Q.

1- The nurse count an adult’s Apical heart beat at 110

Bpm .the nurse describe this as ?

 Options :  Rationale : Ans . ( 3 ) .

 1. Asystole .  Tachycardia in an adult is
defined as a heart rate above
 2. Bigeminy .
100 beat per minutes .

 Asystole is cardiac arrest there

 3. Tachycardia .
is no heart beat .
 4. Bradycardia .
 Bigeminy means that the
heartbeat are coming in pairs .

 Bradycardia in an adult is
defined as a heart rate of 60
Bpm or less .
Q.2- A client has an elevated AST 24 hours following chest
pain and shortness of breath .this is suggestive of which of
the following ?

 Options :  Rationale : Ans. ( 3 ) .

 AST is an enzyme released in response to
 1. Gall bladder tissue damage. The suggestive symptom
disease . of myocardial infarction .

 AST rises 24 hours after myocardial

infarction . It will also rise when there is
 2. Liver disease . liver damage and skeletal muscle injury .

 This client has symptoms typical of

 3. Myocardial myocardial infarction .
infarction .
 Gall bladder disease may present with
pain in the right scapula ( shoulder
 3. Skeletal muscle blade ) region but would not have an
elevated AST .
injury .
Q.3- An adult has a coagulation time of 20 minutes. The
nurse should observe the client for which of the
following?

 Options :  Rationale: Ans. ( 2 ) .

 The normal clotting time is 9 to 12 minutes. A
 1. Blood clots . prolonged clotting time would suggest a
bleeding tendency . The client should be
observed for signs of bleeding such as
 2. Ecchymotic ecchymotic areas .
areas .
 Blood clots would occurs with a clotting time of
less than normal .
 3. Jaundice .
 Jaundice occurs with liver damage or rapid
 4. Infection . breakdown of red blood cell such as is sickle cell
anemia .

 Infection occurs when there are too few white

blood cells .
Q.4- A prothrombin time value would be considered
normal for a client who is receiving warfarin (Coumadin ) .

 Rationale : Ans . ( 2 ) .
 Options :
 When a client receiving coumadin the
 1. 12 sec. prothrombin time should be 1.5 to 2 times. The
normal value which is 11 to 12.5. twenty sec. falls
within that range .
 2. 20 sec.
 12 sec. is normal for someone who is not
 3. 60 sec. receiving coumadin .

 60 sec. is normal for partial thromboplastin

 4. 98 sec. time ( PTT ) test .

 98 sec. on a PTT would be acceptable for a client

who is receiving heparin. It should be 1.5 to 2
times the normal range of 60 to 70 sec .
Q.5- A prothrombin time test should be performed
regularly on person who are taking which medications ?

 Options :  Rationale : Ans . (2 ) .

 1. Heparin .  A prothrombin time test is
done to determine the
 2. Warfarin . effectivness of warfarin .

 3. Phenobarbitol .  A partial thromboplastin time

test is done for person taking
heparin .
 4. Digoxin .

 Phenobarbitol and digoxin do

not require regular clotting test
serum levels of these drugs
may be done if the client is on
long term therapy .
Q.6- The nurse is caring for a client who is receiving
heparin. What drug should be readily available ?

 Options :  Rationale : Ans.( 4 ) .

 1. Vitamin-K .  The available for heparin is
protamine sulfate or sulphate .

 2. Caffeine .  Vitamin-k is the antidote for

coumadin ( warfarin ) .
 3. Calcium  Calcium gluconate is the antidote
for magnesium sulfate .
gluconate .
 Caffeine is a CNS stimulant and
 4. Protamine will increase alertness and heart
sulfate . rate .
Q.7- An adult who is receiving heparin asks the nurse why
it cannot be given by mouth. The nurse responds that
heparin is given parenterally because

 Options :-  Rationale : Ans .( 1 ) .

 1. It is destroyed by  Heparin is a protein and is
gastric secretions . destroyed by gastric
secretions .
 2. It irritates the
gastric mucosa .
 It is given either intravenously
or subcuteneously for that
 3. It irritates the reason .
intestinal lining .

 4. therapeutic
levels can be
achieved more
quickly .
Q.8- An adult who is admitted for a cardiac catheterization
asks the nurse if she will be asleep during the cardiac
catheterization . What is the best initial response for the
nurse to make ?
 Options :-  Rationale : Ans .( 2 ) .
 1. you will be given a  Person who are
general anesthesia . undergoing cardic
catheterization will
receive a sedative but are
 2. you will be sedated but not put to sleep .
not asleep .
 Their cooperation is
 3. the doctor will give you needed during the
an anesthetic if you are procedure . Asking Why
having too much pain . make the client defensive
and is not appropriate for
 4. why do you want to be this client at this time give
asleep . the client the
informations ask for .
Q.9- During the admission interview, a client who is
admitted for a cardiac catheterization says every time I
eat shrimp I get a rash , what action is essential for the
nurse to take at this time ?
 Raationale :Ans .( 1 ) .
 Options :
 Allergy to shellfish is indicative
 1. Notify the physician .
of an allergy to iodine the dye
used in a cardiac
 2. Asks the client if she get a catheterization is a iodine dye .
rash from any other food .  Anaphylactic reaction can
occurs because the exam is
 3. Instruct the dietry scheduled for the morning .
department not to give the
client shrimp .  The nurse should notify the
physician immediately. The
 4. Teach the client the danger other action might have
of eating shrimp and other relevance but are not essential
shellfish . ( safety releted ) at this time .
Q.10- The nurse is preparing a client for a cardiac
catheterization . Which action whould be nurse expect to
take ?

 Options :  Rationale: Ans. (3 ) .

 1. Administer a  It is essential to monitor peripheral
pulses after the procedure . They
radioisotope as ordered should be assessed before the
. procedure to determine location and
baseline levels .
 2. give the client a
 An iodine dye is used during a cardiac
cleansing enema . catheterization not a radioisotope .

 3. Locate and mark  There is no need to give the client an

peripheral pulses. enema .

 Fluid may be encouraged after the test

 4. Encourage high fluid . The client will be NPO for eight
intake before the test . hours before the test .
Q.11- When a client return from undergoing a cardiac
catheterization . It is most essential for the nurse to ?

 Options :  Rationale : Ans . ( 1 ) .

 Checking peripheral pulses is of highest
 1. Check peripheral priority . the complications most likely to
pulse. occurs are hemorrhage and obstruction of
the vessel .

 The client is NPO before the procedure ,

 2. Maintain NPO . not after cold may be applied to the
insertion site to vasoconstrict .

 3. Apply heat to the  Heat vasodilates and is contraindicated

because if might cause bleeding .
insertion site .
 Range of motion exercise might cause
bleeding the extremity used for the
 4. Start range of insertion site is kept quiet immediately
following a cardiac catheterization .
motion exercise
immediately .
Q.12- A younge adult with a history of rheumatic fever as a child is to
have a cardiac catheterization . She asks the nurse why she must
have a cardiac catheterization. The nurse is response is based on the
understanding that cardiac catheterization can accomplish all the
following expect ?
 Options :  Rationale : Ans .( 4 ) .
 1. Assessing the heart  A biopsy specimen cannot be
structures . obtained during a cardiac
catheterization .
 2. Determining the
oxygen levels in the  heart structure can be
heart chambers . assessed , and oxygen level in
the heart chamber can be
 3. Evaluating cardiac determined and cardiac
output . catheterization output can
be measured during a cardiac
catheterization .
 4. Obtaining biopsy
specimen .
Q.13- The nurse responds to the call light of a client who
has a history of angina pectoris . He tells the nurse that he
has just taken a nitroglycerin tablet sublingually for anginal
pain . What action should the nurse take next ?
 Options :  Rationale : Ans .( 1 ) .
 1. If the pain does not  Nitroglycerin can be given at five
subside the 5 minutes ., minutes intervals for upto there
place a second tablet doses if the pain is not relieved .
under the tongue . Positioning with head lower than
feet increase cardiac workload and
 2. Position him with head
whould make the client worse .
lower than feet .
 PRN narcotic are not usually
 3. Administer a narcotic
ordered for client who have anginal
as needed ( PRN ) for pain .
pain if he still has pain in  Nitroglycerin , a vasodilator is
10 minutes . usually the medication of choice at
some point , the physician will need
to be called but there is no need to
 4. Call his physician and alert the code team for possible
alert the code team for intervention .
possible intervention .
Q.14- The nurse is teaching an adult who has angina about
taking nitroglycerin. The nurse tells him he will know the
nitroglycerin is effective when ?

 Rationale : Ans .( 3 ) .
 Options :  Pain relief is the expecteed
 1. He experience outcome when taking
tingling under the nitroglycerin vasodilation of
tongue . coronary vessle will increase the
blood supply to the heart
 2. His pulse rate muscles , decreasing the pain
increase . caused by ischemia .

 3. His pain subside .  Tingling under the tongue and a

headache indicate that the
medication is potent . His pulse
 4. His activity rate increase in activity
tolerance increase . tolerance is nice , but
nitroglycerin is given to relieve
anginal pain .
Q.15- A low sodium , low cholesterol weight reducing diet
is prescribed for an adult with heart disease . The nurse
know that he undrestand his diet when he choosen which
of the following meals ?
 Options ;  Rationale : Ans. ( 1 ) .
 1. Baked skinless  Chicken is a lower in sodium
chicken and mashed than beef or seafood .
potatoes .  Baking adds no sodium to
the chicken .Barbecuing add
 2. Stir – fried chinese sodium and fat and frying
vegetables and rice . add fat and usually sodium
mashed potatoes contain
little sodium .
 3. Tuna fish salad with
celery steaks .
 Chinese food is usually high
in sodium .
 4. Grilled lean steak
 Tuna fish and celery steaks
with carrots . and carrots are high in
sodium .
Q.16- An adult client is admitted with a diagnosis of left
sided congestive heart failure . Which assessment finding
would most likely be present ?

 Options :  Rationale : Ans.( 2 ) .

 1. Distended neck  Dyspnea occurs with left
veins . sided heart failure .

 2. Dyspnea .  Distended neck vein ,

hepatomegaly and pitting
 3. Hepatomegaly . edema are sign of right
sided heart failure .
 4. Pitting edema .
Q.17- Digoxin ( lanoxin ) and furosemide (lasix ) are
ordered for a client who has congestive heart failure .
Which of the following would the nurse also expect to be
ordered for this client ?
 Options :  Rationale : Ans .( 1 ) .
 1. Patassium .  Lasix is a potassium depleting diuretics .
 Digoxin toxicity occurs more quickly in
the presence of a low serum potassium .
 2. Calcium .
 Potassium supplements are usually
ordered when the client is on a
 3. Aspirin . potassium depleting diuretics .
 There is no indications for supplement
 4.Coumadin . calcium .

 Aspirin and coumadin are anticoagulent

and are not indicated because the client
is taking lasix and digoxin .
Q.18- A female client is admitted to the hospital with
obesity and deep vein thrombosis ( DVT ) of the right leg
she weight 275 pounds, which of the following factors is
least related to her diagnosis ?

 Options :  Rationale : Ans. ( 4 ) .

 1. she has been taking  Age is least related to
oral estrogens for the DVT oral estrogens
less 3 years . smoking and a broken
 2. she smoke two packs leg are all risk factors
of cigarette daily . for DVT .
 3. her light femur was
fractured recentaly .
 4. she is 30 year old .
Q.19- An adult male has a high levels of high density
lipoproteins [ HDL ] in preportion to low density
lipoproteins [LDL] .how does this relate to his risk of
developing coronary artery disease[ CAD ]. ?
 Options :  Rationale : Ans .( 1 ) .
 1. his risk for CAD  Although elevated LDL levels
low . in propotion to HDL levels are
positively correlated with CAD
 2. there is no direct
, elevates HDL levels in
correlation . proportion to LDL levels may
decrease the risk of developing
CAD .
 3. his risk may
increase with
 HDL levels may increase with
exercise .
exercise thereby decreasing a
client risk of CAD , age is not a
 4. his risk will predictor of HDL and HDL
increase with age . levels .
Q.20- A adult is diagnosed with hypertension .he is
prescribed chlorothiazide ( Diuril ) 500 mg P O . What
nursing instruction in essential for him ?

 Options ;  Rationale :Ans ( 3 ) .

 1. Drink at least  Chlorothiazide ( Diuril ) is a
two quarts of potassium depleting diuretic .
liquid daily . Orange juice and banana ar e
good source of potassium .
 2.Avoid hard  It is not neccessory to decreases
cheeses . fluid to two quarts when the
client ia taking a diuretic .
 Hard cheeses should be avoided .
 3. Drink orange
juice and eat a When the client is taking
monoamine oxidase inhibitors (
banana daily . MAOI s) . MAOIs are
antidepressent . People who take
 4. Do not take coumadin should not take
aspirin . aspirin .