Title WORKBOOK - CARDIO (KEY) ✅

1 | Page COMPREHENSIVE PHASE WORKBOOK MS: CARDIOVASCULAR SYSTEM NOV 2025 Philippine Nurse Licensure Examination Review 1. Mr. Diongzon came to the family clinic and complained of recent occipital headaches, blurred vision, fatigue, and increasing edema. The nurse reports these findings as indicative of A. Endocarditis B. Hypovolemic shock C. Hypertension D. Ventricular tachycardia 2. Myrna H was diagnosed with myocarditis. Anxious and afraid, she asked the nurse about the prognosis. The most appropriate response by the nurse is A. “A heart transplant would be necessary.” B. “Most often, a person will do well with coronary artery bypass surgery.” C. “A coronary angioplasty would only involve a 1- to 3- day hospitalization.” D. “Recovery usually happens without any special treatment.” 3. Helena S came to the clinic due to fever and chest pain. She was later on diagnosed with bacterial endocarditis. Which of the following interventions should the nurse include? Select all that apply: I. Rest II. Fluid restriction III. Vitamin K (Aquamephyton) IV. Analgesics V. Antibiotics VI. Physical therapy A. 1, 2, 3, 5 B. 1, 2, 5 C. 1, 4, 5 D. 2, 3, 6 4. Bernardo A is a 50 year old patient with uncontrolled Stage II hypertension. During his follow-up consult, a urine sample was requested. He asks why it is needed. The nurse informs the client it is to check for: A. protein, which may indicate the kidneys are affected. B. illegal drugs, which may have caused the hypertension. C. infection, which may cause the blood pressure to rise. D. the appropriate drug level of the antihypertensive medication. 5. Aleena S is a 45 year old who came to the ER due to sudden chest pain. She has been admitted with a possible myocardial infarction and active peptic ulcer disease. Which of the following orders should be questioned? A. Nitroglycerin SL B. Oxygen by nasal cannula C. Morphine IV D. Aspirin PO 6. Merlene is a 12 year old girl diagnosed with rheumatic heart disease. Her mother asks, “How did my child get rheumatic heart disease? We don’t have any family history.” The most appropriate response by the nurse is that rheumatic heart disease is frequently a result of A. hypertension. B. streptococcal infection. C. genetic tendency. D. pregnancy. 7. Which of the following interventions are a priority during exacerbation of left-sided heart failure? Select all that apply: I. Metered dose inhaler of albuterol II. High-Fowler’s position III. Oxygen IV. IV fluids V. Incentive spirometer VI. Diuretics A. 1, 2, 3, 5 B. 2, 3, 6 C. 1, 3, 4 D. 1, 2, 3, 6 8. Nurse Fely is conducting a discharge planning session with Mariana who was diagnosed with heart failure. Which of the following statements by the client shows an appropriate understanding of the nurse’s teaching? A. “I will do weekly finger-stick monitoring of my sodium levels.” B. “I will call my doctor if I gain more than 2 pounds in a day.” C. “I will take my angiotensin-converting enzyme (ACE) inhibitor as needed for shortness of breath.” D. “I will not take my diuretic pill on weekends when I am traveling, in order to avoid incontinence.” 9. The nurse should monitor a client after a coronary angioplasty for which of the following clinical manifestations indicating cardiac tamponade? Select all that apply: I. Muffled heart sounds II. Headache III. Hypotension IV. Vision changes V. Cool, diaphoretic skin VI. Tachycardia A. 1, 2, 4, 5, 6 B. 1, 3, 4, 6 C. 1, 3, 5, 6 D. 2, 3, 4, 5 10. Purita is allergic to penicillin. Immediately after receiving cefazolin (Ancef) IV for prophylaxis for a pacemaker insertion, the client becomes restless, tachycardic, and hypotensive. Which of the following interventions should the nurse implement as the priority? A. Administer epinephrine (adrenaline) B. Obtain stat blood culture C. Administer thrombolytic therapy D. Administer atropine 11. Restituto had a myocardial infarction 5 months ago. He is concerned about when it is safe to resume sexual activity. The most appropriate response by the nurse is A. “You should really talk to your doctor about that.” B. “Continue with the sexual practice with which you are most comfortable.” C. “You need to first undergo a cardiac stress test.” D. “When you’re able to climb two flights of stairs comfortably.” 12. Kelly H is about to undergo a transesophageal echocardiogram (TEE). Which of the following should the nurse include which of the following in the client education? A. “You will be able to eat only liquids for the first day after the procedure.” B. “You will need a designated driver to take you home.” C. “The procedure involves a series of MRI that may require you to come back.” D. “The procedure involves a balloon that will press plaque against the blocked walls of your coronary artery.” * NLE * NCLEX * CGFNS * HAAD * PROMETRICS * DHA * MIDWIFERY * LET * RAD TECH * CRIMINOLOGY * DENTISTRY * PHARMACY *
2 | Page 13. Jerry C received a permanent pacemaker. During the discharge planning, Jerry asks the nurse what machineries to avoid. Which of the following is the most appropriate response by the nurse? A. “There are no restrictions on your activity.” B. “You should avoid working over a running engine.” C. “Avoid standing in front of microwave ovens.” D. “Swimming in the ocean should be avoided.” 14. Lilia, a patient with familial hypercholesterolemia, develops a heavy, substernal chest pain. Which of the following interventions should the nurse do first? A. Administer 2 puffs of albuterol (Proventil) by mouth B. Administer 1 tablet of nitroglycerin under the tongue every 5 minutes; call 911 if no relief after 15 minutes C. Administer 0.04-mg IV push nitroglycerin slowly over 1 to 2 minutes D. Administer immediate synchronized cardioversion 15. Which of the following menu choices should you encourage Lillia to pick? Select all that apply: I. Mozzarella cheese II. Grilled cheddar cheese sandwich III. Tomato juice IV. Peanut-butter sandwich V. 2% milk VI. Tortilla A. 1, 2, 3, 5 B. 3, 4, 5 C. 2, 4, 6 D. 1, 6 16. Delilah X was admitted to the ER with a temperature of 39.4°C or 103°F, tachycardia, and shortness of breath. 2 hours later, she manifested hypotension while exhibiting cool, clammy skin and a decreased urine output. Blood cultures turned out to be positive of S. pneumoniae. The nurse should include which of the following in the plan of care for this client? A. Assistance with pericardiocentesis B. Administration of antihypertensives C. Administration of vasopressors D. Assistance with defibrillation 17. Ernesto is a patient with coronary artery disease who was scheduled for coronary artery bypass graft (CABG) surgery. Which of the following should the nurse include in the preoperative teaching? A. A liquid diet will be ordered for the first 4 to 5 days postoperatively B. Coughing is to be avoided in order to protect the sternal incision C. The hospital stay is generally about 10 days D. High-calorie supplements are encouraged in the first few weeks postoperative 18. Nurse Gerry observes the ECG rhythm of a Benjamin who has received a new permanent pacemaker for third-degree heart block. Several spikes are noted on the rhythm, but are not followed by any other waveforms. The nurse recognizes this as A. An indication that the pacemaker is adhering to the heart. B. A normal finding because spikes should never be seen on a pacemaker ECG rhythm strip. C. The sinoatrial (S-A) node is beating appropriately but may not show up on the rhythm strip. D. An abnormal finding because every spike on the ECG strip should be followed by a waveform. 19. Yuriko came to the ER due to severe pain, pulselessness, and coldness of the left foot. Upon review of his records, he has a known coronary artery disease. Which of the following would be the priority intervention for this client? A. Notify the physician B. Provide education to the client about probable bypass surgery for the client’s leg the following week C. Instruct the client on importance of daily doses of warfarin (Coumadin) D. Instruct the client to restrict activity, keeping it warm and elevated until it heals 20. Plans for nursing interventions for a client in the acute stage of bacterial endocarditis should include which of the following interventions? A. Daily ECGs B. Administration of analgesics as needed C. Strict fluid restriction D. Aggressive physical therapy 21. Romina, a patient with coronary artery disease, is about to undergo coronary angiography. Which of the following is a priority for the nurse to report? A. A history of rheumatic heart disease B. A history of allergy to shellfish C. A recent diagnosis of hyperlipidemia D. A previous coronary angioplasty to the right coronary artery 22. After Romina undergoes a coronary angiogram, which of the following should the nurse include in the plan of care? A. Vigorous leg exercises B. Immediate cardiac stress test C. Encourage fluids D. Activity restriction for 4 to 6 weeks 23. A charge nurse assigned you to a patient with rheumatic fever. Which of the following should you mostly expect to see? A. A geriatric client B. Patient had a history of a varicella zoster infection. C. Patient was diagnosed with a throat culture and serum antistreptolysin titer. D. Diagnosed by a series of two-step blood cultures. 24. Paulita is a quadriplegic was admitted to the ER due to sudden calf pain. She was later on diagnosed with deep vein thrombosis of the leg. Which of the following should the nurse include in the plan of care for the client experiencing pain from a deep vein thrombosis (DVT) of the leg who is receiving heparin and warfarin (Coumadin)? A. Administration of aspirin 325 mg p.o. every 4 hours. B. Patient-controlled analgesic of IV morphine. C. Hydromorphine hydrochloride (Dilaudid) 2 mg intramuscular every 4 hours. D. Ibuprofen (Motrin) 400 mg p.o. every 6 hours p.r.n. 25. Sonny shall undergo a coronary artery bypass graft. The nurse is currently conducting a preoperative teaching on what to expect after the surgery. Which of the following client statements demonstrates that the client correctly understood the teaching? A. “I will be given a pen and paper to communicate, because I will still have a breathing tube in my throat.” B. “I will be fed with a tube into my stomach until I can eat again.” C. “Pain medicine is generally not needed after this surgery.” D. “The nurses will be checking on me every 4 hours.” 26. You are currently teaching a student nurse how to read an electrocardiogram tracing. The student nurse evaluates the PR interval to have what measurement? A. 0.08-0.10 seconds B. 0.10-0.12 seconds C. 0.12-0.20 seconds D. 0.20-0.30 seconds 27. Nurse Farrah is currently reading an ECG tracing in the monitor. Ramon’s ECG strip has an atrial rate that ranges between 250 and 400 and P waves with saw-tooth shape. Interpret the tracing. A. Ventricular fibrillation B. Atrial flutter C. Atrial fibrillation D. Ventricular tachycardia 28. A student nurse is currently studying how to interpret an ECG tracing. She suspects that the tracing reflects ventricular tachycardia. Which of the following rates is typical of a ventricular tachycardia? A. 80-100 bpm B. 100-120 bpm C. 120-180 bpm D. 200-300 bpm 29. Delia was brought to the ER due to sudden loss of consciousness. Upon assessment of ECG, she had a myocardial infarction which resulted to a third-degree heart block, Which of the following interventions is the priority on an emergency basis?
3 | Page A. Temporary pacemaker B. Administer lidocaine C. Cardioversion D. Administer atropine 30. Due to multiple episodes of myocardial infarction, a permanent pacemaker was placed on Ynes. The nurse should include which of the following in the plan of care? A. Instruct the client to avoid lifting the arm on the pacemaker side above shoulder height B. Encourage the client to exercise the shoulder and arm on the side of the pacemaker four times a day C. Encourage the client to wash the pacemaker incision with warm soapy water twice a day D. Instruct the client to avoid the use of microwave ovens 31. Nurse Heidi is a staff nurse in the telemetry unit. Which of the following cases can be delegated to the LPN? A. ventricular tachycardia. B. sinus bradycardia. C. ventricular fibrillation. D. sinus rhythm with a second-degree A-V block type II (Mobitz II). 32. Nurse Maya is a nurse in the medical-surgical floor. She is handling multiple cardiac patients. A number of ECG alarms rang. Which of the following patients should be her priority? A. Sinus rhythm with a first-degree A-V block B. Supraventricular tachycardia (SVT) C. Atrial fibrillation D. Idioventricular rhythm (ventricular escape rhythm) 33. The nurse prioritizes the following clients with dysrhythmias in order of their care. Prioritize the following clients, from highest to lowest priority, in the order in which care should be performed. 1. A client with sinus bradycardia 2. A client with atrial flutter 3. A client with ventricular fibrillation 4. A client with sinus tachycardia A. 1,2,3,4 B. 4,3,1,2 C. 3,2,4,1 D. 3,4,2,1 34. Sara Lee’s SO rushed to the nurses station after she suddenly lost consciousness. The nurse checked the ECG tracing and she was experiencing atrial flutter. In caring for a client with atrial flutter, which of the following goals would have priority? A. Reduce the ventricular rate to below 100 beats per minute B. Identify and treat the underlying cause C. Control the heart rate and maintain cardiac output D. Increase the heart rate 35. Marrieta’s ECG tracing has the following characteristics: Ventricular and atrial rate: 112 bpm Ventricular and atrial rhythm: Regular QRS shape and duration: Normal P wave: Normal and consistent shape; PR interval: 0.16 seconds P:QRS ratio: 1:1 Which of the following should the nurse include in the plan of care for a client? A. Administer lidocaine B. Assess the client C. Administer atropine D. Cardioversion 36. A client is admitted to an emergency department with chest pain unrelieved by nitroglycerin. After an hour of waiting for a bed to open up, the patient’s vital signs are as follows: BP: 70/50, RR: 30, HR: 105. After another hour, the patient has the following VS: BP: 60/40 mmHg, HR: 115, RR: 35. However after 30 minutes, the patient has no palpable BP. Which of the following could have explained the progression? A. Cardiogenic shock B. Cardiac tamponade C. Pulmonary embolism D. Dissecting thoracic aortic aneurysm 37. Satur shall undergo cardiac catheterization. Upon review of history, he has a 3 vessel coronary artery and history of type 2 diabetes mellitus is scheduled for cardiac catheterization. Which of the following medications would need to be withheld for 48 hours before and after the procedure? A. Regular insulin B. Glipizide (Glucotrol) C. Repaglinide (Prandin) D. Metformin (Glucophage) 38. Elisa, a patient with hypothyroidism has a heart rate of 45 beats/min, complains of dizziness, and has a blood pressure of 70/60 mm Hg. Which of the following should the nurse anticipate will be prescribed? A. Defibrillate the client. B. Administer digoxin (Lanoxin). C. Continue to monitor the client. D. Prepare for transcutaneous pacing. 39. Nurse Adela is currently monitoring Paul, a patient with sinus rhythm has a premature ventricular contraction that falls on the T wave of the preceding beat. The client’s rhythm suddenly changes to one with no P waves, no definable QRS complexes, and coarse wavy lines of varying amplitude. How would the nurse correctly interpret this rhythm? A. Asystole B. Atrial fibrillation C. Ventricular fibrillation D. Ventricular tachycardia 40. Mang Isko is a patient with myocardial infarction. However, due to staff shortage, he wasn’t attended urgently until he became tachycardic, shows signs of air hunger, and begins coughing frothy, pink-tinged sputum. Which of the following would the nurse anticipate when auscultating the client’s breath sounds? A. Stridor B. Crackles C. Scattered rhonchi D. Diminished breath sounds 41. A client with myocardial infarction is developing cardiogenic shock. Because of the risk of myocardial ischemia, for which of the following should the nurse carefully assess the client? A. Bradycardia B. Ventricular dysrhythmias C. Rising diastolic blood pressure D. Falling central venous pressure 42. A client who had cardiac surgery 24 hours ago has a urine output averaging 20 mL/hr for 2 hours. The client received a single bolus of 500 mL of intravenous fluid. Urine output for the subsequent hour was 25 mL. Daily laboratory results indicate that the blood urea nitrogen level is 45 mg/dL and the serum creatinine level is 2.2 mg/dL. Based on these findings, the nurse would anticipate that the client is at risk for which of the following? A. Hypovolemia B. Acute renal failure C. Glomerulonephritis D. Urinary tract infection 43. Student Louie is studying a patient’s ECG. The P waves and QRS complexes are regular. The PR interval is 0.16 second, and QRS complexes measure 0.06 second. The overall heart rate is 78 beats/min. Which of the following would be a correct interpretation based on these characteristics? A. Sinus bradycardia B. Sick sinus syndrome C. Normal sinus rhythm D. First-degree heart block 44. Nurse Gerry is currently charting a patient’s care when suddenly a continuous cardiac monitor began to sound its alarm. There were no electrocardiographic complexes on the screen. Which of the following should be the priority action of the nurse? A. Call a code blue. B. Call the physician. C. Check the client status and lead placement. D. Press the recorder button on the electrocardiogram console. 45. However, after an hour, the monitor sounded its alarm again. There are no P waves, the QRS complexes are wide, and the ventricular rate is regular but is at 127 bpm. The nurse determines that the client is experiencing which of the following dysrhythmias? A. Sinus tachycardia B. Ventricular fibrillation