1.

Prolonged occlusion of the right coronary artery produces an infarction in which of he

following areas of the heart?
a. Anterior
b. Apical
c. Inferior
d. Lateral

2. Which of the following is the most common symptom of myocardial infarction?

a. Chest pain
b. Dyspnea
c. Edema
d. Palpitations

3. Which of the following landmarks is the corect one for obtaining an apical pulse?
a. Left intercostal space, midaxillary line
b. Left fifth intercostal space, midclavicular line
c. Left second intercostal space, midclavicular line
d. Left seventh intercostal space, midclavicular line

4. Which of the following systems is the most likely origin of pain the client describes
as knifelike chest pain that increases in intensity with inspiration?
a. Cardiac
b. Gastrointestinal
c. Musculoskeletal
d. Pulmonary

5. A murmur is heard at the second left intercostal space along the left sternal border.
Which valve area is this?
a. Aortic
b. Mitral
c. Pulmonic
d. Tricuspid

6. Which of the following blood tests is most indicative of cardiac damage?

a. Lactate dehydrogenase
b. Complete blood count
c. Troponin I
d. Creatine kinase

7. What is the primary reason for administering morphine to a client with 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

8. Which of the following conditions is most commonly responsible for myocardial

infarction?
a. Aneurysm
b. Heart failure
c. Coronary artery thrombosis
d. Renal failure

9. What supplemental medication is most frequently ordered in conjunction with

furosemide (Lasix)?
a. Chloride
b. Digoxin
c. Potassium
d. Sodium

10. After myocardial infarction, serum glucose levels and free fatty acids are both
increase. What type of physiologic changes are these?
a. Electrophysiologic
b. Hematologic
c. Mechanical
d. Metabolic

11. Which of the following complications is indicated by a third heart sound (S3)?
a. Ventricular dilation
b. Systemic hypertension
c. Aortic valve malfunction
d. Increased atrial contractions

12. A client has chest pain rated at 8 on a 10-point visual analog scale. The 12-lead electrocardiogram
reveals ST elevation in the inferior leads and troponin levels are elevated. What is the highest priority
for nursing management of this client at this time?
a. Monitor daily weights and urine output.
b. Permit unrestricted visitation by family and friends.
c. Provide client education on medications and diet.
d. Reduce pain and myocardial oxygen demand.

13. The nurse has completed an assessment on a client with a decreased cardiac output. Which findings
should receive the highest priority?
a. BP 110/62, atrial fibrillation with HR 82, bibasilar crackles.
b. Confusion, urine output 15 mL over the last 2 hours, orthopnea.
c. SpO2 92 on 2 L nasal cannula, respirations 20, 1+ edema of lower extremities.
d. Weight gain of 1 kg in 3 days, BP 130/80, mild dyspnea with exercise.

14. A 60-year-old comes into the emergency department with crushing substernal chest pain that radiates
to the shoulder and left arm. The admitting diagnosis is acute myocardial infarction (MI). Admission
prescriptions include oxygen by nasal cannula at 4 L/min, complete blood count (CBC), a chest
radiograph, a 12-lead electrocardiogram (ECG), and 2 mg of morphine sulfate given IV. The nurse
should first:
a. Administer the morphine.
b. Obtain a 12-lead ECG.
c. Obtain the blood work.
d. Prescribe the chest radiograph.

15. When administering a thrombolytic drug to the client who is experiencing a myocardial infarction (MI)
and who has premature ventricular contractions, the expected outcome of the drug is to:
a. Promote hydration.
b. Dissolve clots.
c. Prevent kidney failure.
d. Treat dysrhythmias.

16. The client has been managing angina episodes with nitroglycerin. Which of the following indicate the
drug is effective?
a. Decreased chest pain.
b. Increased blood pressure.
c. Decreased blood pressure.
d. Decreased heart rate.

17. The major goal of nursing care for a client with heart failure and pulmonary edema is to:
a. Increase cardiac output.
b. Improve respiratory status.
c. Decrease peripheral edema.
d. Enhance comfort.

18. The nurse teaches a client with heart failure to take oral furosemide in the morning. The primary
reason for this is to help:
a. Prevent electrolyte imbalances.
b. Retard rapid drug absorption.
 c. Excrete excessive fluids accumulated during the night.
d. Prevent sleep disturbances during the night.

19. The most important long-term goal for a client with hypertension is to:
a. Learn how to avoid stress.
b. Explore a job change or early retirement.
c. Make a commitment to long-term therapy.
d. Lose weight.

20. The nurse is developing a care plan with an older adult with hypertension and is instructing the client
that hypertension can be a “silent killer.” The nurse should instruct the client to report signs of which
of the following diseases that are often a result of undetected high blood pressure?
a. Cerebrovascular accidents (CVAs).
b. Liver disease.
c. Myocardial infarction.
d. Pulmonary disease.

21. During physical assessment, the nurse should further assess the client for signs of atrial fibrillation
when palpation of the radial pulse reveals:
a. Two regular beats followed by one irregular beat.
b. An irregular rhythm with pulse rate greater than 100.
c. Pulse rate below 60 bpm.
d. A weak, thready pulse.

22. During cardiopulmonary resuscitation (CPR), the xiphoid process at the lower end of the sternum
should not be compressed when performing cardiac compressions. Which of the following organs
would be most likely at risk for laceration by forceful compressions over the xiphoid process?
a. Lung.
b. Liver.
c. Stomach.
d. Diaphragm.

23. A client is receiving Cilostazol (Pletal) for peripheral arterial disease causing intermittent claudication.
The nurse determines this medication is effective when the client reports which of the following?
a. “I am having fewer aches and pains.”
b. “I do not have headaches anymore.”
c. “I am able to walk further without leg pain.”
d. “My toes are turning grayish black in color.”

24. Which of the following clients is at greatest risk for Buerger's disease?
a. A 29-year-old male with a 14-year history of cigarette smoking.
b. A 38-year-old female who is taking birth control pills.
c. A 54-year-old female with adult-onset diabetes.
d. A 65-year-old male with atherosclerosis.

25. The primary goal for the client with Buerger's disease is to prevent:
a. Embolus formation.
b. Fat embolus formation.
c. Thrombus formation.
d. Thrombophlebitis.

26. Which of the following lab values should the nurse report to the health care provider when the client
has anemia?
a. Schilling test result, elevated.
b. Intrinsic factor, absent.
c. Sedimentation rate, 16 mm/h.
d. Red blood cells (RBCs) within normal range.

27. The nurse devises a teaching plan for the client with aplastic anemia. Which of the following is the
most important concept to teach for health promotion and maintenance?
a. Eat animal protein and dark green, leafy vegetables every day.
 b. Avoid exposure to others with acute infections.
c. Practice yoga and meditation to decrease stress and anxiety.
d. Get 8 hours of sleep at night and take naps during the day.

28. When a client with thrombocytopenia has a severe headache, the nurse interprets that this may
indicate which of the following?
a. Stress of the disease.
b. Cerebral bleeding.
c. Migraine headache.
d. Sinus congestion.

29. The nurse evaluates that the client correctly understands how to report signs and symptoms of
bleeding when the client makes which of the following statements?
a. “Petechiae are large, red skin bruises.”
b. “Ecchymoses are large, purple skin bruises.”
c. “Purpura is an open cut on the skin.”
d. “Abrasions are small pinpoint red dots on the skin.”

30. A client who is taking acetylsalicylic acid (ASA) caplets develops prolonged bleeding from a superficial
skin injury on the forearm. The nurse should tell the client to do which of the following first?
a. Place the forearm under a running stream of lukewarm water.
b. Pat the injury with a dry washcloth.
c. Wrap the entire forearm from the wrist to the elbow.
d. Apply an ice pack for 20 minutes.

31. Which of the following is contraindicated for a client diagnosed with disseminated intravascular
coagulation (DIC)?
a. Treating the underlying cause.
b. Administering heparin.
c. Administering warfarin sodium (Coumadin).
d. Replacing depleted blood products.

32. A client with disseminated intravascular coagulation develops clinical manifestations of microvascular
thrombosis. The nurse should assess the client for:
a. Hemoptysis.
b. Focal ischemia.
c. Petechiae.
d. Hematuria.

33. The nurse should teach the client with neutropenia and the family to avoid which of the following?
a. Using suppositories or enemas.
b. Using a high-efficiency particulate air (HEPA) filter mask.
c. Performing perianal care after every bowel movement.
d. Performing oral care after every meal.

34. A client is about to undergo bone marrow aspiration of the sternum. Which of the following
statements should the nurse include to provide information to the client about what the client will feel
during the procedure?
a. “You may feel a warm solution being wiped over your entire front from your neck down to your
navel and out to your shoulders.”
b. “You will not feel the local anesthetic being applied because it will be sprayed on.”
c. “You will feel a pulling type of discomfort for a few seconds.”
d. “After the needle is removed, you will feel a bandage being applied around your chest.”

35. During the induction stage for treatment of leukemia, the nurse should remove which items that the
family has brought into the room?
a. A Bible.
b. A picture.
c. A sachet of lavender.
d. A hairbrush.
36. The nurse identifies deficient knowledge when the client undergoing induction therapy for leukemia
makes which of the following statements?
a. “I will pace my activities with rest periods.”
b. “I can't wait to get home to my cat!”
c. “I will use warm saline gargle instead of brushing my teeth.”
d. “I must report a temperature of 100°F (37.7°C).”

37. The nurse is evaluating the client's learning about combination chemotherapy. Which of the following
statements by the client about reasons for using combination chemotherapy indicates the need for
further explanation?
a. “Combination chemotherapy is used to interrupt cell growth cycle at different points.”
b. “Combination chemotherapy is used to destroy cancer cells and treat side effects simultaneously.”
c. “Combination chemotherapy is used to decrease resistance.”
d. “Combination chemotherapy is used to minimize the toxicity from using high doses of a single
agent.”

38. Which of the following is the most important goal of nursing care for a client who is in shock?
a. Manage fluid overload.
b. Manage increased cardiac output.
c. Manage inadequate tissue perfusion.
d. Manage vasoconstriction of vascular beds.

39. Which is a priority assessment for the client in shock who is receiving an IV infusion of packed red
blood cells and normal saline solution?
a. Fluid balance.
b. Anaphylactic reaction.
c. Pain.
d. Altered level of consciousness.

40. Which nursing intervention is most important in preventing septic shock?

a. Administering IV fluid replacement therapy as prescribed.
b. Obtaining vital signs every 4 hours for all clients.
c. Monitoring red blood cell counts for elevation.
d. Maintaining asepsis of indwelling urinary catheters.

41. When teaching the client with Myocardial Infarction, the nurse explains that the pain associated with
MI is caused by:
a. Left Ventricular overload
b. Impending circulatory collapse
c. Extracellular electrolyte imbalances
d. Insufficient oxygen reaching the heart muscle

42. Which of the following is an uncontrollable risk factor that has been linked to the development of
coronary artery disease?
a. Exercise
b. Obesity
c. Gender
d. High-cholesterol level

43. A client with angina pectoris as ks the nurse, “what information does ECG provise?” the nurse would
appropriately respond the ECG gives information about the
a. Electrical conduction of the myocardium
b. Oxygenation and perfusion of the heart
c. Contractile status of the ventricles
d. Physical integrity of the muscle

44. How should the nurse instruct the client with angina pectoris to take sublingual nitroglycerine when
chest pain occurs?
a. Take one tablet every 2 to 5 minutes until the pain subsides
b. The one tablet and rest for 10 minutes. Call the physician if the pain persists after 10 minutes
 c. Take one tablet, then an additional tablet every 5 minutes for a toal of the three tablets. Call the
physician if pain persists after three tablets
d. Take one tablet. If pain persists after 5 minutes, take two tablets. If pain still persists 5 minutes
later, call the physician.

45. Proper hand placement for chest compression during CPR is essential to reduce the risk of which of the
following complications?
a. Gastrointestinal bleeding
b. Myocardial Infarction
c. Emesis
d. Rib Fracture

46. The rescuer Understand s the compression to ventilation ration is CPR is:
a. 5:1
b. 15:1
c. 30:2
d. 15:2

47. Which of the following findings indicate congestive heart failure?

a. BUN = 15mg/dl
b. CVP = 17 cm/H2O
c. Serum Potassium = 4 mEq/L
d. Hourly urine output = 30 – 60 mL

48. The client will undergo left – sided cardiac catheterization. Which of the following should not be
included in patient teaching?
a. “You will experience warm sensation as the contrast medium is injected”
b. You will receive anesthesia
c. You will be placed in a tunnel-like device”
d. “You have to tell me if you have allergy to seafoods”

49. The type of artificial cardiac pacemaker which provides a specific number of electrical firings per
minute”
a. Fixed rate pacemaker
b. Demand rate pacemaker
c. Temporary pacemaker
d. Permanent pacemaker

50. Which of the following signs and symptoms would most likely be experienced by a client with right –
sided congestive heart failure?
a. Dyspnea, crackles, ankle edema
b. Engorged neck vein, enlarged liver, weight gain
c. Hemoptysis, Hypertension, Pallor
d. Syncope, hemolytic anemia, clubbing of fingers