NCLEX Cardiovascular System 105 Nursing Practice Questions And Rationales To EASILY Crush The NCLEX!

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NCLEX: Cardiovascular System 105 Nursing Practice Questions and Rationales to EASILY Crush the NCLEX! Chase Hassen Nurse Superhero © 2015

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This book is not intended as a substitute for the medical advice of physicians.

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NCLEX®, NCLEX®-RN, and NCLEX®-PN are registered trademarks of the National Council of State Boards of Nursing, Inc. They hold no affiliation with this product. © Copyright 2015 by Chase Hassen. All rights reserved.

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Table of Contents Chapter 1: NCLEX Questions, Answers & Rationales on the Cardiovascular System Chapter 2: NCLEX Questions Only on the Cardiovascular System

Chapter 1: NCLEX Questions, Answers & Rationales on the Cardiovascular System When studying for the NCLEX test, it is important to take as many practice questions as possible so that you can identify areas you know well and differentiate them from areas that need more review. The following are 105 questions on the Cardiovascular System that may be on the test. Take the test and compare your answers with the questions, answers, and rationales provided below. Good luck!

1.

The function of the cardiovascular system involves any one or more of the following functions. Check all that apply. a.

Oxygen transportation

b.

Metabolic waste removal

c.

Hormone transportation

d.

Neural connectivity

e.

CO2 removal

Answer: a. b. c. e. The cardiovascular system is responsible for the transportation of oxygen and removal of CO2, the removal of metabolic waste products and the transportation of hormones. It is not responsible for neural connectivity.

2.

The heart is incased in what?

a.

The peritoneum

b.

The pericardial sac

c.

Lung tissue

d.

It has no encasement

Answer: b. The heart is encased in the pericardial sac—a connective tissue sac that separates it from other internal organs.

3.

What is the function of the pericardial sac?

a.

To keep foreign antigens from the heart

b.

To keep the heart from enlarging

c.

To provide nutrients to the heart

d.

To provide lubrication for the heart

Answer: d. The function of the pericardial sac is to provide lubrication to the heart when it beats.

4.

Which is not a layer of the heart?

a.

The pericardial layer

b.

The myocardium

c.

The endocardium

d.

The epicardium

Answer: a. The three layers of the heart are the epicardium, the myocardium and the endocardium.

5.

List in order the pathway of blood through the heart from deoxygenated to oxygenated blood. a.

Left ventricle

b.

Right ventricle

c.

Left atrium

d.

Right atrium

Answer: d, b, c, a. Blood goes from the right atrium to the right ventricle, then to the lungs, the left atrium and out the left ventricle.

6.

Which heart valves are closed to prevent backflow of blood into the atria during diastole? List all that apply. a.

Tricuspid valve

b.

Pulmonary valve

c.

Mitral valve

d.

Aortic valve

e.

Pneumonic valve

Answer: a. c. The tricuspid valve and the mitral valve are closed to prevent backflow of blood during diastole.

7.

What artery supplies the back of the left ventricle, the inferior of the left ventricle, the right ventricle, and the right atrium? a.

Left main coronary artery

b.

Left anterior descending artery

c.

Circumflex artery

d.

Right coronary artery

Answer: d. the Right coronary artery supplies the inferior and posterior aspects of the left ventricle, the right ventricle and the right atrium.

8.

What is the cardiac output?

a.

The amount of blood ejected from the left ventricle in one beat.

b.

The amount of blood ejected from each ventricle in one minute.

c. beat.

The amount of blood ejected from both atria and ventricles per

d.

The amount of blood entering the lungs per minute.

Answer: b. The cardiac output is the amount of blood ejected from each ventricle in one minute. The normal value is 4-8 liters per minute.

9.

Which factors affect a person’s cardiac output?

a.

The oxygenation of blood

b.

The stroke volume

c.

The blood volume

d.

The preload

e.

The force of the contraction

Answer: b. d. e. The factors affecting the cardiac output are the stroke volume, the preload and the force of the contraction.

10.

The natural pacemaker of the heart is what?

a.

The AV node

b.

The purkinje fibers

c.

The SA node

d.

The bundle of His

Answer: c. The SA node is the natural pacemaker of the healthy heart.

11.

Distended neck veins mean what? Check all that apply.

a.

Decreased preload

b.

Increased preload

c.

Increased cardiac output

d.

Possible cardiac insufficiency

e.

Rapid heart rate

Answer: b. d. Distended neck veins mean that the preload of the heart is increased and/or that there is increased chance of cardiac insufficiency.

12.

Which vessels carry deoxygenated blood? Select all that apply.

a.

Arteries

b.

Capillaries

c.

Venules

d.

Arterioles

e.

Veins

Answer: b.c.d. The capillaries carry both oxygenated and deoxygenated blood to the venules and veins that carry deoxygenated blood.

13.

The sympathetic nervous system:

a.

Slows the heart rate

b.

Blocks beta-adrenergic receptors on the heart

c.

Increases the heart rate

d.

Determines the cardiac output

Answer: c. The sympathetic nervous system stimulates the beta-adrenergic receptors and increases heart rate.

14.

Which are true regarding heart sounds? Select all that are true.

a.

Diastole occurs between S1 and S2

b.

Systole occurs during S1 and S2

c.

Murmurs indicate vascular turbulence

d.

The time between S1 and S2 is variable

e.

S2 is occasionally absent

Answer: b. c. Systole occurs between S1 and S2 and murmurs represent areas of vascular turbulence.

15.

You are briefly assessing a patient for his risk of stroke. What easy test can you do? a.

Check for a carotid bruit

b.

Assess speech function

c.

Do a carotid ultrasound

d.

Examine the patient for hemiparesis

Answer: a. A simple test for risk of stroke is to examine the patient’s carotid arteries with a stethoscope in order to listen for the presence of a carotid bruit.

16.

The doctor tells you the patient has a grade IV heart murmur.

What does that mean? a.

The patient has a very faint murmur

b.

The murmur can be heard without a stethoscope.

c. chest.

The murmur can be heard with a stethoscope just off the patient’s

d.

The murmur is laud and there is a palpable thrill.

Answer: d. A grade IV heart murmur is loud with a palpable thrill. Murmurs are graded from I-VI.

17.

U wave?

On a standard EKG a U wave is seen. What can be said about the

a.

It represents early ventricular repolarization.

b.

It indicates a myocardial infarction.

c.

You should evaluate the patient for hypokalemia

d.

You should expect ventricular excitability.

Answer: c. A U wave is often present during situations involving hypokalemia.

18.

Common causes of bradycardia include the following. Check all that apply. a.

Highly conditioned athlete

b.

Excess norepinephrine

c.

Inferior myocardial infarction

d.

Parasympathomimetic drugs

e.

Sympathetic drugs

Answer: a. c. d. Causes of bradycardia include being a highly conditioned athlete, having an inferior MI and parasympathomimetic drugs.

19.

The treatment of symptomatic bradycardia with hypotension includes these choices. Check all that apply. a.

Give IV epinephrine.

b.

Give IV atropine.

c.

Hold all parasympathomimetic drugs

d.

Give Nitroprusside

e.

Defibrillate the patient.

Answer: b. c. In a patient with symptomatic bradycardia, the treatment of choice is to hold all parasympathomimetic drugs and give the patient IV atropine.

20.

The patient is having ectopic beats occurring on the T wave of the previous beat while on telemetry. What should you look for? a.

The possibility of supraventricular tachycardia

b.

Third degree heart block

c.

Ventricular tachycardia

d.

The onset of bradycardia

Answer: c. The presence of ectopic beats occurring on the T wave of the previous beat indicates ventricular irritability with the possibility of impending ventricular tachycardia.

21.

The patient’s rhythm on a cardiac monitor shows no P waves and a ventricular rate of 100. What are the possible causes of this condition?

Check all that apply. a.

Excess epinephrine

b.

Alcoholism

c.

Infection

d.

Underlying cardiac disease

e.

Cocaine abuse

Answer: b. c. d. The patient is in atrial fibrillation which can be caused by alcoholism, infection, or underlying heart disease.

22. apply.

What is the significance of atrial fibrillation? Check all that

a.

The patient is at risk for low cardiac output.

b.

The patient is at risk for supraventricular tachycardia.

c.

The patient is at risk for embolic stroke.

d.

The patient is at risk for hypertension.

e.

The patient may develop angina.

Answer: a. c. e. A patient with atrial fibrillation may develop a decreased cardiac output and angina. There is also a risk for embolic stroke from clots developing in the fibrillating atria.

23.

What are effective treatments for symptomatic atrial fibrillation?

Check all that apply. a.

Asynchronized cardioversion

b.

Synchronized cardioversion

c.

IV ibutilide (Corvert)

d.

Radiofrequency catheter ablation

e.

Lanoxin IV

Answer: b. c. d. e. The patient may be treated with defibrillation synchronized to the ventricular beat, receive IV ibutilide, receive IV Lanoxin or have radiofrequency catheter ablation. Asynchronized cardioversion should not be attempted because the patient has a ventricular rhythm that may be disrupted with asynchronized cardioversion.

24.

The patient has a saw-toothed p wave with an atrial rate of 350600 beats per minute and a ventricular rate of 100 beats per minute. What is this rhythm? a.

Atrial fibrillation

b.

Supraventricular tachycardia

c.

Frequent premature atrial contractions

d.

Atrial flutter

Answer: d. A saw-toothed pattern of p waves at a rate of 350-600 beats per minute represents atrial flutter, which is controlled because the ventricular rate is maintained at 100 beats per minute.

25.

The patient has a cardiac rhythm with a progressively longer PR interval for three beats followed by a dropped QRS complex. What is this rhythm? a.

Third degree heart block

b.

Sinus bradycardia

c.

Second degree heart block, Wenckebach type

d.

Atrial flutter

Answer: c. The characteristics of a second degree heart block (Wenckebach) type I is a prolongation of the PR interval for a few beats followed by a single skipped QRS complex.

26. heart?

A junctional rhythm has a pacemaker originating where in the

a.

SA node

b.

AV node

c.

Bundle of His

d.

Ectopic sites in the atria

Answer: b. If the patient is exhibiting a junctional rhythm, the pacemaker of the heart is at the level of the AV node. QRS complexes are usually narrow.

27.

If the patient is experiencing a junctional rhythm and is symptomatic, what treatment measures should be offered? Check all that apply. a.

IV atropine

b.

IV bretyllium

c.

IV nitroprusside

d.

Digoxin should be held

e.

IV procainamide

Answer: a. d. If a symptomatic junctional rhythm is noted, IV atropine can be given to stimulate the SA node. Since digoxin toxicity can cause this type of rhythm, a level should be drawn and the digoxin held until the results of the digoxin level returns.

28. apply.

Which drugs are known to increase the heart rate? Check all that

a.

Procainamide

b.

Epinephrine

c.

Propranolol

d.

Dopamine

e.

Atropine

Answer: b. d. e. Epinephrine, dopamine and atropine will all increase the heart rate. Propranolol will actually lower the heart rate and procainamide is an ant-arrhythmic medication.

29.

In third degree heart block, the ventricular rate is usually what?

a.

120-140 bpm

b.

80-100 bpm

c.

60-80 bpm

d.

20-40 bpm

Answer: d. In third degree heart block, there is no relationship between the P waves and the QRS complex and the ventricular rate is often between 20-40 beats per minute.

30.

Treatments for symptomatic third degree heart block include the following. Check all that apply. a.

IV amiodarone

b.

IV procainamide

c.

IV lidocaine

d.

CPR if pulseless

e.

Synchronized cardioversion

Answer: a. c. d. e. If the patient has a pulse, give IV amiodarone or IV lidocaine. If no pulse is present, you should begin CPR and preparation for synchronized cardioversion should be undertaken.

31.

The patient’s rhythm is ventricular fibrillation. What treatments should you begin? Check all that apply. a.

Synchronized cardioversion

b.

Defibrillation

c.

Epinephrine

d.

Atropine

e.

Amiodarone

Answer: b. c. e. In ventricular fibrillation, the patient should have CPR, be immediately defibrillated, receive IV epinephrine and possibly IV amiodarone.

32.

The patient has frequent symptomatic PVCs. What are the possible causes? List all that apply. a.

Propranolol toxicity

b.

Fever

c.

Digoxin toxicity

d.

Stimulants

e.

Hypokalemia

Answer: b. d. e. Possible causes of frequent PVCs include fever, high levels of cardio-stimulants or hypokalemia. Propranolol and Digoxin do not cause this arrhythmia.

33.

Episodic ventricular tachycardia can be due to any of the following. Select all that apply. a.

Acute MI

b.

Hyponatremia

c.

Cardiomyopathy

d.

Prolonged QT

e.

Hyperkalemia

Answer: a. c. d.e. Episodic ventricular tachycardia can occur in the presence of an acute MI, cardiomyopathy, prolonged QT or hyperkalemia.

Hyponatremia is not a cause of ventricular tachycardia.

34.

A patient has a flat line on the cardiac monitor and is unconscious with no pulse. What is the first thing you should do? a.

Verify asystole in more than one lead.

b.

Intubate the patient

c.

Give IV bretyllium

d.

Give IV procainamide

Answer: a. When asystole is suspected, verify the presence of a flat line in at least one other lead before starting CPR, giving atropine and epinephrine and intubating the patient.

35.

A person has a suspected myocardial infarction. Which blood test is most specific for evidence of a myocardial infarction? a.

Total CPK

b.

Troponin I

c.

AST

d.

LDH

Answer: b. Of all of the above tests, the troponin I test is most specific as evidence of an acute myocardial infarction. The others have other possible sources.

36.

A patient is being given an anticoagulant. The PTT is twice normal and the PT is minimally elevated. What anticoagulant is the patient likely being given? a.

Heparin

b.

Warfarin

c.

Aspirin

d.

Tissue plasminogen activator (TPA)

Answer: a. Heparin elevates the partial thromboplastin time, which is used to measure its effectiveness. The protime (PT) can be mildly elevated as well.

37.

A patient is having a graded exercise test with a treadmill. What things should you tell the patient beforehand? Check all that apply. a.

The test may take up to two hours.

b. normal.

You may expect to have chest pain during this procedure, which is

c.

Wear comfortable clothing and shoes.

d.

You will be monitored throughout the test.

e.

You will be given an IV.

Answer: c. d. The person should wear comfortable clothing and shoes and will be monitored throughout the test. Chest pain is not normal during a stress test and an IV is not warranted. The test rarely lasts more than 15-30 minutes.

38. scan?

What is the purpose of giving dipyridamole prior to a Thallium

a.

To thin the blood

b.

To dilate the coronary arteries

c.

To regulate the heart rhythm

d.

To decrease the blood pressure

Answer: b. Dipyridamole is given prior to a Thallium scan to dilate the coronary arteries for better visualization of the thallium.

39.

What is the purpose of the Technetium Scan?

a.

To look for evidence of CHF.

b.

To measure the electrical activity of the heart.

c.

To show areas of increased uptake in an MI.

d.

To check the ejection fraction.

Answer: c. The purpose of a Technetium scan is to look for areas of increased uptake in areas affected by an MI. The test will show uptake for up to 6 days post-MI.

40.

You are educating a patient having an angioplasty with stent placement. What is an appropriate thing to say to the patient? a.

This will involve open heart surgery

b.

A catheter with a balloon will open blockages and the stent will keep the blockages open. c.

There are no risks to this procedure.

d.

Only one artery will be treated.

Answer: b. During an angioplasty, a catheter will be inserted and a balloon will be used to open arterial blockages. A stent is placed to keep the area of blockage open. More than one artery may be stented. The procedure carries a risk of damage to the coronary arteries with a possible ischemic event. This is used in place of open heart surgery.

41.

A patient is having a transesophageal echocardiogram. What things will you say to educate the patient about the test? Check all that apply. a.

The patient can eat a small meal before the procedure.

b.

The test is to check for heart defects, valvular defects, thrombus or bacterial endocarditis. c.

The patient will swallow a probe.

d.

The patient will be unconscious during the procedure.

e.

The procedure lasts about an hour.

Answer: b. c. The transesophageal echocardiogram involves being NPO for 6 hours before the procedure. The test checks for heart defects, valvular defects, thrombus or bacterial endocarditis. The patient will swallow a probe using local anesthesia and IV sedation. The procedure takes about 15 minutes.

42.

The patient is to have a Thallium scan. What do you say to educate the patient? Check all that apply. a.

Thallium is a radioactive isotope.

b.

A scintillation camera will detect areas of radioactive uptake.

c.

The test involves oral ingestion of Thallium.

d.

The radioactivity lasts in the system for up to a week.

e.

The test is diagnostic of areas of poor uptake indicating cardiac ischemia/infarct.

Answer: a. b. e. The thallium scan involves a radioisotope injected by IV. A scintillation camera will detect areas of radioactive uptake in the heart, diagnostic of areas of cardiac ischemia or infarct. The radioactivity leaves the body within a few hours.

43.

The patient is having an electrophysiology study of the heart.

What do you say to educate the patient? Select all that apply. a.

The test assesses the electrical activity of the heart.

b.

A probe will be passed through the pericardium.

c.

The doctor may stop the patient’s antiarrhythmic medication a few days before the procedure. d.

The patient may eat a small liquid meal before the procedure.

e.

The test is done under general anesthesia.

Answer: a. c. The electrophysiology study of the heart assesses the electrical pathways of the heart. The probe is passed through a femoral vein.

Antiarrythmics may be stopped a few days prior to the test. The patient must be NPO for 6-8 hours before the test, which is done under light sedation.

44. purpose?

Central venous pressure monitoring is used for what main

a.

To check the electrolyte concentration near the heart.

b.

To assess the preload to the heart.

c.

To assess cardiac output.

d.

To obtain the diastolic blood pressure.

Answer: b. The central venous pressure monitoring assesses the preload to the heart and can help with issues of over or under-hydration.

45.

The pacemaker is used whenever there is what going on in the heart? Check all that apply. a.

SVT

b.

Premature ventricular contractions

c.

Bradycardia

d.

Heart block

e.

Atrial fibrillation with rapid ventricular response

Answer: c. d. The pacemaker can increase the heart rate in situations of bradycardia or heart block.

46.

The patient has just had an angioplasty with stent placement.

What will you instruct the patient as part of their education? a.

Chest pain radiating to the left arm is normal after this procedure.

b.

The patient is to be NPO for 6-8 hours after the procedure.

c.

The patient will take clopidogrel (Plavix) for a period of time to reduce platelet aggregation. d.

The patient will be on IV heparin for up to 5 days post-procedure.

Answer: c. After the procedure, the patient will take clopidogrel (Plavix) for a few days to prevent platelet aggregation around the stent.

47.

Complications of an angioplasty with stent placement include the following. Check all that apply. a.

Cerebrovascular accident

b.

Pulmonary embolism

c.

Deep vein thrombosis

d.

Punctured ventricle

e.

Dysrhythmia

Answer: a. d. e. Complications of an angioplasty with stent placement can involve a cerebrovascular accident, blood thrombus, punctured ventricle, breakage of the tip of the catheter, dysrhythmia or sudden death.

48.

The patient has just had a pacemaker inserted. What do you tell him as education following the procedure? Check all that apply. a.

Avoid close contact with an active microwave oven.

b.

Avoid magnetic resonance imaging (MRI)

c.

How to check their pulse

d.

Keep a pacemaker ID card in their wallet

e.

The battery will be changed every six months

Answer: b. c. d. After a pacemaker, the patient is safe to use a microwave but must avoid MRI exams. They need to learn how to check their pulse and should keep a pacemaker ID card in their wallet.

49.

The patient is scheduled for a coronary artery bypass graft surgery. What will you tell him as part of his pre-procedure education? Check all that apply. a. bypass.

The saphenous vein or left internal mammary artery is used for the

b.

The patient will not need to be intubated for the procedure.

c.

The procedure may or may not require the use of cardiopulmonary bypass pump. d.

The surgery will be done under heavy IV sedation.

e.

There will be chest tubes in the chest to drain fluid from around the heart after surgery.

Answer: a. c. e. The saphenous vein or left internal mammary artery will be used for the bypass, which will be done under general anesthesia with an endotracheal tube placed. Chest tubes will be placed at the time of surgery to drain fluid from around the heart.

50.

Following a CABG, the patient may experience which of the following? a.

Increased appetite

b.

Depression

c.

Increased pain tolerance

d.

Rejection of graft

Answer: d. Depression and anorexia are common after a CABG. There is no risk of graft rejection because the patient is using his or her own tissue for the graft. Pain medications will be necessary.

51.

A patient is having a pacemaker implanted. What do you look for to make sure that the pacemaker is functioning? a.

A pacemaker spike that is not followed by a QRS complex.

b.

The presence of regular pacemaker spikes followed by QRS complexes. c.

Premature ventricular contractions.

d.

Atrial fibrillation.

Answer: b. If the pacemaker is functioning, there should be regular pacemaker spikes followed by normal QRS complexes. PVCs may indicate that the pacemaker electrode has become dislodged.

52.

The purpose of a peripheral arteriography is what?

a.

To check the blood pressure in the peripheral arteries.

b.

To evaluate the patient for DVT.

c.

To evaluate the peripheral cardiac output.

d.

To inspect the peripheral arteries for patency, aneurysm or trauma.

Answer: d. The purpose of a peripheral arteriography is to inspect the peripheral arteries for patency, aneurysm or trauma.

53.

In preparation for a peripheral arteriography, what must be done?

Check all that apply. a.

The patient must have a pre-procedure ultrasound of the arteries.

b.

The patient must be assessed for allergy to dye or shellfish.

c.

A serum creatinine must be drawn to assess kidney function.

d.

Obtain a CBC with differential.

e.

Obtain a cardiac echocardiogram.

Answer: b. c. The patient must be assessed for allergy to dye or to shellfish and a serum creatinine must be done to evaluate the kidney’s ability to rid the body of the dye after the procedure.

54.

Complications after a CABG include any of the following. Check all that apply. a.

Low cardiac output

b.

Cardiac tamponade

c.

Graft rejection

d.

Incisional infection

e.

Warm extremities

Answer: a. b. d. Complications of a CABG include low cardiac output, cardiac tamponade, and incisional infection. There is a risk of cool extremities but no risk of rejection as the graft is from the patient themselves.

55.

A patient has been diagnosed with rheumatic heart disease. What do you tell them as part of their education? a.

It primarily occurs in the elderly.

b.

It is an autoimmune disease.

c.

It is caused by a Group A streptococcal infection

d.

There is no risk of joint involvement.

Answer: c. Rheumatic heart disease often follows a Group A streptococcal infection and can have heart, skin or joint involvement. It is not an autoimmune disease and usually occurs in young people.

56. what?

The most important thing to do for rheumatic heart disease is

a.

Complete bedrest

b.

Give immune globulin

c.

Give antibiotics like penicillin

d.

Give acetaminophen for fever

Answer: c. The most important thing to do for rheumatic heart disease is to give antibiotics. Antipyretics may be given for fever and rest is recommended but these are not the most important things to do.

57.

A complication of rheumatic heart disease is what?

a.

Valvular heart disease

b.

Pulmonary embolism

c.

Cardiac tamponade

d.

Coronary artery disease

Answer: a. A possible complication of rheumatic heart disease is valvular heart disease.

58.

You are educating a patient about ventricular septal defects. What do you tell the patient? Check all that apply. a.

It is a congenital opening between the two atria of the heart

b.

It allows blood to flow between the right and left ventricles

c.

It is sometimes seen in Down syndrome

d.

It is not a complication of acute MI

e.

It is a congenital opening between the two ventricles of the heart

Answer: b. c. e. Ventricular septal defects are congenital openings between the two ventricles of the heart. It allows blood to flow between the right and left ventricles. It is sometimes seen in Down syndrome, prematurity, fetal alcohol syndrome, and following an acute MI.

59.

A patient has been diagnosed with endocarditis. What do you tell the patient in educating him? Check all that apply. a.

It is always caused by a bacterium

b.

It can affect heart valves

c.

It may result in vegetative growths on heart valves

d.

It requires amphotericin B

e.

It increases the risk of hemorrhagic stroke

Answer: b. c. Endocarditis is caused by bacterial or fungal infections. It can affect heart valves and cause vegetations on heart valves. There are many antifungal and antibacterial treatments. It increases the risk of embolic stroke but not a hemorrhagic stroke.

60.

Narrowing of the valve between the left atrium and the left ventricle is called what? a.

Tricuspid stenosis

b.

Tricuspid insufficiency

c.

Pulmonic stenosis

d.

Mitral stenosis

Answer: d. Narrowing of the valve between the left atrium and the left ventricle is called mitral stenosis.

61.

Contributing factors to vascular insufficiency include what? List all that apply. a.

Rheumatic heart disease

b.

Male gender

c.

Myocardial infarction

d.

Mitral stenosis

e.

Marfan syndrome

Answer: a. c. e. Vascular insufficiency can be caused by hypertension, rheumatic heart disease, female gender, myocardial infarction, and Marfan syndrome.

62.

A clinical finding in mitral valve regurgitation includes what?

a.

A soft S2

b.

Systolic murmur

c.

Cardiac dysrhythmia

d.

Loud S1

Answer: b. In mitral valve regurgitation, there is the presence of a systolic murmur.

63.

The patient with aortic regurgitation often has which symptoms?

Select all that apply. a.

Increased cardiac output

b.

Palpitations

c.

Systolic murmur

d.

A loud S1

e.

The possibility of an S3

Answer: b, c, e. The patient with aortic regurgitation has a soft S1 with the possibility of an S3, palpitations and a decreased cardiac output.

64.

Which condition is not a major complication of hypertension?

a.

Liver failure

b.

Renal failure

c.

Cerebrovascular accidents

d.

Coronary artery disease

Answer: a. Renal failure, cerebrovascular accidents and coronary artery disease are the three main complications of hypertension.

65.

Hypertension is often associated with what findings? Select all that apply. a.

Arterial wall thickening

b.

Activation of the parasympathetic nervous system

c.

Reduction in Angiotensin II

d.

Increased cardiac output

e.

Increased cardiac wall thickening

Answer: a. e. Hypertension is known to increase the arterial and cardiac wall thickening and to raise angiotensin II. It activates the parasympathetic nervous system and can decrease cardiac output.

66.

Signs and symptoms of hypertension can include the following.

Select all that apply. a.

Jaundice

b.

Occipital headache

c.

Blurry vision

d.

Sunken eyes

e.

Peripheral edema

Answer: b. c. e. Signs and symptoms of severe hypertension can include occipital headache, blurry vision and peripheral edema. The eyes may be puffy from edema.

67.

Some treatments for hypertension include the following. Select all that apply. a.

Diuretics

b.

Angiotensin II agonists

c.

Beta blockers

d.

Calcium channel blockers

e.

Aldosterone

Answer: a. c. d. The treatments for hypertension can include diuretics, , ACE inhibitors, angiotensin II blockers, beta blockers, calcium channel blockers, and centrally-acting agents.

68.

Causes of myocarditis include the following. Select all that apply.

a.

Aldosterone

b.

Infection

c.

Immune reactions

d.

Hypertension

e.

Radiation therapy

Answer: b. c. e. Causes of myocarditis can be infection, immune reactions, radiation therapy, toxins, and alcoholism.

69.

Risk factors for coronary artery disease include the following.

Select all that apply. a.

Low triglyceride levels

b.

Female gender

c.

Menopause

d.

Family history

e.

Diabetes

Answer: c. d. e. Risk factors for coronary heart disease include hyperlipidemia, male gender, menopause, family history, diabetes, and hypertension.

70.

Treatment of those with a high risk of coronary artery disease includes the following. Select all that apply. a.

Antiplatelet agents

b.

Beta blockers

c.

Nortriptyline

d.

Nitrates

e.

Anti-lipemic agents

Answer: a. b. d. e. Patients at risk for coronary artery disease should receive antiplatelet agents, beta blockers or calcium channel blockers, nitrates and anti-lipemic agents.

71.

The patient has hypotension, mid-back pain, and a pulsatile mass in the abdomen. What is the likely diagnosis? a.

Renal arterial aneurysm

b.

Ruptured aortic aneurysm

c.

Unruptured aortic aneurysm

d.

Acute pancreatitis

Answer: b. The patient has hypotension and signs of an aortic aneurysm.

Because the patient is hypotensive, he or she probably has a ruptured aortic aneurysm.

72.

The patient has an ascending thoracic aneurysm. What test can you do to confirm this at the bedside? a.

MRI of the chest

b.

Check for thoracic bruits

c.

CT scan of the chest

d. arms

Check for differences in blood pressure between the left and right

Answer: d. A good bedside test for an ascending thoracic aneurysm is to check for differences between the blood pressure of the left and right arms.

An MRI and CT scan are not bedside tests.

73.

A patient is at risk for rupture of his abdominal aneurysm. What nursing measures should be taken? Check all that apply. a.

Give pressor agents.

b.

Give negative inotropic agents

c.

Give oxygen

d.

Administer anti-platelet agents

e.

Give narcotics for pain

Answer: b. c. e. If a patient is at risk for rupture of an abdominal aortic aneurysm, they should be given anti-hypertensives, negative inotropic agents, oxygen and narcotics. Pressor agents and anti-platelet agents may make the situation worse.

74.

The patient is suspected of having an acute MI. What do you give the patient within ten minutes of onset of symptoms? Check all that apply. a.

Morphine

b.

Calcium channel blockers

c.

Oxygen

d.

Nitroglycerin

e.

Aspirin

Answer: a. c. d. e. As soon as an MI is suspected, the patient should receive morphine, oxygen, nitroglycerine and aspirin.

75.

Aspirin is given in acute MI patients for what purpose?

a.

To act as an anticoagulant

b.

To treat anginal pain

c.

To act as an anti-platelet agent

d.

To lower blood pressure

Answer: c. Aspirin is given to acute MI patients to act as an anti-platelet agent.

76.

What is the most important thing to remember about giving TPA?

a.

It cannot be given to anyone taking warfarin

b.

It must be given within 6 hours of onset of symptoms

c.

It must be given along with aspirin

d.

It is incompatible with heparin

Answer: b. TPA must be administered within 6 hour of onset of symptoms.

IV heparin or SQ heparin is also given to maintain anticoagulation.

77.

The patient has sustained an inferior MI. What coronary artery is likely occluded? a.

Circumflex artery

b.

Left anterior descending artery

c.

Right coronary artery

d.

Right branch of the left anterior descending artery

Answer: c. If the patient has sustained an inferior MI, the coronary artery likely occluded is the right coronary artery.

78.

What does a non-Q-wave myocardial infarction mean?

a.

The MI is through all layers of the myocardium

b.

The MI is in the inner or middle layers of the myocardium

c.

The MI is an inferior MI

d.

The MI is completely reversible

Answer: b. If the patient is having a non-Q-wave myocardial infarction, this means that only the middle or inner layers of the myocardium are affected.

79.

Following a myocardial infarction, what compensatory mechanisms often take place in the body to increase cardiac output? Check all that apply. a.

Decreased heart rate

b.

Increased heart rate

c.

Vascular constriction

d.

Vascular dilatation

e.

Renal retention of sodium and water

Answer: b. c. e. In order to increase cardiac output after an MI, the body responds by increasing heart rate, increasing vascular constriction, and increasing renal retention of sodium and water.

80.

Signs and symptoms of right-sided heart failure include the following. Check all that apply. a.

Weight loss

b.

Peripheral edema

c.

Dyspnea

d.

Liver engorgement

e.

Jugular venous distension

Answer: b. d. e. With right-sided heart failure, the patient suffers from weight gain, peripheral edema, liver engorgement and jugular venous distention.

81.

The patient is showing signs of decreased cardiac output after a motor vehicle accident. You notice muffled heart sounds. What do you suspect? a.

Traumatic cardiac tamponade

b.

Congestive heart failure

c.

Acute MI

d.

Traumatic valvular damage in the heart

Answer: a. Following a motor vehicle accident, a patient with evidence of decreased cardiac output and decreased or muffled heart sounds should be suspected of having a traumatic cardiac tamponade.

82.

Common causes of hypovolemic shock include the following.

Select all that apply. a.

Hemorrhage

b.

Sepsis

c.

Cerebrovascular accident

d.

Peritonitis

e.

Renal insufficiency

Answer: a. b. d. Common causes of shock include acute hemorrhage, sepsis, severe burns, ascites, and peritonitis.

83.

Common causes of cardiogenic shock include the following.

Select all that apply. a.

Hypervolemia

b.

Myocardial infarction

c.

Pericardial tamponade

d.

Renal failure

e.

Tension pneumothorax

Answer: b. c. e. Common causes of cardiogenic shock include myocardial infarction, pericardial tamponade, tension pneumothorax and pulmonary embolism.

84.

Common causes of neurogenic shock include the following.

Select all that apply. a.

Spinal cord injury

b.

General anesthesia

c.

Hypoglycemia

d.

Hyperglycemia

e.

Severe pain

Answer: a. c. e. Common causes of neurogenic shock include spinal cord injury, severe pain, and hypoglycemia.

85.

A patient in the ICU for acute myocardial infarction suddenly develops anuria. What do you suspect? a.

Extension of the MI

b.

Cardiogenic shock

c.

Renal failure

d.

Hypertension

Answer: b. The sudden loss of urine flow in a patient who has had an acute MI is a sign of probable cardiogenic shock.

86.

Causes of shock include the following. Check all that apply.

a.

Low cardiac output

b.

Blood infection

c.

Cerebrovascular accident

d.

Spinal cord transection

e.

Allergic response

Answer: a. b. d. e. Common causes of shock include low cardiac output, blood infection, spinal cord transection or anaphylaxis (allergic shock).

87. is what?

The most invasive treatment of end-stage congestive heart failure

a.

Angioplasty with stent placement

b.

CABG

c.

Heart transplant

d.

Left ventricular assist device

Answer: c. Of the above treatments for end-stage heart failure, a heart transplant is the most invasive treatment.

88.

The identification of Pulsus paradoxus involves doing what?

a.

Checking the pulse of the arms and legs simultaneously.

b.

Checking the systolic blood pressure during inspiration and on expiration. c.

Measuring the amount of jugular venous congestion during expiration. d.

Measuring the pulse during inspiration and expiration.

Answer: b. You can identify pulsus paradoxicus by listening for the systolic blood pressure during inspiration and expiration. If the difference is marked, this is called pulsus paradoxus.

89.

If the patient has pulsus paradoxus, what can you expect?

a.

Pulmonary embolism

b.

Acute MI

c.

Congestive heart failure

d.

Cardiac tamponade

Answer: d. If the patient has pulsus paradoxus, you can be suspicious for a cardiac tamponade.

90.

The patient has severe peripheral vascular disease. Which is the least desired intervention? a.

Graft with a synthetic vessel

b.

Graft with the patient’s own vein

c.

Amputation

d.

Endarterectomy

Answer: c. Of the above possible interventions, amputation is the least desired option.

91.

Causes of acute arterial occlusive disease include the following.

Check all that apply. a.

A thrombosis in a peripheral artery

b.

An embolism from the heart traveling to a peripheral artery

c.

Sudden loss of blood pressure

d.

Vessel trauma

e.

Peripheral arterial aneurysm

Answer: a. b. d. The causes of an acute arterial occlusion include the presence of a thrombus or embolism in a peripheral artery or trauma to the artery.

92.

Possible nursing interventions for acute arterial occlusion of an extremity include the following. Check all that apply. a.

Vigorous massage at the occluded site

b.

Immediate heparin therapy

c.

Tissue plasminogen activator (tPA) infusion

d.

Pain management

e.

Immediate aspirin therapy

Answer: b. c. d. For an acutely occluded artery, nursing interventions include pain management, the starting of heparin and the infusion of tPA.

93.

Acute management of anaphylactic shock includes the following.

Check all that apply. a.

Epinephrine

b.

Nitroprusside

c.

Antibiotics

d.

Oxygen

e.

IV fluids

Answer: a.

94.

Common arteries involved in chronic peripheral vascular disease include the following. Select all that apply. a.

Brachial

b.

Popliteal

c.

Aortoiliac

d.

Radial

e.

Femoral

Answer: b. c. e. Common sites for chronic peripheral vascular disease include the Aortoiliac, femoral, popliteal and tibial arteries.

95.

Which is not a risk factor for chronic peripheral vascular disease?

a.

Deep vein thrombosis

b.

Diabetes mellitus

c.

Hyperlipidemia

d.

Smoking history

Answer: a. Common risk factors for chronic peripheral vascular disease include diabetes mellitus, hyperlipidemia, hypertension, and a smoking history.

96.

Signs and symptoms of chronic peripheral vascular disease include the following. Check all that apply. a.

Dependent rubor

b.

Decreased pulses

c.

Irregular pulses

d.

Skin ulcers

e.

Pale foot on elevation

Answer: a. b. d. e. In chronic peripheral vascular disease, you will notice dependent redness (rubor) of the skin, decreased pulses in the legs, skin ulcers, and a pale foot on elevation.

97.

Diagnostic tests for peripheral vascular disease include the following. Select all that apply. a.

Segmental blood pressure readings

b.

Venous Doppler ultrasound

c.

Peripheral arterial angiography

d.

Arterial ultrasound

e.

Distal blood gases of the dorsalis pedis artery

Answer: a. c. d. Common diagnostic tests for peripheral vascular disease include segmental blood pressure readings down the leg, peripheral arterial angiography and arterial ultrasound.

98. is what?

A common drug used to treat chronic peripheral vascular disease

a.

High dose aspirin therapy

b.

Pentoxifylline (Trental)

c.

Tissue plasminogen activator

d.

Heparin

Answer: b. Pentoxifylline or Trental is a good drug treatment for chronic peripheral vascular disease.

99.

Common treatments for deep vein thrombosis include the following. Select all that apply. a.

Intracaval filter surgery

b.

IV or SQ low molecular weight heparin

c.

Venous Doppler ultrasound

d.

Ventilation-perfusion scan

e.

Elastic compression stockings

Answer: a. b. e. Treatments for deep vein thrombosis include the possibility of inserting an Intracaval filter in the inferior vena cava to prevent pulmonary embolism, IV or SQ low molecular weight heparin and bilateral compression stockings. Venous Doppler ultrasound and a ventilation-perfusion scan are diagnostic modalities.

100. following:

Risk factors for deep vein thrombosis include all but the

a.

Obesity

b.

Anticoagulation therapy

c.

Prolonged sitting

d.

Pregnancy

Answer: b. Obesity, prolonged sitting, and pregnancy are all risk factors for deep vein thrombosis.

101.

Conditions considered risky for the possibility of a pulmonary embolism include the following. Select all that apply. a.

Superficial thrombophlebitis of the lower leg

b.

Hypercoagulable state

c.

Deep vein thrombosis

d.

Cerebrovascular accident

e.

Carotid artery occlusion

Answer: b. c. Hypercoagulable states and deep vein thrombosis are risk factors for pulmonary embolism.

102.

A patient enquires as to the prognosis of his myocarditis. The most proper nursing response would be what? a.

“You may need a heart transplant.”

b.

“A coronary angioplasty will correct the problem.”

c.

“Most people recover without any special treatment.”

d.

“Most people do well if they have a coronary artery bypass graft.”

Answer: c. Most people recover from myocarditis without any special treatment.

103.

A urinalysis is being done on a hypertensive patient who asks why the test is being done. An appropriate response would be what? a.

To check the urine for potassium excretion.

b.

To check the urine for protein, indicating renal involvement.

c. failing.

To check the urinary creatinine level to see if the kidneys are

d.

To check the urine for illicit drugs.

Answer: b. The routine urinalysis is to check for protein which indicates renal involvement.

104.

A post-myocardial infarction patient asks when he can resume sexual activity. As a nurse, you respond: a.

“When you can walk two blocks without chest pain.”

b.

“As soon as you feel comfortable.”

c.

“You should have a cardiac stress test first.”

d.

“When you can comfortably climb two flights of stairs.”

Answer: d. Having an objective mea measure of ability to have sex is a good thing. One good measure of ability to do sexual activity is when the patient can climb two flights of stairs comfortably.

105.

A patient has a subcutaneous pacemaker and wonders about activities he can and cannot do on his upcoming vacation 6 months after pacemaker placement. What do you tell the patient? a.

“Avoid standing in front of microwave ovens.”

b.

“Avoid swimming in the ocean.”

c.

“Your activity can be unrestricted.”

d.

“You should have a stress test before going on vacation.”

Answer: c. Six months after a pacemaker insertion, the patient may have no restrictions on his activity. Older microwave ovens were dangerous for pacemaker patients but modern ones are fine. A stress test is not necessary and swimming after the incision has healed and the leads have successfully attached to the heart is okay.

Chapter 2: NCLEX Questions Only on the Cardiovascular System One mistake many potential takers of the NCLEX examination make is not taking enough practice questions. Practice questions put you into the heart of the testing process so that you can best think critically about a specific area of nursing. This book is dedicated to providing you with a wide range of NCLEX test questions as they relate to the Cardiovascular System.

NOTE: This chapter displays the questions only. This chapter is shown without answers to simulate the actual exam. The answers and rationales for each question are displayed in the first chapter. If you would prefer to view the answers at the same time, click here to be routed to chapter 1.

1.

The function of the cardiovascular system involves any one or more of the following functions. Check all that apply. a.

Oxygen transportation b.

Metabolic waste removal c.

Hormone transportation d.

Neural connectivity e.

CO2 removal Answer:

2. a. b. c. d.

Answer:

The heart is incased in what?

The peritoneum The pericardial sac Lung tissue It has no encasement

3. a. b. c. d.

Answer:

What is the function of the pericardial sac?

To keep foreign antigens from the heart To keep the heart from enlarging To provide nutrients to the heart To provide lubrication for the heart

4. a. b. c. d.

Answer:

Which is not a layer of the heart?

The pericardial layer The myocardium The endocardium The epicardium

5.

List in order the pathway of blood through the heart from deoxygenated to oxygenated blood. a.

Left ventricle b.

Right ventricle c.

Left atrium d.

Right atrium Answer:

6.

Which heart valves are closed to prevent backflow of blood into the atria during diastole? List all that apply. a.

Tricuspid valve b.

Pulmonary valve c.

Mitral valve d.

Aortic valve e.

Pneumonic valve Answer:

7.

What artery supplies the back of the left ventricle, the inferior of the left ventricle, the right ventricle, and the right atrium? a.

Left main coronary artery b.

Left anterior descending artery c.

Circumflex artery d.

Right coronary artery Answer:

8. a. b. c. beat. d.

Answer:

What is the cardiac output?

The amount of blood ejected from the left ventricle in one beat.

The amount of blood ejected from each ventricle in one minute.

The amount of blood ejected from both atria and ventricles per The amount of blood entering the lungs per minute.

9. a. b. c. d. e.

Answer:

Which factors affect a person’s cardiac output?

The oxygenation of blood The stroke volume The blood volume The preload The force of the contraction

10. a. b. c. d.

Answer:

The natural pacemaker of the heart is what?

The AV node The purkinje fibers The SA node The bundle of His

11. a. b. c. d. e.

Answer:

Distended neck veins mean what? Check all that apply.

Decreased preload Increased preload Increased cardiac output Possible cardiac insufficiency Rapid heart rate

12. a. b. c. d. e.

Answer:

Which vessels carry deoxygenated blood? Select all that apply.

Arteries Capillaries Venules Arterioles Veins

13. a. b. c. d.

Answer:

The sympathetic nervous system: Slows the heart rate Blocks beta-adrenergic receptors on the heart Increases the heart rate Determines the cardiac output

14. a. b. c. d. e.

Answer:

Which are true regarding heart sounds? Select all that are true.

Diastole occurs between S1 and S2 Systole occurs during S1 and S2 Murmurs indicate vascular turbulence The time between S1 and S2 is variable S2 is occasionally absent

15.

You are briefly assessing a patient for his risk of stroke. What easy test can you do? a.

Check for a carotid bruit b.

Assess speech function c.

Do a carotid ultrasound d.

Examine the patient for hemiparesis Answer:

16.

The doctor tells you the patient has a grade IV heart murmur.

What does that mean? a.

The patient has a very faint murmur b.

The murmur can be heard without a stethoscope. c.

The murmur can be heard with a stethoscope just off the patient’s chest. d.

The murmur is laud and there is a palpable thrill.

Answer:

17.

On a standard EKG a U wave is seen. What can be said about the U wave? a.

It represents early ventricular repolarization. b.

It indicates a myocardial infarction. c.

You should evaluate the patient for hypokalemia d.

You should expect ventricular excitability.

Answer:

18.

Common causes of bradycardia include the following. Check all that apply. a.

Highly conditioned athlete b.

Excess norepinephrine c.

Inferior myocardial infarction d.

Parasympathomimetic drugs e.

Sympathetic drugs Answer:

19.

The treatment of symptomatic bradycardia with hypotension includes these choices. Check all that apply. a.

Give IV epinephrine. b.

Give IV atropine. c.

Hold all parasympathomimetic drugs d.

Give Nitroprusside e.

Defibrillate the patient.

Answer:

20.

The patient is having ectopic beats occurring on the T wave of the previous beat while on telemetry. What should you look for? a.

The possibility of supraventricular tachycardia b.

Third degree heart block c.

Ventricular tachycardia d.

The onset of bradycardia Answer:

21.

The patient’s rhythm on a cardiac monitor shows no P waves and a ventricular rate of 100. What are the possible causes of this condition?

Check all that apply. a.

Excess epinephrine b.

Alcoholism c.

Infection d.

Underlying cardiac disease e.

Cocaine abuse Answer:

22. apply. a. b. c. d. e.

Answer:

What is the significance of atrial fibrillation? Check all that The patient is at risk for low cardiac output.

The patient is at risk for supraventricular tachycardia.

The patient is at risk for embolic stroke.

The patient is at risk for hypertension.

The patient may develop angina.

23.

What are effective treatments for symptomatic atrial fibrillation?

Check all that apply. a.

Asynchronized cardioversion b.

Synchronized cardioversion c.

IV ibutilide (Corvert) d.

Radiofrequency catheter ablation e.

Lanoxin IV Answer:

24.

The patient has a saw-toothed p wave with an atrial rate of 350600 beats per minute and a ventricular rate of 100 beats per minute. What is this rhythm? a.

Atrial fibrillation b.

Supraventricular tachycardia c.

Frequent premature atrial contractions d.

Atrial flutter Answer:

25.

The patient has a cardiac rhythm with a progressively longer PR interval for three beats followed by a dropped QRS complex. What is this rhythm? a.

Third degree heart block b.

Sinus bradycardia c.

Second degree heart block, Wenckebach type d.

Atrial flutter Answer:

26. heart? a. b. c. d.

Answer:

A junctional rhythm has a pacemaker originating where in the SA node AV node Bundle of His Ectopic sites in the atria

27.

If the patient is experiencing a junctional rhythm and is symptomatic, what treatment measures should be offered? Check all that apply. a.

IV atropine b.

IV bretyllium c.

IV nitroprusside d.

Digoxin should be held e.

IV procainamide Answer:

28. apply. a. b. c. d. e.

Answer:

Which drugs are known to increase the heart rate? Check all that Procainamide Epinephrine Propranolol Dopamine Atropine

29. a. b. c. d.

Answer:

In third degree heart block, the ventricular rate is usually what?

120-140 bpm 80-100 bpm 60-80 bpm 20-40 bpm

30.

Treatments for symptomatic third degree heart block include the following. Check all that apply. a.

IV amiodarone b.

IV procainamide c.

IV lidocaine d.

CPR if pulseless e.

Synchronized cardioversion Answer:

31.

The patient’s rhythm is ventricular fibrillation. What treatments should you begin? Check all that apply. a.

Synchronized cardioversion b.

Defibrillation c.

Epinephrine d.

Atropine e.

Amiodarone Answer:

32.

The patient has frequent symptomatic PVCs. What are the possible causes? List all that apply. a.

Propranolol toxicity b.

Fever c.

Digoxin toxicity d.

Stimulants e.

Hypokalemia Answer:

33.

Episodic ventricular tachycardia can be due to any of the following. Select all that apply. a.

Acute MI b.

Hyponatremia c.

Cardiomyopathy d.

Prolonged QT e.

Hyperkalemia Answer:

34.

A patient has a flat line on the cardiac monitor and is unconscious with no pulse. What is the first thing you should do? a.

Verify asystole in more than one lead. b.

Intubate the patient c.

Give IV bretyllium d.

Give IV procainamide Answer:

35.

A person has a suspected myocardial infarction. Which blood test is most specific for evidence of a myocardial infarction? a.

Total CPK b.

Troponin I c.

AST d.

LDH Answer:

36.

A patient is being given an anticoagulant. The PTT is twice normal and the PT is minimally elevated. What anticoagulant is the patient likely being given? a.

Heparin b.

Warfarin c.

Aspirin d.

Tissue plasminogen activator (TPA) Answer:

37.

A patient is having a graded exercise test with a treadmill. What things should you tell the patient beforehand? Check all that apply. a.

The test may take up to two hours. b.

You may expect to have chest pain during this procedure, which is normal. c.

Wear comfortable clothing and shoes. d.

You will be monitored throughout the test. e.

You will be given an IV. Answer:

38. scan? a. b. c. d.

Answer:

What is the purpose of giving dipyridamole prior to a Thallium To thin the blood To dilate the coronary arteries To regulate the heart rhythm To decrease the blood pressure

39. a. b. c. d.

Answer:

What is the purpose of the Technetium Scan?

To look for evidence of CHF. To measure the electrical activity of the heart.

To show areas of increased uptake in an MI. To check the ejection fraction.

40.

You are educating a patient having an angioplasty with stent placement. What is an appropriate thing to say to the patient? a.

This will involve open heart surgery b.

A catheter with a balloon will open blockages and the stent will keep the blockages open. c.

There are no risks to this procedure. d.

Only one artery will be treated.

Answer:

41.

A patient is having a transesophageal echocardiogram. What things will you say to educate the patient about the test? Check all that apply. a.

The patient can eat a small meal before the procedure. b.

The test is to check for heart defects, valvular defects, thrombus or bacterial endocarditis. c.

The patient will swallow a probe. d.

The patient will be unconscious during the procedure. e.

The procedure lasts about an hour.

Answer:

42.

The patient is to have a Thallium scan. What do you say to educate the patient? Check all that apply. a.

Thallium is a radioactive isotope. b.

A scintillation camera will detect areas of radioactive uptake. c.

The test involves oral ingestion of Thallium. d.

The radioactivity lasts in the system for up to a week. e.

The test is diagnostic of areas of poor uptake indicating cardiac ischemia/infarct.

Answer:

43.

The patient is having an electrophysiology study of the heart.

What do you say to educate the patient? Select all that apply. a.

The test assesses the electrical activity of the heart. b.

A probe will be passed through the pericardium. c.

The doctor may stop the patient’s antiarrhythmic medication a few days before the procedure. d.

The patient may eat a small liquid meal before the procedure. e.

The test is done under general anesthesia.

Answer:

44.

Central venous pressure monitoring is used for what main purpose? a.

To check the electrolyte concentration near the heart. b.

To assess the preload to the heart. c.

To assess cardiac output. d.

To obtain the diastolic blood pressure.

Answer:

45.

The pacemaker is used whenever there is what going on in the heart? Check all that apply. a.

SVT b.

Premature ventricular contractions c.

Bradycardia d.

Heart block e.

Atrial fibrillation with rapid ventricular response Answer:

46.

The patient has just had an angioplasty with stent placement.

What will you instruct the patient as part of their education? a.

Chest pain radiating to the left arm is normal after this procedure. b.

The patient is to be NPO for 6-8 hours after the procedure. c.

The patient will take clopidogrel (Plavix) for a period of time to reduce platelet aggregation. d.

The patient will be on IV heparin for up to 5 days post-procedure.

Answer:

47.

Complications of an angioplasty with stent placement include the following. Check all that apply. a.

Cerebrovascular accident b.

Pulmonary embolism c.

Deep vein thrombosis d.

Punctured ventricle e.

Dysrhythmia Answer:

48.

The patient has just had a pacemaker inserted. What do you tell him as education following the procedure? Check all that apply. a.

Avoid close contact with an active microwave oven. b.

Avoid magnetic resonance imaging (MRI) c.

How to check their pulse d.

Keep a pacemaker ID card in their wallet e.

The battery will be changed every six months Answer:

49.

The patient is scheduled for a coronary artery bypass graft surgery. What will you tell him as part of his pre-procedure education? Check all that apply. a.

The saphenous vein or left internal mammary artery is used for the bypass. b.

The patient will not need to be intubated for the procedure. c.

The procedure may or may not require the use of cardiopulmonary bypass pump. d.

The surgery will be done under heavy IV sedation. e.

There will be chest tubes in the chest to drain fluid from around the heart after surgery.

Answer:

50.

Following a CABG, the patient may experience which of the following? a.

Increased appetite b.

Depression c.

Increased pain tolerance d.

Rejection of graft Answer:

51.

A patient is having a pacemaker implanted. What do you look for to make sure that the pacemaker is functioning? a.

A pacemaker spike that is not followed by a QRS complex. b.

The presence of regular pacemaker spikes followed by QRS complexes. c.

Premature ventricular contractions. d.

Atrial fibrillation.

Answer:

52. a. b. c. d.

Answer:

The purpose of a peripheral arteriography is what?

To check the blood pressure in the peripheral arteries.

To evaluate the patient for DVT. To evaluate the peripheral cardiac output.

To inspect the peripheral arteries for patency, aneurysm or trauma.

53.

In preparation for a peripheral arteriography, what must be done?

Check all that apply. a.

The patient must have a pre-procedure ultrasound of the arteries. b.

The patient must be assessed for allergy to dye or shellfish. c.

A serum creatinine must be drawn to assess kidney function. d.

Obtain a CBC with differential. e.

Obtain a cardiac echocardiogram.

Answer:

54.

Complications after a CABG include any of the following. Check all that apply. a.

Low cardiac output b.

Cardiac tamponade c.

Graft rejection d.

Incisional infection e.

Warm extremities Answer:

55.

A patient has been diagnosed with rheumatic heart disease. What do you tell them as part of their education? a.

It primarily occurs in the elderly. b.

It is an autoimmune disease. c.

It is caused by a Group A streptococcal infection d.

There is no risk of joint involvement.

Answer:

56. what? a. b. c. d.

Answer:

The most important thing to do for rheumatic heart disease is Complete bedrest Give immune globulin Give antibiotics like penicillin Give acetaminophen for fever

57. a. b. c. d.

Answer:

A complication of rheumatic heart disease is what?

Valvular heart disease Pulmonary embolism Cardiac tamponade Coronary artery disease

58.

You are educating a patient about ventricular septal defects. What do you tell the patient? Check all that apply. a.

It is a congenital opening between the two atria of the heart b.

It allows blood to flow between the right and left ventricles c.

It is sometimes seen in Down syndrome d.

It is not a complication of acute MI e.

It is a congenital opening between the two ventricles of the heart Answer:

59.

A patient has been diagnosed with endocarditis. What do you tell the patient in educating him? Check all that apply. a.

It is always caused by a bacterium b.

It can affect heart valves c.

It may result in vegetative growths on heart valves d.

It requires amphotericin B e.

It increases the risk of hemorrhagic stroke Answer:

60.

Narrowing of the valve between the left atrium and the left ventricle is called what? a.

Tricuspid stenosis b.

Tricuspid insufficiency c.

Pulmonic stenosis d.

Mitral stenosis Answer:

61.

Contributing factors to vascular insufficiency include what? List all that apply. a.

Rheumatic heart disease b.

Male gender c.

Myocardial infarction d.

Mitral stenosis e.

Marfan syndrome Answer:

62. a. b. c. d.

Answer:

A clinical finding in mitral valve regurgitation includes what?

A soft S2 Systolic murmur Cardiac dysrhythmia Loud S1

63.

The patient with aortic regurgitation often has which symptoms?

Select all that apply. a.

Increased cardiac output b.

Palpitations c.

Systolic murmur d.

A loud S1 e.

The possibility of an S3 Answer:

64. a. b. c. d.

Answer:

Which condition is not a major complication of hypertension?

Liver failure Renal failure Cerebrovascular accidents Coronary artery disease

65.

Hypertension is often associated with what findings? Select all that apply. a.

Arterial wall thickening b.

Activation of the parasympathetic nervous system c.

Reduction in Angiotensin II d.

Increased cardiac output e.

Increased cardiac wall thickening Answer:

66.

Signs and symptoms of hypertension can include the following.

Select all that apply. a.

Jaundice b.

Occipital headache c.

Blurry vision d.

Sunken eyes e.

Peripheral edema Answer:

67.

Some treatments for hypertension include the following. Select all that apply. a.

Diuretics b.

Angiotensin II agonists c.

Beta blockers d.

Calcium channel blockers e.

Aldosterone Answer:

68. a. b. c. d. e.

Answer:

Causes of myocarditis include the following. Select all that apply.

Aldosterone Infection Immune reactions Hypertension Radiation therapy

69.

Risk factors for coronary artery disease include the following.

Select all that apply. a.

Low triglyceride levels b.

Female gender c.

Menopause d.

Family history e.

Diabetes Answer:

70.

Treatment of those with a high risk of coronary artery disease includes the following. Select all that apply. a.

Antiplatelet agents b.

Beta blockers c.

Nortriptyline d.

Nitrates e.

Anti-lipemic agents Answer:

71.

The patient has hypotension, mid-back pain, and a pulsatile mass in the abdomen. What is the likely diagnosis? a.

Renal arterial aneurysm b.

Ruptured aortic aneurysm c.

Unruptured aortic aneurysm d.

Acute pancreatitis Answer:

72.

The patient has an ascending thoracic aneurysm. What test can you do to confirm this at the bedside? a.

MRI of the chest b.

Check for thoracic bruits c.

CT scan of the chest d.

Check for differences in blood pressure between the left and right arms Answer:

73.

A patient is at risk for rupture of his abdominal aneurysm. What nursing measures should be taken? Check all that apply. a.

Give pressor agents. b.

Give negative inotropic agents c.

Give oxygen d.

Administer anti-platelet agents e.

Give narcotics for pain Answer:

74.

The patient is suspected of having an acute MI. What do you give the patient within ten minutes of onset of symptoms? Check all that apply. a.

Morphine b.

Calcium channel blockers c.

Oxygen d.

Nitroglycerin e.

Aspirin Answer:

75. a. b. c. d.

Answer:

Aspirin is given in acute MI patients for what purpose?

To act as an anticoagulant To treat anginal pain To act as an anti-platelet agent To lower blood pressure

76. a. b. c. d.

Answer:

What is the most important thing to remember about giving TPA? It cannot be given to anyone taking warfarin It must be given within 6 hours of onset of symptoms It must be given along with aspirin It is incompatible with heparin

77.

The patient has sustained an inferior MI. What coronary artery is likely occluded? a.

Circumflex artery b.

Left anterior descending artery c.

Right coronary artery d.

Right branch of the left anterior descending artery Answer:

78. a. b. c. d.

Answer:

What does a non-Q-wave myocardial infarction mean?

The MI is through all layers of the myocardium The MI is in the inner or middle layers of the myocardium The MI is an inferior MI The MI is completely reversible

79.

Following a myocardial infarction, what compensatory mechanisms often take place in the body to increase cardiac output? Check all that apply. a.

Decreased heart rate b.

Increased heart rate c.

Vascular constriction d.

Vascular dilatation e.

Renal retention of sodium and water Answer:

80.

Signs and symptoms of right-sided heart failure include the following. Check all that apply. a.

Weight loss b.

Peripheral edema c.

Dyspnea d.

Liver engorgement e.

Jugular venous distension Answer:

81.

The patient is showing signs of decreased cardiac output after a motor vehicle accident. You notice muffled heart sounds. What do you suspect? a.

Traumatic cardiac tamponade b.

Congestive heart failure c.

Acute MI d.

Traumatic valvular damage in the heart Answer:

82.

Common causes of hypovolemic shock include the following.

Select all that apply. a.

Hemorrhage b.

Sepsis c.

Cerebrovascular accident d.

Peritonitis e.

Renal insufficiency Answer:

83.

Common causes of cardiogenic shock include the following.

Select all that apply. a.

Hypervolemia b.

Myocardial infarction c.

Pericardial tamponade d.

Renal failure e.

Tension pneumothorax Answer:

84.

Common causes of neurogenic shock include the following.

Select all that apply. a.

Spinal cord injury b.

General anesthesia c.

Hypoglycemia d.

Hyperglycemia e.

Severe pain Answer:

85.

A patient in the ICU for acute myocardial infarction suddenly develops anuria. What do you suspect? a.

Extension of the MI b.

Cardiogenic shock c.

Renal failure d.

Hypertension Answer:

86. a. b. c. d. e.

Answer:

Causes of shock include the following. Check all that apply.

Low cardiac output Blood infection Cerebrovascular accident Spinal cord transection Allergic response

87. is what? a. b. c. d.

Answer:

The most invasive treatment of end-stage congestive heart failure Angioplasty with stent placement CABG Heart transplant Left ventricular assist device

88.

The identification of Pulsus paradoxus involves doing what? a.

Checking the pulse of the arms and legs simultaneously. b.

Checking the systolic blood pressure during inspiration and on expiration. c.

Measuring the amount of jugular venous congestion during expiration. d.

Measuring the pulse during inspiration and expiration.

Answer:

89. a. b. c. d.

Answer:

If the patient has pulsus paradoxus, what can you expect?

Pulmonary embolism Acute MI Congestive heart failure Cardiac tamponade

90.

The patient has severe peripheral vascular disease. Which is the least desired intervention? a.

Graft with a synthetic vessel b.

Graft with the patient’s own vein c.

Amputation d.

Endarterectomy Answer:

91.

Causes of acute arterial occlusive disease include the following.

Check all that apply. a.

A thrombosis in a peripheral artery b.

An embolism from the heart traveling to a peripheral artery c.

Sudden loss of blood pressure d.

Vessel trauma e.

Peripheral arterial aneurysm Answer:

92.

Possible nursing interventions for acute arterial occlusion of an extremity include the following. Check all that apply. a.

Vigorous massage at the occluded site b.

Immediate heparin therapy c.

Tissue plasminogen activator (tPA) infusion d.

Pain management e.

Immediate aspirin therapy Answer:

93.

Acute management of anaphylactic shock includes the following.

Check all that apply. a.

Epinephrine b.

Nitroprusside c.

Antibiotics d.

Oxygen e.

IV fluids Answer:

94.

Common arteries involved in chronic peripheral vascular disease include the following. Select all that apply. a.

Brachial b.

Popliteal c.

Aortoiliac d.

Radial e.

Femoral Answer:

95. a. b. c. d.

Answer:

Which is not a risk factor for chronic peripheral vascular disease?

Deep vein thrombosis Diabetes mellitus Hyperlipidemia Smoking history

96.

Signs and symptoms of chronic peripheral vascular disease include the following. Check all that apply. a.

Dependent rubor b.

Decreased pulses c.

Irregular pulses d.

Skin ulcers e.

Pale foot on elevation Answer:

97.

Diagnostic tests for peripheral vascular disease include the following. Select all that apply. a.

Segmental blood pressure readings b.

Venous Doppler ultrasound c.

Peripheral arterial angiography d.

Arterial ultrasound e.

Distal blood gases of the dorsalis pedis artery Answer:

98. is what? a. b. c. d.

Answer:

A common drug used to treat chronic peripheral vascular disease High dose aspirin therapy Pentoxifylline (Trental) Tissue plasminogen activator Heparin

99.

Common treatments for deep vein thrombosis include the following. Select all that apply. a.

Intracaval filter surgery b.

IV or SQ low molecular weight heparin c.

Venous Doppler ultrasound d.

Ventilation-perfusion scan e.

Elastic compression stockings Answer:

100.

Risk factors for deep vein thrombosis include all but the following: a.

Obesity b.

Anticoagulation therapy c.

Prolonged sitting d.

Pregnancy Answer:

101.

Conditions considered risky for the possibility of a pulmonary embolism include the following. Select all that apply. a.

Superficial thrombophlebitis of the lower leg b.

Hypercoagulable state c.

Deep vein thrombosis d.

Cerebrovascular accident e.

Carotid artery occlusion Answer:

102.

A patient enquires as to the prognosis of his myocarditis. The most proper nursing response would be what? a.

“You may need a heart transplant.” b.

“A coronary angioplasty will correct the problem.” c.

“Most people recover without any special treatment.” d.

“Most people do well if they have a coronary artery bypass graft.”

Answer:

103.

A urinalysis is being done on a hypertensive patient who asks why the test is being done. An appropriate response would be what? a.

To check the urine for potassium excretion. b.

To check the urine for protein, indicating renal involvement. c.

To check the urinary creatinine level to see if the kidneys are failing. d.

To check the urine for illicit drugs.

Answer:

104.

A post-myocardial infarction patient asks when he can resume sexual activity. As a nurse, you respond: a.

“When you can walk two blocks without chest pain.” b.

“As soon as you feel comfortable.” c.

“You should have a cardiac stress test first.” d.

“When you can comfortably climb two flights of stairs.”

Answer:

105.

A patient has a subcutaneous pacemaker and wonders about activities he can and cannot do on his upcoming vacation 6 months after pacemaker placement. What do you tell the patient? a.

“Avoid standing in front of microwave ovens.” b.

“Avoid swimming in the ocean.” c.

“Your activity can be unrestricted.” d.

“You should have a stress test before going on vacation.”

Answer:

Conclusion I hope you received a ton of value from this book. Remember, practice makes perfect so you will have to repeat these questions.

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I’ll talk to you soon and see you in the next book! On the next page, you can view some of my other books.

Thank you and good luck on your medical endeavors!

- Chase Hassen Nurse Superhero