Cardio

Question 1

A nurse is caring for a client in the intensive care unit diagnosed with shock. Which definition best describes this shock state?
A. Shock that occurs due to a decrease in intravascular volume
B. Shock that occurs as a result of cardiac dysfunction
C. Shock that occurs secondary to an excessive inflammatory response due to infection
D. Shock that occurs due to damage to the brain or spinal cord

Answer 1

A. Shock that occurs due to a decrease in intravascular volume

Hypovolemic shock is a life-threatening condition characterized by a decrease in intravascular volume in the cardiovascular system, which becomes insufficient to support adequate perfusion of the body tissues

Question 2

After a history and physical indicate a client may be experiencing atrial fibrillation, which diagnostic testing should the nurse prepare the client for?
A. Chest X-ray
B. Cardiac catheterization
C. Magnetic resonance imaging (MRI)
D. 12-lead electrocardiogram (ECG)

Answer 2

D. 12-lead electrocardiogram (ECG)

Question 3

A client recently diagnosed with left-sided heart failure is in the outpatient clinic for shortness of breath. Which additional assessment finding indicates that the client may be experiencing worsening of the condition?
A. Respiratory rate of 12 and shoulder pain 7/10
B. Crackles auscultated bilaterally and pink, frothy sputum
C. Urine output of 1000 mL and increased episodes of vomiting
D. Heart rate of 75 and blood pressure of 105/68

Answer 3

B. Crackles auscultated bilaterally and pink, frothy sputum

Question 4

Following a severe myocardial infarction, a client demonstrates decreased cardiac output. The nurse understands which compound(s) is/are likely being released by the body to compensate for decreased cardiac output? Select all that apply.
A. Epinephrine
B. Histamine
C. Luteinizing hormone
D. Angiotensin II
E. Antidiuretic hormone

Answer 4

A. Epinephrine
D. Angiotensin II
E. Antidiuretic hormone

Question 5

The nurse is caring for an adult client with a blood pressure of 201/125 mmHg who is prescribed intravenous (IV) hydralazine 10 mg once. The medication is available in a vial containing 20 mg/mL. How many mL of the solution should the nurse administer per dose?

Answer 5

0.5 mL

Question 6

The nurse is caring for a client in the emergency department who has a suspected myocardial infarction (MI). The healthcare provider tells the nurse they plan to prescribe a clonidine patch since the client was hypertensive on admission. Before applying the patch, which action should the nurse do first?
A. Ask the client to rate their pain on a scale of 0-10
B. Tell the client to lie down on their back
C. Provide the client with a glass of water
D. Obtain a new blood pressure

Answer 6

D. Obtain a new blood pressure

Clonidine is a medication that lowers blood pressure and should not be administered if the client is currently experiencing hypotension.

Question 7

A client with a history of hypertension presents to the emergency department reporting a severe headache for three days. The triage nurse obtains a blood pressure of 231/187 mmHg and the client’s creatinine is 2.5 mg/dL. After establishing intravenous access, the nurse notifies the healthcare provider. Which medication should the nurse expect the healthcare provider to prescribe for this client’s condition?
A. Dopamine
B. Vasopressin
C. Midodrine
D. Hydralazine

Answer 7

D. Hydralazine

Direct-acting vasodilators, like hydralazine, work because there is an inverse relationship of the size (diameter) of a blood vessel to the blood pressure.

Question 8

A client presents to the ER with palpitations after returning from a vacation. They state that yesterday, they consumed a moderate amount of alcohol and inhaled cocaine. The client has premature atrial contractions (PACs) on their electrocardiogram. What is the most likely cause of the client’s arrhythmia?
A. Myocardial inflammation
B. Orthostatic hypotension
C. Increased sympathetic activity
D. Impaired ventilation

Answer 8

C. Increased sympathetic activity

Illicit drugs like cocaine can increase sympathetic stimulation and raise the likelihood of enhanced automaticity within the atria. This can lead to PACs.

Question 9

The cardiac nurse is caring for several clients who are each prescribed an angiotensin-converting enzyme (ACE) inhibitor. The nurse should hold the next dose and call the provider to discuss the prescription for which client?
A. Adult client recently prescribed spironolactone for heart failure
B. Elderly client diagnosed with acute myocardial infarction (MI)
C. Female client with a potassium level of 4.0 mEq/L
D. Adult male with a blood pressure of 142/88 mmHg

Answer 9

A. Adult client recently prescribed spironolactone for heart failure

ACE inhibitors decrease potassium excretion in the urine, which can lead to hyperkalaemia. So, it is important for clients who are taking ACE inhibitors to avoid taking potassium sparing diuretics, like spironolactone. The nurse should hold the next dose and contact the provider to discuss the prescription for this client.

Question 10

The nurse has administered digoxin to a client for treatment of atrial fibrillation. Which side effect(s) should the nurse monitor for? Select all that apply.
A. Weight gain
B. Hypertension
C. Bradycardia
D. Seizures
E. Diplopia

Answer 10

C. Bradycardia
E. Diplopia

Bradycardia, or low heart rate, is a side effect of cardiac glycosides such as digoxin.
Digoxin can cause certain visual side effects such as diplopia. Diplopia is when a client experiences double vision.

Question 11

The nurse is preparing to provide client education regarding the common causes of peripheral venous disease (PVD). Which contributing disease process should the nurse include in the teaching?
A. Hypertension
B. Type II diabetes
C. Atherosclerosis
D. Congestive heart failure (CHF)

Answer 11

D. Congestive heart failure (CHF)

CHF is associated with the development of PVD. A client with congestive heart failure cannot pump the blood forward, which results in blood pooling in the venous system, increasing venous pressure and causing damage to the veins.

Question 12

The nurse is documenting the plan of care for a client diagnosed with a ST segment elevation myocardial infarction (STEMI). Which nursing intervention is appropriate to include?
A. Educate client about foods low in potassium and magnesium
B. Encourage family members to visit the client frequently
C. Instruct the client not to strain during bowel movements
D. Assist the client in performing active range of motion every hour

Answer 12

C. Instruct the client not to strain during bowel movements

Question 13

A nurse is caring for a client admitted with hypertension. The client’s vital signs at 8 am (08:00) were:
Temperature 37.1°C (98.8 °F)
Blood pressure 110/88 mmHg
Heart rate 78/min
Respirations 20/min
Oxygen saturation 98% on room air
Prior to administering atenolol at 10 am (10:00), which nursing intervention should the nurse perform?
A. Ask the client if they have eaten breakfast
B. Take another temperature
C. Change the administration time
D. Check blood pressure and heart rate

Answer 13

D. Check blood pressure and heart rate

Question 14

A nurse is caring for a client in the compensatory stage of hypovolemic shock. Which consequences of catecholamine release should the nurse expect to observe in this client? Select all that apply.
A. Increased cardiac contractility
B. Increased urine output
C. Increased blood pressure
D. Increased heart rate
E. Increased peripheral resistance

Answer 14

A. Increased cardiac contractility
C. Increased blood pressure
D. Increased heart rate
E. Increased peripheral resistance

Question 15

A 65-year-old client is being discharged after hospitalization following a cardiac arrest event. During hospitalization, the client developed asystole and achieved a return of spontaneous circulation. In the event the client becomes unresponsive at home, what instruction should the nurse provide to the client’s family members in addition to the need to notify emergency responders?
A. “Coach the client to take slow, deep breaths.”
B. “Push hard and fast on the client’s chest.”
C. “Lay the client on their side to prevent choking.”
D. “Administer 4 ounces of fruit juice.

Answer 15

B. “Push hard and fast on the client’s chest.”

Question 16

Which statement(s) should the nurse include when teaching a client with left-sided heart failure to prevent future exacerbations? Select all that apply.
A. “Take your lisinopril and furosemide as ordered.”
B. “Monitor your fluid intake to prevent fluid overload.”
C. “Weigh yourself at the same time each day.”
D. “Eat a low-salt diet to prevent fluid retention.”
E. “Eat lots of high-cholesterol foods to prevent heart disease.”
F. “Increase calcium intake to prevent heart failure.”

Answer 16

A. “Take your lisinopril and furosemide as ordered.”
B. “Monitor your fluid intake to prevent fluid overload.”
C. “Weigh yourself at the same time each day.”
D. “Eat a low-salt diet to prevent fluid retention.”

Question 17

Which statement can be applied to the pathological process of primary hypertension?
A. “Hypertension occurs when a buildup of plaque weakens the arterial walls.”
B. “Secondary hypertension occurs when the veins are weakened.”
C. “Primary hypertension is caused by other medical conditions.”
D. “Genetic factors can affect the cardiovascular and renal systems.”

Answer 17

D. “Genetic factors can affect the cardiovascular and renal systems.”

Primary hypertension has no known underlying cause, but it is thought to be due to the interaction of environmental and genetic factors affecting the cardiovascular and renal systems.

Question 18

The nurse is gathering the medication history from a client diagnosed with congestive heart failure (CHF). The client tells the nurse they are taking a cardiac glycoside. Which medication on the client’s home medication list is within this classification?
A. Digoxin
B. Losartan
C. Bumetanide
D. Captopril

Answer 18

A. Digoxin

Digoxin is a cardiac glycoside used in the treatment of CHF.

Question 19

A client arrives at the emergency department with chest pain and is being evaluated for a possible myocardial infarction (MI). Which diagnostic test(s) should the nurse prepare the client for? Select all that apply.
A. Cardiac Stress Test
B. Chest X-Ray
C. Electrocardiogram (ECG)
D. Serum coagulation panel
E. Complete Metabolic Panel (CMP)

Answer 19

B. Chest X-Ray
C. Electrocardiogram (ECG)
D. Serum coagulation panel
E. Complete Metabolic Panel (CMP)

Question 20

The emergency department nurse is caring for a client experiencing 8/10 chest pain and left arm tingling. The healthcare provider suspects the client is having a myocardial infarction (MI). The nurse should anticipate that the healthcare provider will prescribe which medication?
A. Nitroglycerin
B. Furosemide
C. Atorvastatin
D. Isosorbide dinitrate

Answer 20

A. Nitroglycerin

Question 21

The nurse working on the cardiovascular intensive care unit (CVICU) is preparing to administer phytonadione (vitamin K) 25 mg intravenous push (IVP) STAT once to a client who mistakenly overdosed on warfarin. How many mL should the nurse administer? Round to the nearest tenth.

Answer 21

2.5 mL

Question 22

The cardiac nurse is reviewing the medication administration records (MARs) for each assigned client and recognizes that several clients have been prescribed a beta-adrenergic blocker (β blocker). Which client condition(s) should the nurse anticipate based upon β blockers in the MAR? Select all that apply.
A. Bradycardia
B. Hypertension
C. Glaucoma
D. Pneumonia
E. Chest pain

Answer 22

B. Hypertension
C. Glaucoma

Question 23

The nurse is educating a client about the conditions for which antiplatelets are prescribed. Which condition should the nurse include in the teaching?
A. Deep vein thrombosis (DVT)
B. Congestive heart failure (CHF)
C. Ischemic stroke
D. Hypertension

Answer 23

C. Ischemic stroke

Antiplatelet agents are medications mainly used to treat and prevent thromboembolic events like ischemic stroke. Antiplatelet agents work by preventing platelet clot formation.

Question 24

The nurse is caring for several clients on a coronary care unit (CCU). Which client statement should alert the nurse to a potentially life-threatening complication of a STEMI?
A. “I am still short of breath when I walk.”
B. “I feel sad and alone.”
C. “Everytime I take my nitro, my head starts to hurt.”
D. “I feel like my heart is skipping beats.”

Answer 24

D. “I feel like my heart is skipping beats.”

Question 25

The student nurse is caring for a client diagnosed with deep vein thrombosis (DVT) due to long-standing varicose veins. During an educational session, the client asks, “What is a DVT?” Which is the best response by the student nurse?
A. “DVTs are another name for swelling in the legs that occurs when the veins become stretched out.”
B. “DVT refers to the pain in the back of a calf that comes and goes when walking.”
C. “DVTs are the term used to describe the valves which can no longer pump the blood forward toward the heart.”
D. “DVTs are blood clots that form when blood pools in the vein for long periods.”

Answer 25

D. “DVTs are blood clots that form when blood pools in the vein for long periods.”

Question 26

A client with a history of sinus arrhythmia is a current cigarette smoker with a 10 pack-year history. The nurse is educating the client about ways to prevent cardiac arrhythmias. Which client statement requires clarification?
A. “I shouldn’t smoke anymore, but chewing tobacco is okay.”
B. “I may have to get counseling on how to better deal with stress.”
C. “In addition to smoking, I should also stop drinking alcohol.”
D. “Smoking e-cigarettes is just as bad as traditional cigarettes.”

Answer 26

A. “I shouldn’t smoke anymore, but chewing tobacco is okay.”

Question 27

A nurse at an outpatient clinic takes a phone call from a woman who is very concerned about her father. She states that he has a history of premature atrial contractions and has developed slurred speech. What is the most appropriate response by the nurse?
A. “Has the client been under stress lately?”
B. “Is the client prescribed any opiates?”
C. “What time did the client’s symptoms start?”
D. “Is the client able to eat and drink?”

Answer 27

C. “What time did the client’s symptoms start?”

Question 28

The nurse is caring for a burn victim experiencing hypovolemic shock. Which organ(s) is/are directly responsible for maintaining fluid balance in the body?
A. Pancreas
B. Skin
C. Heart
D. Kidney
E. Gallbladder

Answer 28

B. Skin
C. Heart
D. Kidney

Question 29

The nurse is preparing an interdisciplinary plan of care for a client diagnosed with a myocardial infarction (MI). Which is an appropriate task to delegate to an assistive personnel (AP)?
A. Administer fluids through an intravenous (IV) line
B. Performing a pain assessment
C. Teaching the client about low sodium food choices
D. Obtaining blood pressure and pulse

Answer 29

D. Obtaining blood pressure and pulse

Question 30

A nurse caring for a client on the telemetry unit suspects the client might be experiencing cardiogenic shock. When reviewing the client’s chart, which of the following conditions does the nurse recognize as most likely to lead to cardiogenic shock?
A. Severe diaphoresis
B. Myocardial infarction
C. Anaphylaxis
D. Bacterial infection

Answer 30

B. Myocardial infarction

Question 31

The nurse has provided education for a client with type 1 diabetes who is newly diagnosed with hypertension. Which statement made by the client indicates further teaching is needed?
A. “I will make a follow-up appointment only if my blood pressure increases.”
B. “I will measure my blood pressure at the same time every day.”
C. “I am following up with my endocrinologist to help get my sugars under control.”
D. “I will keep a log of my blood pressures.”

Answer 31

A. “I will make a follow-up appointment only if my blood pressure increases.”

Question 32

The nurse is providing discharge instructions to a client who is prescribed propranolol. Which instruction(s) should the nurse include in the education? Select all that apply.
A. “Monitor your blood pressure and heart rate before taking this medicine.”
B. “Only take this medication if you feel your heart fluttering.”
C. “You need to stand up very slowly to prevent dizziness.”
D. “Report any difficulty breathing or chest tightness.”
E. “If your blood pressure has been normal for a few days, you can stop taking the medication.”

Answer 32

A. “Monitor your blood pressure and heart rate before taking this medicine.”
C. “You need to stand up very slowly to prevent dizziness.”
D. “Report any difficulty breathing or chest tightness.”

Question 33

The nurse is providing education to a nursing student about conditions for which calcium channel blockers can be used in the treatment. Which example should the nurse include in the teaching?
A. Focal seizures
B. Hypotension
C. Angina
D. Parkinson’s disease

Answer 33

C. Angina

Question 34

The nurse is preparing to explain the pathophysiology of atrial fibrillation to a nursing student. Which statement should the nurse include in the teaching?
A. “Impulses that originate from multiple foci during atrial fibrillation tend to override the atrioventricular node.”
B. “Damaged atrial cells cause tissue heterogeneity resulting in electrical impulses generated in a disorganized manner from many foci.”
C. “Impulses generated from many foci reach the ventricles causing fibrillation of the ventricles.”
D. “Mini contractions occur, creating an appearance on an electrocardiogram (ECG) that the ventricles are quivering.”

Answer 34

B. “Damaged atrial cells cause tissue heterogeneity resulting in electrical impulses generated in a disorganized manner from many foci.”

Question 35

The nurse is evaluating the effect of the pharmacological management of a client diagnosed with stable angina. Which statement made by the client indicates the treatment is effective?
A. “Since I have started taking nifedipine, I have only had to use my nitroglycerin once.”
B. “I need to take an extra metoprolol pill, so I do not get chest pain at the gym.”
C. “My cholesterol level went from 300 to 320 after I started taking atorvastatin.”
D. “I take nitroglycerin several times over an hour so my chest pain will go away.”

Answer 35

A. “Since I have started taking nifedipine, I have only had to use my nitroglycerin once.”

Question 36

A client with essential hypertension comes to the community health clinic for routine blood pressure screening. The client tells the nurse they take a diuretic but cannot recall the name of the medication. After reviewing the client’s home medication list, the nurse should identify the client is most likely referring to which medication?
A. Metoprolol
B. Budesonide
C. Hydrochlorothiazide
D. Tamsulosin

Answer 36

C. Hydrochlorothiazide

Question 37

A new nurse is caring for a client diagnosed with anaphylactic shock. The nurse asks a more experienced nurse about the difference between an allergic reaction and anaphylactic shock. What would be the most appropriate response?
A. “Itching is only a sign of an allergic reaction, not anaphylactic shock.”
B. “Exposure to a significant amount of allergen leads to the development of anaphylactic shock, but an allergic reaction is caused by exposure to a small amount of allergen.”
C. “Anaphylactic shock is a reaction involving the entire body.”
D. “Anaphylactic shock involves histamine, while allergic reactions do not.”

Answer 37

C. “Anaphylactic shock is a reaction involving the entire body.”

Question 38

Which information should the nurse include when discussing triggers of chronic stable angina with a client? Select all that apply.
A. Diabetes mellitus type II
B. Obesity
C. Emotional stress
D. Smoking
E. Exercise

Answer 38

C. Emotional stress
E. Exercise

Question 39

The nurse in the emergency department is preparing to administer clonidine to a client being treated for severe hypertension. While conducting the health history, which client statement should alert the nurse to a potential drug-drug interaction?
A. “I take metoprolol 25 mg every morning and at night.”
B. “I usually take 1000 mg of vitamin C every day.”
C. “I have been taking 40 mg of pantoprazole in the morning.”
D. “I use gabapentin every day to help with my nerve pain.”

Answer 39

A. “I take metoprolol 25 mg every morning and at night.”

Question 40

A community health nurse is conducting an education session with a group of adults about risk factors associated with developing heart failure. Which factor(s) should the nurse include in the teaching? Select all that apply.
A. Dysfunctional kidneys
B. Blocked arteries of the heart
C. Chronic high blood pressure
D. Physical trauma or surgery
E. Obsessive-compulsive behaviours

Answer 40

A. Dysfunctional kidneys
B. Blocked arteries of the heart
C. Chronic high blood pressure

Question 41

The nurse in the intensive care unit (ICU) is preparing to administer norepinephrine to a client diagnosed with septic shock who has developed hypotension. Which baseline assessment(s) should the nurse gather prior to administering this medication? Select all that apply.
A. Platelet count
B. Pulmonary artery pressure
C. Arterial blood gases (ABG)
D. Troponin
E. Electrocardiogram (ECG)

Answer 41

B. Pulmonary artery pressure
E. Electrocardiogram (ECG)

Question 42

A nurse on a surgical unit is caring for four clients. Which client is at the highest risk for developing hypovolemic shock?
A. A client 3 days post open reduction and internal fixation of the right femur
B. A client with a severe peanut allergy who was admitted for angioedema
C. A client with a small bowel obstruction who has been vomiting bilious fluid for 72 hours
D. A client with a history of hyperthyroidism whose symptoms are controlled with methimazole

Answer 42

C. A client with a small bowel obstruction who has been vomiting bilious fluid for 72 hours

Question 43

A client prescribed digoxin for the treatment of atrial flutter asks the nurse, “How is the medication going to stop my heart from beating abnormally?” Which is the best response by the nurse?
A. “Digoxin directly slows down the beating of the ventricles of the heart.”
B. “Digoxin blocks nerve signals from the brain to the heart.”
C. “Digoxin relaxes the muscle fibers of the heart.”
D. “Digoxin helps the heart contract more efficiently.”

Answer 43

D. “Digoxin helps the heart contract more efficiently.”

Question 44

Which finding indicates that treatment for left-sided heart failure has been successful?
A. The client can sleep at night with the head of the bed at 90 degrees.
B. The client has had a urinary output of 78 mL in 12 hours.
C. The client’s oxygen is decreased to 0.5L from 3L.
D. The client is unable to move from the bed to chair due to shortness of breath.

Answer 44

C. The client’s oxygen is decreased to 0.5L from 3L.

Question 45

A client admitted to the cardiovascular step down unit is being treated for congestive heart failure (CHF) with a maintenance dose of digoxin. The client is prescribed digoxin 0.25 mg PO daily and the medication is available in 0.125 mg tablets. How many tablet(s) should the nurse administer per dose?

Answer 45

2 tablets

Question 46

A client arrives at the emergency department complaining of chest pain and has been diagnosed with ST segment elevated myocardial infarction (STEMI).
Current vital signs are:
Temperature: 37.5°C (99.6°F)
Heart rate: 111/min
Respirations: 21/min
Oxygen saturation: 95% on room air
Blood pressure: 90/48 mm Hg
Which prescribed treatment should the nurse implement first?
A. Deliver oxygen via nonrebreather mask
B. Deliver intravenous morphine
C. Administer chewable aspirin tablet
D. Administer nitroglycerin sublingual tablet

Answer 46

C. Administer chewable aspirin tablet

Chewable aspirin should be administered to inhibit clotting. This is essential during the acute stages of a STEMI because further clot formatting could cause increased irreversible myocardial tissue death.

Question 47

The home health nurse is performing a medication reconciliation with a new client. The client was recently prescribed alirocumab for elevated low-density lipoprotein (LDL) in addition to a statin. The prescription is noted to be alirocumab 75 mg every two weeks subcutaneously. If there are 150 mg/mL in the prefilled injection pen, how many pen(s) should the nurse administer every two weeks?

Answer 47

0.5 injection pen

Question 48

Which nursing diagnosis should the nurse assign the highest priority for a client with left-sided heart failure?
A. Anxiety related to shortness of breath
B. Excess fluid volume related to excess fluid in the lungs
C. Deficient knowledge related to medication regimen
D. Activity intolerance related to weakness of the legs

Answer 48

B. Excess fluid volume related to excess fluid in the lungs

Question 49

The nurse is documenting the assessment findings for a client with an exacerbation of left-sided heart failure. While auscultating the lungs, the nurse hears brief, high-pitched popping sounds. How should the nurse document this finding?
A. Normal breath sounds on expiration
B. Absent lung sounds bilaterally
C. Crackles in bilateral lung fields
D. Stridor in the left lung field

Answer 49

C. Crackles in bilateral lung fields

Question 50

During the past few months, Eliza, a 56 year old woman has 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. Eliza states, ‘I really thought I was having a heart attack. How can you tell the difference?’ Which response by the nurse would provide the client with the most accurate information about the difference between the pain of angina and that of myocardial infarction?
A. The pain associated with a heart attack is much more severe
B. The pain associated with a heart attack radiates into the jaw and down the left arm
C. It is impossible to differentiate angina pain from that of a heart attack without an ECG
D. The pain of angina is usually relieved by resting or lying down

Answer 50

D. The pain of angina is usually relieved by resting or lying down