Tiêu đề 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 *

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
4 | Page C. Ventricular tachycardia D. Premature ventricular contractions 46. The patient soon stabilized. However, after administration of a drug, the client has frequent bursts of ventricular tachycardia on the cardiac monitor. What should the nurse be most concerned about with this dysrhythmia? A. It can develop into ventricular fibrillation at any time. B. It is almost impossible to convert to a normal rhythm. C. It is uncomfortable for the client, giving a sense of impending doom. D. It produces a high cardiac output that quickly leads to cerebral and myocardial ischemia. 47. Marinelle, who is receiving digitalis, is having frequent premature ventricular contractions. A nurse would place priority on assessment of which of the following? A. Sensation of palpitations B. Causative factors, such as caffeine C. Precipitating factors, such as infection D. Blood pressure and oxygen saturation 48. Jen is a patient who was admitted for thyrotoxicosis. She has developed atrial fibrillation, with a ventricular rate of 153 beats/ min. The nurse should assess the client for which associated signs or symptoms? A. Flat neck veins B. Nausea and vomiting C. Hypotension and dizziness D. Hypertension and headache 49. Amari has been diagnosed with Brugada Syndrome. Nurse Tere has been monitoring Amari’s ECG. There are no P waves; instead, there are fibrillatory waves before each QRS complex. How should the nurse correctly interpret the client’s heart rhythm? A. Atrial fibrillation B. Sinus tachycardia C. Ventricular fibrillation D. Ventricular tachycardia 50. Nurse Venice is monitoring a patient with severe hypokalemia. At first, the patient developed premature ventricular complexes until the patient gone into ventricular tachycardia. The client is awake and alert and has good skin color. The nurse would prepare to do which of the following? A. Immediately defibrillate. B. Prepare for pacemaker insertion. C. Administer amiodarone (Cordarone) intravenously. D. Administer epinephrine (Adrenaline) intravenously. 51. Nurse Rene is caring for an acidotic patient with unstable ventricular tachycardia. The nurse instructs the client to do which of the following, if prescribed, during an episode of ventricular tachycardia? A. Breathe deeply, regularly, and easily. B. Inhale deeply and cough forcefully every 1 to 3 seconds. C. Lie down flat in bed. D. Remove any metal jewelry. 52. Petra C is currently experiencing atrial fibrillation. The SO asks a nurse why the physician is going to perform carotid massage. The nurse responds that this procedure may stimulate the: A. Vagus nerve to slow the heart rate. B. Vagus nerve to increase the heart rate; overdriving the rhythm. C. Diaphragmatic nerve to slow the heart rate. D. Diaphragmatic nerve to overdrive the rhythm. 53. Nurse Marian is currently monitoring a critically ill patient. She notes that although the client has a sinus rhythm, he has 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 or definable QRS complexes. Instead, there are coarse wavy lines of varying amplitude. The nurse assesses this rhythm to be: A. Ventricular tachycardia B. Ventricular fibrillation C. Atrial fibrillation D. Asystole 54. Protacio S ws admitted to the Central ICU due to a posterior wall myocardial infarction. Nurse Fiona had been monitoring his ECG tracing and notes eight PVCs in one minute on the cardiac monitor. The client is receiving an IV infusion of D5W and oxygen at 2 L/minute. The nurse’s first course of action should be to: A. Increase the IV infusion rate. B. Notify the physician promptly. C. Increase the oxygen concentration. D. Administer a prescribed analgesic. 55. Teresita was diagnosed with complete heart block and is currently undergoing pacemaker insertion. Which of the following adaptations would you expect to see in her patient history? A. Nausea and vertigo B. Flushing and slurred speech C. Cephalalgia and blurred vision D. Syncope and slow ventricular rate 56. Gerry X has a right sided heart failure and is currently being monitored for a bundle branch block. The nurse should monitor to observe: A. Sagging ST segments. B. Absence of P wave configurations. C. Inverted T waves following each QRS complex. D. Widening of QRS complexes to 0.12 second or greater. 57. Nurse Coleen is currently auscultating the apical pulse of a client who has atrial fibrillation, the nurse would expect to hear a rhythm that is characterized by: A. The presence of occasional coupled beats. B. Long pauses in an otherwise regular rhythm. C. A continuous and totally unpredictable irregularity. D. Slow but strong and regular beats. 58. Lola Flora came to the clinic today for a regular check-up. It was found out that she has a high cholesterol in the blood. The physician informed her of being at risk for atherosclerosis which can prevent coronary blood flow by which of the following mechanisms? A. Plaques obstruct the vein. B. Plaques obstruct the artery. C. Blood clots form outside the vessel wall. D. Hardened vessels dilate to allow blood to flow through. 59. Martin has undergone a coronary artery bypass graft surgery. The nurse monitors his blood pressure and observed that patient's during inspiration his blood pressure falls to greater than 10 mm Hg. Which of the following surgical complications should the nurse suspect? A. Left-sided heart failure B. Aortic regurgitation C. Complete heart block D. Pericardial tamponade 60. After cardiac surgery, a client’s blood pressure measures 126/80. The nurse determines that the mean arterial pressure (MAP) is which of the following? A. 46 mm Hg B. 80 mm Hg C. 95 mm Hg D. 90 mm Hg 61. Celine came to the clinic with fever, cough, and colds. No history of cardiovascular disease. However her chest pain prompted her to consult. Which of the following questions would best help a nurse to discriminate pain caused by a non- cardiac problem? A. "Have you ever had this pain before?" B. "Can you describe the pain to me?" C. "Does the pain get worse when you breathe in?" D. "Can you rate the pain on a scale of 1-10, with ten (10) being the worst?" 62. Lourdes, a patient with anterior wall myocardial infarction has been transferred from a coronary care unit to a general medical unit with cardiac monitoring. A nurse plans to allow for which of the following client activities? A. Strict bed rest for 24 hours after transfer. B. Bathroom privileges and self-care activities. C. Unsupervised hallway ambulation with distances under 200 feet. D. Ad lib activities because the client is monitored. 63. Carmen is a patient with chronic heart failure. Upon assessment, a 2+ bilateral edema in the lower extremities of a client is present. The nurse would plan to do which of the following next?