Midterm Post-test 3
indicates they understood your
1. Hypercapnia has what effect on
pulmonary blood vessels?
- Pulmonary Vasconstriction
2. Prolonged expiration is manifested by
clients with COPD for what purpose?
- Expiration of retained CO2 and to
prevent collapse airways
3. The term “blue bloaters” is used to
describe clients with?
- Chronic Bronchitis
4. The body compensates when there is
hypoxemia. In what manner does it
compensate?
- Increasing RBC production
5. Alpha 1-antitrypson has a protective
role in the physiology of our bodies as
it
- Protects the lungs from damage by
elastase
6. A nurse plans care for a client with
chronic obstructive pulmonary
disease, knowing that the client is
most likely to experience what type of
acid-base imbalance?
- Respiratory Acidosis
7. The term ‘blue” of “blue bloaters” in
clients with Chronic bronchitis is
derived from
- The client retaining carbon dioxide
than oxygen, which causes
deprivation of tissues with
oxygenated blood
8. A pt with emphysema may present
with all of the ff symptoms, EXCEPT?
- Hypoventilation
9. A patient is newly diagnosed with
COPD due to chronic bronchitis.
You're providing education to the
patient about this disease process.
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Which statement by the patient
teaching about this condition?
- “Complications from this condition
can lead to pulmonary
hypertension and right-sided heart
failure."
10. The term “bloater” in clients with
Chronic Bronchitis is derived from
- The client’s edema formation
11. A patient is presenting with chronic
obstructive pulmonary disease. The
patient has a chronic productive
cough with dyspnea on excretion.
Arterial blood gases show a low
oxygen level and high carbon dioxide
level in the blood. On assessment, the
patient has cyanosis in the lips and
edema in the abdomen and legs.
Based on your nursing knowledge and
the patient's symptoms, you suspect
the patient suffers from what type of
COPD?
- Chronic Bronchitis
12. The nurse assessing the CBC of a
patient with chronic bronchitis
identifies a typical feature of this
disease, which is
- Increased RBC count
13. Smoking is a salient cause of COOPD as
it does the ff, except
- Increases the amount of O2 in the
terminal alveoli
14. Clients with Emphysema are also
called ‘pink puffers”. The term “pink”
is derived from
- Adequate inhalation of O2 early in
the dse process
15. Upon auscultation for heart sounds,
the nurse informed the physician of
 the presence of S3 heart sounds. This
implies
- Rapid ventricular filling
16. Which assessment would be most
appropriate for a patient who is
receiving a loop diuretic for heart
failure?
- Monitor for hypotension
17. Chronic Bronchitis is defined as
- Under COPD where clients
manifest productive cough for at
least 3 months a year for 2
consecutive years.
18. Clients with Emphysema are also
called “puffers” because they
- Are trying to exhale the retained
CO2
19. Elevating the edematous extremities
is contraindicated in clients with
congestive heart failure who are
already
- Dyspneic
20. In Emphysema, destruction of the
alveolar walls causes the following,
except
- Air trapping on inhalation resulting
to O2 retention.
21. The following conditions occur in the
pathophysiology of Chronic
Bronchitis, except
- Loss if elastic recoil of the
lungs/alveoli
22. A hypercapneic client may manifest
acidosis because
- Excess CO2 binds with water to
form carbonic acid
23. A client is receiving digoxin (Lanoxin)
in the treatment of heart failure. The
nurse would particularly assess the
client for signs of digitalis toxicity,
namely
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- Anorexia, and nausea, flickering
lights
24. A client with pulmonary edema has
been on diuretic therapy. The client
has an order for additional furosemide
(Lasix) in the amount of 40 mg IV push.
Knowing that the client also will be
started on digoxin (Lanoxin), a nurse
checks the client’s most recent:
- Potassium Level
25. The nurse conscientiously monitors
the potassium level of a client
receiving digoxin because she knows
that if there is hypokalemia, the serum
level of digoxin will
- Increase
26. In normal ventilation, the diaphragm
moves ________________ during
inhalation.
- Downward as it contracts
27. In the respiratory system, gas
exchange occurs in
- Pulmonary-capillary bed
28. The nurse is assessing a client
diagnosed with emphysema. Clinical
manifestations include the following,
except
- Hypocapnia
29. Weight loss in COPD, particularly in
clients with Emphysema, is most likely
related to
- Dyspnea interfering with eating
and causing energy depletion
30. The morning weight for a client with
emphysema indicates that the client
has gained 5 pounds in less than a
week, even though his oral intake has
been modest. The client's weight gain
may reflect which associated
complication of COPD?
- Cor Pulmonale
Midterm Post-test 2
1. During cardioversion, electrical shock
delivery is is synchronized with the
- R wave
2. A client with no history of heart
disease has experienced acute
myocardial infarction and has been
given thrombolytic therapy with tissue
plasminogen activator. What
assessment finding should the nurse
identify as the most likely indicator
that the client is experiencing
complications of this therapy?
- Tarry stools
3. Which of the following blood tests is
most indicative of cardiac damage?
- Troponin I
4. Anticoagulants and anti-platelet
agents will be given to a client post
PTCA and stenting. These are given
primarily to
- Prevent thrombus formation on
the stent
5. When administered a thrombolytic
drug to the client experiencing an MI,
the nurse explains to him that the
purpose of this drug is to:
- Dissolve clots he may have
6. A patient with ST-segment elevation is
admitted to the emergency
department (ED) and diagnosed as
having an ST-segment-elevation
myocardial infarction (STEMI). Which
question should the nurse ask to
determine whether the patient is a
candidate for thrombolytic therapy?
- “what time did your chest pain
begin?”
7. The nurse teaches the client that the
major difference between angina and
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pain associated with myocardial
infarction (MI) is that:
- Angina is relieved with
nitroglycerin and rest.
8. After an anterior wall myocardial
infarction, which of the following
problems is indicated by auscultation
of crackles in the lungs?
- Left side of the heart
9. The following are contraindications of
thrombolytic agents, except
- Surgery within the last 30 days
10. Streptokinase is the least preferred
thrombolytic agent over tPAs because
- It poses an allergic risk
11. A client is admitted to the ER with
crushing chest pain. A diagnosis of
acute coronary syndrome is
suspected. The nurse expects that the
client's initial treatment will include
which medication?
- Aspirin
12. Which of the following EKG changes
on the patient with chest pain
indicates the highest level of damage?
- Q wave widening
13. You recommend to your client post MI
to eat small, easily digested meals.
The rationale for this is to
- Prevent increase in the workload of
the heart.
14. Range-of-motion exercises following
acute episodes of Myocardial
Infarction is instituted to
- Prevent clot formation
15. Aspirin is administered to the client
experiencing an MI because of its:
- Antiplatelet action
16. A nurse is caring for a client with a
diagnosis of myocardial infarction
(MI). The client calls the nurse
 because the client is experiencing
chest pain. The nurse administers a
sublingual nitroglycerin tablet as
prescribed. The chest pain is
unrelieved by the nitroglycerin. The
next nursing action is which of the
following?
- Contact the physician
17. A patient who is being admitted to the
emergency department with
intermittent chest pain gives the
following list of medications to the
nurse. Which medication has the most
immediate implications for the
patient's care?
- Sildenafil (Viagra)
18. As it decreases mortality in most cases
in the emergent management of acute
MI, oxygen administration is often
followed by the administration of
- Aspirin
19. A patient who has had a myocardial
infarction (MI) states that he is prone
to constipation. The nurse advises him
to establish a regular bowel regimen
because straining or bearing down to
have a bowel movement may
- Trigger a vagal response
20. Forty minutes after arrival to the
emergency room, a patient suffering
an MI is to have emergent
percutaneous transluminal coronary
angioplasty (PTCA) to
- Reperfuse the area of myocardium
deprived of oxygen
21. More than 6 premature ventricular
contractions would cause to nurse to
implement which intervention?
- Administer lidocaine or
amniodarone, an anti-arrhythmic,
as prescribed.
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22. 12-lead ECG is a diagnostic tool used
to evaluate the electrical activity of
the heart. Which of the following ECG
results would reveal that there is
myocardial ischemia?
- ST segment depression and
inverted T wave
23. Passive and active Range-of-motion
exercises are most desired post MI.
However, isometric exercises are
mostly contraindicated because they
cause
- Increase in the heart’s workload
24. For clients manifesting cardiogenic
shock with severely diminishing
cardiac output, dobutamine and
dopamine may be given. In this
specific case, dopamine will be given
at low dose. What therapeutic effect
would this result to?
- Renal arterial dilation
25. What is the primary reason for
administering morphine to a client
with an MI?
- To decrease O2 demand on the
client’s heart
26. What is the most common
complication of MI?
- Arrhythmias
27. When ventricular fibrillation occurs in
a CCU, the first person reaching the
client should
- Defibrillate the client
28. Offering of bedpan to clients suffering
from MI is often contraindicated
because
- It causes the client to strain causing
bradycardia
29. Thrombolytic therapy is administered
in less than 30 minutes from the onset
of manifestations, with an
 effectiveness at highest if given within
the first 2 hours of onset of symptoms.
After 12 hours after symptom
manifestation, its administration is
not anymore advisable as it,
- Puts the client at risk of Intracranial
bleeding
30. A patient who is recovering from an
acute myocardial infarction (AMI) asks
the nurse about when sexual
intercourse can be resumed. Which
response by the nurse is best?
- “Sexual activity uses about as
much as energy as climbing two
flights of stairs.”
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Midterm Post-test 1
1. Mr. Pedro got hold of his prescribed
nitroglycerin (NTG) tablets. The
following are the proper ways of using
nitroglycerin tablets except:
- Discard nitroglycerin tablets if it
causes burning sensation when
placed under the tongue
2. Myocardial oxygen consumption
increases as which of the following
parameters increase?
- Preload, afterload, contractility, &
heart rate.
3. Which of the following heart chamber
has the thickest muscle layer?
- Left ventricle
4. A client is given heparin. After its
administration, the client manifests
severe bleeding. What should be given
to the client to counter this hazardous
side-effect?
- Protamine Sulfate
5. When teaching about nitrate
administration, the nurse should
instruct the client to:
- Change positions slowly
6. Atherosclerosis impedes coronary
blood flow by which of the following
mechanisms?
- Plaques obstruct the artery
7. The “patch-free” period for nitro
patch is instituted to prevent
development of
- Tolerance of the medication
8. Sympathetic stimulation constricts
peripheral arterial blood vessels and
- Increases afterload
9. Which of the following terms
describes the force against which the
left ventricle must expel blood?
 - Afterload
10. Subcutaneous heparin should be
administered in the:
- Abdominal fat
11. Your knowledge in the anatomy of the
heart will tell you that acute
pulmonary edema caused by heart
failure is usually a result of damage to
which of the following areas of the
heart?
- Left ventricle
12. If a client is taking a the client taking anti-coagulants. The
noncardioselective beta blocker like
propranolol, what should be included
in the client’s history taking and
assessment and is deemed as a
contraindication?
- A diagnosis of COPD
13. Which of the following instructions
should be included in the discharge
teaching for a client discharged with a
transdermal nitroglycerin patch?
- "Apply the patch to a nonhairy,
scarless area of the upper torso or
arms."
14. Which of the following terms is used
to describe the amount of stretch on
the myocardium at the end of
diastole?
- Preload
15. If the Purkinje system is damaged,
conduction of the electrical impulses
is impaired through the
- Ventricles
16. In clients taking Coumadine, intake of
green leafy vegetables is minimized
for what reason?
- Green leafy vegetables are high in
vitamin K
17. When teaching a client about
propranolol hydrochloride, the nurse
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should base the information on the
knowledge that propranolol
hydrochloride:
- Blocks beta-adrenergic stimulation
and thus causes decreased heart
rate, myocardial contractility, and
conduction
18. When do coronary arteries primarily
receive blood flow?
- During diastole
19. Bleeding precautions are imparted to
following are included, except
- Telling the client to avoid playing
chess
20. ACE inhibitors like Captopril is given to
a client with angina or MI for the
purpose of
- Decreasing peripheral resistance
through peripheral vasodilation
21. Aspirin is administered to the pt
experiencing an MI because of its:
- Antiplatelet action
22. In teaching a patient about coronary
artery disease, the nurse explains that
the changes that occur in this disorder
involve
- Accumulation of lipid and fibrous
tissue within the coronary arteries.
23. A client with angina pectoris
secondary to atherosclerotic disease
asks why he experiences chest pain
with exertion. The nurse informs him
that exertion
- Increases the heart’s O2 demand
24. A client with an MI of the anterior wall
of the left ventricle most likely has an
occlusion of the
- Left anterior descending artery
25. During the previous few months, a 56-
year-old woman felt brief stabs of
 chest pain while working in her garden 30. What effects do vasodilating
and has had frequent episodes of medications have on preload and
indigestion. She comes to the hospital afterload?
after experiencing severe anterior - Decrease the preload and decrease
chest pain while raking leaves. Her afterload
evaluation confirms a diagnosis of
stable angina pectoris. After
stabilization and treatment, the client
is discharged from the hospital. At her
follow-up appointment, she is
discouraged because she is
experiencing pain with increasing
frequency. She states that she is
visiting an invalid friend twice a week
and now cannot walk up the second
flight of steps to the friend's
apartment without pain. Which of the
following measures that the nurse
could suggest would most likely help
the client deal with this problem?
- Take a nitroglycerin tablet before
climbing the stairs
26. Beta-Adrenergic Blocking agents’
therapeutic effect is
- Reduction of heart rate
27. Which of the following is a potential
side effect of IV furosemide (lasix)?
- Hearing loss
28. The client is given heparin. Basing
from her knowledge of what heparin
is, nurse’s responsibilities should
include checking for occult bleeding.
What manifestation would alert the
nurse?
- Tea or cola-colored urine
29. Which instruction should be included
in discharge teaching for Mr. Pedro
with a new prescription for
simvastatin (Zocor)?
- Liver enzyme levels should be
monitored every few months
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