MS 1 EXAMINATION 2 REVIEWER

1) A patient is scheduled for an angiogram. The nurse should

explain to the patient that the angiogram will confirm the
diagnosis of occlusive arterial disease by*
a. Showing the location of the obstruction and the collateral circulation
b. Scanning the affected extremity and identifying the areas of volume changes
c. Using ultrasound to estimate the velocity changes in the blood vessels
d. Determining how long the client can walk

2) Which of the following explains the influence of aging on the

development of peripheral vascular disease?
a. Decreased resistance
b. Decreased viscosity
c. Increased resistance
d. Increase Viscosity

3) A client is admitted to the emergency room with suspected acute

anterior myocardial (left ventricular) infarction. The client is
severely short of breath and presents with a new systolic
murmur. Based on this assessment finding, which complication
of MI would the nurse suspect?
Cardiogenic Shock
Papillary Muscle Rupture
Cardiac Tamponade
Pericarditis

A client with coronary artery disease (CAD), is prescribed a beta

blocker to manage their disease. The nurse explains to the client that
the primary purpose of using beta-adrenergic blockers in the
management of CAD is to

*
Prevent angiotensin II conversion
Dilate coronary arteries
Decrease homocysteine levels
Decrease workload of the heart
A client in the emergency department complains of squeezing
substernal pain that radiates to the left shoulder and jaw. He also
complains of nausea, diaphoresis, and shortness of breath. What
should the nurse do?
*
Administer oxygen, attach a cardiac monitor, take vital signs, and administer sublingual
nitroglycerin.
Complete the client's registration information, perform an electrocardiogram, gain I.V. access,
and take vital signs.
Gain I.V. access, give sublingual nitroglycerin, and alert the cardiac catheterization team.
Alert the cardiac catheterization team, administer oxygen, attach a cardiac monitor, and notify
the physician.

The healthcare provider prescribes a beta blocker for a client who has
had a myocardial infarction. The nurse should hold the medication and
discuss the order with the healthcare provider if the client has
*
Ventricular dysrhythmias
A blood pressure of 100/80 mm Hg
A heart rate of 62 bpm
Bibasilar crackles in lung bases

Nadolol (Corgard) is prescribed for a patient with chronic stable

angina and left ventricular dysfunction. To determine whether the drug
is effective, the nurse will monitor for

*
Decreased blood pressure and heart rate
Fewer complaints of having cold hands and feet
Improvement in the strength of the distal pulses
The ability to do daily activities without chest pain

A client who has recently started taking rosuvastatin (Crestor) and

niacin (vitamin B3) reports all the following symptoms to the nurse.
Which is most important to communicate to the health care provider?
*
Dizziness when changing positions quickly
Skin flushing after taking the medication
Generalized muscle aches and pains
Nausea when taking the drugs before eating
A client had a percutaneous transluminal coronary angioplasty (PTCA).
What medication will the nurse administer to prevent thrombus
formation in the stent?
*
Diltiazem
Isosorbide mononitrate
Clopidogrel
Metoprolol

The nurse is preparing to discharge a patient who had recovered

uneventfully from a percutaneous coronary intervention (PCI). The
most important instruction that the nurse should include in the
instructions is
*
Resume regular medications as ordered
Report immediately any change in color or temperature of the extremity
Restrict heavy lifting >10 lbs. for one week
Stop smoking and resume a low-fat, low cholesterol diet

The patient is returning from a cardiac catheterization. The femoral

artery approach was used for the procedure. The patient sneezes upon
return. The nurse's priority intervention is to
*
Measure vital signs
Assess for urticaria
Palpate pedal pulses
Check the insertion site

A nurse assesses a client who has just returned to a telemetry unit

after having a coronary angiogram using the left femoral artery
approach. The client's baseline blood pressure (BP) during the
procedure was 132/74 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?

*
BP 144/78 mm Hg
Pedal pulses palpable at +1
Left groin soft with 1 cm ecchymotic area
Apical pulse 132 beats per minute (bpm) with an irregular rhythm
The nurse asks a client who is about to have a cardiac catheterization
about any allergies. The client states, "I always get a rash when I eat
shellfish." Which of the following is the priority nursing action?
*
Notify the provider of the client's allergy
Attach a wristband indicating the client's allergy
Ask the client if any other foods cause such a reaction
Notify the dietary department of the client's allergy

Which cardiac lab is an accurate/best indicator of myocardial injury?

*
Troponin (TNI/TNT)
Total CPK
Lactate
Myoglobin w/ Troponin
BNP

The nurse is taking a health history of a new patient. The patient

reports experiencing pain in his left lower leg and foot when walking.
This pain is relieved with rest. The nurse notes that the left lower leg
is slightly edematous and is hairless. When planning this patient's
subsequent care, the nurse should most likely address what health
problem?
*
Coronary artery disease (CAD)
Intermittent claudication
Arterial embolus
Raynaud's disease

A diagnostic tool that uses powerful magnets to show images of the

heart is
*
an electrocardiogram (EKG).
magnetic resonance imaging (MRI).
an angiography.
a CT scan.

Which of the following actions is the main priority of care for a

patient manifesting signs and symptoms of coronary artery disease?
*
decrease anxiety
enhance heart muscle oxygenation
administer sublingual nitroglycerin
educate client about the sign and symptoms of CAD

Which of the following is the most common symptom of myocardial

infarction (MI)
*
angina
dypnea
edema
palpitation

Which of the following tests is the most indicative of cardiac

damage?
*
Troponin I
CBC
Lactate dehydrogenase
Creatine kinase (CK)

Which of the following conditions is most commonly responsible for

myocardial infarction?
*
aneurism
heart failure
coronary artery thrombosis
renal failure

What is the first intervention for a client experiencing MI?

*
Give oxygen
administer nitroglycerin SL
Obtain ECG
adminster morphine

Which of the following conditions is most closely associated with

weight gain, nausea, and a decrease in urine output?
*
angina pectoris
cardiomyopathy
left- side paralysis
right- side paralysis
Dyspnea, cough, expectoration, weakness, and edema are classic
signs and symptoms of which of the following conditions?
*
pericarditis
hypertension
MI
Heart failure

Which of the following cardiac conditions does a fourth heart sound

(S4) indicate?
*
dilated aorta
normal function of heart
decrease mycardial contractility
Failure of the ventricle to eject all of the blood during systole.

If medical treatments fail, which of the following invasive procedures

is necessary for treating cardiomyopathy?
*
Cardiac catheterization
Coronary artery bypass graft (CABG)
Heart transplantation
Intra-aortic balloon pump (IABP)

Which of the following conditions is the predominant cause of angina?

*
Increased preload
Decreased afterload
Coronary artery spasm
Inadequate oxygen supply to the myocardium.

Which of the following results is the primary treatment goal for

angina?
*
Reversal of ischemia.
Reversal of infarction.
Reduction of stress and anxiety.
Reduction of associated risk factors.

Which of the following interventions should be the first priority when

treating a client experiencing chest pain while walking?
*
Sit the client down.
Get the client back to bed.
get the client back on bed
Obtain ECG

Which of the following is a compensatory response to decreased

cardiac output?
*
decrease BP
altered Level of consciousness
Decrease BP and diuresis
increase BP and increase fluid retention

A client admitted with angina complains of severe chest pain and

suddenly becomes unresponsive. After establishing unresponsiveness,
which of the following actions should the nurse take first?
*
Activate the resuscitation team.
Open the client’s airway.
Check for breathing.
Check for signs of circulation.

Aspirin is administered to the client experiencing an MI because of its:

*
analgesics
antipyretic
antithrombotic
none of the above

Furosemide is administered intravenously to a client with HF. How

soon after administration should the nurse begin to see evidence of
the drug’s desired effect?
*
5- 10 min
30 to 60 min
2- 4 hours
6- 8 hours

What is the most important nursing action for a patient with suspected
heart attack?
Administer morphine for pain
Administer oxygen support 2-3 lpm via nasal cannula
Instruct the patient fot deep breathing exercise
Elevate the head of the bed at high fowler position

Which of the following interventions should be the first priority when

treating a patient experiencing chest pain while walking?
*
Sit the client down
Get the client back to bed
Obtain an ECG
Administer sublingual nitroglycerin

How do you describe the chest pain of the patient with on-going heart
attack?*
Tapping pain
Excruciating pain
Palpitating pain
Chest heaviness

What are your top priorities for investigating chest pain in a patient?*
Total Cholesterol
Troponin I
CK-MB
HDL and LDL

All but one is true about NSTEMI*

NSTEMI occur when there is complete occlusion of coronary vessels
NSTEMI occur when there is incomplete occlusion of coronary vessels
NSTEMI occur if there is tissue necrosis happening
All of the above

Interpret this electrocardiograph*

ST Depression
LBBB
ST Elevation
Normal Sinus Rhythm

It deals with the laboratory result of ST elevation, increased in CK-MB

and positive Troponin-i*
NSTEMI
STEMI
Angina
Stable Angina

Which laboratory must be monitored when administering Coumadin?*

PT
INR
PTC
All of the above

Which of the following terms describes the force against which the
ventricle must expel blood?
*
Afterload
Cardiac output
Overload
Preload

A 55-year-old patient is admitted with an acute inferior-wall myocardial

infarction. During the admission interview, he says he stopped taking
his Metoprolol 5 days ago because he was feeling better. Which of the
following nursing diagnoses takes priority for this patient?
*
Anxiety
Ineffective tissue perfusion (cardiopulmonary)
Acute pain
Ineffective therapeutic regimen management

It deals with the laboratory result of ST depression, normal Troponin-i

and CK-MB
*
STEMI
NSTEMI
Unstable Angina
Stable Angina

Which of the following tests is used most often to diagnose angina?

*
Chest x-ray
Echocardiogram
Cardiac catheterization
12-lead electrocardiogram (ECG)
The immediate medical acute management for myocardial infarction
as follows *
Meperidine, Oxygen, Nitrogen, Atenolol
Monooxide, Oxygen, Nitrogen, Atenolol
Morphine, Oxygen, Nitrates, Aspirin
Morphine, Oxygen, Nitrates, Ambroxol

How much window period is necessary to be a candidate for Tissue

Plasminogen Activator (TPA)?*
4 hrs
6 hrs
8 hrs
10 hrs

Which laboratory must be monitored when administering Heparin?*

PT
INR
PTC
All of the above

What is the primary reason for administering morphine to a patient

with an myocardial infarction?
*
To sedate the patient
To decrease the patient's pain
To decrease the patient's anxiety
To decrease oxygen demand on the patient's heart

Aspirin is administered to the patient experiencing a myocardial

infarction because of its:
*
Anti-pyretic action
Anti-thrombotic action
Anti-platelet action
Analgesic action

Interpret this electrocardiograph*

ST Depression
LBBB
ST Elevation
Normal Sinus Rhythm