Professional Documents
Culture Documents
38. Question
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.
39. Question
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.
41. Question
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.
43. Question
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.
44. Question
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.
45. Question
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.
46. Question
When administered a thrombolytic drug to the client
experiencing an MI, the nurse explains to him that
the purpose of this drug is to:
A. Help keep him well hydrated.
B. Dissolve clots he may have.
C. Prevent kidney failure.
D. Treat potential cardiac arrhythmias.
47. Question
When interpreting an ECG, the nurse would keep in
mind which of the following about the P wave?
Select all that apply.
A. Reflects electrical impulse beginning at the SA
node.
B. Indicated electrical impulse beginning at the AV
node.
C. Reflects atrial muscle depolarization.
D. Identifies ventricular muscle depolarization.
E. Has a duration of normally 0.11 seconds or less.
48. Question
A client has driven himself to the ER. He is 50 years
old, has a history of hypertension, and informs the
nurse that his father died of a heart attack at 60 years
of age. The client is presently complaining of
indigestion. The nurse connects him to an ECG
monitor and begins administering oxygen at 2
L/minute per NC. The nurse’s next action would be
to:
A. Call for the doctor.
B. Start an intravenous line.
C. Obtain a portable chest radiograph.
D. Draw blood for laboratory studies.
49. Question
The nurse receives emergency laboratory results for a
client with chest pain and immediately informs the
physician. An increased myoglobin level suggests
which of the following?
A. Cancer
B. Hypertension
C. Liver disease
D. Myocardial infarction
50. Question
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.
51. Question
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
52. Question
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.
53. Question
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.
54. Question
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.
55. Question
Sublingual nitroglycerin tablets begin to work within
1 to 2 minutes. How should the nurse instruct the
client to use the drug when chest pain occurs?
A. Take one (1) tablet every two (2) to five (5)
minutes until the pain stops.
B. Take one (1) tablet and rest for ten (10) minutes.
Call the physician if pain persists after ten (10)
minutes.
C. Take one (1) tablet, then an additional tablet
every 5 minutes for a total of three (3) tablets. Call
the physician if pain persists after three (3) tablets.
D. Take one (1) tablet. If pain persists after five (5)
minutes, take two (2) tablets. If pain persists five (5)
minutes later, call the physician.
56. Question
Which of the following clients is at greatest risk for
digital toxicity?
58. Question
The action of medication is inotropic when it:
A. Decreased afterload.
B. Increases heart rate.
C. Increases the force of contraction.
D. Is used to treat CHF.
59. Question
Which is the most appropriate action for the nurse to
take before administering digoxin?
60. Question
The therapeutic drug level for digoxin is:
A. 0.1-2.0 ng/mg
B. 1.0-2.0 ng/mg
C. 0.1-0.5 ng/mg
D. 0.5-2.0 ng/mg
61. Question
Blurred vision or halos are signs of:
63. Question
Before giving milrinone (Primacor) by an IV infusion
to a client with symptoms of CHF, which of the
following nursing actions is necessary?
64. Question
When administering an antiarrhythmic agent, which
of the following assessment parameters is the most
important for the nurse to evaluate?
A. ECG.
B. Pulse rate.
C. Respiratory rate.
D. Blood pressure.
65. Question
Which of the following blood tests will tell the nurse
that an adequate amount of drug is present in the
blood to prevent arrhythmias?
A. Serum chemistries.
B. Complete blood counts.
C. Drug levels.
D. None of the above
66. Question
Which of the following drugs should be used only in
situations in which the client can be very closely
monitored, such as a critical care unit?
A. bretylium (Bretylol).
B. digoxin (Lanoxin).
C. quinidine (Cardioquin).
D. inderal (Propranolol).
67. Question
When administering dopamine (Intropin), it is most
important for the nurse to know that:
A. verapamil (Isoptin)
B. nifedipine (Adalat CC)
C. diltiazem (Cardizem)
D. felodipine (Plendil)
69. Question
Which of the following calcium channel blockers has
the most potent peripheral smooth muscle dilator
effect?
A. diltiazem (Cardizem)
B. nifedipine (Adalat CC)
C. nimodipine (Nymalize)
D. verapamil (Calan)
70. Question
Which of the following effects of calcium channel
blockers causes a reduction in blood pressure?
72. Question
Routine laboratory monitoring in clients taking ß
blockers should include:
A. Sodium.
B. Glucose.
C. Thyrotropin.
D. Creatine phosphokinase.
73. Question
ß blockers should be avoided in which of the
following conditions?
A. Bronchoconstriction.
B. Hypertension.
C. Angina.
D. Myocardial infarction.
74. Question
As a knowledgeable nurse, you know that the action
of nitrates is:
75. Question
A 50-year-old client is prescribed to take nitrate each
day for his condition. As a competent nurse, you
know the result of nitrate administration is:
76. Question
A student nurse is asked to give an example of a
long-acting nitrate. He is correct by saying:
A. Nitroglycerin sublingual.
B. Nitroglycerin IV.
C. Isosorbide PO.
D. Nitroglycerin transmucosal.
77. Question
When nitrates are administered early to the acute MI
client, the effect is:
A. Hypotension.
B. Bradycardia.
C. Reduced mortality.
D. Reduced morbidity.
78. Question
When teaching about nitrate administration, the nurse
should instruct the client to:
79. Question
Raymund is reviewing cardiovascular drugs for his
upcoming exam. For a well-prepared student, he
should know that vasodilators are agents that:
81. Question
A nurse is monitoring a client who is taking digoxin
(Lanoxin). All of which are the side effects
associated with the medication, except?
A. Anorexia.
B. Blurred vision.
C. Diarrhea.
D. Tremors.
82. Question
A nurse is providing instructions to a client who is on
nicotinic acid for the treatment of hyperlipidemia.
Which statement made by the nurse indicates a
comprehension of the instructions?
A. "I should take aspirin 30 minutes before nicotinic
acid".
B. "I will drink alcohol in moderation".
C. "Yellowing of the skin is a common side effect".
D. "This medication is taken on an empty stomach".
83. Question
A nurse is giving instruction to a client who is
receiving cholestyramine (Questran) for the treatment
of hyperlipidemia. Which of the following statements
made by the client indicates the need for further
instructions?
84. Question
A nurse is interviewing a client who is about to
receive metoprolol. Upon the history taking, the
client is also taking insulin. Which of the following
statements made by the nurse will correctly explain
the possible interaction of these medications?
85. Question
A client with myocardial infarction is receiving tissue
plasminogen activator, alteplase (Activase, tPA).
While on the therapy, the nurse plans to prioritize
which of the following?
87. Question
A client who is receiving streptokinase therapy
suddenly had a nosebleed. The nurse ensures the
availability of which of the following medication?
A. vitamin K (Mephyton).
B. deferoxamine (Desferal).
C. aminocaproic acid (Amicar).
D. diphenhydramine (Benadryl).
88. Question
A client with deep vein thrombosis is receiving
Streptokinase (Streptase). The nurse would notify the
physician if which of the following assessments is
noted?
89. Question
A client is receiving a continuous infusion of
streptokinase (Streptase). The client suddenly
complains of a difficulty of breathing, itchiness, and
nausea. Which of the following should be the priority
action of the nurse?
A. acetylcysteine (Mucomyst).
B. calcium gluconate (Calcium gluconate).
C. vitamin K (Mephyton).
D. protamine sulfate (Protamine).
91. Question
A client with atrial fibrillation is receiving a
continuous heparin infusion at 1,000 units/hr. The
nurse observes that the client is receiving the
therapeutic effect based on which of the following
results?
A. Activated partial thromboplastin time of 30
seconds.
B. Activated partial thromboplastin time of 60
seconds.
C. Activated partial thromboplastin time of 120
seconds.
D. Activated partial thromboplastin time of 15
seconds.
92. Question
A nurse is caring for a client receiving a heparin
intravenous (IV) infusion. The nurse expects that
which of the following laboratory will be prescribed
to monitor the therapeutic effect of heparin?
93. Question
A nurse is providing instructions to a client who is
receiving warfarin sodium (Coumadin). Which
statement made by the client indicates the need for
further instruction?
A. 1 to 2
B. 4 to 6
C. 8 to 12
D. 12 to 24
95. Question
Which drug is used to stop bleeding associated with
heparin overdose?
A. urokinase (Abbokinase).
B. aminocaproic acid (Amicar).
C. protamine sulfate (Protamine).
D. vitamin K (AquaMEPHYTON
96. Question
The half-life of heparin is:
A. 10 minutes
B. 1 to 1.5 hours
C. 8 to 12 hours
D. 1 to 2 days
97. Question
SC heparin should be administered in the:
A. Flank.
B. Abdominal fat.
C. Leg.
D. Gluteal area.
98. Question
Parenteral anticoagulants work by disrupting:
A. Formation of thromboplastin.
B. Conversion of prothrombin to thrombin.
C. Vitamin K-dependent clotting factors.
D. Conversion of prothrombin to fibrin.
99. Question
Which of the following lipid-lowering agents has the
common side effect of constipation?
A. lovastatin (Mevacor).
B. colestipol (Colestid).
C. gemfibrozil (Lopid).
D. niacin (Nicotinic acid).
100. Question
Which of the following vitamins may not be
absorbed properly when giving bile acid
sequestrants?
A. Vitamin B.
B. Vitamin C.
C. Vitamin B12.
D. Vitamin K.
101. Question
As a competent nurse, you know that the most
significant contraindication for therapy with lipid-
lowering agent is:
A. Renal disease.
B. Diabetes.
C. Liver disease.
D. Cardiac disease.
102. Question
For lipid-lowering agents to be successful, drug
therapy must lower:
A. HDL.
B. LDL.
C. Total fat.
D. All of the above
103. Question
Kylie is reviewing drugs related to cardiovascular
therapies. She should be aware that the desired action
of lipid-lowering agents is to:
104. Question
The nurse is giving instructions to a client
receiving cholestyramine (Prevalite). Which
statement made by the client indicates a need for
further teachings?
105. Question
Which of the following conditions can you safely
administer metoclopramide (Reglan)?
106. Question
A client has been taking Ibuprofen for a while and
was given misoprostol (Cytotec). Which of the
following is exhibiting the therapeutic effect of
Cytotec?
A. Relief of constipation
B. Relief of diarrhea
C. Relief intestinal obstruction
D. Relief of Gastric Ulcers
107. Question
A geriatric patient is prescribed with cimetidine
(Tagamet) for the treatment of heartburn. Which
of the following is the most frequent CNS side
effect of the medication?
A. Agitation
B. Drowsiness
C. Headache
D. Somnolence
108. Question
A nurse is administering an IV bolus of cimetidine
(Tagamet). Which of the following should the
nurse monitor closely follow the administration?
A. Respiratory rate
B. Skin turgor
C. Blood pressure
D. Temperature
109. Question
A client has been given loperamide hydrochloride
(Imodium). Which of the following conditions is
the medication indicated for?
A. Abdominal pain
B. Patients with an ileostomy
C. Bloody Diarrhea
D. Acute dysentery
110. Question
A client has been given ondansetron (Zofran). For
which of the following post-operative condition
should the nurse administer this medication?
A. Abdominal infection
B. Incisional pain
C. Atelectasis
D. Vomiting
111. Question
A client with a duodenal ulcer is diagnosed with
H. pylori infection. The physician prescribed
amoxicillin (Wymox), pantoprazole (Prevacid),
and clarithromycin (Biaxin). Which statement
made by the nurse correctly explains the purpose
of these medications?
112. Question
A patient with Crohn’s disease is receiving an
infusion therapy of infliximab (Remicade). Which
of the following should the nurse do while the
patient is on this medication?
113.Question
A client has been prescribed sucralfate (Carafate)
for the treatment of gastric ulcers. The nurse
instructs the client that this medication is taken?
A. 1 hour before meals
B. 1 hour after meals
C. At the same time with an antacid
D. Lunch time
114. Question
Tincture of opium is given to a patient who is
having diarrheal episodes. Which of the following
is true regarding this medication?
116. Question
A nurse is giving discharge instructions to a client
who is receiving a bulk-forming laxative as part of
the home medications. All of which are examples
of bulk-forming laxative, except?
117. Question
A client with a history of chest pain is admitted to
irritable bowel syndrome. As a nurse, which of the
following medicines will you least expect to be a
part of the medical management?
A. alosetron (Lotronex)
B. tegaserod (Zelnorm)
C. lubiprostone (Amitiza)
D. loperamide (Imodium)
118. Question
What is the priority nursing intervention for a
client receiving antiemetic?
A. senna (Senokot)
B. mineral Oil (Kondremul)
C. polyethylene glycol and electrolytes
(GoLYTELY)
D. sodium Phosphate (Fleet enema)
E. bisacodyl (Dulcolax)
120. Question
Which of the following statements best describes
the action of antacids?
121. Question
Jam is under chemotherapy in which nausea is an
expected side effect. Which of the following drugs
is indicated to prevent such side effects?
A. metoclopramide
B. cimetidine
C. tagamet
D. famotidine
122. Question
Which of the following drugs will reduce the
effectiveness of sucralfate?
A. ranitidine
B. sucralfate
C. metoclopramide
D. meclizine
123. Question
Extrapyramidal symptoms are a side effect of
which of the following drugs?
A. ranitidine
B. omeprazole
C. famotidine
D. metoclopramide
141. The nurse is caring for a client who has just had
implantation of an automatic internal cardioverter-
defibrillator. The nurse should assess which item
based on priority?
1. Anxiety level of the client and family
2. Activation status and settings of the device
3. Presence of a MedicAlert card for the client to
carry
4. Knowledge of restrictions on postdischarge
physical activity
142. A client’s electrocardiogram strip shows atrial
and ventricular rates of 110
beats per minute. The PR interval is 0.14 seconds, the
QRS complex measures
0.08 seconds, and the PP and RR intervals are
regular. How should the nurse
interpret this rhythm?
1. Sinus tachycardia
2. Sinus bradycardia
3. Sinus dysrhythmia
4. Normal sinus rhythm