Nursing 104 – Vascular, Hematologic, and
Cardiac Disorders Comprehensive Review Study
Guide 2025/2026 Verified Questions with
Answers and Rationales
1. A nurse is assessing a client with suspected infective endocarditis. Which of
the following findings should the nurse expect?
A. Hypertension and bradycardia
B. Fever, new or changing heart murmur, and Janeway lesions
C. Peripheral edema and jugular venous distention
D. Dry cough and pleuritic chest pain
Rationale: Infective endocarditis is characterized by fever, new or changing heart
murmurs, and vascular phenomena such as Janeway lesions (painless hemorrhagic
lesions on palms/soles), Osler's nodes (tender subcutaneous nodules on
fingers/toes), and splinter hemorrhages. Hypertension and bradycardia are not
hallmark findings. Peripheral edema and JVD suggest heart failure. Dry cough and
pleuritic chest pain suggest pericarditis or pulmonary conditions.
2. A nurse is providing discharge teaching to a female client who has infective
endocarditis. Which of the following statements by the client indicates an
understanding of the teaching?
A. "I can stop my antibiotics when I feel better."
B. "I will notify my doctor before I have dental procedures."
C. "I do not need to worry about this infection recurring."
D. "I can resume normal activities immediately."
Rationale: Clients with infective endocarditis require antibiotic prophylaxis before
invasive dental procedures to prevent recurrence. Antibiotics must be completed as
prescribed; stopping early can lead to resistance or treatment failure. Recurrence is
a significant risk, and activity should be gradually increased based on cardiac
status.
,3. A nurse is examining the ECG of a client who is having an acute myocardial
infarction. The nurse should identify that elevated ST segments on the ECG
indicate which of the following?
A. Myocardial necrosis
B. Electrolyte imbalance
C. Pericardial effusion
D. Ventricular hypertrophy
Rationale: ST-segment elevation on ECG indicates acute myocardial injury and
necrosis, typically seen in STEMI (ST-elevation myocardial infarction). The
elevated ST segment reflects transmural ischemia and current of injury. Electrolyte
imbalances (e.g., hyperkalemia) cause peaked T waves, not ST elevation.
Pericardial effusion may show low voltage QRS or electrical alternans.
4. A client who has thrombocytopenia asks the nurse why platelets are so
important. Which of the following responses should the nurse make?
A. "Platelets carry oxygen to your tissues."
B. "Platelets help fight off infections."
C. "Platelets plug breaks in blood vessels to stop bleeding."
D. "Platelets regulate your blood pressure."
Rationale: Platelets (thrombocytes) are essential for hemostasis. They aggregate at
sites of vascular injury to form platelet plugs, which are the first step in stopping
bleeding. Oxygen transport is the function of RBCs (hemoglobin). Infection
fighting is the role of WBCs. Blood pressure regulation involves the cardiovascular
system and hormones (e.g., renin-angiotensin system).
5. A nurse is providing teaching about lifestyle changes to a client who
experienced a myocardial infarction and has a new prescription for a beta-
blocker. Which of the following client statements indicates an understanding
of the teaching?
A. "I will take this medication only when I have chest pain."
B. "Before taking my medication, I will count my radial pulse rate."
,C. "I can stop this medication if I feel dizzy."
D. "This medication will cure my heart disease."
Rationale: Beta-blockers decrease heart rate and contractility. Clients should
monitor their pulse before taking the medication and notify the provider if the
pulse is below the prescribed parameter (typically <60 bpm). Beta-blockers are
taken daily, not PRN. Abrupt withdrawal can cause rebound tachycardia and
hypertension. Beta-blockers manage symptoms and reduce mortality but do not
cure heart disease.
6. A nurse in a clinic is assessing the lower extremities of a client who has a
history of peripheral arterial disease (PAD). Which of the following findings
should the nurse expect?
A. Dry, pale skin with minimal body hair
B. Warm, edematous extremities with brown pigmentation
C. Thick, yellow toenails with bounding pulses
D. Rosy pink skin with strong hair growth
Rationale: PAD causes arterial insufficiency leading to dry, pale, shiny skin,
diminished hair growth, and cool extremities. Thick, yellow nails are also common
due to poor perfusion. Warm, edematous extremities with brown pigmentation
suggest venous insufficiency. Bounding pulses are not expected in PAD.
7. While participating in a community health fair, a nurse is providing
information to a client who has a blood pressure of 150/90 mmHg during
screening. Which of the following actions should the nurse take?
A. Start the client on antihypertensive medication immediately
B. Give the client a written record of his BP to bring to his provider
C. Instruct the client to return for rechecking in 1 year
D. Diagnose the client with hypertension
Rationale: A single elevated reading in a community setting requires follow-up
with the client's primary provider. Nurses cannot diagnose or prescribe medication.
The client should be referred for further evaluation. Rechecking should occur
sooner than 1 year.
, 8. A nurse is caring for a client who is postoperative following vein ligation
and stripping for varicose veins. Which of the following actions should the
nurse take?
A. Position the client supine with his legs elevated when in bed
B. Encourage the client to ambulate for 15 min every hour while awake for the first
24 hr
C. Tell the client to sit with his legs dependent after ambulating
D. Instruct the client to wear knee-length socks for 2 weeks after surgery
Rationale: After vein ligation and stripping, leg elevation promotes venous return
and reduces edema. Ambulation should be encouraged but not excessively in the
first 24 hours. Legs should not be kept dependent as this increases venous stasis.
The client should wear thigh-high (not knee-length) compression stockings as
prescribed.
9. A nurse is caring for a client on a telemetry unit who has an irregular radial
pulse. Which of the following ECG abnormalities should the nurse recognize
as atrial flutter?
A. P waves occurring at 0.16 seconds before each QRS complex
B. Atrial rate of 300/min with QRS complex of 80/min
C. Ventricular rate of 82/min with an atrial rate of 80/min
D. An irregular ventricular rate of 125/min with a wide QRS pattern
Rationale: Atrial flutter is characterized by a rapid atrial rate (typically 250–
350/min) with a slower ventricular response due to AV node blocking some
impulses. The classic "sawtooth" flutter waves are seen. Option A describes
normal sinus rhythm. Option C describes sinus rhythm. Option D describes atrial
fibrillation with a rapid ventricular response.
10. A nurse is assessing a client who has pericarditis. Which of the following
findings is most characteristic of this condition?
A. Sharp, pleuritic chest pain that worsens when lying flat and improves when
leaning forward
Cardiac Disorders Comprehensive Review Study
Guide 2025/2026 Verified Questions with
Answers and Rationales
1. A nurse is assessing a client with suspected infective endocarditis. Which of
the following findings should the nurse expect?
A. Hypertension and bradycardia
B. Fever, new or changing heart murmur, and Janeway lesions
C. Peripheral edema and jugular venous distention
D. Dry cough and pleuritic chest pain
Rationale: Infective endocarditis is characterized by fever, new or changing heart
murmurs, and vascular phenomena such as Janeway lesions (painless hemorrhagic
lesions on palms/soles), Osler's nodes (tender subcutaneous nodules on
fingers/toes), and splinter hemorrhages. Hypertension and bradycardia are not
hallmark findings. Peripheral edema and JVD suggest heart failure. Dry cough and
pleuritic chest pain suggest pericarditis or pulmonary conditions.
2. A nurse is providing discharge teaching to a female client who has infective
endocarditis. Which of the following statements by the client indicates an
understanding of the teaching?
A. "I can stop my antibiotics when I feel better."
B. "I will notify my doctor before I have dental procedures."
C. "I do not need to worry about this infection recurring."
D. "I can resume normal activities immediately."
Rationale: Clients with infective endocarditis require antibiotic prophylaxis before
invasive dental procedures to prevent recurrence. Antibiotics must be completed as
prescribed; stopping early can lead to resistance or treatment failure. Recurrence is
a significant risk, and activity should be gradually increased based on cardiac
status.
,3. A nurse is examining the ECG of a client who is having an acute myocardial
infarction. The nurse should identify that elevated ST segments on the ECG
indicate which of the following?
A. Myocardial necrosis
B. Electrolyte imbalance
C. Pericardial effusion
D. Ventricular hypertrophy
Rationale: ST-segment elevation on ECG indicates acute myocardial injury and
necrosis, typically seen in STEMI (ST-elevation myocardial infarction). The
elevated ST segment reflects transmural ischemia and current of injury. Electrolyte
imbalances (e.g., hyperkalemia) cause peaked T waves, not ST elevation.
Pericardial effusion may show low voltage QRS or electrical alternans.
4. A client who has thrombocytopenia asks the nurse why platelets are so
important. Which of the following responses should the nurse make?
A. "Platelets carry oxygen to your tissues."
B. "Platelets help fight off infections."
C. "Platelets plug breaks in blood vessels to stop bleeding."
D. "Platelets regulate your blood pressure."
Rationale: Platelets (thrombocytes) are essential for hemostasis. They aggregate at
sites of vascular injury to form platelet plugs, which are the first step in stopping
bleeding. Oxygen transport is the function of RBCs (hemoglobin). Infection
fighting is the role of WBCs. Blood pressure regulation involves the cardiovascular
system and hormones (e.g., renin-angiotensin system).
5. A nurse is providing teaching about lifestyle changes to a client who
experienced a myocardial infarction and has a new prescription for a beta-
blocker. Which of the following client statements indicates an understanding
of the teaching?
A. "I will take this medication only when I have chest pain."
B. "Before taking my medication, I will count my radial pulse rate."
,C. "I can stop this medication if I feel dizzy."
D. "This medication will cure my heart disease."
Rationale: Beta-blockers decrease heart rate and contractility. Clients should
monitor their pulse before taking the medication and notify the provider if the
pulse is below the prescribed parameter (typically <60 bpm). Beta-blockers are
taken daily, not PRN. Abrupt withdrawal can cause rebound tachycardia and
hypertension. Beta-blockers manage symptoms and reduce mortality but do not
cure heart disease.
6. A nurse in a clinic is assessing the lower extremities of a client who has a
history of peripheral arterial disease (PAD). Which of the following findings
should the nurse expect?
A. Dry, pale skin with minimal body hair
B. Warm, edematous extremities with brown pigmentation
C. Thick, yellow toenails with bounding pulses
D. Rosy pink skin with strong hair growth
Rationale: PAD causes arterial insufficiency leading to dry, pale, shiny skin,
diminished hair growth, and cool extremities. Thick, yellow nails are also common
due to poor perfusion. Warm, edematous extremities with brown pigmentation
suggest venous insufficiency. Bounding pulses are not expected in PAD.
7. While participating in a community health fair, a nurse is providing
information to a client who has a blood pressure of 150/90 mmHg during
screening. Which of the following actions should the nurse take?
A. Start the client on antihypertensive medication immediately
B. Give the client a written record of his BP to bring to his provider
C. Instruct the client to return for rechecking in 1 year
D. Diagnose the client with hypertension
Rationale: A single elevated reading in a community setting requires follow-up
with the client's primary provider. Nurses cannot diagnose or prescribe medication.
The client should be referred for further evaluation. Rechecking should occur
sooner than 1 year.
, 8. A nurse is caring for a client who is postoperative following vein ligation
and stripping for varicose veins. Which of the following actions should the
nurse take?
A. Position the client supine with his legs elevated when in bed
B. Encourage the client to ambulate for 15 min every hour while awake for the first
24 hr
C. Tell the client to sit with his legs dependent after ambulating
D. Instruct the client to wear knee-length socks for 2 weeks after surgery
Rationale: After vein ligation and stripping, leg elevation promotes venous return
and reduces edema. Ambulation should be encouraged but not excessively in the
first 24 hours. Legs should not be kept dependent as this increases venous stasis.
The client should wear thigh-high (not knee-length) compression stockings as
prescribed.
9. A nurse is caring for a client on a telemetry unit who has an irregular radial
pulse. Which of the following ECG abnormalities should the nurse recognize
as atrial flutter?
A. P waves occurring at 0.16 seconds before each QRS complex
B. Atrial rate of 300/min with QRS complex of 80/min
C. Ventricular rate of 82/min with an atrial rate of 80/min
D. An irregular ventricular rate of 125/min with a wide QRS pattern
Rationale: Atrial flutter is characterized by a rapid atrial rate (typically 250–
350/min) with a slower ventricular response due to AV node blocking some
impulses. The classic "sawtooth" flutter waves are seen. Option A describes
normal sinus rhythm. Option C describes sinus rhythm. Option D describes atrial
fibrillation with a rapid ventricular response.
10. A nurse is assessing a client who has pericarditis. Which of the following
findings is most characteristic of this condition?
A. Sharp, pleuritic chest pain that worsens when lying flat and improves when
leaning forward
