Nurs 435 Cardiovascular Exam Questions With Answers 2023
Update Guaranteed Success
1. A client admitted to the hospital with chest pain and a history of type 2 diabetes mellitus is scheduled for
cardiac catheterization. Which medication would need to be withheld for 24 hours before the procedure
and for 48 hours after the procedure?
1. Regular insulin
2. Glipizide (Glucotrol)
3. Repaglinide (Prandin)
4. Metformin (Glucophage)
4. Metformin (Glucophage)
Rationale:
Metformin (Glucophage) needs to be withheld 24 hours before and for 48 hours after cardiac
catheterization because of the injection of contrast medium during the procedure. If the
contrast medium affects kidney function, with metformin in the system, the client would be at
increased risk for lactic acidosis. The medications in the remaining options do not need to be
withheld 24 hours before and 48 hours after cardiac catheterization.
2. The nurse is reviewing an electrocardiogram rhythm strip. The P waves and QRS complexes are
regular. The PR interval is 0.16 second, and QRS complexes measure 0.06 second. The overall heart
rate is 64 beats/minute. Which would be a correct interpretation based on these characteristics?
1. Sinus bradycardia
2. Sick sinus syndrome
3. Normal sinus rhythm
4. First-degree heart block
3. Normal sinus rhythm
Rationale:
Normal sinus rhythm is defined as a regular rhythm, with an overall rate of 60 to 100 beats/minute.
The PR and QRS measurements are normal, measuring 0.12 to 0.20 second and 0.04 to 0.10
second, respectively.
3. A client is wearing a continuous cardiac monitor, which begins to sound its alarm. A nurse sees
no electrocardiographic complexes on the screen. Which is the priority action of the nurse?
1. Call a code.
2. Call the health care provider.
3. Check the client's status and lead placement.
4. Press the recorder button on the electrocardiogram console.
3. Check the client's status and lead placement.
4. A client is having frequent premature ventricular contractions. The nurse should place priority on
assessment of which item?
1. Sensation of palpitations
2. Causative factors, such as caffeine
3. Precipitating factors, such as infection
4. Blood pressure and oxygen saturation
1
, Nurs 435 Cardiovascular Exam Questions With Answers 2023
Update Guaranteed Success
4. Blood pressure and oxygen saturation
Rationale:
Premature ventricular contractions can cause hemodynamic compromise. Therefore, the priority is
to monitor the blood pressure and oxygen saturation. The shortened ventricular filling time can lead
to decreased cardiac output. The client may be asymptomatic or may feel palpitations. Premature
ventricular contractions can be caused by cardiac disorders, states of hypoxemia, or by any number
of physiological stressors, such as infection, illness, surgery, or trauma, and by intake of caffeine,
nicotine, or alcohol.
5. The nurse is evaluating a client's response to cardioversion. Which observation would be of
highest priority to the nurse?
1. Blood pressure
2. Status of airway
3. Oxygen flow rate
4. Level of consciousness
2. Status of airway
6. The nurse is caring for a client who has just had implantation of an automatic internal
cardioverter- defibrillator. The nurse immediately would assess which item based on priority?
1. Anxiety level of the client and family
2. Presence of a Medic-Alert card for the client to carry
3. Knowledge of restrictions of postdischarge physical activity
4. Activation status of the device, heart rate cutoff, and number of shocks it is programmed to deliver
4. Activation status of the device, heart rate cutoff, and number of shocks it is programmed to deliver
7. A client's electrocardiogram strip shows atrial and ventricular rates of 110 beats/minute. The PR interval is
0.14 second, the QRS complex measures 0.08 second, and the PP and RR intervals are regular. How should
the nurse correctly interpret this rhythm?
1. Sinus dysrhythmia
2. Sinus tachycardia
3. Sinus bradycardia
4. Normal sinus rhythm
2. Sinus tachycardia
Rationale:
Sinus tachycardia has the characteristics of normal sinus rhythm, including a regular PP
interval and normal-width PR and QRS intervals; however, the rate is the differentiating
factor. In sinus tachycardia, the atrial and ventricular rates are greater than 100
beats/minute.
8. The nurse is assessing the neurovascular status of a client who returned to the surgical nursing unit 4 hours
ago after undergoing aortoiliac bypass graft. The affected leg is warm, and the nurse notes redness and
edema. The pedal pulse is palpable and unchanged from admission. How should the nurse correctly
interpret the client's neurovascular status?
1. The neurovascular status is normal because of increased blood flow through the leg.
2. The neurovascular status is moderately impaired, and the surgeon should be called.
3. The neurovascular status is slightly deteriorating and should be monitored for another hour.
4. The neurovascular status is adequate from an arterial approach, but venous complications are arising.
2
, Nurs 435 Cardiovascular Exam Questions With Answers 2023
Update Guaranteed Success
1. The neurovascular status is normal because of increased blood flow through the leg.
Rationale:
An expected outcome of aortoiliac bypass graft surgery is warmth, redness, and edema in the
surgical extremity because of increased blood flow. The remaining options are incorrect
interpretations.
9. The nurse is evaluating the condition of a client after pericardiocentesis performed to treat
cardiac tamponade. Which observation would indicate that the procedure was unsuccessful?
1. Rising blood pressure
2. Clearly audible heart sounds
3. Client expressions of relief
4. Rising central venous pressure
4. Rising central venous pressure
Rationale:
Following pericardiocentesis, a rise in blood pressure and a fall in central venous pressure are
expected. The client usually expresses immediate relief. Heart sounds are no longer muffled or
distant.
10. A client with angina complains that the anginal pain is prolonged and severe and occurs at the same time
each day, most often at rest in the absence of precipitating factors. How would the nurse best describe
this type of anginal pain?
1. Stable angina
2. Variant angina
3. Unstable angina
4. Nonanginal pain
2. Variant angina
Rationale:
Variant angina, or Prinzmetal's angina, is prolonged and severe and occurs at the same time
each day, most often at rest. Stable angina is induced by exercise and relieved by rest or
nitroglycerin tablets. Unstable angina occurs at lower levels of activity or at rest, is less
predictable, and is often a precursor of myocardial infarction.
11. The nurse is monitoring a client with acute pericarditis for signs of cardiac tamponade. Which
assessment finding indicates the presence of this complication?
1. Flat neck veins
2. A pulse rate of 60 beats/min
3. Muffled or distant heart sounds
4. Wheezing on auscultation of the lungs
3. Muffled or distant heart sounds
Rationale:
Assessment findings associated with cardiac tamponade include tachycardia, distant or
muffled heart sounds, jugular vein distention with clear lung sounds, and a falling blood
pressure accompanied by pulsus paradoxus (a drop in inspiratory blood pressure greater than
10 mm Hg). Bradycardia is not a sign of cardiac tamponade.
12. The home care nurse is providing instructions to a client with an arterial ischemic leg ulcer about home
care management and self-care management. Which statement, if made by the client, indicates a need for
3
, Nurs 435 Cardiovascular Exam Questions With Answers 2023
Update Guaranteed Success
further instruction?
4
Update Guaranteed Success
1. A client admitted to the hospital with chest pain and a history of type 2 diabetes mellitus is scheduled for
cardiac catheterization. Which medication would need to be withheld for 24 hours before the procedure
and for 48 hours after the procedure?
1. Regular insulin
2. Glipizide (Glucotrol)
3. Repaglinide (Prandin)
4. Metformin (Glucophage)
4. Metformin (Glucophage)
Rationale:
Metformin (Glucophage) needs to be withheld 24 hours before and for 48 hours after cardiac
catheterization because of the injection of contrast medium during the procedure. If the
contrast medium affects kidney function, with metformin in the system, the client would be at
increased risk for lactic acidosis. The medications in the remaining options do not need to be
withheld 24 hours before and 48 hours after cardiac catheterization.
2. The nurse is reviewing an electrocardiogram rhythm strip. The P waves and QRS complexes are
regular. The PR interval is 0.16 second, and QRS complexes measure 0.06 second. The overall heart
rate is 64 beats/minute. Which would be a correct interpretation based on these characteristics?
1. Sinus bradycardia
2. Sick sinus syndrome
3. Normal sinus rhythm
4. First-degree heart block
3. Normal sinus rhythm
Rationale:
Normal sinus rhythm is defined as a regular rhythm, with an overall rate of 60 to 100 beats/minute.
The PR and QRS measurements are normal, measuring 0.12 to 0.20 second and 0.04 to 0.10
second, respectively.
3. A client is wearing a continuous cardiac monitor, which begins to sound its alarm. A nurse sees
no electrocardiographic complexes on the screen. Which is the priority action of the nurse?
1. Call a code.
2. Call the health care provider.
3. Check the client's status and lead placement.
4. Press the recorder button on the electrocardiogram console.
3. Check the client's status and lead placement.
4. A client is having frequent premature ventricular contractions. The nurse should place priority on
assessment of which item?
1. Sensation of palpitations
2. Causative factors, such as caffeine
3. Precipitating factors, such as infection
4. Blood pressure and oxygen saturation
1
, Nurs 435 Cardiovascular Exam Questions With Answers 2023
Update Guaranteed Success
4. Blood pressure and oxygen saturation
Rationale:
Premature ventricular contractions can cause hemodynamic compromise. Therefore, the priority is
to monitor the blood pressure and oxygen saturation. The shortened ventricular filling time can lead
to decreased cardiac output. The client may be asymptomatic or may feel palpitations. Premature
ventricular contractions can be caused by cardiac disorders, states of hypoxemia, or by any number
of physiological stressors, such as infection, illness, surgery, or trauma, and by intake of caffeine,
nicotine, or alcohol.
5. The nurse is evaluating a client's response to cardioversion. Which observation would be of
highest priority to the nurse?
1. Blood pressure
2. Status of airway
3. Oxygen flow rate
4. Level of consciousness
2. Status of airway
6. The nurse is caring for a client who has just had implantation of an automatic internal
cardioverter- defibrillator. The nurse immediately would assess which item based on priority?
1. Anxiety level of the client and family
2. Presence of a Medic-Alert card for the client to carry
3. Knowledge of restrictions of postdischarge physical activity
4. Activation status of the device, heart rate cutoff, and number of shocks it is programmed to deliver
4. Activation status of the device, heart rate cutoff, and number of shocks it is programmed to deliver
7. A client's electrocardiogram strip shows atrial and ventricular rates of 110 beats/minute. The PR interval is
0.14 second, the QRS complex measures 0.08 second, and the PP and RR intervals are regular. How should
the nurse correctly interpret this rhythm?
1. Sinus dysrhythmia
2. Sinus tachycardia
3. Sinus bradycardia
4. Normal sinus rhythm
2. Sinus tachycardia
Rationale:
Sinus tachycardia has the characteristics of normal sinus rhythm, including a regular PP
interval and normal-width PR and QRS intervals; however, the rate is the differentiating
factor. In sinus tachycardia, the atrial and ventricular rates are greater than 100
beats/minute.
8. The nurse is assessing the neurovascular status of a client who returned to the surgical nursing unit 4 hours
ago after undergoing aortoiliac bypass graft. The affected leg is warm, and the nurse notes redness and
edema. The pedal pulse is palpable and unchanged from admission. How should the nurse correctly
interpret the client's neurovascular status?
1. The neurovascular status is normal because of increased blood flow through the leg.
2. The neurovascular status is moderately impaired, and the surgeon should be called.
3. The neurovascular status is slightly deteriorating and should be monitored for another hour.
4. The neurovascular status is adequate from an arterial approach, but venous complications are arising.
2
, Nurs 435 Cardiovascular Exam Questions With Answers 2023
Update Guaranteed Success
1. The neurovascular status is normal because of increased blood flow through the leg.
Rationale:
An expected outcome of aortoiliac bypass graft surgery is warmth, redness, and edema in the
surgical extremity because of increased blood flow. The remaining options are incorrect
interpretations.
9. The nurse is evaluating the condition of a client after pericardiocentesis performed to treat
cardiac tamponade. Which observation would indicate that the procedure was unsuccessful?
1. Rising blood pressure
2. Clearly audible heart sounds
3. Client expressions of relief
4. Rising central venous pressure
4. Rising central venous pressure
Rationale:
Following pericardiocentesis, a rise in blood pressure and a fall in central venous pressure are
expected. The client usually expresses immediate relief. Heart sounds are no longer muffled or
distant.
10. A client with angina complains that the anginal pain is prolonged and severe and occurs at the same time
each day, most often at rest in the absence of precipitating factors. How would the nurse best describe
this type of anginal pain?
1. Stable angina
2. Variant angina
3. Unstable angina
4. Nonanginal pain
2. Variant angina
Rationale:
Variant angina, or Prinzmetal's angina, is prolonged and severe and occurs at the same time
each day, most often at rest. Stable angina is induced by exercise and relieved by rest or
nitroglycerin tablets. Unstable angina occurs at lower levels of activity or at rest, is less
predictable, and is often a precursor of myocardial infarction.
11. The nurse is monitoring a client with acute pericarditis for signs of cardiac tamponade. Which
assessment finding indicates the presence of this complication?
1. Flat neck veins
2. A pulse rate of 60 beats/min
3. Muffled or distant heart sounds
4. Wheezing on auscultation of the lungs
3. Muffled or distant heart sounds
Rationale:
Assessment findings associated with cardiac tamponade include tachycardia, distant or
muffled heart sounds, jugular vein distention with clear lung sounds, and a falling blood
pressure accompanied by pulsus paradoxus (a drop in inspiratory blood pressure greater than
10 mm Hg). Bradycardia is not a sign of cardiac tamponade.
12. The home care nurse is providing instructions to a client with an arterial ischemic leg ulcer about home
care management and self-care management. Which statement, if made by the client, indicates a need for
3
, Nurs 435 Cardiovascular Exam Questions With Answers 2023
Update Guaranteed Success
further instruction?
4
