Med Surg Cardiac Exam UPDATED
ACTUAL Exam Questions and CORRECT
Answers
When developing a health teaching plan for a 60-year-old man with the following risk factors for
coronary artery disease (CAD), the nurse should focus on the
a. family history of coronary artery disease.
b. increased risk associated with the patient's male sex.
c. high incidence of cardiovascular disease in older people.
d. elevation of the patient's serum low density lipoprotein (LDL) level. - CORRECT
ANSWER - D. elevation of the patient's serum low density lipoprotein (LDL) level.
Serum LDL is the only modifiable risk factor.
Which information collected by the nurse who is admitting a patient with chest pain suggests that
the pain is caused by an acute myocardial infarction (AMI)?
a. The pain increases with deep breathing.
b. The pain has persisted longer than 30 minutes.
c. The pain worsens when the patient raises the arms.
d. The pain is relieved after the patient takes nitroglycerin. - CORRECT ANSWER - b.
The pain has persisted longer than 30 minutes.
Cardiac chest pain lasting longer than 30 minutes and not relieved by rest or use of nitroglycerin
could be indicative of AMI.
Which information given by a patient admitted with stable angina will help the nurse confirm
this diagnosis?
,a. The patient rates the pain at a level 3 to 5 (0 to 10 scale).
b. The patient states that the pain "wakes me up at night."
c. The patient says that the frequency of the pain has increased over the last few weeks.
d. The patient states that the pain is resolved after taking one sublingual nitroglycerin tablet. -
CORRECT ANSWER - d. The patient states that the pain is resolved after taking one
sublingual nitroglycerin tablet.
Chronic stable angina refers to chest pain that occurs intermittently over long period of time with
similar pattern of onset, duration, and intensity of symptoms. The pain of chronic stable angina
usually lasts only for a few minutes before subsiding with rest, calming down, or use of
sublingual nitroglycerin (NTG)
After the nurse has finished teaching a patient about use of sublingual nitroglycerin (Nitrostat),
which patient statement indicates that the teaching has been EFFECTIVE?
a. "I can expect indigestion as a side effect of nitroglycerin."
b. "I can only take the nitroglycerin if I start to have chest pain."
c. "I will call an ambulance if I still have pain 5 minutes after taking the nitroglycerin."
d. "I will help slow down the progress of the plaque formation by taking nitroglycerin." -
CORRECT ANSWER - c. "I will call an ambulance if I still have pain 5 minutes after
taking the nitroglycerin."
Chest pain that continues after use of NTG may indicate a change to acute coronary syndrome
(ACS). (Lewis et al., 2017)
Which of these statements made by a patient with coronary artery disease after the nurse has
completed teaching about the therapeutic lifestyle changes (TLC) diet indicates that further
teaching is needed?
a. "I will switch from whole milk to 1% or nonfat milk."
b. "I like fresh salmon and I will plan to eat it more often."
c. "I will miss being able to eat peanut butter sandwiches."
,d. "I can have a cup of coffee with breakfast if I want one." - CORRECT ANSWER - c. "I
will miss being able to eat peanut butter sandwiches."
This answer demonstrates that teaching has been INEFFECTIVE. Peanut butter is an appropriate
source of fat in the diet of a patient with CAD. (Lewis et al., 2017)
A patient who has had severe chest pain for several hours is admitted with a diagnosis of
possible acute myocardial infarction (AMI). Which of these ordered laboratory tests should the
nurse monitor to help determine whether the patient has had an AMI?
a. Homocysteine
b. C-reactive protein
c. Cardiac-specific troponin I and troponin T
d. High-density lipoprotein (HDL) cholesterol - CORRECT ANSWER - c. Cardiac-
specific troponin I and troponin T
Cardiac-specific troponin I and T are highly-specific indicators of MI and have greater
sensitivity and specificity than creatinine-kinase MB (Lewis et al., 2017).
Amlodipine (Norvasc) is ordered for a patient with newly diagnosed Prinzmetal's (variant)
angina. When teaching the patient, the nurse will include the information that amlodipine will
a. reduce the "fight or flight" response.
b. decrease spasm of the coronary arteries.
c. increase the force of myocardial contraction.
d. help prevent clotting in the coronary arteries. - CORRECT ANSWER - b. decrease
spasm of the coronary arteries.
This statement refers to the action of a calcium channel blocker (CCB) (Lewis et al., 2017).
, A patient with a non-ST-segment-elevation myocardial infarction (NSTEMI) is receiving
heparin. What is the purpose of the heparin?
a. Platelet aggregation is enhanced by IV heparin infusion.
b. Heparin will dissolve the clot that is blocking blood flow to the heart.
c. Coronary artery plaque size and adherence are decreased with heparin.
d. Heparin will prevent the development of new clots in the coronary arteries. - CORRECT
ANSWER - d. Heparin will prevent the development of new clots in the coronary arteries.
This answer describes the use of heparin in patients with an NSTEMI.
When administering IV nitroglycerin (Tridil) to a patient with a myocardial infarction (MI),
which action will the nurse take to evaluate the effectiveness of the medication?
a. Check blood pressure.
b. Monitor apical pulse rate.
c. Monitor for dysrhythmias.
d. Ask about chest discomfort. - CORRECT ANSWER - d. Ask about chest discomfort.
IV nitroglycerin is given to promote coronary artery vasodilation and would be evaluated by
assessing the patient's level of chest pain (Lewis et al., 2017).
A patient with ST segment elevation in several electrocardiographic (ECG) leads is admitted to
the emergency department (ED) and diagnosed as having an ST-segment-elevation myocardial
infarction (STEMI). Which question should the nurse ask to determine whether the patient is a
candidate for fibrinolytic therapy?
a. "Do you take aspirin on a daily basis?"
b. "What time did your chest pain begin?" Correct -
c. "Is there any family history of heart disease?"
ACTUAL Exam Questions and CORRECT
Answers
When developing a health teaching plan for a 60-year-old man with the following risk factors for
coronary artery disease (CAD), the nurse should focus on the
a. family history of coronary artery disease.
b. increased risk associated with the patient's male sex.
c. high incidence of cardiovascular disease in older people.
d. elevation of the patient's serum low density lipoprotein (LDL) level. - CORRECT
ANSWER - D. elevation of the patient's serum low density lipoprotein (LDL) level.
Serum LDL is the only modifiable risk factor.
Which information collected by the nurse who is admitting a patient with chest pain suggests that
the pain is caused by an acute myocardial infarction (AMI)?
a. The pain increases with deep breathing.
b. The pain has persisted longer than 30 minutes.
c. The pain worsens when the patient raises the arms.
d. The pain is relieved after the patient takes nitroglycerin. - CORRECT ANSWER - b.
The pain has persisted longer than 30 minutes.
Cardiac chest pain lasting longer than 30 minutes and not relieved by rest or use of nitroglycerin
could be indicative of AMI.
Which information given by a patient admitted with stable angina will help the nurse confirm
this diagnosis?
,a. The patient rates the pain at a level 3 to 5 (0 to 10 scale).
b. The patient states that the pain "wakes me up at night."
c. The patient says that the frequency of the pain has increased over the last few weeks.
d. The patient states that the pain is resolved after taking one sublingual nitroglycerin tablet. -
CORRECT ANSWER - d. The patient states that the pain is resolved after taking one
sublingual nitroglycerin tablet.
Chronic stable angina refers to chest pain that occurs intermittently over long period of time with
similar pattern of onset, duration, and intensity of symptoms. The pain of chronic stable angina
usually lasts only for a few minutes before subsiding with rest, calming down, or use of
sublingual nitroglycerin (NTG)
After the nurse has finished teaching a patient about use of sublingual nitroglycerin (Nitrostat),
which patient statement indicates that the teaching has been EFFECTIVE?
a. "I can expect indigestion as a side effect of nitroglycerin."
b. "I can only take the nitroglycerin if I start to have chest pain."
c. "I will call an ambulance if I still have pain 5 minutes after taking the nitroglycerin."
d. "I will help slow down the progress of the plaque formation by taking nitroglycerin." -
CORRECT ANSWER - c. "I will call an ambulance if I still have pain 5 minutes after
taking the nitroglycerin."
Chest pain that continues after use of NTG may indicate a change to acute coronary syndrome
(ACS). (Lewis et al., 2017)
Which of these statements made by a patient with coronary artery disease after the nurse has
completed teaching about the therapeutic lifestyle changes (TLC) diet indicates that further
teaching is needed?
a. "I will switch from whole milk to 1% or nonfat milk."
b. "I like fresh salmon and I will plan to eat it more often."
c. "I will miss being able to eat peanut butter sandwiches."
,d. "I can have a cup of coffee with breakfast if I want one." - CORRECT ANSWER - c. "I
will miss being able to eat peanut butter sandwiches."
This answer demonstrates that teaching has been INEFFECTIVE. Peanut butter is an appropriate
source of fat in the diet of a patient with CAD. (Lewis et al., 2017)
A patient who has had severe chest pain for several hours is admitted with a diagnosis of
possible acute myocardial infarction (AMI). Which of these ordered laboratory tests should the
nurse monitor to help determine whether the patient has had an AMI?
a. Homocysteine
b. C-reactive protein
c. Cardiac-specific troponin I and troponin T
d. High-density lipoprotein (HDL) cholesterol - CORRECT ANSWER - c. Cardiac-
specific troponin I and troponin T
Cardiac-specific troponin I and T are highly-specific indicators of MI and have greater
sensitivity and specificity than creatinine-kinase MB (Lewis et al., 2017).
Amlodipine (Norvasc) is ordered for a patient with newly diagnosed Prinzmetal's (variant)
angina. When teaching the patient, the nurse will include the information that amlodipine will
a. reduce the "fight or flight" response.
b. decrease spasm of the coronary arteries.
c. increase the force of myocardial contraction.
d. help prevent clotting in the coronary arteries. - CORRECT ANSWER - b. decrease
spasm of the coronary arteries.
This statement refers to the action of a calcium channel blocker (CCB) (Lewis et al., 2017).
, A patient with a non-ST-segment-elevation myocardial infarction (NSTEMI) is receiving
heparin. What is the purpose of the heparin?
a. Platelet aggregation is enhanced by IV heparin infusion.
b. Heparin will dissolve the clot that is blocking blood flow to the heart.
c. Coronary artery plaque size and adherence are decreased with heparin.
d. Heparin will prevent the development of new clots in the coronary arteries. - CORRECT
ANSWER - d. Heparin will prevent the development of new clots in the coronary arteries.
This answer describes the use of heparin in patients with an NSTEMI.
When administering IV nitroglycerin (Tridil) to a patient with a myocardial infarction (MI),
which action will the nurse take to evaluate the effectiveness of the medication?
a. Check blood pressure.
b. Monitor apical pulse rate.
c. Monitor for dysrhythmias.
d. Ask about chest discomfort. - CORRECT ANSWER - d. Ask about chest discomfort.
IV nitroglycerin is given to promote coronary artery vasodilation and would be evaluated by
assessing the patient's level of chest pain (Lewis et al., 2017).
A patient with ST segment elevation in several electrocardiographic (ECG) leads is admitted to
the emergency department (ED) and diagnosed as having an ST-segment-elevation myocardial
infarction (STEMI). Which question should the nurse ask to determine whether the patient is a
candidate for fibrinolytic therapy?
a. "Do you take aspirin on a daily basis?"
b. "What time did your chest pain begin?" Correct -
c. "Is there any family history of heart disease?"
