1. A nurse is administering IV
furosemide to a patient admitted with congestive heart failure. After the
infusion, which of the following symptoms is NOT expected?
A. Increased urinary
output
B. Decreased edema
C. Decreased pain
D.
Decreased blood pressure
2. There are a number of risk
factors associated with coronary artery disease. Which of the following is a
modifiable risk factor?
A. Obesity
B. Heredity
C. Gender
D. Age
3. Tissue plasminogen activator
(t-PA) is considered for treatment of a patient who arrives in the emergency
department following onset of symptoms of myocardial infarction. Which of the
following is a contraindication for treatment with t-PA?
A. Worsening chest
pain that began earlier in the evening.
B. History of cerebral
hemorrhage.
C. History of prior
myocardial infarction.
D. Hypertension.
4. Following myocardial infarction,
a hospitalized patient is encouraged to practice frequent leg exercises and
ambulate in the hallway as directed by his physician. Which of the following
choices reflects the purpose of exercise for this patient?
A. Increases fitness
and prevents future heart attacks.
B. Prevents bedsores.
C. Prevents DVT (deep
vein thrombosis).
D. Prevent constipations.
5. A patient arrives in the
emergency department with symptoms of myocardial infarction, progressing to
cardiogenic shock. Which of the following symptoms should the nurse expect the
patient to exhibit with cardiogenic shock?
A. Hypertension
B. Bradycardia
C. Bounding pulse
D.
Confusion
6. A patient with a history of
congestive heart failure arrives at the clinic complaining of dyspnea. Which of
the following actions is the first the nurse should perform?
A. Ask the patient to
lie down on the exam table
B. Draw blood for
chemistry panel and arterial blood gas (ABG)
C. Send the patient
for a chest x-ray
D. Check blood
pressure
7. A patient has taken an overdose
of aspirin. Which of the following should a nurse most closely monitor for
during acute management of this patient?
A. Onset of pulmonary
edema
B. Metabolic alkalosis
C. Respiratory
alkalosis
D. Parkinson’s disease
type symptoms
8. A patient has recently
experienced a (MI) within the last 4 hours. Which of the following medications
would most like to be administered?
A. Streptokinase
B. Atropine
C. Acetaminophen
D.
Coumadin
9. A 64 year-old male who has been
diagnosed with COPD, and CHF exhibits an increase in total body weight of 10
lbs. over the last few days. The nurse should:
A. Contact the
patient’s physician immediately.
B. Check the intake
and output on the patient’s flow sheet.
C. Encourage the
patient to ambulate to reduce lower extremity edema.
D. Check the patient’s
vitals every 2 hours.
10. A 32 year-old male with a
complaint of dizziness has an order for Morphine via. IV. The nurse should do
which of the following first?
A. Check the patient’s
chest x-ray results.
B. Retake vitals
including blood pressure.
C. Perform a
neurological screen on the patient.
D. Request the
physician on-call assessment the patient.
11. A nurse is caring for a patient
with heart disease is monitoring the patient closely for signs of congestive
heart failure (CHF). The nurse assesses the infant for which early sign of CHF?
A. cough
B. pallor
C. tachycardia
D.
slow and shallow breathing
12. Which of the following is the
most common symptom of myocardial infarction?
A. Chest pain
B. Dyspnea
C. Edema
D.
Palpitaions
13. Which of the following landmarks
is the correct one for obtaining an apical pulse?
A. Left fifth
intercostals space, midaxillary line
B. Left fifth
intercostals space, midclavicular line
C. Left second intercostals
space, midclavicular line
D. Left seventh
intercostals space, midclavicular line
14. What is the primary reason for
administering morphine to a client with a myocardial infarction?
A. To sedate the
client
B. To decrease the
client’s pain
C. To decrease the
client’s anxiety
D. To decrease oxygen
demand on the client’s heart
15. Which of the following
conditions is most commonly responsible for myocardial infarction?
A. Aneurysm
B. Heart failure
C. Coronary artery thrombosis
D. Renal failure
C. Coronary artery thrombosis
D. Renal failure
16. What is the most appropriate
nursing response to a myocardial infarction client who is fearful of dying?
A. “Tell me about your
feelings right now.”
B. “When the doctor
arrives, everything will be fine.”
C. “This is a bad
situation, but you’ll feel better soon.”
D. “Please be assured
we’re doing everything we can to make you feel better.”
17. Which of the following classes
of medications protects the ischemic myocardium by blocking catecholamines and
sympathetic nerve stimulation?
A. Beta-adrenergic
blockers
B. Calcium channel
blockers
C. Narcotics
D. Nitrates
18. What is the most common
complication of a myocardial infarction?
A. Cardiogenic shock
B. Heart failure
C. Arryhtmias
D. Pericardits
19. Which of the following disorders
is jugular vein distention most prominent?
A. Abdominal aortic
aneurysm
B. Heart failure
C. MI
D.
Pneumothorax
20. which of the following symptoms
might a client with right-sided heart failure exhibit?
A. Adequate urine
output
B. Polyuria
C. Oliguria
D.
Polydipsia
21. Which of the following condition
is most closely associated with weight gain, nausea, and a decrease in urine
output?
A. Angina Pectoris
B. Cardiomyopathy
C. Left-sided heart failure
D.
Right-sided heart failure
22. What’s the first intervention
for a patient experiencing chest pain and a Sp02 of 89%?
A. Administer morphine
B. Administer oxygen
C. Administer
sublingual nitroglycerin
D. Obtain an
electrocardiogram (ECC)
23. Which of the following positions
would best aid breathing for a patient with acute pulmonary edema?
A. Lying flat in bed
B. Left side-lying
position
C. High Fowler’s position
D.
Semi-Fowler’s position
24. A 54-year-old client was put in
Quinidine (a drug that decreases myocardial excitability) to prevent atrial
fibrillation. He also has kidney disease. The nurse is aware that this drug,
when given to a client with kidney disease, may
A. Cause cardiac
arrest
B. Cause hypotension
C. Produce mild
bradycardia
D. Be very toxic even
in small doses
25. A cyanotic client with an
unknown diagnosis is admitted to the emergency room. In relation to oxygen, the
first nursing action would be to
A. Wait until the
client's lab work is done
B. Not administer
oxygen unless ordered by the physician
C. Administer oxygen
at 2 liters flow per minute
D. Administer oxygen
at 10 liters flow per minute and check the client's nail beds
26. A client complaining of severe
shortness of breath is diagnosed with congestive heart failure. The nurse
observes a falling pulse-oximetry. The client's color changes to gray and she
expectorates large amounts of pink frothy sputum. The first action of the nurse
would be which of the following?
A. Call the health
care provider
B. Check vital signs
C. Position in high Fowler's
D.
Administer oxygen
27. A nurse enters a client’s room
to discover that the client has no pulse or respirations. After calling for
help, the first action the nurse should take is to:
A. start a peripheral
IV
B. initiate
closed-chest massage
C. establish an airway
D.
obtain the crash cart
28. A client is receiving digoxin
(Lanoxin) 0.25 mg. Daily. The health care provider has written a new order to
give metoprolol (Lopressor) 25 mg. B.I.D. In assessing the client prior to
administering the medications, which of the following should the nurse report
immediately to the health care provider?
A. Blood pressure
94/60
B. Heart rate 76
C. Urine output 50 ml/hour
D.
Respiratory rate 16
29. A client admitted to the
visiting nurse services for assessment and follow-up after being discharged
from the hospital for new-onset congestive heart failure (CHF). The nurse
teaches the client about the dietary restrictions required with CHF. Which
statement by the client indicates that further teaching is needed?
A. “I’m going to have
a ham and cheese sandwich and potato chips for lunch.”
B. I’m going to weigh
myself daily to be sure I don’t gain too much fluid.”
C. “I can have most
fresh fruits and fresh vegetables.”
D. “I’m not supposed
to eat cold cuts.”
30. A nurse is trying to determine
the ability of the client with MI to manage independently at home after
discharge. Which statement by the client is the strongest indicator of the
potential for difficulty after discharge?
A. “I don’t have
anyone to help me with doing housework at home.”
B. “I think I have a
good understanding of what all my medications are for.”
C. “I will be sure to
keep my appointment with the cardiologist.”
D. “I need to start
exercising more to improve my health.”
31. A home care nurse has taught a
client with a nursing diagnosis of decreased cardiac output about helpful
lifestyle adaptations to promote health. Which of the following statements by
the client best demonstrates an understanding of the information provided?
A. “I will eat enough
daily fiber to prevent straining at stool.”
B. “Drinking 2 to 3
ounces of liquor each night will promote blood flow by
enlarging blood vessels.”
C. “I will drink 3000
to 3500 mL of fluid daily to promote good kidney function.”
D. “I will try to
exercise vigorously to strengthen my heart muscle.”
32. A client recovering from
pulmonary edema is preparing for discharge. The nurse plans to teach the client
to do which of the following to manage or prevent recurrent symptoms after
discharge?
A. Take a double dose
of the diuretic if peripheral edema is noted
B. Withhold prescribed
digoxin (Lanoxin) if slight respiratory distress occurs
C. Weigh himself on a
daily basis
D. Sleep with the head
of bed flat
33. A client receiving parenteral
nutrition has a history of congestive heart failure. The physician has ordered
furosemide (LAsix) 40 mg by mouth daily to prevent fluid overload. The nurse
monitors which laboratory value to identify an adverse effect from this
medication.
A. Glucose
B. Sodium
C. Potassium
D.
Magnessium
34. A home health nurse is visiting
an older cliuent whose family has gone out for the day. During the visit, the
client experiences chest pain that is unrelieved by three sublingual
nitroglycerin tablets given by the nurse. Which action by the nurse would be
appropriate at this time?
A. Notify a family
member who is the next of kin
B. Inform the home
care agency supervisor that the visit may be prolonged
C. Call for an
ambulance to transport the client to the hospital emergency department
D. Drive the client to
the physician’s office
35. A client has experienced an
episode of pulmonary edema. The nurse determines that the client’s respiratory
status id improving after this episode if which of the following breath sounds
are noted?
A. Crackles throughout
the lung fields
B. Crackles in the
base
C. Wheezes
D.
Rhonchi
36. A client with pulmonary edema
has an order to receive morphine sulfate intravenously. The nurse determines
that the client is experiencing an intended effect of the medication as
indicated by which of the following assessment findings?
A. Relief of
apprehension
B. Decreased urine
output
C. Increased pulse rate
D.
Increased blood pressure
37. A client recovering from an
exacerbation of left-sided heart failure has a nursing diagnosis of activity
intolerance. Which of the following changes in vital signs during activity
would be the best indicator that the client is tolerating mild exercise?
A. Pulse rate
increased from 80 to 140 beats/min
B. Respiratory rate
increased from 16 to 19 breaths/min
C. Oxygen saturation
decreased from 96% to 91%
D. Blood pressure
deceased from 140/86 mmHg to 112/72 mmHg
38. A client with a history of
myocardial infarction is admitted with shortness of breath, anxiety, and slight
confusion. Assessment findings include a regular heart rate of 120
beats/minute, audible third and fourth heart sounds, blood pressure of 84/64 mm
Hg, bibasilar crackles on lung auscultation, and a urine output of 5 ml over
the past hour. The nurse anticipates preparing the client for transfer to the
intensive care unit and pulmonary artery catheter insertion because:
A. the client is
experiencing heart failure.
B. the client is going
into cardiogenic shock.
C. the client shows
signs of aneurysm rupture.
D. the client is in
the early stage of right-sided heart failure.
39. The nurse administers furosemide
(Lasix) to treat a client with heart failure. Which adverse effect must the
nurse watch for most carefully?
A. Increase in blood
pressure
B. Increase in blood
volume
C. Low serum potassium level
D.
High serum sodium level
40. Which of the following may NOT include clinical manifestation of
left sided CHF?
A.
Dyspnea on exertion
B.
Insomnia
C. Orthopnea
D.
None of the above
41. Which of the following may NOT include clinical manifestation of
right sided CHF?
A.
Weight gain
B.
Nausea
C. Weight loss
D.
Distended neck veins
42. Which of the following is a
major cause of cardiac arrerst?
A.
Ventricular Fibrilation
B.
Congeniya heart disease
C. MI
D.
Heart failure
43. Which of the following may NOT include clinical manifestation of
cardiac arrest?
A.
Immediate loss of consciousness
B.
Absence of palpable pulse
C. Apnea
D.
None of the above
44. Which of the following is NOT a major cause of acute pulmonary
edema?
A.
Left ventricular CHF
B.
Right ventricular CHF
C. Lung injury
D. None of the above
45. Appropriate nursing diagnoses
for patient with congestive heart failure include/s:
A.
Activity Intolerance
B.
Impaired gas exchange
C. Decreased cardiac output
D.
All of the above
46. Which of the following may NOT include clinical manifestation of
right sided CHF?
A.
Ascites
B.
Increase in appetite
C. Liver congestion
D.
All of the above
47. Which of the following should a
nurse teach to a patient with CHF?
A.
High sodium diet
B.
low potassium diet
C. High potassium diet
D.
Force fluid intake
48. Which of the following would
suggest that health teaching made by a nurse to a patient with CHF is effective
would include?
A.
The patient limits activities to level that permit s the heart to rest
B.
The patient exhibit weight loss, indicating increased fluid consumption
C.
The patient exhibit weight gain, indicating reduced fluid consumption
D.
The patient verbalized anxiety towards the disease process
49. Which of the following is
expected to laboratory findings in patients with CHF?
A.
Cardiac atrophy
B.
ECG findings inconsistent with hypertrophy or myocardial damage
C.
ECG findings consistent with hypertrophy or myocardial damage
D.
Cardiomegaly with normal lung status
50. A nurse should promote measures
to provide rest for the heart of patient suffering from CHF. Which of the
following would indicate EFFECTIVE nursing care?
A.
Maintain bedrest with increased activity
B.
Encouraged as many visitors as possible to motivated the patient
C.
Cluster necessary nursing care to minimize disruptions
D.
None of the above
51. A patient with cardiac arrest is
seen by a nurse lying unconsciously in the floor. What should the nurse do
first?
A.
Initiate CPR immediately
B.
Call the physician
C.
Run to the nurses’ station and call for help
D.
Assess the environment for possible assault done to the patient
52. A patient admitted to the
hospital with myocardial infarction develops severe pulmonary edema. Which of
the following symptoms should the nurse expect the patient to exhibit?
A. Slow, deep
respirations
B. Stridor
C. Bradycardia
D.
Air hunger
53. A patient with a history of
congestive heart failure arrives at the clinic complaining of dyspnea. Which of
the following actions is the first the nurse should perform?
A. Ask the patient to
lie down on the exam table
B. Draw blood for
chemistry panel and arterial blood gas (ABG)
C. Send the patient
for a chest x-ray
D. Check blood
pressure
54. Which of the following would a
nurse include in a discharge plan for a patient who is recovering from acute
pulmonary edema?
A.
Annual weight measurement
B.
Plan for rest periods, abruptly increasing daily activity
C.
weigh patient every other day to provide rest periods for the patient
D.
Plan for rest periods, gradually increasing daily activity
55. Which of the following would
indicate that a patient recovering from acute pulmonary edema is complying with
the treatment regimen?
A.
Patient performs weight bearing activities
B.
Patient sleeps at night with head of bed flat
C.
Patient displays decreased anxiety
D.
Patient demonstrates unstable cardiac rhythm, vital signs, and urine output
56. Which of the following would
best suggest that the patient is suffering from pulmonary edema?
A.
Dyspnea and cough producing copious blood-tinged, frothy sputum
B.
Non-frothy sputum
C.
Clear lung sounds
D.
Crackles heard at the base of the lung fields
58. Which of the following is
generally defined as the inability of the heart to supply sufficient blood flow
to meet the needs of the body?
A.
MI
B.
CHF
C. Acute Pulmonary Edema
D.
Cardiac arrest
59. Which of the following is the
cessation of normal circulation of the blood due to failure of the heart to
contract effectively?
A. MI
B.
CHF
C. Acute Pulmonary Edema
D.
Cardiac arrest
60. Which of the following is fluid
accumulation in the lungs. It is due to failure of the heart to remove fluid
from the lung circulation?
A. MI
B.
CHF
C. Acute Pulmonary Edema
D. Cardiac arrest
