1
N461 Exam 2 Practice Questions
Chapter 30 Nursing care of Patients with Coronary Heart Disease
1. The nurse, discussing coronary heart disease risk factors with a group of factory
employees, would include which option(s) as modifiable risk factors? Select all that apply.
a. hypertension
b. diabetes mellitus
c. obesity
d. age
e. heredity
2. Which diagnostic test would the nurse anticipate as priority for a patient admitted with chest
pain to determine coronary heart disease status?
a. coronary angiography
b. stress electrocardiography
c. echocardiography
d. radionuclide testing
3. Aspirin has been prescribed for a patient following a myocardial infarction. What should
the nurse include in teaching about this drug?
a. Check with your healthcare provider before taking any herbal remedies.
b. Report any itching that develops after seven days of taking the drug.
c. Take at a different time of day than warfarin (Coumadin).
d. Do not skip any scheduled appointments to have blood drawn for labs.
4. The nurse is assessing a patient who is six hours postoperative from coronary artery
bypass graft (CABG) surgery. The patient’s heart rate is 120, blood pressure is 90/50, urine
output is decreased, chest tube output is decreased, heart sounds are muffled, and peripheral
pulses are diminished. What action should be taken by the nurse first?
a. Notify the physician immediately.
b. Recheck vital signs in 15 minutes.
c. Reposition the patient.
d. Increase the intravenous fluids.
5. During an office visit, a 55-year-old female patient asks why she has not been prescribed a
daily dose of aspirin. Her 56-year-old husband has been advised by the physician to take a
daily aspirin. What can the nurse explain is the most likely reason for this?
a. The benefit of aspirin in women under age 65 is not clear.
b. Aspirin is not recommended for women.
c. This must have been an oversight.
d. She has other medications that could interfere
6. During a follow-up appointment after a myocardial infarction, a patient states, “My friends
tell me to add more garlic to my diet and start drinking red wine each evening.” Which response
by the nurse is best?
a. “Discuss your idea with the physician to see what would benefit you.”
b. “That sounds fine. See how they work.”
c. “I wouldn’t do that if I were you.”
d. “You should also add ginkgo biloba for cardiovascular health.”
,2
7. During patient teaching about cardiac risk factors, the nurse knows that which laboratory test,
if abnormal, requires further instruction due to the risk for the development of coronary artery
disease?
a. elevated homocysteine
b. elevated creatinine
c. elevated high density lipoprotein (HDL)
d. elevated INR
8. The nurse, caring for a patient admitted with chest pain, realizes that which factor places
the patient at the highest risk for heart disease?
a. overweight and carries the weight around the waist
b. mother died at age 70 of an acute myocardial infarction
c. a single mother of four young children with a low income
d. has a desk job and works long hours
9. The nurse, assessing a middle-aged patient experiencing chest pain, realizes that presence of
which symptoms would be most characteristic of an acute myocardial infarction?
a. substernal pressure type pain, radiating down the left arm
b. colic-like epigastric pain
c. sharp, well-localized unilateral chest and left arm pain
d. sharp, burning chest pain moving from place to place
10. The nurse, caring for a patient diagnosed with Prinzmetal’s or variant angina, realizes this
is a serious type of chest pain. Why is this so?
a. It indicates presence of coronary artery spasm.
b. It indicates there is associated renal disease.
c. It indicates there is associated pulmonary disease.
d. It indicates the presence of a myocardial infarction.
11. A patient enters the emergency department complaining of chest pain that is radiating down
the left arm. The emergent treatment plan for this patient includes which nursing actions?
Select all that apply. Select all that apply.
a. morphine intravenously and oxygen
b. aspirin 325 mg orally
c. open heart surgery
d. heparin drip at 100 units per hour
e. Foley catheter insertion
12. Following a transmural myocardial infarction, which ECG change stays with the patient
for life?
a. Q wave deepening
b. ST segment elevation
c. ST segment depression
d. P wave inversion
13. A patient reports chest pain, nausea, and vomiting off and on for the last 4 days, which the
patient interpreted as the flu. Which laboratory tests will provide information about acute
cardiac damage for this patient?
a. Troponin I and T
b. Red blood cells
c. CPK-MB
d. Homocysteine and platelets
,3
14. Fifteen hours after admission, a patient’s CPK-MB level is markedly increased. What
does this indicate to the treatment team?
a. Cellular necrosis of myocardial tissue has occurred.
b. Lactic acid is present.
c. Thrombolytic therapy is indicated.
d. Cardiac function has returned to normal.
15. The nurse, caring for a patient with myocardial damage, would expect which change on
the ECG tracing?
a. ST segment elevation
b. loss of P waves
c. bradycardia
d. bradycardia
e. widening of the QRS complex
16. The nurse, caring for a patient recovering from an acute myocardial infarction, realizes
that the final extent of cardiac damage is dependent upon which factor?
a. reperfusion of the ischemic zone
b. patient’s ethnicity
c. patient’s gender
d. development of heart block
17. Nursing care of the patient after thrombolytic therapy focuses on the assessment of which
finding that is the most common complication?
a. bleeding
b. reperfusion chest pain
c. lethargy
d. heart block
18. Upon ascultating the chest of a 75-year-old patient who recently experienced a
myocardial infarction (MI) the nurse hears an S3 and lung crackles. Because of these
findings, the nurse would assess for which other condition?
a. heart failure
b. extension of the MI
c. renal failure
d. liver failure
19. The nurse is teaching a patient about coronary artery bypass surgery. Which
statement, included in this teaching, is essential for the patient to understand?
a. “You must still reduce or modify cardiac risk factors.”
b. “This surgery prolongs life on an average of two years.”
c. “You have only a minimal chance of functional improvement, even with this surgery.”
d. “This surgery will cure your atherosclerosis.”
20. A patient, recovering from coronary artery bypass graft (CABG) surgery, tells the nurse that
it feels good to be cured of heart disease. Which of the following is the most appropriate
response for the nurse to make? Select all that apply.
a. “The surgery only relieves the symptoms; it does not cure the disease.”
b. “You must continue to modify your cardiac risk factors.”
c. “You are correct; your heart is now normal.”
d. “You should not ever exercise again.”
e. “There no need to monitor your fat intake any longer.”
, 4
21. Which of the following should the nurse do to assist a patient recovering from
cardiovascular surgery who is demonstrating chest tube output of greater than 100 mL per
hours? Select all that apply. Select all that apply.
a. Report to the surgeon.
b. Check the hemoglobin and hematocrit.
c. Administer a blood transfusion.
d. Notify the family.
22. The family of a patient who experienced a stroke after CABG surgery asks the nurse
what caused the stroke to occur. The nurse’s best response would be which of the following?
a. “Stroke is usually caused by a blood clot that brakes loose and travels to the brain.”
b. “Stroke is usually caused by ruptured plaque inside the coronary artery.”
c. “Stroke is caused by heart failure.”
d. “No one knows what causes strokes.”
23. Coronary heart disease (CHD) is a major problem in the United States. Patients with
which history may require closer evaluation for CHD? Select all that apply.
a. diabetes
b. hyperlipidemia
c. positive family history
d. a premenopausal woman
e. hypotension
24. A nurse is conducting teaching about risk factor management for cardiovascular disease
(CVD) at a senior center. What is the most important information for the nurse to include?
a. Stop smoking.
b. Eat in moderation.
c. Exercise when able.
d. Reduce saturated fats in the diet.
25. The patient asks the nurse about metabolic syndrome. Which is the most accurate answer
for the nurse to provide?
a. “Metabolic syndrome is caused by obesity, physical inactivity, and genetic factors.”
b. “This syndrome is not a concern for females unless they smoke.”
c. “This problem affects only older adults over the age of 65.”
d. “It can be avoided by taking vitamins daily and drinking 64 fluid ounces of water a day.”
26. What information does the nurse consider when administering medication to treat
hyperlipidemia?
a. Such medications include the statins, which act by lowering LDL levels.
b. These medications act by increasing the LDL levels and decreasing the HDL levels.
c. These medications do not include angiotensin-converting enzyme (ACE) inhibitors.
d. Such medications include bile acid sequestrants as first-line drugs to lower cholesterol
levels.
27. A patient who is prescribed atorvastatin (Lipitor) should be monitored for which occurrence?
a. liver enzyme alteration
b. blood glucose and uric acid level alteration
c. renal function alteration
d. sudden back pain and constipation
28. The nurse completed teaching related to dietary management of coronary heart disease
(CHD). Effective teaching would be indicated by which patient statement?
N461 Exam 2 Practice Questions
Chapter 30 Nursing care of Patients with Coronary Heart Disease
1. The nurse, discussing coronary heart disease risk factors with a group of factory
employees, would include which option(s) as modifiable risk factors? Select all that apply.
a. hypertension
b. diabetes mellitus
c. obesity
d. age
e. heredity
2. Which diagnostic test would the nurse anticipate as priority for a patient admitted with chest
pain to determine coronary heart disease status?
a. coronary angiography
b. stress electrocardiography
c. echocardiography
d. radionuclide testing
3. Aspirin has been prescribed for a patient following a myocardial infarction. What should
the nurse include in teaching about this drug?
a. Check with your healthcare provider before taking any herbal remedies.
b. Report any itching that develops after seven days of taking the drug.
c. Take at a different time of day than warfarin (Coumadin).
d. Do not skip any scheduled appointments to have blood drawn for labs.
4. The nurse is assessing a patient who is six hours postoperative from coronary artery
bypass graft (CABG) surgery. The patient’s heart rate is 120, blood pressure is 90/50, urine
output is decreased, chest tube output is decreased, heart sounds are muffled, and peripheral
pulses are diminished. What action should be taken by the nurse first?
a. Notify the physician immediately.
b. Recheck vital signs in 15 minutes.
c. Reposition the patient.
d. Increase the intravenous fluids.
5. During an office visit, a 55-year-old female patient asks why she has not been prescribed a
daily dose of aspirin. Her 56-year-old husband has been advised by the physician to take a
daily aspirin. What can the nurse explain is the most likely reason for this?
a. The benefit of aspirin in women under age 65 is not clear.
b. Aspirin is not recommended for women.
c. This must have been an oversight.
d. She has other medications that could interfere
6. During a follow-up appointment after a myocardial infarction, a patient states, “My friends
tell me to add more garlic to my diet and start drinking red wine each evening.” Which response
by the nurse is best?
a. “Discuss your idea with the physician to see what would benefit you.”
b. “That sounds fine. See how they work.”
c. “I wouldn’t do that if I were you.”
d. “You should also add ginkgo biloba for cardiovascular health.”
,2
7. During patient teaching about cardiac risk factors, the nurse knows that which laboratory test,
if abnormal, requires further instruction due to the risk for the development of coronary artery
disease?
a. elevated homocysteine
b. elevated creatinine
c. elevated high density lipoprotein (HDL)
d. elevated INR
8. The nurse, caring for a patient admitted with chest pain, realizes that which factor places
the patient at the highest risk for heart disease?
a. overweight and carries the weight around the waist
b. mother died at age 70 of an acute myocardial infarction
c. a single mother of four young children with a low income
d. has a desk job and works long hours
9. The nurse, assessing a middle-aged patient experiencing chest pain, realizes that presence of
which symptoms would be most characteristic of an acute myocardial infarction?
a. substernal pressure type pain, radiating down the left arm
b. colic-like epigastric pain
c. sharp, well-localized unilateral chest and left arm pain
d. sharp, burning chest pain moving from place to place
10. The nurse, caring for a patient diagnosed with Prinzmetal’s or variant angina, realizes this
is a serious type of chest pain. Why is this so?
a. It indicates presence of coronary artery spasm.
b. It indicates there is associated renal disease.
c. It indicates there is associated pulmonary disease.
d. It indicates the presence of a myocardial infarction.
11. A patient enters the emergency department complaining of chest pain that is radiating down
the left arm. The emergent treatment plan for this patient includes which nursing actions?
Select all that apply. Select all that apply.
a. morphine intravenously and oxygen
b. aspirin 325 mg orally
c. open heart surgery
d. heparin drip at 100 units per hour
e. Foley catheter insertion
12. Following a transmural myocardial infarction, which ECG change stays with the patient
for life?
a. Q wave deepening
b. ST segment elevation
c. ST segment depression
d. P wave inversion
13. A patient reports chest pain, nausea, and vomiting off and on for the last 4 days, which the
patient interpreted as the flu. Which laboratory tests will provide information about acute
cardiac damage for this patient?
a. Troponin I and T
b. Red blood cells
c. CPK-MB
d. Homocysteine and platelets
,3
14. Fifteen hours after admission, a patient’s CPK-MB level is markedly increased. What
does this indicate to the treatment team?
a. Cellular necrosis of myocardial tissue has occurred.
b. Lactic acid is present.
c. Thrombolytic therapy is indicated.
d. Cardiac function has returned to normal.
15. The nurse, caring for a patient with myocardial damage, would expect which change on
the ECG tracing?
a. ST segment elevation
b. loss of P waves
c. bradycardia
d. bradycardia
e. widening of the QRS complex
16. The nurse, caring for a patient recovering from an acute myocardial infarction, realizes
that the final extent of cardiac damage is dependent upon which factor?
a. reperfusion of the ischemic zone
b. patient’s ethnicity
c. patient’s gender
d. development of heart block
17. Nursing care of the patient after thrombolytic therapy focuses on the assessment of which
finding that is the most common complication?
a. bleeding
b. reperfusion chest pain
c. lethargy
d. heart block
18. Upon ascultating the chest of a 75-year-old patient who recently experienced a
myocardial infarction (MI) the nurse hears an S3 and lung crackles. Because of these
findings, the nurse would assess for which other condition?
a. heart failure
b. extension of the MI
c. renal failure
d. liver failure
19. The nurse is teaching a patient about coronary artery bypass surgery. Which
statement, included in this teaching, is essential for the patient to understand?
a. “You must still reduce or modify cardiac risk factors.”
b. “This surgery prolongs life on an average of two years.”
c. “You have only a minimal chance of functional improvement, even with this surgery.”
d. “This surgery will cure your atherosclerosis.”
20. A patient, recovering from coronary artery bypass graft (CABG) surgery, tells the nurse that
it feels good to be cured of heart disease. Which of the following is the most appropriate
response for the nurse to make? Select all that apply.
a. “The surgery only relieves the symptoms; it does not cure the disease.”
b. “You must continue to modify your cardiac risk factors.”
c. “You are correct; your heart is now normal.”
d. “You should not ever exercise again.”
e. “There no need to monitor your fat intake any longer.”
, 4
21. Which of the following should the nurse do to assist a patient recovering from
cardiovascular surgery who is demonstrating chest tube output of greater than 100 mL per
hours? Select all that apply. Select all that apply.
a. Report to the surgeon.
b. Check the hemoglobin and hematocrit.
c. Administer a blood transfusion.
d. Notify the family.
22. The family of a patient who experienced a stroke after CABG surgery asks the nurse
what caused the stroke to occur. The nurse’s best response would be which of the following?
a. “Stroke is usually caused by a blood clot that brakes loose and travels to the brain.”
b. “Stroke is usually caused by ruptured plaque inside the coronary artery.”
c. “Stroke is caused by heart failure.”
d. “No one knows what causes strokes.”
23. Coronary heart disease (CHD) is a major problem in the United States. Patients with
which history may require closer evaluation for CHD? Select all that apply.
a. diabetes
b. hyperlipidemia
c. positive family history
d. a premenopausal woman
e. hypotension
24. A nurse is conducting teaching about risk factor management for cardiovascular disease
(CVD) at a senior center. What is the most important information for the nurse to include?
a. Stop smoking.
b. Eat in moderation.
c. Exercise when able.
d. Reduce saturated fats in the diet.
25. The patient asks the nurse about metabolic syndrome. Which is the most accurate answer
for the nurse to provide?
a. “Metabolic syndrome is caused by obesity, physical inactivity, and genetic factors.”
b. “This syndrome is not a concern for females unless they smoke.”
c. “This problem affects only older adults over the age of 65.”
d. “It can be avoided by taking vitamins daily and drinking 64 fluid ounces of water a day.”
26. What information does the nurse consider when administering medication to treat
hyperlipidemia?
a. Such medications include the statins, which act by lowering LDL levels.
b. These medications act by increasing the LDL levels and decreasing the HDL levels.
c. These medications do not include angiotensin-converting enzyme (ACE) inhibitors.
d. Such medications include bile acid sequestrants as first-line drugs to lower cholesterol
levels.
27. A patient who is prescribed atorvastatin (Lipitor) should be monitored for which occurrence?
a. liver enzyme alteration
b. blood glucose and uric acid level alteration
c. renal function alteration
d. sudden back pain and constipation
28. The nurse completed teaching related to dietary management of coronary heart disease
(CHD). Effective teaching would be indicated by which patient statement?
