1. The nurse is evaluating a patient suspected of having pericarditis.

Which of the following are associated with

pericarditis?
a. edema and crushing chest pain
b. heart failure and low urine output
c. low urine output and crushing chest pain
d. pleuritic check pain, fever, leukocytosis
2. Where is the apical pulse palpated?
a. 5th intercostals space c. left side of the neck
b. 2nd intercostals space d. 3rd intercostals space
3. The nurse is caring for a patient complaining of chest pain related to pericarditis. What position helps relieve pain?
a. lean forward while sitting
b. lie in the dorsal recumbent position
c. lie in a prone position
d. lie in the supine position
4. The nurse is caring for a patient scheduled to undergo a mitral valve replacement. The nurse should monitor for which
complication of mitral stenosis?
a. Left-sided heart failure c. pulmonary hypertension
b. myocardial infarction d. respiratory alkalosis
5. Prophylactic heparin therapy is prescribed to treat thrombophlebitis in a multiparous client who gave birth 24 hours
ago. After instructing the client about the medication, the nurse determines that the client understands the instructions
when she states which of the following as the purpose of the drug?
a. To thin the blood clots. c. To increase the perspiration for diuresis.
b. To increase the lochial flow. d. To prevent further blood clot formation
6. After being treated with heparin therapy for thrombophlebitis, a multiparous client who gave birth 4 days ago is to be
discharged on oral warfarin. After teaching the client about the medication and possible effects, which of the following
client statements indicates successful teaching?
a. “I can take two aspirin if I get uterine cramps.”
b. “Protamine sulfate should be available if I need it.”
c. “I should use a soft toothbrush to brush my teeth.”
d. “I can drink an occasional glass of wine if I desire.”
7. A multiparous client at 24 hours postpartum demonstrates a positive Homan sign with discomfort. The nurse should:
a. Place a cold pack on the client's perineal area. c. Notify the client's physician immediately.
b. Place the client in semi-Fowler's position. d. Ask the client to ambulate around the room.
8. Prophylactic heparin therapy is prescribed to treat thrombophlebitis in a multiparous client who gave birth 24 hours
ago. After instructing the client about the medication, the nurse determines that the client understands the instructions
when she states which of the following as the purpose of the drug?
a. To thin the blood clots. c. To increase the perspiration for diuresis.
b. To increase the lochial flow. d. To prevent further blood clot formation.
9. While caring for a primipara diagnosed with deep vein thrombosis at 48 hours postpartum who is receiving treatment
with bed rest and intravenous heparin therapy, the nurse should contact the client's physician immediately if the client
exhibited which of the following?
a. Pain in her calf. c. Hypertension.
b. Dyspnea. d. Bradycardia.
10. A primiparous client 3 days postpartum is to be discharged on heparin therapy. After teaching her about possible
adverse effectsof heparin therapy, the nurse determines that the client needs further instruction when she states that
the adverse effects include which of the following?
a. Epistaxis. c. Slow pulse.
b. Bleeding gums. d. Petechiae.
11. 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.
12. The primary goal for the client with Buerger's disease is to prevent:
a. Embolus formation. c. Thrombus formation.
b. Fat embolus formation. d. Thrombophlebitis.
13. A client with Buerger's disease smokes two packs of cigarettes a day. When helping a client change smoking
behavior, it is important to know the client's:
a. Ability to attend support groups.
b. Goals for the treatment.
c. Perception of the negative behavior.
d. Motivation.
14. A client with Buerger's disease has established a goal to stop smoking. Which medication would be the most helpful
in attaining this goal?
a. Bupropion. c. Nitroglycerin.
b. Nicotine. d. Ibuprofen
15. The nurse is assessing a client with Buerger's disease. The nurse should determine if the client is experiencing:
a. Thickening of the intima and media of the artery.
b. Inflammation and fibrosis of arteries, veins, and nerves.
c. Vasospasm lasting several minutes.
d. Pain, pallor, and pulselessness.
16. The nurse is obtaining a blood sample for a partial thromboplastin time test prescribed for a client who is taking
heparin. It is 5 AM when drawing the blood, the nurse should do which of the following? Select all that apply.
a. Awake the client.
b. Check the armband for client identification number and compare with the prescription.
c. Label the sample vial in front of the client.
d. Verify the room number with the room assignment.
e. Ask the client to state his/her name.
17. A client has acute arterial occlusion. The physician has prescribed IV heparin. Before starting the medication, the
nurseshould:
a. Review the blood coagulation laboratory c. Count the client's apical pulse for 1 minute.
values. d. Check the 24-hour urine output record
b. Test the client's stools for occult blood.
18. When instructing a client who has been newly diagnosed with vasospastic disorder (Raynaud's phenomenon) about
management of care, the nurse should discuss which of the following topics?
a. Scheduling a sympathectomy procedure for the next visit.
b. Using a beta blocker medication.
c Follow-up monitoring for development of connective tissue disease.
d. Benefit of an angioplasty to the affected extremities.
19. A client has been diagnosed with vasospastic disorder (Raynaud's phenomenon) on the tip of the nose and
fingertips. The physician has prescribed reserpine (Serpasil) to determine if the client will obtain relief. The client often
works outside in cold weather and also smokes two packs of cigarettes per day. Which of the following should be
included in the discharge plan for this client? Select all that apply.
a. Stopping smoking.
b. Wearing a face covering and gloves in the winter.
c. Placing fingertips in cool water to rewarm them.
d. Finding employment that can be done in a warm environment.
e. Reporting signs of orthostatic hypotension.
20. A client has returned from the cardiac catheterization laboratory after a balloon valvuloplasty for mitral stenosis.
Which of the following requires immediate nursing action?
a. A low, grade 1 intensity mitral regurgitation murmur.
b. SpO2 is 94% on 2 L of oxygen via nasal cannula.
c. The client has become more somnolent.
d. Urine output has decreased from 60 mL/h to 40 mL over the last hour.
21. Good dental care is an important measure in reducing the risk of endocarditis. A teaching plan to promote good
dental care in a client with mitral stenosis should include instructing the client to do which of the following? Select all
that apply.
a. Brush the teeth at least twice a day.
b. Avoid use of an electric toothbrush.
c. Take an antibiotic prior to oral surgery.
d. Floss the teeth at least once a day.
e. Have regular dental checkups.
f. Rinse the mouth with an antibiotic mouthwash once a day.
22. Before a client's discharge after mitral valve replacement surgery, the nurse should evaluate the client's
understanding of postsurgery activity restrictions. Which of the following should the client not engage in until after the
1-month postdischarge appointment with the surgeon?
a. Showering. c. A program of gradually progressive walking.
b. Lifting anything heavier than 10 lb (4.5 kg). d. Light housework.
23. Three days after mitral valve replacement surgery, the client tells the nurse there is a “clicking” noise coming from
the chest incision and the incision seems to becoming larger. The nurse's response should reflect the understanding that
the client may be experiencing which of the following?
a. Anxiety related to altered body image. d. Lack of knowledge regarding the postoperative
b. Anxiety related to altered health status. course
c. Altered tissue perfusion.
24. A client has mitral stenosis and will have a valve replacement. The nurse is instructing the client about health
maintenance prior to surgery. Inability to follow which of the following regimens would pose the greatest health hazard
to this client at this time?
a. Medication therapy. c. Activity restrictions.
b. Diet modification. d. Dental care.
25.Good dental care is an important measure in reducing the risk of endocarditis. A teaching plan to promote good
dental care in a client with mitral stenosis should include instructing the client to do which of the following? Select all
that apply.
a. Brush the teeth at least twice a day.
b. Avoid use of an electric toothbrush.
c. Take an antibiotic prior to oral surgery.
d. Floss the teeth at least once a day.
e. Have regular dental checkups.
f. Rinse the mouth with an antibiotic mouthwash once a day.
26. A 66-year-old client complaining of not feeling well is seen in a clinic. The client is taking several medications for the
control of heart disease and hypertension. These medications include atenolol (Tenormin), digoxin (Lanoxin), and
chlorothiazide (Diuril). A tentative diagnosis of digoxin toxicity is made. Which of the following assessment data would
support this diagnosis?
a. Dyspnea, edema, and palpitations
b. Chest pain, hypotension, and paresthesia
c. Double vision, loss of appetite, and nausea
d. Constipation, dry mouth, and sleep disorder
27. A nurse is caring for a client receiving a heparin intravenous (IV) infusion. The nurse anticipates that which laboratory
study will be prescribed to monitor the therapeutic effect of heparin?
a. Hematocrit c. Prothrombin time
b. Hemoglobin d. Activated partial thromboplastin time
28. In order to prevent deep vein thrombosis (DVT) following abdominal surgery, the nurse should:
a. Restrict fluids. c. Assist the client to remain sedentary.
b. Encourage deep breathing. d. Use pneumatic compression stockings.
29. A client diagnosed with a deep vein thrombosis has heparin sodium infusing at 1,500 units/h. The concentration of
heparin is 25,000units/500 mL. If the infusion remains at the same rate for a full 12-hour shift, how many milliliters of
fluid will infuse?
_________360_________________-mL.
30. The nurse interviews a 22-year-old female client who is scheduled for abdominal surgery the following week. The
client is obese and uses estrogen-based oral contraceptives. This client is at high risk for development of:
a. Atherosclerosis. c. Vasospastic disorder (Raynaud's disease).
b. Diabetes. d. Thrombophlebitis.
31. The nurse observes that an older female has small-to-moderate, distended, and tortuous veins running along the
inner aspect of her lower legs. The nurse should:
a. Apply a half-leg pneumatic compression device.
b. Suggest the client contact her physician.
c. Assess the client for foot ulcers.
d. Encourage the client to avoid standing in one position for long periods of time.
32. Which of the following clients is at risk for varicose veins?
a. A client who has had a cerebrovascular accident.
b. A client who has had anemia.
c. A client who has had thrombophlebitis.
d. A client who has had transient ischemic attacks.
33. A client weighs 300 lb (136 kg) and has a history of deep vein thrombosis and thrombophlebitis. When reviewing a
teaching plan with this client, the nurse determines that the client has understood the nurse's instructions when the
client states a willingness to:
a. Avoid exercise. d. Wear support hose, using rubber bands to
b. Lose weight. hold the stockings up.
c. Perform leg lifts every 4 hours.
34. Which instructions should the nurse include when developing a teaching plan for a client being discharged from the
hospital on anticoagulant therapy after having deep vein thrombosis (DVT)? Select all that apply.
a. Checking urine for bright blood and a dark smoky color.
b. Walking daily as a good exercise.
c. Using garlic and ginger, which may decrease bleeding time.
d. Performing foot/leg exercises and walking around the airplane cabin when on long flights.
e. Preventing DVT because of risk of pulmonary emboli.
f. Avoiding surface bumps because the skin is prone to injury.
35. The nurse is evaluating a patient suspected of having pericarditis. Which of the following are associated with
pericarditis?
a. edema and crushing chest pain
b. heart failure and low urine output
c. low urine output and crushing chest pain
d. pleuritic check pain, fever, leukocytosis