MIDTERMS | CARDIO

NCM 118 MIDTERM CARDIO B. DM

REVIEWER C. Heredity
D. HPN
1) Medical treatment of coronary artery
disease includes which of the following
procedures? 5) Preventable factors that increase the risk
of CAD include:
A. Cardiac catheterization
B. Coronary artery bypass surgery A. High blood cholesterol levels
C. Oral medication administration B. Use of personal protective
D. Percutaneous transluminal equipment
coronary angioplasty C. Cigarette smoking
D. Obesity
E. Exposure to polyacrylamide
2) Atherosclerosis impedes coronary blood
flow by which of the following
mechanisms? 6) There are a number of risk factors
associated with coronary artery disease.
Which of the following is a modifiable risk
A. Plaques obstruct the vein factor?
B. Plaques obstruct the artery
C. Blood clots form outside the
vessel wall A. Obesity.
D. Hardened vessels dilate to B. Heredity.
allow the blood to flow through C. Gender.
D. Age.
3) A client with pneumonia is receiving
supplemental oxygen, 2 L/min via nasal 7) A male client admitted to an acute care
cannula. The client’s history includes facility with pneumonia is receiving
chronic obstructive pulmonary disease supplemental oxygen, 2 L/minute via nasal
(COPD) and coronary artery disease. cannula. The client’s history includes
Because of these findings, the nurse closely chronic obstructive pulmonary disease
monitors the oxygen flow and the client’s (COPD) and coronary artery disease.
respiratory status. Which complication may Because of these history findings, the nurse
arise if the client receives a high oxygen closely monitors the oxygen flow and the
concentration? client’s respiratory status. Which
complication may arise if the client receives
a high oxygen concentration?
A. Apnea
B. Anginal pain
C. Respiratory alkalosis A. Apnea
D. Metabolic acidosis B. Anginal pain
C. Respiratory alkalosis
D. Metabolic acidosis
4) Which of the following risk factors for
coronary artery disease cannot be
corrected? 8) Women in the lower socioeconomic
group have the highest contribution to CAD
related events for their gender.
A. Cigarette smoking
 MIDTERMS | CARDIO

A. True B. DM
B. False C. MI
D. Renal failure
9) Prolonged occlusion of the right
coronary artery produces an infarction in 14) Which of the following diagnostic tools
which of he following areas of the heart? is most commonly used to determine the
location of myocardial damage?
A. Anterior
B. Apical A. Cardiac catheterization
C. Inferior B. Cardiac enzymes
D. Lateral C. Echocardiogram
D. Electrocardiogram
10) When teaching a client with coronary
artery disease about nutrition, the nurse 15) One possible treatment for CAD is
should emphasize coronary angioplasty. What does it
involve?
A. Eating 3 balanced meals a day
B. Adding complex carbohydrates A. A new section of artery
C. Avoiding very heavy meals replaces the blocked section
D. Limiting sodium to 7 gms per B. A tiny balloon is inflated
day inside an artery
C. Medication is used to expand
the artery
11) Which is a symptom of coronary artery
disease? D. None of the above

16) Which of the following actions is the

A. Headache
first priority care for a client exhibiting
B. Sleep problems signs and symptoms of coronary artery
C. Pain or discomfort in the chest, disease?
arms or lower jaw
D. Diarrhea
A. Decrease anxiety
B. Enhance myocardial
12) Which of the following illnesses is the oxygenation
leading cause of death in the US?
C. Administer sublingual
nitroglycerin
A. Cancer D. Educate the client about his
B. Coronary artery disease symptoms
C. Liver failure
D. Renal failure 17) Exceeding which of the following
serum cholesterol levels significantly
13) Which of the following conditions most increases the risk of coronary artery
commonly results in CAD? disease?

A. Atherosclerosis A. 100 mg/dl

 MIDTERMS | CARDIO

B. 150 mg/dl allow for which of the following client

C. 175 mg/dl activities?
D. 200 mg/dl
A. Strict bed rest for 24 hours after
18) Which procedure or test is used to transfer
diagnose CAD? B. Bathroom privileges and self-
care activities
C. Unsupervised hallway
A. Electrocardiogram ambulation with distances
B. Treadmill stress test under 200 feet
C. Cardiac catheterization D. Ad lib activities because the
D. All of the above client is monitored.

19) A client is scheduled for a cardiac

catheterization using a radiopaque dye.
Which of the following assessments is most
critical before the procedure?

A. Intake and output

B. Baseline peripheral pulse rates
C. Height and weight
D. Allergy to iodine or shellfish 22) A nurse notes 2+ bilateral edema in the
lower extremities of a client with
myocardial infarction who was admitted 2
20) A client with no history of days ago. The nurse would plan to do which
cardiovascular disease comes into the of the following next?
ambulatory clinic with flu-like symptoms.
The client suddenly complains of chest
pain. Which of the following questions A. Review the intake and output
would best help a nurse to discriminate pain records for the last 2 days
caused by a non-cardiac problem? B. Change the time of diuretic
administration from morning to
evening
A. “Have you ever had this pain C. Request a sodium restriction of
before?” 1 g/day from the physician.
B. “Can you describe the pain to D. Order daily weights starting the
me?” following morning.
C. “Does the pain get worse when
you breathe in?”
D. “Can you rate the pain on a 23) A client is wearing a continuous cardiac
scale of 1-10, with 10 being the monitor, which begins to sound its alarm. A
worst?” nurse sees no electrocardiogram complexes
on the screen. The first action of the nurse
is to:
21) A client with myocardial infarction has
been transferred from a coronary care unit
to a general medical unit with cardiac A. Check the client status and lead
monitoring via telemetry. A nurse plans to placement
 MIDTERMS | CARDIO

B. Press the recorder button on the B. Lower than the needed

electrocardiogram console. therapeutic level
C. Call the physician C. Within the therapeutic range
D. Call a code blue D. Higher than the therapeutic
range
24) A nurse is assessing the blood pressure
of a client diagnosed with primary 27) A client who has been receiving
hypertension. The nurse ensures accurate heparin therapy also is started on warfarin.
measurement by avoiding which of the The client asks a nurse why both
following? medications are being administered. In
formulating a response, the nurse
incorporates the understanding that
A. Seating the client with arm warfarin:
bared, supported, and at heart
level.
B. Measuring the blood pressure A. Stimulates the breakdown of
after the client has been seated specific clotting factors by the
quietly for 5 minutes. liver, and it takes 2-3 days for
C. Using a cuff with a rubber this to exert an anticoagulant
bladder that encircles at least effect.
80% of the limb. B. Inhibits synthesis of specific
D. Taking a blood pressure within clotting factors in the liver, and
15 minutes after nicotine or it takes 3-4 days for this
caffeine ingestion. medication to exert an
anticoagulant effect.
C. Stimulates production of the
25) IV heparin therapy is ordered for a body’s own thrombolytic
client. While implementing this order, a substances, but it takes 2-4 days
nurse ensures that which of the following for this to begin.
medications is available on the nursing
D. Has the same mechanism of
unit?
action as Heparin, and the
crossover time is needed for the
A. Vitamin K serum level of warfarin to be
B. Aminocaporic acid therapeutic.
C. Potassium chloride
D. Protamine sulfate 28) A 60-year-old male client comes into
the emergency department with complaints
of crushing chest pain that radiates to his
shoulder and left arm. The admitting
diagnosis is acute myocardial infarction.
26) A client is at risk for pulmonary
Immediate admission orders include
embolism and is on anticoagulant therapy
oxygen by NC at 4L/minute, blood work,
with warfarin (Coumadin). The client’s
chest x-ray, an ECG, and 2mg of morphine
prothrombin time is 20 seconds, with a
given intravenously. The nurse should first:
control of 11 seconds. The nurse assesses
that this result is:
A. Administer the morphine
A. The same as the client’s own B. Obtain a 12-lead ECG
baseline level C. Obtain the lab work
 MIDTERMS | CARDIO

D. Order the chest x-ray

29) When administered a thrombolytic

drug to the client experiencing an MI, the
32) The nurse receives emergency
nurse explains to him that the purpose of
laboratory results for a client with chest
this drug is to:
pain and immediately informs the
physician. An increased myoglobin level
A. Help keep him well-hydrated suggests which of the following?
B. Dissolve clots he may have
C. Prevent kidney failure A. Cancer
D. Treat potential cardiac B. Hypertension
arrhythmias.
C. Liver disease
D. Myocardial infarction
30) When interpreting an ECG, the nurse
would keep in mind which of the following
33) When teaching a client about
about the P wave? Select all that apply.
propranolol hydrochloride, the nurse
should base the information on the
A. Reflects electrical impulse knowledge that propranolol hydrochloride:
beginning at the SA node
B. Indicated electrical impulse
A. Blocks beta-adrenergic
beginning at the AV node
stimulation and thus causes
C. Reflects atrial muscle decreased heart rate,
depolarization myocardial contractility, and
D. Identifies ventricular muscle conduction.
depolarization B. Increases norepinephrine
E. Has duration of normally 0.11 secretion and thus decreases
seconds or less. blood pressure and heart rate.
C. Is a potent arterial and venous
31) A client has driven himself to the ER. vasodilator that reduces
He is 50 years old, has a history of peripheral vascular resistance
hypertension, and informs the nurse that his and lowers blood pressure.
father died of a heart attack at 60 years of D. Is an angiotensin-converting
age. The client is presently complaining of enzyme inhibitor that reduces
indigestion. The nurse connects him to an blood pressure by blocking the
ECG monitor and begins administering conversion of angiotensin I to
oxygen at 2 L/minute per NC. The nurse’s angiotensin II.
next action would be to:
34) The most important long-term goal for
A. Call for the doctor a client with hypertension would be to:
B. Start an intravenous line
C. Obtain a portable chest A. Learn how to avoid stress
radiograph B. Explore a job change or early
D. Draw blood for laboratory retirement
studies C. Make a commitment to long-
term therapy
 MIDTERMS | CARDIO

D. Control high blood pressure A. A change in the pattern of her

pain
35) Hypertension is known as the silent B. Pain during sex
killer. This phrase is associated with the C. Pain during an argument with
fact that hypertension often goes her husband
undetected until symptoms of other system D. Pain during or after an activity
failures occur. This may occur in the form such as lawnmowing
of:
38) The physician refers the client with
A. Cerebrovascular accident unstable angina for a cardiac catherization.
B. Liver disease The nurse explains to the client that this
procedure is being used in this specific case
C. Myocardial infarction
to:
D. Pulmonary disease

A. Open and dilate the blocked

36) During the previous few months, a 56-
coronary arteries
year-old woman felt brief twinges of chest
pain while working in her garden and has B. Assess the extent of arterial
had frequent episodes of indigestion. She blockage
comes to the hospital after experiencing C. Bypass obstructed vessels
severe anterior chest pain while raking D. Assess the functional adequacy
leaves. Her evaluation confirms a diagnosis of the valves and heart muscle.
of stable angina pectoris. After stabilization
and treatment, the client is discharged from 39) As an initial step in treating a client
the hospital. At her follow-up appointment, with angina, the physician prescribes
she is discouraged because she is nitroglycerin tablets, 0.3mg given
experiencing pain with increasing sublingually. This drug’s principle effects
frequency. She states that she is visiting an are produced by:
invalid friend twice a week and now cannot
walk up the second flight of steps to the
friend’s apartment without pain. Which of A. Antispasmotic effect on the
the following measures that the nurse could pericardium
suggest would most likely help the client B. Causing an increased
deal with this problem? mycocardial oxygen demand
C. Vasodilation of peripheral
vasculature
A. Visit her friend earlier in the
day. D. Improved conductivity in the
myocardium
B. Rest for at least an hour before
climbing the stairs.
C. Take a nitroglycerin tablet 40) The nurse teaches the client with
before climbing the stairs. angina about the common expected side
D. Lie down once she reaches the effects of nitroglycerin, including:
friend’s apartment.
A. Headache
37) Which of the following symptoms B. High blood pressure
should the nurse teach the client with C. Shortness of breath
unstable angina to report immediately to D. Stomach cramps
her physician?
 MIDTERMS | CARDIO

41) Sublingual nitroglycerin tablets begin D. Tricupsid

to work within 1 to 2 minutes. How should
the nurse instruct the client to use the drug
when chest pain occurs? 45) Which of the following blood tests is
most indicative of cardiac damage?

A. Take one tablet every 2 to 5

minutes until the pain stops. A. Lactate dehydrogenase
B. Take one tablet and rest for 10 B. Complete blood count (CBC)
minutes. Call the physician if C. Troponin I
pain persists after 10 minutes. D. Creatine kinase (CK)
C. Take one tablet, then an
additional tablet every 5 46) Which of the following types of pain
minutes for a total of 3 tablets. is most characteristic of angina?
Call the physician if pain
persists after three tablets.
D. Take one tablet. If pain persists A. Knifelike
after 5 minutes, take two B. Sharp
tablets. If pain still persists 5 C. Shooting
minutes later, call the D. Tightness
physician.
47) Which of the following parameters is
42) Which of the following arteries the major determinate of diastolic blood
primarily feeds the anterior wall of the pressure?
heart?
A. Baroreceptors
A. Circumflex artery B. Cardiac output
B. Internal mammary artery C. Renal function
C. Left anterior descending artery D. Vascular resistance
D. Right coronary artery
48) Which of the following factors can
43) When do coronary arteries primarily cause blood pressure to drop to normal
receive blood flow? levels?

A. During inspiration A. Kidneys’ excretion of sodium

B. During diastolic only
C. During expiration B. Kidneys’ retention of sodium
D. During systole and water
C. Kidneys’ excretion of sodium
and water
44) A murmur is heard at the second left
D. Kidneys’ retention of sodium
intercostal space along the left sternal
and excretion of water
border. Which valve is this?

49) Baroreceptors in the carotid artery

A. Aortic walls and aorta respond to which of the
B. Mitral following conditions?
C. Pulmonic
 MIDTERMS | CARDIO

A. Changes in blood pressure A. Hypocalcemia

B. Changes in arterial oxygen B. Hypermagnesemia
tension C. Hypokalemia
C. Changes in arterial carbon D. Hypernatremia
dioxide tension
D. Changes in heart rate
54) A client is receiving spironolactone to
treat hypertension. Which of the following
50) Which of the following terms instructions should the nurse provide?
describes the force against which the
ventricle must expel blood?
A. “Eat foods high in potassium.”
B. “Take daily potassium
A. Afterload supplements.”
B. Cardiac output C. “Discontinue sodium
C. Overload restrictions.”
D. Preload D. “Avoid salt substitutes.”

51) Which of the following terms is used 55) When assessing an ECG, the nurse
to describe the amount of stretch on the knows that the P-R interval represents the
myocardium at the end of diastole? time it takes for the:

A. Afterload A. Impulse to begin atrial

B. Cardiac index contraction
C. Cardiac output B. Impulse to transverse the atria
D. Preload to the AV node
C. SA node to discharge the
impulse to begin atrial
52) A 57-year-old client with a history of depolarization
asthma is prescribed propanolol (Inderal) to
D. Impulse to travel to the
control hypertension. Before administered
ventricles
propranolol, which of the following actions
should the nurse take first?
56) Following a treadmill test and cardiac
catheterization, the client is found to have
A. Monitor the apical pulse rate coronary artery disease, which is
B. Instruct the client to take inoperative. He is referred to the cardiac
medication with food rehabilitation unit. During his first visit to
C. Question the physician about the unit he says that he doesn’t understand
the order why he needs to be there because there is
D. Caution the client to rise slowly nothing that can be done to make him
when standing. better. The best nursing response is:

53) One hour after administering IV A. “Cardiac rehabilitation is not a

furosemide (Lasix) to a client with heart cure but can help restore you to
failure, a short burst of ventricular many of your former
tachycardia appears on the cardiac monitor. activities.”
Which of the following electrolyte B. “Here we teach you to
imbalances should the nurse suspect? gradually change your lifestyle
 MIDTERMS | CARDIO

to accommodate your heart D. Maintaining at least one IV

disease.” access site
C. “You are probably right but we
can gradually increase your
60) A client is experiencing tachycardia.
activities so that you can live a
The nurse’s understanding of the
more active life.”
physiological basis for this symptom is
D. “Do you feel that you will have explained by which of the following
to make some changes in your statements?
life now?”

A. The demand for oxygen is

57) To evaluate a client’s condition
decreased because of pleural
following cardiac catheterization, the nurse
involvement
will palpate the pulse:
B. The inflammatory process
causes the body to demand
A. In all extremities more oxygen to meet its needs.
B. At the insertion site C. The heart has to pump faster to
C. Distal to the catheter insertion meet the demand for oxygen
D. Above the catheter insertion when there is lowered arterial
oxygen tension.
D. Respirations are labored.
58) A client’s physician orders nuclear
cardiography and makes an appointment
for a thallium scan. The purpose of 61) A client enters the ER complaining of
injecting radioisotope into the bloodstream chest pressure and severe epigastric
is to detect: distress. His VS are 158/90, 94, 24, and
99*F. The doctor orders cardiac enzymes.
If the client were diagnosed with an MI, the
A. Normal vs. abnormal tissue nurse would expect which cardiac enzyme
B. Damage in areas of the heart to rise within the next 3 to 8 hours?
C. Ventricular function
D. Myocardial scarring and
perfusion A. Creatine kinase (CK or CPK)
B. Lactic dehydrogenase (LDH)
C. LDH-1
59) A client enters the ER complaining of D. LDH-2
severe chest pain. A myocardial infarction
is suspected. A 12 lead ECG appears
normal, but the doctor admits the client for 62) A 45-year-old male client with leg
further testing until cardiac enzyme studies ulcers and arterial insufficiency is admitted
are returned. All of the following will be to the hospital. The nurse understands that
included in the nursing care plan. Which leg ulcers of this nature are usually caused
activity has the highest priority? by:

A. Monitoring vital signs A. Decreased arterial blood flow

B. Completing a physical secondary to vasoconstriction
assessment B. Decreased arterial blood flow
C. Maintaining cardiac leading to hyperemia
monitoring C. Atherosclerotic obstruction of
the arteries
 MIDTERMS | CARDIO

D. Trauma to the lower 66) When teaching a patient why

extremities spironolactone (Aldactone) and furosemide
(Lasix) are prescribed together, the nurse
bases teaching on the knowledge that:
63) Which of the following instructions
should be included in the discharge
teaching for a patient discharged with a A. Moderate doses of two
transdermal nitroglycerin patch? different types of diuretics are
more effective than a large dose
of one type
A. “Apply the patch to a nonhairy, B. This combination promotes
nonfatty area of the upper torso
diuresis but decreases the risk
or arms.”
of hypokalemia
B. “Apply the patch to the same C. This combination prevents
site each day to maintain
dehydration and hypovolemia
consistent drug absorption.”
D. Using two drugs increases
C. “If you get a headache, remove osmolality of plasma and the
the patch for 4 hours and then
glomerular filtration rate
reapply.”
D. “If you get chest pain, apply a
second patch right next to the
first patch.” MSN Exam for Myocardial Infarction and
Heart Failure
64) In order to prevent the development of
tolerance, the nurse instructs the patient to: 1) The nurse should visit which of the
following clients first?

A. Apply the nitroglycerin patch

every other day A. The client with diabetes with a
blood glucose of 95mg/dL
B. Switch to sublingual
nitroglycerin when the B. The client with hypertension
patient’s systolic blood being maintained on Lisinopril
pressure elevates to >140 mm C. The client with chest pain and a
Hg history of angina
C. Apply the nitroglycerin patch D. The client with Raynaud’s
for 14 hours each and remove disease
for 10 hours at night
D. Use the nitroglycerin patch for 2) A 23-year-old patient in the 27th week of
acute episodes of angina only pregnancy has been hospitalized on
complete bed rest for 6 days. She
65) Direct-acting vasodilators have which experiences sudden shortness of breath,
of the following effects on the heart rate? accompanied by chest pain. Which of the
following conditions is the most likely
cause of her symptoms?
A. Heart rate decreases
B. Heart rate remains significantly
unchanged A. Myocardial infarction due to a
history of atherosclerosis.
C. Heart rate increases
B. Pulmonary embolism due to
D. Heart rate becomes irregular deep vein thrombosis (DVT).
 MIDTERMS | CARDIO

C. Anxiety attack due to worries client would be appropriate to assign to this

about her baby’s health. nurse? A client with:
D. Congestive heart failure due to
fluid overload. A. Dopamine drip IV with vital
signs monitored every 5
minutes
B. a myocardial infarction that is
3) What is the primary reason for free from pain and
administering morphine to a client with dysrhythmias
myocardial infarction? C. a tracheotomy of 24 hours in
some respiratory distress
D. a pacemaker inserted this
A. To sedate the client
morning with intermittent
B. To decrease the client’s pain capture
C. To decrease the client’s anxiety
D. To decrease oxygen demand on
the client’s heart 7) A female client is brought by ambulance
to the hospital emergency room after taking
an overdose of barbiturates is comatose.
4) A patient arrives in the emergency Nurse Trish would be especially alert for
department with symptoms of myocardial which of the following?
infarction, progressing to cardiogenic
shock. Which of the following symptoms
should the nurse expect the patient to A. Epilepsy
exhibit with cardiogenic shock? B. Myocardial Infarction
C. Renal failure
D. Respiratory failure
A. Hypertension.
B. Bradycardia.
C. Bounding pulse. 8) Tissue plasminogen activator (t-PA) is
D. Confusion. considered for treatment of a patient who
arrives in the emergency department
following onset of symptoms of myocardial
5) In order to be effective, Percutaneous infarction. Which of the following is a
Transluminal Coronary Angioplasty contraindication for treatment with t-PA?
(PTCA) must be performed within what
time frame, beginning with arrival at the
emergency department after diagnosis of A. Worsening chest pain that
myocardial infarction? began earlier in the evening.
B. History of cerebral
hemorrhage.
A. 60 minutes C. History of prior myocardial
B. 30 minutes infarction.
C. 9 days D. Hypertension.
D. 6-12 months
9) A patient admitted to the hospital with
6) Helen, a nurse from the maternity unit is myocardial infarction develops severe
floated to the critical care unit because of pulmonary edema. Which of the following
staff shortage on the evening shift. Which symptoms should the nurse expect the
patient to exhibit?
 MIDTERMS | CARDIO

A. Slow, deep respirations. following actions would help prevent

B. Stridor. Valsalva’s maneuver? Have the client:
C. Bradycardia.
D. Air hunger. A. Assume a side-lying position
B. Clench her teeth while moving
10) A 55-year-old client is admitted with in bed
chest pain that radiates to the neck, jaw and C. Drink fluids through a straw
shoulders that occurs at rest, with high body D. Avoid holding her breath
temperature, weak with generalized during activity
sweating and with decreased blood
pressure. A myocardial infarction is
13) The nurse is giving discharge teaching
diagnosed. The nurse knows that the most
to a client 7 days post myocardial
accurate explanation for one of these
infarction. He asks the nurse why he must
presenting adaptations is:
wait 6 weeks before having sexual
intercourse. What is the best response by
A. Catecholamines released at the the nurse to this question?
site of the infarction causes
intermittent localized pain.
A. “You need to regain your
B. Parasympathetic reflexes from strength before attempting
the infarcted myocardium such exertion.”
causes diaphoresis.
B. “When you can climb 2 flights
C. Constriction of central and of stairs without problems, it is
peripheral blood vessels causes generally safe.”
a decrease in blood pressure.
C. “Have a glass of wine to relax
D. Inflammation in the you, then you can try to have
myocardium causes a rise in the sex.”
systemic body temperature.
D. “If you can maintain an active
walking program, you will
have less risk.”

11) Which of the following is the most 14) Following myocardial infarction, a
common symptom of myocardial hospitalized patient is encouraged to
infarction? practice frequent leg exercises and
ambulate in the hallway as directed by his
A. Chest pain physician. Which of the following choices
B. Dyspnea reflects the purpose of exercise for this
C. Edema patient?
D. Palpitations
A. Increases fitness and prevents
future heart attacks.
12) Nursing measures for the client who has
had an MI include helping the client to B. Prevents bedsores.
avoid activity that results in Valsalva’s C. Prevents DVT (deep vein
maneuver. Valsalva’s maneuver may cause thrombosis).
cardiac dysrhythmias, increased venous D. Prevent constipations.
pressure, increased intrathoracic pressure
and thrombi dislodgement. Which of the
 MIDTERMS | CARDIO

15) Alzheimer’s disease is the secondary 18) An early finding in the EKG of a client
diagnosis of a client admitted with with an infarcted mycardium would be:
myocardial infarction. Which nursing
intervention should appear on this client’s
plan of care?
A. Disappearance of Q waves
B. Elevated ST segments
C. Absence of P wave
A. Perform activities of daily D. Flattened T waves
living for the client to decease
frustration.
B. Provide a stimulating
environment.
C. Establish and maintain a
routine.
D. Try to reason with the client as 19) A nurse caring for several patients on
much as possible. the cardiac unit is told that one is scheduled
for implantation of an automatic internal
cardioverter-defibrillator. Which of the
following patients is most likely to have
this procedure?
16) Which statement best describes the
difference between the pain of angina and
the pain of myocardial infarction? A. A patient admitted for
myocardial infarction without
cardiac muscle damage.
A. Pain associated with angina is B. A post-operative coronary
relieved by rest. bypass patient, recovering on
B. Pain associated with schedule.
myocardial infarction is C. A patient with a history of
always more severe. ventricular tachycardia and
C. Pain associated with angina is syncopal episodes.
confined to the chest area. D. A patient with a history of
D. Pain associated with atrial tachycardia and fatigue.
myocardial infarction is
referred to the left arm.
20) Twenty four hours after admission for
an Acute MI, Jose’s temperature is noted at
17) Patrick who is hospitalized following a 39.3 C. The nurse monitors him for other
myocardial infarction asks the nurse why he adaptations related to the pyrexia,
is taking morphine. The nurse explains that including:
morphine:
A. Shortness of breath
A. Decrease anxiety and B. Chest pain
restlessness C. Elevated blood pressure
B. Prevents shock and relieves D. Increased pulse rate
pain
C. Dilates coronary blood vessels
D. Helps prevent fibrillation of
the heart
 MIDTERMS | CARDIO

21) Mr. Duffy is admitted to the CCU with an effective cough, the nurse should
a diagnosis of R/O MI. He presented in the monitor closely for:
ER with a typical description of pain
associated with an MI, and is now cold and
clammy, pale and dyspneic. He has an IV
A. Pleural effusion.
of D5W running, and is complaining of B. Pulmonary edema.
chest pain. Oxygen therapy has not been C. Atelectasis.
started, and he is not on the monitor. He is D. Oxygen toxicity.
frightened. During the first three days that
Mr. Duffy is in the CCU, a number of 24) A 42-year-old client admitted with an
diagnostic blood tests are obtained. Which acute myocardial infarction asks to see his
of the following patterns of cardiac enzyme chart. What should the nurse do first?
elevation are most common following an
MI?
A. Allow the client to view his
chart
A. SGOT, CK, and LDH are all B. Contact the supervisor and
elevated immediately.
physician for approval
B. SGOT rises 4-6 hours after C. Ask the client if he has
infarction with CK and LDH
concerns about his care
rising slowly 24 hours later.
D. Tell the client that he isn’t
C. CK peaks first (12-24 hours), permitted to view his chart.
followed by the SGOT (peaks
in 24-36 hours) and then the
LDH (peaks 3-4 days). 25) A client with a history of an anterior
D. CK peaks first and remains wall myocardial infarction is being
elevated for 1 to 2 weeks. transferred from the coronary care unit
(CCU) to the cardiac stepdown unit (CSU).
While giving report to the CSU nurse, the
22) To prevent a valsalva maneuver in a CCU nurse says, “His pulmonary artery
client recovering from an acute myocardial wedge pressures have been in the high
infarction, the nurse would normal range.” The CSU nurse should be
especially observant for:
A. Assist the client to use the
bedside commode A. hypertension
B. Administer stool softeners B. high urine output
every day as ordered
C. dry mucous membranes
C. Administer antidysrhythmics D. pulmonary crackles
prn as ordered
D. Maintain the client on strict
bed rest

26) Which patient’s nursing care would be

most appropriate for the charge nurse to
assign to the LPN, under the supervision of
23) A male client with chronic obstructive the RN team leader?
pulmonary disease (COPD) is recovering
from a myocardial infarction. Because the
client is extremely weak and can’t produce A. A 51-year-old patient with
bilateral adrenalectomy just
 MIDTERMS | CARDIO

returned from the post- Which of the following is the most essential
anesthesia care unit nursing action?
B. An 83-year-old patient with
type 2 diabetes and chronic
A. Monitoring urine output
obstructive pulmonary disease
frequently
C. A 38-year-old patient with B. Monitoring blood pressure
myocardial infarction who is
every 4 hours
preparing for discharge
C. Obtaining serum potassium
D. A 72-year-old patient
levels daily
admitted from long-term care
with mental status changes
D. Obtaining infusion pump for
the medication

27) During the second day of

30) On the evening shift, the triage nurse
hospitalization of the client after a
evaluates several clients who were brought
Myocardial Infarction. Which of the
to the emergency department. Which in the
following is an expected outcome?
following clients should receive highest
priority?
A. Able to perform self-care
activities without pain
A. an elderly woman
B. Severe chest pain complaining of a loss of
C. Can recognize the risk factors appetite and fatigue for the
of Myocardial Infarction past week
D. Can Participate in cardiac B. A football player limping and
rehabilitation walking complaining of pain and
program swelling in the right ankle
C. A 50-year-old man,
28) The client with an acute myocardial diaphoretic and complaining
infarction is hospitalized for almost one of severe chest pain radiating
week. The client experiences nausea and to his jaw
loss of appetite. The nurse caring for the D. A mother with a 5-year-old
client recognizes that these symptoms may boy who says her son has been
indicate the: complaining of nausea and
vomited once since noon
A. Adverse effects of
spironolactone (Aldactone) 31) Nurse Betty is assigned to the following
B. Adverse effects of digoxin clients. The client that the nurse would see
(Lanoxin) first after endorsement?
C. Therapeutic effects of
propranolol (Indiral) A. A 34 year-old post operative
D. Therapeutic effects of appendectomy client of five
furosemide (Lasix) hours who is complaining of
pain.
29) Dr. Marquez orders a continuous B. A 44 year-old myocardial
intravenous nitroglycerin infusion for the infarction (MI) client who is
client suffering from myocardial infarction. complaining of nausea.
C. A 26 year-old client was
admitted for dehydration
 MIDTERMS | CARDIO

whose intravenous (IV) has B. Refocus the conversation on

infiltrated. his fears, frustrations and
D. A 63 year-old post operative’s anger about his condition
abdominal hysterectomy C. Explain how his being upset
client of three days whose dangerously disturbs his need
incisional dressing is saturated for rest
with serosanguinous fluid. D. Attempt to explain the
purpose of different hospital
32) After a myocardial infarction, a client is routines
placed on a sodium restricted diet. When
the nurse is teaching the client about the 35) Nurse Patricia finds a female client who
diet, which meal plan would be the most is post-myocardial infarction (MI) slumped
appropriate to suggest? on the side rails of the bed and unresponsive
to shaking or shouting. Which is the nurse
A. 3 oz. broiled fish, 1 baked next action?
potato, ½ cup canned beets, 1
orange, and milk A. Call for help and note the time.
B. 3 oz. canned salmon, fresh B. Clear the airway
broccoli, 1 biscuit, tea, and 1 C. Give two sharp thumps to the
apple precordium, and check the
C. A bologna sandwich, fresh pulse.
eggplant, 2 oz fresh fruit, tea, D. Administer two quick blows.
and apple juice
D. 3 oz. turkey, 1 fresh sweet
potato, 1/2 cup fresh green 36) Which of the following actions is the
beans, milk, and 1 orange first priority of care for a client exhibiting
signs and symptoms of coronary artery
disease?
33) The greatest danger of an uncorrected
atrial fibrillation for a male patient will be
which of the following: A. Decrease anxiety
B. Enhance myocardial
oxygenation
A. Pulmonary embolism C. Administer sublingual
B. Cardiac arrest nitroglycerin
C. Thrombus formation D. Educate the client about his
D. Myocardial infarction symptoms

34) Jose, who had a myocardial infarction 2 37) Medical treatment of coronary artery
days earlier, has been complaining to the disease includes which of the following
nurse about issues related to his hospital procedures?
stay. The best initial nursing response
would be to:
A. Cardiac catherization
B. Coronary artery bypass
A. Allow him to release his surgery
feelings and then leave him C. Oral medication therapy
alone to allow him to regain
D. Percutaneous transluminal
his composure
coronary angioplasty
 MIDTERMS | CARDIO

38) Which of the following is the most C. Coronary artery thrombosis

common symptom of myocardial infarction D. Renal failure
(MI)?
43) Which of the following
A. Chest pain complications is indicated by a third heart
B. Dyspnea sound (S3)?
C. Edema
D. Palpitations A. Ventricular dilation
B. Systemic hypertension
39) Which of the following symptoms is the C. Aortic valve malfunction
most likely origin of pain the client D. Increased atrial contractions
described as knifelike chest pain that
increases in intensity with inspirat Hi ion?

A. Cardiac
B. Gastrointestinal
C. Musculoskeletal 44) After an anterior wall myocardial
D. Pulmonary infarction, which of the following problems
is indicated by auscultation of crackles in
the lungs?
40) Which of the following blood tests is
most indicative of cardiac damage?
A. Left-sided heart failure
A. Lactate dehydrogenase B. Pulmonic valve malfunction
B. Complete blood count (CBC) C. Right-sided heart failure
C. Troponin I D. Tricupsid valve malfunction
D. Creatine kinase (CK)
45) What is the first intervention for a
client experiencing MI?
41) What is the primary reason for
administering morphine to a client with an
MI? A. Administer morphine
B. Administer oxygen
A. To sedate the client C. Administer sublingual
B. To decrease the client’s pain nitroglycerin
C. To decrease the client’s D. Obtain an ECG
anxiety
D. To decrease oxygen demand 46) Which of the following classes of
on the client’s heart medications protects the ischemic
myocardium by blocking catecholamines
and sympathetic nerve stimulation?
42) Which of the following conditions
is most commonly responsible for
myocardial infarction? A. Beta-adrenergic blockers
B. Calcium channel blockers
A. Aneurysm C. Narcotics
B. Heart failure D. Nitrates
 MIDTERMS | CARDIO

47) What is the most common 52) Which of the following symptoms
complication of an MI? might a client with right-sided heart failure
exhibit?
A. Cardiogenic shock
B. Heart failure A. Adequate urine output
C. arrhythmias B. Polyuria
D. Pericarditis C. Oliguria
D. Polydipsia

53) Which of the following classes of

48) With which of the following disorders medications maximizes cardiac
is jugular vein distention most prominent? performance in clients with heart failure by
increasing ventricular contractibility?
A. Abdominal aortic aneurysm
B. Heart failure A. Beta-adrenergic blockers
C. MI B. Calcium channel blockers
D. Pneumothorax C. Diuretics
D. Inotropic agents
49) Toxicity from which of the following
medications may cause a client to see a 54) Stimulation of the sympathetic
green-yellow halo around lights? nervous system produces which of the
following responses?
A. Digoxin
B. Furosemide (Lasix) A. Bradycardia
C. Metoprolol (Lopressor) B. Tachycardia
D. Enalapril (Vasotec) C. Hypotension
D. Decreased myocardial
contractility
50) Which of the following symptoms is
most commonly associated with left-sided
heart failure? 55) Which of the following conditions is
most closely associated with weight gain,
nausea, and a decrease in urine output?
A. Crackles
B. Arrhythmias
C. Hepatic engorgement A. Angina pectoris
D. Hypotension B. Cardiomyopathy
C. Left-sided heart failure
D. Right-sided heart failure
51) In which of the following disorders
would the nurse expect to assess sacral
edema in a bedridden client? 56) Which of the following heart muscle
diseases is unrelated to other cardiovascular
disease?
A. Diabetes
B. Pulmonary emboli
C. Renal failure A. Cardiomyopathy
D. Right-sided heart failure B. Coronary artery disease
 MIDTERMS | CARDIO

C. Myocardial infarction 61) In which of the following types of

D. Pericardial effusion cardiomyopathy does cardiac output remain
normal?
57) Which of the following types of
cardiomyopathy can be associated with A. Dilated
childbirth? B. Hypertrophic
C. Obliterative
A. Dilated D. Restrictive
B. Hypertrophic
C. Myocarditis 62) Which of the following cardiac
D. Restrictive conditions does a fourth heart sound (S4)
indicate?
58) Septal involvement occurs in which
type of cardiomyopathy? A. Dilated aorta
B. Normally functioning heart
C. Decreased myocardial
A. Congestive
contractility
B. Dilated
D. Failure of the ventricle to eject
C. Hypertrophic all of the blood during systole
D. Restrictive

63) Which of the following classes of

59) Which of the following recurring drugs is most widely used in the treatment
conditions most commonly occurs in of cardiomyopathy?
clients with cardiomyopathy?

A. Antihypertensives
A. Heart failure B. Beta-adrenergic blockers
B. Diabetes C. Calcium channel blockers
C. MI D. Nitrates
D. Pericardial effusion

64) If medical treatments fail, which of the

60) Dyspnea, cough, expectoration, following invasive procedures is necessary
weakness, and edema are classic signs and for treating cariomyopathy?
symptoms of which of the following
conditions?
A. Cardiac catherization
B. Coronary artery bypass graft
A. Pericarditis (CABG)
B. Hypertension C. Heart transplantation
C. MI D. Intra-aortic balloon pump
D. Heart failure (IABP)

65) Which of the following conditions is

associated with a predictable level of pain
that occurs as a result of physical or
emotional stress?
 MIDTERMS | CARDIO

A. Anxiety client experiencing chest pain while

B. Stable angina walking?
C. Unstable angina
D. Variant angina A. Sit the client down
B. Get the client back to bed
66) Which of the following types of angina C. Obtain an ECG
is most closely related with an impending D. Administer sublingual
MI? nitroglycerin

A. Angina decubitus 71) Myocardial oxygen consumption

B. Chronic stable angina increases as which of the following
C. Noctural angina parameters increase?
D. Unstable angina
A. Preload, afterload, and
67) Which of the following conditions is cerebral blood flow
the predominant cause of angina? B. Preload, afterload, and renal
blood flow
C. Preload, afterload,
A. Increased preload contractility, and heart rate.
B. Decreased afterload D. Preload, afterload, cerebral
C. Coronary artery spasm blood flow, and heart rate.
D. Inadequate oxygen supply to
the myocardium
72) Which of the following positions
would best aid breathing for a client with
68) Which of the following tests is used acute pulmonary edema?
most often to diagnose angina?
A. Lying flat in bed
A. Chest x-ray B. Left side-lying
B. Echocardiogram C. In high Fowler’s position
C. Cardiac catherization D. In semi-Fowler’s position
D. 12-lead electrocardiogram
(ECG)

69) Which of the following results is the 73) Which of the following blood gas
primary treatment goal for angina? abnormalities is initially most suggestive of
pulmonary edema?
A. Reversal of ischemia
B. Reversal of infarction A. Anoxia
C. Reduction of stress and B. Hypercapnia
anxiety C. Hyperoxygenation
D. Reduction of associated risk D. Hypocapnia
factors

70) Which of the following interventions

should be the first priority when treating a
 MIDTERMS | CARDIO

74) Which of the following is a rheumatic fever. Which assessment

compensatory response to decreased findings confirm this diagnosis?
cardiac output?
A. Erythema marginatum,
A. Decreased BP subcutaneous nodules, and
B. Alteration in LOC fever
C. Decreased BP and diuresis B. Tachycardia, finger clubbing,
D. Increased BP and fluid and a load S3
retention C. Dyspnea, cough, and
palpitations
D. Dyspnea, fatigue, and
75) Which of the following actions is the
synocope
appropriate initial response to a client
coughing up pink, frothy sputum?
79) A client admitted with angina
compains of severe chest pain and suddenly
A. Call for help
becomes unresponsive. After establishing
B. Call the physician unresponsiveness, which of the following
C. Start an I.V. line actions should the nurse take first?
D. Suction the client
A. Activate the resuscitation
76) Which of the following terms team
describes the force against which the B. Open the client’s airway
ventricle must expel blood? C. Check for breathing
D. Check for signs of circulation
A. Afterload
B. Cardiac output
C. Overload
D. Preload

80) A 55-year-old client is admitted with

an acute inferior-wall myocardial
infarction. During the admission interview,
he says he stopped taking his metoprolol
77) Acute pulmonary edema caused by (Lopressor) 5 days ago because he was
heart failure is usually a result of damage to feeling better. Which of the following
which of the following areas of the heart? nursing diagnoses takes priority for this
client?

A. Left atrium
B. Right atrium
A. Anxiety
C. Left ventricle
B. Ineffective tissue perfusion;
cardiopulmonary
D. Right ventricle
C. Acute pain
D. Ineffective therapeutic
78) An 18-year-old client who recently regimen management
had an URI is admitted with suspected
 MIDTERMS | CARDIO

81) A client comes into the E.R. with acute B. “Take prophylactic antibiotics
shortness of breath and a cough that after dental work and invasive
produces pink, frothy sputum. Admission procedures.”
assessment reveals crackles and wheezes, a C. “Include potassium rich foods
BP of 85/46, a HR of 122 BPM, and a in your diet.”
respiratory rate of 38 breaths/minute. The D. “Monitor your pulse
client’s medical history included DM, regularly.”
HTN, and heart failure. Which of the
following disorders should the nurse
suspect? 84) A nurse is conducting a health history
with a client with a primary diagnosis of
heart failure. Which of the following
A. Pulmonary edema disorders reported by the client is unlikely
B. Pneumothorax to play a role in exacerbating the heart
C. Cardiac tamponade failure?
D. Pulmonary embolus
A. Recent URI
82) The nurse coming on duty receives the B. Nutritional anemia
report from the nurse going off duty. Which C. Peptic ulcer disease
of the following clients should the on-duty D. A-Fib
nurse assess first?

85) A nurse is preparing for the admission

A. The 58-year-old client who of a client with heart failure who is being
was admitted 2 days ago with sent directly to the hospital from the
heart failure, BP of 126/76, physician’s office. The nurse would plan on
and a respiratory rate of 21 having which of the following medications
breaths a minute. readily available for use?
B. The 88-year-old client with
end-stage right-sided heart
failure, BP of 78/50, and a A. Diltiazem (Cardizem)
DNR order. B. Digoxin (Lanoxin)
C. The 62-year-old client who C. Propranolol (Inderal)
was admitted one day ago with D. Metoprolol (Lopressor)
thrombophlebitis and
receiving IV heparin.
86) A nurse caring for a client in one room
D. A 76-year-old client who was is told by another nurse that a second client
admitted 1 hour ago with new- has developed severe pulmonary edema.
onset atrial fibrillation and is On entering the 2nd client’s room, the nurse
receiving IV diltiazem would expect the client to be:
(Cardizem).

A. Slightly anxious
83) When developing a teaching plan for
B. Mildly anxious
a client with endocarditis, which of the
following points is most essential for the C. Moderately anxious
nurse to include? D. Extremely anxious

A. “Report fever, anorexia, and 87) A client with pulmonary edema has
night sweats to the physician.” been on diuretic therapy. The client has an
 MIDTERMS | CARDIO

order for additional furosemide (Lasix) in 90) A client’s electrocardiogram strip

the amount of 40 mg IV push. Knowing that shows atrial and ventricular rates of 80
the client also will be started on Digoxin complexes per minute. The PR interval is
(Lanoxin), a nurse checks the client’s most 0.14 second, and the QRS complex
recent: measures 0.08 second. The nurse interprets
this rhythm is:
A. Digoxin level
B. Sodium level A. Normal sinus rhythm
C. Potassium level B. Sinus bradycardia
D. Creatinine level C. Sinus tachycardia
D. Sinus dysrhythmia

91) A client has frequent bursts of

ventricular tachycardia on the cardiac
monitor. A nurse is most concerned with
88) A client who had cardiac surgery 24 this dysrhythmia because:
hours ago has a urine output averaging 19
ml/hr for 2 hours. The client received a A. It is uncomfortable for the
single bolus of 500 ml of IV fluid. Urine client, giving a sense of
output for the subsequent hour was 25 ml. impending doom.
Daily laboratory results indicate the blood
B. It produces a high cardiac
urea nitrogen is 45 mg/dL and the serum
output that quickly leads to
creatinine is 2.2 mg/dL. A nurse interprets
cerebral and myocardial
the client is at risk for:
ischemia.
C. It is almost impossible to
A. Hypovolemia convert to a normal sinus
B. UTI rhythm.
C. Glomerulonephritis D. It can develop into ventricular
D. Acute renal failure fibrillation at any time.

89) A nurse is preparing to ambulate a 92) A home care nurse is making a routine
client on the 3rd day after cardiac surgery. visit to a client receiving digoxin (Lanoxin)
The nurse would plan to do which of the in the treatment of heart failure. The nurse
following to enable the client to best would particularly assess the client for:
tolerate the ambulation?
A. Thrombocytopenia and
A. Encourage the client to cough weight gain
and deep breathe B. Anorexia, nausea, and visual
B. Premedicate the client with an disturbances
analgesic C. Diarrhea and hypotension
C. Provide the client with a D. Fatigue and muscle twitching
walker
D. Remove telemetry equipment 93) A client with angina complains that the
because it weighs down the angina pain is prolonged and severe and
hospital gown. occurs at the same time each day, most
often in the morning, On further assessment
 MIDTERMS | CARDIO

a nurse notes that the pain occurs in the

absence of precipitating factors. This type
of anginal pain is best described as: 97) Which of the following reflects the
principle on which a client’s diet will most
likely be based during the acute phase of
A. Stable angina
MI?
B. Unstable angina
C. Variant angina
D. Nonanginal pain A. Liquids as ordered
B. Small, easily digested meals
C. Three regular meals per day
94) The physician orders continuous
intravenous nitroglycerin infusion for the D. NPO
client with MI. Essential nursing actions
include which of the following? 98) An older, sedentary adult may not
respond to emotional or physical stress as
well as a younger individual because of:
A. Obtaining an infusion pump
for the medication
B. Monitoring BP q4h A. Left ventricular atrophy
C. Monitoring urine output B. Irregular heartbeats
hourly C. peripheral vascular occlusion
D. Obtaining serum potassium D. Pacemaker placement
levels daily
99) Which of the following nursing
95) Aspirin is administered to the client diagnoses would be appropriate for a client
experiencing an MI because of its: with heart failure? Select all that apply.

A. Antipyrectic action A. Ineffective tissue perfusion

B. Antithrombotic action related to decreased
C. Antiplatelet action peripheral blood flow
D. Analgesic action secondary to decreased
cardiac output.
B. Activity intolerance related to
96) Which of the following is an expected increased cardiac output.
outcome for a client on the second day of
C. Decreased cardiac output
hospitalization after an MI?
related to structural and
functional changes.
A. Has severe chest pain D. Impaired gas exchange related
B. Can identify risks factors for to decreased sympathetic
MI nervous system activity.
C. Agrees to participate in a
cardiac rehabilitation walking
program
D. Can perform personal self- 100) Which of the following would be a
care activities without pain priority nursing diagnosis for the client with
heart failure and pulmonary edema?
 MIDTERMS | CARDIO

A. Risk for infection related to C. Right atrial enlargement

stasis of alveolar secretions D. Right ventricular enlargement
B. Impaired skin integrity related
to pressure
C. Activity intolerance related to
pump failure
D. Constipation related to MSN Exam for Cardiovascular Disorders
immobility

101) Captopril may be administered to a 1. Which of the following arteries primarily

client with HF because it acts as a: feeds the anterior wall of the heart?

A. Vasopressor A. Circumflex artery

B. Volume expander B. Internal mammary artery
C. Vasodilator C. Left anterior descending artery
D. Potassium-sparing diuretic D. Right coronary artery

102) Furosemide is administered 2. When do coronary arteries primarily

intravenously to a client with HF. How receive blood flow?
soon after administration should the nurse
begin to see evidence of the drugs desired A. During inspiration
effect? B. During diastole
C. During expiration
A. 5 to 10 minutes D. During systole
B. 30 to 60 minutes
C. 2 to 4 hours 3. Which of the following illnesses is the
D. 6 to 8 hours leading cause of death in the US?

103) Which of the following foods should A. Cancer

the nurse teach a client with heart failure to B. Coronary artery disease
avoid or limit when following a 2-gram
C. Liver failure
sodium diet?
D. Renal failure

A. Apples
B. Tomato juice
C. Whole wheat bread 4. Which of the following conditions most
D. Beef tenderloin commonly results in CAD?

104) The nurse finds the apical pulse A. Atherosclerosis

below the 5th intercostal space. The nurse B. DM
suspects:
C. MI
D. Renal failure
A. Left atrial enlargement
B. Left ventricular enlargement
 MIDTERMS | CARDIO

5. Atherosclerosis impedes coronary blood 9. Medical treatment of coronary artery

flow by which of the following disease includes which of the following
mechanisms? procedures?

A. Plaques obstruct the vein A. Cardiac catheterization

B. Plaques obstruct the artery B. Coronary artery bypass surgery
C. Blood clots form outside the C. Oral medication administration
vessel wall D. Percutaneous transluminal
D. Hardened vessels dilate to coronary angioplasty
allow the blood to flow through
10. Prolonged occlusion of the right
6. Which of the following risk factors for coronary artery produces an infarction in
coronary artery disease cannot be which of he following areas of the heart?
corrected?
A. Anterior
A. Cigarette smoking B. Apical
B. DM C. Inferior
C. Heredity D. Lateral
D. HPN
11. Which of the following is the most
7. Exceeding which of the following serum common symptom of myocardial
cholesterol levels significantly increases infarction?
the risk of coronary artery disease?
A. Chest pain
A. 100 mg/dl B. Dyspnea
B. 150 mg/dl C. Edema
C. 175 mg/dl D. Palpitations
D. 200 mg/dl
12. Which of the following landmarks is the
corect one for obtaining an apical pulse?

8. Which of the following actions is the first

A. Left intercostal space,
priority care for a client exhibiting signs
midaxillary line
and symptoms of coronary artery disease?
B. Left fifth intercostal space,
midclavicular line
A. Decrease anxiety C. Left second intercostal space,
B. Enhance myocardial midclavicular line
oxygenation D. Left seventh intercostal space,
C. Administer sublignual midclavicular line
nitroglycerin
D. Educate the client about his 13. Which of the following systems is the
symptoms most likely origin of pain the client
describes as knifelike chest pain that
increases in intensity with inspiration?
 MIDTERMS | CARDIO

A. Cardiac A. Chloride
B. Gastrointestinal B. Digoxin
C. Musculoskeletal C. Potassium
D. Pulmonary D. Sodium

14. A murmur is heard at the second left 19. After myocardial infarction, serum
intercostal space along the left sternal glucose levels and free fatty acids are both
border. Which valve area is this? increase. What type of physiologic changes
are these?
A. Aortic
B. Mitral A. Electrophysiologic
C. Pulmonic B. Hematologic
D. Tricuspid C. Mechanical
D. Metabolic
15. Which of the following blood tests is
most indicative of cardiac damage?

20. Which of the following complications is

A. Lactate dehydrogenase
indicated by a third heart sound (S3)?
B. Complete blood count
C. Troponin I
D. Creatine kinase A. Ventricular dilation
B. Systemic hypertension
C. Aortic valve malfunction
16. What is the primary reason for
administering morphine to a client with D. Increased atrial contractions
myocardial infarction?
21. After an anterior wall myocardial
infarction, which of the following problems
A. To sedate the client
is indicated by auscultation of crackles in
B. To decrease the client’s pain the lungs?
C. To decrease the client’s anxiety
D. To decrease oxygen demand on
the client’s heart A. Left-sided heart failure
B. Pulmonic valve malfunction
C. Right-sided heart failure
17. Which of the followng conditions is
most commonly responsible for myocardial D. Tricuspid valve malfunction
infarction?
22. Which of the following diagnostic tools
is most commonly used to determine the
A. Aneurysm
location of myocardial damage?
B. Heart failure
C. Coronary artery thrombosis
D. Renal failure A. Cardiac catheterization
B. Cardiac enzymes
C. Echocardiogram
18. What supplemental medication is most
frequently ordered in conjuction with D. Electrocardiogram
furosemide (Lasix)?
 MIDTERMS | CARDIO

23. What is the first intervention for a client 27. With which of the following disorders
experiencing myocardial infarction? is jugular vein distention most prominent?

A. Administer morphine A. Abdominal aortic aneurysm

B. Administer oxygen B. Heart failure
C. Administer sublingual C. Myocardial infarction
nitroglycerin D. Pneumothorax
D. Obtain an electrocardiogram
28. What position should the nurse place
the head of the bed in to obtain the most
accurate reading of jugular vein distention?

A. High-fowler’s
24. What is the most appropriate nursing
B. Raised 10 degrees
response to a myocardial infarction client
who is fearful of dying? C. Raised 30 degrees
D. Supine position

A. “Tell me about your feeling

right now.” 29. Which of the following parameters
should be checked before administering
B. “When the doctor arrives,
digoxin?
everything will be fine.”
C. “This is a bad situation, but
you’ll feel better soon.” A. Apical pulse
D. “Please be assured we’re doing B. Blood pressure
everything we can to make you C. Radial pulse
feel better.” D. Respiratory rate

25. Which of the following classes of 30. Toxicity from which of the following
medications protects the ischemic medications may cause a client to see a
myocardium by blocking catecholamines green halo around lights?
and sympathetic nerve stimulation?

A. Digoxin
A. Beta-adrenergic blockers B. Furosemide
B. Calcium channel blockers C. Metoprolol
C. Narcotics D. Enalapril
D. Nitrates
31. Which ofthe following symptoms is
26. What is the most common complication most commonly associated with left-sided
of a myocardial infarction? heart failure?

A. Cardiogenic shock A. Crackles

B. Heart failure B. Arrhythmias
C. Arrhythmias C. Hepatic engorgement
D. Pericarditis D. Hypotension
 MIDTERMS | CARDIO

36. Which of the following conditions is

most closely associated with weight gain,
32. In which of the following disorders nausea, and a decrease in urine output?
would the nurse expect to assess sacral
eddema in bedridden client?
A. Angina pectoris
B. Cardiomyopathy
A. DM C. Left-sided heart failure
B. Pulmonary emboli D. Right-sided heart failure
C. Renal failure
D. Right-sided heart failure 37. What is the most common cause of
abdominal aortic aneurysm?
33. Which of the following symptoms
might a client with right-sided heart failure
A. Atherosclerosis
exhibit?
B. DM
C. HPN
A. Adequate urine output D. Syphilis
B. Polyuria
C. Oliguria
38. In which of the following areas is an
D. Polydipsia abdominal aortic aneurysm most
commonly located?
34. Which of the following classes of
medications maximizes cardiac
A. Distal to the iliac arteries
performance in clients with heat failure by
increasing ventricular contractility? B. Distal to the renal arteries
C. Adjacent to the aortic branch
D. Proximal to the renal arteries
A. Beta-adrenergic blockers
B. Calcium channel blockers
39. A pulsating abdominal mass usually
C. Diuretics
indicates which of the following
D. Inotropic agents conditions?

35. Stimulation of the sympathetic nervous

A. Abdominal aortic aneurysm
system produces which of the following
responses? B. Enlarged spleen
C. Gastic distention
D. Gastritis
A. Bradycardia
B. Tachycardia
40. What is the most common symptom in
C. Hypotension
a client with abdominal aortic aneurysm?
D. Decreased myocardial
contractility
A. Abdominal pain
B. Diaphoresis
C. Headache
D. Upper back pain
 MIDTERMS | CARDIO

41. Which of the following symptoms C. Middle lower abdomen to the

usually signifies rapid expansion and left of the midline
impending rupture of an abdominal aortic D. Midline lower abdomen to the
aneurysm? right of the midline

A. Abdominal pain 46. Which of the following conditions is

B. Absent pedal pulses linked to more than 50% of clients with
C. Angina abdominal aortic aneurysms?
D. Lower back pain
A. DM
42. What is the definitive test used to B. HPN
diagnose an abdominal aortic aneurysm? C. PVD
D. Syphilis
A. Abdominal X-ray
B. Arteriogram 47. Which of the following sounds is
C. CT scan distinctly heard on auscultation over the
D. Ultrasound abdominal region of an abdominal aortic
aneurysm client?
43. Which of the following complications is
of greatest concern when caring for a A. Bruit
preoperative abdominal aneurysm client? B. Crackles
C. Dullness
A. HPN D. Friction rubs
B. Aneurysm rupture
C. Cardiac arrythmias 48. Which of the following groups of
D. Diminished pedal pulses symptoms indicated a ruptured abdominal
aneurysm?
44. Which of the following blood vessel
layers may be damaged in a client with an A. Lower back pain, increased BP,
aneurysm? decreased RBC, increased
WBC
B. Severe lower back pain,
A. Externa
decreased BP, decreased RBC,
B. Interna increased WBC
C. Media C. Severe lower back pain,
D. Interna and Media decreased BP, decreased RBC,
decreased WBC
D. Intermittent lower back pain,
decreased BP, decreased RBC,
45. When assessing a client for an increased WBC
abdominal aortic aneurysm, which area of
the abdomen is most commonly palpated? 49. Which of the following complications
of an abdominal aortic repair is indicated by
A. Right upper quadrant detection of a hematoma in the perineal
B. Directly over the umbilicus area?
 MIDTERMS | CARDIO

A. Hernia 54. Septal involvement occurs in which

B. Stage 1 pressure ulcer type of cardiomyopathy?
C. Retroperitoneal rupture at the
repair site A. Congestive
D. Rapid expansion of the B. Dilated
aneurysm C. Hypertrophic
D. Restrictive
50. Which hereditary disease is most
closely linked to aneurysm?
55. Which of the following recurring
conditions most commonly occurs in
A. Cystic fibrosis clients with cardiomyopathy?
B. Lupus erythematosus
C. Marfan’s syndrome A. Heart failure
D. Myocardial infarction B. DM
C. MI
51. Which of the following treatments is the D. Pericardial effusion
definitive one for a ruptured aneurysm?
56. What is the term used to describe an
A. Antihypertensive medication enlargement of the heart muscle?
administration
B. Aortogram A. Cardiomegaly
C. Beta-adrenergic blocker B. Cardiomyopathy
administration
C. Myocarditis
D. Surgical intervention D. Pericarditis

57. Dyspnea, cough, expectoration,

weakness, and edema are classic signs and
52. Which of the following heart muscle symptoms of which of the following
diseases is unrelated to other cardiovascular conditions?
disease?

A. Pericarditis
A. Cardiomyopathy
B. Hypertension
B. Coronary artery disease
C. Obliterative
C. Myocardial infarction
D. Restricitive
D. Pericardial Effusion

58. Which of the following types of

53. Which of the following types of cardiomyopathy does not affect cardiac
cardiomyopathy can be associated with output?
childbirth?

A. Dilated
A. Dilated
B. Hypertrophic
B. Hypertrophic
C. Restrictive
C. Myocarditis
D. Obliterative
D. Restrictive
 MIDTERMS | CARDIO

59. Which of the following cardiac

conditions does a fourth heart sound (S4)
indicate?

A. Dilated aorta
B. Normally functioning heart
C. Decreased myocardial
contractility
D. Failure of the ventricle to eject
all the blood during systole

60. Which of the following classes of drugs

is most widely used in the treatment of
cardiomyopathy?

A. Antihypertensive
B. Beta-adrenergic blockers
C. Calcium channel blockers
D. Nitrates