Abuan, Jenna Marie O.

4BSN
CARDIOVASCULAR QUESTIONS

1. A client with hypertension has an order for furosemide. Which lab finding should
be reported to the physician?
A. Phosphorus 2.5 mEq/L
B. Potassium 1.8 mEq/L
C. Calcium 9.4 mg/dl
D. Magnesium 2.4 mEq/L
2. A client is admitted with a diagnosis of heart block. The nurse is aware that the
pacemaker of the heart is the:
A. AV node
B. Purkinje fibers
C. SA node
D. Bundle of His
3. A client is being treated with nitroprusside (Nitropress). The nurse is aware that
this medication:
A. Should be protected from light
B. Is a nonpotassium-sparing diuretic
C. Causes vasoconstriction
D. Decreases circulation to the extremities
4. A client being treated with lisinopril (Zestril) develops a hacking cough. The nurse
should tell the client to:
A. Take half the dose to control the problem
B. Take cough medication to control the problem
C. Stop the medication
D. Report the problem to the doctor
5. An elderly client taking digitalis develops constipation. The nurse is aware that
constipation in a client taking digitalis might:

A. Develop an elevated digitalis level

B. Have a decrease in the digitalis levels
C. Have alterations in sodium levels
D. Develop tachycardia
6. The client is suspected of having had a myocardium infarction. Which diagnostic
finding is most significant?
A. LDH
B. Troponin
C. Creatinine
D. AST
7. A client with an internally implanted defibrillator should be taught to:
A. Avoid driving a car
B. Avoid eating food cooked in a microwave
C. Refrain from using a cellular phone
D. Report swelling at the site
8. A client is scheduled for a cardiac catheterization. Following the procedure, the
nurse should:
A. Assess for allergy to iodine
B. Check pulses proximal to the site
C. Assess the urinary output
D. Check to ensure that the client has a consent form signed
9. A client with Buergers disease complains of pain in the lower extremities. The
nurse is aware that Buergers disease is also called:
A. Pheochromocytoma
B. Intermittent claudication
C. Kawasaki disease
D. Thromboangiitis obliterans
10. A client with an abdominal aneurysm frequently complains of:
A. A headache
B. Shortness of breath only during sleep

C. Lower back pain

D. Difficulty voiding
11. The client is admitted to the intensive care area following a coronary artery
bypass graft. The nurse caring for the client manages the fluid volume status by
checking the central venous pressure and finds a reading of 4 mm Hg. Which action
should the nurse take at this time?
A. Increase the rate of IV fluid using the protocol provided
B. Continue her care with no further action
C. Decrease the IV fluid using the protocol provided
D. Administer furosemide (Lasix) as ordered
12. The client with hypertension is being treated with diuretics and beta blockers for
his hypertension. While taking beta blockers, the client should:
A. Refrain from operating heavy equipment such as a bulldozer
B. Check his pulse rate daily
C. Allow six weeks for the medication to reach its optimal level
D. Increase his intake of potassium-rich foods
13. The client has an order for furosemide (Lasix) to be taken every morning. Which
food contains the most potassium?
A. One-half cup of mashed potatoes
B. One-fourth cup of sweet potatoes
C. One baked potato
D. One cup of french-fried potatoes
14. The client with hypercholesterolemia has an order to decrease the amount of
cholesterol in his diet. Which cooking oil contains the most cholesterol?
A. Safflower
B. Sunflower
C. Palm
D. Canola
15. The client has been prescribed simvastatin (Zocor) for control of his
hypercholesterolemia. When taking this medication, the client should be taught to:
A. Take the medication with grapefruit juice

B. Have his liver enzyme checked every six months

C. Take the medication in the morning for optimal absorption
D. Report any weakness or drowsiness to the physician
16. The client with hypertension has an order for lisinopril plus hydrochlorothiazide
(HTCZ) (Zestorectic). Prior to his initial dose, the client should be taught to:
A. Check his pulse rate daily
B. Remain in bed for 34 hours after taking the initial dose
C. Expect a drop in his cholesterol level within six weeks
D. Increase his intake of folic-acidrich food such as orange juice
17. Which of the following is an untoward effect of angiotensin-converting agents
that should be reported to the doctor?
A. Postural dizziness
B. Occasional nausea
C. 1+ petal edema
D. Persistent hacking cough
18. The client with angina should be taught to take nitroglycerine sublingually with
the onset of the first signs of chest pain. Which instructions should be included with
your teaching plan?
A. Take one tablet every 10 minutes until the pain subsides.
B. If a burning sensation of the tongue occurs, stop the medication immediately.
C. Keep the medication in the brown bottle to preserve the strength of the
medication.
D. Refill the supply of nitroglycerine every three months.
19. The client with a fourth-degree heart block has a permanent pacemaker
implanted. Which activity should be avoided by the client with a pacemaker?
A. Using a cellular phone
B. Wearing a pager
C. Traveling by airplane
D. Having a magnetic resonance imaging test
20. Which breakfast selection would be best for the client taking digitalis (Lanoxin)?
A. Bran muffin, orange juice, and a cup of coffee

B. A bagel with jelly and a cup of coffee

C. Bacon and egg on toast and a cup of coffee
D. Ham-and-cheese biscuit and coffee
21. If the client becomes toxic to his digitalis, he will experience which of the
following symptoms?
A. Tachycardia
B. Hypotension
C. Nausea and vomiting
D. Diarrhea
22. The nurse is performing an ECG tracing on the client with a history of cardiac
disease. Where should the nurse apply the negative lead?
A. On the clients right chest at the second intercostal space
B. On the clients anterior right leg
C. On the clients left chest at the second intercostal space
D. On the clients left chest at the apex of the heart
23. The nurse is checking the pulse rate of a six-week-old patient with aortic
stenosis who has an order for digitalis. The clients pulse rate is found to be 82
beats per minute. Which action is most appropriate?
A. Contact the physician prior to administering the medication
B. Administer the medication and recheck the pulse rate 30 minutes later
C. Administer the medication and document the pulse rate
D. Withhold the medication and document the finding
24. The client is admitted to the emergency room following a motor vehicle
accident. An ECG reveals frequent premature ventricular contractions. Which
medication is often used to treat premature ventricular contractions?
A. Amiodarone (Cordarone)
B. Atropine sulfate (Atropine)
C. Epinephrine bitartrate (Epinephryl)
D. Enoxaparin (Lovenox)
25. The client is admitted with ventricular fibrillation. The nurse should begin
defibrillation by shocking at:

A. 360 Joules
B. 200 Joules
C. 400 Joules
D. 600 Joules
26. The nurse is caring for the client admitted with severe chest pain. After checking
the vital signs, the nurses next action should be to:
A. Prepare to administer oxygen by mask
B. Administer morphine
C. Prepare the defibrillator
D. Take a complete history
27. The client with arteriosclerosis is scheduled for a cardiac catheterization. Which
of the following is the primary responsibility of the nurse prior to the procedure?
A. Explain the procedure to the client
B. Check the laboratory results for a prothrombin time
C. Take the clients vital signs
D. Obtain a permit for the examination
28. After the clients cardiac catheterization where the femoral artery is used as the
access vessel, the nurse should:
A. Check for allergies to iodine
B. Tell the client to refrain from drinking liquids
C. Explain the need to flex and extend the leg
D. Check the pedal pulse in the operative leg
29. The client is admitted two weeks after the onset of chest pain. Which laboratory
test is the most indicative for a myocardial infarction?
A. Creatine kinase (CK-MB)
B. Troponin level
C. Lactic acid dehydrogenase (LDH)
D. Blood urea nitrogen (BUN)
30. The client returns to the intensive care unit following a coronary artery bypass
graft. The nurse notes that the client is suddenly experiencing shortness of breath

with muffled heart sounds. The blood pressure is 90/40, and the pulse rate is 110
beats per minute. Which action is most appropriate initially?
A. Check the mediastinal tube for drainage
B. Recheck the vital signs
C. Administer pain medication
D. Decrease the intravenous flow rate
31. Which breakfast cereal choice is the best choice for the client recovering from a
myocardial infarction?
A. Instant-cooking cereals
B. Puffed rice
C. Raisin Bran
D. Cocoa Puffs
32. The client with congestive heart failure has an order for milrinone (Primacor). If
the doctor decides to check the BNP, the nurse should do which of the following?
A. Slow the rate of the Primacor infusion
B. Administer a diuretic prior to checking the BNP
C. Continue the Primacor as ordered
D. Stop the Primacor for two hours prior to the test
33. The client is discharged with a prescription for sodium warfarin (Coumadin). The
nurse should instruct the client to:
A. Take the medication with water only
B. Eat green vegetables at least three times per week
C. Avoid constipation by increasing the amount of fiber in the diet
D. Administer the medication in the abdomen with a tuberculin syringe
34. A 55-year-old female is admitted to the emergency room complaining of
indigestion and back and shoulder pain. She tells the nurse that she has taken
several antacids for the past two days without relief of her symptoms. Which action
would be most appropriate at this time?
A. Ask the client if she has a history of gastric ulcers
B. Allow the client to rest undisturbed
C. Take the clients vital signs and contact the physician

D. Obtain a history to rule out a hiatal hernia

35. The client is receiving Coumadin (warfarin sodium has a Protime level of 44
seconds). The nurse should anticipate an order for which of the following?
A. AquaMEPHYTON
B. Physostigmine
C. Ropivacaine
D. Methimazole
36. The client is admitted with a diagnosis of congestive heart failure. Which finding
supports the diagnosis of left-sided congestive heart failure?
A. Pitting edema 3+
B. Ascites
C. Jugular vein distention
D. Fatigue
37. Which statement, if made by the client, would cause the nurse to suspect a
sacular abdominal aortic aneurysm?
A. I sometimes have indigestion when I lie down.
B. I often have pulsating sensations in my abdomen.
C. I feel fatigue and shortness of breath with minimal exertion.
D. I have extreme pain radiating down my left arm.
38. The client returns from surgery following a coronary artery bypass graft with a
mitral valve replacement. Which medication will be ordered for the client who has a
metal valve replacement?
A. Chlorothiazide (Diuril)
B. Clonidine HCl (Catapres)
C. Sodium warfarin (Coumadin)
D. Propranolol (Inderal)
39. The client with peripheral vascular disease is diagnosed with intermittent
claudication. Which action by the nurse would help the client to relieve symptoms of
intermittent claudication?
A. Apply antithrombolytic stockings as ordered
B. Encourage the use of a heating pad to the effected leg

C. Massage the effected extremity

D. Encourage the client to ambulate
40. The client has a femoral popliteal bypass graft. Which instruction should be
given to the client prior to discharge?
A. Rest in high Fowlers position
B. Avoiding crossing the legs at the ankles
C. Keep the procedural leg straight
D. Check the radial pulse rate daily
41. Which instruction should be given to the client being discharged after a
myocardial infarction?
A. You can begin having intercourse when you can climb three flights of stairs
without experiencing breathlessness.
B. You should take nitroglycerine at the first signs of chest pain.
C. You can take sildenafil (Viagra) for erectile dysfunction.
D. You should walk at least three miles every day to increase cardiac output.
42. The client is admitted with possible thrombophlebitis. Which action should be
priority? A
Ask the client to remain in bed
B. Assess using Homans sign
C. Schedule the client for a Doppler study
D. Apply a moist heating pad to the extremity
53. The client with Raynauds phenomena should be taught to:
A. Keep the feet elevated while resting
B. Wear mittens when she is out in the cold
C. Avoid caffeine intake
D. Drink warm liquids to loosen lung secretions
44. The client is being treated for Buergers disease. Another name for Buergers
disease is:
A. Thrombophlebitis
B. Coronary thrombosis

C. Thromboangiitis obliterans
D. Arteritis
45. The nurse is preparing to monitor the clients central venous pressure. Which
position would provide the most reliable measurement of the CVP?
A. Supine
B. High Fowlers
C. Left Sims
D. Prone
46. A client admitted to the hospital with chest pain and a history of type 2
diabetes mellitus is scheduled for cardiac catheterization. Which medication
would need to be withheld for 24 hours before the procedure and for 48 hours
after the procedure?
A. Regular insulin
B. Glipizide (Glucotrol)
C. Repaglinide (Prandin)
D. Metformin (Glucophage)
47. The nurse is reviewing an electrocardiogram rhythm strip. The P waves and QRS
complexes are regular. The PR interval is 0.16 second, and QRS complexes measure
0.06 second. The overall heart rate is 64 beats/minute. Which would be a correct
interpretation based on these characteristics?
A.Sinus bradycardia
B.Sick sinus syndrome
C.Normal sinus rhythm
D.First-degree heart block
48. A client is wearing a continuous cardiac monitor, which begins to sound its
alarm. A nurse sees no electrocardiographic complexes on the screen. Which is the
priority action of the nurse?
A.Call a code.
B.Call the health care provider.
C.Check the client's status and lead placement.
D.Press the recorder button on the electrocardiogram console.

49. A client is having frequent premature ventricular contractions. The nurse should
place priority on assessment of which item?
A.Sensation of palpitations
B.Causative factors, such as caffeine
C.Precipitating factors, such as infection
D.Blood pressure and oxygen saturation
50. The nurse is caring for a client who has just had implantation of an automatic
internal cardioverter-defibrillator. The nurse immediately would assess which item
based on priority?
A.Anxiety level of the client and family
B.Presence of a Medic-Alert card for the client to carry
C.Knowledge of restrictions of postdischarge physical activity
D.Activation status of the device, heart rate cutoff, and number of shocks it is
programmed to deliver

ANSWER

1. B

21. C

2. C

22. A

3. A

23. A

4. D

24. A

5. A

25. B

6. B

26. A

7. D

27. C

8. C

28. D

9. D

29. B

10. C

30. A

11. A

31. B

12. B

32. D

13. C

33. C

14. C

34. C

15. B

35. A

16. B

36. C

17. D

37. B

18. C

38. C

19. D

39. A

20. A

40. C

41. B

46. D

42. A

47. C

43. B

48. C

44. C

49. D

45. A

50. D

Answers with Explanations

1. Answer B is correct. The client taking furosemide is at risk for developing
hypokalemia (decreased potassium) because this drug is a nonpotassium-sparing
diuretic. A potassium level of 1.8 is extremely low and might result in cardiac
dysrhythmias. Answers A, C, and D are incorrect because the levels noted in the
question are within normal levels.
2. Answer C is correct. The pacemaker of the heart is the SA node. The impulse
moves from the SA node to the AV node on to the right and left bundle branches
and finally to the Purkinje fibers. This makes answers A, B, and D incorrect.
3. Answer A is correct. Nitroglycerine preparations should be protected from light
because light decreases the effectiveness of this category of medication. Answer B
is incorrect because Nitropress is not a diuretic. Answer C is incorrect because
Nitropress is a vasodilator, not a vasoconstrictor. Answer D is incorrect because
nitroglycerine does not decrease circulation to the extremities.
4. Answer D is correct. A hacking cough is a common side effect and should be
reported to the doctor. The client should not be told to half the dose because this
can result in an elevated blood pressure, so answer A is incorrect. Answer B is
incorrect because taking a cough medication will mask the symptom of a possible
allergic reaction. Answer C is incorrect because, although the client stops taking the
medication, this answer states that the client can report the finding to the doctor at
the time of the scheduled visit. She should report this finding immediately.
5. Answer A is correct. The client taking digitalis should avoid constipation because
constipation can lead to digitalis toxicity. Answer B is incorrect because constipation
will not lead to a decrease in the digitalis levels. Answer C is incorrect because
constipation does not result in alterations in the sodium level. Answer D is incorrect
because digitalis toxicity will result in brachycardia, not tachycardia.
6. Answer B is correct. The best diagnostic tool for confirming that the client has
experienced a myocardial infarction is the troponin level. Another lab value
associated with a myocardial infarction is the CKMB. Answer A is incorrect because
the LDH is also elevated in clients with muscle trauma not associated with an MI.
Answer C is incorrect because the creatinine level indicates renal function. Answer D
is incorrect because the AST level is elevated with gallbladder and liver disease as
well as muscle inflammation.
7. Answer D is correct. The client with an implantable defibrillator should report
redness, pain, and swelling at the site of the implant. Answers A, B, and C are
incorrect because the client can drive a car, eat food cooked in a microwave, and
use a cellular phone. The client probably will be told to wait three months to drive a
car. He should put his food in the microwave and step five feet away from the

microwave during cooking. A cellular phone can be used but should be held in the
right hand.
8. Answer C is correct. The dye used in the procedure can cause a decrease in renal
function. The clients renal function should be assessed and changes reported to the
doctor immediately. Answer A is incorrect because the clients allergies should be
checked prior to the procedure, not after the procedure. The femoral artery is
commonly used as the site for a catheterization. Answer B is incorrect because the
pulses should be checked distal to the site. Answer D is incorrect because the
permit should be signed prior to the procedure.
9. Answer D is correct. The other name for Buergers disease is thromboangiitis
obliterans. Answer A is incorrect because pheochromocytoma is an adrenal tumor.
Answer B is incorrect because intermittent claudication is pain in an extremity when
walking. Answer C is incorrect because Kawasaki disease is an acute vasculitis that
can result in an aneurysm in the thoracic area.
10. Answer C is correct. Clients with abdominal aortic aneurysms often complain of
nausea, lower back pain, and feeling their heart beat in the abdomen. Answer A is
incorrect because a headache is a symptom of a cerebral aneurysm. Answer B is
incorrect because, although the client with an abdominal aneurysm might have
shortness of breath, this symptom is not particular to during sleep. Answer D is
incorrect because difficulty voiding is not associated with an abdominal aneurysm.
11. Answer A is correct. The normal CVP reading is 812 mm Hg. A reading of 4
indicates possible bleeding and fluid loss. The nurse should administer IV fluid as
ordered. Answers B, C, and D are incorrect actions at this time.
12. Answer B is correct. While taking beta blockers, the client should be taught to
check his pulse daily. This category of blood pressure drugs slows the pulse rate.
Answer A is incorrect because the client can operate heavy equipment when taking
beta blockers. Answer C is incorrect because beta blockers reach their optimal
levels within days of beginning the medication. Answer D is incorrect because there
is no need to increase potassium-rich foods when taking beta blockers. There is a
need to increase potassium-rich foods while taking diuretics that are not potassiumsparing.
13. Answer C is correct. The peel of a baked potato contains large amounts of
potassium. Answers A, B, and D contain lesser amounts of potassium and are
therefore incorrect.
14. Answer C is correct. Palm oil and coconut oil are extremely high in cholesterol.
These oils contribute to coronary artery disease. Answers A and B are incorrect
because these oils are recommended for clients with coronary artery disease.
Answer D is incorrect because canola oil contains less fat and cholesterol than palm
oil.

15. Answer B is correct. Because simvastatin (Zocor) can damage the liver, liver
enzymes should be checked every six months. Answer A is incorrect because this
medication should not be taken with grapefruit juice. Answer C is incorrect because
Zocor should be taken at night for optimal absorption. Answer D is incorrect
because weakness or drowsiness is not associated with Zocor. It is true, however,
that extreme muscle soreness and weakness while taking Zocar can be related to
rhabdomylysis. Rhabdomylysis is a muscle-wasting disorder.
16. Answer B is correct. Lisinopril (Zestril) can cause postural hypotension. The
client should be taught to supine for approximately 34 hours after the initial dose.
The blood pressure should be checked frequently to determine the effects of the
medication. Answer A is incorrect because lisinopril is an ACE inhibitor and does not
have a direct effect on the pulse rate. Answer C is incorrect because lisinopril does
not lower cholesterol levels. Answer D is incorrect because there is no need to
increase folic acid while taking lisinopril.
17. Answer D is correct. A hacking cough, often associated with
angiotensinconverting agents, is an untoward effect that should be reported to the
doctor. The cough might indicate an allergic reaction to the medication. Answer A is
incorrect because the client might experience dizziness upon arising. Answer B is
incorrect because occasional nausea is not associated with an untoward effect of
angiotensinconverting agents. Answer C is incorrect because pedal edema is
associated with fluid retention and peripheral vascular disease, not angiotensinconverting agents.
18. Answer C is correct. The medication should be kept in a brown bottle because
light deteriorates the medication. Answer A is incorrect because the client can take
one pill every five minutes times three doses. If the pain does not subside, he
should go to the emergency department immediately. Answer B is incorrect because
a burning sensation is expected. Answer D is incorrect because the supply of
nitroglycerine should be refilled every six months.
19. Answer D is correct. Clients with a pacemaker or an internal defibrillator should
not have a magnetic resonance imaging test. Answers A and B are incorrect
because a client with a pacemaker can use a cellular phone or carry a pager if the
device is used on the opposite side of the pacemaker. Answer C is incorrect because
the client can travel by airplane. Use of a handheld metal detector is
contraindicated.
20. Answer A is correct. The client taking digitalis (Lanoxin) can avoid toxicity by
increasing the amount of fiber in his diet. The bran muffin and orange juice provide
the most fiber and ensure a diet that includes potassium (in the orange juice).
Potassium has to be consumed in moderate amounts to avoid toxicity. Answers B, C,
and D are incorrect because they are lower in fiber.

21. Answer C is correct. The signs of digitalis toxicity are halos around lights,
brachycardia, nausea, and vomiting. Answer A is incorrect because the client will
experience brachycardia not tachycardia. Hypotension can occur but is not a sign of
toxicity, so answer B is incorrect. Answer D is incorrect because a client with
constipation, not a client with diarrhea, is more likely to be toxic.
22. Answer A is correct. The white lead or negative lead is placed on the clients
right side at the second intercostal space. Answers B, C, and D are incorrect
because the negative lead is not placed at these locations.
23. Answer A is correct. If the pulse rate is less than 100 beats per minute in the
infant, the rate should be reported to the physician. Answers B and C are incorrect
because the nurse should not administer the medication if the pulse rate is less
than 100 beats per minute. Answer D is incorrect because the nurse should report
the finding.
24. Answer A is correct. Amiodarone (Cordarone) can be used to treat premature
ventricular contractions. This drug, along with lidocaine and magnesium sulfate, will
slow the heart rate. Answers B and C are incorrect because both these drugs speed
the heart rate. Answer D is incorrect because enoxaparin (Lovenox) is a heparin
derivative used as an anticoagulant.
25. Answer B is correct. When defibrillation is performed, three quick successive
shocks are delivered with the third at 360 Joules. Answer A is incorrect because the
third shock should be at 360 Joules. Answers C and D are incorrect because 400 and
600 Joules are too high.
26. Answer A is correct. The nurse should be ready to apply oxygen when caring for
the client experiencing chest pain. Using standard protocol, oxygen can be
administered to increase the oxygenation of the myocardium. Morphine can be
administered after acquiring an order, so answer B is incorrect. Answer C is incorrect
because at this time it is not necessary to defibrillate the client. Answer D is
incorrect because a complete history should be taken when the client is stable.
27. Answer C is correct. The primary responsibility of the nurse is to obtain the vital
signs. The doctor is primarily responsible for explaining the procedure, checking the
laboratory results for a prothrombin time, and obtaining a permit; therefore answers
A, B, and D are incorrect.
28. Answer D is correct. Checking the pulse in the procedure extremity is imperative
because a clot might be present. A clot will result in decreased pulse rate and
strength. Answers A and B are incorrect because checking for allergies and
withholding fluids should be done prior to the procedure. The client should be
instructed to drink more after the procedure to increase the excretion of the dye by
the kidneys. Answer C is incorrect because the client should keep the leg straight.

29. Answer B is correct. Troponin levels can remain elevated for as long as two
weeks. If the client had an MI two weeks ago, the creatine kinase (CK-MB) will most
likely have returned to normal; therefore, answer A is incorrect. Answers C and D
are incorrect because they can be elevated with an MI but are not specific to this
condition.
30. Answer A is correct. Muffled heart sounds and a lack of drainage from the
mediastinal tube indicate cardiac tamponade or fluid around the heart. This must be
reported immediately to the physician. Answer B is incorrect because rechecking
the vital signs wastes valuable time. Answer C is incorrect because there is no data
to support the need for pain medication and it might lower the blood pressure.
Answer D is incorrect because decreasing the intravenous flow rate can further
shock.
31. Answer B is correct. Puffed rice, puffed wheat, and shredded wheat have less
sodium than any of the other choices. Answers A, C, and D are incorrect for this
reason.
32. Answer D is correct. To ensure accuracy of the BNP laboratory test, Primacor
should be stopped two hours prior to the test. Answers A, B, and C are incorrect
actions.
33. Answer C is correct. Constipation can lead to an elevated level when taking
sodium warfarin. Both diarrhea and constipation can affect the absorption of this
medication. Answer A is incorrect because the medication can be taken with fruit
juice or other liquids. Answer B is incorrect because the client should not exceed
one serving of green leafy vegetables per week. Answer D is incorrect because
sodium is taken orally, not by injection.
34. Answer C is correct. The clients symptoms, while vague, can indicate a
myocardial infarction. Taking the vital signs and contacting the physician will allow
the doctor to order laboratory tests and an ECG to rule out an MI. Answers A, B, and
D are incorrect because they waste time that could be vital to ensure life and
improve the prognosis.
35. Answer A is correct. The other name for vitamin K is AquaMEPHYTON. Answer B
is incorrect because physostigmine is Antilirium, an anticholinesterase medication
used to reverse the effects of diazepam (Valium). Answer C is incorrect because
ropivacaine is Naropin, a drug used as a local anesthetic. Answer D is incorrect
because methimazole is Tapazole, a drug used to treat hypothyroidism.
36. Answer C is correct. Symptoms of left-sided congestive heart failure include
jugular vein distention; coughing with frothy, pink-tinged sputum; and shortness of
breath. Answers A and B are symptoms of right-sided congestive failure. Answer D
is incorrect because fatigue is not specific to a diagnosis of left-sided congestive
heart failure.

37. Answer B is correct. A common complaint in a client with an abdominal aortic

aneurysm is the presence of pulsation in the abdomen. Answer A is incorrect
because indigestion when lying down indicates gastroesophageal reflux disorder
(GERD). Answer C is incorrect because feeling fatigue and shortness of breath with
minimal exertion can indicate many problems, one of which is congestive heart
failure. Answer D is incorrect because pain radiating down the left arm indicates a
possible myocardial infarction.
38. Answer C is correct. Clients with a metallic valve replacement require lifelong
anticoagulant therapy with drugs such as sodium warfarin (Coumadin). Answer A is
incorrect because chlorothiazide (Diuril) is a diuretic. Answer B is incorrect because
clonidine HCl (Catapres) is an antihypertensive. Answer D is incorrect because
propranolol (Inderal) is a beta blocker used for hypertension, for mitral valve
prolapse, and to lower the pulse rate in anxiety disorders.
39. Answer A is correct. Intermittent claudication is burning and pain when the
client is ambulating. Applying antithrombolytic stockings helps support muscles and
blood vessels and decreases the pooling of blood. Answer B is incorrect because a
heating pad can cause burning in the client with peripheral vascular disease.
Answer C is incorrect because massaging the extremity can lead to a pulmonary
embolism. Answer D is incorrect because ambulation increases the clients pain.
40. Answer C is correct. The client with a femoral popliteal bypass graft should be
taught to keep the procedural leg as straight as possible because bending the leg or
crossing the leg at the knee can impede circulation and close the grafted vessel.
Answer A is incorrect because the client should rest in a supine or semi-Fowlers
position. Answer B is incorrect because the client can cross the legs at the ankles,
but not at the knee. Answer D is incorrect because the radial pulse (pulse in the
wrist) need not be checked daily. Checking the pedal and posterior tibial pulses can
reveal decreased blood flow.
41. Answer B is correct. A client who has experienced a myocardial infarction should
take nitroglycerine at the first sign of chest pain. Three sublingual tablets can be
taken to treat angina pain. If the pain persists, the client should go to the hospital.
Answer A is incorrect because the client can begin having intercourse when he can
climb one flight of stairs without being breathless. Answer C is incorrect because
sildenafil (Viagra) should not be taken within 24 hours of taking a nitrite such as
nitroglycerine. Answer D is incorrect because the client should begin a step
program that consists of a progressive exercise plan that does not mandate three
miles per day.
42. Answer A is correct. When thrombophlebitis is suspected, the client should
remain in bed to decrease the threat of a pulmonary embolus. Answer B is incorrect
because Homans sign is no longer used to assess the client for the presence of
thrombophlebitis since this subjective assessment tool can cause the clot to
dislodge and travel to the lungs. Answer C is incorrect because the doctor will

schedule the client for a Doppler study. Answer D is incorrect because applying a
heating pad to the extremity will be ordered by the doctor after the client is fully
assessed.
43. Answer B is correct. Raynauds phenomena is a vascular spasm occurring when
the client is exposed to cold. The hands, nose, and chin are commonly affected.
Wearing mittens when is exposed to cold will help decrease the symptoms of
Raynauds phenomena. Answer A is incorrect because there is no correlation to
keeping the feet elevated and the incidence of Raynauds. Answer C is incorrect
because caffeine intake is not associated with Raynauds phenomena. Answer D is
incorrect because Raynauds phenomena is not a problem associated with lung
disorders.
44. Answer C is correct. Buergers disease results when spasms of the arteries and
veins occur, primarily in the lower extremities. These spasms result in blood clot
formation and eventual destruction of the vessels. Answer A is incorrect because
thrombophlebitis is a blood clot with an inflammation of the vein. Answer B is
incorrect because coronary thrombosis is a clot in the coronary arteries. Answer D is
incorrect because arteritis is an inflammation of the arteries.
45. Answer A is correct. To correctly assess the CVP, the nurse should place the
client in a supine position. The zero of the manometer should be placed at the fifth
intercostals space, mid-axillary line (phlebostatic axis). Answers B, C, and D are
incorrect because they will not give a correct reading.
46. Metformin (Glucophage) needs to be withheld 24 hours before and for 48 hours
after cardiac catheterization because of the injection of contrast medium during the
procedure. If the contrast medium affects kidney function, with metformin in the
system, the client would be at increased risk for lactic acidosis. The medications in
the remaining options do not need to be withheld 24 hours before and 48 hours
after cardiac catheterization.
47. Normal sinus rhythm is defined as a regular rhythm, with an overall rate of 60 to
100 beats/minute. The PR and QRS measurements are normal, measuring 0.12 to
0.20 second and 0.04 to 0.10 second, respectively.
48. Sudden loss of electrocardiographic complexes indicates ventricular asystole or
possibly electrode displacement. Accurate assessment of the client and equipment
is necessary to determine the cause and identify the appropriate intervention. The
remaining options are secondary to client assessment.
49. Premature ventricular contractions can cause hemodynamic compromise.
Therefore, the priority is to monitor the blood pressure and oxygen saturation. The
shortened ventricular filling time can lead to decreased cardiac output. The client
may be asymptomatic or may feel palpitations. Premature ventricular contractions
can be caused by cardiac disorders, states of hypoxemia, or by any number of

physiological stressors, such as infection, illness, surgery, or trauma, and by intake

of caffeine, nicotine, or alcohol.
50. The nurse who is caring for the client after insertion of an automatic internal
cardioverter-defibrillator needs to assess device settings, similar to after insertion of
a permanent pacemaker. Specifically, the nurse needs to know whether the device
is activated, the heart rate cutoff above which it will fire, and the number of shocks
it is programmed to deliver. The remaining options are also nursing interventions
but are not the priority.