Cardiovascular NCLEX Exam | 150
questions & Correct Answers
A client returns to the nursing unit after an above-the-knee amputation of the right leg.
The nurse positions the client: - ✔✔With the foot of the bed elevated
(During the first 24 hours after amputation, the nurse elevates the foot of the bed (but not the
residual limb itself) to reduce edema. After the first 24 hours, the bed is kept flat to prevent
hip flexion contractures. The health care provider's postoperative prescriptions regarding
positioning are always followed.)
A client with chronic atrial fibrillation is being started on amiodarone (Cordarone) as
maintenance therapy for dysrhythmia suppression. A nurse provides instructions to the client
about the medication. Which statement by the client indicates a need for further instruction? -
✔✔"I will stop taking the prescribed anticoagulant after starting this new medication."
(Amiodarone is used for the dysrhythmia atrial fibrillation. The medication will have no effect in
preventing thrombus formation within the atria so anticoagulants need to be continued. The
medication increases sun sensitivity so protective measures are essential. Thyroid function
studies should be monitored as the medication can affect thyroid function. Because the
medication can cause corneal microdeposits, follow-up with the ophthalmologist is important.)
A nurse is planning to teach a client with peripheral arterial disease about measures to limit
disease progression. The nurse should include which items on a list of suggestions to be
given to the client? Select all that apply. - ✔✔1.
Cut down on the amount of fats consumed in the diet.
,3.
Walk each day to increase circulation to the legs.
4.
Be careful not to injure the legs or feet.
5.
Eat a well-balanced diet every day.
(Long-term management of peripheral arterial disease consists of measures that increase
peripheral circulation (exercise), relieve pain, and maintain tissue integrity (foot care and
nutrition). Application of heat directly to the extremity is contraindicated. The affected
extremity may have decreased sensitivity and is at risk for burns. Direct application of
heat raises oxygen and nutritional requirements of the tissue even further.)
A client is receiving a continuous intravenous (IV) infusion of heparin in the treatment of deep
vein thrombosis. The nurse is told that the client's activated partial thromboplastin time
(aPTT) level is 65 seconds and that the client's baseline before the initiation of therapy was 30
seconds. The nurse identifies these results as: - ✔✔Within the therapeutic range
(The normal aPTT varies between 20 and 36 seconds, depending on the type of activator used
in testing. The therapeutic dose of heparin for treatment of deep vein thrombosis is to keep
the aPTT between 1.5 and 2.5 times normal. Thus the client's aPTT is within the therapeutic
range, and the dose should remain unchanged.)
A client is at risk for developing disseminated intravascular coagulopathy (DIC). The nurse
should become concerned with which of the following fibrinogen levels? - ✔✔90 mg/dL
(The normal fibrinogen level is 180 to 340 mg/dL for men and 190 to 420 mg/dL for women. A
critical value is less than 100 mg/dL. With DIC, the fibrinogen level drops because fibrinogen is
,used up in the clotting process. For these reasons, the nurse should become most
concerned with the level of 90 mg/dL.)
A nurse notes that a client who is attached to a cardiac monitor suddenly develops atrial
fibrillation at a rate of 130. The nurse notifies the registered nurse immediately and prepares the
client for which initial intervention? - ✔✔Administration of a calcium channel blocker
(The initial treatment goal when atrial fibrillation suddenly occurs is to control the rate of
impulses with the administration of a calcium-channel blocker or a β-blocker. Defibrillation is
indicated when a client is in pulseless ventricular tachycardia or ventricular fibrillation.
Electrical cardioversion is an option for atrial fibrillation if the client is clinically unstable or if
the client has not responded to chemical cardioversion after a 6-week period of anticoagulant
therapy. Anticoagulant therapy, for example, with a continuous heparin infusion, is indicated
to prevent development of thrombus formation in the atria but is not the priority over rate
control.)
A hospitalized client with a history of angina pectoris is ambulating in the corridor. The client
suddenly complains of severe substernal chest pain. The nurse should take which action first?
- ✔✔Assist the client to sit or lie down.
(Chest pain is caused by an imbalance between myocardial oxygen supply and demand. During
episodes of pain, the nurse first limits the client's activity and assists the client to a position of
comfort, checks the vital signs, administers oxygen and medication according to protocol, and
obtains a 12-lead electrocardiogram.)
A nurse notes bilateral 2+ edema in the lower extremities of a client with known coronary
artery disease who was admitted to the hospital 2 days ago. Based on this finding, the nurse
implements which action? - ✔✔Reviews the intake and output records for the last 2 days
(Edema is the accumulation of excess fluid in the interstitial spaces, which can be determined
by intake greater than output and by a sudden increase in weight (2.2 lb = 1 kg). To determine
, the extent of fluid accumulation, the nurse first reviews the intake and output records for
the past 2 days.)
A client brings the following medications to the clinic for her yearly physical. The nurse
realizes which medication has been prescribed to treat heart failure? - ✔✔Digoxin
(Lanoxin)
(Digoxin strengthens the heart beat, as well as decreases the heart rate. It is used in the treatment
of congestive heart failure. Potassium chloride increases the potassium level. Although digoxin
does lower the potassium level, potassium chloride is not specifically administered for heart
failure. Warfarin and amiodarone do not treat congestive heart failure.)
A nurse is assisting in preparing a client for a cardiac catheterization. The nurse
understands that it is important to check the client for a history of: - ✔✔Allergy to
shellfish
(Allergy to seafood, iodine, or iodine contrast media in the pre-procedure period may
necessitate a skin test for allergy severity and the use of prophylactic antihistamines to
prevent an allergic response to the contrast medium. The other options are important parts of
the client's history but are not specific to a cardiac catheterization procedure.)
A student nurse is assigned to assist in caring for a client with acute pulmonary edema who is
receiving digoxin (Lanoxin) and heparin therapy. The nursing instructor reviews the plan of
care formulated by the student and tells the student that which intervention is unsafe? -
✔✔Restricting the client's potassium intake
(Clients with acute pulmonary edema are on a sodium-restricted diet, not potassium restricted.
Restricting potassium makes the client more prone to digoxin toxicity. Digoxin should be held
and the health care provider notified when the client's heart rate is less than 60 beats per
minute, unless otherwise prescribed. Heparin should be administered with a 25- or 27-gauge
needle to reduce tissue trauma. Resting after meals decreases the demands placed on the heart
and should be encouraged.)
A client has an inoperable abdominal aortic aneurysm (AAA). The nurse teaches the client about
the need for: - ✔✔Antihypertensives
questions & Correct Answers
A client returns to the nursing unit after an above-the-knee amputation of the right leg.
The nurse positions the client: - ✔✔With the foot of the bed elevated
(During the first 24 hours after amputation, the nurse elevates the foot of the bed (but not the
residual limb itself) to reduce edema. After the first 24 hours, the bed is kept flat to prevent
hip flexion contractures. The health care provider's postoperative prescriptions regarding
positioning are always followed.)
A client with chronic atrial fibrillation is being started on amiodarone (Cordarone) as
maintenance therapy for dysrhythmia suppression. A nurse provides instructions to the client
about the medication. Which statement by the client indicates a need for further instruction? -
✔✔"I will stop taking the prescribed anticoagulant after starting this new medication."
(Amiodarone is used for the dysrhythmia atrial fibrillation. The medication will have no effect in
preventing thrombus formation within the atria so anticoagulants need to be continued. The
medication increases sun sensitivity so protective measures are essential. Thyroid function
studies should be monitored as the medication can affect thyroid function. Because the
medication can cause corneal microdeposits, follow-up with the ophthalmologist is important.)
A nurse is planning to teach a client with peripheral arterial disease about measures to limit
disease progression. The nurse should include which items on a list of suggestions to be
given to the client? Select all that apply. - ✔✔1.
Cut down on the amount of fats consumed in the diet.
,3.
Walk each day to increase circulation to the legs.
4.
Be careful not to injure the legs or feet.
5.
Eat a well-balanced diet every day.
(Long-term management of peripheral arterial disease consists of measures that increase
peripheral circulation (exercise), relieve pain, and maintain tissue integrity (foot care and
nutrition). Application of heat directly to the extremity is contraindicated. The affected
extremity may have decreased sensitivity and is at risk for burns. Direct application of
heat raises oxygen and nutritional requirements of the tissue even further.)
A client is receiving a continuous intravenous (IV) infusion of heparin in the treatment of deep
vein thrombosis. The nurse is told that the client's activated partial thromboplastin time
(aPTT) level is 65 seconds and that the client's baseline before the initiation of therapy was 30
seconds. The nurse identifies these results as: - ✔✔Within the therapeutic range
(The normal aPTT varies between 20 and 36 seconds, depending on the type of activator used
in testing. The therapeutic dose of heparin for treatment of deep vein thrombosis is to keep
the aPTT between 1.5 and 2.5 times normal. Thus the client's aPTT is within the therapeutic
range, and the dose should remain unchanged.)
A client is at risk for developing disseminated intravascular coagulopathy (DIC). The nurse
should become concerned with which of the following fibrinogen levels? - ✔✔90 mg/dL
(The normal fibrinogen level is 180 to 340 mg/dL for men and 190 to 420 mg/dL for women. A
critical value is less than 100 mg/dL. With DIC, the fibrinogen level drops because fibrinogen is
,used up in the clotting process. For these reasons, the nurse should become most
concerned with the level of 90 mg/dL.)
A nurse notes that a client who is attached to a cardiac monitor suddenly develops atrial
fibrillation at a rate of 130. The nurse notifies the registered nurse immediately and prepares the
client for which initial intervention? - ✔✔Administration of a calcium channel blocker
(The initial treatment goal when atrial fibrillation suddenly occurs is to control the rate of
impulses with the administration of a calcium-channel blocker or a β-blocker. Defibrillation is
indicated when a client is in pulseless ventricular tachycardia or ventricular fibrillation.
Electrical cardioversion is an option for atrial fibrillation if the client is clinically unstable or if
the client has not responded to chemical cardioversion after a 6-week period of anticoagulant
therapy. Anticoagulant therapy, for example, with a continuous heparin infusion, is indicated
to prevent development of thrombus formation in the atria but is not the priority over rate
control.)
A hospitalized client with a history of angina pectoris is ambulating in the corridor. The client
suddenly complains of severe substernal chest pain. The nurse should take which action first?
- ✔✔Assist the client to sit or lie down.
(Chest pain is caused by an imbalance between myocardial oxygen supply and demand. During
episodes of pain, the nurse first limits the client's activity and assists the client to a position of
comfort, checks the vital signs, administers oxygen and medication according to protocol, and
obtains a 12-lead electrocardiogram.)
A nurse notes bilateral 2+ edema in the lower extremities of a client with known coronary
artery disease who was admitted to the hospital 2 days ago. Based on this finding, the nurse
implements which action? - ✔✔Reviews the intake and output records for the last 2 days
(Edema is the accumulation of excess fluid in the interstitial spaces, which can be determined
by intake greater than output and by a sudden increase in weight (2.2 lb = 1 kg). To determine
, the extent of fluid accumulation, the nurse first reviews the intake and output records for
the past 2 days.)
A client brings the following medications to the clinic for her yearly physical. The nurse
realizes which medication has been prescribed to treat heart failure? - ✔✔Digoxin
(Lanoxin)
(Digoxin strengthens the heart beat, as well as decreases the heart rate. It is used in the treatment
of congestive heart failure. Potassium chloride increases the potassium level. Although digoxin
does lower the potassium level, potassium chloride is not specifically administered for heart
failure. Warfarin and amiodarone do not treat congestive heart failure.)
A nurse is assisting in preparing a client for a cardiac catheterization. The nurse
understands that it is important to check the client for a history of: - ✔✔Allergy to
shellfish
(Allergy to seafood, iodine, or iodine contrast media in the pre-procedure period may
necessitate a skin test for allergy severity and the use of prophylactic antihistamines to
prevent an allergic response to the contrast medium. The other options are important parts of
the client's history but are not specific to a cardiac catheterization procedure.)
A student nurse is assigned to assist in caring for a client with acute pulmonary edema who is
receiving digoxin (Lanoxin) and heparin therapy. The nursing instructor reviews the plan of
care formulated by the student and tells the student that which intervention is unsafe? -
✔✔Restricting the client's potassium intake
(Clients with acute pulmonary edema are on a sodium-restricted diet, not potassium restricted.
Restricting potassium makes the client more prone to digoxin toxicity. Digoxin should be held
and the health care provider notified when the client's heart rate is less than 60 beats per
minute, unless otherwise prescribed. Heparin should be administered with a 25- or 27-gauge
needle to reduce tissue trauma. Resting after meals decreases the demands placed on the heart
and should be encouraged.)
A client has an inoperable abdominal aortic aneurysm (AAA). The nurse teaches the client about
the need for: - ✔✔Antihypertensives
