final coaching cardio

8/3/2019 Final Coaching Cardio

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CARDIOVASCULAR SYSTEM


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1. Which of the following arteriesprimarily feeds the anterior wallof the heart?

a. Circumflex arteryb. Internal mammary artery

c. Left anterior descending artery

d. Right coronary artery


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2. When do coronary arteries primarilyreceive blood flow?

a. During inspiration

b. During diastole

c. During expirationd. During systole


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3. Which of the following conditions mostcommonly results in coronary artery

disease?

a. Atherosclerosis

b. Diabetes mellitusc. Myocardial ischemia

d. Renal failure


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4. Atherosclerosis impedes coronaryblood flow by which of the following

mechanisms?

a. Plaques obstruct the vein

b. Plaques obstruct the arteryc. Blood clots form outside the vessel

wall

d. Hardened vessels dilate to allow bloodto flow through


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5. Which of the following actions is thefirst priority of care for a client

exhibiting signs and symptoms ofcoronary artery disease?

a. Decrease anxietyb. Enhance myocardial oxygenation

c. Administer sublingual nitroglycerin

d. Educate the client about his symptoms


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7. Which of the following is the mostcommon symptom of myocardial

infarction ?

a. Chest pain

b. Dyspneac. Edema

d. palpitations


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8. Which of the following landmarks is thecorrect one for obtaining an apical

pulse?

a. Left 5th ICS, midaxillary line

b. Left 5th ICS, midclavicular linec. Left 2nd ICS, midclavicular line

d. Left 7th ICS, midclavicular line


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9. A murmur is heard at the second leftICS along the left sternal border.

Which valve area is this?

a. Aortic

b. Mitralc. Pulmonic

d. Tricuspid


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10. Which of the following conditions ismost commonly responsible for

myocardial infarction?

a. Aneurysm

b. Heart failurec. Coronary artery thrombosis

d. Renal failure


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11. What is the primary reason foradministering morphine to client with a

myocardial infarction?

a. To sedate the client

b. To decrease the clients painc. To decrease the clients anxiety

d. To decrease oxygen demand on theclients heart


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12. What supplemental medications ismost frequently ordered in conjunction

with furosemide?

a. Chloride

b. Digoxinc. Potassium

d. Sodium


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13. Which of the following complicationsis indicated by a third heart sound

(S3)?

a. Ventricular dilation

b. Systemic hypertensionc. Aortic valve malfunction

d. Increased atrial contractions


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14. After an anterior wall myocardialinfarction, which of the following

problems is indicated by auscultationof crackles in the lungs?

a. Left sided heart failureb. Pulmonic valve malfunction

c. Right sided heart failure

d. Tricuspid valve malfunction


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15. What is the first interventionfor a client experiencingmyocardial infarction?

a. Administer morphineb. Administer oxygen

c. Administer sublingualnitroglycerin

d. Obtain an electrocardiogram


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16. Which of the following classes ofmedications protects the ischemic

myocardium by blockingcatecholamines and sympatheticnerve stimulation?

a. Beta-adrenergic blocker

b. Calcium channel blockerc. Narcotics

d. Nitrates


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17. What is the most commoncomplication of a myocardialinfarction?

a. Cardiogenic shockb. Heart failure

c. Arrythmiasd. Pericarditis


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18. Which of the following

parameters should be checkedbefore administering digoxin?

a. Apical pulseb. Blood pressure

c. Radial pulsed. Respiratory pulse


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19. Toxicity from which of the

following medications maycause a client to see a greenhalo lights?

a. Digoxin

b. Furosemidec. Metoprolol

d. Enalapril


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20. Stimulation of the sympatheticnervous system produces which ofthe following responses?

a.Bradycardiab.Tachycardia

c.Hypotensiond.Decreased myocardialcontractility


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21. What is the most commoncause of an abdominal aorticaneurysm?

a.Atherosclerosisb.Diabetes mellitus

c.Hypertensiond.Syphilis


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22. A pulsating abdominal massusually indicates which of thefollowing conditions?

a.Abdominal aortic aneurysmb.Enlarged spleen

c.Gastric distensiond.Gastritis


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23. What is the most commonsymptom in a client withabdominal aortic aneurysm?

a.Abdominal painb.Diaphoresis

c.Headached.Upper back pain


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24. When assessing a client for anabdominal aortic aneurysm, which area

of the abdomen is most commonlypalpated?

a. Right upper quadrantb. Directly over the umbilicus

c. Middle lower abdomen to the let of the

midlined. Middle lower abdomen to the right of

the midline


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25. Which of the following soundsis distinctly heard on auscultation

over the abdominal region of anabdominal aneurysm clients?

a.Bruit

b.Crackles

c.Friction rubsd.Dullness


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26. Which of the following cardiacconditions does a fourth heart

sound (S4) indicate?

a.Dilated aortab.Normally functioning heart

c.Decreased myocardial contractility

d.Failure of the ventricle to eject allthe blood during systole


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27. Which of the following conditionsis associated with a predictable

level of pain that occurs as a resultof physical or emotional stress?

a. Anxiety

b. Stable angina

c. Unstable anginad. Variant angina


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28. After undergoing a cardiaccatheterization, the client ha a large

puddle of blood under his buttocks.Which of the following steps should thenurse take first?

a. Call for help

b. Obtain vital signs

c. Ask client to lift upd. Apply gloves and assess the groin site


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29. Which of the following

medications is the drug ofchoice for angina pectoris?

a. Aspirinb. Furosemide (Lasix)

c. Nitroglycerind. Nifedipine


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30.Which of the followingconditions is the predominantcause of angina?

a.Increased preloadb.Decreased afterload

c.Coronary artery spasmd.Inadequate oxygen supply to themyocardium


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31. Which of the following treatments is asuitable surgical intervention for

unstable angina?

a. Cardiac catheterization

b. Echocardigramc. Nitroglycerin

d. Percutaneous transluminal coronary

angioplasty (PTCA)


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32. Which of the following percentagesrepresents the amount of damage the

myocardium must sustain before signsand symptoms of cardiogenic shockdevelop?

a. 10%

b. 25%

c. 40%d. 90%


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33. Which of the following diagnosticstudies can determine when cellular

metabolism becomes anaerobic andwhen pH decreases?

a.Arterial blood gas (ABG) levels

b.Complete blood count (CBC)

c.Electrocardiogram (ECG)d.Lung scan


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34. Which of the following factorscan cause blood pressure to drop to

normal levels?a. kidneys excretion of sodium only

b. Kidneys retention of sodium andwater

c. Kidneys excretion of sodium and

waterd. Kidneys retention of sodium and

excretion of water


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35. Baroreceptors in the carotidartery walls and aorta respond to

which of the following conditions?

a. Changes in blood pressure

b. Changes in arterial oxygen tension

c. Changes in arterial carbon dioxide

tensiond. Changes in heart rate


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36. Which of the following hormonesis responsible for raising arterial

pressure and promoting venousreturn?

a. Angiotensin I

b. Angiotensin II

c. Thyroid hormoned. Insulin


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37. Which of the following terms isused to describe persistently

elevated blood pressure with anunknown cause that accounts forapproximately 90% of hypertension

cases?a. Accelerated hypertension

b. Malignant hypertensionc. Primary hypertension

d. Secondary hypertension


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38. The hypothalamus respondsto a decrease in blood pressureby secreting which of thefollowing substances?

a. Angiotensin

b. Antidiuretic hormone (ADH)c. Epinephrine

d. Renin


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39. Which of the following partsof the eye is examined to seearterial changes caused byhypertension?

a.Cornea

b.Foveac.Retina

d.Sclera


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40. Which of the followingconditions causes varicose veins?

a.Tunica media tear

b.Intraluminal occlusionc.Intraluminal valvular compression

d.Intraluminal valvularincompetence


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41. Which of the followingfactors causes primary varicoseveins?

a. Hypertensionb. Pregnancy

c. Thrombosisd. Trauma


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42. Which of the followingsymptoms commonly occur in a

client with varicose veins?

a. Fatigue and pressureb. Fatigue and cool feet

c. Sharp pain and fatigued. Sharp pain and cool feet


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43. Which of the followingactivities should a client withvaricose veins avoid?

a. Exerciseb. Leg elevation

c. Prolonged lyingd. Wearing tight clothing

44 h h f h f ll


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44. Which of the followingtreatments is recommended for

postoperative management of aclient who has undergone ligationand stripping?

a. Sittingb. Bedrest

c. Ice packsd. Elastic leg compression


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45. Which of the followingfactors usually causes deep veinthrombosis (DVT)?

a. Aerobic exerciseb. Inactivity

c. Pregnancyd. Tight clothing


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46. Which of the following terms isused to describe a thrombus lodged

in the lungs?

a. Hemothoraxb. Pneumothorax

c. Pulmonary embolism

d. Pulmonary hypertension

47 Whi h f h f ll i


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47. Which of the followingcharacteristics is typical of the

pain associated with deep veinthrombosis (DVT)?

a. Dull acheb. No pain

c. Sudden onsetd. Tingling


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48. Which of the following oralmedications is administered toprevent further thrombusformation?

a. Warfarin (Coumadin)b. Heparin

c. Furosemided. Metoprolol (Lopressor)

49 Whi h f th f ll i i


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49.Which of the following is acompensatory response to

decreased cardiac output?a. Decreased blood pressure

b. Alteration in level ofconsciousness (LOC)

c. Decreased blood pressure and

diuresisd. Increased blood pressure andfluid volume


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50. Which of the following termsdescribes the force againstwhich the ventricle must expelblood?

a. Afterload

b. Cardiac output

c. overload

d. Preload


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51. How quickly can an episode ofacute pulmonary edemadevelop?

a. In minutesb. In hour

c. In 1 hourd. In 3 hours

52 Whi h f th f ll i t i


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52. Which of the following terms isused to describe the amount of

stretch on the myocardium at theend of diastole?

a. Afterloadb. Cardiac index

c. Cardiac outputd. Preload

53 A 57 ld li i h hi f


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53. A 57 year old client with a history ofbronchial asthma is prescribed

propranolol (Inderal) to controlhypertension. Before administeringpropranolol, which of the followingactions should the nurse take first?

a. Monitor the apical pulse rateb. Instruct the client to take the

medication with food

c. Question the physician about the orderd. Caution the client to rise slowly when

standing

54 One h ur after administerin I V


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54. One hour after administering I.V.fursosemide (Lasix) to a client with

heart failure, a short burst ofventricular tachycardia appears on thecardiac monitor. Which of thefollowing electrolyte imbalances shouldthe nurse suspect?

a. Hypocalcemia

b. Hypermagnesemia

c. Hypokalemia

d. Hypernatremia

55 A 35 year old client was admitted to the


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55. A 35 year old client was admitted to thecoronary care unit (CCU) 2 days ago with anacute myocardial infarction. Which of the

following actions would breach clientconfidentiality?a. The CCU nurse gives a verbal report to the

nurse on the telemetry unit before

transferring the client to that unitb. The CCU nurse notifies the on-call physicianabout a change in the clients condition

c. The emergency department nurse calls up

the latest electrocardiogram results tocheck the clients progress

d. At the clients request, the CCU nurseupdates the clients wife on his condition


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56. For a client who is being treatedfor ventricular tachycardia, why

should the teaching plan include aninstruction to eat foods such asbananas?

a. Because bananas are high incarbohydrate

b. Because bananas are high in

potassiumc. Because bananas are low in sodium

d. Because bananas are high in fiber


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58. A 54 year old client is admitted with anacute inferior-wall myocardium infarction(MI). During the admission interview, hesays he stopped taking his metoprolol(Lopressor) 5 days ago because he wasfeeling better. Which of the followingnursing diagnosis takes priority for this

client?a. Anxietyb. Ineffective tissue perfusion

(Cardiopulmonary)c. Acute paind. Ineffective therapeutic regimen

management

59 When developing a teaching plan for a


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59. When developing a teaching plan for aclient with endocarditis, which of the

following points is most essential forthe nurse to include?

a. Report fever, anorexia, and nightsweats to the physician.

b. Take prophylactic antibiotics afterdental work and invasive procedures.

c. Include potassium-rich foods in yourdiet.

d. Monitor your pulse rate daily.

60 Which finding suggests that fluid


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60. Which finding suggests that fluidresuscitation has been effective

for a 23 year old client admittedin hypovolemic shock?

a. Urine ouput of 15 ml/hrb. Urine output of 20ml/hr

c. Urine output of 30ml/hrd. Urine output of 30ml/hr

61 A client seems anxious immediately


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61. A client seems anxious immediatelyafter the physician tells him that hehas suffered an acute myocardial

infarction. Which of the followingactions should the nurse take?

a. Leave the room to give the client

privacyb. Walk over to the client and say,Youseem anxious.

c. Offer the client a sedatived. Ask the chaplain to spend time withthe client

62 The physician orders total serum


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62. The physician orders total serumcalcium measurements in a client

who experiences an arrhthymia. Toensure an accurate calcium level,which other laboratory value should

be measured?a. serum albumin

b. Serum potassium

c. Serum magnesium

d. Serum vitamin D

63 A 45 year old client admitted with an


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63. A 45 year old client admitted with anacute inferior myocardial infarction(MI) undergoes emergency cardiaccatheterization. The nurse shouldexpect an occlusion in which coronaryartery?

a. Right coronary arteryb. Circumflex arteryc. Left anterior descending artery,

diagonal branchd. Left anterior descending, septalbranch

64 When auscultating the heart of


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64. When auscultating the heart ofthe client with heart failure, the

nurse hears an extra heart soundimmediately after an S2. howshould the nurse document this

sound?a. As a first heart sound (S1)

b. As a third heart sound (S3)

c. As a fourth heat sound (S4)

d. As a murmur

65 A client is scheduled for a cardiac


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65. A client is scheduled for a cardiacangiography. In reviewing the clientsrecord what significant finding needs

to be reported to the physician beforethe exam?

a. The client reported an allergy to

shrimpb. The clients ECG shows atrialfibrillation

c. The potassium level is 5.0mEq/L.d. The client has a history of chronicrenal failure

66. The nurse is developing a plan for a client


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66. The nurse is developing a plan for a clientwho is going home with a new diagnosis ofheart failure. The nurse is teaching the

client to monitor fluid status. The bestinstruction is to teach the client to do whichof the following?

a. Restrict fluid intake to 800ml per day

b. Increase the dose of diuretics of there isdecreased urinationc. Record body weight every day before

breakfast and report a weight gain of 3 or

more pounds in a weekd. Keep track of daily output and call the

doctor for if it is less than 1L on any day

67 The nurse is caring for a client who has just


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67. The nurse is caring for a client who has justhad a cardiac catheterization. The clientinsists on getting up to go to the bathroomto urinate immediately when he is broughtback to his room. Which of the followingwould be the nurse best response?

a. You cant walk yet. You may be too weakafter the procedure and may fall.

b. If you bend your leg, you will risk bleedingfrom the insertion site. It is an artery, andit could lead to complications.

c. If you get out of bed, you may have an

arrhythmia.d. the doctor has ordered that you stay onbedrest for the next 6hours. It is importantthat you follow these orders.

68. A client is getting ready to go home after a


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68. A client is getting ready to go home after amyocardial infarction. The client is askingquestions about his medications, and wants

to know why metoprolol (Lopressor) wasprescribed. The nurses best response wouldbe which of the following?

a. Your heart was beating too slowly, and

Lopressor increases your heart rateb. Lopressor helps to increase the bloodsupply to the heart by dilating your coronaryarteries

c. This medication helps make your heart beatstronger to supply more blood to your body.d. It slows your heart rate and decreases the

amount of work it has to do so it can heal.

69 A client is taking digoxin (Lanoxin) and


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69. A client is taking digoxin (Lanoxin) andfurosemide (Lasix) for heart failure.

Which of the following would be thebest menu choices for this client?

a. Chicken with baked potato

b. Eggs and hamc. Grilled cheese sandwich and Frenchfried potatoes

d. Pizza with pepperoni

0 d d d h d d


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70. Cardiac disorder that is considered asSilent killer?

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