Cardiac Cath Lab RN A – Comprehensive Practice
Exam 2026 A+ GRADED
Pre-Procedure & Patient Assessment (Questions 1-
20)
1. A patient is scheduled for a cardiac catheterization. Which of the following pre-procedure
lab values is MOST critical for the nurse to review to prevent a common post-procedure
complication?
A. White Blood Cell count (WBC)
B. Hemoglobin A1c
C. Blood Urea Nitrogen (BUN) and Creatinine
D. Liver function tests (ALT/AST)
-Correct Answer-: C
Rationale: Contrast-induced nephropathy (CIN) is a significant risk associated with contrast
media used during catheterization. Reviewing baseline renal function (BUN and creatinine) is
essential to identify at-risk patients and implement preventive measures like hydration .
2. A patient is being prepared for a left heart catheterization via the femoral approach. Which
finding is an absolute contraindication for this procedure?
A. A history of hypertension controlled with medication
,B. An active infection at the groin puncture site
C. A documented allergy to shellfish
D. A previous coronary artery bypass graft (CABG) surgery
-Correct Answer-: B
Rationale: An active infection at the planned access site is an absolute contraindication due to
the high risk of introducing bacteria into the bloodstream, which could lead to sepsis . Allergies
can be managed with pre-medication, and previous surgeries or controlled hypertension do not
necessarily preclude the procedure.
3. Prior to a patient's first cardiac catheterization, the nurse provides teaching. Which
statement by the patient indicates a correct understanding of the procedure?
A. "I will receive general anesthesia and be completely asleep."
B. "I probably will feel tired afterward from lying on a hard table for a while."
C. "It will be very painful when the catheter is first put in."
D. "The procedure will take place in a standard operating room."
-Correct Answer-: B
Rationale: Patients are typically awake but receive moderate sedation. They may feel pressure
but not sharp pain. The procedure is performed in a specialized cath lab, not an OR. Lying still
on a firm table can indeed lead to fatigue afterward .
4. What is the primary purpose of performing an Allen's test before a radial artery
catheterization?
A. To assess for patency of the ulnar artery
,B. To measure the patient's baseline oxygen saturation
C. To determine the appropriate size of the radial sheath
D. To check for any radial artery pulse
-Correct Answer-: A
Rationale: The Allen's test (or modified Allen's test) evaluates the competence of the ulnar
artery and the palmar arch to ensure collateral blood flow to the hand exists. If the ulnar artery
cannot adequately perfuse the hand, occluding the radial artery with a sheath could cause
ischemia .
5. A patient with a documented iodine allergy is scheduled for a procedure requiring contrast.
What is the most common pre-medication regimen ordered?
A. Diphenhydramine (Benadryl) and a corticosteroid
B. Epinephrine and atropine
C. Furosemide (Lasix) and normal saline
D. Acetaminophen (Tylenol) and ibuprofen (Motrin)
-Correct Answer-: A
Rationale: For patients with a known contrast allergy, pre-medication with corticosteroids (e.g.,
prednisone) and antihistamines (e.g., diphenhydramine) is standard practice to reduce the risk
and severity of an allergic reaction .
6. The "time-out" is performed immediately before skin incision. Which elements must be
verified during this process?
A. The patient's preferred language and dietary restrictions
, B. The patient's insurance authorization and discharge plan
C. The correct patient, correct procedure, and correct site
D. The names of the patient's family members in the waiting room
-Correct Answer-: C
Rationale: The universal protocol, mandated by The Joint Commission, requires a final
verification of the correct patient, procedure, site, and side, as well as ensuring all equipment
and implants are available, before any invasive procedure begins .
7. The "ALARA" principle is a fundamental safety concept in the cath lab. What does it stand
for?
A. Always Lower Activated Clotting Time
B. A Left Anterior Oblique Angiographic view
C. A specific type of low-osmolar contrast media
D. As Low As Reasonably Achievable
-Correct Answer-: D
Rationale: ALARA is the guiding principle of radiation safety, meaning that all reasonable
methods should be used to minimize radiation exposure to patients and staff, such as using
shielding, limiting fluoroscopy time, and maximizing distance from the source .
8. A patient’s pre-procedure INR (International Normalized Ratio) is 3.2. Why is this value of
significant concern?
A. It indicates the patient has a high risk for developing a thrombus during the case.
B. It increases the patient's risk of bleeding from the arterial access site.
Exam 2026 A+ GRADED
Pre-Procedure & Patient Assessment (Questions 1-
20)
1. A patient is scheduled for a cardiac catheterization. Which of the following pre-procedure
lab values is MOST critical for the nurse to review to prevent a common post-procedure
complication?
A. White Blood Cell count (WBC)
B. Hemoglobin A1c
C. Blood Urea Nitrogen (BUN) and Creatinine
D. Liver function tests (ALT/AST)
-Correct Answer-: C
Rationale: Contrast-induced nephropathy (CIN) is a significant risk associated with contrast
media used during catheterization. Reviewing baseline renal function (BUN and creatinine) is
essential to identify at-risk patients and implement preventive measures like hydration .
2. A patient is being prepared for a left heart catheterization via the femoral approach. Which
finding is an absolute contraindication for this procedure?
A. A history of hypertension controlled with medication
,B. An active infection at the groin puncture site
C. A documented allergy to shellfish
D. A previous coronary artery bypass graft (CABG) surgery
-Correct Answer-: B
Rationale: An active infection at the planned access site is an absolute contraindication due to
the high risk of introducing bacteria into the bloodstream, which could lead to sepsis . Allergies
can be managed with pre-medication, and previous surgeries or controlled hypertension do not
necessarily preclude the procedure.
3. Prior to a patient's first cardiac catheterization, the nurse provides teaching. Which
statement by the patient indicates a correct understanding of the procedure?
A. "I will receive general anesthesia and be completely asleep."
B. "I probably will feel tired afterward from lying on a hard table for a while."
C. "It will be very painful when the catheter is first put in."
D. "The procedure will take place in a standard operating room."
-Correct Answer-: B
Rationale: Patients are typically awake but receive moderate sedation. They may feel pressure
but not sharp pain. The procedure is performed in a specialized cath lab, not an OR. Lying still
on a firm table can indeed lead to fatigue afterward .
4. What is the primary purpose of performing an Allen's test before a radial artery
catheterization?
A. To assess for patency of the ulnar artery
,B. To measure the patient's baseline oxygen saturation
C. To determine the appropriate size of the radial sheath
D. To check for any radial artery pulse
-Correct Answer-: A
Rationale: The Allen's test (or modified Allen's test) evaluates the competence of the ulnar
artery and the palmar arch to ensure collateral blood flow to the hand exists. If the ulnar artery
cannot adequately perfuse the hand, occluding the radial artery with a sheath could cause
ischemia .
5. A patient with a documented iodine allergy is scheduled for a procedure requiring contrast.
What is the most common pre-medication regimen ordered?
A. Diphenhydramine (Benadryl) and a corticosteroid
B. Epinephrine and atropine
C. Furosemide (Lasix) and normal saline
D. Acetaminophen (Tylenol) and ibuprofen (Motrin)
-Correct Answer-: A
Rationale: For patients with a known contrast allergy, pre-medication with corticosteroids (e.g.,
prednisone) and antihistamines (e.g., diphenhydramine) is standard practice to reduce the risk
and severity of an allergic reaction .
6. The "time-out" is performed immediately before skin incision. Which elements must be
verified during this process?
A. The patient's preferred language and dietary restrictions
, B. The patient's insurance authorization and discharge plan
C. The correct patient, correct procedure, and correct site
D. The names of the patient's family members in the waiting room
-Correct Answer-: C
Rationale: The universal protocol, mandated by The Joint Commission, requires a final
verification of the correct patient, procedure, site, and side, as well as ensuring all equipment
and implants are available, before any invasive procedure begins .
7. The "ALARA" principle is a fundamental safety concept in the cath lab. What does it stand
for?
A. Always Lower Activated Clotting Time
B. A Left Anterior Oblique Angiographic view
C. A specific type of low-osmolar contrast media
D. As Low As Reasonably Achievable
-Correct Answer-: D
Rationale: ALARA is the guiding principle of radiation safety, meaning that all reasonable
methods should be used to minimize radiation exposure to patients and staff, such as using
shielding, limiting fluoroscopy time, and maximizing distance from the source .
8. A patient’s pre-procedure INR (International Normalized Ratio) is 3.2. Why is this value of
significant concern?
A. It indicates the patient has a high risk for developing a thrombus during the case.
B. It increases the patient's risk of bleeding from the arterial access site.
