CV Review Questions

A nurse is assessing a patient's right lower leg, which is wrapped with an elastic bandage, and finds it to be cooler and paler than the left lower leg. What should the nurse do next? a) Notify the attending physician of the finding. b) Elevate the extremity. c) Assess the distal pulses. d) Lower the head of the bed to 30 degrees or less

c

A patient has chest pain rated at 8 on a 10-point visual analog scale. The 12-lead electrocardiogram reveals ST elevation in the inferior leads and troponin levels are elevated. What should the nurse do first? a) Monitor daily weights and urine output. b) Provide patient education on medications and diet. c) Reduce pain and myocardial oxygen demand. d) Limit visitation by family and friends

c

A patient had a repair of a thoracoabdominal aneurysm 2 days ago. Select the assessment finding which must be reported immediately to the health care provider (HCP). a) heart rate of 100 beats per minute after ambulating 200 feet (0.06 km) b) urine output of 2,000 mL in 24 hours c) abdominal pain at 5 on a scale of 0 to 10 for the last 2 days d) weakness and numbness in the lower extremities

d

A patient has a total serum cholesterol level of 326 mg/dl (18.1 mmol/l). The nurse explains this level: a) Is borderline normal and may require dietary modification. b) Is low and requires no further treatment. c) Is normal and requires no further treatment. d) Is high and will require dietary modification

d

A patient is scheduled to have a graded exercise test. The nurse explains to the patient that the test will determine how: a) far he or she can walk. b) long he or she can walk. c) to set the incline gradient on a treadmill. d) well the body reacts to controlled exercise stress.

d

sudden attacks of respiratory distress that awaken the sleeper, usually after several hours of sleep in a reclining position.

PND (paroxysmal nocturnal dyspnea)

A nurse is caring for a patient with end-stage heart failure. Which statement by the patient best demonstrates understanding of an advance directive? a) "A living will makes my decisions for health care known if I can't speak for myself" b) "A health care power of attorney allows my daughter to use my funds to pay my health care costs, if I can't do so." c) "I will rely on my doctor to know about my preferences." d) "Once I decide on an advance directive, I cannot change my mind."

a

A nurse is preparing a patient for cardiac catheterization. The nurse must provide which nursing intervention immediately when the patient returns to his room after the procedure? a) Assess the puncture site frequently for hematoma formation or bleeding. b) Force fluids for 6 hours after the procedure. c) Administer the prescribed analgesia. d) Apply ice to the puncture site for 12 hours post procedure.

a

A patient says, "My father died of a heart attack when he was 60, and I suppose I will, too." Which of the following responses by the nurse would be the most appropriate? a) "Tell me more about what you are feeling." b) "Are you thinking that you won't recover from this illness?" c) "You have a fine doctor. Everything will be all right soon, I'm sure." d) "Would you agree that this would be very unlikely?"

a

A patient with chest pain is admitted to the telemetry unit from the emergency department. Select the priority nursing action. a) Assess troponin 1 levels b) Assess B-type natriuretic peptide c) Monitor the white blood cell count d) Monitor the platelet count

a

A patient with deep vein thrombosis has been receiving warfarin for 2 months. The patient is to go to an anticoagulant monitoring laboratory every 3 weeks. The last visit to the laboratory was 2 weeks ago. The patient reports bleeding gums, increased bruising, and dark stools. What should the nurse should instruct the patient to do? a) Decrease the dose of the warfarin. b) Decrease the amount of vitamin K in the diet. c) Notify the health care provider (HCP) about the bleeding d) Return to laboratory for analysis of prothrombin times.

a

A patient with septic shock has continued to deteriorate and has become unresponsive. The nurse has inserted an intravenous line and an oral airway. Which of the following is the highest priority for the nurse at this time? a) Confirm the placement of the oral airway. b) Examine the IV site for infiltration. c) Monitor temperature every 4 hours. d) Check the surgical dressing to ensure that it is intact.

a

A physician orders aspirin, 325 mg P.O. daily for a patient who has experienced a transient ischemic attack (TIA). The nurse should teach the patient that the physician has ordered this medication to: a) reduce the chance of blood clot formation. b) prevent intracranial bleeding. c) control headache pain. d) enhance the immune response.

a

Select the desired therapeutic outcome after administering a thrombolytic drug to a patient experiencing a myocardial infarction (MI) and premature ventricular contractions (dysrhythmias). a) dissolve clots b) promote hydration c) treat dysrhythmias d) prevent kidney failure

a

The nurse is caring for a patient post myocardial infarction (MI). Orders include strict bed rest and clear liquid diet. Select the correct statement about clear liquid diets post MI. a) To reduce oxygen (work/energy) demands b) To reduce amount of fecal elimination c) To avoid fluctuations in blood sugar d) To balance stomach gastric acidity

a

Which of the following patients is at risk for varicose veins? a) A patient who has had thrombophlebitis b) A patient who has had a cerebrovascular accident c) A patient who has had transient ischemic attacks d) A patient who has had anemia

a

A monitor technician on the telemetry unit asks a charge nurse why every patient whose monitor shows atrial fibrillation is receiving warfarin. Which response by the charge nurse is best? a) "It's just a coincidence; most patients with atrial fibrillation don't receive warfarin." b) "Warfarin prevents atrial fibrillation from progressing to a lethal arrhythmia." c) "Warfarin prevents clot formation in the atria of patients with atrial fibrillation." d) "Warfarin controls heart rate in the patient with atrial fibrillation."

c

Clinical manifestation of reversible myocardial ischemia. Symptom of coronary artery disease.

angina

A home care nurse visits a patient with atrial fibrillation taking Coumadin (warfarin). Which patient statement indicates a need for further teaching about Coumadin (warfarin)? a) "I'll use an electric razor to shave." b) "I'll eat six servings of fresh, dark green vegetables every day." c) "I'll report unexplained or severe bruising to my doctor right away." d) "I'll watch my gums for bleeding when I brush my teeth."

b

A nurse is providing discharge instructions to a patient with peripheral vascular disease that include stressreduction techniques. The patient asks, "Why is reducing stress important?" Select the correct rationale for using stress reduction techniques. a) "Reducing stress is helpful only in smoking cessation programs" b) "Stress stimulates the release of vasoconstricting catecholamines" c) "Stress reduction techniques distract you during claudication pain." d) "Reducing stress decreases amount of medication required to control disease"

b

A patient is taking spironolactone to control her hypertension. Her serum potassium level is [6 mEq/L (56mmol/L)]. Select the priority assessment. a) respiratory rate b) electrocardiogram (ECG) results c) neuromuscular function d) bowel sounds

b

An older adult takes two 81-mg aspirin tablets daily to prevent heart attack. The patient reports constant "ringing" in both ears. Select the correct response by the nurse. a) Tell the patient "ringing" in the ears is associated with aging b) Explain the "ringing" may be related to the aspirin c) Refer the patient to have a Weber test d) Schedule the patient for audiometric testing

b

Antiembolism stockings help prevent deep vein thrombosis (DVT) by: a) elevating extremity to prevent pooling of blood b) promoting venous return and decreasing stasis c) providing warmth to the extremity d) encouraging ambulation to prevent pooling of blood

b

Knee-high sequential compression devices have been prescribed for a newly admitted patient. The patient reports new pain localized in the right calf area that is noted to be slightly reddened and warm to touch upon initial assessment. What should the nurse do first? a) Leave the compression devices off, and report the assessment findings to the oncoming shift. b) Leave the compression devices off, and contact the health care provider (HCP) to report the assessment findings. c) Massage the area of discomfort before applying the compression devices. d) Offer analgesics as ordered, and apply the compression devices.

b

Select the assessment measuring effectiveness of fluid replacement therapy in a patient with hypovolemic shock a) hemoglobin level b) blood pressure c) heart rate d) temperature

b

Select the critical assessment finding in a patient with a decreased cardiac output a) weight gain of 1 kg in 3 days, BP 130/80 mm Hg, mild dyspnea with exercise b) confusion, urine output 15 mL over the last 2 hours, orthopnea c) BP 110/62 mm Hg, atrial fibrillation with HR 82 bpm, bilateral basilar crackles d) SpO2 92% on 2 L nasal cannula, respirations 20 breaths/min, 1+ edema of lower extremities

b

Select the crucial test results to have on hand before tissue plasminogen activator or alteplase recombinant is administered. a) potassium level b) partial thromboplastin time c) Lee-White clotting time d) fibrin split product

b

The nurse monitors the serum electrolyte levels of a patient taking digoxin. Which electrolyte imbalance is a common cause of digoxin toxicity? a) hypocalcemia b) hypokalemia c) hyponatremia d) hypomagnesemia

b

The nurse should instruct a patient who has been diagnosed with Raynaud's phenomenon to: a) immerse the hands in cold water during an episode. b) wear gloves when handling ice or frozen foods. c) live in a cold climate. d) wear light garments when the temperature gets below 50° F (10° C).

b

The nurse teaches a patient recently diagnosed with hypertension about low-calorie, low-fat, and low-sodium diet. Which menu selection is consistent with a low calorie, low fat and low sodium diet? a) mixed green salad with blue cheese dressing, crackers, and ham b) baked chicken, an apple, and a slice of bread c) ham sandwich on rye bread and an orange d) hot dogs, baked beans, celery and carrot sticks

b

The patient is admitted with left lower leg pain, a positive Homans' sign, and a temperature of 100.4° F (38° C). The nurse should assess the patient further for signs of: a) intermittent claudication. b) deep vein thrombosis (DVT) in the left leg. c) IV drug abuse d) aortic aneurysm

b

A patient is admitted with a diagnosis of thrombophlebitis and deep vein thrombosis of the right leg. A loading dose of heparin has been given in the emergency department, and IV heparin will be continued for the next several days. The nurse should develop a plan of care for this patient that will involve: a) encouraging green leafy vegetables in the diet. b) administering aspirin as ordered. c) monitoring the patient's activated partial thromboplastin time (aPTT) and International Normalized Ratio (PT/INR). d) monitoring the patient's prothrombin time (PT)

c

A patient is participating in a cardiac research study managed by his personal physician. Which statement indicates a need for additional teaching about patient rights as a research study participant? a) "I understand there may be risks associated with this study." b) "I may withdraw study participation anytime, but I will lose compensation" c) "I'll have to find a new physician if I don't complete this study." d) "My confidentiality won't be compromised by this study."

c

A patient is taking metoprolol and hydrochlorothiazide. The medication is effective if it: a) decreases dyspnea. b) increases the heart rate. c) lowers the blood pressure. d) improves circulation in the extremities

c

A patient with severe angina-related chest pain and electrocardiogram changes is seen in the emergency department. The nurse anticipates an order for which lab test? a) Myoglobin b) Creatine kinase c) Troponin d) Lactate dehydrogenase

c

The nurse is concerned about the risks of hypoxemia and metabolic acidosis in a patient who is in shock. What finding should the analyze for evidence of hypoxemia and metabolic acidosis in a patient with shock? a) White blood cell differential b) Red blood cells (RBCs) and hemoglobin count findings c) Arterial blood gas (ABG) findings d) Oxygen saturation level

c

The patient with peripheral vascular disease is prescribed diltiazem. Select the assessment indicating medication effectiveness. a) sedation b) vasodilation c) relief of anxiety d) vasoconstriction

c

Which would be most likely to assist the patient with hypertension in maintaining an exercise program? a) Explain the exercise program to the patient's spouse. b) Give the patient a written exercise program. c) Tailor a program to the patient's needs and abilities. d) Reassure the patient that he or she can do the exercise program.

c

chest pain that occurs intermittently over a long period with the same patterns of onset, duration, and intensity of symptoms

chronic stable angina

an accessory blood pathway developed through enlargement of secondary vessels after obstruction of a main channel

collateral circulation

type of blood vessel disorder that is included in the general category of atherosclerosis.... "caused by a narrowing or obstruction of one more coronary arteries as a result of atherosclerosis, which is an accumulation of lipid-containing plaque in the arteries"

coronary artery disease

A group of patients has been taught external cardiac compressions. Which of the following hand placements would demonstrate that learning has occurred? a) The heel of one hand on the sternum and the fleshy part of a clenched fist on the lower sternum. b) The heels of each hand side by side, extending the fingers over the chest. c) The fingers of one hand on the sternum and the fingers of the other hand on top of them. d) The heel of one hand on the sternum and the heel of the other on top of it, with the fingers interlocking

d

A patient with known coronary artery disease reports intermittent chest pain, usually with exertion. The physician diagnoses angina pectoris and orders sublingual nitroglycerin to treat acute angina episodes. Select the correct patient instruction for nitroglycerine. a) "You may take a sublingual nitroglycerin tablet every 30 minutes, up to 4 doses, if needed" b) "Replace leftover sublingual nitroglycerin tablets every 9 months to ensure pills are fresh." c) "A burning sensation after nitroglycerine administration indicates the tablets are potent." d) "Nitroglycerin may cause dizziness when you stand up quickly."

d

A patient with stage IV heart failure has a living will indicate that he does not want to be placed on a ventilator. A nurse is caring for this patient when he begins experiencing severe dyspnea. The nurse should: a) ask the patient's family to consent to ventilator placement. b) administer oxygen and hope the patient will change his mind. c) call for respiratory therapy to intubate the patient. d) administer oxygen, morphine, and a bronchodilator for patient comfort.

d

A patient's cholesterol profile is: total cholesterol 265 mg/dl, low-density lipoprotein (LDL) 139 mg/dl, and highdensity lipoprotein (HDL) 32 mg/dl. The patient asks how to lower his cholesterol. Select the correct instruction. a) Begin a running program, working up to 2 miles (3.2 km) per day b) Patient's cholesterol is within recommended guidelines c) Patient should continue the prescribed statin medication d) Refer to dietitian for diet instruction and on-going follow-up

d

An 80-year-old patient is admitted with nausea and vomiting. The patient has a history of heart failure and is being treated with digoxin. The patient has been nauseated for a week and began vomiting 2 days ago. Laboratory values indicate hypokalemia. Because of these clinical findings, the nurse should assess the patient carefully for: a) chronic renal failure b) metabolic acidosis c) exacerbation of heart failure d) digoxin toxicity

d

In order to prevent deep vein thrombosis (DVT) following abdominal surgery, the nurse should: a) limit fluids to 1000 ml in 24 hours. b) assist the patient to remain sedentary. c) encourage deep breathing. d) use pneumatic compression stockings.

d

Select the correct strategy to facilitate learning self-care skills for patients after cerebrovascular accident (CVA). a) Dress the patient, explaining each step of the process as completed b) Encourage patient to wear clothing designed for people with CVA c) Advise the patient to ask for help when dressing d) Teach patient to put clothing on the affected side first

d

The nurse instructs a patient with coronary artery disease on the proper use of nitroglycerin. The patient has had 2 previous episodes of angina-related chest pain. Select the correct instruction of nitroglycerin use and anginarelated chest pain. a) Call 911 if two nitroglycerin tablets taken 5 minutes apart are ineffective b) Take one nitroglycerine tablet and immediately call 911 c) Call 911 if five nitroglycerin tablets taken every 5 minutes are ineffective d) Call 911 if three nitroglycerin tablets taken every 5 minutes are ineffective

d

The nurse is planning care for a patient who is diagnosed with peripheral vascular disease (PVD) and has a history of heart failure. The nurse should develop a plan of care that is based on the fact that the patient may have a low tolerance for exercise related to: a) Decreased pain. b) Increased blood viscosity. c) Increased blood flow. d) Decreased blood flow.

d

The nurse is preparing to administer oral digoxin to a child. The child reports nausea, has vomited, and an apical heart rate of 45 beats per minute. Select the priority nursing action. a) Tell parents vomiting and bradycardia are common b) Administer the digoxin and document findings c) Hold digoxin until the child has stopped vomiting d) Hold digoxin, notify the provider, and document

d

When performing cardiopulmonary resuscitation (CPR), which finding indicates that external chest compressions are effective? a) pupillary dilation b) cool, dry skin c) mottling of the skin d) palpable pulse

d

Which condition most commonly results in coronary artery disease (CAD)? a) Renal failure b) Diabetes mellitus c) Myocardial infarction d) Atherosclerosis

d

the inability of the ventricles to relax and fill during diastole. Often referred to as HF with normal EF (ejection fraction).

diastolic failure

A patient experiences orthostatic hypotension while receiving furosemide to treat hypertension. Select the correct nursing action. a) Administer I.V. fluids as ordered. b) Instruct the patient to sit for several minutes before standing. c) Administer a vasodilator as ordered. d) Insert an indwelling urinary catheter as ordered.

e

A patient with an acute myocardial infarction is receiving nitroglycerin by continuous I.V. infusion. Which patient statement indicates that this drug is producing its therapeutic effect? a) "I feel a tingling sensation around my mouth." b) "My chest pain is decreasing." c) "I have a bad headache." d) "My vision is blurred, so my blood pressure must be up."

e

an abnormal clinical syndrome that involves inadequate pumping and/or filling of the heart.

heart failure

results from the inability of the heart to pump blood effectively. It is caused by impaired contractile function, increased afterload, cardiomyopathy, and mechanical abnormalities.

systolic failure