Cardiac FT

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1. Question The nurse performs

admission assessment for an older client
admitted to the telemetry floor.  The
client’s history reveals type 2 diabetes,
mitral valve prolapse, and hypertension. 
Which assessment information is an
important indication of risk for heart
failure (HF) (Select all that apply)? 
The patient takes furosemide (Lasix)
20 mg/day.
The patient's potassium level is 4.7
mEq/L.
The patient is an African American
man.
The patient's age is greater than
65.
Incorrect Try Again
2. Question The nurse is assessing an
elderly client admitted with a diagnosis of
chronic heart failure (HF).  The spouse asks
the nurse the primary cause for HF, and
the nurse responds that HF may be caused
by: 
Endocarditis
 Pleural effusion
Atherosclerosis
Atrial-septal defect
Incorrect Try Again
3. Question The nurse is caring for a
hospitalized client with admitting diagnosis
of right-sided heart failure (HF).  What
assessment finding is most consistent with
the client’s diagnosis?
Pulmonary edema
Distended neck veins
Dry hacking cough
Orthopnea
Incorrect Try Again
4. Question The nurse is assessing a
client admitted to the telemetry unit from
the Emergency Department with
complaints of increasing shortness of
breath, and is coughing pink-tinged frothy
sputum.  During the history assessment,
the nurse documents a history of left-sided
heart failure. The nurse recognizes the
presenting signs and symptoms of which
health problem?
Right-sided heart failure
Acute pulmonary edema
Bacterial Pneumonia
Myocardial Infarction
Incorrect Try Again
5. Question The nurse is caring for a
patient who has right-sided heart failure,
and is scheduled to receive the second
dose of bumetanide (Bumex).   Prior to
administration of the drug, assessment of
the client reveals a marked decrease from
4+ to 1+ ankle edema, neck distention is
less than earlier, and the client lost 3
pounds in 24 hours. What action should the
nurse take?
Hold the bumetanide
Give the bumetanide early
Notify the physician
Give the scheduled dose
Incorrect Try Again
6. Question A client has a new
prescription captopril (Capoten) following a
clinic visit.  What should the nurse include
in teaching about the drug? (Select all that
apply.)
Take the medication with meals
Report any cough that develops.
Report to the clinic for weekly blood
serum labs.
Check blood pressure prior to dose,
log findings, and report changes.
Incorrect Try Again
7. Question The nurse is providing
discharge education on fluid balance
monitoring to a patient with a new
diagnosis of right-sided heart failure. The
nurse will stress which priority instruction
for monitoring fluid balance?
Weigh daily at the same time in
similar clothing
 Take self-pulse rates and report
findings below 60
Take blood pressure at the same
time daily
Bowel movements should be logged
Incorrect Try Again
8. Question The nurse is caring for a
patient with severe left ventricular
dysfunction and understands the client is
at risk for sudden cardiac death.  The
nurse anticipates which medical
intervention?
Insertion of an implantable
cardioverter defibrillator
Insertion of an implantable atrial
pacemaker
Administration of thrombolytic
agents
Cardioversion under light anesthesia
Incorrect Try Again
9. Question The nurse is caring for a
client who has been placed on long-term
anticoagulation for management of
intracardiac thrombi found on the
echocardiogram.  The nurse includes which
health history reason for increased risk of
intracardiac thrombi?
Atrial fibrillation
Pericarditis
Pleural effusion
Recent surgery
Incorrect Try Again
 10. Question The nurse is caring for a
client with heart failure who is receiving a
prescribed angiotensin-converting enzyme
inhibitor (ACEI).  The patient is asking how
the drug works for heart failure.  What will
the nurse include in teaching the client
about this medication? (Select all that
apply.)
The ACEI reduces fluid volume
The ACEI relaxes blood vessels and
lowers blood pressure
The ACEI reduces workload on the
heart
The ACEI decreases pulmonary
venous pressure.
Incorrect Try Again
11. Question The nurse is performing
an assessment on a client with a history of
cardiovascular disease, diabetes,
hypertension, and hypothyroidism. The
client is experiencing exhaustion with
simple activities of daily living and short
ambulation, and states a 5 pound weight
gain over 4 days. Assessment reveals 4+
edema to lower extremities and jugular
distention. The nurse will report findings to
the health care provider and anticipates
which medical condition?
Acute pericarditis
Myocardial infarction
Left-sided heart failure
Right-sided heart failure
Incorrect Try Again
 12. Question The nurse is assessing a
client who reports pain to the left lower
extremity, especially while ambulating. The
discomfort is relieved with rest. 
Assessment findings confirm left lower leg
3+ edema, hairless, and mottled in color.
Which health problem will the nurse most
likely include in the planning of the client’s
care?
Coronary artery disease (CAD)
Intermittent claudication
Arterial embolus
Raynaud's disease
Incorrect Explanation:Claudication
occurs when blood flow is narrowed to
peripheral circulation.  It may occur during
exercise or movement, depending on
where the arterial narrowing is located. 
Signs are pain relieved by ceasing the
activity (intermittent pain); however, in
advanced stages pain occurs at rest;
discolored skin or ulcerations from reduced
blood flow (and cool to touch); and achy or
burning sensation. Peripheral artery
disease (PAD) is linked with intermittent
claudication versus CAD.  Arterial embolus
and Raynaud’s do not correlate with
findings from assessment or health
history. 
13. Question The nurse is caring for an
acutely ill patient with a history of renal
insufficiency who is on anticoagulant
therapy.  What will the nurse anticipate in
the individualized plan of care for the
heparin therapy?
Heparin is contraindicated in the
treatment of this patient.
Heparin may be administered
subcutaneously, but not IV.
Lower doses of heparin are
required for this patient.
Coumadin will be substituted for
heparin.
Incorrect Try Again
14. Question A nurse is caring for a
client with venous disease in the lower
extremities and is ordered radiologic
testing.  The nurse educates the client on
which exam will likely be ordered for lower
venous disease?
Duplex ultrasonography
Echocardiography
Positron emission tomography (PET)
Radiography
Incorrect Try Again
15. Question The nurse is caring for a
post-surgical client.  During the
assessment, the client complains of sudden
onset of pain to the right lower leg.  The
right lower leg is swollen, reddened, and
warm to touch.  What is the most
appropriate action by the nurse?
Administer 10,000U dose of
subcutaneous heparin followed by
continuous IV Heparin.
 Inform the physician that the client
has signs and symptoms of venous
thrombosis.
Ambulate the client immediately to
restore circulation.
Place heating pad to right leg for 15
minutes followed by smaller size
compression stockings.
Incorrect Try Again
16. Question A nurse is caring for a
patient who returned from surgical
popliteal bypass graft procedure.  A
priority assessment during the first 24
hours will include:
Assess pulse of affected extremity
every 15 minutes, followed by agency
policy.
Palpate the affected leg for pain and
venous return during every assessment.
Assess the patient for signs and
symptoms of compartment syndrome
every 2 hours.
Perform Doppler evaluation once
daily.
Incorrect Try Again
17. Question A nurse caring for a client
with peripheral arterial insufficiency
determined the nursing diagnosis of
altered peripheral arterial insufficiency. 
Which intervention will be most
appropriate for the client?
Elevate his legs and arms above his
 heart when resting.
Encourage the patient to engage in
a moderate amount of exercise.
Encourage extended periods of
sitting or standing.
Discourage walking in order to limit
pain.
Incorrect Try Again
18. Question The nurse is caring for a
patient diagnosed with peripheral arterial
occlusive disease (PAD).  What assessment
finding is most consistent with this
diagnosis?
Thick, tough, brownish pigmented
skin to extremities
Unequal peripheral pulses between
extremities
Complaints of pain relieved by
elevation
Diffuse varicosities along back of
legs bilaterally
Incorrect Try Again
19. Question The nurse is caring for a
client with a new prosthetic cardiac valve
and is preparing discharge teaching. 
During discharge teaching, the nurse
should provide education on the
importance of antibiotic prophylaxis prior
to which of the following?
When exposed to influenza or
pneumococcal pneumonia
Prior to the next cardiac stress test
 Dental procedures
Prior to any trip outside the United
States
Incorrect Try Again
20. Question The emergency
department (ED) nurse is assessing a client
who arrived with severe retrosternal chest
pain described as burning and sharp which
worsens on inspiration.  The health care
provider diagnoses the client with acute
pericarditis.  Which finding is most
consistent with this diagnosis?
Wheezes
Friction rub
Fine crackles
Coarse crackles
Incorrect Try Again
21. Question The nurse is assigned five
clients on the medical floor of the hospital. 
The hospital’s infection control committee
is creating a proactive program to identify
clients at risk for hospital acquired
infective endocarditis.  Which of the five
clients would be most at risk for hospital-
acquired infective endocarditis?
Patients with kidney failure and
receiving in-hospital dialysis.
Oncology patients who just received
immunotherapeutic agents.
Clients out of the Intensive Care
Unit who were treated with
thrombolytics
 All pediatric clients being treated
with IV antibiotics.
Incorrect Try Again
22. Question The nurse is caring for a
young adult client following a balloon
valvuloplasty of the aortic valve.  During
the post procedure assessment, the nurse
monitors for which complications related to
valvuloplasty.? (Select all that apply) 
Sudden cardiac arrhythmia
Emboli
Sudden mental status changes
Redness near the radial vein access
site
Incorrect Try Again
23. Question The nurse is caring for a
patient is admitted with a diagnosis of
dilated cardiomyopathy. Assessment
includes analysis of which laboratory
results that would be used to prioritize
assessment findings?
Electrolyte panel, specifically
sodium levels
Kidney function panel, specifically
GFR, Serum Creatinine, and BUN
Liver function panel, specifically
AST, ALT, and bilirubin
White blood cell panel, specifically
lymphocytes
Incorrect Try Again
24. Question The nurse caring for a
client with dilated cardiomyopathy is
scheduling a transthoracic
echocardiogram, which might reveal what
type of finding associated with the
diagnosis?
Decreased ejection fraction
Decreased heart rate
Presence of bundle branch block
Asymptomatic ventricular
tachycardia
Incorrect Try Again
25. Question Part of the plan of care for
a client who recently received mechanical
valve prosthesis is discharge education for
home management.   Which information
will the nurse determine to have the most
priority?
The need to reschedule valve
replacement within 5 years
Report near high or low blood
pressure and heart rates
Strategies for preventing
atherosclerosis
Strategies for infection prevention
Incorrect Try Again
26. Question The nurse is caring for a
client with mitral stenosis on the telemetry
floor and notices a change on the
telemetry monitor.  The nurse expects
which most common heart rhythm change
based on the disease process?
Ventricular fibrillation
Sinus tachycardia
 Atrial fibrillation
Sinus bradycardia
Incorrect Try Again
27. Question A client is admitted for
observation following complaints of
intermittent chest pain while mowing the
grass.  The pain persisted for an hour
following the activity.  All cardiac labs,
electrocardiogram, and radiologic studies
were normal and the client was provided
nitroglycerin for a new diagnosis of angina
pectoris. Discharge education includes
information that angina is most often
attributable to what cause?
Decreased workload on the heart
Atrial Septal defect
Infarction of the myocardium
Coronary arteriosclerosis
Incorrect Try Again
28. Question The nurse is preparing an
individualized education plan for a client
who has a history of smoking and is two
days post cardiac surgery.  Which
information best addresses client
education as an intervention for the
nursing diagnosis of ineffective airway
clearance related to pulmonary secretions?
Client Teach-Back on low sodium
diet
Client teaching and demonstration
of self-injection of lenoxaparin (Lovenox)
Client teaching on the need for
 weekly PTT and INR for lenoxaparin
therapy
Client teaching and demonstration
of deep breathing and coughing
exercises
Incorrect Try Again
29. Question The nurse just received
report from the cardiac catheterization
team following a percutaneous coronary
intervention (PCI) procedure.  During the
assessment, the nurse notices a blood
soaked dressing and bleeding from the
femoral artery access site. What action
should the nurse perform first?
Add another dressing layer on top of
the saturated dressing.
Raise the leg and place the client in
trendelenburg position.
Immediately pull on the femoral
sheath until it is out of the femoral site.
Call for help and apply pressure to
the site immediately.
Incorrect Try Again
30. Question The nurse is caring for an
older client who was admitted for extreme
weakness, dizziness, and orthopnea.  A
diagnosis of heart failure is confirmed.
Which of the following tests is a helpful in
determining the diagnosis of heart failure?
Electrolyte Panel
Liver Function Panel
12-lead Electrocardiogram
 Brain Natriuretic Peptide (BNP)
Incorrect Try Again
31. Question The nurse is caring for a
patient who is scheduled for a
percutaneous transluminal coronary
angioplasty (PTCA). Which information by
the nurse best explains the procedure?
“The procedure involves attaching
grafts to replace blocked coronary
arteries.”
“The procedure includes threading a
catheter with a sharp blade at its tip to
scrape plaque build-up.”
“The procedure involves opening a
blocked artery with an inflatable
balloon located on the end of a
catheter.”
“The procedure involves a catheter
with monitor on its tip which will stay in
place during open heart surgery.”
Incorrect Try Again
32. Question The nurse is caring for a
client in Intensive Care Unit for myocardial
infarction.  The client has a 18 gauge
peripheral IV site and will utilize the site
for starting an intravenous nitroglycerin
infusion.  The nurse understands that
intra-arterial monitoring of blood pressure
is preferred for monitoring; however, until
the arterial line is established, the nurse
will monitor the patient using which type
of equipment?
 Noninvasive blood pressure
monitor will be utilized.
Central Venous Pressure gauge will
be utilized.
The nurse will hold the Nitroglycerin
infusion until arterial line is inserted.
Pulse oximeter connected to
monitor console
Incorrect Try Again
33. Question A client is brought to the
emergency department (ED) by family for
unrelieved chest pain for 45 minutes. 
Which of the following interventions are
most important?
Administer oxygen, give a dose of
NTG sublingual, and follow with a
nonsteroidal anti-inflammatory.
Begin a heparin drip, administer
oxygen, and call the lab for stat troponin
levels.
Apply oxygen, administer morphine
sulphate, and place client on bed rest
with cardiac monitoring.
Have the client to chew two aspirin
325 mg each, administer oxygen, and
bring the crash cart to the bedside.
Incorrect Try Again
34. Question The nurse is providing
education for a client diagnosed with
angina pectoris.  Further education is
needed after the client verbalizes which
statement after teaching is provided?
“I know that exercise may increase
the heart’s oxygen demands, and may
cause angina; however, moderate
exercise is beneficial.”
“Exercise must be avoided at all
costs, and I will be more comfortable in
my chair during the day.”
“I can log symptoms and activities
that precipitate angina attacks.”
“If I experience angina, I will stop
the activity and sit or lie down to reduce
oxygen requirements until the pain
subsides.”
Incorrect Try Again
35. Question A client with coronary
artery disease (CAD) requires education on
risk factors that can be controlled or
modified.  Which of the risk factors will the
nurse indicate that are controlled or
modified?  A) Gender, obesity, family
history, and smoking
Genetics, smoking, inactivity, and
gender
Drinking alcohol, stress, gender, and
smoking
Obesity, inactivity, diet, and
smoking
Obesity, stress, genetics, and
ethnicity
Incorrect Try Again
 36. Question The nurse is scheduling a
client for a cardiac catheterization.  The
client has type 2 diabetes and takes
metformin.  Which action will the nurse
take prior to scheduling the procedure?
The nurse will instruct the client to
have fasting A1C and glucose tolerance
test prior to the procedure.
The nurse will instruct the client to
eat a low carbohydrate diet three days
prior to the procedure.
The nurse will instruct the client to
hold the metformin for 24 hours before
the procedure and 48 hours after the
procedure.
The nurse instructs the client to
take all medications the morning of the
procedure but not to drink or eat
afterwards.
Incorrect Try Again
37. Question The nurse is caring for a
client who required insertion of an
automatic internal cardioverter-
defibrillator and is preparing information
for home management and safety.  Which
information by the nurse is most important
for client instruction?
Self-management of anxiety through
biofeedback.
Keeping a log of activities that
occur near electromagnetic sources.
Encouraging swimming alone as a
 healthy activity.
Instruction on use of a Medic-Alert
device.
Incorrect Try Again
38. Question The nurse is caring for a
client who has a rapid heart rate of 135
beats/minute and heart monitor reveals
atrial fibrillation.  Which of the following
assessment findings would the nurse
expect to find?
GI distress
Hypotension and distended neck
veins
Increased urinary output
Hypertension and flat neck veins
Incorrect Try Again
39. Question The nurse is caring for a
client with telemetry heart monitor, and
notices flat electrocardiographic complexes
and occasional sinus rhythm.  The monitor
alarms sound when cardiac complexes
become absent, and then alarms cease
when sinus rhythm occurs.  Which is the
priority action by the nurse?
Immediately go to the client’s
hospital room and assess telemetry
lead placement
Immediately call a Code and bring
the crash cart to the client’s room
Immediately call the health care
provider for pulseless electrical activity
Immediately record the telemetry
 findings at the main telemetry station
Incorrect Try Again
40. Question A client with stage 2
hypertension returns to the clinic for
follow-up.  The client states that
prescribed antihypertensives are taken if
the client remembers.  The client also
states that lunch on the job consists of fast
food and does not have time to fix a lunch
in the mornings. After assessment and
analysis, the nurse has identified a nursing
diagnosis of risk for ineffective health
maintenance related to nonadherence to
therapeutic regimen. Which type of
teaching/education would benefit the client
most?
Ask the client if there is a death
wish because of the noncompliance then
proceed to ask why the client does not
want to live to see grandchildren.
Give the client free movie tickets for
blood pressure less than 150/80 with the
next visit and increase the incentive for
the next three visits.
Provide written education
materials, Teach-back, med-minder log,
and a list of foods that are low salt and
low fat that can be ordered in
restaurants near work.
Provide medical journal articles on
recent research in early death, mortality,
and co-morbidities with hypertension
 and heart disease.
Incorrect Try Again
41. Question The nurse is caring for a
client who is prescribed
hydrochlorothiazide for hypertension.
Following administration of this
medication, the nurse should anticipate
what effect?
Increased blood pressure related to
increased cardiac output
Increased urine output related to
diuretic effect
Elevated potassium
Mild agitation
Incorrect Try Again
42. Question The nurse is caring for a
client diagnosed with pre-hypertension.
The nurse initiates what type of instruction
for lifestyle changes that may help prevent
progression of the hypertension?
Avoid foods high in potassium and
carbohydrates.
Maintain exercise on a regular
basis for at least 30 minutes.
Limit protein and gradually progress
to vegetarian lifestyle.
Limit strenuous activities to non-
aerobic, non-weight bearing.
Incorrect Try Again
43. Question The nurse is caring for an
older adult diagnosed with primary
hypertension and is preparing an
education plan for beta-blocker medication
and management of hypertension while at
home.  Which health promotion education
is most important for the nurse to include?
Make sure to drink plenty of fluids to
prevent dehydration.
Change positions slowly, rise
slowly, and use supports to prevent
falls
Do not engage in exercise until the
medication is in the system for 6 weeks.
Eat at least 2000 calories per day
Incorrect Try Again
44. Question The emergency
department (ED) nurse assessed a client
with complaint of headache for the past
two days.  Blood pressure on admission to
the ED was 196/114 and second blood
pressure was 188/100.  The ED nurse
administered hydrochlorothiazide followed
by losartan.  Five hours later the blood
pressure was reduced by 10% and
complaints of headache lessened.  The ED
nurse provided instructions based on
follow-up for which type of hypertension?
Pre-hypertension
Stage 1 hypertension
Stage 2 hypertension
Stage 3 hypertension
Incorrect Try Again
45. Question A client with stage 1
hypertension appears at the clinic for
follow-up.  The patient's BP is 138/88 mm
Hg. The patient asks why it is important to
treat hypertension. What would be the
nurse's best response?
“Hypertension causes relaxation and
dilation of arteries which strains the
heart.”
“Hypertension if unchecked
increases risk of adult onset of Type 1
Diabetes.”
“Hypertension is the leading cause
of death in people your age.”
“Hypertension greatly increases
your risk of stroke and heart disease.”
Incorrect Try Again
46. Question A client is recovering from
a heart transplant and asks the nurse why
he must take Cyclosporine. How should the
nurse best respond?
Cyclosporine decreases the risk of
thrombus formation by interfering with
coagulation cascade.
Cyclosporine minimizes rejection of
the transplant and must be taken long-
term.
Cyclosporine increases
contractibility of the donor heart.
Cyclosporine helps prevent preload
and afterload dysfunction in the
cardiovascular system.
Incorrect Try Again
 47. Question The nurse is providing
education to a client with a history
rheumatic heart. Information includes risk
factors for bacterial endocarditis.  The
nurse asks through teach-back if the client
knows the importance of taking which of
the following drugs prior to scheduled
invasive procedures?
Amoxicillin (Amoxil)
Solumedrol
Warfarin (Coumadin)
Metoprolol (Lopressor)
Incorrect Try Again
48. Question The nurse is caring for a
client admitted for acute pericarditis. 
Which nursing diagnosis should take
priority during the first 24 hours of nursing
care?
Risk for falls related to weakness,
pain, and dizziness
Acute pain related to inflammation
of the pericardium
Imbalanced nutrition: less than body
requirements related to decreased
intake, nausea and anorexia
Activity intolerance related to
fatigue and physical weakness
Incorrect Try Again
49. Question The nurse is caring for a
client with complaints of claudication.  An
ankle-brachial index (ABI) is ordered and
the client asks what the test measures and
 why it is important.  Which statement by
the nurse best describes the ABI?
“The ankle-brachial index is a
noninvasive procedure to check your
risk of peripheral artery disease.”
“The ankle-brachial index produces
a ratio of SBP with retrograde wave
reflection from resistant distal
arterioles.”
“The test is a physician ordered
exam, but nothing compares to old
fashion palpation of your pulses.”
“The test is no big deal. Don’t worry
about anything as results can be
misleading.”
Incorrect Try Again
50. Question The nurse is caring for a
client with an open lower extremity leg
ulcer.  The wound margins are irregular,
wound bed is red, and is draining moderate
amounts of thick exudate.  The nurse
documents which type of ulcer?
Arterial ulcer
Venous ulcer
Edema ulcer
Wound ulcer
Incorrect Try Again
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