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ATI ADULT MEDICAL SURGICAL NURSING – UNIT 4 Cardiovascular System
120 Questions with Rationales
SECTION 1: CARDIOVASCULAR ASSESSMENT & DIAGNOSTICS
1. A nurse is auscultating heart sounds. The S1 heart sound is
caused by:
A. Closure of the aortic and pulmonic valves
B. Closure of the mitral and tricuspid valves
C. Opening of the mitral and tricuspid valves
D. Filling of the ventricles
Answer: B
Rationale: S1 is the "lub" sound caused by closure of the
atrioventricular (mitral and tricuspid) valves at the beginning of
ventricular systole.
2. Which of the following is a normal finding when assessing the
cardiovascular system?
A. S3 gallop in an older adult
B. Apical impulse at the fifth intercostal space, midclavicular line
C. Jugular venous distention when supine at 45 degrees
D. A bruit over the carotid artery
Answer: B
Rationale: The point of maximal impulse (PMI) is normally at
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the 5th ICS, midclavicular line. S3 in older adults, JVD at 45°,
and carotid bruits are abnormal.
3. A nurse is assessing a client's jugular veins. The client should
be positioned at:
A. 15 degrees
B. 30–45 degrees
C. 90 degrees
D. Flat
Answer: B
Rationale: Jugular venous pressure is assessed with the head of
bed elevated 30–45 degrees to visualize the internal jugular
vein.
4. Which laboratory test is most specific for myocardial
infarction?
A. CK-MB
B. Troponin I or T
C. Myoglobin
D. LDH
Answer: B
Rationale: Cardiac troponins are the most specific and sensitive
biomarkers for myocardial injury; they remain elevated longer.
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5. A client is scheduled for a cardiac catheterization. Which
nursing action is most important before the procedure?
A. Assess for allergies to iodine or shellfish
B. Give a full meal
C. Encourage ambulation
D. Withhold all fluids for 24 hours
Answer: A
Rationale: Contrast dye used during cardiac catheterization
contains iodine; allergy assessment is essential. NPO status is
usually 6–8 hours, not 24.
6. After a cardiac catheterization via the femoral artery, the
nurse should:
A. Keep the affected leg extended and monitor the puncture
site
B. Allow the client to ambulate immediately
C. Place the client in high Fowler's position
D. Remove the dressing after 2 hours
Answer: A
Rationale: The affected leg should be kept straight to prevent
hematoma; bed rest and site monitoring are required.
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7. Which finding after cardiac catheterization requires
immediate intervention?
A. Mild bruising at the puncture site
B. The client reports chest pain and the site has expanding
hematoma
C. Slight oozing that stops with pressure
D. Pulse 80 bpm
Answer: B
Rationale: Chest pain and expanding hematoma may indicate
arterial dissection or retroperitoneal bleeding; requires
immediate action.
8. A nurse is preparing a client for an echocardiogram. Which
statement is accurate?
A. "You will need to be NPO for 12 hours."
B. "This test uses sound waves to evaluate heart structure and
function."
C. "You will receive contrast dye through an IV."
D. "You will need to lie still for 4 hours after."
Answer: B
Rationale: Echocardiography uses ultrasound; no NPO or
contrast needed for standard transthoracic echo.
ATI ADULT MEDICAL SURGICAL NURSING – UNIT 4 Cardiovascular System
120 Questions with Rationales
SECTION 1: CARDIOVASCULAR ASSESSMENT & DIAGNOSTICS
1. A nurse is auscultating heart sounds. The S1 heart sound is
caused by:
A. Closure of the aortic and pulmonic valves
B. Closure of the mitral and tricuspid valves
C. Opening of the mitral and tricuspid valves
D. Filling of the ventricles
Answer: B
Rationale: S1 is the "lub" sound caused by closure of the
atrioventricular (mitral and tricuspid) valves at the beginning of
ventricular systole.
2. Which of the following is a normal finding when assessing the
cardiovascular system?
A. S3 gallop in an older adult
B. Apical impulse at the fifth intercostal space, midclavicular line
C. Jugular venous distention when supine at 45 degrees
D. A bruit over the carotid artery
Answer: B
Rationale: The point of maximal impulse (PMI) is normally at
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the 5th ICS, midclavicular line. S3 in older adults, JVD at 45°,
and carotid bruits are abnormal.
3. A nurse is assessing a client's jugular veins. The client should
be positioned at:
A. 15 degrees
B. 30–45 degrees
C. 90 degrees
D. Flat
Answer: B
Rationale: Jugular venous pressure is assessed with the head of
bed elevated 30–45 degrees to visualize the internal jugular
vein.
4. Which laboratory test is most specific for myocardial
infarction?
A. CK-MB
B. Troponin I or T
C. Myoglobin
D. LDH
Answer: B
Rationale: Cardiac troponins are the most specific and sensitive
biomarkers for myocardial injury; they remain elevated longer.
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5. A client is scheduled for a cardiac catheterization. Which
nursing action is most important before the procedure?
A. Assess for allergies to iodine or shellfish
B. Give a full meal
C. Encourage ambulation
D. Withhold all fluids for 24 hours
Answer: A
Rationale: Contrast dye used during cardiac catheterization
contains iodine; allergy assessment is essential. NPO status is
usually 6–8 hours, not 24.
6. After a cardiac catheterization via the femoral artery, the
nurse should:
A. Keep the affected leg extended and monitor the puncture
site
B. Allow the client to ambulate immediately
C. Place the client in high Fowler's position
D. Remove the dressing after 2 hours
Answer: A
Rationale: The affected leg should be kept straight to prevent
hematoma; bed rest and site monitoring are required.
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7. Which finding after cardiac catheterization requires
immediate intervention?
A. Mild bruising at the puncture site
B. The client reports chest pain and the site has expanding
hematoma
C. Slight oozing that stops with pressure
D. Pulse 80 bpm
Answer: B
Rationale: Chest pain and expanding hematoma may indicate
arterial dissection or retroperitoneal bleeding; requires
immediate action.
8. A nurse is preparing a client for an echocardiogram. Which
statement is accurate?
A. "You will need to be NPO for 12 hours."
B. "This test uses sound waves to evaluate heart structure and
function."
C. "You will receive contrast dye through an IV."
D. "You will need to lie still for 4 hours after."
Answer: B
Rationale: Echocardiography uses ultrasound; no NPO or
contrast needed for standard transthoracic echo.
