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1. Decrease anxiety
2. Enhancing myocardial oxygenation is always the first priority when a pt exhibits signs or
symptoms of cardiac compromise. W/out adequate oxygenation, the myocardium suffers
damage. Sublingual nitroglycerin is administered to treat acute angina, but administration isn't
the first priority. Although educating the pt & decreasing anxiety are important in care delivery,
neither are priorities when a pt is compromised.
2. Medical treatment of coronary artery disease includes which of the following procedures?
1. Cardiac catherization
3. Oral med administration is a noninvasive, medical treatment for coronary artery disease.
Cardiac catherization isn't a treatment, but a diagnostic tool. Coronary artery bypass surgery &
percutaneous transluminal coronary angioplasty are invasive, surgical treatments.
3. Which of the following is the most common symptom of myocardial infarction (MI)?
1. Chest pain
2. Dyspnea
3. Edema
4. Palpitations
Coronary Artery Disease & Hypertension Practice Quiz (50 Questions)
1. The most common symptom of an MI is chest pain, resulting from deprivation of oxygen to
the heart. Dyspnea is the second most common symptom, related to an increase in the
metabolic needs of the body during an MI. Edema is a later sign of heart failure, often seen
after an MI. Palpitations may result from reduced cardiac output, producing arrhythmias.
4. Which of the following symptoms is the most likely origin of pain the pt described as
knifelike chest pain that increases in intensity with inspiration?
1. Cardiac
2. Gastrointestinal
3. Musculoskeletal
4. Pulmonary
1. Lactate dehydrogenase
3. Troponin I
3. Troponin I levels rise rapidly & are detectable w/in 1 hour of myocardial injury. Troponin I
levels aren't detectable in people w/out cardiac injury. Lactate dehydrogenase (LDH) is present
in almost all body tissues & not specific to heart muscle. LDH isoenzymes are useful in
diagnosing cardiac injury. CBC is obtained to review blood counts, & a complete chemistry is
obtained to review electrolytes. Because CK levels may rise w/ skeletal muscle injury, CK
isoenzymes are required to detect cardiac injury
1. To sedate the pt
7. Which of the following conditions is most commonly responsible for myocardial infarction?
1. Aneurysm
2. Heart failure
4. Renal failure
3. Coronary artery thrombosis causes an inclusion of the artery, leading to myocardial death. An
aneurysm is an outpouching of a vessel & doesn't cause an MI. Renal failure can be associated
w/ MI but isn't a direct cause. Heart failure is usually a result from an MI.
1. Ventricular dilation
2. Systemic hypertension
1. Rapid filling of the ventricle causes vasodilation that is auscultated as S3. Increased atrial
contraction or systemic hypertension can result in a fourth heart sound. Aortic valve
malfunction is heard as a murmur.
9. After an anterior wall myocardial infarction, which of the following problems is indicated
by auscultation of crackles in the lungs?
1. The left ventricle is responsible for most of the cardiac output. An anterior wall MI may result
in a decrease in left ventricular function. When the left ventricle doesn't function properly,
resulting in left-sided heart failure, fluid accumulates in the interstitial & alveolar spaces in the
lungs & causes crackles. Pulmonic & tricuspid valve malfunction causes right sided heart failure.
Coronary Artery Disease & Hypertension Practice Quiz (50 Questions)
1. Administer morphine
2. Administer oxygen
4. Obtain an ECG
2. Administering supplemental oxygen to the pt is the first priority of care. The myocardium is
deprived of oxygen during an infarction, so additional oxygen is administered to assist in
oxygenation & prevent further damage. Morphine & nitro are also used to treat MI, but they're
more commonly administered after the oxygen. An ECG is the most common diagnostic tool
used to evaluate MI.
11. Which of the following classes of meds protects the ischemic myocardium by blocking
catecholamines & sympathetic nerve stimulation?
1. Beta-adrenergic blockers
3. Narcotics
4. Nitrates
1. Beta-adrenergic blockers work by blocking beta receptors in the myocardium, reducing the
response to catecholamines & sympathetic nerve stimulation. They protect the myocardium,
helping to reduce the risk of another infarction by decreasing myocardial oxygen demand.
Calcium channel blockers reduce the workload of the heart by decreasing the heart rate.
Narcotics reduce myocardial oxygen demand promote vasodilation, & decrease anxiety.
Nitrates reduce myocardial oxygen consumption by decreasing left ventricular end-diastolic
pressure (preload) & systemic vascular resistance (afterload).
1. Cardiogenic shock
2. Heart failure
3. arrhythmias
Coronary Artery Disease & Hypertension Practice Quiz (50 Questions)
4. Pericarditis
3. Arrhythmias, caused by oxygen deprivation to the myocardium, are the most common
complication of an MI. Cardiogenic shock, another complication of an MI, is defined as the end
stage of left ventricular dysfunction. This condition occurs in approximately 15% of pts w/ MI.
Because the pumping function of the heart is compromised by an MI, heart failure is the second
most common complication. Pericarditis most commonly results from a bacterial or viral
infection but may occur after the MI.
13. With which of the following disorders is jugular vein distention most prominent?
2. Heart failure
3. MI
4. Pneumothorax
2. Elevated venous pressure, exhibited as jugular vein distention, indicates a failure of the heart
to pump. JVD isn't a symptom of abdominal aortic aneurysm or pneumothorax. An MI, if severe
enough, can progress to heart failure, however, in & of itself, an MI doesn't cause JVD.
14. Toxicity from which of the following meds may cause a pt to see a green-yellow halo
around lights?
1. Digoxin
2. Furosemide (Lasix)
3. Metoprolol (Lopressor)
4. Enalapril (Vasotec)
1. One of the most common signs of digoxin toxicity is the visual disturbance known as the
"green-yellow halo sign." The other meds aren't associated w/ such an effect.
15. Which of the following symptoms is most commonly associated with left-sided heart
failure?
1. Crackles
2. Arrhythmias
3. Hepatic engorgement
Coronary Artery Disease & Hypertension Practice Quiz (50 Questions)
4. Hypotension
1. Crackles in the lungs are a classic sign of left-sided heart failure. These sounds are caused by
fluid backing up into the pulmonary system. Arrhythmias can be associated w/ both right- &
left-sided heart failure. Left-sided heart failure causes hypertension secondary to an increased
workload on the system.
16. In which of the following disorders would the nurse expect to assess sacral edema in a
bedridden pt?
1. Diabetes
2. Pulmonary emboli
3. Renal failure
4. The most accurate area on the body to assess dependent edema in a bed-ridden pt is the
sacral area. Sacral, or dependent, edema is secondary to right-sided heart failure.
17. Which of the following symptoms might a pt with right-sided heart failure exhibit?
2. Polyuria
3. Oliguria
4. Polydipsia
3. Inadequate deactivation of aldosterone by the liver after right-sided heart failure leads to
fluid retention, which causes oliguria.
18. Which of the following classes of meds maximizes cardiac performance in pts with heart
failure by increasing ventricular contractibility?
1. Beta-adrenergic blockers
3. Diuretics
4. Inotropic agents
Coronary Artery Disease & Hypertension Practice Quiz (50 Questions)
4. Inotropic agents are administered to increase the force of the heart's contractions, thereby
increasing ventricular contractility & ultimately increasing cardiac output.
19. Stimulation of the sympathetic nervous system produces which of the following
responses?
1. Bradycardia
2. Tachycardia
3. Hypotension
2. Stimulation of the sympathetic nervous system causes tachycardia & increased contractility.
The other symptoms listed are related to the parasympathetic nervous system, which is
responsible for slowing the heart rate.
20. Which of the following conditions is most closely associated with weight gain, nausea, & a
decrease in urine output?
1. Angina pectoris
2. Cardiomyopathy
4. Weight gain, nausea, & a decrease in urine output are secondary effects of right-sided heart
failure. Cardiomyopathy is usually identified as a symptom of left-sided heart failure. Left-sided
heart failure causes primarily pulmonary symptoms rather than systemic ones. Angina pectoris
doesn't cause weight gain, nausea, or a decrease in urine output.
21. Which of the following heart muscle diseases is unrelated to other cardiovascular
disease?
1. Cardiomyopathy
3. Myocardial infarction
4. Pericardial effusion
Coronary Artery Disease & Hypertension Practice Quiz (50 Questions)
1. Cardiomyopathy isn't usually related to an underlying heart disease such as atherosclerosis.
The etiology in most cases is unknown. CAD & MI are directly related to atherosclerosis.
Pericardial effusion is the escape of fluid into the pericardial sac, a condition associated w/
Pericarditis & advanced heart failure.
22. Which of the following types of cardiomyopathy can be associated with childbirth?
1. Dilated
2. Hypertrophic
3. Myocarditis
4. Restrictive
1. Although the cause isn't entirely known, cardiac dilation & heart failure may develop during
the last month of pregnancy or the first few months after birth. The condition may result from a
preexisting cardiomyopathy not apparent prior to pregnancy. Hypertrophic cardiomyopathy is
an abnormal symmetry of the ventricles that has an unknown etiology but a strong familial
tendency. Myocarditis isn't specifically associated w/ childbirth. Restrictive cardiomyopathy
indicates constrictive pericarditis; the underlying cause is usually myocardial.
1. Congestive
2. Dilated
3. Hypertrophic
4. Restrictive
24. Which of the following recurring conditions most commonly occurs in pts with
cardiomyopathy?
1. Heart failure
2. Diabetes
3. MI
4. Pericardial effusion
1. Because the structure & function of the heart muscle is affected, heart failure most commonly
occurs in pts w/ cardiomyopathy. MI results from prolonged myocardial ischemia due to
Coronary Artery Disease & Hypertension Practice Quiz (50 Questions)
reduced blood flow through one of the coronary arteries. Pericardial effusion is most
predominant in pts w/ pericarditis.
25. Dyspnea, cough, expectoration, weakness, & edema are classic signs & symptoms of
which of the following conditions?
1. Pericarditis
2. Hypertension
3. MI
4. Heart failure
4. These are the classic signs of failure. Pericarditis is exhibited by a feeling of fullness in the
chest & auscultation of a pericardial friction rub. Hypertension is usually exhibited by
headaches, visual disturbances, & a flushed face. MI causes heart failure but isn't related to
these symptoms.
26. In which of the following types of cardiomyopathy does cardiac output remain normal?
1. Dilated
2. Hypertrophic
3. Obliterative
4. Restrictive
2. Cardiac output isn't affected by hypertrophic cardiomyopathy because the size of the
ventricle remains relatively unchanged. All of the rest decrease cardiac output.
27. Which of the following cardiac conditions does a fourth heart sound (S4) indicate?
1. Dilated aorta
28. Which of the following classes of drugs is most widely used in the treatment of
cardiomyopathy?
1. Antihypertensives
2. Beta-adrenergic blockers
4. Nitrates
2. By decreasing the heart rate & contractility, beta-blockers improve myocardial filling &
cardiac output, which are primary goals in the treatment of cardiomyopathy. Antihypertensives
aren't usually indicated because they would decrease cardiac output in pts who are already
hypotensive. Calcium channel blockers are sometimes used for the same reasons as beta-
blockers; however, they aren't as effective as beta-blockers & cause increased hypotension.
Nitrates aren't used because of their dilating effects, which would further compromise the
myocardium.
29. If medical treatments fail, which of the following invasive procedures is necessary for
treating cariomyopathy?
1. Cardiac catherization
3. Heart transplantation
3. The only definitive treatment for cardiomyopathy that can't be controlled medically is a heart
transplant because the damage to the heart muscle is irreversible.
30. Which of the following conditions is associated with a predictable level of pain that occurs
as a result of physical or emotional stress?
1. Anxiety
2. Stable angina
3. Unstable angina
4. Variant angina
2. The pain of stable angina is predictable in nature, builds gradually, & quickly reaches
maximum intensity. Unstable angina doesn't always need a trigger, is more intense, & lasts
Coronary Artery Disease & Hypertension Practice Quiz (50 Questions)
longer than stable angina. Variant angina usually occurs at rest—not as a result of exercise or
stress.
31. Which of the following types of angina is most closely related with an impending MI?
1. Angina decubitus
3. Noctural angina
4. Unstable angina
4. Unstable angina progressively increases in frequency, intensity, & duration & is related to an
increased risk of MI w/in 3 to 18 months.
1. Increased preload
2. Decreased afterload
4. Inadequate oxygen supply to the myocardium is responsible for the pain accompanying
angina. Increased preload would be responsible for right-sided heart failure. Decreased
afterload causes increased cardiac output. Coronary artery spasm is responsible for variant
angina.
33. Which of the following tests is used most often to diagnose angina?
1. Chest x-ray
2. Echocardiogram
3. Cardiac catherization
34. Which of the following results is the primary treatment goal for angina?
1. Reversal of ischemia
2. Reversal of infarction
1. Reversal of the ischemia is the primary goal, achieved by reducing oxygen consumption &
increasing oxygen supply. An infarction is permanent & can't be reversed.
35. Which of the following interventions should be the first priority when treating a pt
experiencing chest pain while walking?
3. Obtain an ECG
1. The initial priority is to decrease the oxygen consumption; this would be achieved by sitting
the pt down. An ECG can be obtained after the pt is sitting down. After the ECGm sublingual
nitro would be administered. When the pt's condition is stabilized, he can be returned to bed.
36. Myocardial oxygen consumption increases as which of the following parameters increase?
3. Myocardial oxygen consumption increases as preload, afterload, renal contractility, & heart
rate increase. Cerebral blood flow doesn't directly affect myocardial oxygen consumption.
Coronary Artery Disease & Hypertension Practice Quiz (50 Questions)
37. Which of the following positions would best aid breathing for a pt with acute pulmonary
edema?
2. Left side-lying
4. In semi-Fowler's position
3. A high Fowler's position promotes ventilation & facilitates breathing by reducing venous
return. Lying flat & side-lying positions worsen the breathing & increase workload of the heart.
Semi-Fowler's position won't reduce the workload of the heart as well as the Fowler's position
will.
38. Which of the following blood gas abnormalities is initially most suggestive of pulmonary
edema?
1. Anoxia
2. Hypercapnia
3. Hyperoxygenation
4. Hypocapnia
1. Decreased BP
2. Alteration in LOC
4. The body compensates for a decrease in cardiac output w/ a rise in BP, due to the stimulation
of the sympathetic NS & an increase in blood volume as the kidneys retain sodium & water.
Blood pressure doesn't initially drop in response to the compensatory mechanism of the body.
Alteration in LOC will occur only if the decreased cardiac output persists.
Coronary Artery Disease & Hypertension Practice Quiz (50 Questions)
40. Which of the following actions is the appropriate initial response to a pt coughing up pink,
frothy sputum?
4. Suction the pt
1. Production of pink, frothy sputum is a classic sign of acute pulmonary edema. Because the pt
is at high risk for decompensation, the nurse should call for help but not leave the room. The
other three interventions would immediately follow.
41. Which of the following terms describes the force against which the ventricle must expel
blood?
1. Afterload
2. Cardiac output
3. Overload
4. Preload
1. Afterload refers to the resistance normally maintained by the aortic & pulmonic valves, the
condition & tone of the aorta, & the resistance offered by the systemic & pulmonary arterioles.
Cardiac output is the amount of blood expelled by the heart per minute. Overload refers to an
abundance of circulating volume. Preload is the volume of blood in the ventricle at the end of
diastole.
42. Acute pulmonary edema caused by heart failure is usually a result of damage to which of
the following areas of the heart?
1. Left atrium
2. Right atrium
3. Left ventricle
4. Right ventricle
3. The left ventricle is responsible for the majority of force for the cardiac output. If the left
ventricle is damaged, the output decreases & fluid accumulates in the interstitial & alveolar
spaces, causing pulmonary edema. Damage to the left atrium would contribute to heart failure
Coronary Artery Disease & Hypertension Practice Quiz (50 Questions)
but wouldn't affect cardiac output or, therefore, the onset of pulmonary edema. If the right
atrium & right ventricle were damaged, right-sided heart failure would result.
43. An 18-year-old pt who recently had an URI is admitted with suspected rheumatic fever.
Which assessment findings confirm this diagnosis?
1. Diagnosis of rheumatic fever requires that the pt have either two major Jones criteria or one
minor criterion plus evidence of a previous streptococcal infection. Major criteria include
carditis, polyarthritis, Sydenham's chorea, subcutaneous nodules, & erythema maginatum
(transient, nonprurtic macules on the trunk or inner aspects of the upper arms or thighs). Minor
criteria include fever, arthralgia, elevated levels of acute phase reactants, & a prolonged PR-
interval on ECG.
44. A pt admitted with angina compains of severe chest pain & suddenly becomes
unresponsive. After establishing unresponsiveness, which of the following actions should the
nurse take first?
1. Immediately after establishing unresponsiveness, the nurse should activate the resuscitation
team. The next step is to open the airway using the head-tilt, chin-lift maneuver & check for
breathing (looking, listening, & feeling for no more than 10-seconds). If the pt isn't breathing,
give two slow breaths using a bag mask or pocket mask. Next, check for signs of circulation by
palpating the carotid pulse.
45. A 55-year-old pt is admitted with an acute inferior-wall myocardial infarction. During the
admission interview, he says he stopped taking his metoprolol (Lopressor) 5 days ago because
he was feeling better. Which of the following nursing diagnoses takes priority for this pt?
Coronary Artery Disease & Hypertension Practice Quiz (50 Questions)
1. Anxiety
3. Acute pain
2. MI results from prolonged myocardial ischemia caused by reduced blood flow through the
coronary arteries. Therefore, the priority nursing diagnosis for this pt is Ineffective tissue
perfusion (cardiopulmonary). Anxiety, acute pain, & ineffective therapeutic regimen
management are appropriate but don't take priority.
46. A pt comes into the E.R. with acute shortness of breath & a cough that produces pink,
frothy sputum. Admission assessment reveals crackles & wheezes, a BP of 85/46, a HR of 122
BPM, & a respiratory rate of 38 breaths/minute. The pt's medical history included DM, HTN,
& heart failure. Which of the following disorders should the nurse suspect?
1. Pulmonary edema
2. Pneumothorax
3. Cardiac tamponade
4. Pulmonary embolus
1. SOB, tachypnea, low BP, tachycardia, crackles, & a cough producing pink, frothy sputum are
late signs of pulmonary edema.
47. The nurse coming on duty receives the report from the nurse going off duty. Which of the
following pts should the on-duty nurse assess first?
1. The 58-year-old pt who was admitted 2 days ago with heart failure, BP of 126/76, & a RR 21
bpm
2. The 88-year-old pt with end-stage right-sided heart failure, BP of 78/50, & a DNR order.
3. The 62-year-old pt who was admitted one day ago with thrombophlebitis & receiving IV
heparin.
4. A 76-year-old pt who was admitted 1 hour ago with new-onset atrial fibrillation & is
receiving IV diltiazem (Cardizem).
4. The pt w/ A-fib has the greatest potential to become unstable & is on IV med that requires
close monitoring. After assessing this pt, the nurse should assess the pt w/ thrombophlebitis
who is receiving a heparin infusion, & then go to the 58-year-old pt admitted 2-days ago w/
heart failure (her s/s are resolving & don't require immediate attention). The lowest priority is
the 89-year-old w/ end stage right-sided heart failure, who requires time consuming supportive
measures.
Coronary Artery Disease & Hypertension Practice Quiz (50 Questions)
48. When developing a teaching plan for a pt with endocarditis, which of the following points
is most essential for the nurse to include?
1. The most essential teaching point is to report signs of relapse, such as fever, anorexia, &
night sweats, to the physician. To prevent further endocarditis episodes, prophylactic antibiotics
are taken before & sometimes after dental work, childbirth, or GU, GI, or gynecologic
procedures. A potassium-rich diet & daily pulse monitoring aren't necessary for a pt w/
endocarditis.
49. A nurse is conducting a health history with a pt with a primary diagnosis of heart failure.
Which of the following disorders reported by the pt is unlikely to play a role in exacerbating
the heart failure?
1. Recent URI
2. Nutritional anemia
4. A-Fib
50. A nurse is preparing for the admission of a pt 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 meds readily available for use?
1. Diltiazem (Cardizem)
2. Digoxin (Lanoxin)
3. Propranolol (Inderal)
4. Metoprolol (Lopressor)
Coronary Artery Disease & Hypertension Practice Quiz (50 Questions)
2. Digoxin exerts a positive inotropic effect on the heart while slowing the overall rate through a
variety of mechanisms. Digoxin is the med of choice to treat heart failure. Diltiazem (calcium
channel blocker) & propranolol & metoprolol (beta blockers) have a negative inotropic effect &
would worsen the failing heart.
51. A nurse caring for a pt in one room is told by another nurse that a second pt has
developed severe pulmonary edema. On entering the 2nd pt's room, the nurse would expect
the pt to be:
1. Slightly anxious
2. Mildly anxious
3. Moderately anxious
4. Extremely anxious
4. Pulmonary edema causes the pt to be extremely agitated & anxious. The pt may complain of
a sense of drowning, suffocation, or smothering.
52. A pt with pulmonary edema has been on diuretic therapy. The pt has an order for
additional furosemide (Lasix) in the amount of 40 mg IV push. Knowing that the pt also will be
started on Digoxin (Lanoxin), a nurse checks the pt's most recent:
1. Digoxin level
2. Sodium level
3. Potassium level
4. Creatinine level
3. The serum potassium level is measured in the pt receiving digoxin & furosemide. Heightened
digitalis effect leading to digoxin toxicity can occur in the pt w/ hypokalemia. Hypokalemia also
predisposes the pt to ventricular dysrhythmias.
53. A pt who had cardiac surgery 24 hours ago has a urine output averaging 19 ml/hr for 2
hours. The pt 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 & the
serum creatinine is 2.2 mg/dL. A nurse interprets the pt is at risk for:
1. Hypovolemia
2. UTI
Coronary Artery Disease & Hypertension Practice Quiz (50 Questions)
3. Glomerulonephritis
4. The pt who undergoes cardiac surgery is at risk for renal injury from poor perfusion,
hemolysis, low cardiac output, or vasopressor med therapy. Renal insult is signaled by
decreased urine output, & increased BUN & creatinine levels. The pt may need meds such as
dopamine (Intropin) to increase renal perfusion & possibly could need peritoneal dialysis or
hemodialysis.
54. A nurse is preparing to ambulate a pt on the 3rd day after cardiac surgery. The nurse
would plan to do which of the following to enable the pt to best tolerate the ambulation?
2. The nurse should encourage regular use of pain med for the first 48 to 72 hours after cardiac
surgery because analgesia will promote rest, decrease myocardial oxygen consumption
resulting from pain, & allow better participation in activities such as coughing, deep breathing,
& ambulation. Options 1 & 3 will not help in tolerating ambulation. Removal of telemetry
equipment is contraindicated unless prescribed.
55. A pt's electrocardiogram strip shows atrial & ventricular rates of 80 complexes per
minute. The PR interval is 0.14 second, & the QRS complex measures 0.08 second. The nurse
interprets this rhythm is:
2. Sinus bradycardia
3. Sinus tachycardia
4. Sinus dysrhythmia
56. A pt has frequent bursts of ventricular tachycardia on the cardiac monitor. A nurse is most
concerned with this dysrhythmia because:
2. It produces a high cardiac output that quickly leads to cerebral & myocardial ischemia.
57. A home care nurse is making a routine visit to a pt receiving digoxin (Lanoxin) in the
treatment of heart failure. The nurse would particularly assess the pt for:
2. The first signs & symptoms of digoxin toxicity in adults include abdominal pain, N/V, visual
disturbances (blurred, yellow, or green vision, halos around lights), bradycardia, & other
dysrhythmias.
58. A pt with angina complains that the angina pain is prolonged & severe & occurs at the
same time each day, most often in the morning, On further assessment a nurse notes that the
pain occurs in the absence of precipitating factors. This type of anginal pain is best described
as:
1. Stable angina
2. Unstable angina
3. Variant angina
Coronary Artery Disease & Hypertension Practice Quiz (50 Questions)
4. Nonanginal pain
3. Stable angina is induced by exercise & is relieved by rest or nitroglycerin tablets. Unstable
angina occurs at lower & lower levels of activity & rest, is less predictable, & is often a precursor
of myocardial infarction. Variant angina, or Prinzmetal's angina, is prolonged & severe & occurs
at the same time each day, most often in the morning.
59. The physician orders continuous intravenous nitroglycerin infusion for the pt with MI.
Essential nursing actions include which of the following?
2. Monitoring BP q4h
1. IV nitro infusion requires an infusion pump for precise control of the med. BP monitoring
would be done w/ a continuous system, & more frequently than every 4 hours. Hourly urine
outputs are not always required. Obtaining serum potassium levels is not associated w/
nitroglycerin infusion.
1. Antipyrectic action
2. Antithrombotic action
3. Antiplatelet action
4. Analgesic action
2. Aspirin does have antipyretic, antiplatelet, & analgesic actions, but the primary reason ASA is
administered to the pt experiencing an MI is its antithrombotic action.
61. Which of the following is an expected outcome for a pt on the second day of
hospitalization after an MI?
4. By day 2 of hospitalization after an MI, pts are expected to be able to perform personal care
w/out chest pain. Day 2 hospitalization may be too soon for pts to be able to identify risk factors
for MI or begin a walking program; however, the pt may be sitting up in a chair as part of the
cardiac rehabilitation program. Severe chest pain should not be present.
62. Which of the following reflects the principle on which a pt's diet will most likely be based
during the acute phase of MI?
1. Liquids as ordered
4. NPO
2. Recommended dietary principles in the acute phase of MI include avoiding large meals
because small, easily digested foods are better digested foods are better tolerated. Fluids are
given according to the pt's needs, & sodium restrictions may be prescribed, especially for pts w/
manifestations of heart failure. Cholesterol restrictions may be ordered as well. Pts are not
prescribed a diet of liquids only or NPO unless their condition is very unstable.
63. An older, sedentary adult may not respond to emotional or physical stress as well as a
younger individual because of:
2. Irregular heartbeats
4. Pacemaker placement
1. In older adults who are less active & do not exercise the heart muscle, atrophy can result.
Disuse or deconditioning can lead to abnormal changes in the myocardium of the older adult. As
a result, under sudden emotional or physical stress, the left ventricle is less able to respond to
the increased dem&s on the myocardial muscle.
Coronary Artery Disease & Hypertension Practice Quiz (50 Questions)
64. Which of the following nursing diagnoses would be appropriate for a pt with heart
failure? Select all that apply.
1. Ineffective tissue perfusion R/T decreased peripheral blood flow secondary to decreased CI
1 & 3. HF is a result of structural & functional abnormalities of the heart tissue muscle. The
heart muscle becomes weak & does not adequately pump the blood out of the chambers. As a
result, blood pools in the left ventricle & backs up into the left atrium, & eventually into the
lungs. Therefore, greater amounts of blood remain in the ventricle after contraction thereby
decreasing cardiac output. In addition, this pooling leads to thrombus formation & ineffective
tissue perfusion because of the decrease in blood flow to the other organs & tissues of the body.
Typically, these pts have an ejection fraction of less than 50% & poorly tolerate activity. Activity
intolerance is related to a decrease, not increase, in cardiac output. Gas exchange is impaired.
However, the decrease in cardiac output triggers compensatory mechanisms, such as an
increase in sympathetic nervous system activity.
65. Which of the following would be a priority nursing diagnosis for the pt with heart failure
& pulmonary edema?
3. Activity intolerance is a primary problem for pts w/ heart failure & pulmonary edema. The
decreased cardiac output associated w/ heart failure leads to reduced oxygen & fatigue. Pts
frequently complain of dyspnea & fatigue. The pt could be at risk for infection related to stasis
of secretions or impaired skin integrity related to pressure. However, these are not the priority
nursing diagnoses for the pt w/ HF & pulmonary edema, nor is constipation related to
immobility.
1. Vasopressor
2. Volume expander
3. Vasodilator
Coronary Artery Disease & Hypertension Practice Quiz (50 Questions)
4. Potassium-sparing diuretic
3. ACE inhibitors have become the vasodilators of choice in the pt w/ mild to severe HF.
Vasodilator drugs are the only class of drugs clearly shown to improve survival in overt heart
failure.
67. Furosemide is administered intravenously to a pt with HF. How soon after administration
should the nurse begin to see evidence of the drugs desired effect?
1. 5 to 10 min
2. 30 to 60 min
3. 2 to 4 hours
4. 6 to 8 hours
1. After IV injection of furosemide, diuresis normally begins in about 5 minutes & reaches its
peak w/in about 30 minutes. Med effects last 2 - 4 hours.
68. Which of the following foods should the nurse teach a pt with heart failure to avoid or
limit when following a 2-gram sodium diet?
1. Apples
2. Tomato juice
4. Beef tenderloin
2. Canned foods & juices, such as tomato juice, are typically high in sodium & should be avoided
in a sodium-restricted diet. BRING ON THE STEAK!
69. The nurse finds the apical pulse below the 5th intercostal space. The nurse suspects: