SITUATIONAL EXAMS MIDTERM COVERAGE
1. Examination of a patient in a supine position reveals distended jugular veins from the base of the neck to the angle of
the jaw. This finding indicates:
A. decreased venous return.
B. increased central venous pressure.
C. increased pulmonary artery capillary pressure.
D. left-sided heart failure.
2. When caring for a patient who has intermittent claudication, the cardiac-vascular nurse advises the patient to:
A. apply graduated compression stockings before getting out of bed.
B. elevate their legs when sitting.
C. refrain from exercising.
D. walk as tolerated.
3. Which factor is most closely associated with successful smoking cessation?
A. Enrollment in a short-term support group.
B. Lack of reliance on nicotine gum as a secondary intervention.
C. Preparation of a plan to deal with potential relapses.
D. Reliance on a single intervention.
4. A patient who is in the 10th week of outpatient cardiac rehabilitation continues to exhibit symptoms of depression.
When developing a discharge plan, the cardiac-vascular nurse includes:
A. a referral for counseling and possible medication.
B. a trial of herbal remedies.
C. alternative therapies, including yoga and massage.
D. comprehensive information about the patient's cardiac status to help reduce their anxiety.
5. When reviewing a patient's four-week diet history, the cardiac-vascular nurse identifies a pattern of high-calorie intake
on Monday, Wednesday, and Friday nights. The patient states that their spouse recently started taking a night class on
those evenings at a local university. The patient's diet history indicates:
A. a disabling family coping behavior.
B. a lack of dietary instruction.
C. a need for cooking classes.
D. an individual coping behavior.
7. As the cardiac-vascular nurse prepares to administer an experimental cardiac drug to a patient who is participating in a
research study, the patient states that they no longer want the medication. The nurse advises the patient that:
A. participation in the study is critical to improving the quality of patient outcomes.
B. the medication dose has been scheduled for administration.
C. the primary investigator will speak with the patient about their decision.
D. they have the right to refuse the medication and to withdraw from the study.
8. What is the primary consideration when preparing to administer thrombolytic therapy to a patient who is experiencing
an acute myocardial infarction (MI)?
A. History of heart disease.
B. Sensitivity to aspirin.
C. Size and location of the MI.
D. Time since onset of symptoms.
, 9. A 55-year-old patient who is diagnosed with an evolving myocardial infarction (MI) insists on going home. The
cardiac-vascular nurse encourages the patient to be admitted because the greatest risk within the first 24 hours of
sustaining an MI is:
A. heart failure.
B. pulmonary embolism.
C. ventricular aneurysm.
D. ventricular fibrillation.
10. A patient comes to the emergency department (ED) and reports a swollen and painful leg but denies sustaining any
injury. The physical examination reveals a tense calf muscle, decreased sensation to the foot and leg, and absent pedal
pulses. The cardiac-vascular nurse asks the patient when the symptoms began because:
A. arterial thrombosis is sudden and emergent, and an embolism develops gradually.
B. compartment syndrome develops days after an arterial occlusion.
C. irreversible anoxic injury to muscles and nerves can occur in as few as four hours.
D. metabolic alkalosis from muscle swelling is cardiotoxic.
11. A primary prevention for reducing a female patient's risk of developing coronary heart disease is to:
A. avoid excessive weight gain during pregnancy.
B. enroll in a cardiac rehabilitation program.
C. take 81 mg/d.
D. take nitroglycerin (Nitrostat) at the onset of chest pain.
12. Excessive alcohol use while on warfarin sodium (Coumadin) therapy leads to:
A. decreased anticoagulation effect.
B. decreased international normalized ratio.
C. increased anticoagulation effect.
D. increased vitamin K absorption.
13. While the cardiac-vascular nurse preceptor is orienting a graduate nurse on the telemetry unit, a patient experiences
cardiac arrest. Which action by the preceptor, during the emergency cardiac care procedure, facilitates the graduate
nurse's competence and professional development?
A. Asking the graduate nurse to review the policy and procedure for cardiac arrest.
B. Assigning the graduate nurse to comfort the family during the arrest.
C. Directing the graduate nurse to attempt IV access.
D. Involving the graduate nurse in the resuscitation by assigning a basic task.
14. A patient is admitted to the hospital for a carotid angiogram with stent placement. The patient's spouse states, "I
don't want my spouse to find out there is a risk of a stroke connected with this procedure because they won't sign the
consent form." The cardiac-vascular nurse's most appropriate action is to:
A. assess the patient's level of understanding of the risks, benefits, and alternatives.
B. assure the patient's spouse that the risk of stroke is minimal.
C. offer the patient emotional support and reinforce the benefits of the procedure.
D. perform a neurologic assessment to establish a baseline.
15. A patient who is recovering from a myocardial infarction may benefit from meditation because this technique:
A. decreases sympathetic nervous system activity.
B. decreases vasodilation.
C. increases sympathetic nervous system activity.
1. Examination of a patient in a supine position reveals distended jugular veins from the base of the neck to the angle of
the jaw. This finding indicates:
A. decreased venous return.
B. increased central venous pressure.
C. increased pulmonary artery capillary pressure.
D. left-sided heart failure.
2. When caring for a patient who has intermittent claudication, the cardiac-vascular nurse advises the patient to:
A. apply graduated compression stockings before getting out of bed.
B. elevate their legs when sitting.
C. refrain from exercising.
D. walk as tolerated.
3. Which factor is most closely associated with successful smoking cessation?
A. Enrollment in a short-term support group.
B. Lack of reliance on nicotine gum as a secondary intervention.
C. Preparation of a plan to deal with potential relapses.
D. Reliance on a single intervention.
4. A patient who is in the 10th week of outpatient cardiac rehabilitation continues to exhibit symptoms of depression.
When developing a discharge plan, the cardiac-vascular nurse includes:
A. a referral for counseling and possible medication.
B. a trial of herbal remedies.
C. alternative therapies, including yoga and massage.
D. comprehensive information about the patient's cardiac status to help reduce their anxiety.
5. When reviewing a patient's four-week diet history, the cardiac-vascular nurse identifies a pattern of high-calorie intake
on Monday, Wednesday, and Friday nights. The patient states that their spouse recently started taking a night class on
those evenings at a local university. The patient's diet history indicates:
A. a disabling family coping behavior.
B. a lack of dietary instruction.
C. a need for cooking classes.
D. an individual coping behavior.
7. As the cardiac-vascular nurse prepares to administer an experimental cardiac drug to a patient who is participating in a
research study, the patient states that they no longer want the medication. The nurse advises the patient that:
A. participation in the study is critical to improving the quality of patient outcomes.
B. the medication dose has been scheduled for administration.
C. the primary investigator will speak with the patient about their decision.
D. they have the right to refuse the medication and to withdraw from the study.
8. What is the primary consideration when preparing to administer thrombolytic therapy to a patient who is experiencing
an acute myocardial infarction (MI)?
A. History of heart disease.
B. Sensitivity to aspirin.
C. Size and location of the MI.
D. Time since onset of symptoms.
, 9. A 55-year-old patient who is diagnosed with an evolving myocardial infarction (MI) insists on going home. The
cardiac-vascular nurse encourages the patient to be admitted because the greatest risk within the first 24 hours of
sustaining an MI is:
A. heart failure.
B. pulmonary embolism.
C. ventricular aneurysm.
D. ventricular fibrillation.
10. A patient comes to the emergency department (ED) and reports a swollen and painful leg but denies sustaining any
injury. The physical examination reveals a tense calf muscle, decreased sensation to the foot and leg, and absent pedal
pulses. The cardiac-vascular nurse asks the patient when the symptoms began because:
A. arterial thrombosis is sudden and emergent, and an embolism develops gradually.
B. compartment syndrome develops days after an arterial occlusion.
C. irreversible anoxic injury to muscles and nerves can occur in as few as four hours.
D. metabolic alkalosis from muscle swelling is cardiotoxic.
11. A primary prevention for reducing a female patient's risk of developing coronary heart disease is to:
A. avoid excessive weight gain during pregnancy.
B. enroll in a cardiac rehabilitation program.
C. take 81 mg/d.
D. take nitroglycerin (Nitrostat) at the onset of chest pain.
12. Excessive alcohol use while on warfarin sodium (Coumadin) therapy leads to:
A. decreased anticoagulation effect.
B. decreased international normalized ratio.
C. increased anticoagulation effect.
D. increased vitamin K absorption.
13. While the cardiac-vascular nurse preceptor is orienting a graduate nurse on the telemetry unit, a patient experiences
cardiac arrest. Which action by the preceptor, during the emergency cardiac care procedure, facilitates the graduate
nurse's competence and professional development?
A. Asking the graduate nurse to review the policy and procedure for cardiac arrest.
B. Assigning the graduate nurse to comfort the family during the arrest.
C. Directing the graduate nurse to attempt IV access.
D. Involving the graduate nurse in the resuscitation by assigning a basic task.
14. A patient is admitted to the hospital for a carotid angiogram with stent placement. The patient's spouse states, "I
don't want my spouse to find out there is a risk of a stroke connected with this procedure because they won't sign the
consent form." The cardiac-vascular nurse's most appropriate action is to:
A. assess the patient's level of understanding of the risks, benefits, and alternatives.
B. assure the patient's spouse that the risk of stroke is minimal.
C. offer the patient emotional support and reinforce the benefits of the procedure.
D. perform a neurologic assessment to establish a baseline.
15. A patient who is recovering from a myocardial infarction may benefit from meditation because this technique:
A. decreases sympathetic nervous system activity.
B. decreases vasodilation.
C. increases sympathetic nervous system activity.
