Drills on Cardiovascular Health Problems 1. The nurse is preparing a client for a cardiac catheterization.

What is the best explanation regarding the purpose of cardiac catheterization with coronary angiography? a. Evaluate the exercise tolerance. b. Study the conduction system. c. Evaluate coronary artery blood flow.

d. Measure the pumping capacity of the heart.

2. The nurse is administering nitroglycerin intravenously to relieve chest pain. What is the therapeutic action medication? a. Increases diuresis and glomerular filtration, which results in decreased venous return. b. Increases the force of contraction of the myocardium, thereby increasing oxygen delivery. c. Produces an immediate analgesic effect and relieves chest pain.

d. Increases the coronary blood supply and decreases the afterload.

3. The client who experiences angina has been told to follow a low-cholesterol diet. Which of the following meals should the nurse tell the client would be best on her low-cholesterol diet? a. hamburger, salad, and milkshake b. c. d. baked liver, green beans, and coffee spaghetti with tomato sauce, salad, and coffee Fried chicken, green beans, and skim milk

4. 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. c. d. Pain during sexual activity. Pain during an argument with her husband. Pain during or after an activity such as lawn-mowing.

5. 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 blocked coronary arteries. b. c. d. Assess the extent of arterial blockage. Bypass obstructed vessels. Assess the functional adequacy of the valves and heart muscle.

6. A client with angina asks the nurse, What information does an ECG provide?. The nurse would respond that electrocardiogram (ECG) primarily gives information about the: a. Electrical conduction of the myocardium. b. c. d. Oxygenation and perfusion of the heart. Contractile status of the ventricles. Physical integrity of the heart muscle.

7. The nurse teaches the client with angina about the common side effects of nitroglycerin, including: a. Headache. b. c. d. High blood pressure Shortness of breath Stomach cramps

8. A 60-year old male client comes into the ER with complaints of crushing substernal chest pain that radiates to his shoulder and left arm. Immediate admission orders include oxygen by nasal cannula at 4 L/minute, blood work, a chest radiograph, a 12-lead ECG, and 2 mg of morphine sulfate given intravenously. The nurse should first: a. Administer the morphine, as ordered. b. Obtain a 12-lead ECG. c. d. Obtain the blood work. Administer oxygen via nasal cannula.

9. When administering a thrombolytic drug to the client experiencing MI, the nurse explains to him that the purpose of this drug is to: a. Help keep him well hydrated. b. c. d. Dissolve clots that he may have. Prevent kidney failure. Threat potential cardiac dysrythmias.

10. Aspirin is administered to the client experiencing an MI because of its: a. Antipyretic action b. c. d. Antithrombotic action Antiplatelet action Analgesic action

11. The nurse is assessing a client whose condition is being stabilized after an MI. What finding on the nursing assessment would indicate renal perfusion? a. Decreasing serum blood urea nitrogen (BUN) level. b. c. d. Specific gravity of less than 1.010 Urine output of less than 30 ml/hr Low urine osmolarity and creatinine clearance.

12. A 72-year old woman is admitted to the telemetry unit for placement of a permanent pacemaker. A priority goal for the client within 24-hours after insertion of a permanent pacemaker would be to: a. Maintain skin integrity. b. c. d. Maintain cardiac conduction stability. Decrease cardiac output. Increase activity level.

13. The client who had a permanent pacemaker implanted 2 days earlier is being discharged from the hospital. Outcome criteria include that the client: a. Selects a low-cholesterol diet to control coronary artery disease.

b. c. d.

States a need for bed rest for 1 week after discharge. Verbalizes safety precautions needed to prevent pacemaker malfunction. Explains signs and symptoms of myocardial infarction.

14. A 69-year old woman has a history of heart failure. She is admitted to the emergency department with heart failure complicated by pulmonary edema. On admission of this client, which of the following should be assessed first? a. Blood pressure. b. c. d. Skin breakdown. Serum potassium. Urine output.

15. In which of the following positions should the nurse place a client with suspected heart failure? a. Semi-sitting (Low Fowlers position). b. c. d. Lying on the right side (Sims position). High Fowlers position. Trendelenburg position.

16. Which of the following would be a priority nursing diagnosis for a client with heart failure and pulmonary edema? a. Risk for infection related to line placements. b. c. d. Impaired skin integrity related to pressure. Activity intolerance related to imbalance between oxygen supply and demand. Constipation related to immobility.

17. Digoxin is administered intravenously to a client with heart failure, primarily because this drug acts to: a. Dilate coronary arteries. b. c. Increase myocardial contractility. Decrease cardiac dysrythmias.

d.

Decrease electrical conductivity in the heart.

18. The nurse teaches the client with heart failure to take oral furosemide in the morning. The primary reason for this is to help: a. Prevent electrolyte imbalances. b. c. d. Retard rapid drug absorption. Excrete excessive fluids accumulated during the night. Prevent sleep disturbances during the night.

19. The nurse should teach the client that signs of digitalis toxicity include which of the following: a. Skin rashes over the chest and back. b. c. d. Increased appetite. Visual disturbances such as seeing yellow spots. Elevated blood pressure.

20. To help maintain a normal blood serum level of potassium, the client receiving loop diuretic should be encouraged to eat such foods as bananas, orange juice, and: a. Spinach. b. c. d. Skimmed milk. Baked chicken. Brown rice.

21. The nurses discharge planning for the client with congestive heart failure would stress the significance of which of the following? a. Maintaining a high-fiber diet. b. c. d. Walking 2 miles everyday. Obtaining daily weights at the same time each day. Remaining sedentary for most of the day.

22. The nurse has been assigned to a client with Raynauds disease. The nurse realizes that the underlying etiology of Raynauds disease is unknown but that it is characterized by: a. Episodic vasospastic disorder of the small arteries. b. c. d. Episodic vasospastic disorder of the small veins. Episodic vasospastic disorder of the capillaries. Episodic vasospastic disorder of the aorta.

23. The nurse should instruct a client who has been diagnosed with Raynauds disease to: a. Immerse her hands in cold water during an episode. b. c. d. Wear light garments when the temperature gets below 10 Celsius. Wear gloves when handling ice or frozen foods. Live in a cold climate.

24. Stress can produce vasospasm in clients with Raynauds disease. The client states she is worried about making the necessary behavioral changes to control the vasospastic episodes. Which of the following nursing diagnosis is appropriate? a. Activity intolerance related to Raynauds disease. b. c. d. Anxiety related to change in health status. Disturbed body image related to illness treatment. Impaired social interaction related to self-concept disturbance.

25. The nurse has been assigned to a client with Buergers disease. Which of the following anatomic areas are most often affected by this vascular condition? a. Hands and fingers. b. c. d. Lower legs and feet. Head and neck. Lower back.

26. A 30-year old male client is admitted with Buergers disease. Which of the following factors has increased the clients risk for development of Buergers disease?

a. History of cigarette smoking. b. c. d. Occupational exposure to radiation. Age and gender. History of hypertension.

27. The client with Buergers disease experiences which of the following signs or symptoms? a. Thickening of the intima and media of the artery. b. c. d. Inflammation and fibrosis of arteries, veins, and nerves. Vasospasm lasting several minutes. Pain, pallor, and pulselessness.

28. Which of the following is the most important goal of nursing care for a client who is in shock? a. Manage fluid overload. b. c. Manage increased cardiac output. Manage inadequate tissue perfusion.

d. Manage vasoconstriction of vascular beds.

29. Which of the following nursing assessment findings indicates hypovolemic shock in a client who has had a 15% blood loss? a. Pulse rate less than 60 bpm. b. c. d. Respiratory rate of 4 breaths/minute. Pupils unequally dilated. Systolic blood pressure less than 90 mm Hg.

30. Which of the following findings is the best indication that fluid replacement for the client in hypovolemic shock is adequate? a. Urine output greater than 30 mL/hour. b. c. Systolic blood pressure greater than 110 mm Hg. Diastolic blood pressure greater than 90 mm Hg.

d.

Respiratory rate of 20 breaths/minute.

31. What is the priority assessment for the client in shock who is receiving an intravenous infusion of
packed red blood cells and normal saline solution? a. Fluid balance. b. c. Anaphylactic reaction. Pain.

d. Altered level of consciousness.

32. Which of the following would be an essential nursing action for the client who is receiving dopamine hydrochloride for treatment of shock? a. Administer pain medication concurrently. b. c. d. Monitor blood pressure continuously. Evaluate arterial blood gases at least every 2 hours. Monitor for signs of infection.

33. What nursing intervention is most important in preventing septic shock? a. Administering intravenous fluid replacement therapy as ordered. b. c. d. Obtaining vital signs every 4 hours for all client. Monitoring red blood cell counts for elevation. Maintaining asepsis of indwelling urinary catheters.

34. A client is discharged after being hospitalized for thrombophlebitis. She will be driving home with her daughter, who lives 2 hours away. During the 2-hour ride the client should: a. Perform arm circles while riding the car. b. c. d. Perform active ankle and foot range-of-motion exercises. Elevate her legs while riding in the car. Take an ambulance home.

35. A client is receiving an IV infusion of 5% dextrose in water (D5W). The skin around the IV insertion site is red, warm to touch, and painful. The nurse should first: a. Administer acetaminophen (Tylenol). b. c. d. Change the D5W to normal saline. Discontinue the IV. Place a warm compress on the area.

36. Bed rest is related to an increased incidence of thrombophlebitis. The plan of care for a client on bed rest would not include a. Turning every 2 hours. b. c. d. Passive and active range-of-motion exercises. Use of thromboembolytic disease support (TED) hose. Maintaining the client in the supine position.

37. The nurse understands that certain risk factors are related to DVT. Which of the following is one such risk factor? a. The client exercises on a regular basis. b. c. d. The client lives alone at home. The client recently had abdominal surgery. The client wears antithrombotic hose on a regular basis.

38. With a client who has undergone abdominal or pelvic surgery, the nurse implements strategies to
prevent a DVT. Interventions for promoting the circulation in the lower extremities include: a. Avoiding fluids. b. c. d. Encouraging deep breathing. Remaining sedentary. Using pneumatic compression stockings.

39. A client weighs 300 pounds and has a history of DVT and thrombophlebitis. When reviewing a teaching plan with this client, the nurse knows that the client has understood the nurses instructions when he states he will: a. Avoid exercise. b. c. d. Lose weight. Perform leg lifts every four hours. Wear support hose using rubber bands to hold the stockings up.

40. Which of the following clients is at risk for varicose veins? a. A client who has had a cerebral vascular accident. b. c. d. A client who has anemia. A client who has had thrombophlebitis. A client who has had transient ischemia attacks.