DYSRHYTHMIAS PRACTICE
QUESTIONS AND ANSWERS LATEST
UPDATE 2025 WITH RATIONALES
When developing a health teaching plan for a 65-year-old patient with all these risk
factors for coronary artery disease (CAD), the nurse will focus on the
a.
family history of heart disease.
b.
increased risk associated with the patient's ethnicity.
c.
high incidence of cardiovascular disease in older people.
d.
low activity level the patient reports. - answers Correct Answer: D
Rationale: Because family history, ethnicity, and age are nonmodifiable risk factors, the
nurse should focus on the patient's activity level. An increase in activity will help reduce
the patient's risk for developing CAD.
Cognitive Level: Application Text Reference: pp. 790-792
Nursing Process: Planning
NCLEX: Health Promotion and Maintenance
the nurse is admitting a patient who is complaining of chest pain to the emergency
department (ED). Which information collected by the nurse suggests that the pain is
caused by an acute myocardial infarction (AMI)?
a.
The pain worsens when the patient raises the arms.
b.
The pain increases with deep breathing.
c.
The pain is relieved after the patient takes nitroglycerin.
d.
The pain has persisted longer than 30 minutes. - answers Correct Answer: D
Rationale: Chest pain that lasts for 20 minutes or more is characteristic of AMI.
Changes in pain that occur with raising the arms or with deep breathing are more typical
of pericarditis or musculoskeletal pain. Stable angina is usually relieved when the
patient takes nitroglycerin.
Cognitive Level: Application Text Reference: p. 803
Nursing Process: Assessment NCLEX: Physiological Integrity
A patient is admitted to the ED after an episode of severe chest pain, and the physician
schedules the patient for coronary angiography and possible percutaneous coronary
,intervention (PCI). The nurse prepares the patient for the procedure by explaining that it
is used to
a.
determine whether there are any structural defects in the chambers of the heart.
b.
locate any coronary artery obstructions and administer thrombolytic agents.
c.
measure the amount of blood being pumped from the heart with each contraction.
d.
visualize any coronary artery blockages and dilate any obstructed arteries. - answers
Correct Answer: D
Rationale: Visualization of the coronary arteries and possible balloon dilation are
scheduled for this patient. Thrombolytic therapy is an alternative treatment if the patient
is experiencing acute coronary syndrome (ACS) but is not the ordered therapy for this
patient. Although angiography might help to detect structural defects or changes in
cardiac output, it is not the reason for the procedure in this patient with symptoms of
CAD.
Cognitive Level: Application Text Reference: p. 807
Nursing Process: Implementation NCLEX: Physiological Integrity
Which information given by a patient admitted with chronic stable angina will help the
nurse confirm this diagnosis?
a.
The patient rates the pain at a level 3 to 5 (0-10 scale).
b.
The patient states that the pain "wakes me up at night."
c.
The patient indicates that the pain is resolved after taking one sublingual nitroglycerin
tablet.
d.
The patient says that the frequency of the pain has increased over the last few weeks. -
answers Correct Answer: C
Rationale: Chronic stable angina is typically relieved by rest or nitroglycerin
administration. The level of pain is not a consistent indicator of the type of angina. Pain
occurring at rest or with increased frequency is typical of unstable angina.
Cognitive Level: Application Text Reference: p. 798
Nursing Process: Assessment NCLEX: Physiological Integrity
Which electrocardiographic (ECG) change will be of most concern to the nurse when
admitting a patient with chest pain?
a.
Sinus tachycardia
b.
Inverted T wave
,c.
ST-segment elevation
d.
Frequent PACs - answers Correct Answer: C
Rationale: The patient is likely to be experiencing an ST-segment-elevation myocardial
infarction (STEMI) and immediate therapy with PCI or fibrinolytic medications is
indicated to minimize the amount of myocardial damage. The other ECG changes also
suggest a need for therapy, but not as rapidly.
A patient who has had severe chest pain for the last 4 hours is admitted with a
diagnosis of possible AMI. Which of these ordered laboratory tests should the nurse
monitor to help determine whether the patient has had an MI?
a.
Troponin levels
b.
C-reactive protein
c.
High-density lipoprotein (HDL) cholesterol
d.
Homocysteine - answers Correct Answer: A
Rationale: Troponin levels increase about 3 hours after the onset of MI. The other
laboratory data are useful in determining the patient's risk for developing CAD but are
not helpful in determining whether an acute MI is in progress.
Cognitive Level: Application Text Reference: pp. 805-806
Nursing Process: Assessment NCLEX: Physiological Integrity
Nifedipine (Procardia) is ordered for a patient with newly diagnosed Prinzmetal's
(variant) angina. When teaching the patient, the nurse will include the information that
Procardia will
a.
help to prevent clotting in the coronary arteries.
b.
decrease spasm of the coronary arteries.
c.
increase the force of myocardial contraction.
d.
reduce the "fight or flight" response. - answers Correct Answer: B
Rationale: Prinzmetal's angina is caused by coronary artery spasm. Calcium-channel
blockers (e.g., nifedipine) are a first-line therapy for this type of angina. Platelet
inhibitors, such as aspirin, help to prevent coronary artery thrombosis, and β-blockers
decrease sympathetic stimulation of the heart. Medications or activities that increase
myocardial contractility will increase the incidence of angina by increasing oxygen
demand.
Cognitive Level: Application Text Reference: p. 801
, Nursing Process: Implementation NCLEX: Physiological Integrity
A patient with chronic stable angina is being treated with metoprolol (Lopressor). The
nurse will suspect that the patient is experiencing a side effect of the metoprolol if
a.
the patient is restless and agitated.
b.
the BP is 190/110 mm Hg.
c.
the cardiac monitor shows a heart rate of 45.
d.
the patient complains about feeling anxious. - answers Correct Answer: C
Rationale: Patients taking β-blockers should be monitored for bradycardia. Because this
category of medication inhibits the sympathetic nervous system, restless, agitation,
hypertension, and anxiety will not be side effects.
Cognitive Level: Application Text Reference: p. 801
Nursing Process: Evaluation NCLEX: Physiological Integrity
A patient with a non-ST segment elevation myocardial infarction (NSTEMI) is receiving
heparin. What is the purpose of the heparin?
a.
Heparin will dissolve the clot that is blocking blood flow to the heart.
b.
Coronary artery plaque size and adherence are decreased with heparin.
c.
Heparin will prevent the development of clots in the coronary arteries.
d.
Platelet aggregation is enhanced by IV heparin infusion. - answers Correct Answer: C
Rationale: Heparin helps prevent the conversion of fibrinogen to fibrin and decreases
coronary artery thrombosis. It does not change coronary artery plaque, dissolve already
formed clots, or enhance platelet aggregation.
Cognitive Level: Comprehension Text Reference: p. 800
Nursing Process: Implementation NCLEX: Physiological Integrity
While admitting a patient with an AMI, which action should the nurse carry out first?
a.
Assess peripheral pulses.
b.
Check the oxygen saturation.
c.
Attach the cardiac monitor.
d.
Obtain the BP. - answers Correct Answer: C
QUESTIONS AND ANSWERS LATEST
UPDATE 2025 WITH RATIONALES
When developing a health teaching plan for a 65-year-old patient with all these risk
factors for coronary artery disease (CAD), the nurse will focus on the
a.
family history of heart disease.
b.
increased risk associated with the patient's ethnicity.
c.
high incidence of cardiovascular disease in older people.
d.
low activity level the patient reports. - answers Correct Answer: D
Rationale: Because family history, ethnicity, and age are nonmodifiable risk factors, the
nurse should focus on the patient's activity level. An increase in activity will help reduce
the patient's risk for developing CAD.
Cognitive Level: Application Text Reference: pp. 790-792
Nursing Process: Planning
NCLEX: Health Promotion and Maintenance
the nurse is admitting a patient who is complaining of chest pain to the emergency
department (ED). Which information collected by the nurse suggests that the pain is
caused by an acute myocardial infarction (AMI)?
a.
The pain worsens when the patient raises the arms.
b.
The pain increases with deep breathing.
c.
The pain is relieved after the patient takes nitroglycerin.
d.
The pain has persisted longer than 30 minutes. - answers Correct Answer: D
Rationale: Chest pain that lasts for 20 minutes or more is characteristic of AMI.
Changes in pain that occur with raising the arms or with deep breathing are more typical
of pericarditis or musculoskeletal pain. Stable angina is usually relieved when the
patient takes nitroglycerin.
Cognitive Level: Application Text Reference: p. 803
Nursing Process: Assessment NCLEX: Physiological Integrity
A patient is admitted to the ED after an episode of severe chest pain, and the physician
schedules the patient for coronary angiography and possible percutaneous coronary
,intervention (PCI). The nurse prepares the patient for the procedure by explaining that it
is used to
a.
determine whether there are any structural defects in the chambers of the heart.
b.
locate any coronary artery obstructions and administer thrombolytic agents.
c.
measure the amount of blood being pumped from the heart with each contraction.
d.
visualize any coronary artery blockages and dilate any obstructed arteries. - answers
Correct Answer: D
Rationale: Visualization of the coronary arteries and possible balloon dilation are
scheduled for this patient. Thrombolytic therapy is an alternative treatment if the patient
is experiencing acute coronary syndrome (ACS) but is not the ordered therapy for this
patient. Although angiography might help to detect structural defects or changes in
cardiac output, it is not the reason for the procedure in this patient with symptoms of
CAD.
Cognitive Level: Application Text Reference: p. 807
Nursing Process: Implementation NCLEX: Physiological Integrity
Which information given by a patient admitted with chronic stable angina will help the
nurse confirm this diagnosis?
a.
The patient rates the pain at a level 3 to 5 (0-10 scale).
b.
The patient states that the pain "wakes me up at night."
c.
The patient indicates that the pain is resolved after taking one sublingual nitroglycerin
tablet.
d.
The patient says that the frequency of the pain has increased over the last few weeks. -
answers Correct Answer: C
Rationale: Chronic stable angina is typically relieved by rest or nitroglycerin
administration. The level of pain is not a consistent indicator of the type of angina. Pain
occurring at rest or with increased frequency is typical of unstable angina.
Cognitive Level: Application Text Reference: p. 798
Nursing Process: Assessment NCLEX: Physiological Integrity
Which electrocardiographic (ECG) change will be of most concern to the nurse when
admitting a patient with chest pain?
a.
Sinus tachycardia
b.
Inverted T wave
,c.
ST-segment elevation
d.
Frequent PACs - answers Correct Answer: C
Rationale: The patient is likely to be experiencing an ST-segment-elevation myocardial
infarction (STEMI) and immediate therapy with PCI or fibrinolytic medications is
indicated to minimize the amount of myocardial damage. The other ECG changes also
suggest a need for therapy, but not as rapidly.
A patient who has had severe chest pain for the last 4 hours is admitted with a
diagnosis of possible AMI. Which of these ordered laboratory tests should the nurse
monitor to help determine whether the patient has had an MI?
a.
Troponin levels
b.
C-reactive protein
c.
High-density lipoprotein (HDL) cholesterol
d.
Homocysteine - answers Correct Answer: A
Rationale: Troponin levels increase about 3 hours after the onset of MI. The other
laboratory data are useful in determining the patient's risk for developing CAD but are
not helpful in determining whether an acute MI is in progress.
Cognitive Level: Application Text Reference: pp. 805-806
Nursing Process: Assessment NCLEX: Physiological Integrity
Nifedipine (Procardia) is ordered for a patient with newly diagnosed Prinzmetal's
(variant) angina. When teaching the patient, the nurse will include the information that
Procardia will
a.
help to prevent clotting in the coronary arteries.
b.
decrease spasm of the coronary arteries.
c.
increase the force of myocardial contraction.
d.
reduce the "fight or flight" response. - answers Correct Answer: B
Rationale: Prinzmetal's angina is caused by coronary artery spasm. Calcium-channel
blockers (e.g., nifedipine) are a first-line therapy for this type of angina. Platelet
inhibitors, such as aspirin, help to prevent coronary artery thrombosis, and β-blockers
decrease sympathetic stimulation of the heart. Medications or activities that increase
myocardial contractility will increase the incidence of angina by increasing oxygen
demand.
Cognitive Level: Application Text Reference: p. 801
, Nursing Process: Implementation NCLEX: Physiological Integrity
A patient with chronic stable angina is being treated with metoprolol (Lopressor). The
nurse will suspect that the patient is experiencing a side effect of the metoprolol if
a.
the patient is restless and agitated.
b.
the BP is 190/110 mm Hg.
c.
the cardiac monitor shows a heart rate of 45.
d.
the patient complains about feeling anxious. - answers Correct Answer: C
Rationale: Patients taking β-blockers should be monitored for bradycardia. Because this
category of medication inhibits the sympathetic nervous system, restless, agitation,
hypertension, and anxiety will not be side effects.
Cognitive Level: Application Text Reference: p. 801
Nursing Process: Evaluation NCLEX: Physiological Integrity
A patient with a non-ST segment elevation myocardial infarction (NSTEMI) is receiving
heparin. What is the purpose of the heparin?
a.
Heparin will dissolve the clot that is blocking blood flow to the heart.
b.
Coronary artery plaque size and adherence are decreased with heparin.
c.
Heparin will prevent the development of clots in the coronary arteries.
d.
Platelet aggregation is enhanced by IV heparin infusion. - answers Correct Answer: C
Rationale: Heparin helps prevent the conversion of fibrinogen to fibrin and decreases
coronary artery thrombosis. It does not change coronary artery plaque, dissolve already
formed clots, or enhance platelet aggregation.
Cognitive Level: Comprehension Text Reference: p. 800
Nursing Process: Implementation NCLEX: Physiological Integrity
While admitting a patient with an AMI, which action should the nurse carry out first?
a.
Assess peripheral pulses.
b.
Check the oxygen saturation.
c.
Attach the cardiac monitor.
d.
Obtain the BP. - answers Correct Answer: C
