Critical Care: Cardiac Sample Exam Question and Answers [100% Correct] 2025 Latest Release!!

Critical Care: Cardiac Sample Exam Question and Answers [100% Correct] 2025 Latest Release!! A patient is being discharged after hospitalization for left ventricular systolic dysfunction. As a nurse, which of the following statements about this condition is incorrect? A) "Signs and symptoms of this type of heart failure may include: difficulty breathing, a persistent cough, shortness of breath when lying down, and unexpected weight gain." B) "It is crucial to monitor daily weight, as well as fluid and salt intake." C) "Left-sided heart failure can eventually lead to right-sided heart failure if it is not managed properly." D) "This type of heart failure can cause fluid congestion in the hepatic veins, leading to peripheral edema." D Which of the following are NOT typical signs or symptoms of right-sided heart failure? Select all that apply: A) Jugular vein distention B) Persistent coughing C) Unexpected weight gain D) Crackles in the lungs E) Frequent nighttime urination F) Difficulty breathing while lying down B, D, F A patient has been diagnosed with left-sided systolic dysfunction heart failure. Which of the following f indings are expected with this condition? A) An echocardiogram shows an ejection fraction of 38%. B) Heart catheterization reveals an ejection fraction of 65%. C) The patient experiences frequent episodes of nocturnal dyspnea. D) Both options A and C are common findings in left-sided systolic dysfunction heart failure. D 1 True or False: People with left-sided diastolic dysfunction heart failure generally have a normal ejection fraction. A) True A B) False A patient with a history of heart failure makes the following statements. Which one suggests the patient may be experiencing a heart failure exacerbation? A) "I’ve noticed that I gained 6 pounds over the past week." B) "I need to prop myself up with a pillow to breathe while I sleep." C) "I haven’t noticed any swelling in my feet or hands recently." D) Both the second and third statements are correct. E) The first and second statements suggest potential heart failure exacerbation. E Which of the following patients is at the highest risk for heart failure exacerbation? A) A 55-year-old female who regularly limits sodium and fluid intake. B) A 73-year-old male who has missed his Amiodarone dose for a month and is experiencing atrial f ibrillation. C) A 67-year-old female recently discharged after heart valve replacement surgery. D) A 78-year-old male with a history of eczema and cystic fibrosis. B A 74-year-old female presents in the emergency room with complaints of difficulty breathing, a persistent cough, and trouble sleeping due to shortness of breath. On assessment, you find crackles in the lungs, a respiratory rate of 25 breaths per minute, and an oxygen saturation of 90% on room air. Which lab result supports your suspicion of heart failure? A) Potassium level of 5.6 B) BNP level of 820 B C) BUN level of 9 D) Troponin level less than 0.02 Which of the following tests are NOT used in diagnosing heart failure? A) Echocardiogram 2 B) Brain natriuretic peptide (BNP) blood test C) Nuclear stress test D) Holter monitoring D What type of heart failure is described by the inability of the ventricle to fill properly due to stiffness, resulting in fluid backing up into the lungs and causing shortness of breath? A) Left ventricular systolic dysfunction B) Left ventricular right-sided dysfunction C) Right ventricular diastolic dysfunction D) Left ventricular diastolic dysfunction D A patient with left-sided heart failure is struggling to breathe. Which nursing intervention is most appropriate? A) Encourage the patient to cough and perform deep breathing exercises. B) Position the patient in Semi-Fowler’s position. C) Help the patient into a High Fowler’s position. C D) Provide chest percussion therapy. During discharge teaching for a patient with a history of heart failure, which statement indicates the patient understands the dietary restrictions? A) "I will limit my sodium intake to 5-6 grams per day." B) "I will make sure to include canned vegetables and fish in my diet." C) "I’m happy I can still eat sandwiches, especially bologna and cheese ones." D) "I will limit my consumption of frozen meals." D Select all of the correct statements for educating a patient with heart failure: A) It is important for patients to notify their physician if they gain more than 6 pounds in one day or 10 pounds in a week. B) Patients with heart failure should receive an annual flu vaccine and stay up-to-date on the pneumonia vaccine. B 3 C) Heart failure patients should limit their sodium intake to 2-3 grams per day. C D) Heart failure can be aggravated by illness, excess fluid or sodium intake, and arrhythmias. D E) Heart failure patients should limit exercise due to the associated risks. A patient taking Digoxin is experiencing severe bradycardia, nausea, and vomiting. A lab result shows a Digoxin level of 4 ng/mL. What medication would you expect the physician to order? A) Narcan B) Aminophylline C) Digibind C D) No medication, as this Digoxin level is normal. Which of the following is considered a late sign of heart failure? A) Shortness of breath B) Difficulty breathing when lying down C) Edema D) Foamy, blood-tinged sputum D True or False: The left anterior descending coronary artery provides blood supply to the right ventricle and to the front of the septum False Which coronary artery provides blood to the left atrium and left ventricle: A. Right marginal artery B. Posterior descending artery C. Left circumflex artery D. Right coronary artery C Which patient(s) are most at risk for developing coronary artery disease? Select-all-that-apply: A. A 25 year old patient who exercises 3 times per week for 30 minutes a day and has a history of cervical cancer. 4 B. A 35 year old male with a BMI of 30 and reports smoking 2 packs of cigarettes a day. C. A 45 year old female that reports her father died at the age of 42 from a myocardial infraction. D. A 29 year old that has type I diabetes. B, C, D A patient reports during a routine check-up that he is experiencing chest pain and shortness of breath while performing activities. He states the pain goes away when he rests. This is known as: A. Unstable angina B. Variant angina C. Stable angina D. Prinzmetal angina c Keeping the patient in question 4 in mind: What type of diagnostic tests will the physician most likely order (at first) for this patient to evaluate the cause of the patient's symptoms? Select-all-that-apply: A. EKG B. Stress test C. Heart catheterization D. Balloon angioplasty A, B, 5 You're providing education to a patient who will be undergoing a heart catheterization. Which statement by the patient requires you to re-educate the patient about this procedure? A. "The brachial artery is most commonly used for this procedure." B. "A dye is injected into the coronary arteries to assess for blockages." C. "Not all patients who have a heart catheterization will need a stent placement." D. "I will not be completely asleep and will be able to breathe on my own during the procedure." A A patient reports having crushing chest pain that radiates to the jaw. You administer sublingual nitroglycerin and obtain a 12 lead EKG. Which of the following EKG findings confirms your suspicion of a possible myocardial infraction? A. absent Q wave B. QRS widening C. absent P-wave D. ST segment elevation D A patient is receiving treatment for stable coronary artery disease. The doctor prescribes the patient Plavix. What important information will you include in the patient's teaching? Select-all-that-apply: A. If you are scheduled for any planned surgical procedures, let your doctor know you are taking Plavix because this medication will need to be discontinued 5-7 days prior to the procedure. 6 B. A normal side effect of this medication is a dry cough. C. Avoid green leafy vegetables while taking Plavix. D. Notify the doctor, immediately, if you develop bruising, problems urinating, or fever. A, D A patient calls the cardiac clinic you are working at and reports that they have taken 3 sublingual doses of nitroglycerin as prescribed for chest pain, but the chest pain is not relieved. What do you educate the patient to do next? A. Take another dose of Nitroglycerin in 5 minutes. B. Call 911 immediately C. Lie down and rest to see if that helps with relieving the pain D. Take two doses of Nitroglycerin in 5 minutes B Lipitor is prescribed for a patient with a high cholesterol level. As the nurse, how do you educate the patient on how this drugs works on the body? A. Lipitor increases LDL levels and decreases HDL levels, total cholesterol, and triglyceride levels. B. Lipitor decreases LDL, HDL levels, total cholesterol, and triglyceride levels. 7 C. Lipitor increases HDL levels, total cholesterol, and triglyceride levels. D. Lipitor increases HDL levels and decreases LDL, total cholesterol, and triglyceride levels. D A patient taking Zocor is reporting muscle pain. You are evaluating the patient's lab work and note that which of the following findings could cause muscle pain? A. Elevated potassium level B. Elevated CPK (creatine kinase level) C. Decreased potassium level D. Decreased CPK (creatine kinase level) B A patient who has diabetes will be started on Metoprolol for medical management of coronary artery disease. Which of the following will you include in your discharge teaching about this medication? A. Check your heart rate regularly because Metoprolol can cause an irregular heart rate. B. Check your glucose regularly because this medication can cause hyperglycemia. C. Check your blood pressure regularly because this medication can cause hypertension. D. Check your glucose regularly because this medication can mask the typical signs and symptoms of hypoglycemia. D 8 True or False: ACE inhibitors work to decrease the workload on the heart by blocking the conversion of Angiotensin II to Angiotensin I which causes vasodilation. False Which of the following patients are MOST at risk for developing heart failure? Select-all-that-apply: A. A 69 year old male with a history of alcohol abuse and is recovering from a myocardial infarction. B. A 55 year old female with a health history of asthma and hypoparathyroidism. C. A 30 year old male with a history of endocarditis and has severe mitral stenosis. D. A 45 year old female with lung cancer stage 2. E. A 58 year old female with uncontrolled hypertension and is being treated for influenza. a, c, e These drugs are used as first-line treatment of heart failure. They work by allowing more blood to flow to the heart which decreases the work load of the heart and allows the kidneys to secrete sodium. However, some patients can develop a nagging cough with these types of drugs. This description describes? A. Beta-blockers B. Vasodilators C. Angiotensin II receptor blockers D. Angiotensin-converting-enzyme inhibitors d 9 A patient with heart failure is taking Losartan and Spironolactone. The patient is having EKG changes that presents with tall peaked T-waves and flat p-waves. Which of the following lab results confirms these f indings? A. Na+ 135 B. BNP 560 C. K+ 8.0 D. K+ 1.5 c During your morning assessment of a patient with heart failure, the patient complains of sudden vision changes that include seeing yellowish-green halos around the lights. Which of the following medications do you suspect is causing this issue? A. Lisinopril B. Losartan C. Lasix D. Digoxin d Select all the correct statements about the pharmacodynamics of Beta-blockers for the treatment of heart failure: A. These drugs produce a negative inotropic effect on the heart by increasing myocardial contraction. 10 B. A side effect of these drugs include bradycardia. C. These drugs are most commonly prescribed for patients with heart failure who have COPD. D. Beta-blockers are prescribed with ACE or ARBs to treat heart failure. b, d You are assisting a patient up from the bed to the bathroom. The patient has swelling in the feet and legs. The patient is receiving treatment for heart failure and is taking Hydralazine and Isordil. Which of the following is a nursing priority for this patient while assisting them to the bathroom? A. Measure and record the urine voided. B. Assist the patient up slowing and gradually. C. Place the call light in the patient's reach while in the bathroom. D. Provide privacy for the patient. b A patient is taking Digoxin. Prior to administration you check the patient's apical pulse and find it to be 61 bpm. Morning lab values are the following: K+ 3.3 and Digoxin level of 5 ng/mL. Which of the following is the correct nursing action? A. Hold this dose and administer the second dose at 1800. B. Administer the dose as ordered. C. Hold the dose and notify the physician of the Digoxin level. 11 D. Hold this dose until the patient's potassium level is normal. c Which of the following is a common side effect of Spironolactone? A. Renal failure B. Hyperkalemia C. Hypokalemia D. Dry cough b The physician's order says to administered Lasix 40 mg IV twice a day. The patient has the following morning labs: Na+ 148, BNP 900, K+ 2.0, and BUN 10. Which of the following is a nursing priority? A. Administer the Lasix as ordered B. Notify the physician of the BNP level C. Assess the patient for edema D. Hold the dose and notify the physician about the potassium level d A client with atrial fibrillation is receiving a continuous heparin infusion at 1000 units/hr. The nurse would determine that the client is receiving the therapeutic effect based on which of the following results? A. Prothrombin Time of 12.5 seconds B. Activated partial thromboplastin time of 60 seconds C. Activated Partial thromboplastin time of 28 seconds 12 D. Activated Partial thromboplastin time longer than 120 seconds B A client who is receiving digoxin daily has a serum potassium level of 3mEq/L and is complaining of anorexia. The provider prescribes a serum digoxin level to be done. The nurse checks the results and should expect to not which level is outside of therapeutic range? A. 0.3 ng/ml B. 0.5 ng/ml C. 0.8 ng/ml D. 1.0 ng/ml 4 The nurse is monitoring a client who is taking propanolol. Which assessment finding indicates a potential adverse complication associated with this medication A. Development and complaint of insomnia B. The development of audible expiratory wheezes C.A baseline bp of 150/80 followed by a bp of 138/72 after 2 doses D. A baseline resting HR of 88 beats/min followed by a resting HR of 72 beats/min after 2 doses Beta-blockers can cause bronchospasm. A client is diagnosed with an ST-segment elevation MI (STEMI) and is receiving a tissue plasminogen activator, altepase. Which is action is a priority nursing intervention? A. Monitor for kidney failure B. Monitor for psychosocial status C. monitor for signs of bleeding D. have heparin sodium available =thrombolytic C. B. 13 The nurse is planning to administer hydrocholothiazide to a client. the nurse should monitor for which adverse reaction? A. Hypouricemia, Hyperkalemia B. Increased risk of osteoporosis C. Hypokalemia, hyperglycemia, sulfa allergy D. HyperKalemia, hypoglycemia, penicillin allergy C The nurse is monitoring a client who is taking digoxin for adverse effects. Which findings are characteristics of digoxin toxicity? 1. Tremors 2. Diarrhea 3. Irritability 4. Blurred Vision 5. Nausea and Vomiting 2, 4, 5 A client admitted to the hospital with chest pain and a history of type 2 diabetes mellitus is scheduled for cardiac catheterization. Which med would need to be withheld 24hrs before and 48 hrs after the procedure? A. Glipizide B. Metformin C. Repaglinide D. Regular Insulin B A client in sinus bradycardia, with a heart rate of 45 beats/minute, complains of dizziness and has a blood pressure of 82/60 mm Hg. Which prescription should the nurse anticipate will be prescribed? A. Defibrillate the client. B. Administer digoxin (Lanoxin). 14 C. Continue to monitor the client. D. Prepare for transcutaneous pacing. D The nurse in a medical unit is caring for a client with heart failure. The client suddenly develops extreme dyspnea, tachycardia, and lung crackles and the nurse suspects pulmonary edema. The nurse immediately asks another nurse to contact the health care provider and prepares to implement which priority interventions: Select all that apply. 1. administer O2 2. insert foley 3. administer furosemide 4. administer morphine IV 5. Transport client to coronary care unit (CCU) Place the client in a low fowlers side lying position 1, 2, 3, 4 A client with myocardial infarction suddenly becomes tachycardic, shows signs of air hunger, and begins coughing pink frothy sputum. Which finding would the nurse anticipate when auscultating the patients lungs? A. Stridor B. Crackles C. Scattered Rhonchi D. Diminished breath sounds B A client with MI is developing cardiogenic shock because of the risk of myocardial ischemia, what condition should the nurse carefully assess for? A. Bradycardia B. Ventricular dysrhythmias C. Rising diastolic bp D. falling central venous pressure B 15 Dysrhythmias occur as a result of decreased oxygenation and severe damage to the myocardium A client is wearing a continuous cardiac monitor, which begins to sound its alarm. A nurse sees no electrocardiographic complexes on the screen. Which is the priority action of the nurse? A. Call a code. B. Call the health care provider. C. Check the client's status and lead placement. D. Press the recorder button on the electrocardiogram console. C The nurse is watching the cardiac monitor and notices that the rhythm suddenly changes. No P waves, QRS complexes are wide; ventricular rate is 140 beats/minute. The nurse interprets that the client is experiencing which rhythm? A. Sinus tachycardia B. Ventricular fibrillation C. Ventricular tachycardia D. Premature ventricular contractions (PVCs) C A client has frequent bursts of ventricular tachycardia on the cardiac monitor. What should the nurse be most concerned about with this dysrhythmia? A. It can develop into ventricular fibrillation at any time B. It is almost impossible to convert to a normal rhythm C. It is uncomfortable for the client, giving a sense of impending doom D. It produces a high cardiac output that quickly leads to cerebral and myocardial ischemia A client has developed atrial fibrillation, which a ventricular rate of 150 beats per minute. A nurse assesses the client for which associated signs/symptoms: a. Hypotension and dizziness b. Nausea and vomiting A 16 c. Hypertension and headache d. Flat neck veins A The nurse is watching the cardiac monitor and notices that the rhythm suddenly changes. No P waves; instead, the monitor screen shows there are fibrillatory waves before each QRS complex. The nurse interprets that the client is experiencing which rhythm? A. A Fib B. Sinus Tachycardia C.Ventricular fib D. Ventricular tachycardia A A client's electrocardiogram strip shows atrial and ventricular rates of 110 beats/minute. The PR interval is 0.14 second, the QRS complex measures 0.08 second, and the PP and RR intervals are regular. How should the nurse correctly interpret this rhythm? A.Sinus dysrhythmia B.Sinus tachycardia C.Sinus bradycardia D.Normal sinus rhythm B. A nurse is caring for a client who had a resection of AAA yesterday. The client has an IV infusion rate of 150ml/hr, unchanged for the last 10hrs. The clients' urine output for the last 3 hours has been 90, 50, 28 ml. The clients BUN: 35mg/dL and the serum creatinine level: 1.8 mg/dL. Which nursing action is the priority? 1. Check urine specific gravity 2. call health care provider 3. put iv line on a pump so infusion rate is to stay stable 4. check to see if the client had a blood sample for a serum albumin level drawn 2 The nurse notes that a client with sinus rhythm has a premature ventricle contraction that falls on the Twave of the preceding beat. The clients rhythm suddenly changes to one with no p waves, no definable 17 QRS complexes and coarse wavy lines of varying amplitude. How should the nurse correctly interpret this rhythm? A. Asystole B. A fib C. Ventricular fib D. Ventricular tachycardia C A hospitalized client with a diagnosis of abdominal aortic aneurysm suddenly complains of severe back pain and shortness of breath. What should the nurse do? *The nurse should suspect a rupture and should immediately contact the health care provider. The nurse should also stay with the patient, monitor vital signs, and neuro status. A nurse is caring for a 35-year-old patient who has been diagnosed with hypovolemic shock as a result of severe hemorrhage. In which position should the nurse place this patient to promote optimal circulation? a. In the Sims' position b. Supine with the legs elevated c. Trendelenburg d. Left side-lying with the head flat B This position promotes venous return from the lower extremities so that blood can flow back to the heart; the cardiovascular system does not have to work as hard and blood can be shunted to central organs until the patient receives appropriate treatment. A hypertensive patient reports to the hospital complaining of chest pain. Cardiac labs come back within normal limits but the physician decides to admit the patient for closer monitoring RR: 22 Temp: 99.6 HR: 145 18 BP: 80/45 A. Call the physician and ask for an order for vasopressors. B. Provide the client with pain medication. C. Notify the physician and prepare the client for surgery. D. Retake the clients temperature. C A patient with heart failure has been prescribed intravenous diuretic medications to control fluid and congestion. Which nursing intervention would the nurse need to perform in order to best monitor fluid and electrolyte balance in this patient? a. Monitor for signs of pancreatic dysfunction b. Administer pain medications as ordered c. Insert a Foley catheter d. Check the patient's weight daily D Which of the following arteries primarily feeds the anterior wall of the heart? A. Circumflex artery B. Internal mammary artery C. Left anterior descending artery D. Right coronary artery C Which of the following conditions most commonly results in CAD? A. Atherosclerosis B. DM C. MI D. Renal failure A 19 Which of the following risk factors for coronary artery disease cannot be corrected? A. Cigarette smoking B. DM C. Heredity D. HPN C Which of the following actions is the first priority care for a client exhibiting signs and symptoms of coronary artery disease? A. Decrease anxiety B. Enhance myocardial oxygenation C. Administer sublingual nitroglycerin D. Educate the client about his symptoms B Medical treatment of coronary artery disease includes which of the following procedures? A. Cardiac catheterization B. Coronary artery bypass surgery C. Oral medication administration D. Percutaneous transluminal coronary angioplasty C What is the primary reason for administering morphine to a client with myocardial infarction? A. To sedate the client B. To decrease the client's pain C. To decrease the client's anxiety D. To decrease oxygen demand on the client's heart D 20 Which of the following conditions is most commonly responsible for myocardial infarction? A. Aneurysm B. Heart failure C. Coronary artery thrombosis D. Renal failure C What supplemental medication is most frequently ordered in conjunction with furosemide (Lasix)? A. Chloride B. Digoxin C. Potassium D. Sodium C After an anterior wall myocardial infarction, which of the following problems is indicated by auscultation of crackles in the lungs? A. Left-sided heart failure B. Pulmonic valve malfunction C. Right-sided heart failure D. Tricuspid valve malfunction A What is the first intervention for a client experiencing myocardial infarction? A. Administer morphine B. Administer oxygen C. Administer sublingual nitroglycerin D. Obtain an electrocardiogram B 21 What is the most common complication of a myocardial infarction? A. Cardiogenic shock B. Heart failure C. Arrhythmias D. Pericarditis C What position should the nurse place the head of the bed in to obtain the most accurate reading of jugular vein distention? A. High-Fowler's B. Raised 10 degrees C. Raised 30 degrees D. Supine position C Which of the following parameters should be checked before administering digoxin? A. Apical pulse B. Blood pressure C. Radial pulse D. Respiratory rate A Toxicity from which of the following medications may cause a client to see a green halo around lights? A. Digoxin B. Furosemide C. Metoprolol D. Enalapril A 22 Which of the following symptoms is most commonly associated with left-sided heart failure? A. Crackles B. Arrhythmias C. Hepatic engorgement D. Hypotension A Which of the following symptoms might a client with right-sided heart failure exhibit? A. Adequate urine output B. Polyuria C. Oliguria D. Polydipsia C Inadequate deactivation of aldosterone by the liver after right-sided heart failure leads to fluid retention, which causes oliguria . Which of the following classes of medications maximizes cardiac performance in clients with heart failure by increasing ventricular contractility? A. Beta-adrenergic blockers B. Calcium channel blockers C. Diuretics D. Inotropic agents D Inotropic agents are administered to increase the force of the heart's contractions, thereby increasing ventricular contractility and ultimately increasing cardiac output. Stimulation of the sympathetic nervous system produces which of the following responses? A. Bradycardia 23 B. Tachycardia C. Hypotension D. Decreased myocardial contractility B Which of the following conditions is most closely associated with weight gain, nausea, and a decrease in urine output? A. Angina pectoris B. Cardiomyopathy C. Left-sided heart failure D. Right-sided heart failure D Which of the following symptoms usually signifies rapid expansion and impending rupture of an abdominal aortic aneurysm? A. Abdominal pain B. Absent pedal pulses C. Angina D. Lower back pain D What is the definitive test used to diagnose an abdominal aortic aneurysm? A. Abdominal X-ray B. Arteriogram C. CT scan D. Ultrasound B Which of the following complications is of greatest concern when caring for a preoperative abdominal aneurysm client? 24 A. HPN B. Aneurysm rupture C. Cardiac arrhythmias D. Diminished pedal pulses B Which of the following groups of symptoms indicated a ruptured abdominal aneurysm? A. Lower back pain, increased BP, decreased RBC, increased WBC B. Severe lower back pain, decreased BP, decreased RBC, increased WBC C. Severe lower back pain, decreased BP, decreased RBC, decreased WBC D. Intermittent lower back pain, decreased BP, decreased RBC, increased WBC B Severe lower back pain indicates an aneurysm rupture, secondary to pressure being applied within the abdominal cavity. When rupture occurs, the pain is constant because it can't be alleviated until an aneurysm is repaired. Blood pressure decreases due to the loss of blood. After the aneurysm ruptures, the vasculature is interrupted and blood volume is lost, so blood pressure wouldn't increase. For the same reason, the RBC count is decreased - not increase. The WBC count increases as cells migrate to the site of injury. Which hereditary disease is most closely linked to aneurysm? A. Cystic fibrosis B. Lupus erythematosus C. Marfan's syndrome D. Myocardial infarction C Which of the following treatments is the definitive one for a ruptured aneurysm? A. Antihypertensive medication administration B. Aortogram C. Beta-adrenergic blocker administration 25 D. Surgical intervention D The nurse is concerned about a deteriorating client. Which signs of cardiogenic shock does the nurse expect? Select all that apply a. cool and moist skin b. hr 126bpm c bounding pedal pulse d. urine output 20ml/hr e. bp 88/46 a, b, d, e a nurse performing a physical assessment for a client with right-sided HF notes a slight indentation lasting 15 seconds. this is categorized as what measurement of edema? A. 1+ B. 3+ C. 2+ D. 4+ C The nurse evaluates the cardiac rhythm of a client with CAD. The heart monitor shows isolated premature ventricular contractions (PVC). How does the nurse respond? A. Notify the healthcare provider immediately B. prepare to administer antiarrhythmic C. Prepare for cardioversion D. Continue to monitor the clients' rhythm D The nurse educator teaches a nurse about physical assessment for a client with an aortic dissection. What statement by the nurse indicates understanding? A. Reposition the client to semi-fowlers 26 B. Auscultate the carotid arteries for bruits C. Avoid deep palpation of the abdomen D. avoid the side-lying position c The nurse teaches a client scheduled for a percutaneous transluminal coronary angioplasty (PTCA). What response by the client demonstrates an understanding of this procedure? A "The purpose of the procedure is to measure the coronary artery pressure" B " The balloon-tipped catheter compresses the plaque against the walls of the coronary arteries" C "The procedure will cauterize the plaque blocking the coronary artery" D "The procedure inserts a mesh device that keeps the coronary artery patent" B The nurse cares for a client at risk for premature ventricular contractions (PVC). When monitoring the clients ECG rhythm, what characteristics indicate PVC? A. Wide QRS complexes and inverted P waves B. Narrow QRS complexes and no P waves C. Narrow QRS complexes and peaked P waves D. Wide QRS complexes and no P waves D The nurse cares for a client with infective endocarditis related to sharing IV needles. What does the nurse expect to find upon physical examination? A.Fever B. Osler Nodes C. Paradoxical pulse D. Pericardial friction rub E.Splinter hemorrhages a, b, e A client is admitted to the cardiac unit for MI. How does the nurse prioritize actions? 27 1. Insert an IV catheter 2. Begin Cardiac monitoring 3. provide a drink of water 4. initiate thrombolytic therapy 2, 1,4, 3 The nurse cares for a client with atrial fibrillation and a rate of 123bpm. How does the heart rate affect cardiac output for this client? A. Ventricular filling time is decreased B. Stroke Volume Increases C. Oxygen Demand decreases D. Ventricular filling time increases A The nurse plans care for a client with acute decompensated HF. Which interventions does the nurse include in the client's plan of care? select all that apply A. Administer O2 B. Assess for JVD and hepatomegaly C. Monitor O2 sat and RR D. Administer loop diuretics E. Maintain client in an upright postion a, b, c, d, e, The nurse provides pre-procedure education to a client scheduled to have a cardiac catheterization. which statement does the nurse include? A. " The procedure is performed at the bedside" B. " You may feel flushing, warmth, or palpitations during the procedure." C. "There may at first be some intense pain that resolves quickly." D. "you may develop a headache but this is normal" B 28 The client is taking spironolactone daily is prescribed digoxin for the treatment of HF. Which response by the client indicates an understanding of the medication regimen? Select all that apply 1. Spironolactone may affect my digoxin blood level 2. I should seek medical care if I experience palpitations 3. I should report seeing halos or rings of light 4. Digoxin toxicity is a rare issue 5.My radial pulse rate should decrease 1, 2, 3, 5 The nurse reviews a clients ECG and notes P waves. With regard to the cardiac cycle, what does the P wave indicate? A. atrial depolarization B. ventricular repolarization C. ventricular depolarization D. Atrial repolarization A A client has a cardiac catheterization using the femoral insertion site and returns to the nursing unit. What action does the nurse avoid during the immediate recovery period? A. Elevating HOB B.Resuming routine pre-procedure medications C.Assessing the motor function of the client's foot D. Providing fluids by mouth A A nurse plans care for a client with acute decompensated HF. Which interventions assist the nurse to improve the client's cardiac output? Select all that apply A. Place patient in upright position. 29 B. monitor body temp C. Assess fluid intake and output D. Monitor for dyspnea at rest E. Provide a restful environment A, B, C, D, E The nurse cares for a client diagnosed with an acute MI. the nurse attributes what ECG changes to the pathology of MI? A. T wave inversion B. Abnormal Q wave C. Irregular PR interval D. ST elevation E. U wave A, B, D A nurse cares for a client with pericarditis and notes inverted T waves on the ECG. What priority intervention by the nurse is most appropriate? A. Notify HCP B. Assess the client for chest discomfort C. Obtain vital signs including O2 sat D. administer O2 100% B Inverted or depressed T waves on the patients EKG indicates tissue ischemia or decreased O2 to the t issues The nurse reviews the health record for a client with CAD. when assessing client risk, what elevated lab value is the most likely to cause the progression of CAD? A. Blood glucose B. HDL C. LDL 30 D. Microalbuminuria C The nurse evaluates a middle-aged adult client with CAD, obesity, and nicotine addiction. The nurse counsels the client about what additional factors that increase the risk for CAD? A. History of valve disease B. DM type II C. Elevated HDL levels D. Familial HTN B The nurse reviews the prescribed medications for a client with asthma, diabetes, and acute HF. Which pharmacological intervention is prescribed to reduce myocardial workload? A. Montelukast B. Dobutamine C. Lopressor/metoprolol D. Morphine sulfate E. salmeterol B,C,D A client with underlying sinus tachycardia experiences frequent short episodes of VT, what lab test does the nurse expect the HCP will evaluate to determine a possible cause of ventricular tachycardia? A. Potassium B. Sodium C. Chloride D. Magnesium D The nurse cares for a client who was diagnosed with acute MI. The nurse incorporates which assessments as part of the monitoring for common complications of MI? Select all that apply 31 A. Lung auscultation B. Cognitive assessment C. Apical Heart Rate D. residual urine volumes E. Daily weight A, C, E A client with a left bundle branch block asks the nurse to explain the ECG monitor pattern. What teaching by the nurse explains the wide QRS complex? A. VENTRICULAR DEPOLARIZATION OCCURS THROUGH AN ALTERNATE PATHWAY B. VENTRICULAR REPOLARIZATION IS PROLONGED, RESULTING IN A LARGE T WAVE C. DEPOLARIZATION OF THE PURKINJE FIBERS OCCURS NORMALLY D. DELAYED ATRIAL REPOLARIZATION CAUSES A BIGGER WAVE A the nurse assesses a male client in the ER with chest pain. Chest pain suspicious for MI includes which feature? A. described as gnawing B. accompanied by nausea C. Stabbing pain D. Radiates to jaw D The nurse evaluates a clients cardiac monitor strip and notes a 58 bpm, regular rhythm, P waves normal in size and shape, a normally shaped QRS measuring 0.08 seconds, and consistent PR interval that measures 0.24 seconds. How does the nurse document this rhythm? A. Sinus tachydysrhythmia B. ventricular tachycardia C. sinus bradydysrhythmia D. Normal sinus rhythm C` 32 The nurse assesses a client with CAD who has been hospitalized for 3 days. the nurse notes moderate peripheral edema bilaterally and crackles in the lungs. What should the nurse do first? A. Teach the client about sodium restricted diet B. Request an order for daily weights C. Discuss diuretic options with the provider D. Review intake and output since admission D A client on telemetry monitoring develops torsades de pointes with a hr of 180bpm what does the nurse prepare to administer IV? A.Diltiazem B.Lidocaine C. Magnesium Sulfate D. Amiodarone c The nurse assesses a client who is scheduled for same-day surgery. The client reports chest and shoulder pain, perspiration and SOB. Which action does the nurse take first? A. Complete the preoperative checklist and call for transport to the operating room. B. Check the client's electrolytes and perform CBC C. Initiate protocol for the medical emergency team, and notify the physician D. request a chest x-ray and call for an ECG to be completed c A client arriving in the ER reports chest pain radiating to the shoulder and sob that began 2 days earlier. What lab test is most important to evaluate? A.Myoglobin B. Lactate dehydrogenase 33 C. Creatine Kinase-MB D. Troponin-I D The nurse assesses a client after MI from occlusion of the left anterior descending artery 3 days ago. the nurse is most concerned to find what new heart sound? A. Mild apical murmur B. Pericardial friction rub C. Ejection Click D. loud S4 B It indicates early pericarditis, which may occur within 3 days during recovery from an MI A client is admitted to the hospital due to MI. what medical intervention does the nurse manage to increase coronary perfusion and decrease cardiac workload? A. dobutamine IV B. therapeutic hypothermia C. intra-aortic balloon pump D. external pacemaker C The nurse provides discharge instructions to a client with congestive heart failure, which food does the nurse instruct the client to avoid? A. spinach B. Ice cream C. Orange juice D. steak sauce D The nurse assesses a client with acute chest pain. What signs or symptoms suggest angina pectoris? SAA 34 1. Pain resolved after eating 2. pain relieved by rest 3. pain getting worse with deep breathing 4. pain in the chest spreading to arms and back 5. pain occurring with activity 2, 4, 5 The nurse reviews a clients ECG and notes narrow QRS waves. with regard to the cardiac cycle, what does the QRS waveform indicate? A. Ventricular depolarization B ventricular repolarization C atrial repolarization D atrial depolarizaiton A A client is evaluated with an ECG in the ER for suspected acute MI and is having chest pain unrelieved by rest. What does the nurse expect the HCP to provide INITIALLY?? A. ATROPINE B. O2 C. ASPIRIN D.TISSUE PLASMINOGEN ACTIVATOR E. NTG B, C, E A UNIT NURSE ASSESSES A CLIENT WITH SOB, DIAPHORESIS, AND CHEST PAIN THAT RADIATES DOWN THE LEFT ARM. AFTER ACTIVATING THE MEDICAL RESPONSE TEAM, WHAT ACTIONS DOES THE NURSE PERFORM NEXT? A. Admin O2, initiate telemetry, check vitals, prepare norepinephrine B. Admin O2, check vitals, notify the cardiac catherization team C. Adminster O2, start an IV, and administer morphine D. Administer O2, initiate ECG, measure vitals, prepare sublingual nitroglycerin D 35 The nurse performs an admission assessment for a cleint with a history of MI. which signs and symptoms of left sided HF should the nurse look for? SELECT ALL THAT APPLY A. CIRCUMORAL CYANOSIS B. PULMONARY CRACKLES C. LEG EDEMA D. DRY COUGH E. JVD ABD The nurse teaches a client with newly diagnosed HF. which responses by the client indicate understanding? select all that apply a. it results from too much fluid in the heart b. the heart does not have enough oxygen c. the heart is unable to pump effectively d. it is a condition, not a disease e. the heart cannot handle a normal volume of blood C, D, E A nurse assesses a client admitted with palpitations and a palpable radial pulse of 122bpm. the nurse notes saw-tooth waves between each QRS complex on the cardiac monitor instead of normal P waves. What cardiac rhythm is most likely the cause of the client's symptoms? A. Supraventricular tachycardia B. ventricular fibrillation C.atrial flutter D. atrial fibrillation c What clinical sign does the nurse find when assessing a client with right-sided HF? 36 A. A dry Cough B. Clubbing C. Pulmonary crackles D. Leg Edema D The nurse is concerned about a deteriorating client. Which signs of cardiogenic shock does the nurse expect? Select all that apply 1. HR of 126bpm 2. Urine Output 20ml/hr 3. cool and moist skin 4. bounding pedal pulse 88/46 1, 2, 3, 5 A client with HF is prescribed lisinopril (Prinivil, Zestril) at discharge. Which teaching does the nurse include for this medication? select all that apply 1. This drug may contribute to hyperkalemia 2. This drug can make it easier to exercise 3. report a cough immediately 4. it relaxes blood vessels which lower bp 5. it is safe to take during pregnancy 1, 2, 3, 4 Ace inhibitors affect the kidney and may cause hyperkalemia A nurse cares for a client with severe acute left sided HF. the nurse includes which nursing intervention in the care plan? 1. Reduce stress in the environment 2. limit fluid intake to 1500ml daily 3. administer dobutamine as prescribed te the legs higher than the heart 5. administer furosemide as prescribed 1, 2, 3, 5 37