CARDIO QUESTIONS WITH RATIO 3

HYPERTENSION/CORONARY ARTERY DISEASE

1. A client is scheduled for a cardiac catheterization using a radiopaque dye. Which of the following assessments
is most critical before the procedure?

 A. Intake and output

 B. Baseline peripheral pulse rates
 C. Height and weight
 D. Allergy to iodine or shellfish
2.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?
o A. “Have you ever had this pain before?”
o B. “Can you describe the pain to me?”
o C. “Does the pain get worse when you breathe in?”
o D. “Can you rate the pain on a scale of 1-10, with ten (10) being the worst?”
3. Aclient with myocardial infarction has been transferred from a coronary care unit to a general medical unit
with cardiac monitoring via telemetry. A nurse plans to allow for which of the following client activities?
o A. Strict bed rest for 24 hours after transfer.
o B. Bathroom privileges and self-care activities.
o C. Unsupervised hallway ambulation with distances under 200 feet.
o D. Ad lib activities because the client is monitored.
4. 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?
o A. Review the intake and output records for the last two (2) days.
o B. Change the time of diuretic administration from morning to evening.
o C. Request a sodium restriction of one (1) g/day from the physician.
o D. Order daily weight starting the following morning.
5. A client is wearing a continuous cardiac monitor, which begins to sound its alarm. A nurse sees no
electrocardiogram complexes on the screen. The first action of the nurse is to:
o A. Check the client status and lead placement.
o B. Press the recorder button on the electrocardiogram console.
o C. Call the physician.
o D. Call a code blue.
6.A nurse is assessing the blood pressure of a client diagnosed with primary hypertension. The nurse ensures
accurate measurement by avoiding which of the following?
o A. Seating the client with arm bared, supported, and at heart level.
o B. Measuring the blood pressure after the client has been seated quietly for 5 minutes.
o C. Using a cuff with a rubber bladder that encircles at least 80% of the limb.
o D. Taking a blood pressure within 15 minutes after nicotine or caffeine ingestion.
7.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?
o A. Vitamin K
o B. Aminocaproic acid
o C. Potassium chloride
o D. Protamine sulfate
8.A client is at risk for pulmonary embolism and is on anticoagulant therapy with warfarin (Coumadin). The
client’s prothrombin time is 20 seconds, with a control of 11 seconds. The nurse assesses that this result is:
o A. The same as the client’s own baseline level.
 o B. Lower than the needed therapeutic level.
o C. Within the therapeutic range.
o D. Higher than the therapeutic range.
9. A client who has been receiving heparin therapy also is started on warfarin. The client asks a nurse why
both medications are being administered. In formulating a response, the nurse incorporates the understanding
that warfarin:
o A. Stimulates the breakdown of specific clotting factors by the liver, and it takes two (2)-
three (3) days for this to exert an anticoagulant effect.
o B Inhibits synthesis of specific clotting factors in the liver, and it takes 3-4 days for this
medication to exert an anticoagulant effect.
o C. Stimulates production of the body’s own thrombolytic substances, but it takes 2-4 days for
this to begin.
o D. Has the same mechanism of action as Heparin, and the crossover time is needed for the
serum level of warfarin to be therapeutic.
10.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:
o A. Administer the morphine.
o B. Obtain a 12-lead ECG.
o C. Obtain the lab work.
o D. Order the chest x-ray.
11. When administered a thrombolytic drug to the client experiencing an MI, the nurse explains to him that the
purpose of this drug is to:
o A. Help keep him well hydrated.
o B. Dissolve clots he may have.
o C. Prevent kidney failure.
o D. Treat potential cardiac arrhythmias.
12. When interpreting an ECG, the nurse would keep in mind which of the following about the P wave? Select
all that apply.
o A. Reflects electrical impulse beginning at the SA node.
o B. Indicated electrical impulse beginning at the AV node.
o C. Reflects atrial muscle depolarization.
o D. Identifies ventricular muscle depolarization.
o E. Has a duration of normally 0.11 seconds or less.
13.A client has driven himself to the ER. He is 50 years old, has a history of hypertension, and informs the
nurse that his father died of a heart attack at 60 years of age. The client is presently complaining of
indigestion. The nurse connects him to an ECG monitor and begins administering oxygen at 2 L/minute per
NC. The nurse’s next action would be to:
o A. Call for the doctor.
o B. Start an intravenous line.
o C. Obtain a portable chest radiograph.
o D. Draw blood for laboratory studies.
14.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?
o A. Cancer
o B. Hypertension
o C. Liver disease
 o D. Myocardial infarction
15.Whenteaching a client about propranolol hydrochloride, the nurse should base the information on the
knowledge that propranolol hydrochloride:
o A. Blocks beta-adrenergic stimulation and thus causes decreased heart rate, myocardial
contractility, and Conduction.
o B. Increases norepinephrine secretion and thus decreases blood pressure and heart rate.
o C. Is a potent arterial and venous vasodilator that reduces peripheral vascular resistance and
lowers blood pressure.
o D. Is an angiotensin-converting enzyme inhibitor that reduces blood pressure by blocking the
conversion of angiotensin I to angiotensin II.
16.The most important long-term goal for a client with hypertension would be to:
o A. Learn how to avoid stress.
o B. Explore a job change or early retirement.
o C. Make a commitment to long-term therapy.
o D. Control high blood pressure.
17.Hypertension is known as the silent killer. This phrase is associated with the fact that hypertension often
goes undetected until symptoms of other system failures occur. This may occur in the form of:
o A. Cerebrovascular accident
o B. Liver disease
o C. Myocardial infarction
o D. Pulmonary disease
18.During the previous few months, a 56-year-old woman felt brief twinges of chest pain while working in
her garden and has had frequent episodes of indigestion. She comes to the hospital after experiencing severe
anterior chest pain while raking leaves. Her evaluation confirms a diagnosis of stable angina pectoris. After
stabilization and treatment, the client is discharged from the hospital. At her follow-up appointment, she is
discouraged because she is experiencing pain with increasing frequency. She states that she is visiting an
invalid friend twice a week and now cannot walk up the second flight of steps to the friend’s apartment
without pain. Which of the following measures that the nurse could suggest would most likely help the client
deal with this problem?
o A. Visit her friend earlier in the day.
o B. Rest for at least an hour before climbing the stairs.
o C. Take a nitroglycerin tablet before climbing the stairs.
o D. Lie down once she reaches the friend’s apartment.
o

19.Whichof the following symptoms should the nurse teach the client with unstable angina to report
immediately to her physician?
o A. A change in the pattern of her pain.
o B. Pain during sex.
o C. Pain during an argument with her husband.
o D. Pain during or after an activity such as lawn mowing.
20.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:
o A. Open and dilate the blocked coronary arteries.
o B. Assess the extent of arterial blockage.
o C. Bypass obstructed vessels.
o D. Assess the functional adequacy of the valves and heart muscle.
21.As 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:
 o A. Antispasmodic effect on the pericardium.
o B. Causing an increased myocardial oxygen demand.
o C. Vasodilation of peripheral vasculature.
o D. Improved conductivity in the myocardium.
22.The nurse teaches the client with angina about the common expected side effects of nitroglycerin,
including:
o A. Headache
o B. High blood pressure
o C. Shortness of breath
o D. Stomach cramps
23.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?
o A. Take one (1) tablet every two (2) to five (5) minutes until the pain stops.
o B. Take one (1) tablet and rest for ten (10) minutes. Call the physician if pain persists after ten
(10) minutes.
o 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.
o 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.
24.Which of the following arteries primarily feeds the anterior wall of the heart?
o A. Circumflex artery
o B. Internal mammary artery
o C. Left anterior descending artery
o D. Right coronary artery
25.When do coronary arteries primarily receive blood flow?
o A. During inspiration
o B. During diastolic
o C. During expiration
o D. During systole
26.Prolonged occlusion of the right coronary artery produces an infarction in which of the following areas of
the heart?
o A. Anterior
o B. Apical
o C. Inferior
o D. Lateral
27.A murmur is heard at the second left intercostal space along the left sternal border. Which valve is this?
o A. Aortic
o B. Mitral
o C. Pulmonic
o D. Tricuspid
28.Which of the following blood tests is most indicative of cardiac damage?
o A. Troponin I
o B. Complete blood count (CBC)
o C. Creatine kinase (CK)
o D. Lactate dehydrogenase
29.Which of the following diagnostic tools is most commonly used to determine the location of myocardial
damage?
o A. Cardiac catheterization
o B. Cardiac enzymes
o C. Echocardiogram
o D. Electrocardiogram (ECG)
30.Which of the following types of pain is most characteristic of angina?
o A. Knifelike
o B. Sharp
o C. Shooting
o D. Tightness
31.Which of the following parameters is the major determinant of diastolic blood pressure?
o A. Baroreceptors
o B. Cardiac output
o C. Renal function
o D. Vascular resistance
32.Which of the following factors can cause blood pressure to drop to normal levels?
o A. Kidneys’ excretion of sodium only.
o B. Kidneys’ retention of sodium and water.
o C. Kidneys’ excretion of sodium and water.
o D. Kidneys’ retention of sodium and excretion of water
33.Baroreceptors in the carotid artery walls and aorta respond to which of the following conditions?
o A. Changes in blood pressure.
o B. Changes in arterial oxygen tension.
o C. Changes in arterial carbon dioxide tension.
o D. Changes in heart rate.
34.Which of the following terms describes the force against which the ventricle must expel blood?
o A. Afterload
o B. Cardiac output
o C. Overload
o D. Preload
35.Which of the following terms is used to describe the amount of stretch on the myocardium at the end of
diastole?
o A. Afterload
o B. Cardiac index
o C. Cardiac output
o D. Preload
36.A57-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?
o A. Monitor the apical pulse rate.
o B. Instruct the client to take medication with food.
o C. Question the physician about the order.
o D. Caution the client to rise slowly when standing.
37.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?
o A. Hypocalcemia
o B. Hypermagnesemia
o C. Hypokalemia
o D. Hypernatremia
38.A client is receiving spironolactone to treat hypertension. Which of the following instructions should the
nurse provide?
o A. “Eat foods high in potassium.”
o B. “Take daily potassium supplements.”
o C. “Discontinue sodium restrictions.”
o D. “Avoid salt substitutes.”
39.When assessing an ECG, the nurse knows that the P-R interval represents the time it takes for the:
o A. Impulse to begin atrial contraction.
o B. Impulse to transverse the atria to the AV node.
o C. SA node to discharge the impulse to begin atrial depolarization.
o D. Impulse to travel to the ventricles.
40.Following a treadmill test and cardiac catheterization, the client is found to have coronary artery disease,
which is inoperative. He is referred to the cardiac rehabilitation unit. During his first visit to the unit he says
that he doesn’t understand why he needs to be there because there is nothing that can be done to make him
better. The best nursing response is:
o A. “Cardiac rehabilitation is not a cure but can help restore you to many of your former
activities.”
o B. “Here we teach you to gradually change your lifestyle to accommodate your heart disease.”
o C. “You are probably right but we can gradually increase your activities so that you can live a
more active life.”
o D. “Do you feel that you will have to make some changes in your life now?”
41.To evaluate a client’s condition following cardiac catheterization, the nurse will palpate the pulse:
o A. In all extremities
o B. At the insertion site
o C. Distal to the catheter insertion
o D. Above the catheter insertion
42.Aclient’s physician orders nuclear cardiography and makes an appointment for a thallium scan. The
purpose of injecting radioisotope into the bloodstream is to detect:
o A. Normal vs. abnormal tissue
o B. Damage in areas of the heart
o C. Ventricular function
o D. Myocardial scarring and perfusion
43.A client enters the ER complaining of severe chest pain. A myocardial infarction is suspected. A 12 lead
ECG appears normal, but the doctor admits the client for further testing until cardiac enzyme studies are
returned. All of the following will be included in the nursing care plan. Which activity has
the highest priority?
o A. Monitoring vital signs.
o B. Completing a physical assessment.
o C. Maintaining cardiac monitoring.
o D. Maintaining at least one IV access site.
44.A client is experiencing tachycardia. The nurse’s understanding of the physiological basis for this symptom
is explained by which of the following statements?
o A. The demand for oxygen is decreased because of pleural involvement.
o B. The inflammatory process causes the body to demand more oxygen to meet its needs.
o C. The heart has to pump faster to meet the demand for oxygen when there is lowered arterial
oxygen tension.
o D. Respirations are labored.
45.A client enters the ER complaining of chest pressure and severe epigastric distress. His VS are 158/90, 94,
24, and 99*F. The doctor orders cardiac enzymes. If the client were diagnosed with an MI, the nurse would
expect which cardiac enzyme to rise within the next 3 to 8 hours?
o A. Creatine kinase (CK or CPK)
o B. Lactic dehydrogenase (LDH)
o C. LDH-1
o D. LDH-2
46.A45-year-old male client with leg ulcers and arterial insufficiency is admitted to the hospital. The nurse
understands that leg ulcers of this nature are usually caused by:
o A. Decreased arterial blood flow secondary to vasoconstriction.
o B. Decreased arterial blood flow leading to hyperemia.
o C. Atherosclerotic obstruction of the arteries.
o D. Trauma to the lower extremities.
47.Which of the following instructions should be included in the discharge teaching for a patient discharged
with a transdermal nitroglycerin patch?
o A. “Apply the patch to a non-hairy, non-fatty area of the upper torso or arms.”
o B. “Apply the patch to the same site each day to maintain consistent drug absorption.”
o C. “If you get a headache, remove the patch for 4 hours and then reapply.”
o D. “If you get chest pain, apply a second patch right next to the first patch.”
48.In order to prevent the development of tolerance, the nurse instructs the patient to:
o A. Apply the nitroglycerin patch every other day.
o B. Switch to sublingual nitroglycerin when the patient’s systolic blood pressure elevates to
>140 mm Hg.
o C. Apply the nitroglycerin patch for 14 hours each and remove for 10 hours at night.
o D. Use the nitroglycerin patch for acute episodes of angina only.
49.Direct-acting vasodilators have which of the following effects on the heart rate?
o A. Heart rate decreases.
o B. Heart rate remains significantly unchanged.
o C. Heart rate increases.
o D. Heart rate becomes irregular.
50.When teaching a patient why spironolactone (Aldactone) and furosemide (Lasix) are prescribed together,
the nurse bases teaching on the knowledge that:
o A. Moderate doses of two different types of diuretics are more effective than a large dose of
one type.
o B. This combination promotes diuresis but decreases the risk of hypokalemia.
o C. This combination prevents dehydration and hypovolemia.
o D. Using two drugs increases osmolality of plasma and the glomerular filtration rate.
Prepared by: Murada J. Ismael
Source: NCLEX (Nurseslabs)