COMPETENCY APPRAISAL1 QUIZ

Name: BAGNOL, CHERYL M.

Instruction: Chose your best answer and rationalize/expound your answer.

1. Which of the following is done for the management of pain in myocardial infarction?
a. Rest
b. Administering nitroglycerine
c Administering Mefenamic Acid
D Administering Demerol

ANSWER: Rest is the most management done for mycardial infarction. (complete bed rest without bathroom
privila\eged. .

2. A potassium sparing diuretic is prescribed to a patient with heart failure. Which of the following drugs is a
potassium-sparing diuretic?
a Furosemide
b. Triamterene
c. Diuril
d. Bumex

ANSWER: The triamterene and hydrochlorothiazide capsule is a diuretic/antihypertensive drug

product that combines natriuretic and antikaliuretic effects

3. A client has a diagnosis of right-sided heart failure. You expect to note which manifestations during assessment and
work-up:
a. Coughing
b. Ascites
c. Hemoptysis
d. Dyspnea

ANSWER: Dyspnea is a sensation of running out of the air and of not being able to breathe fast enough or
deeply enough. It results from multiple interactions of signals and receptors in the CNS, peripheral
receptors chemoreceptors, and mechanoreceptors in the upper airway, lungs, and chest wall.

4. The nurse realizes that a pacemaker is used in some client to serve function normally performed by the:
a. AV node
b. SA node
c. Bundle of His
d. Accelerator nerve to heart

5. The nurse observes a client’s cardiac monitor and identifies asystole. This dysrhythmia requires nursing attention
because the heart is:
a. Not beating
b. Beating slowly
c. Beating regularly
 d. Beating rapidly
6. Tricuspid and mitral valves is also known as:
a. Semilunar valves
b. Pulmonic valves
c. Atrioventricular valves
d. Aortic Valves

ANSWER: Atrioventricular valves: These valves separate the atria from the ventricles on each side of the
heart and prevent backflow from the ventricles into the atria during systole. They include the mitral and
tricuspid valves.

7. Ventricular contraction is a phase in cardiac cycle called:

a. Diastolic phase
b. Systolic phase
c. Lub-dub phase
d. Resting Phase

ANSWER: Cardiac cycle events can be divided into diastole and systole. Diastole represents ventricular filling,
and systole represents ventricular contraction/ejection.

8. A muscular structure that separates the right and left side of the heart:
a. Pericardium
b. SA node
c. Septum
d. Atrium

ANSWER: The left and the right side of the heart is separated by a wall called septum. The partition between the
chambers helps to avoid the mixing up of blood rich in oxygen with blood rich in carbon dioxide.

9. Which of the following statements reflect a common symptom associated with aspirin toxicity?
a. “I’m having frequent urination”
b. “I hear buzzing sounds”
c. “I feel nauseated and sick”
d. “My neck is aching.”

ANSWER:

10. A client asks what the coronary arteries have to do with angina. When determining the answer, the nurses should
take into consideration that the coronary arteries:
a. Supply blood to the endocardium
b. Carry blood from the aorta to the myocardium
c. Carry reduced oxygen-content blood to the lungs
d. Carry high-oxygen content blood from the lungs towards the heart

ANSWER:
11.The nurse teaching the client about behavioral changes, which can affect development of atherosclerosis, should
discuss which of the following as a non-modifiable risk factor for atherosclerosis?
a. cigarette smoking
b. hyperlipidemia
c. female over 55 years of age
d. sedentary lifestyle

ANSWER:

12. A 48 year old woman presents to the hospital complaining of chest pain, tachycardia and dyspnea. On exam,
heart sounds are muffled. Which of the following assessment findings would support a diagnosis of cardiac
tamponade?
a. A deviated trachea
b. Absent breath sounds to the lower lobes
c. Pulse 40 with inspiration
d. Blood pressure 140/80

ANSWER: Paradoxical pulse is a hallmark symptom of cardiac tamponade. As pressure is exerted on the left
ventricle from fluid, the natural increase in pressure from the right ventricle during inspiration creates even more
pressure, diminishing cardiac output.

13. The client has ST segment depression on his 12-lead ECG. The nurse determines that this would indicate the
following:
a. necrosis
b. Injury
c. Ischemia
d. nothing significant

ANSWER: Depressed ST segment and inverted T-waves represent myocardial ischemia. Injury has a ST segment
elevation.

14.Felicia Gomez is 1 day postoperative from coronary artery bypass surgery. The nurse understands that a
postoperative patient who’s maintained on bed rest is at high risk for developing:
a. angina
b. arterial bleeding
c. deep vein thrombosis (DVT)
d. dehiscence of the wound

15. A client with congestive heart failure has digoxin (Lanoxin) ordered everyday. Prior to giving the medication,
the nurse checks the digoxin level which is therapeutic and ausculates an apical pulse. The apical pulse is 63 bpm for
1 full minute. The nurse should:
a. Hold the Lanoxin
b. Give the half dose now, wait an hour and give the other half
c. Call the physician
d. Give the Lanoxin as ordered
 ANSWER: D. Give the Lanoxin as ordered. The Lanoxin should be held for a pulse of 60 bpm. Nurses cannot
arbitrarily give half of a dose without a physician’s order. Unless specific parameters are given concerning pulse
rate, most resources identify 60 as the reference pulse.

16. Nurse Hazel teaches the client with angina about common expected side effects of nitroglycerin including:
a. high blood pressure
b. stomach cramps
c. headache
d. shortness of breath

ANSWER: Because of its widespread vasodilating effects, nitroglycerin often produces side effects such as headache.

17. The following are lipid abnormalities. Which of the following is a risk factor for the development of atherosclerosis
and PVD?
a. High levels of low density lipid (LDL) cholesterol
b. High levels of high density lipid (HDL) cholesterol
c. Low concentration triglycerides
d. Low levels of LDL cholesterol.

ANSWER: An increased in LDL cholesterol concentration has been documented at risk factor for the development
of atherosclerosis. LDL cholesterol is not broken down into the liver but is deposited into the wall of the blood
vessels.

18. The nurse is aware the early indicator of hypoxia in the unconscious client is:
a. Cyanosis
b. Increased respirations
c. Hypertension
d. Restlessness

ANSWER: Restlessness is an early indicator of hypoxia. The should suspect hypoxia in unconscoius client who
suddenly becomes restless.

19. Nurse hazel 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. Liver disease
b. Myocardial damage
c. Hypertension
d. Cancer

ANSWER: Detection of myoglobin is an diagnostic tool to determine whether myocardial damage has occurred.

20. Nurse Maureen would expect the a client with mitral stenosis would demonstrate symptoms associated with
congestion in the:
a. Right atrium
b. Superior vena cava
c. Aorta
d. Pulmonary
ANSWER: When mitral stenosis is present, the left atrium has difficulty emptying its contents into the left ventricle
because there is no valve to prevent backward flow into the pulmonary vein, the pulmonary circulation is under
pressure.

21. Upon assessment the nurse notes that the client has a deep vein thrombosis (DVT). The client asked what might
have caused it. The nurse enumerated the causes of the thrombus formation by saying that a Virchow’s triad are
the following except:
a. Venous stasis
b. Homan’s sign
c. Vessel wall injury
d. Too much blood coagulating ability

ANSWER: The Homan sign is a clinical finding of pain behind the knee upon forced dorsiflexion of the foot.

22. One of the collaborative management for DVT is an anticoagulant therapy. The antidote for heparin is:
a. Coumadin
b. Vitamin K
c. Protamin sulfate
d. Succimer

ANSWER: Protamine is a medication used to reverse and neutralize the anticoagulant effects of heparin. Protamine
is the specific antagonist that neutralizes heparin-induced anticoagulation.

23. A hypertensive client has been prescribed with Apresoline. What drug classification does this drug belong?
a. Diuretics
b. Beta blockers
c Vasodilator
d. Calcium channel blocker

ANSWER: Apresoline (hydralazine hydrochloride) is an antihypertensive drug indicated for treatment of

hypertension by relaxing vascular smooth muscle.

24.Upon reading the client’s chart, Verapamil (Calan) is also prescribed for the client. This drug is an antihypertive
that specifically is classified as:
a. Diuretics
b. Beta blockers
c. Vasodilator
d. Calcium channel blocker

ANSWER: Calan (verapamil hydrochloride) is a calcium channel blocker used to treat hypertension (high blood
pressure), angina (chest pain), and certain heart rhythm

25. During the lecture-discussion in a nursing university, the clinical instructor focused on peripheral vascular
disorders. Included in this disorders is a disease causing arterial vasospasm in the fingers when exposed to cold
which is called:
a. Aneurysm
b. Raynaud’s disease
 c. Buerger’s disease
d. Cold stress

ANSWER: Raynaud's phenomenon is a condition that causes the blood vessels in the extremities to narrow,
restricting blood flow. The episodes or “attacks” usually affect the fingers and toes. In rare cases, attacks occur in
other areas such as the ears or nose. disease causes some areas of the body — such as fingers and toes — to feel
numb and cold in response to cold temperatures.

26. A 33 year old male client enters the clinic with complaints of pain at the calf muscle. He said that pain
aggravates when he ambulates or walks. You expect this disorder to be an:
a. Arterial disorder
b. Hypertension
c. Venous disorder
d. Raynaud’s disease

ANSWER: The calf muscle pump contributes to venous return from the legs, and reduced calf pump function
(rCPF) is linked to chronic venous

27. A nurse is conducting a health teaching on thrombophlebitis. The most effective action to prevent
thrombophlebitis after a vein surgery is done is to do which of the following:
a. Elevating the leg when lying or sitting
b. Compression with elastic bandage
c. Allying pressure on the site
d. Early ambulation

ANSWER: Inelastic bandages exert passive compression and are recommended in the treatment of edema, deep
vein thrombosis

28. Buerger’s disease or thromboangitis Obliterans commonly affects:

a. Medical professionals
b. Smokers
c. Adolescents
d. A and B

ANSWER: People at the greatest risk for Buerger disease are those who are heavy smokers. Men of Asian or
Eastern European descent, who are between ages 20 and 40 seem to be especially at risk. It has also been identified
cigar smokers, marijuana users, and those who use smokeless tobacco such as chewing tobacco and snuff.

29. A client is diagnosed with a heart failure. The nurse keeps in mind that a special consideration of what laboratory
value should be carefully monitored if a patient is on digitalis therapy (Digoxin).
a. Serum Potassium
b. BUN and creatinine
c. Heart Rate
d. Calcium

ANSWER: Digoxin is a type of drug called a cardiac glycoside. Their function is to slow your heart rate down and
improve the filling of your ventricles (two of the chambers of the heart) with blood. For people with atrial
fibrillation, where the heart beats irregularly, a different volume of blood is pumped out each time.
30. The following are risk predictors of decubitus ulcers except:
a. Friction
b. Activity
c. Moisture
d. Thrombophlebitis

ANSWER: People who are older, immobile or bedridden are most at risk for bedsores. These pressure ulcers occur
when there's prolonged pressure on your skin. Friction, moisture and traction (pulling on skin) also lead to bedsores.

Question 23 Explanation:
thrombophlebitis is an inflammation of the vein that occurs 7-14 days post operatively if the patient will not promote
early ambulation. A,B and C are risk factors of D.Ulcer.

31. A client was admitted in the ER with profuse bleeding due to a vehicular accident. You expect what type of shock
will occur in this client if prompt treatment is not implemented?
a. Cardiogenic
b. Neurogenic
c. Anaphylactic
d. Hypovolemic

ANSWER: Hypovolemic shock is an emergency condition in which severe blood or other fluid loss makes the heart
unable to pump enough blood to the body.

32. The physician stated that approximately a patient lost 1,000 to 1,500 cc of blood. This patient may show the
following signs EXCEPT:
a. Weakness and anxiety
b. Minimal urine output
c. Heart rate of 100 – 120 bpm
d. Capillary refill time (CRT) >3 seconds

33. When assessing a wound that exhibits signs of blood coagulation and healing, the nurse understands that the
soluble substance becomes an insoluble gel is:
a. Fibrin
b. Thrombin
c. Fibrinogen
d. Prothrombin

ANSWER: Fibrin is a tough protein substance that is arranged in long fibrous chains; it is formed from fibrinogen, a
soluble protein that is produced by the liver and found in blood plasma. When tissue damage results in bleeding,
fibrinogen is converted at the wound into fibrin by the action of thrombin, a clotting enzyme.

34. Vitamin is essential for normal blood clotting because it promotes:

a. Platelet aggregation
b. Ionization of blood calcium
c. Fibrinogen formation of the liver
d. Prothrombin formation by the liver

ANSWER: Vitamin K helps to make various proteins that are needed for blood clotting and the building of bones.
Prothrombin is a vitamin K-dependent protein directly involved with blood clotting.
 35. Nurse Fiona is caring a patient with Raynaud’s disease. Which of the following outcomes concerning medication
regimen is of highest priority?
a. Controlling the pain once vasospasm occur
b. Relaxing smooth muscle to avoid vasospasms
c. Preventing major disabilities that may occur
d. Avoiding lesions on the feet

36. Assessment of a client with possible thrombophlebitis to the left leg and a deep vein thrombosis is done by
pulling up on the toes while gently holding down on the knee. The client complains of extreme pain in the calf. This
should be documented as:
a. positive tourniquet test
b. positive homan’s sign
c. negative homan’s sign
d. negative tourniquet test

ANSWER: A positive Homan's sign in the presence of other clinical signs may be a quick indicator of DVT.

37. Nurse Maureen is aware that a client who has been diagnosed with chronic renal failure recognizes an adequate
amount of high-biologic-value protein when the food the client selected from the menu was:
a. Raw carrots
b. Apple juice
c. Whole wheat bread
d. Cottage cheese

ANSWER: 1 cup of cottage cheese contains approximately 225 calories, 27 g of protein, 9 g of fat, 30 mg cholesterol
and 6 g of carbs. It contains optimal levels of amino acids essentials for life.

38. A client has been diagnosed with hypertension. The nurse priority nursing diagnosis would be:
a. Ineffective health maintenance
b. Impaired skin integrity
c. Deficient fluid volume
d. Pain

ANSWER: Managing hypertension is the priority for the client with hypertension. Clients with hypertension frequently
do not experience pain, deficient volume, or impaired skin integrity.

39. A client is scheduled for insertion of an inferior vena cava (IVC) filter. Nurse Patricia consults the physician about
withholding which regularly scheduled medication on the day before the surgery?
a. Potassium Chloride
b. Warfarin Sodium
c. Furosemide
d. Docusate

40. Which of the following is not a sign of thromboembolism?

a. Edema
b. Swelling
c. Redness
d. Coolness