Cardiac Practice Questions
The client is diagnosed with acute pericarditis. Which sign/symptom warrants immediate attention by the nurse? 1. Muffled heart sounds 2. Nondistended jugular veins 3. Bounding peripheral pulses 4. Pericardial friction rub
1. Muffled heart sounds
A client is diagnosed with essential HTN and taking a loop diuretic daily. Which assessment data would require immediate intervention by the nurse? 1. The client gained 2 kg in 1-2 days 2. The client's K level is 4.5 mEq 3. The telemetry reads NSR 4. The client's BP is 148/92
1. The client gained 2 kg in 1-2 days
The nurse admits a client with diagnosed PVD. Which data supports a diagnosis of venous insufficiency? 1. The client has bright red skin on the lower extremity 2. The client has a brownish purple area on the lower legs 3. The client complains of pain after ambulating short distances 4. The client has non-healing wounds on the toes and ankles
2. The client has a brownish purple area on the lower legs
Which cardiac enzyme would the nurse expect to elevate first in a client diagnosed with a myocardial infarction? 1.CK 2.LDH 3.Troponin 4.WBC
3 Troponin
The client presents to the outpatient clinic with calf pain. The client reports a recent airplane trip. Which should the nurse assess first? 1. The nurse should assess lung and heart sounds 2. The nurse should determine the length of the airplane trip 3. The nurse should determine if the client has chest pain 4. The nurse should measure and palpate the calf for warmth
4. The nurse should measure and palpate the calf for warmth
A nurse is caring for a client post-cardiac catheterization. Which of the following complications should the nurse monitor for? (Select all that apply.) a) Bleeding at the catheter insertion site b) Increased blood pressure c) Chest pain d) Decreased urine output e) Allergic reaction to the contrast media f) Bradycardia
a) Bleeding at the catheter insertion site c) Chest pain e) Allergic reaction to the contrast media
A client is scheduled for a cardiac catheterization. The nurse should assess the client for allergies, particularly to which substance commonly used in the procedure? a) Iodine b) Barium c) Nitroglycerin d) Lidocaine
a) Iodine
A patient has a severe blockage in his right coronary artery. Which heart structures would the nurse expect to be affected by this blockage? (select all that apply) a. AV node b. Left ventricle c. Coronary sinus d. Right ventricle e. Pulmonic valve
a. AV node b. Left ventricle d. Right ventricle
Which homeostatic mechanism is stimulated to compensate for a rise in blood pressure? a. Baroreceptors that inhibit the sympathetic nervous system, causing vasodilation b. Chemoreceptors that inhibit the sympathetic nervous system, causing vasodilation c. Baroreceptors that inhibit the parasympathetic nervous system, causing vasodilation d. Chemoreceptors that stimulate the sympathetic nervous system, causing an increased heart rate
a. Baroreceptors that inhibit the sympathetic nervous system, causing vasodilation
A patient with newly discovered high BP has an average reading of 158/98 mm Hg after 3 months of exercise and diet modifications. Which management strategy would the nurse expect? a. Drug therapy will be needed because the BP has not reached the goal. b. BP monitoring should continue for 3 months to confirm a diagnosis of hypertension. c. Lifestyle changes are less important since they were not effective, and drugs will be started. d. More changes in the patient's lifestyle are needed for a longer time before starting drug therapy.
a. Drug therapy will be needed because the BP has not reached the goal.
Which is a priority intervention for a patient during the acute phase of rheumatic fever? a. Giving IV antibiotics as prescribed b. Managing pain with opioid analgesics c. Encouraging fluid intake for hydration d. Performing frequent active range-of-motion exercises
a. Giving IV antibiotics as prescribed
A patient is admitted to the hospital in a hypertensive emergency (BP 244/142 mm Hg). Sodium nitroprusside is started to treat the elevated BP. Which management strategies would the nurse anticipate? (select all that apply) a. Measuring hourly urine output b. Continuous BP monitoring with an arterial line c. Decreasing the MAP by 50% within the first hour d. Maintaining bed rest and giving tranquilizers to lower the BP e. Assessing the patient for signs of heart failure and changes in mental status
a. Measuring hourly urine output b. Continuous BP monitoring with an arterial line e. Assessing the patient for signs of heart failure and changes in mental status
Which instruction is a key aspect of teaching for the patient on anticoagulant therapy? a. Monitor for and report any signs of bleeding. b. Do not take acetaminophen (Tylenol) for a headache. c. Decrease your dietary intake of foods containing vitamin K. d. Arrange to have blood drawn twice a week to check drug effects.
a. Monitor for and report any signs of bleeding.
A patient with chronic heart failure and atrial fibrillation is treated with low-dose digitalis and a loop diuretic. Which actions would the nurse take to prevent complications of this drug combination? (select all that apply) a. Monitor serum potassium levels. b. Teach the patient how to take a pulse rate. c. Keep an accurate measure of intake and output. d. Withhold digitalis if the pulse rhythm is irregular. e. Teach the patient about diet potassium restrictions.
a. Monitor serum potassium levels. b. Teach the patient how to take a pulse rate.
Which nursing responsibilities are priorities when caring for a patient returning from a cardiac catheterization? (select all that apply) a. Monitoring vital signs and ECG b. Checking the catheter insertion site and distal pulses c. Helping the patient to ambulate to the bathroom to void d. Telling the patient that he will be sleepy from the general anesthesia e. Teaching the patient about the risks of the radioactive isotope injection
a. Monitoring vital signs and ECG b. Checking the catheter insertion site and distal pulses
A patient with infective endocarditis develops sudden left leg pain with pallor, paresthesia, and a loss of peripheral pulses. Which action would the nurse take first? a. Notify the HCP of the change in perfusion. b. Start anticoagulant therapy with IV heparin. c. Elevate the leg to improve the venous return. d. Position the patient in reverse Trendelenburg.
a. Notify the HCP of the change in perfusion.
A patient is diagnosed with mitral stenosis and new-onset atrial fibrillation. Which interventions could the nurse delegate to assistive personnel (AP)? (select all that apply) a. Obtain and record daily weight. b. Determine apical-radial pulse rate. c. Observe for overt signs of bleeding. d. Teach the patient how to avoid bruising and bleeding. e. Obtain and record vital signs, including pulse oximetry.
a. Obtain and record daily weight. c. Observe for overt signs of bleeding. e. Obtain and record vital signs, including pulse oximetry.
A patient is in the ICU with a diagnosis of NSTEMI. Which drugs would the nurse expect the patient to receive? (select all that apply) a. Oral statin therapy b. Antiplatelet therapy c. Thrombolytic therapy d. Prophylactic antibiotics e. Intravenous nitroglycerin
a. Oral statin therapy b. Antiplatelet therapy e. Intravenous nitroglycerin
Which item would the nurse zero to establish accurate hemodynamic monitoring for a patient? a. Pressure monitoring system to phlebostatic axis b. Pressure monitoring system to the level of the midclavicular line c. Cardiac output monitoring system to the level of the left ventricle d. Pressure monitoring system to the level of the catheter tip in the patient
a. Pressure monitoring system to phlebostatic axis
A defect in which BP-regulating mechanisms can result in the development of hypertension? (select all that apply) a. Release of norepinephrine b. Secretion of prostaglandins c. Stimulation of the sympathetic nervous system d. Stimulation of the parasympathetic nervous system e. Activation of the renin-angiotensin-aldosterone system
a. Release of norepinephrine c. Stimulation of the sympathetic nervous system e. Activation of the renin-angiotensin-aldosterone system
Which findings would the nurse expect when assessing a patient with infective endocarditis? (select all that apply) a. Retinal hemorrhages b. Splinter hemorrhages c. Presence of Osler's nodes d. Painless nodules over bony prominences e. Erythematous macules on the palms and soles
a. Retinal hemorrhages b. Splinter hemorrhages c. Presence of Osler's nodes e. Erythematous macules on the palms and soles
Which statements accurately describe heart failure with preserved ejection fraction (HFpEF)? (select all that apply) a. Uncontrolled hypertension is a primary cause. b. Left ventricular ejection fraction may be within normal limits. c. The pathophysiology involves ventricular relaxation and filling. d. Multiple evidence-based therapies have been shown to decrease mortality. e. Therapies focus on symptom control and treatment of underlying conditions.
a. Uncontrolled hypertension is a primary cause. b. Left ventricular ejection fraction may be within normal limits. c. The pathophysiology involves ventricular relaxation and filling. e. Therapies focus on symptom control and treatment of underlying conditions.
Which condition would the nurse teach the patient is a possible long-term consequence of rheumatic fever? a. Valvular heart disease b. Pulmonary hypertension c. Superior vena cava syndrome d. Hypertrophy of the right ventricle
a. Valvular heart disease
Which condition is likely to cause a pulse deficit of 23 beats? a. Dysrhythmia b. Heart murmur c. Gallop rhythm d. Pericardial friction rub
a. dysrhythmia
After teaching a patient about ways to decrease risk factors for CAD, which patient statement indicates to the nurse that further instruction is needed? a. "I can keep my blood pressure normal with medication." b. "I would like to add weightlifting to my exercise program." c. "I can change my diet to decrease my intake of saturated fats." d. "I will change my lifestyle to reduce activities that increase my stress."
b. "I would like to add weightlifting to my exercise program."
Which patient is at highest risk for venous thromboembolism (VTE)? a. A 62-year-old man with spider veins who is having arthroscopic knee surgery b. A 32-year-old woman who smokes, takes oral contraceptives, and is planning a long flight c. A 26-year-old woman who is 3 days postpartum and received maintenance IV fluids for 12 hours during her labor d. An active 72-year-old man at home recovering from transurethral resection of the prostate for benign prostatic hyperplasia
b. A 32-year-old woman who smokes, takes oral contraceptives, and is planning a long flight
Which information would the nurse include in teaching a patient about CAD? (select all that apply) a. Diffuse involvement of plaque formation in coronary veins b. Abnormal levels of cholesterol, especially low-density lipoproteins c. Accumulation of lipid and fibrous tissue within the coronary arteries d. Development of angina due to a decreased blood supply to the heart muscle e. Chronic vasoconstriction of coronary arteries leading to permanent vasospasm
b. Abnormal levels of cholesterol, especially low-density lipoproteins c. Accumulation of lipid and fibrous tissue within the coronary arteries d. Development of angina due to a decreased blood supply to the heart muscle
In the patient with supraventricular tachycardia, which assessment indicates decreased cardiac output? a. Hypertension and dyspnea b. Chest pain and palpitations c. Abdominal distention and tachypnea d. Bounding pulses and a systolic murmur
b. Chest pain and palpitations
Which information would the nurse include when explaining the cause of rest pain with PAD? a. Vasospasm of cutaneous arteries in the feet b. Decrease in blood flow to the nerves of the feet c. Increase in retrograde venous perfusion to the lower legs d. Constriction in blood flow to leg muscles during exercise
b. Decrease in blood flow to the nerves of the feet
Which part of the vascular system provides hemostasis? a. Thin capillary vessels b. Endothelial layer of the arteries c. Elastic middle layer of the veins d. Smooth muscle of the arterial wall
b. Endothelial layer of the arteries
Which item in a patient history would the nurse recognize as a modifiable risk factor for the development of hypertension? a. Low-calcium diet b. Excess alcohol use c. Family history of hypertension d. Consumption of a high-protein diet
b. Excess alcohol use
Which action does the P wave on an ECG represent? a. Firing of the SA node and repolarizing the atria b. Firing of the SA node and depolarizing the atria c. Conduction through the AV node and depolarizing the atria d. Conduction through the AV node and spreading to the bundle of His
b. Firing of the SA node and depolarizing the atria
Which are the greatest risks for patients in the first year after heart transplantation? (select all that apply) a. Cancer b. Infection c. Rejection d. Vasculopathy e. Sudden cardiac death
b. Infection c. Rejection e. Sudden cardiac death
A hospitalized patient with a history of chronic stable angina tells the nurse they are having chest pain. Which information about ischemia would the nurse use as a basis for planning care? a. It will always progress to myocardial infarction. b. It can be relieved by rest, nitroglycerin, or both. c. It is often associated with vomiting and extreme fatigue. d. It indicates that irreversible myocardial damage is occurring.
b. It can be relieved by rest, nitroglycerin, or both.
Which clinical findings would the nurse expect in a person with an acute lower extremity VTE? (select all that apply) a. Pallor and coolness of foot and calf b. Mild to moderate calf pain and tenderness c. Grossly decreased or absent pedal pulses d. Unilateral edema and induration of the thigh e. Palpable cord along a superficial varicose vein
b. Mild to moderate calf pain and tenderness d. Unilateral edema and induration of the thigh
Which heart valve sound is heard best at the left midclavicular line at the level of the 5th ICS? a. Aortic b. Mitral c. Tricuspid d. Pulmonic
b. Mitral
The nurse is caring for a patient who is 2 days post MI. The patient reports that chest pain when taking a deep breath. Which action would be a priority? a. Notify the provider STAT and obtain a 12-lead ECG. b. Obtain vital signs and auscultate for a pericardial friction rub. c. Apply high-flow O2 by face mask and auscultate breath sounds. d. Medicate the patient with an opiate analgesic and reevaluate in 30 minutes.
b. Obtain vital signs and auscultate for a pericardial friction rub.
Which clinical manifestations can the nurse expect to see in both patients with Buerger disease and patients with Raynaud phenomenon? (select all that apply) a. Intermittent low-grade fevers b. Sensitivity to cold temperatures c. Gangrenous ulcers on fingertips d. Color changes of fingers and toes e. Episodes of superficial vein thrombosis
b. Sensitivity to cold temperatures c. Gangrenous ulcers on fingertips d. Color changes of fingers and toes
Which subjective data related to the cardiovascular system would the nurse plan to obtain? (select all that apply) a. Annual income b. Smoking history c. Spiritual preferences d. Number of pillows used to sleep e. Blood for basic laboratory studies
b. Smoking history c. Spiritual preferences d. Number of pillows used to sleep
A patient is admitted to the hospital with a diagnosis of abdominal aortic aneurysm. Which signs and symptoms would suggest that the aneurysm has ruptured? a. Rapid onset of shortness of breath and hemoptysis b. Sudden low back pain and bruising along the flank c. Patchy blue mottling on feet and toes and rest pain d. Gradually increasing substernal chest pain and diaphoresis
b. Sudden low back pain and bruising along the flank
Which patient teaching points would the nurse include when providing discharge instructions to a patient with a new permanent pacemaker? (select all that apply) a. Avoid or limit air travel. b. Take and record a daily pulse rate. c. Obtain and wear a Medic Alert ID device at all times. d. Avoid lifting arm on the side of the pacemaker above shoulder. e. Do not use a microwave oven because it interferes with pacemaker function.
b. Take and record a daily pulse rate. c. Obtain and wear a Medic Alert ID device at all times. d. Avoid lifting arm on the side of the pacemaker above shoulder.
A 50-year-old woman who weighs 95 kg has a history of high blood pressure, high sodium intake, tobacco use, and sedentary lifestyle. Which is the most important risk factor for peripheral artery disease (PAD) to address in the nursing plan of care? a. Salt intake b. Tobacco use c. Excess weight d. Sedentary lifestyle
b. Tobacco use
The hemodynamic changes the nurse expects to find after successful initiation of intraaortic balloon pump therapy include (select all that apply) a. decreased SV. b. decreased SVR. c. decreased PAWP. d. increased diastolic BP. e. decreased myocardial O2 consumption.
b. decreased SVR. c. decreased PAWP. d. increased diastolic BP. e. decreased myocardial O2 consumption.
The nurse teaches a patient with peripheral arterial disease. The nurse determines that further teaching is needed if the patient makes which statement? a."I should not use heating pads to warm my feet." b."I should cut back on my walks if it causes pain in my legs." c."I will examine my feet every day for any sores or red areas." d."I can quit smoking if I use nicotine gum and a support group."
b."I should cut back on my walks if it causes pain in my legs."
Which nursing interventions are the priority 8 hours after an abdominal aortic aneurysm repair? a. Assessing nutrition status and diet preferences b. Starting IV heparin and monitoring anticoagulation c. Administering IV fluids and watching kidney function d. Elevating the legs and applying compression stockings
c. Administering IV fluids and watching kidney function
A patient is recovering from an uncomplicated MI. Which rehabilitation guideline is a priority to include in the teaching plan? a. Refrain from sexual activity for a minimum of 3 weeks. b. Plan a diet program that aims for a 1- to 2-lb. weight loss per week. c. Begin an exercise program that aims for at least 5 30-minute sessions per week. d. Consider the use of erectile agents and prophylactic NTG before sexual activity.
c. Begin an exercise program that aims for at least 5 30-minute sessions per week.
Which goal is the first priority of interprofessional care for a patient with a suspected acute aortic dissection? a. Reduce anxiety b. Monitor chest pain c. Control blood pressure d. Increase myocardial contractility
c. Control blood pressure
Which finding is expected in the assessment of an 81-year-old patient? a. Narrowed pulse pressure b. Diminished carotid artery pulses c. Difficulty isolating the apical pulse d. Increased heart rate in response to stress
c. Difficulty isolating the apical pulse
The nurse is caring for a patient with acute decompensated heart failure who is receiving IV dobutamine. Which drug action is expected? (select all that apply) a. Raises the heart rate b. Dilates renal blood vessels c. Increases heart contractility d. Acts as a selective β-agonist e. Increases systemic vascular resistance
c. Increases heart contractility d. Acts as a selective β-agonist
Which finding is the strongest predictor of risk for sudden cardiac death? a. Aortic valve disease b. Mitral valve disease c. Left ventricular dysfunction d. Atherosclerotic heart disease
c. Left ventricular dysfunction
The nurse is caring for a patient newly admitted with heart failure secondary to dilated cardiomyopathy. Which intervention would be a priority? a. Encourage caregivers to learn CPR. b. Consider a consultation with hospice for palliative care. c. Monitor the patient's response to prescribed medications. d. Arrange for the patient to enter a cardiac rehabilitation program.
c. Monitor the patient's response to prescribed medications.
A patient with syncope has continuous ECG monitoring. The rhythm strip shows: Atrial rate 74 beats/min and regular; ventricular rate 62 beats/min and irregular; P wave normal shape; PR interval lengthens progressively until a P wave is not conducted; QRS normal shape. Which intervention would the nurse prioritize? a. Administer epinephrine 1 mg IV push. b. Prepare the patient for synchronized cardioversion. c. Observe for symptoms of hypotension and angina. d. Apply transcutaneous pacemaker pads on the patient.
c. Observe for symptoms of hypotension and angina
Where is the blood flow altered when a patient has a tricuspid valve problem? a. Vena cava and right atrium b. Left atrium and left ventricle c. Right atrium and right ventricle d. Right ventricle and pulmonary artery
c. Right atrium and right ventricle
Which information would the nurse teach the patient scheduled for a radiofrequency catheter ablation procedure? a. Ventricular bradycardia may be induced and treated during the procedure. b. A catheter will be placed in both femoral arteries to allow double-catheter intervention. c. The procedure will destroy areas of the conduction system that are causing rapid heart rhythms. d. General anesthetic will be given to prevent the awareness of any "sudden cardiac death" experiences.
c. The procedure will destroy areas of the conduction system that are causing rapid heart rhythms.
A client is undergoing a transesophageal echocardiogram (TEE). The nurse provides preprocedure teaching and emphasizes that the client should: a) Drink plenty of water before the test b) Avoid eating for at least 8 hours before the test c) Continue taking all medications as prescribed d) Lie still with minimal movement during the procedure
d) Lie still with minimal movement during the procedure
The nurse is planning care and teaching for a patient with venous leg ulcers. Which patient action is the most important in healing and control of this condition? a. Following activity guidelines. b. Using moist environment dressings. c. Taking horse chestnut seed extract daily. d. Applying graduated compression stockings.
d. Applying graduated compression stockings.
The ECG monitor of a patient in the cardiac care unit after an MI shows ventricular bigeminy with a rate of 50 beats/min. Which action would the nurse take? a. Perform defibrillation. b. Administer IV amiodarone. c. Prepare for pacemaker insertion. d. Assess the patient's response.
d. Assess the patient's response.
The nurse prepares a patient for elective synchronized cardioversion. Which information would the nurse consider in planning for the procedure? a. Defibrillation delivers a lower dose of electrical energy. b. Cardioversion is a treatment for atrial bradydysrhythmias. c. Defibrillation delivers a shock during the QRS complex. d. Cardioversion is painful for an awake patient.
d. Cardioversion is painful for an awake patient.
Which factor is a significant barrier to hospice referrals for patients with stage D heart failure? a. Family member refusal b. Scarcity of hospice care c. History of pacemaker placement d. Difficulty in estimating prognosis
d. Difficulty in estimating prognosis
Which information would the nurse apply to a teaching plan for a patient with hypertension? a. All patients with elevated BP need drug therapy b. Obese persons must achieve a normal weight to lower BP. c. It is not necessary to limit salt in the diet if taking a diuretic. d. Lifestyle modifications are needed for persons with elevated BP.
d. Lifestyle modifications are needed for persons with elevated BP.
Which intervention is a priority in nursing management of a patient with myocarditis? a. Providing meticulous skincare b. Assuring tight glycemic control c. Administering antibiotic prophylaxis d. Monitoring oxygenation and ventilation
d. Monitoring oxygenation and ventilation
Which compensatory mechanism involved in both chronic heart failure and acute decompensated heart failure leads to fluid retention and edema? a. Ventricular dilation b. Ventricular hypertrophy c. Increased systemic blood pressure d. Renin-angiotensin-aldosterone activation
d. Renin-angiotensin-aldosterone activation
Which treatment would the nurse anticipate for an otherwise healthy person with an initial VTE? a. IV argatroban as an inpatient b. IV unfractionated heparin as an inpatient c. Subcutaneous unfractionated heparin as an outpatient d. Subcutaneous low-molecular-weight heparin as an outpatient
d. Subcutaneous low-molecular-weight heparin as an outpatient
Which consideration would the nurse include in the management of the older adult with hypertension? a. Preventing primary hypertension from converting to secondary hypertension b. Recognizing that the older adult is less likely to adhere to the drug therapy regimen than a younger adult c. Ensuring that the patient receives larger initial doses of antihypertensive drugs because of impaired absorption d. Using a precise technique in assessing the BP of the patient because of the possible presence of orthostatic hypertension
d. Using a precise technique in assessing the BP of the patient because of the possible presence of orthostatic hypertension