ENHANCEMENT REVIEW
EVALUATIVE EXAMINATION
CARDIOLOGY
1. Which among the following is a main indicator of shock D. May be a forerunner of hemorrhage
presence or progression during the INITIAL stage of 11. You observe a nursing student taking a blood pressure
hypovolemic shock? (BP) ona patient. The patient’s BP range over the past 24
A. Blood pressure hours is135/65 to 125/70 mm Hg. The student used a BP
B. Respiratory rate cuff that wastoo narrow for the patient. Which of the
C. Pulse rate following BP readingsmade by the student is most likely
D. Temperature caused by the incorrectchoice of BP cuff?
2. Myocardial infarction leads to which type of shock? A. 90/40 mmHg
A. Distributive shock B. 130/70 mmHg
B. Neurogenic shock C. 120/60 mmHg
C. Cardiogenic shock D. 160/80 mmHg
D. Hypovolemic shock 12. After endorsements, you receive the following four
3. Kristine asked the nurse floater why furosemide is given to patients. Which among them should you assess FIRST?
a patient with congestive heart failure The correct A. 54-year-old woman who had surgery for a
response of the nurse is that it fractured arm, BP 160/86, HR 72bpm
A. Lowers the preload B. 750year-old woman who had mastectomy of the
B. Constricts the arteries left breast, with RR 22 and BP 148/62
C. Decreases the afterload C. 63-year-old man with ulcers from diabetes,
D. Increases the afterload temperature of 37.3C, HR 84
4. Being new in the cardiac unit, Kristine emphasized to the D. 89-year-old man who has pneumonia, RR 28,
nurse floater that the long standing hallmark in nursing SpO2 89%
intervention for patients taking Digoxin is 13. A patient presents in the clinic with dizziness and fatigue.
A. Checking the BP with same apparatus Thenursing assistant reports a very slow radial pulse of
B. Palpate the radial pulse for pulsusalternans 44. What would be your FIRST intervention?
C. Taking the apical rate for one full minute A. Call for an electrocardiogram STAT.
D. Monitor intake and output hourly B. Assess for apical pulse and any evidence of pulse
5. what is the priority adverse effect of captopril? deficit
A. angioedema C. Request the nursing assistant to repeat
B. persistent cough assessment of radial pulse.
C. hypotension D. Prepare to institute cardiac-life support
D. hypertenson interventions.
6. What is incorrect teaching about nitroglycerine? 14. A client has a history of heart failure and hasbeen taking
A. stock for 6-8mos several medications, including furosemide(Lasix), digoxin
B. store in amber colored container (Lanoxin) and potassiumchloride. The client has nausea,
C. max 3 tabs in 5 min interval blurred vision,headache, and weakness. The nurse notes
D. rotate sites for patches that theclient is confused. The telemetry strip shows
7. While on rounds a patient asks Kristine why she is firstdegreeatrioventricular block. The nurse shouldassess
receiving Enoxaparin for prevention of deep vein the client for signs of which condition?
thrombosis when, with last hip surgery she received A. Hyperkalemia.
heparin. The nurse is correct in saying which of the B. Digoxin toxicity.
following? C. Fluid deficit.
A. Enoxaparin is less expensive and easier to D. Pulmonary edema.
administer than heparin 15. The physician orders continuous intravenous nitroglycerin
B. There is less risk of bleeding and does not affect infusion for the client with
laboratory results MI. Essential nursing actions include which of the following?
C. Enoxaparin lasts twice as long as heparin A. Obtaining an infusion pump for medication
D. Enoxaparin can be given orally while heparin by B. Monitoring BP every 4 hours
injection C. Monitoring urine output hourly
8. A client with acute chest pain is receivingI.V. morphine D. Obtaining serum potassium daily
sulfate. Which of the following resultsare intended effects 16. A nurse is assessing a client with heartfailure. The nurse
of morphine in this client EXCEPT? should assess the client based onwhich compensatory
A. Reduces myocardial oxygen consumption. mechanisms that are activatedin the presence of heart
B. Promotes reduction in respiratory rate. failure Except?
C. Reduces blood pressure and heart rate. A. Ventricular hypertrophy.
D. Reduces anxiety and fear. B. Renin-angiotensin-aldosterone system.
9. what is the best procedure for TYPE A aortic aneurysms? C. Jugular venous distention.
A. STAT SURGICAL CLIPPING D. Sympathetic nervous stimulation.
B. DM MGT 17. Which of the following sets of conditions isan indication
C. HYPERTENSION CONTROL that a client with a history of left-sidedheart failure is
D. LIFESTYLE MODIFICATIONS developing pulmonary edema?
10. Another client has undergone an Open-Heart surgery and A. Distended jugular veins and wheezing.
he develops a temperature of 102°F (38.8°C). The Nurse B. Dependent edema and anorexia.
notifies the Physician because elevated temperature: C. Coarse crackles and tachycardia.
A. Increases the cardiac output D. Hypotension and tachycardia.
B. May be indicate cerebral edema 18. How do you assess systolic bruit?
C. Are likely to lead to diaphoresis A. auscultate using bell at epigastric area
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B. b. auscultate using diaphragm at epigastric area B. Vagal stimulation
C. c. palpate the epigastric area C. Appearance of blisters
D. d. percuss the epigastric area D. Perforation of the stomach
19. what is a sign of right sided heart failure except? 31. What is the diet for patients with CHF?
A. activity intolerance A. Low sodium
B. edema B. Low potassium
C. rbc hemolysis
C. Low phosphorous
D. elevated CVP
20. What is the diagnostic test for CHF? D. Low calcium
A. Brain natriuretic peptide 32. Which type of shock is a complication of massive
hemorrhage in a patient who underwent surgery?
B. 2d echo
A. Distributive shock
C. CXR B. Neurogenic shock
D. ECG C. Cardiogenic shock
21. Which laboratory test is not related to cardiac damage? D. Hypovolemic shock
A. CKMB 33. Which of the following nursing diagnosiswould be
B. TROP I appropriate for a client with systolic heartfailure except?
A. Ineffective peripheral tissue perfusion relatedto a
C. TROP T
decreased stroke volume.
D. MYOGLOBIN B. Activity intolerance related to impaired
22. A client with angina complains that the anginal pain is gasexchange and perfusion.
prolonged and severe and occurs at the same time of each C. Dyspnea related to pulmonary congestion
day, most often at rest in the absence of precipitating andimpaired gas exchange.
factors. How would the nurse best describe this type of D. Decreased cardiac output related to impaired
anginal pain? cardiac filling.
A. Stable angina E. Impaired renal perfusion related to adecreased
B. Variant angina cardiac output
C. Unstable angina 34. What is the leading cause of MI?
D. Nonanginal pain A. CAD
23. What is the priority assessment in patients before B. Drug abuse
angiography? C. high fat diet
A. VS D. sedentary lifestyle
B. status of pulses 35. what is the number one predisposing factor for CAD?
C. weight A. Emotional stress
D. height B. excessive exercise
24. Which of the following diuretics causes hyperkalemia? C. excessive eating
A. Spironolactone D. excessive loving
B. Lasix 36. The nurse document that a client’s Pulse pressure is
C. Hydrochlorothiazide decreasing. To determine the accuracy of this statement,
D. Furoscan what must the Nurse calculate?
A. Force exerted against an Arterial wall
25. To hasten the absorption of a nitroglycerine tablet, the
B. Different between the Apical and Radial rates
nurse floater should instruct a patient to
C. Difference between Systolic and Diastolic readings
A. Move the tablet around with the tip of the tongue
D. May be a forerunner of Hemorrhage
B. Break up the tablet before placing it under the
37. What statement about angina is false?
tongue
C. Place the tablet under the tongue along with A. It is reversible
warm water B. Radiates on right shoulder and arm
D. Swallow saliva before placing the tablet under the C. Main drug is nitroglycerine
tongue D. Caused by myocardial ischemia
26. A client experiences initial indications of excitation after 38. When teaching a client with MI, the nurse explains that
having an I.V. infusion of lidocaine hydrochloride started. the pain associated with MI is caused by:
The nurse should further assess the client when the client A. Left ventricle overload
reports having: B. Impending circulatory collapse
A. Palpitations. C. Extracellular electrolyte imbalance
B. Tinnitus. D. Insufficient oxygen reaching the heart muscle
C. Urinary frequency. 39. A 70-year-old female is scheduled to undergo mitral valve
D. Lethargy. replacement for severe mitral stenosis and mitral
27. What is the byproduct of ace inhibitor metabolism? regurgitation. Although the diagnosis was made during
A. bradykinin childhood, she did not have symptoms until 4 years ago.
B. ammonia Recently, she noticed increased symptoms, despite daily
C. urea doses of digoxin and furosemide. During the initial
D. tachycardia interview with the client, the nurse would most likely learn
28. What is the reaction of metformin with dye? that the client’s childhood health history included:
A. Increases toxicity A. Chickenpox.
B. Decreases renal clearance B. Poliomyelitis.
C. Bronchospasm C. Rheumatic fever.
D. Increase in potassium D. Meningitis.
29. Patient Carol has sore throat frequently because she is 40. Patient Jo is suffering from cardiac embolism because of
usually fond of sweets and a lot of senseless loquacious illicit drug use and improper injections. What is the clinical
talking. What is her greatest risk factor? symptom of embolisms?
A. Rheahumatic heart disease A. Chest pain
B. CHF B. Diaphoresis
C. Angina C. DOB
D. MI D. Rashes at the chest
30. In a client about to undergo sigmoidoscopy, which should 41. When talking a client’s apical pulse, where should the
be of concern by the nurse? nurse place the stethoscope?
A. Presence of white stools A. Just to the left of the median point of the sternum
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B. In the fifth intercostal space at the left midclavicular
line
C. Between the sixth and seventh ribs at the left
medaxillary line
D. Between the third and fourth ribs and to the left of
the sternum
42. Patient Miko has developed pericarditis after being
stabbed in the chest. What is the clinical symptom of
pericarditis?
A. Chest pain that radiates to left shoulder
B. Chest pain that radiates to the right shoulder
C. Chest pain that increases upon lying down
D. Chest pain that increases upon sitting down
43. During an interview, the nurse discovered that the spouse
of a debilitated client’s regularly digitally removes stool
from the client’s rectum. The nurse explores other
strategies to regulate the client’s bowel movement
because impaction could stimulate the vagus nerve and
result in:
A. Tachycardia
B. Slowing of the Heart
C. Dilation of the Bronchioles
D. Coronary Artery Vasodilation
44. What is the clinical symptom of cardiac tamponade?
A. Cushings triad
B. Becks triad
C. Virchows triad
D. Chinese triad
45. A client with episodes of a Cardiac Dysrhythmias is to
wear a Holter monitor for 24 hours. When planning a
teaching session for this client, what information should
the Nurse include about the monitor? The monitor:
A. Can be taken off while bathing
B. Can record activities and manifestation of response
C. will assist in determining the size and counter of
the hearth
D. will record tracing of abnormal cardiac rhythms
during activities of daily living
46. A client is scheduled for a cardiac catheterization. The
nurse should do which of the following pre-procedure
tasks except?
A. Administer all ordered oral medications.
B. Check for iodine sensitivity.
C. Verify that written consent has been obtained.
D. Withhold food and oral fluids before the procedure.
47. Nurse July now receives patient SM from the
catheterization laboratory. In the first few hours after
cardiac catheterization, which nursing measure would be
most essential?
A. Checking pedal pulse in the extremity used for the
cut-down
B. Encouraging the client to cough and deep breathe
hourly
C. Keeping the client sedated to maintain the pressure
dressing
D. Monitoring the client’s urine output
48. . what is the initial management for patients with chest
pain and diagnosed with MI?
A. o2
B. morphine
C. CKMB test
D. ECG test
49. A client admitted to the hospital with chest pain and a
history of type 2 DM is scheduled for cardiac catherization.
Which of the following medications would need to be
withheld for 48 hours before and after the procedure?
A. Regular Insulin
B. Glipiziden (Gluturol)
C. Repaglinide (Prandin)
D. Metformin (Glucophage)
50. What is the priority management for patients taking
morphine with dizziness and difficulty focusing?
a. administer methadone
b. elevate HOB
c. administer Narcan
d. administer o2
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