ATI MED SURG: CAD & MI Competency test preparation
questions with approved Answers 2025/2026
A nurse is teaching the partner of a client who had an acute myocardial infarction
(MI) about the reason blood was drawn from the client. Which of the following
statements should the nurse make regarding cardiac enzymes studies?
A.) "These tests help determine the degree of damage to the heart tissues."
B.) "Cardiac enzymes will identify the location of the MI."
C.) "These tests will enable the provider to determine the heart structure and mobility of
the heart valves."
D.) "Cardiac enzymes assist in diagnosing the presence of pulmonary congestion."
A.) "These tests help determine the degree of damage to the heart tissues."
-Cardiac enzyme studies are obtained because the degree of enzyme elevation
reflects the degree of damage to the myocardium. The enzymes most commonly
measured are CPK and troponin. These enzymes have a characteristic rise and
fall pattern after an MI. It may take 4 hr or more after the onset of manifestations
for the test to become abnormal and up to 24 hr for the level to peak. Eventually,
the levels in the blood fall back to normal. Consequently, serial blood tests must
be taken from the client to document and evaluate enzyme levels.
Other Rationales:
B.) "Cardiac enzymes will identify the location of the MI.": The nurse should inform the
partner and the client of the protocols and prescriptions for the client who has an MI to
decrease anxiety. The nurse should include that the 12-lead electrocardiogram may be
used to determine the location of the MI in the teaching.
C.) "These tests will enable the provider to determine the heart structure and mobility of
the heart valves.": An echocardiogram is a diagnostic tool used to determine the heart
structure and mobility of the heart valves. It can be used to diagnose cardiomyopathy,
valvular disorders, aneurysms and left ventricular function.
D.) "Cardiac enzymes assist in diagnosing the presence of pulmonary congestion.":
Pulmonary congestion, a complication of MI, is suspected when crackles or rales are
auscultated in the chest. Should this occur, the nurse should inform the client and
partner that it is diagnosed by chest x-ray.
A nurse is caring for a client who reports a new onset of severe chest pain. Which
of the following actions should the nurse take to determine if the client is
experiencing a myocardial infarction?
,A.) Check the client's blood pressure
B.) Auscultate heart tones
C.) Perform a 12-lead ECG
D.) Determine if pain radiates to the left arm
C.) Perform a 12-lead ECG
-The nurse should perform a 12-lead ECG when a client complains of chest pain
to determine if the client is experiencing a myocardial infarction.
Other Explanations:
A.) Check the client's blood pressure: The nurse should check the client’s vital signs
when chest pain is present. However, these findings will not determine if the client is
experiencing a myocardial infarction.
B.) Auscultate heart tones: The nurse should auscultate heart tones as part of a
complete assessment when a client complains of chest pain. However, these findings
will not determine if the client is experiencing a myocardial infarction.
D.) Determine if pain radiates to the left arm: The nurse should identify the location of
pain as part of a complete assessment. However, radiation to the left arm can be
present in other conditions and therefore does not indicate that the client is experiencing
a myocardial infarction.
A nurse in the emergency room is caring for a client who presents with
manifestations that indicate a myocardial infarction. Which of the following
prescriptions should the nurse take first?
A.) Attach the leads for a 12-lead ECG.
B.) Obtain a blood sample.
C.) Initiate oxygen therapy.
D.) Insert the IV catheter.
C.) Initiate oxygen therapy
-The greatest risk to the client’s safety is myocardial ischemia and cellular death;
therefore, the priority action the nurse should take is to administer oxygen to help
minimize this possibility.
Other Rationales:
A.) Attach the leads for a 12-lead ECG: It is important to determine the client’s heart
rhythm and allow for appropriate treatment; however, another action is the nurse’s
priority.
, B.) Obtain a blood sample: It is important to obtain blood samples in order to determine
the client’s cardiac enzyme levels; however, another prescription should be
implemented by the nurse first.
D.) Insert the IV catheter: Gaining intravenous access is important because it allows for
the delivery of medications quickly; however, another action is the nurse’s priority.
A nurse is caring for a client who just had a cardiac catheterization. Which of the
following nursing interventions should the nurse include in the client's plan of
care? (Select all that apply.)
A.) Check peripheral pulses in the affected extremity.
B.) Place the client in high-Fowler's position.
C.) Measure the client's vital signs every 4 hr.
D.) Keep the client's hip and leg extended.
E.) Have the client remain in bed up to 6 hr.
Correct:
A.) Check peripheral pulses in the affected extremity.
-The nurse should check pulse points plus skin temperature and color in the affected
extremity as prescribed by the facility, which is commonly every 15 min for 1 hr, every
30 min for 1 hr, and hourly for 4 hr.
D.) Keep the client's hip and leg extended.
-The nurse should keep the client from flexing the knee or hip and can use a knee brace
to prevent bending the affected leg.
E.) Have the client remain in bed up to 6 hr.
-Clients who had manual or mechanical pressure after catheter removal require 6 hr of
bed rest. Those who had a closure device or patch only need 2 hr of bed rest.
Incorrect:
B.) Place the client in high-Fowler's position.
-The client should remain flat or with the head of the bed elevated no more than 30° for
2 to 6 hr after the procedure.
C.) Measure the client's vital signs every 4 hr.
-The nurse should measure the client's vital signs frequently, with each check of the
affected extremity.
questions with approved Answers 2025/2026
A nurse is teaching the partner of a client who had an acute myocardial infarction
(MI) about the reason blood was drawn from the client. Which of the following
statements should the nurse make regarding cardiac enzymes studies?
A.) "These tests help determine the degree of damage to the heart tissues."
B.) "Cardiac enzymes will identify the location of the MI."
C.) "These tests will enable the provider to determine the heart structure and mobility of
the heart valves."
D.) "Cardiac enzymes assist in diagnosing the presence of pulmonary congestion."
A.) "These tests help determine the degree of damage to the heart tissues."
-Cardiac enzyme studies are obtained because the degree of enzyme elevation
reflects the degree of damage to the myocardium. The enzymes most commonly
measured are CPK and troponin. These enzymes have a characteristic rise and
fall pattern after an MI. It may take 4 hr or more after the onset of manifestations
for the test to become abnormal and up to 24 hr for the level to peak. Eventually,
the levels in the blood fall back to normal. Consequently, serial blood tests must
be taken from the client to document and evaluate enzyme levels.
Other Rationales:
B.) "Cardiac enzymes will identify the location of the MI.": The nurse should inform the
partner and the client of the protocols and prescriptions for the client who has an MI to
decrease anxiety. The nurse should include that the 12-lead electrocardiogram may be
used to determine the location of the MI in the teaching.
C.) "These tests will enable the provider to determine the heart structure and mobility of
the heart valves.": An echocardiogram is a diagnostic tool used to determine the heart
structure and mobility of the heart valves. It can be used to diagnose cardiomyopathy,
valvular disorders, aneurysms and left ventricular function.
D.) "Cardiac enzymes assist in diagnosing the presence of pulmonary congestion.":
Pulmonary congestion, a complication of MI, is suspected when crackles or rales are
auscultated in the chest. Should this occur, the nurse should inform the client and
partner that it is diagnosed by chest x-ray.
A nurse is caring for a client who reports a new onset of severe chest pain. Which
of the following actions should the nurse take to determine if the client is
experiencing a myocardial infarction?
,A.) Check the client's blood pressure
B.) Auscultate heart tones
C.) Perform a 12-lead ECG
D.) Determine if pain radiates to the left arm
C.) Perform a 12-lead ECG
-The nurse should perform a 12-lead ECG when a client complains of chest pain
to determine if the client is experiencing a myocardial infarction.
Other Explanations:
A.) Check the client's blood pressure: The nurse should check the client’s vital signs
when chest pain is present. However, these findings will not determine if the client is
experiencing a myocardial infarction.
B.) Auscultate heart tones: The nurse should auscultate heart tones as part of a
complete assessment when a client complains of chest pain. However, these findings
will not determine if the client is experiencing a myocardial infarction.
D.) Determine if pain radiates to the left arm: The nurse should identify the location of
pain as part of a complete assessment. However, radiation to the left arm can be
present in other conditions and therefore does not indicate that the client is experiencing
a myocardial infarction.
A nurse in the emergency room is caring for a client who presents with
manifestations that indicate a myocardial infarction. Which of the following
prescriptions should the nurse take first?
A.) Attach the leads for a 12-lead ECG.
B.) Obtain a blood sample.
C.) Initiate oxygen therapy.
D.) Insert the IV catheter.
C.) Initiate oxygen therapy
-The greatest risk to the client’s safety is myocardial ischemia and cellular death;
therefore, the priority action the nurse should take is to administer oxygen to help
minimize this possibility.
Other Rationales:
A.) Attach the leads for a 12-lead ECG: It is important to determine the client’s heart
rhythm and allow for appropriate treatment; however, another action is the nurse’s
priority.
, B.) Obtain a blood sample: It is important to obtain blood samples in order to determine
the client’s cardiac enzyme levels; however, another prescription should be
implemented by the nurse first.
D.) Insert the IV catheter: Gaining intravenous access is important because it allows for
the delivery of medications quickly; however, another action is the nurse’s priority.
A nurse is caring for a client who just had a cardiac catheterization. Which of the
following nursing interventions should the nurse include in the client's plan of
care? (Select all that apply.)
A.) Check peripheral pulses in the affected extremity.
B.) Place the client in high-Fowler's position.
C.) Measure the client's vital signs every 4 hr.
D.) Keep the client's hip and leg extended.
E.) Have the client remain in bed up to 6 hr.
Correct:
A.) Check peripheral pulses in the affected extremity.
-The nurse should check pulse points plus skin temperature and color in the affected
extremity as prescribed by the facility, which is commonly every 15 min for 1 hr, every
30 min for 1 hr, and hourly for 4 hr.
D.) Keep the client's hip and leg extended.
-The nurse should keep the client from flexing the knee or hip and can use a knee brace
to prevent bending the affected leg.
E.) Have the client remain in bed up to 6 hr.
-Clients who had manual or mechanical pressure after catheter removal require 6 hr of
bed rest. Those who had a closure device or patch only need 2 hr of bed rest.
Incorrect:
B.) Place the client in high-Fowler's position.
-The client should remain flat or with the head of the bed elevated no more than 30° for
2 to 6 hr after the procedure.
C.) Measure the client's vital signs every 4 hr.
-The nurse should measure the client's vital signs frequently, with each check of the
affected extremity.
