress) testing on a treadmill, which
assessment finding requires the most rapid action by the nurse?
a. Patient complaint of feeling tired
b. Pulse change from 87 to 101 beats/minute
c. Blood pressure (BP) increase from 134/68 to 150/80 mm Hg
d. Newly inverted T waves on the electrocardiogram - ANSWER d. Newly inverted T waves on the
electrocardiogram
ECG changes associated with coronary ischemia indicate that the myocardium is not getting adequate
oxygen delivery and that the exercise test should be terminated immediately
When admitting a patient for a cardiac cath and coronary angiogram, which information about the
patient is most important for the nurse to communicate to the HCP
a. The patient's pedal pulses are +1
b. The patient is allergic shellfish
c. The patient had a heart attack a year ago
d. The patient has not eaten anything today - ANSWER b. the patient is allergic shellfish
