Nclex Made Incredible Easy - Cardio Questions

 

Part II

Care of the adult

3 Cardiovascular disorders 33  33  71  4 Hematologic & immune disorders 71  5 Respiratory disorders 95  95  6 Neurosensory disorders 135 135   7 Musculoskeletal disorders 169  169  197  8 Gastrointestinal disorders 197  9 Endocrine disorders 223  223  251   10 Genitourinary disorders 251 279  11 Integumentary disorders 279 

electrocardiogram (ECG) is showing ST elevation in Leads V 2, V 3, and 1. A client's electrocardiogram  V 4. Which artery is most likely to be occluded? 1. Circumflex artery  2. Internal Internal mammary artery  3. Left anterior descending artery  4. Right coronary artery  2. A nurse on a telemetry unit teaches a student nurse how coronary arteries primarily receive blood flow. It would be most important for the nurse to emphasize that most of the blood flow to coronary arteries is supplied during  which of the following? following? 1. During inspiration 2. During During diastole 3. During expiration 4. During During systole

1

 

3. Which of the following illnesses, if stated by a client, would indicate that he understandss the leading cause of death in the United States? understand 1. Cancer 2. Coronary Coronary artery disease (CAD) 3. Liver failure 4. Renal failure 4. Which condition most commonly results in coronary artery disease (CAD)? 1. Atherosclerosis  Atherosclerosis 2. Diabetes Diabetes mellitus 3. Myocardial infarction (MI) 4. Renal Renal failure 5. A nurse describes atherosclerosis for client education. Which of the following statements,, if made by the client, requires additional teaching? statements 1. Plaques obstruct the coronary artery. 2. Plaques obstruct the vein. 3. Hardened vessels can't dilate to allow blood to flow through.   4. Atheroscl  Atherosclerosis erosis can caus causee angina. 6. Which risk factor for coronary artery disease is non-modifiable? 1. Cigarette smoking 2. Diabetes Diabetes mellitus 3. Heredity  4. Hypertension Hypertension 7. Exceeding which serum cholesterol level significantly increases the risk of  coronary artery disease (CAD)? 1. 100 mg/dl 2. 150 150 mg/dl 3. 175 mg/dl 4. 240 240 mg/dl 8. Which action is the first priority of care for a client exhibiting signs and symptoms of coronary artery disease? 1. Decrease anxiety. 2. Enhance Enhance myocardial oxygenation. 2

 

  3. Administer sublingual nitrogly sublingual nitroglycerin. cerin. 4. Educate Educate the client about his symptoms symptoms..

9. Medical treatment of coronary artery disease (CAD) includes which procedure? 1. Cardiac catheteriza catheterization tion 2. Coronary Coronary artery bypass surgery  3. Oral medication administration 4. Percutaneous Percutaneous transluminal coronary angioplasty  10. A client's electrocardiogram shows ST elevation in leads II, III, and aV F, suggesting occlusion of the right coronary artery. Which area of the heart is experiencing experiencin g an infarction? 1. Anterior  Anterior 2. Apical   3. Inferior 4. Lateral Lateral 11. Which is the most common symptom of myocardial infarction (MI)? 1. Chest pain 2. Dyspnea Dyspnea 3. Edema 4. Palpitations Palpitations 12. Which landmark is the correct one for obtaining an apical pulse? 1. Left fifth intercosta intercostall space, midaxillary line 2. Left Left fifth intercosta intercostall space, midclavicular line 3. Left second intercostal space, midclavicular line 4. Left Left seventh intercostal space, midclavicular line 13. Which system is the most likely origin of pain the client describes as knifelike chest pain that increases in intensity with inspiration? 1. Cardiac 2. Gastrointestinal Gastrointestinal 3. Musculoskeletal 4. Pulmonary  Pulmonary  3

 

14. While assessing a client's heart sounds, a murmur is heard at the second left intercostal space along the left sternal border. Which valve is most likely  involved? 1. Aortic  Aortic 2. Mitral Mitral 3. Pulmonic 4. Tricuspid 15. Which blood test is the best indicator for myocardial injury? 1. Lactate dehydrogenase (LD) 2. Complete Complete blood count (CBC) 3. Troponin I 4. Creatine Creatine kinase (CK) 16. What is the primary reason for administering morphine to a client with a myocardial infarction? 1. To sedate the client 2. To To decrease the client's pain 3. To decrease the client's anxiety  4. To To decrease oxygen demand on the client's heart 17. In caring for a client with cardiac problems, the nurse must know that the condition most likely responsible for myocardial infarction (MI) is which of the following? 1. Aneurysm   Aneurysm 2. Heart Heart failure 3. Coronary artery thrombosis 4. Renal Renal failure 18. What supplemental medication is most frequently ordered in conjunction  with furosemide furosemide (Lasix)? 1. Chloride 2. Digoxin Digoxin 3. Potassium 4. sodium sodium

4

 

19. In order to anticipate problems in a client following a myocardial infarction (MI), the nurse should understand that which type of physiological changes will increase serum glucose levels and free fatty acid production? 1. Electrophysiologic 2. Hematologic Hematologic 3. Mechanical 4. Metabolic 20. Which complication complication is indicated by a third heart sound ((S S3)? 1. Ventricular  Ventricular dilation 2. Systemic Systemic hypertension 3. Aortic   valve malfunction malfunction 4. Increased Increased atrial contractions 21. After an anterior-wall myocardial infarction (MI), which problem is indicated  by auscultation auscultation of crackles iin n the lungs? 1. Left-sided heart failure 2. Pulmonic Pulmonic valve malfunctio malfunction n 3. Right-sided heart failure 4. Tricuspid Tricuspid valve malfunction malfunction 22. A client who is being evaluated for myocardial infarction (MI) asks the nurse  which diagnostic tool is most commonl commonly y used to determine the location of  myocardial damage. Which of the following would be the best response by the nurse? 1. Cardiac catheterization 2. Cardiac Cardiac enzymes 3. Echocardiogram 4. Electrocardiogram Electrocardiogram (ECG) 23. What is the first intervention for a client experiencing myocardial infarction (MI)? 1. Administer   Administer morphine. morphine. 2. Administer   oxygen. oxygen. 3. Administer   sublingual nitrogly sublingual nitroglycerin. cerin. 4. Obtain Obtain an electroca electrocardiogram rdiogram (ECG).

5

 

24. What is the most appropriate nursing response to a myocardial infarction (MI) client who is fearful of dying? 1. “Tell me about your feelings right now.” now.”   2. “When “When the doctor arrives, everything will be fine.”  fine.”  3. “This is a bad situation, but you'll feel better soon.” soon.”   4. “Please “Please be assured we're doing everything we can to make you feel better.”  better.”  25. Which class of medications protects the ischemic myocardium by blocking catecholamines and sympathetic nerve stimulation? 1. Beta-adrenergic blockers 2. Calcium Calcium channel blockers 3. Opioids 4. Nitrates Nitrates 26. What is the most common complication of a myocardial infarction (MI)? 1. Cardiogenic shock  2. Heart Heart failure   3. Arrhythmi  Arrhythmias as 4. Pericarditis Pericarditis

27. With which disorder is jugular vein distention most prominent? 1. Abdominal   Abdominal aortic aortic aneurysm 2. Heart Heart failure 3. Myocardial infarction (MI) 4. Pneumothorax Pneumothorax 28. In what position should the nurse place the head of the bed to obtain the most accurate reading of jugular vein distention? 1. High Fowler's 2. Raised Raised 10 degrees 3. Raised 30 degrees 4. supine supine

6

 

29. A client is ordered to start receving digoxin 0.25 mg P.O. Which parameter should be checked first before administerin administering g digoxin? 1. Apical  Apical pulse 2. Blood Blood pressure 3. Radial pulse 4. Respiratory Respiratory rate 30. A client complains that he sees a green halo around lights. Upon reviewing the client's medication list, the nurse determines that this is most likely caused by  a high level of which medication? 1. Digoxin 2. Furosemide Furosemide (Lasix) 3. Metoprolol (Lopresso ( Lopressor) r) 4. Enalapril Enalapril (Vasotec)

31. Which symptom is most commonl commonly y associated with left-sided heart failure? 1. Crackles   2. Arrhythmi  Arrhythmias as 3. Hepatic engorgement 4. Hypotension Hypotension 32. In which disorder would the nurse expect to assess sacral edema in a  bedridden client? client? 1. Diabetes mellitus 2. Pulmonary Pulmonary emboli 3. Chronic kidney disease 4. Right-sided heart failure

33. Which symptom might a client with rightsided heart failure exhibit? 1. Adequate   Adequate urine output output 2. Polyuria Polyuria 3. Oliguria 4. Polydipsia Polydipsia

7

 

34. Which of the following drug classes should be administered to a client with heart failure to maximize cardiac performance by increasing ventricular contractility? 1. Beta-adrenergic blockers 2. Calcium Calcium channel blockers 3. Diuretics 4. Inotropic agents 35. The heart rhythm of a client who has experienced cardiac arrest and is receiving cardiopulmonary resuscitation (CPR) deteriorates to ventricular fibrillation. Which action should the nurse perform first? 1. Administer   Administer 1 mg mg of epinephrine I.V I.V.. 2. Defibrillate Defibrillate with 360 joules. 3. Continue CPR.   4. Administer vasopressin 40 un vasopressin units its I.V.

36. Which condition is most closely associated with weight gain, nausea, and a decrease in urine output? 1. Angina   Angina pectoris pectoris 2. Cardiomyopathy  Cardiomyopathy  3. Left-sided heart failure 4. Right-sided Right-sided heart failure 37. A client's rhythm strip shows a regular rhythm with atrial and ventricular rates of 70 beats/minute, a PR interval of 0.24, and a QRS duration of 0.08 second. The nurse interprets this rhythm as: 1. normal sinus rhythm (NSR). 2. NSR NSR with 1-degree atrioventricul atrioventricular ar (AV) block. 3. sinus arrhythmia. 4. accelerated accelerated junctional rhythm. 38. A client with abdominal aortic aneurysm asks the nurse in which area are abdominal aortic aneurysms most commonly located. Which of the following  would be the nurse's nurse's best respon response? se? 1. Distal to the iliac arteries 2. Distal Distal to the renal arteries   3. Adjacent to the aortic aortic arch 4. Proximal Proximal to the renal arteries 8

 

39. While palpating a client's abdomen, the nurse notes a pulsating abdominal mass. This may indicate which condition? 1. Abdominal  Abdominal aortic aortic aneurysm 2. Enlarged Enlarged spleen 3. Gastric distention 4. Gastritis Gastritis 40. What is the most common symptom in a client with abdominal aortic aneurysm? 1. Abdominal  Abdominal pain pain 2. Diaphoresis Diaphoresis 3. Headache 4. Upper Upper back pain 41. Which symptom usually signifies rapid expansion and impending rupture of  an abdominal aortic aneurysm? 1. Abdominal   Abdominal pain pain   2. Absent pedal pulses pulses   3. Angina 4. Lower Lower back pain 42. What is the definitive test used to diagnose an abdominal aortic aneurysm? 1. Abdominal   Abdominal X-ray  X-ray    2. Aortogram 3. Computed tomography (CT) scan 4. Ultrasound Ultrasound

43. Which complication is of greatest concern when caring for a preoperative abdominal aortic aneurysm client? 1. Hypertension   2. Aneurysm rupture rupture 3. Cardiac arrhythmias 4. Diminished Diminished pedal pulses

9

 

44. Which precaution should a nurse take when caring for a client with a myocardial infarction who has received a thrombolytic agent? 1. Avoid  Avoid puncture wounds wounds 2. Monitor Monitor potassium levels. 3. Maintain a supine position. 4. Encourage Encourage fluids.

45. When assessing a client for an abdominal aortic aneurysm, which area of the abdomen is most commonly palpated? 1. Right upper quadrant 2. Directly Directly over the umbilicus u mbilicus 3. Middle lower abdomen to the left of the midline 4. Middle Middle lower abdomen to the right of the midline 46. Which condition is linked to more than 50% of clients with abdominal aortic aneurysms? 1. Diabetes mellitus 2. Hypertension Hypertension 3. Peripheral vascular disease 4. syphilis syphilis

47. When auscultating the abdominal region of a client with abdominal aortic aneurysm, the nurse hears a bruit. Which of the following indicates the significancee of this finding? significanc 1. It is a normal finding. 2. It It reflects a partial arterial occlusion. 3. It indicates a collection of fluid in the lungs. 4. It It shows an inflammation of the peritoneal surface surface..

48. Which group of symptoms indicates a ruptured abdominal aortic aneurysm? 1. Lower back pain, increased blood pressure, decreased red blood cell (RBC) count, increased white blood cell (WBC) count 2. Severe Severe lower back pain, decreased blood pressure, decreased RBC count, increased WBC count 3. Severe lower back pain, decreased blood pressure, decreased RBC count, 10

 

decreased WBC count 4. Intermittent Intermittent lower back pain, decreased blood pressure, decreased RBC count, increased WBC count 49. Which complication of an abdominal aortic repair is indicated by detection of  a hematoma in the perineal area? 1. Hernia 2. stage stage 1 pressure ulcer 3. Retroperitoneal rupture at the repair site 4. Rapid Rapid expansion of the aneurysm 50. Which genetic disease is most closely linked to aneurysm? 1. Cystic fibrosis 2. Hemophilia Hemophilia 3. Marfan's syndrome 4. sickle sickle cell anemia

51. What is the best treatment for a ruptured aneurysm? 1. Antihypertensive   Antihypertensive medication adm administration inistration   2. Aortogram 3. Beta-adrenergic blocker administration 4. Surgical intervention 52. When teaching a client about cardiomyopathy, which statement by the client indicates that further teaching is needed related to the causes of cardiomyopathy? 1. “It is caused by a plaque in the arteries.” arteries.”   2. “It “It is caused by a virus.”  virus.”  3. “It is caused by bacteria.” bacteria.”   4. “It “It is caused by certain drugs.” drugs.”  

11

 

53. The nurse is counseling a client on types of cardiomyopathy associated with childbirth.. The nurse should teach the client about which of the following? childbirth 1. Dilated 2. Hypertrophic Hypertrophic obstructive 3. Myocarditis 4. Restrictive Restrictive 54.  54.  The nurse is reviewing a client's echocardiogram, which states, “hypertrophy  of the ventricular septum.” The client should be further evaluated for which type of cardiomy cardiomyopathy? opathy? 1. Congestive 2. Dilated Dilated 3. Hypertroph Hypertrophic ic obstructive 4. Restrictive Restrictive

55. Which recurring condition most commonly occurs in clients with cardiomyopathy? 1. Heart failure 2. Diabetes mellitus 3. Myocardial infarction (MI) 4. Pericardial Pericardial effusion

56. While assessing a client with dilated cardiomyopathy, the nurse notices that

12

 

the electrocardiogram (ECG) rhythm no longer has any P waves, only a fine wavy  line. The ventricular rhythm is irregular with a QRS duration of 0.08 second. The heart rate is 110 beats/minute. The nurse interprets this rhythm as: 1. atrial fibrillation. 2. ventricular   fibrillation. fibrillation. 3. atrial flutter. 4. sinus tachycardia. 57. Dyspnea, cough, weight gain, weakness, and edema are classic signs and symptoms of which condition? 1. Pericarditis 2. Hypertension Hypertension 3. Myocardial infarction (MI) 4. Heart Heart failure

58. In which type of cardiomyopathy does cardiac output remain normal? 1. Dilated 2. Hypertrophic Hypertrophic obstructive 3. Obliterative 4. Restrictive Restrictive 59. Which cardiac condition does a fourth heart sound (S4) indicate? 1. Dilated aorta 2. Normally Normally functioning heart 3. Decreased myocardial contractility  4. F Failure ailure of the ventricle to eject all the blood during systole

13

 

60. Which class of drugs is most widely used in the treatment of  cardiomyopathy? 1. Anticoagulants  Anticoagulants 2. Beta-adrenergic Beta-adrenergic blockers 3. Calcium channel blockers 4. Nitrates Nitrates 61. If medical treatment for cardiomyopathy fails, the nurse should prepare the client for which of the following procedures? 1. Cardiac catheteriza catheterization tion 2. Coronary Coronary artery bypass graft (CABG) 3. Heart transplantation 4. Intra-aortic Intra-aortic balloon pump (IABP) 62. Which condition is associated with a predictable level of pain that occurs as a result of physical or emotional stress? 1. Anxiety    Anxiety  2. stable stable angina 3. Unstable angina 4. Variant angina angina   63. After undergoing a cardiac catheterization, a client has a large puddle of   blood under his buttocks. Whic Which h step should the n nurse urse take first? 1. Call for help. 2. Obtain Obtain vital signs. 3. Ask   the client client to “lift up.” up.”   4. Apply   gloves and and assess the groin site.

64. A client with angina pectoris has an electrocardiogram (ECG) performed during an episode of chest pain. Which change on the ECG indicates myocardial ischemia? 1. Increased QRS duration 2. shortened shortened PR interval 3. Pathological Q-wave formation   4. T-wave inversion 65. Which type of angina is most closely associated with an impending

14

 

myocardiall infarction (MI)? myocardia 1. Variant   Variant angina angina 2. Chronic Chronic stable angina 3. Microvascular angina 4. Unstable Unstable angina

66. A client with angina pectoris comes to the emergency room. Which of the following drugs can the nurse expect to administer as the drug of choice? 1. Aspirin  Aspirin 2. Furosemide (Lasix) 3. Nitroglycerin 4. Nifedipine Nifedipine (Procardia) 67. While assessing a client diagnosed with angina, the client asks what causes it.  Which of the following following respon responses ses by the nurs nursee would be the most appr appropriate? opriate? 1. Increased preload 2. Decreased Decreased afterload 3. Coronary artery spasm 4. Inadequate Inadequate oxygen supply to the myocardium 68. A nurse is preparing a client for cardiac catheterization. Which assessment is most important prior to the procedure? 1. Weight   Weight and height 2. Allergy   to iodine or shellfish 3. Apical   heart rate heart 4. Cardiac Cardiac rhythm 69. The nurse is teaching a client about angina. Which statement by the nurse  would be most accurate accurate regard regarding ing the primary tre treatment atment goal? 1. Reversal of ischemia 2. Reversal Reversal of infarction 3. Reduction of stress and anxiety  4. Reduction Reduction of associated risk factors

15

 

70. A 59-year-old female client is experiencing chest pain at rest that is unresponsive to nitroglycerine. The physician diagnoses unstable angina and alerts the nurse that the client will require treatment with immediate surgical intervention. Which treatment is most suitable? 1. Cardiac catheteriza catheterization tion 2. Echocardiogram Echocardiogram 3. Heart transplantation 4. Percutaneous Percutaneous transluminal transluminal coronary angioplasty (PTCA) 71. Which intervention should be the first priority when treating a client experiencing experiencin g chest pain while walking? 1. Sit the client down. 2. Get the client back to bed. 3. Obtain an electroca electrocardiogram rdiogram (ECG).   4. Administer sublingual nitrogly sublingual nitroglycerin. cerin. 72. The nurse is assessing a client with heart failure. The client is experiencing tachycardia, decreased blood pressure, and decreased peripheral pulses. The nurse interprets these symptoms as indicating which condition? 1. Anaphylactic  Anaphylactic shock  2. Cardiogenic Cardiogenic shock  3. Distributive shock  4. Myocardial Myocardial infarction (MI) 73. Which of the following conditions may result in cardiogenic shock? 1. Acute   Acute myocardial myocardial infarctio infarction n (MI) 2. Coronary Coronary artery disease (CAD) 3. Decreased hemoglobin level 4. Hypotension Hypotension

16

 

74. Which percentage represents the amount of damage the myocardium must sustain before signs and symptoms of cardiogenic shock develop? 1. 10°% 2. 25% 25% 3. 40% 4. 90% 90% 75. Which of the following parameters increases as myocardial oxygen consumption increases? 1. Preload, afterload, and cerebral blood flow  2. Preload, Preload, afterload, and renal blood flow  3. Preload, afterload, contractility, and heart rate 4. Preload, Preload, afterload, cerebral blood flow, and heart rate 76. Which factor would be most useful in detecting a client's risk of developing cardiogenic shock? 1. Decreased heart rate 2. Decreased Decreased cardiac index 3. Decreased blood pressure 4. Decreased cerebral blood flow  77. Which symptom is one of the earliest signs of cardiogenic shock? 1. Cyanosis 2. Decreased Decreased urine output 3. Presence of fourth heart sound (S4) 4. Altered   level of consciousnes consciousnesss

78. Which diagnostic study can determine when cellular metabolism becomes anaerobic and when pH decreases? 1. Arterial   Arterial blood blood gas (ABG) levels 2. Complete Complete blood count (CBC) 3. Electroca Electrocardiogram rdiogram (ECG) 4. Lung Lung scan 79. What is the first treatment goal for cardiogenic shock? 1. Correct hypoxia

17

 

2. Prevent Prevent infarction 3. Correct metabolic acidosis 4. Increase Increase myocardial oxygen supply  80. Which drug is most commonly used to treat cardiogenic shock? 1. Dopamine 2. Enalapril Enalapril (Vasotec) 3. Furosemide (Lasix) 4. Metoprolol Metoprolol (Lopressor ( Lopressor)) 81. Which is the most important instrument used as a diagnostic and monitoring tool for determining the severity of a shock state? 1. Arterial  Arterial line line 2. Indwelling Indwelling urinary catheter 3. Electroca Electrocardiogram rdiogram (ECG) monitor 4. Pulmonary Pulmonary artery catheter

82. A client has a continuous blood pressure reading of 142/90 mm Hg. Into  which classification classification does this reading fall accordin according g to the Seventh Joint National Committee (JNC 7) on the Prevention, Detection, Evaluation, and Treatment of  High Blood Pressure? 1. Stage 2 hypertension 2. Prehypertension Prehypertension 3. Stage 1 hypertensio hypertension n 4. Normal Normal 83. Which sound will be heard during the first phase of Korotkoff's sounds? 1. Disappearance of sounds 2. Faint, Faint, clear tapping sounds   murmur or swishing 3. A swishing sounds 4. Soft, Soft, muffling sounds 84. Which of the following is a key point to include when teaching the nursing assistant about the major determinant of diastolic blood pressure? 1. Baroreceptors   2. Cardiac output 3. Renal function

18

 

  4. Vascular resistance resistance 85. A nurse knows that kidneys play an important role in regulating blood pressure. When hypertension occurs, which responses by the kidneys help normalizee blood pressure? normaliz 1. The kidneys retain sodium and excrete water. 2. The The kidneys excrete sodium and excrete water. 3. The kidneys retain sodium and retain water. 4. The The kidneys excrete sodium and retain water.

86. Which change would indicate the baroreceptors in the carotid artery walls and aorta are functioning? 1. Changes in blood pressure 2. Changes Changes in arterial oxygen tension 3. Changes in arterial carbon dioxide tension 4. Changes Changes in heart rate 87. The nurse is teaching a client about blood pressure and hormones. Which of  the following responses indicates the client understands which hormone raises arterial pressure and promotes venous return? 1. Angiotensin   Angiotensin I   2. Angiotensin II II 3. Thyroid hormone 4. Insulin Insulin

88. Which term is used to describe persistently elevated blood pressure with an unknown cause that accounts for approximately 90% of hypertension cases?

19

 

1. Accelerated   Accelerated hypertension 2. Malignant Malignant hypertension 3. Primary hypertension 4. Secondary Secondary hypertension 89. The nurse is assessing a client with hypertension. The nurse should be alert for which of the most common symptoms of hypertension? 1. Blurred vision 2. Epistaxis Epistaxis 3. Headache 4. Peripheral Peripheral edema

90. The bell of the stethoscope is most commonly placed over which artery to obtain a blood pressure measuremen measurement? t? 1. Brachial 2. Brachiocephalic Brachiocephalic 3. Radial 4. Ulnar Ulnar 91. Which of the following statements, if made by the client, indicates an understanding understand ing of why furosemide (Lasix) is administered to treat hypertension hypertension?? 1. It dilates peripheral blood vessels. 2. It It decreases sympathetic cardioacceleration. 3. It inhibits the angiotensin-converting enzyme. 4. It It inhibits reabsorption of sodium and water in the loop of Henle. 92. A 52-year-old client with a history of hypertension has just had a total hip replacement. The physician orders hydrochlorothiazide 35 mg oral solution by  mouth, once per day. The label on the solution reads hydrochlorothiazide 50 mg/5 milliliters. To administer the correct dose, how many milliliters should the nurse pour? Record your answer using one decimal place. _______ ml

20

 

93. Which statement by the nurse accurately explains the need for a client with hypertension to obtain an annual eye exam? 1. “By  “By examining examining your corneas, an ophthalmologist can visualize microvascular hemorrhages in your eyes.”  eyes.”  2. “By “By examining the fovea in your eyes, an ophthalmol ophthalmologist ogist can visualize microvascular venous occlusions in your eyes.”  eyes.”  3. “By examining the retina in your eyes, an an ophthalmologist can detect changes in the arteries in your eyes.”  eyes.”  4. “By “By examining the sclera of your eyes, an ophthalmologist can detect changes in the arteries in your eyes.”  eyes.”  94. Based on which of the following conditions would the nurse suspect the client has varicose veins? 1. Tunica media tear 2. Intraluminal Intraluminal occlusion 3. Intraluminal valvular compression 4. Intraluminal Intraluminal valvular incompetence 95. A nurse determines that a client with varicose veins understands the factor causing primary varicose veins when the client states which of the following? 1. Hypertension 2. Pregnancy  Pregnancy  3. Thrombosis 4. Trauma Trauma 96. The nurse assessing a client for varicose veins would look for which commonly occurring symptom? 1. Fatigue and pressure 2. Fatigue Fatigue and cool feet 3. Sharp pain and fatigue 4. Sharp Sharp pain and cool feet

97. While planning to teach a client with varicose veins, the nurse should include

21

 

in the teaching plan that varicose veins most commonly occur in which type of   vein? 1. Brachial 2. Femoral Femoral 3. Renal 4. Saphenous Saphenous 98. Which condition is caused by increased hydrostatic pressure and chronic  venous stasis? stasis? 1. Venous  Venous occlusion occlusion 2. Cool Cool extremities 3. Nocturnal calf muscle cramps 4. Diminished Diminished blood supply to the feet 99. The nurse is providing discharge instructions for a client with varicose veins. The nurse determines the need for further teaching when the client states which of the following? 1. “Exercise will make me feel better.”  better.”  2. “I “I have to elevate my legs.”  legs.”  3. “Lying down can relieve my symptoms.”  symptoms.”  4. “Wearing “Wearing tight clothes will not affect me.”  me.” 

100. Which test demonstrates the backward flow of blood through incompetent  valves of superficial superficial veins? 1. Trendelenbur Trendelenburg's g's test 2. Manual Manual compression test 3. Perthes' test 4. Plethysmography  Plethysmography  101. The nurse should assess for what signs and symptoms in a client with secondary varicose veins? 1. Pallor and severe pain 2. Severe Severe pain and edema 3. Edema and pigmentation   4.  Absent growth pigme pigmentation 102. The hair nurse shouldand prepare antation client for which treatment to eliminate varicose

22

 

 veins? 1. Ablation   Ablation therapy  therapy  2. Cold Cold therapy  3. Ligation and stripping 4. Radiation Radiation

103. Which treatment is recommended for postoperative management of a client  who has undergone undergone ligation and str stripping? ipping? 1. Sitting 2. Bed rest 3. Ice packs 4. Elastic Elastic leg compressi compression on 104. Which client is most at risk for developing deep vein thrombosis (DVT)? 1. A   A 62-year-old female recoveri recovering ng from a total hip rreplacement. eplacement. 2. A   35-year-old female female 2 days postpa postpartum. rtum. 3. A   33-year-old male male runner with A Achilles chilles tend tendonitis. onitis. 4. An   ambulatory ambulatory 70-year-old ma male le who's recover recovering ing from pneumon pneumonia. ia.

105. Which complication of lower extremity deep vein thrombosis is manifested  by dyspnea, chest chest pain, and dim diminished inished breath so sounds? unds? 1. Hemothorax 2. Pneumothorax Pneumothorax 3. Pulmonary embolism   4. Pulmonary hypertens hypertension 106. Which term refersion to the condition of blood coagulating faster than normal,

23

 

causing thrombin and other clotting factors to multiply? 1. Embolus 2. Hypercoagulability  Hypercoagulability  3. Venous   stasis stasis 4. Venous   wall injury  injury 

107. Which characteristic is typical of the pain associated with deep vein thrombosis (DVT)? 1. Dull ache 2. No pain 3. Sudden onset 4. Tingling Tingling 108. A client is admitted with deep vein thrombosis (DVT). Which of the following treatments treatments would be most appropriate to relieve the pain? 1. Application  Application of heat 2. Bed Bed rest 3. Exercise 4. Leg Leg elevation 109. Which term best describes the findings on cautious palpation of the vein in typical superficial thrombophleb thrombophlebitis? itis? 1. Dilated 2. Knotty  Knotty  3. Smooth 4. Tortuous Tortuous 110. While assessing a client with deep vein thrombosis (DVT), which of the following terms indicates calf pain experienced by the client due to sharp dorsiflexion of the foot? 1. Dyskinesia 2. Eversion Eversion 3. Positive Babinski's reflex 4. Positive Positive Homans' sign

24

 

111. A client is admitted to the unit with intermittent claudication (cramplike pain in the calves). Which of the following responses by the nurse would most accurately explain the cause of the condition to the client? 1. Inadequate blood supply  2. Elevated Elevated leg position 3. Dependent leg position 4. Inadequate Inadequate muscle oxygenation 112. The nurse should prepare a client with intermittent claudication to receive  which medical medical treatment? 1. Analgesics  Analgesics 2. Warfarin (Coumadin) (Coumadin)   3. Heparin 4. Pentoxifylline Pentoxifylline (Trental) 113. Which oral medication is administered to prevent further thrombus formation? 1. Warfarin  Warfarin (Coumadin) (Coumadin) 2. Heparin Heparin 3. Furosemide (Lasix) 4. Metoprolol Metoprolol (Lopresso ( Lopressor) r)

114. A nurse should place the client with pulmonary edema in which position to facilitate breathing? 1. Lying flat in bed 2. Left Left side-lying   3. high Fowler's position 4. In In semi-Fowler's In position

25

 

115. Which blood gas abnormality is initially most suggestive of pulmonary  edema? 1. Anoxia  Anoxia 2. Hypercapnia Hypercapnia 3. Hyperoxygenation 4. Hypocapnia Hypocapnia 116. A nurse is caring for a 78-year-old female client with sick sinus syndrome  who's awaiting permanen permanentt pacemaker placement. Given this client's risk of  decreased cardiac output, what assessment findings would indicate that she's experiencing experiencin g an initial drop in cardiac output? 1. Decreased blood pressure 2. Alteration   in level level of consci consciousness ousness (LOC) 3. Decreased blood pressure and diuresis 4. Increased Increased blood pressure and fluid volume 117. Which action is the appropriate initial response to a client coughing up pink, frothy sputum? 1. Call for help. 2. Call the physician. 3. Start an I.V. line. 4. Suction Suction the client.

118. Which precaution should a client be instructed to take after an episode of  acute pulmonary edema? 1. Limit caloric intake. 2. Restrict Restrict carbohydrates. 3. Measure weight twice per day. 4. Call Call the physician if there is weight gain of more than 3 lb (1.5 kg) in 1 day. 119. The nurse knows that a 45-year-old client with severe hypertension will experience increased increased workload of the heart due to which of the following? 1. Increased afterload 2. Increased Increased cardiac output   3. the heart 4. Overload Increasedof Increased preload

26

 

120. A client with acute pulmonary edema has been taking an angiotensinconverting enzyme (ACE) inhibitor. The nurse teaches him that this medication has been ordered for which reason? 1. To promote diuresis 2. To To increase contractility  3. To decrease contracti contractility  lity  4. To reduce blood pressure 121. A client with acute pulmonary edema caused by heart failure asks the nurse  which area of the heart is usually damaged. damaged. The best response by the nurse would  be which of the following? following? 1. Left atrium 2. Right Right atrium 3. Left ventricle 4. Right Right ventricle

122. Which statement by a nurse to the health care aide best explains the need to promptly report changes in respiratory rate for a client diagnosed with heart failure? 1. “Pulmonary edema, a lifelife-threatenin threatening g condition, can develop in minutes.” minutes.”   2. “Severe “Severe acute respiratory syndrome (SARS) is a complication of heart failure.”  failure.”    3. “Pneumothorax, isx, a consequence of inadequate with heart failure.”  failure.”   4. ““Pneumonia Pneumothora a life life--threatenin threatening g condition,ventilation can develop in minutes.” minutes.”    123. The nurse evaluates her teaching by asking the student nurse which term is used to describe the amount of stretch on the myocardium at the end of diastole.  Which of the following following is most a accurate? ccurate? 1. Afterload   Afterload 2. Cardiac Cardiac index 3. Cardiac output 4. Preload Preload 124. Which action should a nurse take when administering a new blood pressure medication to a client?

  1.  Administer the medication the the only cclient lientifwithout explanation. planation. 2. Inform Inform the client of the newtodrug he asks ex about it.

27

 

3. Inform the client of the new medication, its name, use, and the reason for the change in medication.   4. Administer the medication, an the and d inform the clie client nt that the phys physician ician will later explain the medication.

125. Antihypertensives should be used cautiously in clients already taking which other drug? 1. Ibuprofen (Advil) 2. Diphenhydramine Diphenhydramine (Benadryl) 3. Thioridazine 4. Vitamins   126. A 57-year-old client with a history of bronchial asthma is prescribed propranolol (Inderal) to control hypertension. Before administering propranolol,  which action action should the nurs nursee take first? 1. Monitor apical pulse rate. 2. Instruct Instruct the client to take the medication with food. 3. Question the physician about the order. 4. Caution Caution the client to rise slowly when standing.

127. One hour after I.V. furosemide (Lasix) is administered to a client with heart failure, a short burst of ventricular tachycardia appears on the cardiac monitor.  Which electrolyte electrolyte imbalan imbalance ce should the n nurse urse suspect? 1. Hypocalcemia 2. Hypermagnesemia Hypermagnesemia   3. 4. Hypokalemia Hypernatremia Hypernatremia

28

 

128. A client has a reduced serum high-density lipoprotein (HDL) level and an elevated low-density lipoprotein (LDL) level. Which dietary modification is appropriate appropria te for this client? 1. Fiber intake of less than 10% of total calories daily  2. Less Less than 40% of calories from fat 3. Cholesterol intake of less than 300 mg daily  4. Less than 7% of calories from saturated fat 129. A paradoxical pulse occurs in a client who had coronary artery bypass graft (CABG) surgery 2 days ago. Which surgical complication should the nurse suspect? 1. Left-sided heart failure 2. Aortic   regurgitation regurgitation 3. Complete heart block  4. Pericardial Pericardial tamponade

130. A 35-year-old client was admitted to the coronary care unit (CCU) 2 days ago with an acute myocardial infarction. Which action would breach client confidentiality? 1. The CCU nurse gives a verbal report to the nurse on the telemetry unit before transferring transferri ng the client to that unit.   2. The CCU nurse notifies the on-call physician about a change in the client's condition. 3. The emergency department (ED) nurse calls up the latest electrocardiogram results to check the client's progress.   the client's request, the CCU n 4. At nurse urse updates the client's client's wife on h his is condition. 131. A client arriving in the emergency department (ED) is receiving cardiopulmonary resuscitation from paramedics, who are giving ventilations through an endotracheal (ET) tube that they placed in the client's home. During a pause in compressions, the cardiac monitor shows narrow QRS complexes and a heart rate of 55 beats/minute with a palpable pulse. Which action should the nurse take first? 1. Start an I.V. line and administer amiodarone, amiodarone, 300 mg I.V. over 10 minutes.   2. Check ET placement. 3. Obtain an tube arterial blood gas (ABG) sample.

29

 

  4. Administer atropine, 1 mg I.V. atropine,

132. After unsuccessful cardiopulmonary resuscitation efforts, the nurse must prepare an Islamic client for the morgue. Which nursing action should the nurse take? 1. Allowing   Allowing the client's client's family to perform the ri ritualistic tualistic was washing hing 2. Doing Doing nothing; the Burial Society will perform a ritual cleansing 3. Doing nothing; only the family and close friends may touch the body  4. Providing Providing routine postmortem care 133. A 63-year-old client has Prinzmetal's angina. To reduce the risk of coronary  artery spasms, which type of medication is the physician most likely to prescribe? 1. Beta-adrenergic blocker   2. Angiotensin-c  Angiotensin-converting onverting enzym enzymee (ACE) inhibitor 3. Inotropic vasodilator 4. Calcium Calcium channel blocker

134. An 86-year-old client with heart failure is receiving furosemide (Lasix), 40 mg I.V. The physician orders 40 mEq of potassium chloride in 100 ml of dextrose 5% in water, to infuse over 4 hours. The client's most recent serum potassium level is 3.0 mEq/L. At which infusion rate should the nurse set the I.V. pump? 1. 25 ml/hour 2. 10 10 ml/hour 3. 100 ml/hour 4. 50 50 ml/hour 135.ventricular A nurse is planning discharge for a client who is for being treated for tachycardia. Whichinstructions of the following rationales including

30

 

 bananas in the the client's diet would be most accurate? 1. Because bananas are high in carbohydrate 2. Because Because bananas are high in potassium 3. Because bananas are low in sodium 4. Because Because bananas are high in fiber

136. After cardiac surgery, a client's blood pressure measures 126/80 mm Hg. The nurse determines that mean arterial pressure (MAP) is: 1. 46 mm Hg. 2. 80 80 mm Hg. 3. 95 mm Hg. 4. 90 90 mm Hg. 137. A charge nurse is preparing client care assignments for the next shift. A  client who underwent femoral-popliteal bypass surgery is scheduled to return from the postanesthesia care unit. Which staff member should receive this client? 1. Registered nurse with 1 year of experience 2. Licensed Licensed practical practical nurse (LPN) with 5 years of experience 3. Nursing assistant assistant with 15 years of eexperience xperience 4. Charge Charge nurse with 10 years of experience 138. An 18-year-old client who recently had an upper respiratory infection is admitted with suspected rheumatic fever. Which assessment findings confirm this diagnosis? 1. Erythema marginatum, subcutaneous subcutaneous nodules, and fever 2. Tachycardia, Tachycardia, finger clubbing, and a loud second heart sound (S2) 3. Dyspnea, cough, and palpitations 4. Dyspnea, Dyspnea, fatigue, and syncope

31

 

139. A client with new onset of atrial fibrillation is receiving warfarin (Coumadin) to help prevent thromboemboli. The warfarin dosage will reach therapeutic levels when the International Normalized Ratio (INR) falls within  which range? range? 1. 1 to 2 2. 1.5 1.5 to 2.5 3. 2 to 3 4. 2.5 2.5 to 3.5 140. A 38-year-old client comes to the emergency department complaining that his heart “suddenly began to race.” After attaching him to the cardiac monitor, the nurse observes atrial tachycardia. Which rhythm strip characteris characteristics tics indicate this arrhythmia? 1. Atrial   Atrial rate greater greater than the ven ventricular tricular rate rate,, sawtooth P waves 2. Irregular Irregular rhythm, indiscernible atrial rate, absent P waves 3. Regular atrial and ventricular rhythms, rate of 123 beats/minute 4. Regular Regular atrial and ventricular ventricular rhythms, P wave hidden in the T wave, rate of  210 beats/min beats/minute ute 141. A client is receiving spironolactone to treat hypertension. Which instruction should the nurse provide? 1. “Eat foods high in potassium.” potassium.”   2. “Take “Take daily potassium supplements.”  supplements.”  3. “Discontin “Discontinue ue sodium restrictio restrictions.” ns.”   4. “Avoid “Avoid salt substitutes.” substitutes.”   142. A 23-year-old client develops cardiac tamponade when the car he was driving hits a telephone pole; he wasn't wearing a seat belt. The nurse helps the physician perform pericardiocentesis. Which outcome would indicate that pericardiocentesis pericardioc entesis has been effective? 1. Neck vein distention 2. Pulsus Pulsus paradoxus 3. Increased blood pressure 4. Muffled Muffled heart sounds 143. A client admitted with angina complains of severe chest pain and suddenly   becomes unresponsive. unresponsive. After establishing unresponsiveness unresponsiveness,, which action should the nurse take first? 1. Activate  Activate the resuscitation resuscitation tea team. m. 2. Open Open the client's airway. 3. Check for breathing. 4. Check Check for signs of circulation.

32

 

144. A 54-year-old client is admitted with an acute inferior-wall myocardial infarction (MI). During the admission interview, he says he stopped taking his metoprolol (Lopressor) 5 days ago because he was feeling better. Which nursing diagnosis takes priority for this client? 1. Anxiety   Anxiety    2. Risk for decreased cardiac cardiac tissue perfusion perfusion     3. Acute pain  pain    4. Ineffective family therapeutic regi family regimen men managem management  ent   145. A client comes to the emergency department with acute shortness of breath and a cough that produces pink, frothy sputum. Admission assessment reveals crackles and wheezes, a blood pressure of 82/45 mm Hg, a heart rate of 120  beats/minute,  beats/min ute, and a respiratory rate of 38 breaths/ breaths/minute. minute. The client's medical history includes diabetes mellitus, hypertension, and heart failure. Which disorder should the nurse suspect? 1. Pulmonary edema 2. Pneumothorax Pneumothorax 3. Cardiac tamponade 4. Pulmonary Pulmonary embolus 146. A 57-year-old client with acute arterial occlusion of the left leg undergoes an emergency embolectomy. Six hours later, the nurse isn't able to obtain pulses in his left foot using Doppler ultrasound. She immediately notifies the physician,  who asks her to prepare the client for surgery. As the nurse enters the client's room prepare him, response he states by that won't have any more surgery. Which action to is the best initial thehe nurse? 1. Explaining the risks of not having the surgery  2. Notifying Notifying the physician immediately  3. Notifying the nursing supervisor 4. Recording Recording the client's refusal in the nurses' notes

33

 

147. The nurse coming on duty receives the report from the nurse going off duty.  Which client client should the on-duty n nurse urse assess first first?? 1. The 58-year-old client who was admitted 2 days ago with heart failure, blood pressure of 126/76 mm Hg, and a respiratory rate of 22 breaths/minute 2. The 89-year-old client with end-stage right-sided heart failure, blood pressure of 78/50 mm Hg, and a “Do not resuscitate” order  order  3. The 62-year-old client who was admitted 1 day ago with thrombophl thrombophlebitis ebitis and is receiving I.V. heparin 4. The The 75-year-old client who was admitted 1 hour ago with new-onset atrial fibrillation and is receiving I.V. diltiazem (Cardizem) 148. When developing a teaching plan for a client with endocarditis endocarditis,, which point is most essential for the nurse to include? 1. “Report fever, anorexia, and night sweats to the physician.” physician.”   2. “Take “Take prophylactic antibiotics after dental work and invasive procedures.” procedures.”   3. “Include potassiumpotassium-rich foods in your diet.”  diet.”  4. “Monitor “Monitor your pulse rate daily.”  daily.”  149. Which finding suggests that fluid resuscitation has been effective for a 23 year-old client client admitted in h hypovolemic ypovolemic sh shock? ock? 1. Urine output of 15 ml/hour 2. Urine Urine output of 20 ml/hour 3. Urine output of 25 ml/hour 4. Urine Urine output of 30 ml/hour 150. A client is being monitored via telemetry using a 3 lead system. Which graphic shows the correct electrode positions to monitor modified chest lead 1 (MCL1)?.

151. An e1derly client has a history of aortic stenosis. Identify the area where the nurse should place the stethoscope to best hear the murmur.

34

 

152. A client with deep vein thrombosis has an I.V. infusion of heparin sodium infusing at 1,500 units/hour. The concentration in the bag is 25,000 units/500 ml. How many milliliters should the nurse document as intake from this infusion for an 8-hour shift? Record your answer using a whole number.  _________________milliliters  _________________milli liters 153. The nurse suspects that her client is in cardiac arrest. According to the  American Heart Association (AHA), she should perform the actions listed below. Order these actions in the sequence that the nurse should perform them. 1. Activate  Activate the emergency emergency resp response onse team. 2. Assess   responsiveness.. responsiveness 3. Call for a defibrillator defibrillator.. 4. Provide Provide two slow breaths.   5. Assess pulse. pulse.   6. Assess breathing. breathing.

35