Med Surg Cardiac UPDATED ACTUAL
Exam Questions and CORRECT Answers
Which of the following is an early warning symptom of acute coronary syndrome (ACS) and
heart failure (HF)? - CORRECT ANSWER - Fatigue
During the auscultation of a patient's heart sounds, the nurse notes an S4. The nurse recognizes
that an S4 is associated with which of the following? - CORRECT ANSWER -
Hypertensive heart disease
Auscultation of the heart requires familiarization with normal and abnormal heart sounds. An
extra sound just before S1 is an S4 heart sound, or atrial gallop. An S4 sound often is associated
with hypertensive heart disease. A sound that follows S1 and S2 is called an S3 heart sound or a
ventricular gallop. An S3 heart sound is often an indication of heart failure in an adult. In
addition to heart sounds, auscultation may reveal other abnormal sounds, such as murmurs and
clicks, caused by turbulent blood flow through diseased heart valves.
The nurse accompanies a client to an exercise stress test. The client can achieve the "target heart
rate," but the ECG leads show an ST-segment elevation. The nurse recognizes this as a "positive"
stress test, and will begin to prepare the client for which of the following procedures? -
CORRECT ANSWER - Cardiac catheterization
An elevated ST-segment means an evolving myocardial infarction. A cardiac catheterization
would be the logical next step.
A patient's heart rate is observed to be 140 bpm on the monitor. The nurse knows that the patient
is at risk for what complication? - CORRECT ANSWER - Myocardial ischemia
As heart rate increases, diastolic time is shortened, which may not allow adequate time for
myocardial perfusion. As a result, patients are at risk for myocardial ischemia (inadequate
oxygen supply) during tachycardias (heart rate greater than 100 bpm), especially patients with
coronary artery disease.
The nurse is caring for a client on a monitored telemetry unit. During morning assessment, the
nurse notes abnormal ECG waves on the telemetry monitor. Which action would the nurse do
first? - CORRECT ANSWER - Assess the client
, When a nurse notes an abnormal rhythm on a telemetry monitor, the first action is to assess the
client. After client assessment, the nurse is able to make an informed decision on the next
nursing action.
The nurse is educating a patient at risk for atherosclerosis. What nonmodifiable risk factor does
the nurse identify for the patient? - CORRECT ANSWER - Positive family history
The health history provides an opportunity for the nurse to assess patients' understanding of their
personal risk factors for coronary artery, peripheral vascular, and cerebrovascular diseases (see
Chart 27-1 in Chapter 27) and any measures that they are taking to modify these risks. Risk
factors are classified by the extent to which they can be modified by changing one's lifestyle or
modifying personal behaviors. Stress, obesity, and hyperlipidemia are all risk factors that can be
modified by personal behaviors. Family history is a nonmodifiable risk factor, because it cannot
be changed.
A patient is being scheduled for a stress test. The patient is unable to exercise during the test. The
nurse would include information about which medication used for pharmacologic stress testing?
- CORRECT ANSWER - Dipyridamole
If the patient is unable to exercise, a pharmacologic stress test is performed by injecting a
vasodilating agent, dipyridamole (Persantine) or adenosine (Adenocard), to mimic the
physiologic effects of exercise. The stress test may be combined with an echocardiogram or
radionuclide imaging techniques to examine myocardial function during exercise and rest.
Digoxin would not be used for stress testing. Thallium 201 and Cardiolite are radioisotopes used
in myocardial perfusion scanning. (less)
Identify which of the following as an age-related change associated with conduction system of
the heart?
a) Thrills
b) Tachycardia
c) Heart block
d) Murmur - CORRECT ANSWER - Heart block
Age-related changes to the conduction system may include bradycardia and heart block. Age-
related changes to the heart valves include the presence of a murmur or thrill.
Exam Questions and CORRECT Answers
Which of the following is an early warning symptom of acute coronary syndrome (ACS) and
heart failure (HF)? - CORRECT ANSWER - Fatigue
During the auscultation of a patient's heart sounds, the nurse notes an S4. The nurse recognizes
that an S4 is associated with which of the following? - CORRECT ANSWER -
Hypertensive heart disease
Auscultation of the heart requires familiarization with normal and abnormal heart sounds. An
extra sound just before S1 is an S4 heart sound, or atrial gallop. An S4 sound often is associated
with hypertensive heart disease. A sound that follows S1 and S2 is called an S3 heart sound or a
ventricular gallop. An S3 heart sound is often an indication of heart failure in an adult. In
addition to heart sounds, auscultation may reveal other abnormal sounds, such as murmurs and
clicks, caused by turbulent blood flow through diseased heart valves.
The nurse accompanies a client to an exercise stress test. The client can achieve the "target heart
rate," but the ECG leads show an ST-segment elevation. The nurse recognizes this as a "positive"
stress test, and will begin to prepare the client for which of the following procedures? -
CORRECT ANSWER - Cardiac catheterization
An elevated ST-segment means an evolving myocardial infarction. A cardiac catheterization
would be the logical next step.
A patient's heart rate is observed to be 140 bpm on the monitor. The nurse knows that the patient
is at risk for what complication? - CORRECT ANSWER - Myocardial ischemia
As heart rate increases, diastolic time is shortened, which may not allow adequate time for
myocardial perfusion. As a result, patients are at risk for myocardial ischemia (inadequate
oxygen supply) during tachycardias (heart rate greater than 100 bpm), especially patients with
coronary artery disease.
The nurse is caring for a client on a monitored telemetry unit. During morning assessment, the
nurse notes abnormal ECG waves on the telemetry monitor. Which action would the nurse do
first? - CORRECT ANSWER - Assess the client
, When a nurse notes an abnormal rhythm on a telemetry monitor, the first action is to assess the
client. After client assessment, the nurse is able to make an informed decision on the next
nursing action.
The nurse is educating a patient at risk for atherosclerosis. What nonmodifiable risk factor does
the nurse identify for the patient? - CORRECT ANSWER - Positive family history
The health history provides an opportunity for the nurse to assess patients' understanding of their
personal risk factors for coronary artery, peripheral vascular, and cerebrovascular diseases (see
Chart 27-1 in Chapter 27) and any measures that they are taking to modify these risks. Risk
factors are classified by the extent to which they can be modified by changing one's lifestyle or
modifying personal behaviors. Stress, obesity, and hyperlipidemia are all risk factors that can be
modified by personal behaviors. Family history is a nonmodifiable risk factor, because it cannot
be changed.
A patient is being scheduled for a stress test. The patient is unable to exercise during the test. The
nurse would include information about which medication used for pharmacologic stress testing?
- CORRECT ANSWER - Dipyridamole
If the patient is unable to exercise, a pharmacologic stress test is performed by injecting a
vasodilating agent, dipyridamole (Persantine) or adenosine (Adenocard), to mimic the
physiologic effects of exercise. The stress test may be combined with an echocardiogram or
radionuclide imaging techniques to examine myocardial function during exercise and rest.
Digoxin would not be used for stress testing. Thallium 201 and Cardiolite are radioisotopes used
in myocardial perfusion scanning. (less)
Identify which of the following as an age-related change associated with conduction system of
the heart?
a) Thrills
b) Tachycardia
c) Heart block
d) Murmur - CORRECT ANSWER - Heart block
Age-related changes to the conduction system may include bradycardia and heart block. Age-
related changes to the heart valves include the presence of a murmur or thrill.
