A NEW UPDATED VERSION CARDIOLOGY PRACTICE
EXAM QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES (MOST TESTED QUESTIONS FROM
PAST EXAMS) |ALREADY GRADED A+ (FULL REVISED
EXAM)
What are the clinical manifestations of myocardial infarction in women? Select all
that apply.
A. Anoxia
B. Indigestion
C. Unusual fatigue
D. Sleep disturbances
E. Tightness of the chest - ANSWER: B, C, D
Rationale
Indigestion, unusual fatigue, and sleep disturbances are clinical manifestations of
myocardial infarction in women. Anoxia and tightness of the chest are clinical
manifestations of angina pectoris, not myocardial infarction.
The nurse provides discharge teaching to a client who has received prescriptions for
digoxin, furosemide, and a 2-gram sodium diet. Which statement from the client
indicates that further teaching is needed?
A. "I must check my pulse every day."
B. "I can gradually increase my exercise as long as I take rest periods."
C. "I should call my healthcare provider if I have difficulty breathing when I am lying
flat."
D. "I can use a little table salt on my food as long as I do not use it when cooking
food." - ANSWER: D
Rationale
The response "I can use a little table salt on my food as long as I do not use it when
cooking" demonstrates that the client did not understand the discharge teaching.
Table salt and foods high in sodium should be avoided. Sodium intake causes fluid
retention, which can precipitate a fluid volume excess, which contributes to heart
failure. Digoxin should be withheld if the client's pulse is less than a preset rate (i.e.,
60 beats per minute) because this is a sign of digoxin toxicity; the risk of digoxin
,toxicity is increased if the client develops hypokalemia as a result of receiving
furosemide. Slowly increasing activities while ensuring rest periods limits the stress
on the heart and is desirable. Orthopnea is a sign of pulmonary edema related to
heart failure, and the healthcare provider should be notified.
A nurse is caring for a client with heart failure. The healthcare provider prescribes a
2-gram sodium diet. What should the nurse include when explaining how a low-salt
diet helps achieve a therapeutic outcome?
A. Allows excess tissue fluid to be excreted
B. Helps to control the volume of food intake and thus weight
C. Aids the weakened heart muscle to contract and improves cardiac output
D. Assists in reducing potassium accumulation that occurs when sodium intake is
high - ANSWER: A
Rationale
A decreased concentration of extracellular sodium causes a decrease in the release
of antidiuretic hormone (ADH); this leads to increased excretion of urine. Sodium
restriction does not control the volume of food intake; weight is controlled by a low-
calorie diet and exercise (if permitted). The resulting elimination of excess fluid
reduces the workload of the heart but does not improve contractility. Potassium is
retained inefficiently by the body; an adequate intake of potassium is needed.
A nurse is conducting cholesterol screening for a manufacturing corporation during a
health fair. A 50-year-old man who is 6 feet (183 cm) tall and weighs 293 pounds
(133 kg) puts out his cigarette and asks the nurse how to modify his risk factors for
coronary artery disease. On which risk factors should the nurse help the client focus?
Select all that apply.
A. Age
B. Height
C. Weight
D. Smoking
E. Family history - ANSWER: C, D
Rationale
Obesity is a modifiable risk factor that is associated with coronary artery disease
(CAD); an increased fat intake contributes to an increased serum cholesterol and
atherosclerosis. Smoking, which constricts the blood vessels, is a modifiable risk
factor for CAD. The incidence of CAD does increase with age. However, age is not a
,modifiable risk factor. Height is unrelated to the incidence of CAD. Family history is
not a modifiable risk factor for CAD because one cannot control heredity.
A nurse is teaching a group of clients about risk factors for heart disease. Which
factors will the nurse include that increase a client's risk for a myocardial infarction
(MI)? Select all that apply.
A. Obesity
B. Hypertension
C. Diabetes insipidus
D. Asian-American ancestry
E. Increased high-density lipoprotein (HDL) - ANSWER: A, B
Rationale
Obesity increases cardiac workload associated with vascular changes that lead to
ischemia, which causes an MI. Hypertension damages blood vessels and increases
peripheral resistance and cardiac workload, which may lead to an MI. Diabetes
mellitus, not insipidus, is a risk factor for an MI. The risk is higher for African-
Americans, not Asian-Americans. Increased levels of low-density lipoprotein (LDL),
not HDL, increase the risk for heart disease.
The nurse is conducting a nutrition class for a group of clients with heart failure (HF).
Which information is most important for the nurse to share with the class?
A. Restricting fluid intake
B. Eating a low caloric diet to reduce weight
C. Recognizing which products are high in cholesterol
D. Choosing fresh or frozen vegetables instead of canned ones - ANSWER: D
Rationale
The key principle to teach HF clients is the importance of decreasing sodium in their
diet and which foods contain sodium. If sodium is decreased, water retention will
decrease also. Fresh or frozen vegetables have less sodium than canned ones. If the
client is on a low-sodium diet and receiving diuretics but continues to be fluid
overloaded, then fluid restriction may be instituted. A low caloric diet is not
indicated for all HF clients. Some are very thin because of various factors, including
the work of breathing and rapid heart rate. A low cholesterol diet is important for
clients with coronary artery disease and for the American population in general but
is not specifically related to HF.
, A primary healthcare provider prescribes a heart-healthy diet for a client with
angina. The client's spouse says to the nurse, "I guess I'm going to have to cook two
meals, one for my spouse and one for myself." Which is the most appropriate
response by the nurse?
A. "The diet prescribed for your spouse is a healthy diet. It contains guidelines that
many of us should follow."
B. "I wouldn't bother. For this diet all that you need to do is to reduce the amount of
salt you use and fry foods in peanut oil."
C. "You're right. Be careful to cook a small portion for each of you to eat to not waste
food."
D. "This is a difficult diet to follow. I recommend that you shop daily for food so there
are no temptations in the kitchen." - ANSWER: A
Rationale
Heart-healthy diets are low in cholesterol, sodium, and fat, particularly saturated
fats, and high in vegetables and fruits; this type of diet is advocated for all
individuals. Fried foods are not advocated on a heart-healthy diet; peanut oil is a
monounsaturated fatty acid, and these acids should not exceed 15% of the calories
of the diet. The responses "You're right. Be careful to cook a small portion for each
of you to eat to not waste food" and "This is a difficult diet to follow. I recommend
that you shop daily for food so there are no temptations in the kitchen" can be
discouraging and encourage noncompliance.
A client with an inferior myocardial infarction has a heart rate of 120 beats per
minute. Which goal achievements are priority?
A. Increase left ventricular filling and improve cardiac output
B. Decrease oxygen needs of the vital organs and prevent cardiac dysrhythmias
C. Decrease the workload on the heart and promote maximum coronary artery filling
D. Increase venous return to the right atrium and increase pulmonary arterial blood
flow - ANSWER: C
Rationale
With a myocardial infarction, circulation of blood to cardiac muscle is reduced,
depriving it of oxygen; therefore the oxygen demands of the body need to be
decreased to reduce stress on the heart and reduce cardiac output. Increased
coronary artery filling allows more blood and therefore oxygen to reach cardiac
muscle; this increases myocardial efficiency. Increasing left ventricular filling
increases the workload of the heart. Oxygenation of vital organs must be
maintained. Decreasing oxygen to vital organs of the body may interfere with their
EXAM QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES (MOST TESTED QUESTIONS FROM
PAST EXAMS) |ALREADY GRADED A+ (FULL REVISED
EXAM)
What are the clinical manifestations of myocardial infarction in women? Select all
that apply.
A. Anoxia
B. Indigestion
C. Unusual fatigue
D. Sleep disturbances
E. Tightness of the chest - ANSWER: B, C, D
Rationale
Indigestion, unusual fatigue, and sleep disturbances are clinical manifestations of
myocardial infarction in women. Anoxia and tightness of the chest are clinical
manifestations of angina pectoris, not myocardial infarction.
The nurse provides discharge teaching to a client who has received prescriptions for
digoxin, furosemide, and a 2-gram sodium diet. Which statement from the client
indicates that further teaching is needed?
A. "I must check my pulse every day."
B. "I can gradually increase my exercise as long as I take rest periods."
C. "I should call my healthcare provider if I have difficulty breathing when I am lying
flat."
D. "I can use a little table salt on my food as long as I do not use it when cooking
food." - ANSWER: D
Rationale
The response "I can use a little table salt on my food as long as I do not use it when
cooking" demonstrates that the client did not understand the discharge teaching.
Table salt and foods high in sodium should be avoided. Sodium intake causes fluid
retention, which can precipitate a fluid volume excess, which contributes to heart
failure. Digoxin should be withheld if the client's pulse is less than a preset rate (i.e.,
60 beats per minute) because this is a sign of digoxin toxicity; the risk of digoxin
,toxicity is increased if the client develops hypokalemia as a result of receiving
furosemide. Slowly increasing activities while ensuring rest periods limits the stress
on the heart and is desirable. Orthopnea is a sign of pulmonary edema related to
heart failure, and the healthcare provider should be notified.
A nurse is caring for a client with heart failure. The healthcare provider prescribes a
2-gram sodium diet. What should the nurse include when explaining how a low-salt
diet helps achieve a therapeutic outcome?
A. Allows excess tissue fluid to be excreted
B. Helps to control the volume of food intake and thus weight
C. Aids the weakened heart muscle to contract and improves cardiac output
D. Assists in reducing potassium accumulation that occurs when sodium intake is
high - ANSWER: A
Rationale
A decreased concentration of extracellular sodium causes a decrease in the release
of antidiuretic hormone (ADH); this leads to increased excretion of urine. Sodium
restriction does not control the volume of food intake; weight is controlled by a low-
calorie diet and exercise (if permitted). The resulting elimination of excess fluid
reduces the workload of the heart but does not improve contractility. Potassium is
retained inefficiently by the body; an adequate intake of potassium is needed.
A nurse is conducting cholesterol screening for a manufacturing corporation during a
health fair. A 50-year-old man who is 6 feet (183 cm) tall and weighs 293 pounds
(133 kg) puts out his cigarette and asks the nurse how to modify his risk factors for
coronary artery disease. On which risk factors should the nurse help the client focus?
Select all that apply.
A. Age
B. Height
C. Weight
D. Smoking
E. Family history - ANSWER: C, D
Rationale
Obesity is a modifiable risk factor that is associated with coronary artery disease
(CAD); an increased fat intake contributes to an increased serum cholesterol and
atherosclerosis. Smoking, which constricts the blood vessels, is a modifiable risk
factor for CAD. The incidence of CAD does increase with age. However, age is not a
,modifiable risk factor. Height is unrelated to the incidence of CAD. Family history is
not a modifiable risk factor for CAD because one cannot control heredity.
A nurse is teaching a group of clients about risk factors for heart disease. Which
factors will the nurse include that increase a client's risk for a myocardial infarction
(MI)? Select all that apply.
A. Obesity
B. Hypertension
C. Diabetes insipidus
D. Asian-American ancestry
E. Increased high-density lipoprotein (HDL) - ANSWER: A, B
Rationale
Obesity increases cardiac workload associated with vascular changes that lead to
ischemia, which causes an MI. Hypertension damages blood vessels and increases
peripheral resistance and cardiac workload, which may lead to an MI. Diabetes
mellitus, not insipidus, is a risk factor for an MI. The risk is higher for African-
Americans, not Asian-Americans. Increased levels of low-density lipoprotein (LDL),
not HDL, increase the risk for heart disease.
The nurse is conducting a nutrition class for a group of clients with heart failure (HF).
Which information is most important for the nurse to share with the class?
A. Restricting fluid intake
B. Eating a low caloric diet to reduce weight
C. Recognizing which products are high in cholesterol
D. Choosing fresh or frozen vegetables instead of canned ones - ANSWER: D
Rationale
The key principle to teach HF clients is the importance of decreasing sodium in their
diet and which foods contain sodium. If sodium is decreased, water retention will
decrease also. Fresh or frozen vegetables have less sodium than canned ones. If the
client is on a low-sodium diet and receiving diuretics but continues to be fluid
overloaded, then fluid restriction may be instituted. A low caloric diet is not
indicated for all HF clients. Some are very thin because of various factors, including
the work of breathing and rapid heart rate. A low cholesterol diet is important for
clients with coronary artery disease and for the American population in general but
is not specifically related to HF.
, A primary healthcare provider prescribes a heart-healthy diet for a client with
angina. The client's spouse says to the nurse, "I guess I'm going to have to cook two
meals, one for my spouse and one for myself." Which is the most appropriate
response by the nurse?
A. "The diet prescribed for your spouse is a healthy diet. It contains guidelines that
many of us should follow."
B. "I wouldn't bother. For this diet all that you need to do is to reduce the amount of
salt you use and fry foods in peanut oil."
C. "You're right. Be careful to cook a small portion for each of you to eat to not waste
food."
D. "This is a difficult diet to follow. I recommend that you shop daily for food so there
are no temptations in the kitchen." - ANSWER: A
Rationale
Heart-healthy diets are low in cholesterol, sodium, and fat, particularly saturated
fats, and high in vegetables and fruits; this type of diet is advocated for all
individuals. Fried foods are not advocated on a heart-healthy diet; peanut oil is a
monounsaturated fatty acid, and these acids should not exceed 15% of the calories
of the diet. The responses "You're right. Be careful to cook a small portion for each
of you to eat to not waste food" and "This is a difficult diet to follow. I recommend
that you shop daily for food so there are no temptations in the kitchen" can be
discouraging and encourage noncompliance.
A client with an inferior myocardial infarction has a heart rate of 120 beats per
minute. Which goal achievements are priority?
A. Increase left ventricular filling and improve cardiac output
B. Decrease oxygen needs of the vital organs and prevent cardiac dysrhythmias
C. Decrease the workload on the heart and promote maximum coronary artery filling
D. Increase venous return to the right atrium and increase pulmonary arterial blood
flow - ANSWER: C
Rationale
With a myocardial infarction, circulation of blood to cardiac muscle is reduced,
depriving it of oxygen; therefore the oxygen demands of the body need to be
decreased to reduce stress on the heart and reduce cardiac output. Increased
coronary artery filling allows more blood and therefore oxygen to reach cardiac
muscle; this increases myocardial efficiency. Increasing left ventricular filling
increases the workload of the heart. Oxygenation of vital organs must be
maintained. Decreasing oxygen to vital organs of the body may interfere with their
