CARDIO POST TEST

1. A client with no history of cardiovascular disease comes into the ambulatory clinic with flu-like
symptoms. The client suddenly complains of chest pain. Which of the following questions would best
help a nurse to discriminate pain caused by a non-cardiac problem?

A. “Have you ever had this pain before?”

B. “Can you describe the pain to me?”

C. “Does the pain get worse when you breathe in?”

D. “Can you rate the pain on a scale of 1-10, with ten (10) being the worst?”

2. A nurse notes 2+ bilateral edema in the lower extremities of a client with myocardial infarction who
was admitted two (2) days ago. The nurse would plan to do which of the following next?

A. Review the intake and output records for the last two (2) days.

B. Change the time of diuretic administration from morning to evening.

C. Request a sodium restriction of one (1) g/day from the physician.

D. Order daily weight starting the following morning.

3. A 60-year-old male client comes into the emergency department with complaints of crushing chest
pain that radiates to his shoulder and left arm. The admitting diagnosis is acute myocardial infarction.
Immediate admission orders include oxygen by NC at 4L/minute, blood work, chest X-ray, an ECG, and
two (2) mg of morphine given intravenously. The nurse should first:

A. Administer the morphine.

B. Obtain a 12-lead ECG.

C. Obtain the lab work.

D. Order the chest x-ray.

4. When interpreting an ECG, the nurse would keep in mind which of the following about the P wave?
Select all that apply.

A. Reflects electrical impulse beginning at the SA node.

B. Indicated electrical impulse beginning at the AV node.

D. Identifies ventricular muscle depolarization.

E. Has a duration of normally 0.11 seconds or less.

5. The nurse receives emergency laboratory results for a client with chest pain and immediately
informs the physician. An increased myoglobin level suggests which of the following?

A. Cancer

B. Hypertension

C. Liver disease

D. Myocardial infarction

6. When teaching a client about propranolol hydrochloride, the nurse should base the information on
the knowledge that propranolol hydrochloride:

A. Blocks beta-adrenergic stimulation and thus causes decreased heart rate, myocardial contractility,
and Conduction.

B. Increases norepinephrine secretion and thus decreases blood pressure and heart rate.

C. Is a potent arterial and venous vasodilator that reduces peripheral vascular resistance and lowers
blood pressure.

D. Is an angiotensin-converting enzyme inhibitor that reduces blood pressure by blocking the conversion
of angiotensin I to angiotensin II.

7. The most important long-term goal for a client with hypertension would be to:

A. Learn how to avoid stress.

B. Explore a job change or early retirement.

C. Make a commitment to long-term therapy.

D. Control high blood pressure.

8. Which of the following symptoms should the nurse teach the client with unstable angina to report
immediately to her physician?

A. A change in the pattern of her pain

B. Pain during sex.

D. Pain during or after an activity such as lawn mowing.

9. The physician refers the client with unstable angina for a cardiac catheterization. The nurse explains
to the client that this procedure is being used in this specific case to:

A. Open and dilate the blocked coronary arteries.

B. Assess the extent of arterial blockage.

C. Bypass obstructed vessels.

D. Assess the functional adequacy of the valves and heart muscle.

10. It is an initial step in treating a client with angina, the physician prescribes nitroglycerin tablets,
0.3mg given sublingually. This drug’s principal effects are produced by:

A. Antispasmodic effect on the pericardium.

B. Causing an increased myocardial oxygen demand.

C. Vasodilation of peripheral vasculature.

D. Improved conductivity in the myocardium

11. 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

12. When do coronary arteries primarily receive blood flow?

A. During inspiration

B. During diastolic

C. During expiration

D. During systole
13. murmur is heard at the second left intercostal space along the left sternal border. Which valve is
this?

A. Aortic

B. Mitral

C. Pulmonic

D. Tricuspid

14. Which of the following blood tests is most indicative of cardiac damage?

A. Troponin I

B. Complete blood count (CBC)

C. Creatine kinase (CK)

D. Lactate dehydrogenase

15. Which of the following diagnostic tools is most commonly used to determine the location of
myocardial damage?

A. Cardiac catheterization

B. Cardiac enzymes

C. Echocardiogram

D. Electrocardiogram (ECG)

16. Which of the following terms describes the force against which the ventricle must expel blood?

A. Afterload

B. Cardiac output

C. Overload

D. Preload

17. Which of the following terms is used to describe the amount of stretch on the myocardium at the
end of diastole?

A. Afterload
B. Cardiac index

C. Cardiac output

D. Preload

18. A 57-year-old client with a history of asthma is prescribed propranolol (Inderal) to control
hypertension. Before administered propranolol, which of the following actions should the nurse take
first?

A. Monitor the apical pulse rate.

B. Instruct the client to take medication with food.

C. Question the physician about the order.

D. Caution the client to rise slowly when standing.

19. To evaluate a client’s condition following cardiac catheterization, the nurse will palpate the pulse:

A. In all extremities

B. At the insertion site

C. Distal to the catheter insertion

D. Above the catheter insertion

20. A client is experiencing tachycardia. The nurse’s understanding of the physiological basis for this
symptom is explained by which of the following statements?

A. The demand for oxygen is decreased because of pleural involvement.

B. The inflammatory process causes the body to demand more oxygen to meet its needs.

C. The heart has to pump faster to meet the demand for oxygen when there is lowered arterial oxygen
tension.

D. Respirations are labored.

21. Which of the following instructions should be included in the discharge teaching for a patient
discharged with a transdermal nitroglycerin patch?

A. “Apply the patch to a non-hairy, non-fatty area of the upper torso or arms.”

B. “Apply the patch to the same site each day to maintain consistent drug absorption.”
C. “If you get a headache, remove the patch for 4 hours and then reapply.”

D. “If you get chest pain, apply a second patch right next to the first patch.”

22. in order to prevent the development of tolerance, the nurse instructs the patient to:

A. Apply the nitroglycerin patch every other day.

B. Switch to sublingual nitroglycerin when the patient’s systolic blood pressure elevates to >140 mm Hg.

C. Apply the nitroglycerin patch for 14 hours each and remove for 10 hours at night.

D. Use the nitroglycerin patch for acute episodes of angina only.

23. When teaching a patient why spironolactone (Aldactone) and furosemide (Lasix) are prescribed
together, the nurse bases teaching on the knowledge that:

A. Moderate doses of two different types of diuretics are more effective than a large dose of one type.

B. This combination promotes diuresis but decreases the risk of hypokalemia.

C. This combination prevents dehydration and hypovolemia.

D. Using two drugs increases osmolality of plasma and the glomerular filtration rate.

24. Which of the following actions is the first priority of 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.

25. Medical treatment of coronary artery disease includes which of the following procedures?

A. Cardiac catheterization

B. Coronary artery bypass surgery

C. Oral medication therapy

D. Percutaneous transluminal coronary angioplasty

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.

27. Which of the following complications is indicated by a third heart sound (S3)?

A. Ventricular dilation

B. Systemic hypertension

C. Aortic valve malfunction

D. Increased atrial contractions

28. 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

29. 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

30. Which of the following types of angina is most closely related with an impending MI?
A. Angina decubitus

B. Chronic stable angina

C. Nocturnal angina

D. Unstable angina

31. The sign of myocardial ischemia is

a. ST elevation

b. Pathologic Q wave

c. T wave is tall

d. ST depression

32. A nurse is preparing for the admission of a client with heart failure who is being sent directly to the
hospital from the physician’s office. The nurse would plan on having which of the following medications
readily available for use?

A. diltiazem (Cardizem)

B. digoxin (Lanoxin)

C. propranolol (Inderal)

D. metoprolol (Lopressor)

33. The nurse is teaching a client with a history of atherosclerosis. To decrease the risk of
atherosclerosis, the nurse should encourage the client to:

A. Avoid focusing on his weight.

B. Increase his activity level.

C. Follow a regular diet.

D. Continue leading a high-stress lifestyle.

34. The nurse teaching the client about behavioral changes, which can affect development of
atherosclerosis, should discuss which of the following as a non-modifiable risk factor for atherosclerosis?

A. cigarette smoking

B. hyperlipidemia
C. female over 55 years of age

D. sedentary lifestyle

35. The following are lipid abnormalities. Which of the following is a risk factor for the development of
atherosclerosis and PVD?

A. High levels of low density lipid (LDL) cholesterol

B. High levels of high density lipid (HDL) cholesterol

C. Low concentration triglycerides

D. Low levels of LDL cholesterol.

36. Patient Isabel was admitted in the CCU with chef complaint of chest pain, to rule out a myocardial
infarction (MI). Which cardiac enzyme test is most specific of an MI?

A. TROP I

B. MYOGLOBIN

C. CPK

D. CK-MB

37. The client has ST segment depression on his 12-lead ECG. The nurse determines that this would
indicate the following:

A. necrosis

B. injury

C. ischemia

D. nothing significant

38. Nurse Len is administering sublingual nitrglycerin (Nitrostat) to the newly admitted client.
Immediately afterward, the client may experience:

A. Throbbing headache or dizziness

B. Nervousness or paresthesia.

C. Drowsiness or blurred vision.

39. In evaluating the effect of nitroglycerin, Nurse Arthur should know that it reduces preload and
relieves angina by:

A. Increasing contractility and slowing heart rate.

B. Increasing AV conduction and heart rate.

C. Decreasing contractility and oxygen consumption.

D. Decreasing venous return through vasodilation.

40. A 48 year old woman presents to the hospital complaining of chest pain, tachycardia and dyspnea.
On exam, heart sounds are muffled. Which of the following assessment findings would support a
diagnosis of cardiac tamponade?

A. A deviated trachea

B. Absent breath sounds to the lower lobes

C. Pulse 40 with inspiration

D. Blood pressure 140/80

41. A client with congestive heart failure has digoxin (Lanoxin) ordered everyday. Prior to giving the
medication, the nurse checks the digoxin level which is therapeutic and ausculates an apical pulse. The
apical pulse is 63 bpm for 1 full minute. The nurse should:

A. Hold the Lanoxin

B. Give the half dose now, wait an hour and give the other half

C. Call the physician

D. Give the Lanoxin as ordered

42. A client is receiving captopril (Capoten) for heart failure. The nurse should notify the physician that
the medication therapy is ineffective if an assessment reveals:

A. A skin rash.

B. Peripheral edema.

C. A dry cough.
D. Postural hypotension.

43. Toxicity from which of the following medications may cause a client to see a green-yellow halo
around lights?

A. Digoxin

B. Furosemide

C. Lithium

D. Captopril

44. IV heparin therapy is ordered for a client. While implementing this order, a nurse ensures that
which of the following medications is available in the nursing unit?

A. Vitamin K

B. Aminocaproic acid

C. Potassium chloride

D. Protamine sulfate

45. The nurse administered a thrombolytic drug to the client experiencing an MI, the nurse explains to
him that the purpose of this drug is to:

A. Help keep him well hydrated.

B. Dissolve clots he may have.

C. Prevent kidney failure.

D. Treat potential cardiac arrhythmias

46. Sublingual nitroglycerin tablets begin to work within 1 to 2 minutes. How should the nurse instruct
the client to use the drug when chest pain occurs?

A. Take one (1) tablet every two (2) to five (5) minutes until the pain stops.

B. Take one (1) tablet and rest for ten (10) minutes. Call the physician if pain persists after ten (10)
minutes.

C. Take one (1) tablet, then an additional tablet every 5 minutes for a total of three (3) tablets. Call the
physician if pain persists after three (3) tablets.
D. Take one (1) tablet. If pain persists after five (5) minutes, take two (2) tablets. If pain persists five (5)
minutes later, call the physician.

47. One hour after administering IV furosemide (Lasix) to a client with heart failure, a short burst of
ventricular tachycardia appears on the cardiac monitor. Which of the following electrolyte imbalances
should the nurse suspect?

A. Hypocalcemia

B. Hypermagnesemia

C. Hypokalemia

D. Hypernatremia

48. The nurse assessing a patient with a deep venous thrombosis (DVT) becomes concerned when the
patient demonstrates which sign or symptom

a. Hematuria

b. Tingling in the limbs

c. Hematemesis

d. Hemoptysis

49. A nurse is monitoring a client with acute pericarditis for signs of cardiac tamponade. Which
assessment finding would indicate the presence of this complication?

a. A pulse rate of 60 beats per minute

b. Flat neck veins

c. Muffled or distant heart sounds

d. A blood pressure (BP) 0f 128/82 mmHg

50. Nurse Ron is caring for a male client taking an anticoagulant. The nurse should teach the client to:

A. Report incidents of diarrhea.

B. Avoid foods high in vitamin K

C. Use a straight razor when shaving.

D. Take aspirin to pain relief.

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