NUR 5461/NUR5461 Module 2 V2 |
Cardiovascular and Hematologic System
Q&A with Rationale | William Paterson
University
1. A patient with heart failure is prescribed Lisinopril. Which laboratory value is most critical
for the nurse to monitor closely?
A. Serum Calcium
B. Serum Phosphate
C. Serum Magnesium
D. Serum Potassium
Correct Answer: D
Expert Explanation: Lisinopril is an ACE inhibitor that can cause the retention of
potassium by the kidneys. Hyperkalemia is a significant risk, especially in patients with
heart failure or renal impairment. Monitoring serum potassium levels is essential to
prevent life-threatening cardiac dysrhythmias.
2. When assessing a patient with right-sided heart failure, which clinical manifestation should
the nurse expect to find?
A. Pulmonary crackles
B. Paroxysmal nocturnal dyspnea
,C. Hemoptysis
D. Jugular venous distention
Correct Answer: D
Expert Explanation: Right-sided heart failure leads to systemic venous congestion
because the right ventricle cannot pump blood effectively into the pulmonary circulation.
This results in signs like jugular venous distention, peripheral edema, and hepatomegaly.
Pulmonary symptoms like crackles and dyspnea are typically associated with left-sided
heart failure.
3. Which medication is considered the gold standard for immediate relief of acute anginal
pain?
A. Metoprolol
B. Sublingual Nitroglycerin
C. Amlodipine
D. Atorvastatin
Correct Answer: B
Expert Explanation: Sublingual nitroglycerin acts quickly as a potent vasodilator to
reduce myocardial oxygen demand and improve coronary blood flow. It is the primary
treatment for acute episodes of stable or unstable angina. Patients are instructed to take it
at the first sign of chest pain and seek emergency help if symptoms do not improve.
, 4. A patient presents with a suspected myocardial infarction. Which cardiac biomarker is
most specific and rises earliest in the bloodstream?
A. Creatine Kinase (CK-MB)
B. Myoglobin
C. Troponin I
D. Lactate Dehydrogenase (LDH)
Correct Answer: C
Expert Explanation: Troponin I is highly specific to cardiac muscle damage and is the
preferred marker for diagnosing myocardial infarction. It begins to rise within a few hours
of injury and remains elevated for up to two weeks. While myoglobin rises faster, it lacks
the specificity of Troponin I.
5. A patient taking Warfarin has an International Normalized Ratio (INR) of 5.5 but shows no
signs of bleeding. What is the priority nursing action?
A. Prepare for a blood transfusion
B. Start an IV infusion of Protamine Sulfate
C. Administer Vitamin K as prescribed
D. Encourage the patient to eat leafy greens
Correct Answer: C
Cardiovascular and Hematologic System
Q&A with Rationale | William Paterson
University
1. A patient with heart failure is prescribed Lisinopril. Which laboratory value is most critical
for the nurse to monitor closely?
A. Serum Calcium
B. Serum Phosphate
C. Serum Magnesium
D. Serum Potassium
Correct Answer: D
Expert Explanation: Lisinopril is an ACE inhibitor that can cause the retention of
potassium by the kidneys. Hyperkalemia is a significant risk, especially in patients with
heart failure or renal impairment. Monitoring serum potassium levels is essential to
prevent life-threatening cardiac dysrhythmias.
2. When assessing a patient with right-sided heart failure, which clinical manifestation should
the nurse expect to find?
A. Pulmonary crackles
B. Paroxysmal nocturnal dyspnea
,C. Hemoptysis
D. Jugular venous distention
Correct Answer: D
Expert Explanation: Right-sided heart failure leads to systemic venous congestion
because the right ventricle cannot pump blood effectively into the pulmonary circulation.
This results in signs like jugular venous distention, peripheral edema, and hepatomegaly.
Pulmonary symptoms like crackles and dyspnea are typically associated with left-sided
heart failure.
3. Which medication is considered the gold standard for immediate relief of acute anginal
pain?
A. Metoprolol
B. Sublingual Nitroglycerin
C. Amlodipine
D. Atorvastatin
Correct Answer: B
Expert Explanation: Sublingual nitroglycerin acts quickly as a potent vasodilator to
reduce myocardial oxygen demand and improve coronary blood flow. It is the primary
treatment for acute episodes of stable or unstable angina. Patients are instructed to take it
at the first sign of chest pain and seek emergency help if symptoms do not improve.
, 4. A patient presents with a suspected myocardial infarction. Which cardiac biomarker is
most specific and rises earliest in the bloodstream?
A. Creatine Kinase (CK-MB)
B. Myoglobin
C. Troponin I
D. Lactate Dehydrogenase (LDH)
Correct Answer: C
Expert Explanation: Troponin I is highly specific to cardiac muscle damage and is the
preferred marker for diagnosing myocardial infarction. It begins to rise within a few hours
of injury and remains elevated for up to two weeks. While myoglobin rises faster, it lacks
the specificity of Troponin I.
5. A patient taking Warfarin has an International Normalized Ratio (INR) of 5.5 but shows no
signs of bleeding. What is the priority nursing action?
A. Prepare for a blood transfusion
B. Start an IV infusion of Protamine Sulfate
C. Administer Vitamin K as prescribed
D. Encourage the patient to eat leafy greens
Correct Answer: C
