Med-Surg Nsg: Cardiovascular Review Questions
Med-Surg: Cardiovascular Review Questions
Terms in this set (575)
1. A client complains of crushing chest pain Answer: 1. Aspirin, oxygen, nitroglycerin, and morphine
that radiates to his left arm. He should be
presented with the following treatment:
1. Aspirin, oxygen, nitroglycerin, and
morphine
2. Aspirin, oxygen, nitroglycerin, and
codeine
3. Oxygen, nitroglycerin, meperidine, and
thrombolytics
4. Aspirin, oxygen, nitroprusside, and
morphine
2. Which lifestyle changes should a client Answer: 4. All of the Above
diagnosed with coronary artery disease
consider?
1. Smoking cessation
2. Establishing a regular exercise routine
3. Weight reduction
4. All of the Above
3. A client's cardiac monitor alarm sounds, Answer: 2. Assess the client.
indicating ventricular tachycardia. The
nurse should:
1. perform immediate defibrillation.
2. Assess the client.
3. Call the physician.
4. Administer a precordial thump.
4. A complication of peripheral vascular Answer: 1. stasis ulcer.
disease may be:
1. stasis ulcer.
2. Pressure ulcer.
3. Gastric ulcer.
4. Duodenal ulcer.
5. A key diagnostic test for heart failure is: Answer: 2. B-type natriuretic peptide.
1. serum potassium.
2. B-type natriuretic peptide.
3. Troponin I
4. cardiac enzymes.
Med-Surg Nsg: Cardiovascular Review Questions
,6. While auscultating the heart sounds of a Answer: 2. S3.
client with mitral insufficiency, the nurse Rationale: An S3, is heard following an S2. This indicates that the client is
hears an extra heart sound immediately experiencing heart failure and results from increased filling pressures. An S1 is a
after the S2. The nurse should document normal heart sound made by the closing of the mitral and tricuspid valves. An S4 is
this extra heart sound as a: heard before S1 and is caused by resistance to ventricular filling. A murmur of mitral
1. S1. insufficiency occurs during systole and is heard when there's turbulent blood flow
2. S3. across the valve.
3. S4.
4. mitral murmur.
7. A nurse administers heparin to a client Answer: 1. PTT
with deep vein thrombophlebitis. Which Rationale: The therapeutic effectiveness of heparin is determined by monitoring the
laboratory value should the nurse monitor patient's PTT, PT, HCT, and CBC don't monitor the therapeutic effectiveness of
to determine the effectiveness of heparin? heparin. Monitoring the PT determines warfarin's effectiveness.
1. PTT
2. HCT
3. CBC
4. PT
Answer. 3. Monitor peripheral pulses.
8. A client has just returned from cardiac
Rationale: After cardiac catheterization, monitor peripheral pulses to assess
catheterization. Which nursing intervention
peripheral perfusion. Helping the client ambulate to the bathroom is incorrect
would be most appropriate?
because the client should be on bed rest for 4 to 8 hours after the procedure to
1. Help the client ambulate to the
reduce the risk of bleeding at the insertion site. Restricting fluids is incorrect because
bathroom.
the client should be encouraged to drink fluids after the procedure, unless
2. Restrict fluids.
contraindicated. Adequate hydration reduces the risk of nephrotoxicity that can
3. Monitor peripheral pulses.
occur with the use of contrast dye. Although urine output is monitored following
4. Insert an indwelling urinary catheter.
cardiac catheterization, the insertion of a urinary catherter isn't necessary.
9. A client is in the first postoperative day Answer: 3. On his right side
after left femoropopliteal revascularization. Rationale: Following revascularization, avoid positioning the client on the surgical
Which position would be most appropriate side. Because this client had left femoropoliteal revascularization, he may be
for this client? positioned on the right side. Placing the client on the left side is incorrect because
1. On his left-sided this would position the client on the operative side. Positioning the client in high
2. In high Fowler's position Fowler's position is incorrect because the client should avoid flexion at the surgical
3. On his right side site. Placing the client in a left lateral decubitus position is incorrect because this
4. In a left lateral decubitus position would place the client on the surgical side and cause flexion at the site.
Med-Surg: Cardiovascular Review Questions
,10. A nurse is evaluating a client with left- Answer: 2. Dyspnea
sided heart failure. Which finding should Rationale: Dyspnea may occur in a client with left-sided heart failure. Ascites,
the nurse expect to assess? hepatomegaly, and jugular vein distention are assessment findings in right-sided
1. Ascites heart failure.
2. Dyspnea
3. Hepatomegaly
4. Jugular vein distention
11. A client has developed acute pulmonary Answer: 1. Interstitial edema by chest X-ray
edema. Which test result should the nurse Rationale: The chest X-ray of a client with acute pulmonary edema shows interstitial
expect? edema as a result of the heart's failure to pump adequately. Metabolic alkalosis is
1. Interstitial edema by chest X-ray incorrect because the ABG analysis of a client in acute pulmonary edema shows
2. Metabolic alkalosis by ABG analysis respiratory alkalosis or acidosis. Bradycardia is incorrect because the ECG would
3. Bradycardia by ECG most likely indicate tachycardia. Decreased PAWP is incorrect because PAWP rises in
4. Decreased PAWP by hemodynamic the client with acute pulmonary edema.
monitoring
12. A nurse is performing discharge Answer: 2. begin a daily walking program
teaching for a client with PVD. The nurse Rationale: The nurse should encourage the client with PVD to follow a program of
should teach the client to: walking and other leg exercises. Inspecting the feet weekly is incorrect because the
1. inspect his feet weekly nurse should teach the client to inspect his feet daily. Wearing constrictive clothing is
2. begin a daily walking program incorrect because the client should wear loose clothing that doesn't restrict
3. wear constrictive clothing circulation. Standing when possible—rather than sitting—is incorrect because the
4. stand rather than sit when possible client should avoid standing for long periods.
13. If a nurse knows a client's heart rate, Answer: Stroke Volume
what other value and formula does she Rationale: Cardiac output equals stroke volume (the amount of blood ejected with
need to know to calculate CO? each beat) times heart rate. [CO = SV X HR]
14. A client comes to the clinic and states Answer: 3. ACE inhibitors
he has a history of hypertension. Which Rationale: ACE inhibitors may be prescribed to help control high blood pressure.
type of medication might the nurse expect Other types of medications that may be prescribed include diuretics, calcium
the client to be taking to control his blood channel blockers, angiotensin II receptor blockers, and beta-adrenergic blockers.
pressure? Antilipemics help lower serum cholesterol levels. Antibiotics are used to fight
1. Antilipemics infection, and antidiabetics help control serum glucose levels.
2. Antibiotics
3. ACE inhibitors
4. Antidiabetics
15. A cardiologist prescribes digoxin Answer: 0.5 tablet(s)
(Lanoxin)125 mcg by mouth every morning Rationale: 0.5 tablets. The nurse should begin by converting 125 mcg to milligrams.
for a client diagnosed with heart failure. 125 mcg / 1,000 = 0.125 mg. The following formula is used to calculate drug dosages:
The pharmacy dispenses tablets that dose on hand / quality on hand = dose desired./ X. The nurse should use the
contain 0.25 mg each. How many tablets following equations: 0.25 mg / 1 tablet = 0.125 mg / X. The equation then becomes
should the nurse administer in each dose? 0.25(x) = 0.125. Which is 0..25 = X = 0.5 tablet
Record your answer using one decimal
place.
, 16. A client is prescribed diltiazem Answer: 2. Lower his heart rate and blood pressure.
(Cardizem) to manage his hypertension. Rationale: Diltiazem, a calcium channel blocker, will reduce both the heart rate and
The nurse should tell the client the blood pressure. It doesn't directly affect urine output.
diltiazem will:
1. lower his blood pressure only.
2. Lower his heart rate and blood pressure.
3. Lower his blood pressure and increase
his urine output
4. lower his heart rate and blood pressure
and increase his urine output.
17. A client reports substernal chest pain. Answer: 1. Improving myocardial oxygenation and reducing cardiac workload.
Test results show electrocardiographic Rationale: The client is exhibiting clinical signs and symptoms of a myocardial
changes and an elevated cardiac troponin infarction (MI); therefore, nursing care should focus on improving myocardial
level. What should be the focus of nursing oxygenation and reducing cardiac workload. Confirming the diagnosis of MI and
care? preventing complications, reducing anxiety and relieving pain, and providing a
1. Improving myocardial oxygenation and nondemanding environment are secondary to improving myocardial oxygenation
reducing cardiac workload. and reducing workload. Stressors can't be eliminated, only reduced.
2. Confirming a suspected diagnosis and
preventing complications.
3. Reducing anxiety and relieving pain.
4. Eliminating stressors and providing a
nondemanding environment.
18. A client with a myocardial infarction and Answer: 3. Aortic valve is closed.
cardiogenic shock is placed on an intra- Rationale: An intra-aortic ballon pump (IAPB) inflates during diastole when the
aortic ballon pump (IAPB). If the device is tricuspid and mitral valves are open and the aortic and pulmonic valves are closed.
functioning properly, the balloon inflates
when the:
1. tricuspid valve is closed.
2. Pulmonic valve is open.
3. Aortic valve is closed.
4. Mitral valve is closed.
19. A client with unstable angina receives Answer: 2. A systolic blood pressure below 90 mm Hg.
routine applications of nitroglycerin Rationale: Nitroglycerin is a vasodilator and can lower arterial blood pressure. As a
ointment. The nurse should delay the next rule, when the client's systolic blood pressure is below 90 mm Hg, the nurse should
dose if the client has: delay the dose and notify the physician. Nitroglycerin isn't contraindicated in a client
1. atrial fibrillation. with atrial fibrillation. Headache, a common occurrence with nitroglycerin isn't a
2. A systolic blood pressure below 90 mm cause for withholding a dose. Application sites should be changed with each dose,
Hg. especially if skin irritation occurs.
3. A headache.
4. Skin redness at the current site.
20. A client experiences acute myocardial Answer: 3. Return of the ST segment to baseline.
ischemia. The nurse administers oxygen and Rationale: During episodes of myocardial ischemia, an ECG may show ST-segmant
sublingual nitroglycerin. When assessing an elevation or depression. With successful treatment, the ST segment should return to
electrocardiogram (ECG) for evidence that baseline. Widening QRS complex, presence of a Q wave, and frequent ectopic beats
blood flow to the myocardium has aren't directly indicative of myocardial ischemia.
improved, the nurse should focus on the:
1. widening of the QRS complex.
2. Frequency of ectopic beats.
3. Return of the ST segment to baseline.
4. Presence of a significant Q wave.
Med-Surg: Cardiovascular Review Questions
Terms in this set (575)
1. A client complains of crushing chest pain Answer: 1. Aspirin, oxygen, nitroglycerin, and morphine
that radiates to his left arm. He should be
presented with the following treatment:
1. Aspirin, oxygen, nitroglycerin, and
morphine
2. Aspirin, oxygen, nitroglycerin, and
codeine
3. Oxygen, nitroglycerin, meperidine, and
thrombolytics
4. Aspirin, oxygen, nitroprusside, and
morphine
2. Which lifestyle changes should a client Answer: 4. All of the Above
diagnosed with coronary artery disease
consider?
1. Smoking cessation
2. Establishing a regular exercise routine
3. Weight reduction
4. All of the Above
3. A client's cardiac monitor alarm sounds, Answer: 2. Assess the client.
indicating ventricular tachycardia. The
nurse should:
1. perform immediate defibrillation.
2. Assess the client.
3. Call the physician.
4. Administer a precordial thump.
4. A complication of peripheral vascular Answer: 1. stasis ulcer.
disease may be:
1. stasis ulcer.
2. Pressure ulcer.
3. Gastric ulcer.
4. Duodenal ulcer.
5. A key diagnostic test for heart failure is: Answer: 2. B-type natriuretic peptide.
1. serum potassium.
2. B-type natriuretic peptide.
3. Troponin I
4. cardiac enzymes.
Med-Surg Nsg: Cardiovascular Review Questions
,6. While auscultating the heart sounds of a Answer: 2. S3.
client with mitral insufficiency, the nurse Rationale: An S3, is heard following an S2. This indicates that the client is
hears an extra heart sound immediately experiencing heart failure and results from increased filling pressures. An S1 is a
after the S2. The nurse should document normal heart sound made by the closing of the mitral and tricuspid valves. An S4 is
this extra heart sound as a: heard before S1 and is caused by resistance to ventricular filling. A murmur of mitral
1. S1. insufficiency occurs during systole and is heard when there's turbulent blood flow
2. S3. across the valve.
3. S4.
4. mitral murmur.
7. A nurse administers heparin to a client Answer: 1. PTT
with deep vein thrombophlebitis. Which Rationale: The therapeutic effectiveness of heparin is determined by monitoring the
laboratory value should the nurse monitor patient's PTT, PT, HCT, and CBC don't monitor the therapeutic effectiveness of
to determine the effectiveness of heparin? heparin. Monitoring the PT determines warfarin's effectiveness.
1. PTT
2. HCT
3. CBC
4. PT
Answer. 3. Monitor peripheral pulses.
8. A client has just returned from cardiac
Rationale: After cardiac catheterization, monitor peripheral pulses to assess
catheterization. Which nursing intervention
peripheral perfusion. Helping the client ambulate to the bathroom is incorrect
would be most appropriate?
because the client should be on bed rest for 4 to 8 hours after the procedure to
1. Help the client ambulate to the
reduce the risk of bleeding at the insertion site. Restricting fluids is incorrect because
bathroom.
the client should be encouraged to drink fluids after the procedure, unless
2. Restrict fluids.
contraindicated. Adequate hydration reduces the risk of nephrotoxicity that can
3. Monitor peripheral pulses.
occur with the use of contrast dye. Although urine output is monitored following
4. Insert an indwelling urinary catheter.
cardiac catheterization, the insertion of a urinary catherter isn't necessary.
9. A client is in the first postoperative day Answer: 3. On his right side
after left femoropopliteal revascularization. Rationale: Following revascularization, avoid positioning the client on the surgical
Which position would be most appropriate side. Because this client had left femoropoliteal revascularization, he may be
for this client? positioned on the right side. Placing the client on the left side is incorrect because
1. On his left-sided this would position the client on the operative side. Positioning the client in high
2. In high Fowler's position Fowler's position is incorrect because the client should avoid flexion at the surgical
3. On his right side site. Placing the client in a left lateral decubitus position is incorrect because this
4. In a left lateral decubitus position would place the client on the surgical side and cause flexion at the site.
Med-Surg: Cardiovascular Review Questions
,10. A nurse is evaluating a client with left- Answer: 2. Dyspnea
sided heart failure. Which finding should Rationale: Dyspnea may occur in a client with left-sided heart failure. Ascites,
the nurse expect to assess? hepatomegaly, and jugular vein distention are assessment findings in right-sided
1. Ascites heart failure.
2. Dyspnea
3. Hepatomegaly
4. Jugular vein distention
11. A client has developed acute pulmonary Answer: 1. Interstitial edema by chest X-ray
edema. Which test result should the nurse Rationale: The chest X-ray of a client with acute pulmonary edema shows interstitial
expect? edema as a result of the heart's failure to pump adequately. Metabolic alkalosis is
1. Interstitial edema by chest X-ray incorrect because the ABG analysis of a client in acute pulmonary edema shows
2. Metabolic alkalosis by ABG analysis respiratory alkalosis or acidosis. Bradycardia is incorrect because the ECG would
3. Bradycardia by ECG most likely indicate tachycardia. Decreased PAWP is incorrect because PAWP rises in
4. Decreased PAWP by hemodynamic the client with acute pulmonary edema.
monitoring
12. A nurse is performing discharge Answer: 2. begin a daily walking program
teaching for a client with PVD. The nurse Rationale: The nurse should encourage the client with PVD to follow a program of
should teach the client to: walking and other leg exercises. Inspecting the feet weekly is incorrect because the
1. inspect his feet weekly nurse should teach the client to inspect his feet daily. Wearing constrictive clothing is
2. begin a daily walking program incorrect because the client should wear loose clothing that doesn't restrict
3. wear constrictive clothing circulation. Standing when possible—rather than sitting—is incorrect because the
4. stand rather than sit when possible client should avoid standing for long periods.
13. If a nurse knows a client's heart rate, Answer: Stroke Volume
what other value and formula does she Rationale: Cardiac output equals stroke volume (the amount of blood ejected with
need to know to calculate CO? each beat) times heart rate. [CO = SV X HR]
14. A client comes to the clinic and states Answer: 3. ACE inhibitors
he has a history of hypertension. Which Rationale: ACE inhibitors may be prescribed to help control high blood pressure.
type of medication might the nurse expect Other types of medications that may be prescribed include diuretics, calcium
the client to be taking to control his blood channel blockers, angiotensin II receptor blockers, and beta-adrenergic blockers.
pressure? Antilipemics help lower serum cholesterol levels. Antibiotics are used to fight
1. Antilipemics infection, and antidiabetics help control serum glucose levels.
2. Antibiotics
3. ACE inhibitors
4. Antidiabetics
15. A cardiologist prescribes digoxin Answer: 0.5 tablet(s)
(Lanoxin)125 mcg by mouth every morning Rationale: 0.5 tablets. The nurse should begin by converting 125 mcg to milligrams.
for a client diagnosed with heart failure. 125 mcg / 1,000 = 0.125 mg. The following formula is used to calculate drug dosages:
The pharmacy dispenses tablets that dose on hand / quality on hand = dose desired./ X. The nurse should use the
contain 0.25 mg each. How many tablets following equations: 0.25 mg / 1 tablet = 0.125 mg / X. The equation then becomes
should the nurse administer in each dose? 0.25(x) = 0.125. Which is 0..25 = X = 0.5 tablet
Record your answer using one decimal
place.
, 16. A client is prescribed diltiazem Answer: 2. Lower his heart rate and blood pressure.
(Cardizem) to manage his hypertension. Rationale: Diltiazem, a calcium channel blocker, will reduce both the heart rate and
The nurse should tell the client the blood pressure. It doesn't directly affect urine output.
diltiazem will:
1. lower his blood pressure only.
2. Lower his heart rate and blood pressure.
3. Lower his blood pressure and increase
his urine output
4. lower his heart rate and blood pressure
and increase his urine output.
17. A client reports substernal chest pain. Answer: 1. Improving myocardial oxygenation and reducing cardiac workload.
Test results show electrocardiographic Rationale: The client is exhibiting clinical signs and symptoms of a myocardial
changes and an elevated cardiac troponin infarction (MI); therefore, nursing care should focus on improving myocardial
level. What should be the focus of nursing oxygenation and reducing cardiac workload. Confirming the diagnosis of MI and
care? preventing complications, reducing anxiety and relieving pain, and providing a
1. Improving myocardial oxygenation and nondemanding environment are secondary to improving myocardial oxygenation
reducing cardiac workload. and reducing workload. Stressors can't be eliminated, only reduced.
2. Confirming a suspected diagnosis and
preventing complications.
3. Reducing anxiety and relieving pain.
4. Eliminating stressors and providing a
nondemanding environment.
18. A client with a myocardial infarction and Answer: 3. Aortic valve is closed.
cardiogenic shock is placed on an intra- Rationale: An intra-aortic ballon pump (IAPB) inflates during diastole when the
aortic ballon pump (IAPB). If the device is tricuspid and mitral valves are open and the aortic and pulmonic valves are closed.
functioning properly, the balloon inflates
when the:
1. tricuspid valve is closed.
2. Pulmonic valve is open.
3. Aortic valve is closed.
4. Mitral valve is closed.
19. A client with unstable angina receives Answer: 2. A systolic blood pressure below 90 mm Hg.
routine applications of nitroglycerin Rationale: Nitroglycerin is a vasodilator and can lower arterial blood pressure. As a
ointment. The nurse should delay the next rule, when the client's systolic blood pressure is below 90 mm Hg, the nurse should
dose if the client has: delay the dose and notify the physician. Nitroglycerin isn't contraindicated in a client
1. atrial fibrillation. with atrial fibrillation. Headache, a common occurrence with nitroglycerin isn't a
2. A systolic blood pressure below 90 mm cause for withholding a dose. Application sites should be changed with each dose,
Hg. especially if skin irritation occurs.
3. A headache.
4. Skin redness at the current site.
20. A client experiences acute myocardial Answer: 3. Return of the ST segment to baseline.
ischemia. The nurse administers oxygen and Rationale: During episodes of myocardial ischemia, an ECG may show ST-segmant
sublingual nitroglycerin. When assessing an elevation or depression. With successful treatment, the ST segment should return to
electrocardiogram (ECG) for evidence that baseline. Widening QRS complex, presence of a Q wave, and frequent ectopic beats
blood flow to the myocardium has aren't directly indicative of myocardial ischemia.
improved, the nurse should focus on the:
1. widening of the QRS complex.
2. Frequency of ectopic beats.
3. Return of the ST segment to baseline.
4. Presence of a significant Q wave.
