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TOP RANK REVIEW ACADEMY, INC. Page 2 | 3 17. Question A client comes to the outpatient clinic and tells the nurse that he has had leg pains that begin when he walks but cease when he stops walking. Which of the following conditions would the nurse assess for? A. An acute obstruction in the vessels of the legs. B. Peripheral vascular problems in both legs. C. Diabetes D. Calcium deficiency 18. Which of the following would be a priority nursing diagnosis for the client with heart failure and pulmonary edema? A. Risk for infection related to stasis of alveolar secretions. B. Impaired skin integrity related to pressure. C. Activity intolerance related to pump failure. D. Constipation related to immobility. 19. Which of the following diagnostic tools is most commonly used to determine the location of myocardial damage? A. Cardiac catheterization B. Cardiac enzymes C. Echocardiogram D. Electrocardiogram (ECG) 20. A significant cause of venous thrombosis is: A. Altered blood coagulation B. Stasis of blood C. Vessel wall injury D. All of the Above 21. A 57-year-old client with a history of asthma is prescribed propranolol (Inderal) to control hypertension. Before administered propranolol, which of the following actions should the nurse take first? A. Monitor the apical pulse rate. B. Instruct the client to take medication with food. C. Question the physician about the order. D. Caution the client to rise slowly when standing. 22. Which of the following conditions is the predominant cause of angina? A. Increased preload B. Decreased afterload C. Coronary artery spasm D. Inadequate oxygen supply to the myocardium. 23. Which of the following interventions should be the first priority when treating a client experiencing chest pain while walking? A. Sit the client down. B. Get the client back to bed. C. Obtain an ECG. D. Administer sublingual nitroglycerin. 24. Which of the following positions would best aid breathing for a client with acute pulmonary edema? A. Lying flat in bed. B. Left side-lying. C. In high Fowler's position. D. In semi-Fowler's position. 25. One hour after administering IV furosemide (Lasix) to a client with heart failure, a short burst of ventricular tachycardia appears on the cardiac monitor. Which of the following electrolyte imbalances should the nurse suspect? A. Hypocalcemia B. Hypermagnesemia C. Hypokalemia D. Hypernatremia 26. Which of the following blood tests is most indicative of cardiac damage? A. Troponin I B. Complete blood count (CBC) C. AST levels D. Lactate dehydrogenase 27. A client is receiving spironolactone to treat hypertension. Which of the following instructions should the nurse provide? A. "Eat foods high in potassium." B. "Take daily potassium supplements." C. "Discontinue sodium restrictions." D. "Avoid salt substitutes." 28. Which of the following is an uncontrollable risk factor that has been linked to the development of coronary artery disease (CAD)? A. Exercise B. Obesity C. Gender D. High - cholesterol level 29. Which of the following conditions is most commonly responsible for myocardial infarction? A. Aneurysm B. Heart failure C. Coronary artery thrombosis D. Renal failure 30. The nurse administers digoxin to the client with congestive heart failure. The nurse should first check which of the following? A. Weight B. Heart rate C. Blood pressure D. Respiratory rate 31. What is the primary reason for administering morphine to a pt with an MI? A. To sedate the pt B. To decrease the pt's pain C. To decrease the pt's anxiety D. To decrease oxygen demand on the pt's heart 32. A client is experiencing tachycardia. The nurse's understanding of the physiological basis for this symptom is explained by which of the following statements? A. The demand for oxygen is decreased because of pleural involvement. B. The inflammatory process causes the body to demand more oxygen to meet its needs. C. The heart has to pump faster to meet the demand for oxygen when there is lowered arterial oxygen tension. D. Respirations are labored. 33. Which of the following is the most common symptom of myocardial infarction (MI)? A. Chest pain B. Dyspnea C. Edema D. Palpitations 34. Stimulation of the sympathetic nervous system produces which of the following responses? A. Bradycardia B. Tachycardia C. Hypotension D. Decreased myocardial contractility 35. Which of the following classes of meds maximizes cardiac performance in pts with heart failure by increasing ventricular contractibility? A. Beta-adrenergic blockers B. Calcium channel blockers C. Diuretics D. Inotropic agents 36. Pharmacologic treatment of coronary artery disease includes which of the following procedures? A. Cardiac catheterization B. Coronary artery bypass surgery C. Oral med therapy D. Percutaneous transluminal coronary angioplasty 37. Which of the following symptoms is most commonly associated with left-sided heart failure? A. Crackles B. Arrhythmias C. Hepatic engorgement D. Hypotension
TOP RANK REVIEW ACADEMY, INC. Page 3 | 3 38. Which of the following actions is the first priority of care for a pt exhibiting signs & symptoms of coronary artery disease? A. Decrease anxiety B. Enhance myocardial oxygenation C. Administer subtingual nitroglycerin D. Educate the pt about his symptoms 39. Toxicity from which of the following meds may cause a pt to see a green-yellow halo around lights? A. Digoxin (Lanoxin) B. Furosemide (Lasix) C. Metoprolol (Lopressor) D. Enalapril (Vasotec) 40. With which of the following disorders is jugular vein distention most prominent? A. Abdominal aortic aneurysm B. Heart failure C. MI D. Pneumothorax 41. Direct-acting vasodilators have which of the following effects on the heart rate? A. Heart rate decreases. B. Heart rate remains significantly unchanged. C. Heart rate increases. D. Heart rate becomes irregular 42. In order to prevent the development of tolerance, the nurse instructs the patient to: A. Apply the nitroglycerin patch every other day. B. Switch to sublingual nitroglycerin when the patient's systolic blood pressure elevates to >140 mm Hg. C. Apply the nitroglycerin patch for 14 hours each and remove for 10 hours at night. D. Use the nitroglycerin patch for acute episodes of angina only. 43. What is the most common complication of an MI? A. Cardiogenic shock B. Heart failure C. arrhythmias D. Pericarditis 44. A 45-year-old male client with leg ulcers and arterial insufficiency is admitted to the hospital. The nurse understands that leg ulcers of this nature are usually caused by: A. Decreased arterial blood flow secondary to vasoconstriction. B. Decreased arterial blood flow leading to hyperemia. C. Atherosclerotic obstruction of the arteries. D. Trauma to the lower extremities. 45. Which of the following classes of meds protects the ischemic myocardium by blocking sympathetic nerve stimulation? A. Beta-adrenergic blockers B. Calcium channel blockers C. Narcotics D. Nitrates 46. What is the first intervention for a pt experiencing MI? A. Administer morphine B. Administer oxygen C. Administer sublingual nitroglycerin D. Obtain an ECG 47. After myocardial infarction, which of the following problems is indicated by auscultation of crackles in the lungs? A. Left-sided heart failure B. Pulmonic valve malfunction C. Right-sided heart failure D. Tricuspid valve malfunction 48. Which of the following is a compensatory response to decreased cardiac output? A. Decreased BP. B. Alteration in LOC. C. Decreased BP and diuresis. D. Increased BP and fluid retention. 49. Acute pulmonary edema caused by heart failure is usually a result of damage to which of the following areas of the heart? A. Left atrium B. Right atrium C. Left ventricle D. Right ventricle 50. Which of the following factors can cause blood pressure to drop to normal levels? A. Kidneys' excretion of sodium only. B. Kidneys' retention of sodium and water. C. Kidneys' excretion of sodium and water. D. Kidneys' retention of sodium and excretion of water

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