CARDIO WORKBOOK 5.
5. The nurse admits a client who had an infarct in the inferior
1. A nurse is evaluating the blood pressure (BP) results for
multiple clients with cardiac problems on a telemetry unit.
Which BP reading suggests to the nurse that the client’s mean
arterial pressure (MAP) is abnormal and warrants notifying the
physician? *
a. 110/50 mm Hg
b. 94/60 mm Hg
c. 98/36 mm Hg
d. 140/78 mm Hg
2. A nurse assesses a patient who has just returned to the ward
after having a coronary angiogram through the left femoral
artery. The client’s baseline blood pressure (BP) during the
procedure was 130/70 mm Hg and the cardiac rhythm was a
normal sinus throughout. Which assessment finding should
indicate to the nurse that the client may be experiencing a
complication? *
a. BP 135/75 mmHg
b. Apical pulse 142 bpm with an irregular-irregular rhythm
c. Pedal pulses +1
d. Left groin soft with 1cm ecchymoses
3. In a health teaching session with a client newly diagnosed
with chronic stable angina, the nurse should incorporate which
of the following measures that would prevent recurrence of
angina? i. Wear a face mask when outdoors in cold weather ii.
Increase isometric arm exercises iii. Avoid straining at stool iv.
Perform most exertional activities in the morning v. Take
nitroglycerin before a stressful situation even when there is no
pain present vi. Eliminate tobacco use. *
a. I, II, III, IV, VI
b. III, IV, V, VI
c. I, III, IV, V
d. I, III, V, VI
4. A client is diagnosed with acute coronary syndrome. During
the morning shift, he complains of sharp chest pains radiating to
the left shoulder. The nurse notes that the client has tachycardia
with premature ventricular contractions (PVCs). Admitting
orders included all of the following interventions for treating
chest pain. Which should the nurse implement first? *
a. Obtain a stat 12-lead electrocardiogram (ECG).
b. Administer oxygen by nasal cannula.
c. Administer sublingual nitroglycerin.
d. Administer morphine sulfate intravenously.
postoperative period should be immediately referred by the
septal wall of the myocardium. Upon assessment, the nurse
noted jugular vein distention and ascites. Which among these is
likely the complication the client is experiencing? *
a. Pulmonic valve malfunction
b. Right-sided heart failure
c. Ruptured septum
d. Left-sided heart failure
6. A client with a history of myocardial infarction 3 days ago
complains of unusual fatigue. Upon assessment, the nurse finds
that the client is dyspneic with activity, with HR: 110 bpm and
generalized edema. Which action by the nurse is most
appropriate? *
a. Continue to monitor client’s cardiac rhythm
b. Administer high-flow oxygen
c. Encourage the client to increase rest
d. Compare baseline weight with his current weight
7. A client has developed atrial fibrillation and has a HR of 166
beats per minute. The nurse should assess the client for which
possible effect of this condition? *
a. Hypertension and headache
b. Flat neck veins
c. Nausea and vomiting
d. Hypotension and dizziness
8. A patient prescribed with nitroglycerin is being instructed by
the nurse about its administration. Which of these should not be
included in the nurse’s instruction? *
a. Sit down for a few minutes when taking nitroglycerin.
b. If throbbing headache and flushing are experienced after
taking nitroglycerin, immediately call the emergency medical
services.
c. Nitroglycerin supply is renewed every 6 months.
d. Never store nitroglycerin tablets in metal pillboxes.
9. While looking at the cardiac monitor, the nurse suddenly
notes that her patient is having ventricular tachycardia. Which
action should she take first? *
a. Call a code.
b. Prepare for cardioversion.
c. Prepare for defibrillation.
d. Determine client’s responsiveness.
10. A PACU nurse is caring for a patient who just had coronary
artery bypass graft. Which assessment finding in the immediate
nurse to the physician? *
a. No chest tube output for 1 hour when previously it was
copious
b. ABG results of pH 7.32; PCO2 48; HCO3 28; PO2 80
c. Urine output of 160cc in the last 4 hours
d. Temperature of 37.4°C
11. Which among the following patients with cardiac conditions
should a nurse prioritize FIRST? *
a. A 56-year-old patient admitted a day ago, with chest pain, on
IV heparin, and has a PTT due back in 30 minutes
b. A 65-year-old patient with end-stage cardiomyopathy, blood
pressure (BP) of 78/50 mm Hg, 20 mL/ hr urine output, and a
“Do Not Resuscitate” order and whose family has just arrived
c. A 72-year-old client who was transferred 2 hours ago from
the Medical ICU after his coronary artery bypass graft and has
new onset atrial fibrillation
d. A 42-year-old patient who underwent aortic valve
replacement 2 days ago, with BP 114/72mmHg, HR 100bpm,
RR 28 breaths/min, and temperature of 38.4°C
12. During the start of her AM shift, a nurse receives a verbal
order for a cardiac catheterization to be done on a client in the
afternoon. Which action should the nurse do first? 
a. Initiate NPO status for the patient.
b. Start an IV infusion of 0.9 NaCl
c. Ask the client to sign the consent form.
d. Teach the patient about the procedure.
13. A client with acute chest pain is receiving morphine sulfate
via IV. Which of the following results are the intended effects
of this drug? Select all that apply. i. Reduces myocardial
oxygen consumption ii. Prevents ventricular remodeling iii.
Reduces BP and HR iv. Reduces fear and anxiety v. Decreases
respiratory rate *
a. I, III, IV
b. I, II, III, IV
c. I, III, IV, V
d. I, III
14. After a myocardial infarction, the admitted patient is
instructed to move his legs while resting in bed. This exercise is
to: *
a. Prepare the client for ambulation
b. Promote urinary and intestinal elimination
c. Prevent thrombophlebitis and formation of blood clots
d. Decrease the likelihood of pressure ulcer formation
15. After administering tissue plasminogen activator (t-PA) to a
patient, what should the nurse do? *
a. Observe client for chest pain
b. Monitor for fever
c. Review the 12-lead ECG
d. Auscultate breath sounds
16. Following diagnosis of angina pectoris, the patient reports
inability to walk up two flights of stairs without experiencing
pain. What measure should the nurse instruct the client to do to
prevent this problem? *
a. Climb the steps early in the day.
b. Rest for at least an hour before climbing the stairs
c. Take a nitroglycerin tablet before climbing the stairs
d. Lie down after climbing the stairs
17. What is the reason a nurse teaches a client with heart failure
to take oral furosemide in the morning? *
a. To prevent electrolyte imbalances
b. To retard rapid drug absorption
c. To help excrete excessive fluids accumulated during the
night
d. To prevent sleep disturbances during the night
18. A client is scheduled for cardiac catheterization. Which
among these should the nurse perform before the procedure?
Select all that apply. I. Verify that written consent has been
obtained II. Administer all prescribed oral medications III.
Check for iodine sensitivity IV. Insert a urinary drainage
catheter V. Withhold food and oral fluids prior to the
procedure *
A.I,III,V
B.II,III,IV
C.II,IV,V
D,III,I,V
19. A patient taking digoxin should report which of the
following indications of its toxicity *
a. Rashes over chest and back
b. Increased appetite
c. Elevated blood pressure
d. Visual disturbances
20. A client who recently experienced a myocardial infarction is
scheduled to have a percutaneous transluminal coronary
angioplasty (PTCA). The nurse should plan to teach the client 9. A conduction abnormality whereby no atrial impulse travels
about which aspect of a balloon-tipped catheter? * through the AV node is known as second-degree AV block type
a. A meshlike device will be inflated that will spring open. 2. *
b. The catheter will be used to compress the plaque against the
coronary blood vessel wall. 10. The endocardium is the layer of the heart where the heart
c. The catheter will cut away the plaque from the coronary muscle itself is found. *
vessel wall using a cutting blade.
d. The catheter will be positioned in a coronary artery to take
pressure measurements in the vessel VASCULAR CONDITIONS
21. A cardiac catheterization, using the femoral artery approach, 1. When assessing the lower extremities of a client with
is performed to assess the degree of coronary artery thrombosis peripheral vascular disease (PVD), the nurse notes bilateral
in a client. Which of these actions should the nurse not include ankle edema. This edema is primarily caused by: *
in caring during the post-procedure period? * a. Increased venous pressure
a. Checking the client’s groin for bleeding b. Competent venous valves
b. Encouraging the client to increase fluid intake c. Increased muscular activity
c. Placing the client’s bed in the high-Fowler’s position d. Decreased blood volume
d. Instructing the client to move the toes when checking
2. A client who has been diagnosed with peripheral vascular
circulation, motion, and sensation
disease (PVD) is being discharged. The client needs more
II. Modified True or False Write TRUE if the statement is teaching if she states that she will: *
correct. If the statement is false, replace the underlined word/s a. Avoid heating pads
with the answer that will make the statement correct. b. Avoid crossing the legs
c. Wear leather shoes
1. Confirmation of a diagnosis of heart failure is through an d. Use iodine on an injured site
echocardiogram. *
3. The client has aching, weakness, and a cramping sensation in
2. The characteristic sign of pericarditis is friction rub. * both of the lower extremities while walking. To promote health
and maintain the client's level of activity, the nurse should
3. When there is incomplete closure of the tricuspid valve, the suggest that the client try: *
blood flows backward from the right ventricle to the right a. Riding a stationary bike
atrium. * b. Skiing
c. Jogging
4. The most common site of myocardial infarction is the left d. Golfing
ventricle *
4. The doctor prescribed a client with pentoxifylline for his
intermittent claudication. To be able to determine its
5. The QRS complex in the ECG represents the ventricular
effectiveness, the nurse should ask if the client: *
repolarization. *
a. Can wiggle the toes
b. Has improved circulation in the legs
6. A sawtooth P wave is seen in patients with atrial flutter. *
c. Is urinating more frequently
d. Is less dizzy
7. The Purkinje fiber is the primary pacemaker of the heart. *
5. A client who has undergone an amputation of three toes and a
8. The first heart sound (S1) is generated by the closure of the femoral-popliteal bypass asks you which leg positions can he
semilunar valves. * assume while sitting. A nurse would give an incorrect answer if
she suggest the patient to: *
a. Flex his ankles
b. Cross his legs
c. Elevate his legs
d. Extend his knees
6. A nurse admits a client with a diagnosis of severe cellulitis in
his left leg. The nurse anticipates the prescribed treatment will
include: *
a. Debriding the left leg
b. Obtaining baseline coagulation laboratory tests and initiating
anticoagulation therapy
c. Applying sequential compression devices
d. Administering IV antiobiotics
7. A patient had a femoral-popliteal artery bypass graft surgery
48 hours ago. A priority nursing action at this time should be
to: *
a. Monitor the dorsalis pedis and posterior tibial pulses
bilaterally every 4 hours.
b. Monitor intake and output.
c. Maintain the client at a 60-degree sitting position when
resting in bed.
d. Report any edema that develops in the operative leg.
8. A new nurse reads presence of lymphedema in the chart of
his patient who had undergone surgery for breast cancer. He
then asks his senior nurse what lymphedema. Which statement
to the new nurse regarding lymphedema is correct? *
a. Lymphedema frequently signifies that there is a recurrence
of the malignancy.
b. Lymphedema usually resolves after the cancer treatment is
completed when collateral lymph circulation develops.
c. Lymphedema is characterized by severe swelling in the arm
and hand on the affected side.
d. Lymphedema is mainly controlled by encouraging women to
keep their arm elevated.
9. An 85-year-old female client is brought to the emergency
department due to chest pains. She tells a nurse that the chest
pain is stabbing through the chest into her back. Her blood
pressure is 220/140 mm Hg. The nurse expects the diagnosis to
be: *
a. Acute arterial occlusion
b. Pulmonary embolism
c. Aortic dissection
d. Subclavian steal syndrome
10. Which assessment findings in a patient with thoracic c. I, II, IV
aneurysm suggest occurrence of rupture? Select all that apply. i. d. II, III, V
Severe chest pain radiating to the back ii. Abdominal distention
iii. Hypotension iv. Dyspnea v. Oliguria * 15. A client who has diabetes is taking metoprolol for
a. II, III, IV, V hypertension. Which of the following information should the
b. I, III, IV nurse include in the teaching plan? Select all that apply. i. Have
c. I, III, IV, V a blood glucose level drawn every 6 to 12 months during
d. I, II, III, IV, V therapy. ii. Use an appropriate decongestant if needed. iii. These
tablets should be taken with food at same time each day. iv.
11. A male client seeks care at a vascular clinic and is Report any fainting spells to the health care provider v. Do not
diagnosed with Buerger’s disease (thromboangiitis obliterans). crush or chew the tablets. vi. Notify the health care provider if
A nurse is teaching the client ways to prevent progression of the pulse is 82 per minute. *
disease. Which prevention measure should be the nurse’s initial a. I, II, IV VI
focus when teaching the client? * b. I, III, IV, V
a. Abstaining from all tobacco products in all forms c. II, III, IV, V, VI
b. Avoiding exposure to cold d. I, II, III, IV, V
c. Maintaining meticulous hygiene practices
d. Following a low-fat diet SHOCK
12. A nurse is completing a health history on a client admitted 1. The nurse suspects that a client who had a myocardial
to a hospital with recurrent lower extremity cellulitis. The client infarction is developing cardiogenic shock. The nurse should
tells the nurse that he has tinea pedis. The nurse concludes that assess for which peripheral vascular manifestation of this
this is significant because: * complication? *
a. The loss of skin integrity that occurs with tinea pedis allows a. Cool, clammy skin with weak or thread pedal pulses
bacteria to enter the tissue. b. Cool, dry skin with pulsus alternans
b. The cellulitis is commonly caused by a fungus. c. Flushed, dry skin with bounding pedal pulses
c. The cellulitis should resolve with topical fungicide therapy. d. Warm, moist skin with irregular pedal pulses
d. The client is at risk for developing a painful neuralgia after
2. What is the mean arterial pressure (MAP) of a person with a
the infection has resolved.
blood pressure 130/80 mmHg? *
13. The nurse has completed giving medication instructions to a a. 97
client receiving enalapril to treat hypertension. What statement b. 50
made by the client is an indication that he was not able to fully c. 105
understand the teaching? * d. 113
a. “Change positions slowly.”
3. What is the normal pulse pressure? *
b. “Monitor the blood pressure every week.”
a. 80-100 mmHg
c. “Use salt moderately in cooking and on foods.”
b. 30-40 mmHg
d. “Report signs and symptoms of infection to the health care
c. 0-5 mmHg
provider.”
d. 60-80 mmHg
14. A client is taking clonidine for treatment of his
4. What is the earliest manifestation of shock? *
hypertension. The nurse should teach the client about which of
a. Decreased oxygen saturation
the following common adverse effects of this drug? Select all
b. Tachycardia
that apply i. Hyperkalemia ii. Dry mouth. iii. Pancreatitis. iv.
c. Bradypnea
Impotence. v. Sleep disturbance *
d. Decreased urine output
a. II, IV, V
b. I, III, V
5. Milrinone is indicated in the patient experiencing a. Reduced preload and afterload II. Identification Write the answer that is being asked in the
hypovolemic shock. The nurse knows that this drug acts by: * b. Increased renal and mesenteric blood flow following items.
a. Increasing peripheral resistance while increasing venous c. Increased cardiac output
return to the heart d. Vasoconstriction 1. Urine output that is indicative of decreased glomerular
b. Stimulating beta1 receptor sites on the heart and improving filtration.
heart contractility 11. In caring for the client above, who is receiving dopamine for 2. Normal central venous pressure *
c. Dilating coronary arteries shock treatment, what should the nurse do? * 3. Effect of epinephrine and norepinephrine on blood vessels *
d. Decreasing cardiac preload and increasing cardiac afterload a. Monitory blood pressure continuously. 4. Releases vasopressin to increase glomerular reabsorption and
b. Administer pain medication concurrently blood pressure *
6. A child undergoes surgical removal of a brain tumor. During c. Evaluate ABGs at least every 2 hours 5. Enzyme that converts angiotensin I to angiotensin II *
the postoperative period, the nurse is monitoring the child and d. Monitor for infection.
notes that the child is restless, the pulse rate is elevated, and the 1. Penicillin sensitivity *
blood pressure has decreased significantly from the baseline 12. Which among the following nursing interventions is the a. Hypovolemic d/t an internal fluid shift
value. The nurse suspects that the child is in shock. Which is the most important in preventing septic shock? * b. Hypovolemic d/t external fluid loss
most appropriate nursing action? * a. Maintaining asepsis of indwelling urinary catheters c. Cardiogenic
a. Place the child in a supine position. b. Administering IV fluid replacement therapy as prescribed d. Neurogenic
b. Place the child in Trendelenburg’s position. c. Obtaining vital signs q4h for all clients e. Anaphylactic
c. Increase the flow rate of the intravenous fluids. d. Monitoring red blood cell counts for elevation f. Septic
d. Notify the HCP. g. Noncoronary cardiogenic shock
13. Which of the following is an indication of a complication of
7. A patient who sustained T6 injury from a vehicular accident septic shock? * 2. Pulmonary embolism *
manifests severe hypotension and bradycardia. What should be a. Acute respiratory distress syndrome a. Hypovolemic d/t an internal fluid shift
the initial action of the nurse caring for the patient? * b. Mitral valve prolapse b. Hypovolemic d/t external fluid loss
a. Insert large-bore IV catheters. c. Anaphylaxis c. Cardiogenic
b. Prepare to administer Lasix. d. Chronic obstructive pulmonary disease d. Neurogenic
c. Place the patient on Trendelenburg. e. Anaphylactic
14. The nurse considers which of the following as the best
d. Notify the physician. f. Septic
indication that fluid replacement for a client in hypovolemic
g. Noncoronary cardiogenic shock
8. Among the following goals, which is the most important in shock is adequate? *
nursing care for a client who is in shock? (Billings, 104) * a. Systolic BP > 110mmHg 3. Vomiting *
a. Manage vasoconstriction of vascular beds b. Diastolic BP >90 mmHg a. Hypovolemic d/t an internal fluid shift
b. Manage fluid overload c. Urine output greater than 30mL/hr b. Hypovolemic d/t external fluid loss
c. Manage increased cardiac output d. RR of 20 breaths/min c. Cardiogenic
d. Manage inadequate tissue perfusion d. Neurogenic
15. Which of the following indicates that a client who has had a
e. Anaphylactic
9. Which is a priority assessment for the client in shock who is 15% blood loss has developed hypovolemic shock? *
f. Septic
receiving an IV infusion of packed red blood cells and normal a. Unequally dilated pupils
g. Noncoronary cardiogenic shock
saline solution? (Billings, 108) * b. Systolic BP 75mmHg
a. Fluid balance c. Pulse rate 50 bpm 4. Dysrhythmias *
b. Pain d. RR 4 cycles/min a. Hypovolemic d/t an internal fluid shift
c. Anaphylactic reaction b. Hypovolemic d/t external fluid loss
16. Which of the fosllowing is a risk factor for hypovolemic
d. Altered LOC c. Cardiogenic
shock? 
d. Neurogenic
10. The patient who does not respond adequately to fluid a. Antigen-antibody reaction
e. Anaphylactic
replacement was prescribed with Dopamine HCl via IV b. Gram-negative bacteria
f. Septic
infusion. What would the nurse assess the client for in c. Hemorrhage
g. Noncoronary cardiogenic shock
determining the effectiveness of the drug? * d. Vasodilation
5. Spinal cord injury * b. Hypovolemic d/t external fluid loss
a. Hypovolemic d/t an internal fluid shift c. Cardiogenic
b. Hypovolemic d/t external fluid loss d. Neurogenic
c. Cardiogenic e. Anaphylactic
d. Neurogenic f. Septic
e. Anaphylactic g. Noncoronary cardiogenic shock
f. Septic
g. Noncoronary cardiogenic shock

6. Immunosuppression *
a. Hypovolemic d/t an internal fluid shift
b. Hypovolemic d/t external fluid loss
c. Cardiogenic
d. Neurogenic
e. Anaphylactic
f. Septic
g. Noncoronary cardiogenic shock

7. Bee sting allergy *

a. Hypovolemic d/t an internal fluid shift
b. Hypovolemic d/t external fluid loss
c. Cardiogenic
d. Neurogenic
e. Anaphylactic
f. Septic
g. Noncoronary cardiogenic shock

8. Burns *
a. Hypovolemic d/t an internal fluid shift
b. Hypovolemic d/t external fluid loss
c. Cardiogenic
d. Neurogenic
e. Anaphylactic
f. Septic
g. Noncoronary cardiogenic shock

9. Peritonitis *
a. Hypovolemic d/t an internal fluid shift
b. Hypovolemic d/t external fluid loss
c. Cardiogenic
d. Neurogenic
e. Anaphylactic
f. Septic
g. Noncoronary cardiogenic shock

10. Valvular damage *

a. Hypovolemic d/t an internal fluid shift