CARDIOVASCULAR TEST QUESTIONS

Question 1

WRONG

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?

"I will observe the color of my urine and stool".

"I will take Ecotrin (Enteric coated aspirin) for my headaches".

"I will avoid drinking alcohol".

"I will take the medicine daily at the same time".

Question 1 Explanation: 
Ecotrin is an aspirin-containing product and should be avoided due to the risk of
bleeding.

Question 2

WRONG

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?

Prothrombin time (PT).

Activated partial thromboplastin time (Aptt).

Hematocrit (Hgb).

Hemoglobin (Hct).

Question 2 Explanation: 
Activated partial thromboplastin time assess the therapeutic level of heparin.
Option A: Assess the therapeutic level of warfarin sodium (Coumadin). Options C
and D: Measures the aspect of the red blood cells.
 CARDIOVASCULAR TEST QUESTIONS

Question 3

WRONG

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?

Activated partial thromboplastin time of 30 seconds.

Activated partial thromboplastin time of 60 seconds.

Activated partial thromboplastin time of 120 seconds.

Activated partial thromboplastin time of 15 seconds.

Question 3 Explanation: 
The normal range for activated partial thromboplastin time is 20-36 seconds. The
activated partial thromboplastin time must be 1.5 to 2.5 times the normal value, the
client's Appt would be considered therapeutic if it was 60 seconds.

Question 4

WRONG

A client is receiving intravenous heparin therapy. The nurse ensures the availability
in which of the following medication?

Acetylcysteine (Mucomyst).

Calcium gluconate.

Vitamin K (Mephyton).

Protamine sulfate.

Question 4 Explanation: 
Protamine sulfate is the antidote that reverses the anticoagulant effects of heparin
by binding to it. Option A is the antidote for acetaminophen toxicity. Option B is the
antidote for magnesium sulfate toxicity. Option C is the antidote for warfarin
sodium toxicity.
 CARDIOVASCULAR TEST QUESTIONS

Question 5

CORRECT

A client is receiving a continuous infusion of streptokinase (Streptase). The client

suddenly complaints of a difficulty of breathing, itchiness, and nausea. Which of the
following should be the priority action of the nurse?

Stop the infusion and notify the physician.

Administer protamine sulfate and provide oxygen therapy.

Administer antihistamine then continue the infusion.

Slow the infusion and administer oxygen.

Question 5 Explanation: 
Severe allergic reaction to streptokinase requires immediate discontinuation of
Streptokinase,then notify the physician and administer an adrenergic,
antihistamine, and/or corticosteroid agents as ordered.

Question 6

CORRECT

A client with deep vein thrombosis is receiving Streptokinase (Streptase). The nurse
would notify the physician if which of the following assessment is noted?

A temperature of 99.2° Fahrenheit.

A pulse rate of 99 beats per minute.

A respiratory rate of 25 breaths per minute.

A blood pressure of 185/110 mm Hg.

Question 6 Explanation: 
Thrombolytic therapy is contraindicated with uncontrolled hypertension (systolic BP
>180 mm Hg and/or diastolic BP >110 mm Hg) because of the risk of cerebral
hemorrhage. Options A, B, and C may be present during the therapy but will not
warrant the immediate knowledge of the physician before starting the therapy.
 CARDIOVASCULAR TEST QUESTIONS

Question 7

CORRECT

A client who is receiving streptokinase therapy suddenly had a nose bleeding. The
nurse ensures the availability in which of the following medication?

Vitamin K (Mephyton).

Deferoxamine (Desferal).

Aminocaproic acid (Amicar).

Diphenhydramine (Benadryl).

Question 7 Explanation: 
Bleeding can be reversed with the use of aminocaproic acid as an antidote for
streptokinase. Option A is the antidote for warfarin sodium toxicity. Option B is the
antidote for iron toxicity. Option D is an antihistamine that can be used for any
allergic reaction.

Question 8

WRONG

A nurse is providing health teachings regarding antiplatelet medications. Which of

the following is not true regarding the use of this medication?

Antiplatelet medication inhibits the aggregation of platelets in the clotting process,

thereby prolonging bleeding time.

Antiplatelet medications cannot be used with anticoagulants.

Take the medication with food to prevent gastrointestinal upset.

A routine bleeding time is monitored during the therapy.

Question 8 Explanation: 
Antiplatelet and anticoagulant therapies are effective in keeping a clot from forming
or stopping the growth of one.
 CARDIOVASCULAR TEST QUESTIONS

Question 9

CORRECT

A client is receiving Procainamide (Procanbid) for the treatment of ventricular

arrhythmia. The client suddenly complains of nausea and drowsiness. Which of the
intervention should the nurse do first?

Check the blood pressure and heart rate.

Do a 12-lead electrocardiogram right away.

Measure the heart rate on the rhythm strip.

Give hydralazine (Apresoline) per orem.

Question 9 Explanation: 
The client is experiencing signs of procainamide toxicity, the priority nursing action
is to obtain vital signs immediately. Options B and C are done after checking the
vital signs. Option D will cause hypotension.

Question 10

WRONG

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?

Observe for neurological changes.

Monitor for any signs of renal failure.

Check the food diary.

Observe for signs of bleeding.

 CARDIOVASCULAR TEST QUESTIONS
Question 10 Explanation: 
Bleeding is the priority concern for a client taking thrombolytic medication.

Question 11

WRONG

A nurse is caring a client who is taking digoxin (Lanoxin) 0.25mcg tab once a day.
The client suddenly complaints of anorexia, nausea, vomiting, and diarrhea. The
physician is ruling a digoxin toxicity. As a nurse, you know the therapeutic digoxin
rate is?

0.25-0.5 ng/ml.

0.5-2 ng/ml.

1.5-3 ng/ml.

3.5-4.5 ng/ml.

Question 11 Explanation: 
The therapeutic level of digoxin is 0.5-2 ng/ml.

Question 12

WRONG

A nurse is monitoring a client who is taking Carvedilol (Coreg CR). Which of the
following assessment made by the nurse would warrant a possible complication
with the use of this medication?

Baseline blood pressure of 160/100 mm hg followed by a blood pressure of 120/70 mm hg

after 3 doses.

Baseline heart rate of 97 bpm followed by a heart rate of 62 bpm after 3 doses.
 CARDIOVASCULAR TEST QUESTIONS

Complaints of nightmares and insomnia.

Complaints of dyspnea.

Question 12 Explanation: 
Complaints of dyspnea is a sign of bronchospasm which is one of the serious
complication of beta blockers. Options A and B shows a decrease in the blood
pressure and heart rate which are expected in this therapy. Option C is a side effect
of this medication.

Question 13

CORRECT

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?

"This medication will maintain the blood sugar level on a normal range".

"This medication will have no effect in the blood sugar level".

"This medication may mask some of the symptoms of hypoglycemia such as tremor,
palpitation, and rapid heartbeat.

"This medication may mask some of the symptoms of hyperglycemia such as headache,
increased thirst, and blurred vision".

Question 13 Explanation: 
Beta-blockers such as metoprolol may increase the risk of hypoglycemia in patients
receiving insulin. In addition, beta-blockers may mask some of the symptoms of
hypoglycemia such as tremor, palpitation, and rapid heartbeat, making it more
difficult to recognize an oncoming episode.

Question 14

CORRECT
 CARDIOVASCULAR TEST QUESTIONS
A client is about to receive Metolazone (Zaroxolyn). The nurse in charge
understands that which of the following laboratory results are related to the
administration of the medication?

Hyperkalemia and hypocalcemia.

Hyperkalemia and hypoglycemia.

Hypouricemia and hypoglycemia.

Hypokalemia and hyperglycemia.

Question 14 Explanation: 
Metolazone is a thiazide diuretic that may put clients risk for hypokalemia,
hyperglycemia, hyperlipidemia, hypercalcemia and hyperuricemia.

Question 15

WRONG

A client with congestive heart failure is being treated with Torsemide (Demadex).
The nurse obtains the following vital signs: Blood pressure of 100/65 mm hg; pulse
rate of 91 beats per minute; and respiration of 25 breaths per minute? Which of the
following will be the priority assessment of the nurse after the initiation of the
dose?

Urine output.

Serum potassium and calcium.

Blood pressure.

Weight.

Question 15 Explanation: 
The priority assessment in this situation will be the monitoring of the blood
pressure because hypotension poses a risk in this medication. Options A, B, and D
are monitored but they are not the priority.

Question 16
 CARDIOVASCULAR TEST QUESTIONS
WRONG

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?

"This medication comes in a powder that must be mixed with juice or water before
administration".

"I will avoid eating foods rich in saturated fats".

"I will continue taking nicotinic acid as part of the treatment".

"Constipation, belching and heartburn are some of the side effects".

Question 16 Explanation: 
A combination of Cholestyramine (Questran) and nicotinic acid damages the liver.
Options A, B, and D are true regarding this medication.

Question 17

CORRECT

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?

"I should take aspirin 30 minutes before nicotinic acid".

"I will drink alcohol in moderation".

"Yellowing of the skin is a common side effect".

"This medication is taken on an empty stomach".

Question 17 Explanation: 
The use of aspirin or a nonsteroidal anti-inflammatory drug 30 minutes before
decreases flushing which is a side effect of taking nicotinic acid. Option B: Drinking
alcohol will cause liver abnormalities. Option C is a sign of liver dysfunction and
 CARDIOVASCULAR TEST QUESTIONS
should be immediately informed the physician. Option D: This medication is taken
with meals to decrease gastrointestinal upset.

Question 18

WRONG

A nurse is monitoring a client who is taking Digoxin (Lanoxin). All of which are the
side effects associated with the medication, except?

Anorexia.

Blurred vision

Diarrhea.

Tremors.

Question 18 Explanation: 
Signs of digoxin toxicity are as follows, anorexia, nausea, vomiting, diarrhea, and
blurred vision.

Question 19

WRONG

A nurse is interviewing a patient who is about to receive bumetanide (Bumex).

Which of the following is a concern related to the administration of the medication?

Penicillin allergy.

Sulfa allergy.

Soy containing allergy.

Cephalosporin allergy.

Question 19 Explanation: 
Loop diuretics such as bumetanide are sulfa-based medications, and a client with
sulfa allergy is at risk for an allergic reaction.
 CARDIOVASCULAR TEST QUESTIONS
Question 20

WRONG

A client arrives in the emergency with complaints of chest pain, and is diagnosed
with acute MI. A morphine 4mg IV was given 5 minutes ago. Which of the following
assessment made by the nurse indicates a further immediate action?

Respiratory rate from 20 bpm to 12 bpm.

Blood pressure from 120/70 to 100/60 mmHg.

The client still complains of chest pain with a pain scale of 2/10

Cardiac rate of 103 bpm and a normal sinus rhythm of the ECG.

Question 20 Explanation: 
The goal for the client with an acute myocardial infarction is to eliminate the pain.
Even pain related at a level of 2/10 should be managed with an additional dose of
morphine. Options A, B, and D: although hypotension, respiratory depression, and
tachycardia are the side effects of morphine but they do not require further action
at this time.

Terms in this set (98)

1. The nurse is preparing to teach the pt newly diagnosed with angina pectoris how to self-
administer nitroglycerine (NTG) tablets. What pt teaching should the nurse emphasize? select
all that apply
A. stop all activities immediately and sit down if chest pain occurs
B. if the pain is unrelieved after three NTG tablets, continue to rest and call the prescriber
right away
C. After discharge, keep NTG tablets on your bedside table day and night
D. immediately after chest pain begins, notify your personal prescriber
E. the NTG tablet should tingle when placed under the tongue

A,B,E

2. the pt states, "I always put my nitroglycerine patch in the same place so I do not forget to
take it off." Which of the following is the best response by the nurse?
A. change the patch every 24 hours
B. massage into the skin if ointment comes in contact with your hands
 CARDIOVASCULAR TEST QUESTIONS
C. rotate the NTG patch to a different hairless area each day
D. after removing the patch, scrub the are vigorously with soap and water

3. A healthcare provider orders NTG to be administered by IV drip. The nurse carrying out the
order would monitor for which of the following as a priority specific to medication?
A. shortness of breath when raising head of bed
B. urine output
C. blood pressure and heart rate
D. facial flushing and headache

4. Before a pt receives metoprolol (Lopressor) for hypertension, the nurse should ask the pt
about a history of which of the following?
A. bronchospasms
B. seizures
C. peripheral vascular disease
D. myasthenia gravis

5. The nurse provides discharge instructions to a pt about the use of amiodarone. Which of
the following statements indicates that the pt has the knowledge necessary to safely
administer the drug?
A. as soon as the physician says I can stop taking this medication, I will be able to enjoy the sun
again
B. the side effects of this med may not begin to show up for several weeks or even months
after I start taking it
C. If my pulse drops below 100 beats/minute, I should call the physician right away
D. If I miss a dose of me, I should take it as soon as I remember it

6. The nurse is scheduled to administer a dose of digoxin to and adult pt with atrial
fibrillation. The pt has a potassium level of 4.3 mEq/L. The nurse should perform which of the
following activities next?
A. withhold dose only for that day
B. obtain order for dose of potassium before giving digoxin
C. withhold dose and notify prescriber
D. administer dose as ordered

7. A pt is taking digoxin and furosemide (Lasix) to manage congestive heart failure. The nurse
determines that the pt understands diet therapy when the pt makes which meal choice?
A. veggie beef soup, mac and cheese, and a roll
B. beef ravioli w/ bread
C. baked white fish, mashed potatoes, and carrot salad
D. roasted chicken, brown rice, and stewed tomatoes

C
 CARDIOVASCULAR TEST QUESTIONS
8. After a healthcare provider prescribed propranolol for a pt with frequent premature
ventricular contractions, the nurse should include with of the following in the care plan?
A. inform pt that excessive respiratory response to activity should gradually decrease
B. measure heart rate daily before taking dose
C. Pt will have increased resistance to infection
D. current skin eruptions will improve within 30 days

9. A pt with atrial fibrillation is receiving continuous heparin infusion at 1000 units/hr. The
nurse would determine that the pt is receiving the therapeutic effect based on which of the
following results?
A. prothrombin time of 12.5 seconds
B. apt time of 60 seconds
C. apt time of 28 seconds
D. apt time longer than 120 sec

10. A nurse provides discharge instructions to a post op pt who is taking warfarin sodium
(Coumadin). Which statement, if made by the pt, reflects the need for further teaching?
A. I will take my pills every day at the same time
B. I will be certain to limit my alcohol consumption
C. I have already called my family to pick up my Medic-Alert bracelet
D. I will take enteric-coated Aspirin for my headaches

11. A nurse is caring for a pt receiving heparin IV. The nurse anticipates that which lab study
will be prescribed to monitor the therapeutic effect of heparin?
A. hematocrit
B. hemoglobin
C. prothrombin time
D. activated partial thromboplastin time

12. A pt is diagnosed with an acute myocardial infarction and is receiving tissue plasminogen
activator, alteplase (Activase). Which of the following is a priority nursing intervention?
A. monitor for renal failure
B. monitor for psychosocial status
C. monitor for signs of bleeding
D. have heparin sodium available

C
 CARDIOVASCULAR TEST QUESTIONS
13. A home health nurse instructs a pt about the use of a nitrate patch. The nurse tells the pt
that which of the following will prevent pt tolerance to nitrates?
A. do not remove the patches
B. have a 12-hr no-nitrate time
C. have a 24-hr no-nitrate time
D. keep nitrates on 48 hrs, then off 24 hrs

14. a pt is receiving thrombolytic therapy with a continuous infusion of streptokinase. The pt

suddenly becomes extremely anxious with complaints of itching. A nurse hears stridor and on
examination of the pt notes generalized urticarial and hypotension. Which of the following
should be the priority action?
A. administer oxygen and protamine sulfate
B. stop the infusion and call the physician
C. cut the infusion rate in half and sit the pt up in bed
D. administer benadryl and continue the infusion slowly

15. Which of the following pts is at greatest risk for digital toxicity?
A. a 25 y/o pt with congestive heart disease
B. a 50 y/o pt with CHF
C. a 60 y/o pt who had an MI
D. an 80 y/o pt with CHF

16. Which of the following is a contraindication for digoxin administration?

A. BP of 140/90
B. HR>80
C. HR<60
D. RR>18

17. The action of medication is inotropic when it:

A. decreases afterload
B. increases heart rate
C. increases the force of contraction
D. is uses to treat CHF

C'

18. Which is the most important action for the nurse to take before administering digoxin?
A. monitor the potassium level
B. assess the BP
C. evaluate urinary output
D. avoid giving with a thiazide diuretic

19. The therapeutic drug level for digoxin is:

A. 0.1-2.0
 CARDIOVASCULAR TEST QUESTIONS
B. 1.0-2.0
C. 0.1-0.5
D. 0.5-2.0

20. Blurred vision or halos are signs of:

A. beta blocker toxicity
B. digoxin toxicity
C. diuretic toxicity
D. ACE inhibitor toxicity

21. beta blockers should be avoided in which of the following conditions:

A. bronchoconstriction
B. hypertension
C. Angina
D. myocardial infarction

22. You know that the action of nitrates is:

A. smooth muscle contraction
B. vasoconstriction
C. smooth muscle relaxation
D. increase preload

23. A 50 y/o pt is prescribed to take nitrate each day for his condition. You know the result of
nitrate administration is:
A. decreased myocardial oxygen demand
B. increased myocardial oxygen demand
C. increased left ventricular end-diastolic volume
D. increased atrial pressure

23. A student nurse is asked to give an example of a long-acting nitrate. She is correct by
saying:
A. Nitroglycerin sublingual
B. nitroglycerin IV
C. isosorbide PO
D. Nitroglycerin transmucosal

C
 CARDIOVASCULAR TEST QUESTIONS
23. When nitrates are administered early to the acute MI pt, the result is:
A. Hypotension
B. Bradycardia
C. reduced mortality
D. reduced morbidity

24. When teaching about nitrate administration, the nurse should instruct the pt to:
A. change positions slowly
B. take pulse weekly
C. reduce salt intake
D. chew the sustained-release tablets

25. Nurse Margie just administered an ACE inhibitor to her pt. Before ambulating the pt for
the first time after administration, the nurse should monitor for:
A. hypokalemia
B. irregular heartbeat
C. edema
D. hypotension

26. Mira is managing her hypertension with an ACE inhibitor. Which of the following
statements stated by her indicates a need for further teaching?
A. I should not take my pills with food
B. I need to increase my intake of orange juice, bananas, and green veggies
C. I will avoid coffee, tea, and cola
D. I will avoid salt substitutes

27. The action of an ACE inhibitor interrupts the renin-angiotensin-aldosterone mechanism,

thereby producing which of the following?
A. reduced renal blood flow
B. reduced sodium and water retention
C. increased peripheral vascular resistance
D. increased sodium excretion and potassium reabsorption

28. Raymund is reviewing on cardio drugs for his upcoming exam. For a well-prepared
student, he should know that vasodilators are agents that:
A. relax smooth muscle
B. are used to treat hypotension
C. stimulate the adrenergic receptors
D. cause respiratory depression

A
 CARDIOVASCULAR TEST QUESTIONS
29. As a competent nurse, you are aware that vasodilators are used mainly to treat:
A. diabetes
B. hypertension
C. atrial fibrillation
D. hypotension

30. Which of the following is a potential side effect of IV furosemide (Lasix)?

A. drowsiness
B. diarrhea
C. cystitis
D. hearing loss

31. All potassium-sparing diuretics:

A. are required during blood transfusions
B. enhance aldosterone action
C. cause hypokalemia
D. are weak diuretics

32. Which of the following pts is most likely to experience adverse effects from tx with
diuretics?
A. a 21 y/o college student
B. a 40 y/o unmarried man
C. a 60 y/o widower
D. a 75 y/o man

33. SC heparin should be administered in the:

A. flank
B. abdominal fat
C. thigh
D. buttock

34. The half-life of heparin is:

A. 10 minutes
B. 1-1.5 hrs
C. 8-12 hrs
D. 1-2 days

35. When teaching the pt about the signs and symptoms of cardiac glycoside toxicity, the
nurse should alert the pt to watch for:
 CARDIOVASCULAR TEST QUESTIONS
A. visual changes
B. flickering lights or halos
C. dizziness when standing up
D. increased urine output

36. during assessment of a pt who is receiving digoxin, which finding would indicate an
increased possibility of toxicity?
A. apical pulse rate of 60 bpm
B. digoxin level of 1.5
C. serum potassium level of 2.0
D. serum potassium level of 4.8

37. When a pt is experiencing digitalis toxicity, in which of the following situations would it
be appropriate to treat with digoxin immune Fab (Digibind)?
A. hypokalemia
B. hyperkalemia
C. apical heart rate of 60 bpm
D. supraventricular dysrhythmias

38. A pt with a rapid, irregular heart rhythm is being treated in the ER with adenosine. During
administration of this drug, the nurse should be prepared to monitor the pt for which effect?
A. nausea and vomiting
B. transitory asystole
C. muscle tetany
D. hypertension

39. When assessing a pt who has been taking amiodarone for 6 months, which adverse
reaction might the nurse identify?
A. glycosuria
B. dysphagia
C. photophobia
D. urticaria

40. A pt has a new prescription from transdermal nitroglycerin patches. The nurse teaches the
pt that these patches are most appropriately used for which of the following?
A. to relieve exertional angina
B. to prevent palpatations
C. to prevent the occurrence of angina
D. to reduce the severity of anginal episodes

C
 CARDIOVASCULAR TEST QUESTIONS
41. A nurse with adequate knowledge about the administration of IV nitroglycerin will
recognize that which of the following statements is correct?
A. the intravenous form is given by bolus injection
B. because the IV forms are short-lived, the dosing must be every 2 hours
C. IV nitroglycerin must be protected form exposure to light through use of special tubing
D. IV nitroglycerin can be given via gravity drip infusions

42. A nurse with adequate knowledge about the administration of IV nitroglycerin will
recognize that which of the following statements is correct?
A. the intravenous form is given by bolus injection
B. because the IV forms are short-lived, the dosing must be every 2 hours
C. IV nitroglycerin must be protected form exposure to light through use of special tubing
D. IV nitroglycerin can be given via gravity drip infusions

43. Which statement by the pt reflects the need for additional pt education about the CCB
diltiazem (Cardizem)?
A. I can take this drug to stop acute anginal attacks
B. I understand that food and antacids alter the absorption of this oral drug
C. when the long-acting forms are taken, the drug cannot be crushed
D. this drug may cause my blood pressure to drop, so I should be careful when getting up

44. While assessing a pt with angina who is to start Beta Blocker therapy, the nurse is aware
that the presence of which condition may be a problem if these drugs are used:
A. hypertension
B. essential tremors
C. exertional angina
D. asthma

45. A 68 y/o man has been taking the nitrate isosorbide for 2 years for angina. He recently
has been experiencing erectile dysfunction and wants a prescription for sildenafil (Viagra).
Which response would the nurse most likely hear from the prescriber?
A. He will have to be switched to isosorbide mononitrate if he wants to take sildenafil
B. taking sildenafil with the nitrate may result in severe hypotension
C. I'll write a prescription, but if he uses it, he needs to stop talking the isosorbide for one dose
D. these drugs are compatible with each other, and so I'll write a prescription

46. Which of the following adverse effects is of most concern for the older adult pt taking
anti-hypertensive drugs
A. dry mouth
B. hypotension
C. restlessness
D. constipation

B
 CARDIOVASCULAR TEST QUESTIONS
47. when giving antihypertensives drugs, the nurse must consider giving the first dose at
bedtime for which of the following classes of drugs?
A. alpha blockers
B. diuretics
C. ACE inhibitors
D. vasodilators

48. A 56 y/o man started antihypertensive drug therapy 3 months earlier and is in the office
for a follow-up visit. While the nurse is taking his BP, he informs the nurse that he has had
some problems with sexual intercourse. Which of the following would be the most
appropriate response by the nurse:
A. not to worry. Tolerance will develop
B. the physician can work with you on changing the dose or drug
C. sexual dysfunction happens with this therapy, and you must learn to accept it
D. this is an unusual occurrence, but it is important to stay on your meds

49. when a pt is being taught about the potential adverse effects of an ACE inhibitor, which of
the following should be mentioned as possibly occurring when this drug is taken to treat
hypertension
A. hypokalemia
B. nausea
C. dry, nonproductive cough
D. sedation

50. When applying a nitro patch it should be placed on

A. non hairy part of the chest
B. thigh
C. upper back
D. buttocks

51. a pt with congestive heart failure is receiving digoxin. What is the desired effect:
A. neck vein distention
B. decreased appetite
C. increased urinary output
D. increased pedal edema

52. a pt has a new prescription for an adrenergic drug. During a review of the pt's list of
current meds, which would cause concern about a possible interaction with this new
prescription:
A. a benzodiazepine taken as needed for allergies
 CARDIOVASCULAR TEST QUESTIONS
B. a multivitamin with iron
C. an oral anticoagulant
D. NSAIDS

53. A pt has a potassium level of 6.0 and a digoxin level of 3.0. What medication would the
nurse be giving:
A. digibind
B. sodium citrate
C. epinephrine
D. lidocaine

54. positive inotropic action does which of the following?

A. decreases heart rate
B. decreases cellular conduction
C. increases contractility

55. what is the digitalizing dose of Digoxin (Lanoxin)?

A. 0.125-0.5
B. 0.5-2
C. 0.5-3

56. Hypokalemia is a potential side effect of Digoxin. You need to educate your pt on
consuming potassium-rich foods. Which of the following will you include in your list of
potassium-rich foods?
A. Eggs
B. strawberries
C. whole grain bread

57. a pt has been admitted with chest pain. He states that it began while he was watching tv
on his couch. Which kind of angina does he likely have?
A. stable
B. unstable
C. variant

58. which of the following is NOT a nursing intervention relevant to administration of

nitroglycerin?
A. inform the pt there may be a burning sensation under their tongue upon ingestion
 CARDIOVASCULAR TEST QUESTIONS
B. inform the pt that this med must be kept in its original bottle
C. inform the pt that a headache is the most common side effect associated with this drug

59. Which group of drugs can be either selective or non-selective?

a. sodium channel blockers
B. beta blockers
C. calcium channel blockers

60. which of the following is a class of antidysrhythmic drug?

A. osmotic
B. carbonic-anhydrase inhibitor
C. beta adrenergic blocker

61. When administering hydrochlorothiazide, which labs must be monitored?

A. BUN, creatinine
B. INR, electrolytes
C. APPT, PTT

62. which of the following is the serum abnormality with thiazides?

A. hyperkalemia
B. hyperglycemia
C. hyperchloremia

63. Which of the following serum abnormalities is unique to loop diuretics?

A. hypokalemia
B. hypomagnesia
C. hyponatremia

64. potassium sparing diuretics work where?

A. collecting distal tubules
B. ascending loop of henle
C. descending loop of henle

65. What is the antidote for heparin?

A. vitamin K
B. immunefab
C. protamine sulfate

C
 CARDIOVASCULAR TEST QUESTIONS
66. which of the following anticoagulants is used prophylactically?
A. heparin
B. lovenox
B. coumadin

67. which of the following drugs are known as "clot busters"?

A. anticoagulants
B. antiplatelets
C. thrombolytics

68. Which of the following must be given within 3 hours of the beginning of an MI or stroke?
A. thrombolytics
B. antiplatelets
C. cardiac glycosides

69. Which drug category has intermittent claudication as a characteristic side effect?
A. peripheral vasodilators
B. diuretics
C. antilipidemics

70. what is the most common side effect of ACE inhibitors?

A. headache
B. persistent dry cough
C. visual disturbances

71. Your pt is on coumadin. You must instruct them to limit their intake of what?
A. milk
B. juice
C. tea

72. A pt is on Spironolactone (Aldactone) and has a potassium level of 5.9. What should the
nurse do?
A. hold the med and contact the physician
B. give the med as prescribed
C. give the pt half the prescribed dose
D. give the pt a banana
 CARDIOVASCULAR TEST QUESTIONS
A

73. Which of the following is a potential side effect of IV furosemide (lasix)?

A. drowsiness
B. diarrhea
C. cystitis
D. hearing loss

74. the nurse reviews lab studies of a pt receiving digoxin (Lanoxin). Intervention by the nurse
is required if the results include which of the following laboratory values?
A. serum digoxin level of 1.2 ng/dL
B. Serum potassium level of 3 mEq/L
C. hemoglobin of 14.4 g/ dL
D. serum sodium level of 140 mEq/L

75. A nurse teaching a pt on correct self administration of sublingual nitroglycerin (Nitrostat)

tablets realizes the pt requires further teaching when they state:
A. I will call an ambulance while administering the 3rd tablet
B. I will not drive while taking nitroglycerin tablets
C. I will keep my tablets in a clear bottle
D. I will not take nitroglycerin with erectile dysfunction medication

76. Your pt is currently taking Digoxin. What should you, as a nurse be prepared to administer
in the event of digitalis toxicity?
A. potassium
B. digibind
C. protamine sulfate
D. heparin

77. Your pt starts showing signs of gynecomastia, which diuretic would you suspect they are
on?
A. potassium-sparing
B. thiazide
C. loop
D. calcium channel blockers

78. The nurse is monitoring a pt taking digoxin (Lanoxin) for treatment of heart failure. Which
assessment finding indicates a therapeutic effect of the drug?
A. HR 110 beats/minute
 CARDIOVASCULAR TEST QUESTIONS
B. HR 58 beats/minute
C. urinary output 40 mL/hr
D. BP 90/50 mm Hg

79. the nurse knows that the mechanism of action of Clopidogrel (Plavix) is to:
A. inhibit the actions of vitamin K
B. turn plasminogen to plasmin
C. inhibit the aggregation of platelets
D. inhibit angiotensin I from converting to angiotensin II

80. nursing interventions for a pt receiving enoxaparin (Lovenox) may include:

A. monitoring multiple lab tests and values
B. monitoring for development of deep vein thrombosis
C. teaching the pt or family to give subcutaneous injections at home
D. teaching to observe for excessive bleeding

81. a client who has been taking warfarin (Coumadin) is admitted with coffee-ground emesis.
What is the nurse's primary action?
A. Administer vitamin E
B. Administer vitamin K
C. Administer protamine sulfate
D. Administer calcium gluconate

82. all potassium-sparing diuretics:

A. are required during blood transfusions
B. enhance aldosterone action
C. cause hypokalemia
D. are weak diuretics

83. when a pt is experiencing digitalis toxicity, in which of the following situations would it be
appropriate to treat with digoxin immune Fab (digibind)
A. hypokalemia
B. hyperkalemia
C. apical heart rate of 60 bpm
D. supraventricular arrhythmias

84. A client receives a dose of furosemide (Lasix) 120 mg intravenously for treatment of
congestive heart failure. Which symptom indicates that an adverse reaction is most likely
occurring?
A. bradycardia
B. weight gain
 CARDIOVASCULAR TEST QUESTIONS
C. hypotension
D. crackles

85. Sublingual nitroglycerin is given to a client who experiences chest pain. Which symptom
can occur with nitroglycerin?
A. tachycardia
B. tinnitus
C. diarrhea
D. Diplopia

86. An elderly client receives instructions regarding the use of warfarin sodium (Coumadin).
Which statement indicates the client understands the possible food interactions which may
occur with this medication?
A. I'm going to miss having my evening glass of wine now
B. I told my daughter to buy bananas for me. I'll have to eat more of those now
C. I will have to watch my intake of salads, something that I really love
D. I am going to begin eating more fish and pork and leave beef alone now

87. An elderly pt is prescribed spironolactone (Aldactone) with the addition of potassium

chloride (Kaochlor). Which statement is a true statement regarding the use of these two
meds together?
A. spironolactone should not have potassium chloride added to the regimen b/c it is a
potassium-sparing diuretic
B. potassium is necessary when clients are placed on spironlocatone b/c it is a loop diuretic
C. spironolactone and potassium chloride have no additive or antagonistic effects with each
other
D. potassium chloride added to spironolactone causes renal failure

88. A 62 y/o male pt has nitroglycerin (Nitrostat) added to his med regimen. Which statement
made by this pt indicates that further education is needed?
A. I will take this med if I have an episode of chest pain
B. I will wait at least 1 hour after I take my sildanefil (Viagra) before using Nitrostat
C. I can take up to 3 tablets every 5 minutes if my angina occurs
D. I know that I must put this tablet under my tongue for it to work

87. which dietary change must a pt make when starting treatment with the med
spironolactone?
 CARDIOVASCULAR TEST QUESTIONS
A. eat extra helpings of bananas
B. increase intake of water
C. avoid salt substitutes
D. increase intake of green leafy veggies

88. a 68 y/o male is experiencing severe hypotension after receiving IV nitroglycerin. What is
the most probable cause for this reaction?
A. pt is having a MI
B. the pt has a high potassium level
C. the pt routinely exercises, but has not be active in over a week
D. the pt failed to report that he is on Viagra

89. a pt receives a nitroglycerin drip. Which is the true statement regarding the use of this
med in IV therapy?
A. vented tubing is needed to administer this med
B. a glass bottle and vented tubing are needed to administer this med
C. admixture must be done under a laminar flow hood with proper handling techniques
D. this med cannot be given through small diameter catheters in elderly pts

90. nitroglycerin is ordered for an elderly pt who is having an episode of chest pain. Which is
a correct statement regarding the use of nitroglycerin spray instead of nitroglycerin tablets in
this age group?
A. there is increased absorption in the older client with the spray
B. older clients attempt to chew the tablet
C. tablets dissolve slower in this population
D. the spray lasts longer in the system

91. alpha-adrenergic blocking agents include medications such as doxazosin and prazosin
hydrochloride. The mechanism of action for these meds is to:
A. inhibit the parasympathetic system
B. stimulate the sympathetic system
C. inhibit the sympathetic system
D. stimulate the parasympathetic system

92. Warfarin works by obstructing certain clotting factors in the clotting cascade. Which info
is correct regarding this mechanism of action?
A. interference with calcium occurs within the clotting cascade
B. increased solubility of vitamin D occurs in the mucosal lining of the stomach
 CARDIOVASCULAR TEST QUESTIONS
C. decreased functioning of vitamin K occurs within the production sites
D. binding with magnesium occurs in the hepatic cells

93. a nurse gives a subq injection of heparin sodium (heparin). Which is a true statement
regarding this injection?
A. massage the area after heparin is administered subq
B. aspiration before injection can cause hematoma formation
C. give the injection each time in the same general area
D. hold the skin taut when giving the injection

94. A pt who is being discharged home will be giving his own enoxaparin sodium (Lovenox)
subq. Which statement by the client indicates the need for further education?
A. i remember that i need to hold the needle at a 45 degree angle
B. i know to pinch the skin up for the injection
C. i will not pull back on the plunger before injecting the med
D. i am going to use the right side of my lower abdomen all the time

Terms in this set (22)

1. The community health nurse is planning health promotion teaching targeted at preventing
coronary artery disease (CAD). Which ethnic group would the nurse select as the highest
priority for this intervention?

A. White male
B. Hispanic male
C. African American male
D. Native American female

A. White male

The incidence of CAD and myocardial infarction (MI) is highest among white, middle-aged men.
Hispanic individuals have lower rates of CAD than non-Hispanic whites or African Americans.
African Americans have an earlier age of onset and more severe CAD than whites and more
than twice the mortality rate of whites of the same age. Native Americans have increased
mortality in less than 35-year-olds and have major modifiable risk factors such as diabetes.
 CARDIOVASCULAR TEST QUESTIONS
2. Which individuals would the nurse identify as having the highest risk for CAD?

A. A 45-year-old depressed male with a high-stress job

B. A 60-year-old male with below normal homocysteine levels
C. A 54-year-old female vegetarian with elevated high-density lipoprotein (HDL) levels
D. A 62-year-old female who has a sedentary lifestyle and body mass index (BMI) of 23 kg/m2

A. A 45-year-old depressed male with a high-stress job

The 45-year-old depressed male with a high-stress job is at the highest risk for CAD. Studies
demonstrate that depression and stressful states can contribute to the development of CAD.
Elevated HDL levels and low homocysteine levels actually help to prevent CAD. Although a
sedentary lifestyle is a risk factor, a BMI of 23 kg/m2 depicts normal weight, and thus the
patient with two risk factors is at greatest risk for developing CAD.

3. When providing nutritional counseling for patients at risk for CAD, which foods would the
nurse encourage patients to include in their diet (select all that apply)?

A. Tofu
B. Walnuts
C. Tuna fish
D. Whole milk
E. Orange juice

A, B, C.

Tuna fish, tofu, and walnuts are all rich in omega-3 fatty acids, which have been shown to
reduce the risks associated with CAD when consumed regularly.

4. Which antilipemic medications should the nurse question for a patient with cirrhosis of the
liver (select all that apply)?

A. Niacin (Nicobid)
B. Ezetimibe (Zetia)
C. Gemfibrozil (Lopid)
D. Atorvastatin (Lipitor)
E. Cholestyramine (Questran)

B, D.

Ezetimibe (Zetia) should not be used by patients with liver impairment. Adverse effects of
atorvastatin (Lipitor), a statin drug, include liver damage and myopathy. Liver enzymes must be
monitored frequently and the medication stopped if these enzymes increase. Niacin's side
effects subside with time, although decreased liver function may occur with high doses.
Cholestyramine is safe for long-term use.
 CARDIOVASCULAR TEST QUESTIONS
5. After teaching a patient with chronic stable angina about nitroglycerin, the nurse
recognizes the need for further teaching when the patient makes which statement?

A. "I will replace my nitroglycerin supply every 6 months."

B. "I can take up to five tablets every 3 minutes for relief of my chest pain."
C. "I will take acetaminophen (Tylenol) to treat the headache caused by nitroglycerin."
D. "I will take the nitroglycerin 10 minutes before planned activity that usually causes chest
pain."

B. "I can take up to five tablets every 3 minutes for relief of my chest pain."

The recommended dose of nitroglycerin is one tablet taken sublingually (SL) or one metered
spray for symptoms of angina. If symptoms are unchanged or worse after 5 minutes, the patient
should be instructed to activate the emergency medical services (EMS) system. If symptoms are
improved, repeat the nitroglycerin every 5 minutes for a maximum of three doses and contact
EMS if symptoms have not resolved completely.

6. The nurse would assess a patient with complaints of chest pain for which clinical
manifestations associated with a myocardial infarction (MI) (select all that apply)?

A. Flushing
B. Ashen skin
C. Diaphoresis
D. Nausea and vomiting
E. S3 or S4 heart sounds

B, C, D, E.

During the initial phase of an MI, catecholamines are released from the ischemic myocardial
cells, causing increased sympathetic nervous system (SNS) stimulation. This results in the
release of glycogen, diaphoresis, and vasoconstriction of peripheral blood vessels. The patient's
skin may be ashen, cool, and clammy (not flushed) as a result of this response. Nausea and
vomiting may result from reflex stimulation of the vomiting center by severe pain. Ventricular
dysfunction resulting from the MI may lead to the presence of the abnormal S3 and S4 heart
sounds.

7. When planning emergent care for a patient with a suspected MI, what should the nurse
anticipate administrating?

A. Oxygen, nitroglycerin, aspirin, and morphine

B. Oxygen, furosemide (Lasix), nitroglycerin, and meperidine
C. Aspirin, nitroprusside (Nipride), dopamine (Intropin), and oxygen
D. Nitroglycerin, lorazepam (Ativan), oxygen, and warfarin (Coumadin)

A. Oxygen, nitroglycerin, aspirin, and morphine

The American Heart Association's guidelines for emergency care of the patient with chest pain
 CARDIOVASCULAR TEST QUESTIONS
include the administration of oxygen, nitroglycerin, aspirin, and morphine. These interventions
serve to relieve chest pain, improve oxygenation, decrease myocardial workload, and prevent
further platelet aggregation. The other medications may be used later in the patient's
treatment.

8. The nurse is providing teaching to a patient recovering from an MI. How should resumption
of sexual activity be discussed?

A. Delegated to the primary care provider

B. Discussed along with other physical activities
C. Avoided because it is embarrassing to the patient
D. Accomplished by providing the patient with written material

B. Discussed along with other physical activities

Although some nurses may not feel comfortable discussing sexual activity with patients, it is a
necessary component of patient teaching. It is helpful to consider sex as a physical activity and
to discuss or explore feelings in this area when other physical activities are discussed. Although
providing the patient with written material is appropriate, it should not replace a verbal
dialogue that can address the individual patient's questions and concerns.

9. Postoperative care of a patient undergoing coronary artery bypass graft (CABG) surgery
includes monitoring for what common complication?

A. Dehydration
B. Paralytic ileus
C. Atrial dysrhythmias
D. Acute respiratory distress syndrome

C. Atrial dysrhythmias

Postoperative dysrhythmias, specifically atrial dysrhythmias, are common in the first 3 days
following CABG surgery. Although the other complications could occur, they are not common
complications.

10. A patient was admitted to the emergency department (ED) 24 hours earlier with
complaints of chest pain that were subsequently attributed to ST-segment-elevation
myocardial infarction (STEMI). What complication of MI should the nurse anticipate?

A. Unstable angina
B. Cardiac tamponade
C. Sudden cardiac death
D. Cardiac dysrhythmias

D. Cardiac dysrhythmias

The most common complication after MI is dysrhythmias, which are present in 80% of patients.
 CARDIOVASCULAR TEST QUESTIONS
Unstable angina is considered a precursor to MI rather than a complication. Cardiac tamponade
is a rare event, and sudden cardiac death is defined as an unexpected death from cardiac
causes. Cardiac dysfunction in the period following an MI would not be characterized as sudden
cardiac death.

11. The nurse is examining the ECG of a patient who has just been admitted with a suspected
MI. Which ECG change is most indicative of prolonged or complete coronary occlusion?

A. Sinus tachycardia
B. Pathologic Q wave
C. Fibrillatory P waves
D. Prolonged PR interval

B. Pathologic Q wave

The presence of a pathologic Q wave, as often accompanies STEMI, is indicative of complete

coronary occlusion. Sinus tachycardia, fibrillatory P waves (e.g., atrial fibrillation), or a
prolonged PR interval (first-degree heart block) are not direct indicators of extensive occlusion.

12. For which problem is percutaneous coronary intervention (PCI) most clearly indicated?

A. Chronic stable angina

B. Left-sided heart failure
C. Coronary artery disease
D. Acute myocardial infarction

D. Acute myocardial infarction

PCI is indicated to restore coronary perfusion in cases of myocardial infarction. Chronic stable
angina and CAD are normally treated with more conservative measures initially. PCI is not
relevant to the pathophysiology of heart failure, such as left-sided heart failure.

13. The patient comes to the ED with severe, prolonged angina that is not immediately
reversible. The nurse knows that if the patient once had angina related to a stable
atherosclerotic plaque and the plaque ruptures, there may be occlusion of a coronary vessel
and this type of pain. How will the nurse document this situation related to pathophysiology,
presentation, diagnosis, prognosis, and interventions for this disorder?

A. Unstable angina Incorrect

B. Acute coronary syndrome (ACS)
C. ST-segment-elevation myocardial infarction (STEMI)
D. Non-ST-segment-elevation myocardial infarction (NSTEMI)
 CARDIOVASCULAR TEST QUESTIONS
B. Acute coronary syndrome (ACS)

The pain with ACS is severe, prolonged, and not easy to relieve. ACS is associated with
deterioration of a once-stable atherosclerotic plaque that ruptures, exposes the intima to blood,
and stimulates platelet aggregation and local vasoconstriction with thrombus formation. The
unstable lesion, if partially occlusive, will be manifest as unstable angina or NSTEMI. If there is
total occlusion, it is manifest as a STEMI.

14. The patient is being dismissed from the hospital after ACS and will be attending
rehabilitation. What information does the patient need to be taught about the early recovery
phase of rehabilitation?

A. Therapeutic lifestyle changes should become lifelong habits.

B. Physical activity is always started in the hospital and continued at home.
C. Attention will focus on management of chest pain, anxiety, dysrhythmias, and other
complications.
D. Activity level is gradually increased under cardiac rehabilitation team supervision and with
ECG monitoring.

D. Activity level is gradually increased under cardiac rehabilitation team supervision and with
ECG monitoring.
In the early recovery phase after the patient is dismissed from the hospital, the activity level is
gradually increased under supervision and with ECG monitoring. The late recovery phase
includes therapeutic lifestyle changes that become lifelong habits. In the first phase of recovery,
activity is dependent on the severity of the angina or MI, and attention is focused on the
management of chest pain, anxiety, dysrhythmias, and other complications. With early recovery
phase, the cardiac rehabilitation team may suggest that physical activity be initiated at home,
but this is not always done.

15. A patient experienced sudden cardiac death (SCD) and survived. What should the nurse
expect to be used as preventive treatment for the patient?

A. External pacemaker
B. An electrophysiologic study (EPS)
C. Medications to prevent dysrhythmias
D. Implantable cardioverter-defibrillator (ICD)

D. Implantable cardioverter-defibrillator (ICD)

An ICD is the most common approach to preventing recurrence of SCD. An external pacemaker
may be used in the hospital but will not be used for the patient living daily life at home. An EPS
may be done to determine if a recurrence is likely and determine the most effective medication
treatment. Medications to prevent dysrhythmias are used but are not the best prevention of
SCD.

16. A female patient who has type 1 diabetes mellitus has chronic stable angina that is
controlled with rest. She states that over the past few months she has required increasing
amounts of insulin. What goal should the nurse use to plan care that should help prevent
 CARDIOVASCULAR TEST QUESTIONS
cardiovascular disease progression?

A. Exercise almost every day.

B. Avoid saturated fat intake.
C. Limit calories to daily limit.
D. Keep Hgb A1C less than 7%.

D. Keep Hgb A1C less than 7%.

If the Hgb A1C is kept below 7%, this means that the patient has had good control of her blood
glucose over the past 3 months. The patient indicates that increasing amounts of insulin are
being required to control her blood glucose. This patient may not be adhering to the dietary
guidelines or therapeutic regimen, so teaching about how to maintain diet, exercise, and
medications to maintain stable blood glucose levels will be needed to achieve this goal.

17. The nurse assesses the right femoral artery puncture site as soon as the patient arrives
after having a stent inserted into a coronary artery. The insertion site is not bleeding or
discolored. What should the nurse do next to ensure the femoral artery is intact?

A. Palpate the insertion site for induration.

B. Assess peripheral pulses in the right leg.
C. Inspect the patient's right side and back.
D. Compare the color of the left and right legs.

C. Inspect the patient's right side and back.

The best method to determine that the right femoral artery is intact after inspection of the
insertion site is to logroll the patient to inspect the right side and back for retroperitoneal
bleeding. The artery can be leaking and blood is drawn into the tissues by gravity. The
peripheral pulses, color, and sensation of the right leg will be assessed per agency protocol.

18. The nurse prepares a discharge teaching plan for a 44-year-old male patient who has
recently been diagnosed with coronary artery disease. Which risk factor should the nurse
plan to focus on during the teaching session?

A. Type A personality
B. Elevated serum lipids
C. Family cardiac history
D. Hyperhomocysteinemia

B. Elevated serum lipids

Dyslipidemia is one of the four major modifiable risk factors for coronary artery disease (CAD).
The other major modifiable risk factors are hypertension, tobacco use, and physical inactivity.
Research findings related to psychologic states (i.e., type A personality) as a risk factor for
coronary artery disease have been inconsistent. Family history is a nonmodifiable risk factor.
High homocysteine levels have been linked to an increased risk for CAD.
 CARDIOVASCULAR TEST QUESTIONS
19. The nurse instructs a 68-year-old woman with hypercholesterolemia about natural lipid-
lowering therapies. The nurse determines further teaching is necessary if the patient makes
which statement?

A. "Omega-3 fatty acids are helpful in reducing triglyceride levels."

B. "I should check with my physician before I start taking any herbal products."
C. "Herbal products do not go through as extensive testing as prescription drugs do."
D. "I will take garlic instead of my prescription medication to reduce my cholesterol."

D. "I will take garlic instead of my prescription medication to reduce my cholesterol."

Current evidence does not support using garlic in the treatment of elevated cholesterol. Strong
evidence supports the use of omega-3 fatty acids for reduction of triglyceride levels. Many
herbal products are not standardized and effects are not predictable. Patients should consult
with their health care provider before starting herbal or natural therapies.

20. A 52-year-old male patient has received a bolus dose and an infusion of alteplase
(Activase) for an ST-segment elevation myocardial infarction (STEMI). To determine the
effectiveness of this medication, the nurse should assess the patient for the

A. presence of chest pain.

B. blood in the urine or stool.
C. tachycardia with hypotension.
D. decreased level of consciousness.

A. presence of chest pain.

Alteplase is a fibrinolytic that is administered to patients who have had an STEMI. If the
medication is effective, the patient's chest pain will resolve because the medication dissolves the
thrombus in the coronary artery and results in reperfusion of the myocardium. Bleeding is a
major complication of fibrinolytic therapy. Signs of major bleeding include decreased level of
consciousness, blood in the urine or stool, and increased heart rate with decreased blood
pressure.

21. A 74-year-old man with a history of prostate cancer and hypertension is admitted to the
emergency department with substernal chest pain. Which action will the nurse complete
before administering sublingual nitroglycerin?

A. Administer morphine sulfate IV.

B. Auscultate heart and lung sounds.
C. Obtain a 12-lead electrocardiogram (ECG).
D. Assess for coronary artery disease risk factors.

C. Obtain a 12-lead electrocardiogram (ECG).

 CARDIOVASCULAR TEST QUESTIONS
If a patient has chest pain, the nurse should institute the following measures: (1) administer
supplemental oxygen and position the patient in upright position unless contraindicated, (2)
assess vital signs, (3) obtain a 12-lead ECG, (4) provide prompt pain relief first with a nitrate
followed by an opioid analgesic if needed, and (5) auscultate heart sounds. Obtaining a 12-lead
ECG during chest pain aids in the diagnosis.

23. Which patient is at greatest risk for sudden cardiac death?

A. A 42-year-old white woman with hypertension and dyslipidemia

B. A 52-year-old African American man with left ventricular failure
C. A 62-year-old obese man with diabetes mellitus and high cholesterol
D. A 72-year-old Native American woman with a family history of heart disease

B. A 52-year-old African American man with left ventricular failure

Patients with left ventricular dysfunction (ejection fraction < 30%) and ventricular dysrhythmias
after MI are at greatest risk for sudden cardiac death (SCD). Other risk factors for SCD include
(1) male gender (especially African American men), (2) family history of premature
atherosclerosis, (3) tobacco use, (4) diabetes mellitus, (5) hypercholesterolemia, (6)
hypertension, and (7) cardiomyopathy