1.

Which of the following actions is the first described as knifelike chest pain that
priority of care for a client exhibiting signs increases in intensity with inspiration?
and symptoms of coronary artery disease?

1. Cardiac
1. Decrease anxiety
2. Gastrointestinal
2. Enhance myocardial oxygenation
3. Musculoskeletal
3. Administer sublingual nitroglycerin
4. Pulmonary
4. Educate the client about his symptoms

5. Which of the following blood tests is

2. Medical treatment of coronary artery most indicative of cardiac damage?
disease includes which of the following
procedures?
1. Lactate dehydrogenase
2. Complete blood count (CBC)
1. Cardiac catheterization
3. Troponin I
2. Coronary artery bypass surgery
4. Creatine kinase (CK)
3. Oral medication therapy
4. Percutaneous transluminal coronary
angioplasty 6. What is the primary reason for
administering morphine to a client with an
MI?
3. Which of the following is the most
common symptom of myocardial infarction
(MI)? 1. To sedate the client
2. To decrease the client’s pain
1. Chest pain 3. To decrease the client’s anxiety
2. Dyspnea 4. To decrease oxygen demand on the
client’s heart
3. Edema
4. Palpitations
7. Which of the following conditions is most
commonly responsible for myocardial
4. Which of the following symptoms is the infarction?
most likely origin of pain the client
 3. Administer sublingual nitroglycerin
1. Aneurysm 4. Obtain an ECG
2. Heart failure
3. Coronary artery thrombosis 11. Which of the following classes of
medications protects the ischemic
4. Renal failure
myocardium by blocking catecholamines
and sympathetic nerve stimulation?

8. Which of the following complications is

indicated by a third heart sound (S3)?
1. Beta-adrenergic blockers
2. Calcium channel blockers
1. Ventricular dilation
3. Narcotics
2. Systemic hypertension
4. Nitrates
3. Aortic valve malfunction
4. Increased atrial contractions
12. What is the most common complication
of an MI?

9. After an anterior wall myocardial

infarction, which of the following problems
1. Cardiogenic shock
is indicated by auscultation of crackles in
the lungs? 2. Heart failure
3. arrhythmias
1. Left-sided heart failure 4. Pericarditis
2. Pulmonic valve malfunction
3. Right-sided heart failure 13. With which of the following disorders is
jugular vein distention most prominent?
4. Tricupsid valve malfunction

1. Abdominal aortic aneurysm

10. What is the first intervention for a client
experiencing MI? 2. Heart failure
3. MI
1. Administer morphine 4. Pneumothorax
2. Administer oxygen
14. Toxicity from which of the following
medications may cause a client to see a
1. Adequate urine output
green-yellow halo around lights?
2. Polyuria
3. Oliguria
1. Digoxin
4. Polydipsia
2. Furosemide (Lasix)
3. Metoprolol (Lopressor)
18. Which of the following classes of
4. Enalapril (Vasotec)
medications maximizes cardiac
performance in clients with heart failure by
increasing ventricular contractility?
15. Which of the following symptoms is
most commonly associated with left-sided
heart failure?
1. Beta-adrenergic blockers
2. Calcium channel blockers
1. Crackles
3. Diuretics
2. Arrhythmias
4. Inotropic agents
3. Hepatic engorgement
4. Hypotension
19. Stimulation of the sympathetic nervous
system produces which of the following
responses?
16. In which of the following disorders
would the nurse expect to assess sacral
edema in a bedridden client?
1. Bradycardia
2. Tachycardia
1. Diabetes
3. Hypotension
2. Pulmonary emboli
4. Decreased myocardial contractility
3. Renal failure
4. Right-sided heart failure
20. Which of the following conditions is
most closely associated with weight gain,
nausea, and a decrease in urine output?
17. Which of the following symptoms might
a client with right-sided heart failure
exhibit?
1. Angina pectoris 4. Restrictive
2. Cardiomyopathy
3. Left-sided heart failure 24. Which of the following recurring
conditions most commonly occurs in clients
4. Right-sided heart failure
with cardiomyopathy?

21. Which of the following heart muscle

1. Heart failure
diseases is unrelated to other
cardiovascular disease? 2. Diabetes
3. MI
1. Cardiomyopathy 4. Pericardial effusion
2. Coronary artery disease
3. Myocardial infarction 25. Dyspnea, cough, expectoration,
weakness, and edema are classic signs and
4. Pericardial effusion
symptoms of which of the following
conditions?

22. Which of the following types of

cardiomyopathy can be associated with
1. Pericarditis
childbirth?
2. Hypertension
3. MI
1. Dilated
4. Heart failure
2. Hypertrophic
3. Myocarditis
26. In which of the following types of
4. Restrictive
cardiomyopathy does cardiac output
remain normal?

23. Septal involvement occurs in which type

of cardiomyopathy?
1. Dilated
2. Hypertrophic
1. Congestive
3. Obliterative
2. Dilated
4. Restrictive
3. Hypertrophic
27. Which of the following cardiac 30. Which of the following conditions is
conditions does a fourth heart sound (S4) associated with a predictable level of pain
indicate? that occurs as a result of physical or
emotional stress?

1. Dilated aorta
1. Anxiety
2. Normally functioning heart
2. Stable angina
3. Decreased myocardial contractility
3. Unstable angina
4. Failure of the ventricle to eject all of the
blood during systole 4. Variant angina

28. Which of the following classes of drugs 31. Which of the following types of angina is
is most widely used in the treatment of most closely related with an impending MI?
cardiomyopathy?

1. Angina decubitus
1. Antihypertensives
2. Chronic stable angina
2. Beta-adrenergic blockers
3. Nocturnal angina
3. Calcium channel blockers
4. Unstable angina
4. Nitrates

32. Which of the following conditions is the

predominant cause of angina?
29. If medical treatments fail, which of the
following invasive procedures is necessary
1. Increased preload
for treating cardiomyopathy?
2. Decreased afterload
3. Coronary artery spasm
1. Cardiac catheterization
4. Inadequate oxygen supply to the
2. Coronary artery bypass graft (CABG)
myocardium
3. Heart transplantation
4. Intra-aortic balloon pump (IABP)
33. Which of the following tests is used
most often to diagnose angina?
1. Chest x-ray
2. Echocardiogram
3. Cardiac catheterization
4. 12-lead electrocardiogram (ECG)
1. Preload, afterload, and cerebral blood
flow
2. Preload, afterload, and renal blood flow
3. Preload, afterload, contractility, and
heart rate.
4. Preload, afterload, cerebral blood flow,
and heart rate.

34. Which of the following results is the

37. Which of the following positions would
primary treatment goal for angina?
best aid breathing for a client with acute
pulmonary edema?

1. Reversal of ischemia
2. Reversal of infarction 1. Lying flat in bed

3. Reduction of stress and anxiety 2. Left side-lying

4. Reduction of associated risk factors 3. In high Fowler’s position

4. In semi-Fowler’s position

35. Which of the following interventions

should be the first priority when treating a
38. Which of the following blood gas
client experiencing chest pain while
abnormalities is initially most suggestive of
walking?
pulmonary edema?

1. Sit the client down

1. Anoxia
2. Get the client back to bed
2. Hypercapnia
3. Obtain an ECG
3. Hyperoxygenation
4. Administer sublingual nitroglycerin
4. Hypocapnia

36. Myocardial oxygen consumption

39. Which of the following is a
increases as which of the following
compensatory response to decreased
parameters increase?
cardiac output?
 2. Right atrium
1. Decreased BP 3. Left ventricle
2. Alteration in LOC 4. Right ventricle
3. Decreased BP and diuresis
4. Increased BP and fluid retention 43. An 18-year-old client who recently had
an URI is admitted with suspected
rheumatic fever. Which assessment findings
40. Which of the following actions is the confirm this diagnosis?
appropriate initial response to a client
coughing up pink, frothy sputum?
1. Erythema marginatum, subcutaneous
nodules, and fever
1. Call for help
2. Tachycardia, finger clubbing, and a load
2. Call the physician S3

3. Start an I.V. line 3. Dyspnea, cough, and palpitations

4. Suction the client 4. Dyspnea, fatigue, and syncope

41. Which of the following terms describes 44. A client admitted with angina complains
the force against which the ventricle must of severe chest pain and suddenly becomes
expel blood? unresponsive. After establishing
unresponsiveness, which of the following
actions should the nurse take first?
1. Afterload
2. Cardiac output
1. Activate the resuscitation team
3. Overload
2. Open the client’s airway
4. Preload
3. Check for breathing
4. Check for signs of circulation
42. Acute pulmonary edema caused by
heart failure is usually a result of damage to
which of the following areas of the heart? 45. A 55-year-old client is admitted with an
acute inferior-wall myocardial infarction.
During the admission interview, he says he
1. Left atrium stopped taking his metoprolol (Lopressor) 5
days ago because he was feeling better.
Which of the following nursing diagnoses
takes priority for this client?
1. Anxiety
2. Ineffective tissue perfusion;
cardiopulmonary
3. Acute pain
4. Ineffective therapeutic regimen
management
46. A client comes into the E.R. with acute
shortness of breath and a cough that
produces pink, frothy sputum. Admission
assessment reveals crackles and wheezes, a
BP of 85/46, a HR of 122 BPM, and a
respiratory rate of 38 breaths/minute. The
client’s medical history included DM, HTN,
and heart failure. Which of the following
disorders should the nurse suspect?
1. Pulmonary edema
2. Pneumothorax
3. Cardiac tamponade
4. Pulmonary embolus
47. The nurse coming on duty receives the
report from the nurse going off duty. Which
of the following clients should the on-duty
nurse assess first?
1. The 58-year-old client who was admitted
2 days ago with heart failure, BP of 126/76,
and a respiratory rate of 21 breaths a
minute.
2. The 88-year-old client with end-stage
right-sided heart failure, BP of 78/50, and a
DNR order.
3. The 62-year-old client who was admitted
one day ago with thrombophlebitis and
receiving IV heparin.
4. A 76-year-old client who was admitted 1
hour ago with new-onset atrial fibrillation
and is receiving IV diltiazem (Cardizem).
48. When developing a teaching plan for a
client with endocarditis, which of the
following points is most essential for the
nurse to include?
1. “Report fever, anorexia, and night sweats
to the physician.”
2. “Take prophylactic antibiotics after
dental work and invasive procedures.”
3. “Include potassium rich foods in your
diet.”
4. “Monitor your pulse regularly.”
49. A nurse is conducting a health history
with a client with a primary diagnosis of
heart failure. Which of the following
disorders reported by the client is unlikely
to play a role in exacerbating the heart
failure?
1. Recent URI the amount of 40 mg IV push. Knowing that
the client also will be started on Digoxin
2. Nutritional anemia
(Lanoxin), a nurse checks the client’s most
3. Peptic ulcer disease recent:

4. A-Fib
1. Digoxin level

50. A nurse is preparing for the admission of 2. Sodium level

a client with heart failure who is being sent
directly to the hospital from the physician’s
office. The nurse would plan on having
which of the following medications readily
available for use?
1. Diltiazem (Cardizem)
2. Digoxin (Lanoxin)
3. Propranolol (Inderal)
4. Metoprolol (Lopressor)
3. Potassium level
4. Creatinine level
53. A client who had cardiac surgery 24
hours ago has a urine output averaging 19
ml/hr for 2 hours. The client received a
single bolus of 500 ml of IV fluid. Urine
output for the subsequent hour was 25 ml.
Daily laboratory results indicate the blood
urea nitrogen is 45 mg/dL and the serum
creatinine is 2.2 mg/dL. A nurse interprets
the client is at risk for:

51. A nurse caring for a client in one room is

told by another nurse that a second client
1. Hypovolemia
has developed severe pulmonary edema.
On entering the 2nd client’s room, the 2. UTI
nurse would expect the client to be:
3. Glomerulonephritis
4. Acute renal failure
1. Slightly anxious
2. Mildly anxious
54. A nurse is preparing to ambulate a client
3. Moderately anxious on the 3rd day after cardiac surgery. The
nurse would plan to do which of the
4. Extremely anxious
following to enable the client to best
tolerate the ambulation?

52. A client with pulmonary edema has

been on diuretic therapy. The client has an
order for additional furosemide (Lasix) in
1. Encourage the client to cough and deep
breathe
57. A home care nurse is making a routine
2. Premedicate the client with an analgesic visit to a client receiving digoxin (Lanoxin) in
the treatment of heart failure. The nurse
3. Provide the client with a walker
would particularly assess the client for:
4. Remove telemetry equipment because it
weighs down the hospital gown.
1. Thrombocytopenia and weight gain
2. Anorexia, nausea, and visual disturbances
55. A client’s electrocardiogram strip shows
atrial and ventricular rates of 80 complexes 3. Diarrhea and hypotension
per minute. The PR interval is 0.14 second,
4. Fatigue and muscle twitching
and the QRS complex measures 0.08
second. The nurse interprets this rhythm is:

58. A client with angina complains that the

angina pain is prolonged and severe and
1. Normal sinus rhythm
occurs at the same time each day, most
2. Sinus bradycardia often in the morning, On further
assessment a nurse notes that the pain
3. Sinus tachycardia
occurs in the absence of precipitating
4. Sinus dysrhythmia factors. This type of anginal pain is best
described as:

56. A client has frequent bursts of

ventricular tachycardia on the cardiac 1. Stable angina
monitor. A nurse is most concerned with
2. Unstable angina
this dysrhythmia because:
3. Variant angina
4. Nonanginal pain
1. It is uncomfortable for the client, giving a
sense of impending doom.
2. It produces a high cardiac output that 59. The physician orders continuous
quickly leads to cerebral and myocardial intravenous nitroglycerin infusion for the
ischemia. client with MI. Essential nursing actions
include which of the following?
3. It is almost impossible to convert to a
normal sinus rhythm.
4. It can develop into ventricular fibrillation 1. Obtaining an infusion pump for the
at any time. medication
2. Monitoring BP q4h
3. Monitoring urine output hourly
4. Obtaining serum potassium levels daily
60. Aspirin is administered to the client
experiencing an MI because of its:
3. Three regular meals per day
4. NPO
63. An older, sedentary adult may not
respond to emotional or physical stress as
well as a younger individual because of:

1. Left ventricular atrophy

1. Antipyretic action
2. Irregular heartbeats
2. Antithrombotic action
3. Peripheral vascular occlusion
3. Antiplatelet action
4. Pacemaker placement
4. Analgesic action

64. Which of the following nursing

61. Which of the following is an expected
diagnoses would be appropriate for a client
outcome for a client on the second day of
with heart failure? Select all that apply.
hospitalization after an MI?

1. Ineffective tissue perfusion related to

1. Has severe chest pain
decreased peripheral blood flow secondary
2. Can identify risks factors for MI to decreased cardiac output.

3. Agrees to participate in a cardiac 2. Activity intolerance related to increased

rehabilitation walking program cardiac output.

4. Can perform personal self-care activities 3. Decreased cardiac output related to

without pain structural and functional changes.
4. Impaired gas exchange related to
decreased sympathetic nervous system
62. Which of the following reflects the
activity.
principle on which a client’s diet will most
likely be based during the acute phase of
MI?
65. Which of the following would be a
priority nursing diagnosis for the client with
heart failure and pulmonary edema?
1. Liquids as ordered
2. Small, easily digested meals
1. Risk for infection related to stasis of
alveolar secretions
1. Apples
2. Impaired skin integrity related to
2. Tomato juice
pressure
3. Whole wheat bread
3. Activity intolerance related to pump
failure 4. Beef tenderloin
4. Constipation related to immobility

69. The nurse finds the apical pulse below

the 5th intercostal space. The nurse
66. Captopril may be administered to a
suspects:
client with HF because it acts as a:

1. Left atrial enlargement

1. Vasopressor
2. Left ventricular enlargement
2. Volume expander
3. Right atrial enlargement
3. Vasodilator
4. Right ventricular enlargement
4. Potassium-sparing diuretic

70. Which of the following arteries primarily

67. Furosemide is administered
feeds the anterior wall of the heart?
intravenously to a client with HF. How soon
after administration should the nurse begin
to see evidence of the drugs desired effect?
1. Circumflex artery
2. Internal mammary artery
1. 5 to 10 minutes
3. Left anterior descending artery
2. 30 to 60 minutes
4. Right coronary artery
3. 2 to 4 hours
4. 6 to 8 hours

68. Which of the following foods should the

nurse teach a client with heart failure to
avoid or limit when following a 2-gram
sodium diet?