Med-Surg: Cardiovascular Review
Questions
1. A client complains of crushing chest pain that radiates to his left arm. He should be
presented with the following treatment:
1. Aspirin, oxygen, nitroglycerin, and morphine
2. Aspirin, oxygen, nitroglycerin, and codeine
3. Oxygen, nitroglycerin, meperidine, and thrombolytics
4. Aspirin, oxygen, nitroprusside, and morphine - Answer Answer: 1. Aspirin, oxygen,
nitroglycerin, and morphine
2. Which lifestyle changes should a client diagnosed with coronary artery disease
consider?
1. Smoking cessation
2. Establishing a regular exercise routine
3. Weight reduction
4. All of the Above - Answer Answer: 4. All of the Above
3. A client's cardiac monitor alarm sounds, indicating ventricular tachycardia. The nurse
should:
1. perform immediate defibrillation.
2. Assess the client.
3. Call the physician.
4. Administer a precordial thump. - Answer Answer: 2. Assess the client.
4. A complication of peripheral vascular disease may be:
1. stasis ulcer.
2. Pressure ulcer.
3. Gastric ulcer.
4. Duodenal ulcer. - Answer Answer: 1. stasis ulcer.
5. A key diagnostic test for heart failure is:
1. serum potassium.
2. B-type natriuretic peptide.
3. Troponin I
4. cardiac enzymes. - Answer Answer: 2. B-type natriuretic peptide.
6. While auscultating the heart sounds of a client with mitral insufficiency, the nurse
hears an extra heart sound immediately after the S2. The nurse should document this
extra heart sound as a:
1. S1.
2. S3.
3. S4.
4. mitral murmur. - Answer Answer: 2. S3.
Rationale: An S3, is heard following an S2. This indicates that the client is experiencing
heart failure and results from increased filling pressures. An S1 is a normal heart sound
made by the closing of the mitral and tricuspid valves. An S4 is heard before S1 and is
,Med-Surg: Cardiovascular Review
Questions
caused by resistance to ventricular filling. A murmur of mitral insufficiency occurs during
systole and is heard when there's turbulent blood flow across the valve.
7. A nurse administers heparin to a client with deep vein thrombophlebitis. Which
laboratory value should the nurse monitor to determine the effectiveness of heparin?
1. PTT
2. HCT
3. CBC
4. PT - Answer Answer: 1. PTT
Rationale: The therapeutic effectiveness of heparin is determined by monitoring the
patient's PTT, PT, HCT, and CBC don't monitor the therapeutic effectiveness of heparin.
Monitoring the PT determines warfarin's effectiveness.
8. A client has just returned from cardiac catheterization. Which nursing intervention
would be most appropriate?
1. Help the client ambulate to the bathroom.
2. Restrict fluids.
3. Monitor peripheral pulses.
4. Insert an indwelling urinary catheter. - Answer Answer. 3. Monitor peripheral pulses.
Rationale: After cardiac catheterization, monitor peripheral pulses to assess peripheral
perfusion. Helping the client ambulate to the bathroom is incorrect because the client
should be on bed rest for 4 to 8 hours after the procedure to reduce the risk of bleeding
at the insertion site. Restricting fluids is incorrect because the client should be
encouraged to drink fluids after the procedure, unless contraindicated. Adequate
hydration reduces the risk of nephrotoxicity that can occur with the use of contrast dye.
Although urine output is monitored following cardiac catheterization, the insertion of a
urinary catherter isn't necessary.
9. A client is in the first postoperative day after left femoropopliteal revascularization.
Which position would be most appropriate for this client?
1. On his left-sided
2. In high Fowler's position
3. On his right side
4. In a left lateral decubitus position - Answer Answer: 3. On his right side
Rationale: Following revascularization, avoid positioning the client on the surgical side.
Because this client had left femoropoliteal revascularization, he may be positioned on
the right side. Placing the client on the left side is incorrect because this would position
the client on the operative side. Positioning the client in high Fowler's position is
incorrect because the client should avoid flexion at the surgical site. Placing the client in
a left lateral decubitus position is incorrect because this would place the client on the
surgical side and cause flexion at the site.
10. A nurse is evaluating a client with left-sided heart failure. Which finding should the
nurse expect to assess?
,Med-Surg: Cardiovascular Review
Questions
1. Ascites
2. Dyspnea
3. Hepatomegaly
4. Jugular vein distention - Answer Answer: 2. Dyspnea
Rationale: Dyspnea may occur in a client with left-sided heart failure. Ascites,
hepatomegaly, and jugular vein distention are assessment findings in right-sided heart
failure.
11. A client has developed acute pulmonary edema. Which test result should the nurse
expect?
1. Interstitial edema by chest X-ray
2. Metabolic alkalosis by ABG analysis
3. Bradycardia by ECG
4. Decreased PAWP by hemodynamic monitoring - Answer Answer: 1. Interstitial
edema by chest X-ray
Rationale: The chest X-ray of a client with acute pulmonary edema shows interstitial
edema as a result of the heart's failure to pump adequately. Metabolic alkalosis is
incorrect because the ABG analysis of a client in acute pulmonary edema shows
respiratory alkalosis or acidosis. Bradycardia is incorrect because the ECG would most
likely indicate tachycardia. Decreased PAWP is incorrect because PAWP rises in the
client with acute pulmonary edema.
12. A nurse is performing discharge teaching for a client with PVD. The nurse should
teach the client to:
1. inspect his feet weekly
2. begin a daily walking program
3. wear constrictive clothing
4. stand rather than sit when possible - Answer Answer: 2. begin a daily walking
program
Rationale: The nurse should encourage the client with PVD to follow a program of
walking and other leg exercises. Inspecting the feet weekly is incorrect because the
nurse should teach the client to inspect his feet daily. Wearing constrictive clothing is
incorrect because the client should wear loose clothing that doesn't restrict circulation.
Standing when possible—rather than sitting—is incorrect because the client should
avoid standing for long periods.
13. If a nurse knows a client's heart rate, what other value and formula does she need
to know to calculate CO? - Answer Answer: Stroke Volume
Rationale: Cardiac output equals stroke volume (the amount of blood ejected with each
beat) times heart rate. [CO = SV X HR]
14. A client comes to the clinic and states he has a history of hypertension. Which type
of medication might the nurse expect the client to be taking to control his blood
pressure?
, Med-Surg: Cardiovascular Review
Questions
1. Antilipemics
2. Antibiotics
3. ACE inhibitors
4. Antidiabetics - Answer Answer: 3. ACE inhibitors
Rationale: ACE inhibitors may be prescribed to help control high blood pressure. Other
types of medications that may be prescribed include diuretics, calcium channel
blockers, angiotensin II receptor blockers, and beta-adrenergic blockers. Antilipemics
help lower serum cholesterol levels. Antibiotics are used to fight infection, and
antidiabetics help control serum glucose levels.
15. A cardiologist prescribes digoxin (Lanoxin)125 mcg by mouth every morning for a
client diagnosed with heart failure. The pharmacy dispenses tablets that contain 0.25
mg each. How many tablets should the nurse administer in each dose? Record your
answer using one decimal place. - Answer Answer: 0.5 tablet(s)
Rationale: 0.5 tablets. The nurse should begin by converting 125 mcg to milligrams. 125
mcg / 1,000 = 0.125 mg. The following formula is used to calculate drug dosages: dose
on hand / quality on hand = dose desired./ X. The nurse should use the following
equations: 0.25 mg / 1 tablet = 0.125 mg / X. The equation then becomes 0.25(x) =
0.125. Which is 0..25 = X = 0.5 tablet
16. A client is prescribed diltiazem (Cardizem) to manage his hypertension. The nurse
should tell the client the diltiazem will:
1. lower his blood pressure only.
2. Lower his heart rate and blood pressure.
3. Lower his blood pressure and increase his urine output
4. lower his heart rate and blood pressure and increase his urine output. - Answer
Answer: 2. Lower his heart rate and blood pressure.
Rationale: Diltiazem, a calcium channel blocker, will reduce both the heart rate and
blood pressure. It doesn't directly affect urine output.
17. A client reports substernal chest pain. Test results show electrocardiographic
changes and an elevated cardiac troponin level. What should be the focus of nursing
care?
1. Improving myocardial oxygenation and reducing cardiac workload.
2. Confirming a suspected diagnosis and preventing complications.
3. Reducing anxiety and relieving pain.
4. Eliminating stressors and providing a nondemanding environment. - Answer Answer:
1. Improving myocardial oxygenation and reducing cardiac workload.
Rationale: The client is exhibiting clinical signs and symptoms of a myocardial infarction
(MI); therefore, nursing care should focus on improving myocardial oxygenation and
reducing cardiac workload. Confirming the diagnosis of MI and preventing
complications, reducing anxiety and relieving pain, and providing a nondemanding
environment are secondary to improving myocardial oxygenation and reducing
workload. Stressors can't be eliminated, only reduced.
Questions
1. A client complains of crushing chest pain that radiates to his left arm. He should be
presented with the following treatment:
1. Aspirin, oxygen, nitroglycerin, and morphine
2. Aspirin, oxygen, nitroglycerin, and codeine
3. Oxygen, nitroglycerin, meperidine, and thrombolytics
4. Aspirin, oxygen, nitroprusside, and morphine - Answer Answer: 1. Aspirin, oxygen,
nitroglycerin, and morphine
2. Which lifestyle changes should a client diagnosed with coronary artery disease
consider?
1. Smoking cessation
2. Establishing a regular exercise routine
3. Weight reduction
4. All of the Above - Answer Answer: 4. All of the Above
3. A client's cardiac monitor alarm sounds, indicating ventricular tachycardia. The nurse
should:
1. perform immediate defibrillation.
2. Assess the client.
3. Call the physician.
4. Administer a precordial thump. - Answer Answer: 2. Assess the client.
4. A complication of peripheral vascular disease may be:
1. stasis ulcer.
2. Pressure ulcer.
3. Gastric ulcer.
4. Duodenal ulcer. - Answer Answer: 1. stasis ulcer.
5. A key diagnostic test for heart failure is:
1. serum potassium.
2. B-type natriuretic peptide.
3. Troponin I
4. cardiac enzymes. - Answer Answer: 2. B-type natriuretic peptide.
6. While auscultating the heart sounds of a client with mitral insufficiency, the nurse
hears an extra heart sound immediately after the S2. The nurse should document this
extra heart sound as a:
1. S1.
2. S3.
3. S4.
4. mitral murmur. - Answer Answer: 2. S3.
Rationale: An S3, is heard following an S2. This indicates that the client is experiencing
heart failure and results from increased filling pressures. An S1 is a normal heart sound
made by the closing of the mitral and tricuspid valves. An S4 is heard before S1 and is
,Med-Surg: Cardiovascular Review
Questions
caused by resistance to ventricular filling. A murmur of mitral insufficiency occurs during
systole and is heard when there's turbulent blood flow across the valve.
7. A nurse administers heparin to a client with deep vein thrombophlebitis. Which
laboratory value should the nurse monitor to determine the effectiveness of heparin?
1. PTT
2. HCT
3. CBC
4. PT - Answer Answer: 1. PTT
Rationale: The therapeutic effectiveness of heparin is determined by monitoring the
patient's PTT, PT, HCT, and CBC don't monitor the therapeutic effectiveness of heparin.
Monitoring the PT determines warfarin's effectiveness.
8. A client has just returned from cardiac catheterization. Which nursing intervention
would be most appropriate?
1. Help the client ambulate to the bathroom.
2. Restrict fluids.
3. Monitor peripheral pulses.
4. Insert an indwelling urinary catheter. - Answer Answer. 3. Monitor peripheral pulses.
Rationale: After cardiac catheterization, monitor peripheral pulses to assess peripheral
perfusion. Helping the client ambulate to the bathroom is incorrect because the client
should be on bed rest for 4 to 8 hours after the procedure to reduce the risk of bleeding
at the insertion site. Restricting fluids is incorrect because the client should be
encouraged to drink fluids after the procedure, unless contraindicated. Adequate
hydration reduces the risk of nephrotoxicity that can occur with the use of contrast dye.
Although urine output is monitored following cardiac catheterization, the insertion of a
urinary catherter isn't necessary.
9. A client is in the first postoperative day after left femoropopliteal revascularization.
Which position would be most appropriate for this client?
1. On his left-sided
2. In high Fowler's position
3. On his right side
4. In a left lateral decubitus position - Answer Answer: 3. On his right side
Rationale: Following revascularization, avoid positioning the client on the surgical side.
Because this client had left femoropoliteal revascularization, he may be positioned on
the right side. Placing the client on the left side is incorrect because this would position
the client on the operative side. Positioning the client in high Fowler's position is
incorrect because the client should avoid flexion at the surgical site. Placing the client in
a left lateral decubitus position is incorrect because this would place the client on the
surgical side and cause flexion at the site.
10. A nurse is evaluating a client with left-sided heart failure. Which finding should the
nurse expect to assess?
,Med-Surg: Cardiovascular Review
Questions
1. Ascites
2. Dyspnea
3. Hepatomegaly
4. Jugular vein distention - Answer Answer: 2. Dyspnea
Rationale: Dyspnea may occur in a client with left-sided heart failure. Ascites,
hepatomegaly, and jugular vein distention are assessment findings in right-sided heart
failure.
11. A client has developed acute pulmonary edema. Which test result should the nurse
expect?
1. Interstitial edema by chest X-ray
2. Metabolic alkalosis by ABG analysis
3. Bradycardia by ECG
4. Decreased PAWP by hemodynamic monitoring - Answer Answer: 1. Interstitial
edema by chest X-ray
Rationale: The chest X-ray of a client with acute pulmonary edema shows interstitial
edema as a result of the heart's failure to pump adequately. Metabolic alkalosis is
incorrect because the ABG analysis of a client in acute pulmonary edema shows
respiratory alkalosis or acidosis. Bradycardia is incorrect because the ECG would most
likely indicate tachycardia. Decreased PAWP is incorrect because PAWP rises in the
client with acute pulmonary edema.
12. A nurse is performing discharge teaching for a client with PVD. The nurse should
teach the client to:
1. inspect his feet weekly
2. begin a daily walking program
3. wear constrictive clothing
4. stand rather than sit when possible - Answer Answer: 2. begin a daily walking
program
Rationale: The nurse should encourage the client with PVD to follow a program of
walking and other leg exercises. Inspecting the feet weekly is incorrect because the
nurse should teach the client to inspect his feet daily. Wearing constrictive clothing is
incorrect because the client should wear loose clothing that doesn't restrict circulation.
Standing when possible—rather than sitting—is incorrect because the client should
avoid standing for long periods.
13. If a nurse knows a client's heart rate, what other value and formula does she need
to know to calculate CO? - Answer Answer: Stroke Volume
Rationale: Cardiac output equals stroke volume (the amount of blood ejected with each
beat) times heart rate. [CO = SV X HR]
14. A client comes to the clinic and states he has a history of hypertension. Which type
of medication might the nurse expect the client to be taking to control his blood
pressure?
, Med-Surg: Cardiovascular Review
Questions
1. Antilipemics
2. Antibiotics
3. ACE inhibitors
4. Antidiabetics - Answer Answer: 3. ACE inhibitors
Rationale: ACE inhibitors may be prescribed to help control high blood pressure. Other
types of medications that may be prescribed include diuretics, calcium channel
blockers, angiotensin II receptor blockers, and beta-adrenergic blockers. Antilipemics
help lower serum cholesterol levels. Antibiotics are used to fight infection, and
antidiabetics help control serum glucose levels.
15. A cardiologist prescribes digoxin (Lanoxin)125 mcg by mouth every morning for a
client diagnosed with heart failure. The pharmacy dispenses tablets that contain 0.25
mg each. How many tablets should the nurse administer in each dose? Record your
answer using one decimal place. - Answer Answer: 0.5 tablet(s)
Rationale: 0.5 tablets. The nurse should begin by converting 125 mcg to milligrams. 125
mcg / 1,000 = 0.125 mg. The following formula is used to calculate drug dosages: dose
on hand / quality on hand = dose desired./ X. The nurse should use the following
equations: 0.25 mg / 1 tablet = 0.125 mg / X. The equation then becomes 0.25(x) =
0.125. Which is 0..25 = X = 0.5 tablet
16. A client is prescribed diltiazem (Cardizem) to manage his hypertension. The nurse
should tell the client the diltiazem will:
1. lower his blood pressure only.
2. Lower his heart rate and blood pressure.
3. Lower his blood pressure and increase his urine output
4. lower his heart rate and blood pressure and increase his urine output. - Answer
Answer: 2. Lower his heart rate and blood pressure.
Rationale: Diltiazem, a calcium channel blocker, will reduce both the heart rate and
blood pressure. It doesn't directly affect urine output.
17. A client reports substernal chest pain. Test results show electrocardiographic
changes and an elevated cardiac troponin level. What should be the focus of nursing
care?
1. Improving myocardial oxygenation and reducing cardiac workload.
2. Confirming a suspected diagnosis and preventing complications.
3. Reducing anxiety and relieving pain.
4. Eliminating stressors and providing a nondemanding environment. - Answer Answer:
1. Improving myocardial oxygenation and reducing cardiac workload.
Rationale: The client is exhibiting clinical signs and symptoms of a myocardial infarction
(MI); therefore, nursing care should focus on improving myocardial oxygenation and
reducing cardiac workload. Confirming the diagnosis of MI and preventing
complications, reducing anxiety and relieving pain, and providing a nondemanding
environment are secondary to improving myocardial oxygenation and reducing
workload. Stressors can't be eliminated, only reduced.
