Cardiovascular and Hematology Quiz

Abdurahim, Fatima Nazhrin

1. A nurse notices frequent artifacts on the ECG monitor for a client whose leads are connected by cable
to a console at the bedside. The nurse examines the client to determine the cause. Which of the
following items is unlikely to be responsible for the artifact?
A. Frequent movement of the client.
B. Tightly secured cable connections.
C. Leads applied over hairy areas.
D. Leads applied to the limb

2. A nurse is assessing an electrocardiogram rhythm strip. The P waves and QRS complexes are regular.
The PR interval is 0.16 second, and QRS complexes measure 0.06 second. The overall heart rate is 64
beats per minute. The nurse assesses the cardiac rhythm as:
A. Normal sinus rhythm
B. Sinus bradycardia
C. Sick sinus syndrome
D. First-degree heart block

Adjap, Shahinaz
3. A nurse is watching the cardiac monitor and notices that the rhythm suddenly changes. There are no P
waves, the QRS complexes are wide, and the ventricular rate is regular but over 100. The nurse
determines that the client is experiencing:
A. Premature ventricular contractions
B. Ventricular tachycardia
C. Ventricular fibrillation
D. Sinus tachycardia

4. A nurse is viewing the cardiac monitor in a client’s room and notes that the client has just gone into
ventricular tachycardia. The client is awake and alert and has good skin color. The nurse would prepare
to do which of the following?
A. Immediately defibrillate.
B. Prepare for pacemaker insertion.
C. Administer amiodarone (Cordarone) intravenously.
D. Administer epinephrine (Adrenaline) intravenously.

Altar, Catherine Sienna

5. A nurse is caring for a client with unstable ventricular tachycardia. The nurse instructs the client to do
which of the following, if prescribed, during an episode of ventricular tachycardia?
A. Breathe deeply, regularly, and easily.
B. Inhale deeply and cough forcefully every 1 to 3 seconds.
C. Lie down flat in bed.
D. Remove any metal jewelry.

6. A client is scheduled for a cardiac catheterization using a radiopaque dye. Which of the following
assessments is most critical before the procedure?
A. Intake and output
B. Baseline peripheral pulse rates
C. Height and weight
D. Allergy to iodine or shellfish

Asaali, Zheena Reem

7. A client with no history of cardiovascular disease comes into the ambulatory clinic with flu-like
symptoms. The client suddenly complains of chest pain. Which of the following questions would best
help a nurse to discriminate pain caused by a non-cardiac problem?
A. “Have you ever had this pain before?”
B. “Can you describe the pain to me?”
C. “Does the pain get worse when you breathe in?”
D. “Can you rate the pain on a scale of 1-10, with ten (10) being the worst?”

8. A client with myocardial infarction has been transferred from a coronary care unit to a general
medical unit with cardiac monitoring via telemetry. A nurse plans to allow for which of the following
client activities?
A. Strict bed rest for 24 hours after transfer.
B. Bathroom privileges and self-care activities.
C. Unsupervised hallway ambulation with distances under 200 feet.
D. Ad lib activities because the client is monitored.

Castor, Arianne Kaye

9.A nurse notes 2+ bilateral edema in the lower extremities of a client with myocardial infarction who
was admitted two (2) days ago. The nurse would plan to do which of the following next?
A. Review the intake and output records for the last two (2) days.
B. Change the time of diuretic administration from morning to evening.
C. Request a sodium restriction of one (1) g/day from the physician.
D. Order daily weight starting the following morning.

10. A client is wearing a continuous cardiac monitor, which begins to sound its alarm. A nurse sees no
electrocardiogram complexes on the screen. The first action of the nurse is to:
A. Check the client status and lead placement.
B. Press the recorder button on the electrocardiogram console.
C. Call the physician.
D. Call a code blue.

Diya, Shainaleen
11.A nurse is assessing the blood pressure of a client diagnosed with primary hypertension. The nurse
ensures accurate measurement by avoiding which of the following?
A. Seating the client with arm bared, supported, and at heart level.
B. Measuring the blood pressure after the client has been seated quietly for 5 minutes.
C. Using a cuff with a rubber bladder that encircles at least 80% of the limb.
D. Taking a blood pressure within 15 minutes after nicotine or caffeine ingestion.

12. IV heparin therapy is ordered for a client. While implementing this order, a nurse ensures that which
of the following medications is available in the nursing unit?
A. Vitamin K
B. Aminocaproic acid
C. Potassium chloride
D. Protamine sulfate

Dovadova, Merjen
13. A client is at risk for pulmonary embolism and is on anticoagulant therapy with warfarin (Coumadin).
The client’s prothrombin time is 20 seconds, with a control of 11 seconds. The nurse assesses that this
result is:
A. The same as the client’s own baseline level.
B. Lower than the needed therapeutic level.
C. Within the therapeutic range.
D. Higher than the therapeutic range.

14. A client who has been receiving heparin therapy also is started on warfarin. The client asks a nurse
why both medications are being administered. In formulating a response, the nurse incorporates the
understanding that warfarin:
A. Stimulates the breakdown of specific clotting factors by the liver, and it takes two (2)- three (3) days
for this to exert an anticoagulant effect.
B Inhibits synthesis of specific clotting factors in the liver, and it takes 3-4 days for this medication to
exert an anticoagulant effect.
C. Stimulates production of the body’s own thrombolytic substances, but it takes 2-4 days for this to
begin.
D. Has the same mechanism of action as Heparin, and the crossover time is needed for the serum level
of warfarin to be therapeutic.

Escandar, Maria Therese

15. A 60-year-old male client comes into the emergency department with complaints of crushing chest
pain that radiates to his shoulder and left arm. The admitting diagnosis is acute myocardial infarction.
Immediate admission orders include oxygen by NC at 4L/minute, blood work, chest X-ray, an ECG, and
two (2) mg of morphine given intravenously. The nurse should first;
A. Administer the morphine.
B. Obtain a 12-lead ECG.
C. Obtain the lab work.
D. Order the chest x-ray.

16. When teaching a patient why spironolactone (Aldactone) and furosemide (Lasix) are prescribed
together, the nurse bases teaching on the knowledge that:
A. Moderate doses of two different types of diuretics are more effective than a large dose of one type.
B. This combination promotes diuresis but decreases the risk of hypokalemia.
C. This combination prevents dehydration and hypovolemia.
D. Using two drugs increases osmolality of plasma and the glomerular filtration rate.

Fabian, Bryan Lemuele

17. 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.
18. Which of the following instructions should be included in the discharge teaching for a patient
discharged with a transdermal nitroglycerin patch?
A. “Apply the patch to a non-hairy, non-fatty area of the upper torso or arms.”
B. “Apply the patch to the same site each day to maintain consistent drug absorption.”
C. “If you get a headache, remove the patch for 4 hours and then reapply.”
D. “If you get chest pain, apply a second patch right next to the first patch.”

Imlan, Al-Moazz
19. 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.

20. A client enters the ER complaining of chest pressure and severe epigastric distress. His VS are
158/90, 94, 24, and 99*F. The doctor orders cardiac enzymes. If the client were diagnosed with an MI,
the nurse would expect which cardiac enzyme to rise within the next 3 to 8 hours?
A. Creatine kinase (CK or CPK)
B. Lactic dehydrogenase (LDH)
C. LDH-1
D. LDH-2

Javier Karla
21. The most important long-term goal for a client with hypertension would be to:
A. Learn how to avoid stress.
B. Explore a job change or early retirement.
C. Make a commitment to long-term therapy.
D. Control high blood pressure.

22. Hypertension is known as the silent killer. This phrase is associated with the fact that hypertension
often goes undetected until symptoms of other system failures occur. This may occur in the form of:
A. Cerebrovascular accident
B. Liver disease
C. Myocardial infarction
D. Pulmonary disease

Jumawan, Jenel
23. Which of the following symptoms should the nurse teach the client with unstable angina to report
immediately to her physician?
A. A change in the pattern of her pain.
B. Pain during sex.
C. Pain during an argument with her husband.
D. Pain during or after an activity such as lawn mowing.

24. The physician refers the client with unstable angina for a cardiac catheterization. The nurse explains
to the client that this procedure is being used in this specific case to:
A. Open and dilate the blocked coronary arteries.
B. Assess the extent of arterial blockage.
C. Bypass obstructed vessels.
D. Assess the functional adequacy of the valves and heart muscle.

Lim, China Mae

25. As an initial step in treating a client with angina, the physician prescribes nitroglycerin tablets, 0.3mg
given sublingually. This drug’s principal effects are produced by:
A. Antispasmodic effect on the pericardium.
B. Causing an increased myocardial oxygen demand.
C. Vasodilation of peripheral vasculature.
D. Improved conductivity in the myocardium.

26. Prolonged occlusion of the right coronary artery produces an infarction in which of the following
areas of the heart?
A. Anterior
B. Apical
C. Inferior
D. Lateral

Marquez, Joshua
27. Which of the following blood tests is most indicative of cardiac damage?
A. Troponin I
B. Complete blood count (CBC)
C. Creatine kinase (CK)
D. Lactate dehydrogenase

28. Which of the following types of pain is most characteristic of angina?

A. Knifelike
B. Sharp
C. Shooting
D. Tightness

Marquez, Maria Theresa

29. Which of the following parameters is the major determinant of diastolic blood pressure?
A. Baroreceptors
B. Cardiac output
C. Renal function
D. Vascular resistance

30. 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
Miranda, Ryan atom
31. Which of the following classes of medications protects the ischemic myocardium by blocking
catecholamines and sympathetic nerve stimulation?
A. Beta-adrenergic blockers
B. Calcium channel blockers
C. Narcotics
D. Nitrates

32. Toxicity from which of the following medications may cause a client to see a green-yellow halo
around lights?
A. digoxin (Lanoxin)
B. furosemide (Lasix)
C. metoprolol (Lopressor)
D. enalapril (Vasotec)

Morden, Tanya Vien

33. Which of the following symptoms is most commonly associated with left-sided heart failure?
A. Crackles
B. Arrhythmias
C. Hepatic engorgement
D. Hypotension

34. In which of the following disorders would the nurse expect to assess sacral edema in a bedridden
client?
A. Diabetes
B. Pulmonary emboli
C. Renal failure
D. Right-sided heart failure

Ocalinas, Criston Niel

35. Which of the following symptoms might a client with right-sided heart failure exhibit?
A. Adequate urine output
B. Polyuria
C. Oliguria
D. Polydipsia

36. The nurse is preparing to teach a client with microcytic hypochromic anemia about the diet to follow
after discharge. Which of the following foods should be included in the diet?
A. Eggs
B. Lettuce
C. Citrus fruits
D. Cheese

Omar, Ashra Ghea

37. A client with pernicious anemia asks why she must take vitamin B12 injections for the rest of her life.
What is the nurse’s best response?
A. “The reason for your vitamin deficiency is an inability to absorb the vitamin because the stomach is
not producing sufficient acid.”
 B. “The reason for your vitamin deficiency is an inability to absorb the vitamin because the stomach is
not producing sufficient intrinsic factor.”
C. “The reason for your vitamin deficiency is an excessive excretion of the vitamin because of kidney
dysfunction.”
D. “The reason for your vitamin deficiency is an increased requirement for the vitamin because of rapid
red blood cell production.”

38. When comparing the hematocrit levels of a post-op client, the nurse notes that the hematocrit
decreased from 36% to 34% on the third day even though the RBC and hemoglobin values remained
stable at 4.5 million and 11.9 g/dL, respectively. Which nursing intervention is most appropriate?
A. Check the dressing and drains for frank bleeding.
B. Call the physician.
C. Continue to monitor vital signs.
D. Start oxygen at 2L/min per NC.

Orillineda, Jo Antonette
39. A client is to receive epoetin (Epogen) injections. What laboratory value should the nurse assess
before giving the injection?
A. Hematocrit
B. Partial thromboplastin time
C. Hemoglobin concentration
D. Prothrombin time

40. A client states that she is afraid of receiving vitamin B12 injections because of the potential toxic
reactions. What is the nurse’s best response to relieve these fears?
A. “Vitamin B12 will cause ringing in the ears before a toxic level is reached.”
B. “Vitamin B12 may cause a very mild skin rash initially.”
C. “Vitamin B12 may cause mild nausea but nothing toxic.”
D. “Vitamin B12 is generally free of toxicity because it is water soluble.”

Rivera, Deserie Anne

41. A client with microcytic anemia is having trouble selecting food items from the hospital menu. Which
food is best for the nurse to suggest for satisfying the client’s nutritional needs and personal
preferences?
A. Egg yolks
B. Brown rice
C. Vegetables
D. Tea

42. A client with macrocytic anemia has a burn on her foot and states that she had been watching
television while lying on a heating pad. What is the nurse’s first response?
A. Assess for potential abuse.
B. Check for diminished sensations.
C. Document the findings.
D. Clean and dress the area.
Sabatl, Nur-Aini
43. Which of the following nursing assessments is a late symptom of polycythemia vera?
A. Headache
B. Dizziness
C. Pruritus
D. Shortness of breath

44. When a client is diagnosed with aplastic anemia, the nurse monitors for changes in which of the
following physiological functions?
A. Bleeding tendencies
B. Intake and output
C. Peripheral sensation
D. Bowel function

Sanaani, Pervez
45. Which of the following blood components is decreased in anemia?
A. Erythrocytes
B. Granulocytes
C. Leukocytes
D. Platelets

46. A client with anemia may be tired due to a tissue deficiency of which of the following substances?
A. Carbon dioxide
B. Factor VIII
C. Oxygen
D. T-cell antibodies

Tan, Wesly Cushan

47.Which of the following cells is the precursor to the red blood cell (RBC)?
A. B cell
B. Macrophage
C. Stem cell
D. T cell

48. Which of the following symptoms is expected with hemoglobin of 10 g/dl?

A. None
B. Pallor
C. Palpitations
D. Shortness of breath

Tawasil, Fatima Yuneza

49. Which of the following diagnostic findings are most likely for a client with aplastic anemia?
A. Decreased production of T-helper cells.
B. Decreased levels of white blood cells, red blood cells, and platelets.
C. Increased levels of WBCs, RBCs, and platelets.
D. Reed-Sternberg cells and lymph node enlargement.
50. A client with iron deficiency anemia is scheduled for discharge. Which instruction about prescribed
ferrous gluconate therapy should the nurse include in the teaching plan?
A. “Take the medication with an antacid.”
B. “Take the medication with a glass of milk.”
C. “Take the medication with cereal.”
D. “Take the medication on an empty stomach.”

Tipa, Daruis Eugene

51. Which of the following disorders results from a deficiency of factor VIII?
A. Sickle cell disease
B. Christmas disease
C. Hemophilia A
D. Hemophilia B

52. The nurse explains to the parents of a 1-year-old child admitted to the hospital in a sickle cell crisis
that the local tissue damage the child has on admission is caused by which of the following?
A. Autoimmune reaction complicated by hypoxia.
B. Lack of oxygen in the red blood cells.
C. Obstruction to circulation.
D. Elevated serum bilirubin concentration.

Tungao, Wesal
53. The mothers asks the nurse why her child’s hemoglobin was normal at birth but now the child has S
hemoglobin. Which of the following responses by the nurse is most appropriate?
A. “The placenta bars passage of the hemoglobin S from the mother to the fetus.”
B. “The red bone marrow does not begin to produce hemoglobin S until several months after birth.”
C. “Antibodies transmitted from you to the fetus provide the newborn with temporary immunity.”
D. “The newborn has a high concentration of fetal hemoglobin in the blood for some time after birth.”

54. Which of the following would the nurse identify as the priority nursing diagnosis during a toddler’s
vaso-occlusive sickle cell crisis?
A. Ineffective coping related to the presence of a life-threatening disease
B. Decreased cardiac output related to abnormal hemoglobin formation
C. Pain related to tissue anoxia
D. Excess fluid volume related to infection

Urao, Algosaibi
55. A mother asks the nurse if her child’s iron deficiency anemia is related to the child’s frequent
infections. The nurse responds based on the understanding of which of the following?
A. Little is known about iron-deficiency anemia and its relationship to infection in children.
B. Children with iron deficiency anemia are more susceptible to infection than are other children.
C. Children with iron-deficiency anemia are less susceptible to infection than are other children.
D. Children with iron-deficient anemia are equally as susceptible to infection as are other children.

56. Which of the following foods would the nurse encourage the mother to offer to her child with iron
deficiency anemia?
A. Rice cereal, whole milk, and yellow vegetables
B. Potato, peas, and chicken
C. Macaroni, cheese, and ham
D. Pudding, green vegetables, and rice

Usman, Khaironnisa
57. The physician has ordered several laboratory tests to help diagnose an infant’s bleeding disorder.
Which of the following tests, if abnormal, would the nurse interpret as most likely to indicate
hemophilia?
A. Bleeding time
B. Tourniquet test
C. Clot retraction test
D. Partial thromboplastin time (PTT)

58. Which of the following assessments in a child with hemophilia would lead the nurse to suspect early
hemarthrosis?
A. Child’s reluctance to move a body part.
B. Cool, pale, clammy extremity.
C. Ecchymosis formation around a joint.
D. Instability of a long bone in passive movement.

Ma’am Gonzaga
59. A child suspected of having sickle cell disease is seen in a clinic, and laboratory studies are
performed. A nurse checks the lab results, knowing which of the following would be increased in this
disease?
A. Platelet count
B. Hematocrit level
C. Reticulocyte count
D. Hemoglobin level

60. A clinic nurse instructs the mother of a child with sickle cell disease about the precipitating factors
related to pain crisis. Which of the following, if identified by the mother as a precipitating factor,
indicates the need for further instructions?
A. Infection
B. Trauma
C. Fluid overload
D. Stress