POWERHOUSE MSN 1 IFC PNLE 2024-CARDIOVASCULAR ; CIRCULATORY & HEMATOLOGIC

Nino Roman O. Sayson BSN RM PHRN USRN CCRN MHPEdc MSNc

1. A client with congestive heart failure (CHF) has gained 7 pounds since yesterday. In assessing this situation, it would be
most important for the nurse to
a) ask the client if he or she needs the backrest higher to breathe comfortably.
b) check the client’s 24-hour intake-output record for the past 2 days.
c) auscultate the lungs for a pericardial friction rub.
d) Examine the client’s legs and sacral area.
2. A client returns from a cardiac catheterization with a bandage over the right groin. An unlicensed personnel (UP)
assigned to the client reports that the client’s right foot is cool to the touch. The first action of the nurse should be to
a) check the foot every 15 minutes.
b) call the provider and report the findings.
c) loosen the bandage.
d) check the client’s groin.
3. An eight-year-old girl suffered a partial thickness scald burn over most of her anterior thigh and lower leg. What
admission assessment would give the nurse the most data about the probability of shock occurring?
a) Edema, weeping blisters, high serum potassium, low serum sodium.
b) Tachycardia, hyperventilation, and a pale appearance.
c) Variations in hyperthermia and hypothermia, and decreased gastric motility.
d) Anemia from red blood cell loss through damaged capillaries.
4. The mother of a child who just returned from a cardiac catheterization asks the nurse why her son has to keep his leg
traight for 4-6 hours. The nurse’s response includes which of the following statements?
a) “This will minimize pain and discomfort.”
b) “This will facilitate healing of the vessel.”
c) “This will promote adequate rest for the heart.”
d) “This will maintain circulation.”
5. A client who was hospitalized for congestive heart failure is getting ready to discharge on 40 mg furosemide (Lasix)
once a day by mouth (PO). The nurse should include which of the following in the teaching plan.
a) signs and symptoms of hypertension
b) signs and symptoms of hypokalemia
c) advising client to go to the beach to be exposed to direct sunlight
d) advising the client to take Lasix before bed.
6. The nurse knows that when assessing a client suspected of having a myocardial infarction it is most important to ask
which of the following?
a) “What medications are you currently taking?”
b) “Have you ever had similar symptoms in the past?”
c) “How long ago did these symptoms start?”
d) “Have you been under a lot of stress lately?”
7. Prior to administering morphine IV push to a client with chest pain, the nurse should
a) evaluate the EKG.
b) not administer the drug; it is outside the RN scope of practice.
c) perform the Glasgow coma scale to evaluate neurologic status.
d) check the blood pressure.
8. A client is discharged on digoxin (Lanoxin) 0.25 mg po daily. Which statement by the client would reflect an
understanding of the discharge teaching?
a) “I will notify the clinic if I experience increased urinary output.”
b) “If I experience an increase in heart rate I will notify the clinic.”
c) “I will notify the clinic if I experience nausea and vomiting.”
d) If I experience an increase in muscle strength, I will notify the clinic.”
9. A client, with a history of congestive heart failure, is admitted to the hospital complaining of changes in vision, nausea,
and vomiting. Stat diagnostic studies are ordered. The nurse expects which finding?
a) Digoxin level of 2.2 ng/ml
b) Digoxin level of 0.5 ng/ml
c) Serum potassium of 5.5 mEq/L
d) Serum potassium of 2.0 mEq/
11. The nurse is caring for a client who has just returned to the surgical unit following a femoral
arteriogram. Which initial assessment by the nurse is most essential?
a) Auscultating the lungs.
b) Obtaining a blood pressure.
c) Palpating the carotid pulse.
d) Inspecting the groin area.
12. The nurse is caring for a man who has angina. He complains of chest pain. Nitroglycerin is given
because it
a) slows and strengthens the heart rate.
b) assists smooth muscles to contract.
c) increases venous return to the heart.
d) reduces both preload and afterload.
13. A patient has received thromboembolytic therapy following a Myocardial Infarction with Streptokinase.
Which of the following drugs should the nurse have on hand if the patient develops excessive bleeding or
hemorrhage?
a) Protamine Sulfate
b) Aminocaproic Acid (Amicar)
c) Vitamin K
d) Heparin
14. A 67-year-old was admitted with a diagnosis of left-sided heart failure. Furosemide (Lasix) 80 mg was
given slowly by IV push. The nurse is assessing the client following administration of the medication.
Which finding indicates that the furosemide (Lasix) is not having the desired effect?
a) Oliguria.
b) Decrease in blood pressure.
c) Absence of rales.
d) Polydipsia.
15. Mr. A. is receiving Coumadin (warfarin) 5 mg po qd for treatment of a resolving deep vein thrombosis.
The nurse is ready to administer his daily dose of Coumadin when she observes several ecchymotic
areas on the client's extremities. When asked, the client states his gums have been bleeding when he
brushes his teeth. Which nursing action is most appropriate?
a) Administer the daily dose of Coumadin, then notify the physician so tomorrow's dose can be
adjusted.
b) Administer the daily dose of Coumadin. These are the expected side effects of Coumadin.
c) Hold the Coumadin and notify the physician of the assessment findings.
d) Hold the Coumadin until the next daily dose is due.
16. An adult male client is admitted with a diagnosis of acute M.I. (myocardial infarct). He is attached to a
cardiac monitor and has an IV catheter in place. His cardiac rhythm has been normal sinus rhythm with
occasional PVCs. The nurse notes a sudden change on the cardiac monitor screen to a very irregular,
chaotic-looking pattern. The client appears to be sleeping. The most appropriate action on the part of the
nurse is to
a) Administer a precordial thump.
b) obtain the defibrillator.
c) begin cardiopulmonary resuscitation.
d) check the client's ECG electrodes.
17. The nurse is caring for a client with a newly implanted pacemaker. When monitoring pacemaker
functioning, which of the following should the nurse initially assess?
a)Electrocardiogram.
b)Pulse.
c) Blood pressure.
d)Incision site.
18. The nurse is caring for a client with Raynaud's phenomenon. The nurse should instruct the client to
avoid which of the following situations?
a) Living in a warm climate.
b) Active exercising.
c) Exposure to cold temperatures.
d) Alcohol consumption.
19. The nurse is assisting a child with congestive heart failure. Which of the following would the child be
least likely to manifest?
a)Weakness and fatigue.
b)Dyspnea.
c) Tachycardia.
d)Oliguria.
20. The nurse is performing a cardiovascular assessment on an elderly client. What findings would be
expected?
a)A bounding radial pulse.
b)An early systolic murmur.
c) First-degree heart block.
d)Frequent bursts of tachycardia
 CARDIOVASCULAR , CIRCULATORY AND HEMATOLOGIC IFC 2024 set 2

1. A 55-year-old man with a history of angina pectoris, complains of chest pain radiating
to the jaw. After taking three nitroglycerin gr 1/150 tablets he is still having the chest
pain. His skin is cool and pale and he is diaphoretic and mildly short of breath. The best
initial action for the nurse to take is to
A. auscultate heart and lung sounds.
B. administer another nitroglycerin tablet.
C. initiate telemetry monitoring.
D. assist him to a supine position.
2. An adult male is being discharged from the hospital following a myocardial infarction.
The nurse knows that he understands the guidelines for resuming sexual activity if he
states that
A. bedtime is the best time to have intercourse.
B. he should exercise for 10 - 15 minutes before intercourse, to "warm up".
C. he should take a nitroglycerin before intercourse to prevent chest pain.
D. it is best to avoid having intercourse when the stomach is empty.
3. Ms. G. is scheduled for a percutaneous transluminal coronary angioplasty (PTCA).
She says to the nurse, "Can you tell me again what the doctor is going to do? I don't
remember exactly what she told me." The most appropriate response by the nurse would
be,
A. "A clot dissolving drug is administered through a catheter into the blocked section
of your artery."
B. "A piece of vein from your leg is used to bypass the blocked section of your
artery."
C. "A tiny rotating blade is used to scrape off the plaque that is blocking your artery."
D. "A balloon is placed next to the plaque blocking your artery, then the balloon is
inflated to crush the plaque."
4. Mr. P. is being discharged following coronary artery bypass graft surgery (CABG). The
nurse recognizes that Mr. P. needs additional teaching if he makes which of the
following statements?
A. "I'll be going to a support group to help me quit smoking."
B. "I need to use a golf cart instead of walking around the course."
C. "I should bake or broil my chicken instead of frying it."
D. "I've learned a breathing exercise to help me calm down if I get upset."
5. An adult is on long-term aspirin therapy and is experiencing tinnitus. The nurse best
interprets this to mean
A. the aspirin is working correctly.
B. the client ingested more medicine than was recommended.
C. the client has an upper GI bleed.
D. he is experiencing a mild overdosage.
6. Which of the following assessment findings by the nurse indicates right ventricular
failure in a client?
A. Pink frothy sputum.
B. Paroxysmal nocturnal dyspnea.
C. Jugular venous distention.
D. Crackles.
7. A nurse is assessing a client with fatigue, tachycardia, crackles, and pink frothy
sputum. Which nursing diagnosis is of the most importance?
A. Impaired skin integrity.
B. Impaired gas exchange.
C. Potential for injury.
D. Anxiety.
8. Mr. P. is admitted with an acute exacerbation of congestive heart failure. His vital
signs are: T 99, P 115, R 32, BP 154/100. His ankles are edematous and crackles are
auscultated at the bases of both lungs, 0.5 mg of digoxin (Lanoxin) IV and 40 mg of
furosemide (Lasix) IV are administered immediately. The nurse recognizes that the
medications are having a therapeutic effect if
A. Mr. P.'s pulse rate decreases below 100.
B. Mr. P. has an increased urine specific gravity.
C. Mr. P. expectorates frothy sputum.
D. Mr. P.'s lungs are clear to auscultation.
9. A client is admitted with pulmonary edema. The nurse is preparing to administer
morphine sulfate. What beneficial effect does morphine have in pulmonary edema?
A. Decreases anxiety, work of breathing, and vasodilates.
B. Decreases respiratory rate.
C. Provides an analgesic and sedative effect.
D. Decreases anxiety and vasoconstricts.
10. An adult female is being discharged after having a ventricular demand pacemaker
inserted. The nurse should include which of the following in the teaching plan for this
client?
A. She should not use remote control devices (e.g., TV channel selector).
B. She must leave the room while a microwave oven is in operation.
C. She will need to avoid air travel.
D. She should not pass through metal detectors.
11. Ms. T. has a ventricular demand pacemaker that is set at 72 beats per minute. The
nurse knows that Ms. T.'s pacemaker is functioning correctly if which of the following
appears on the ECG?
A. Pacemaker spikes instead of QRS complexes.
B. Pacemaker spikes followed by QRS complexes.
C. Pacemaker spikes before each P wave.
D. Pacemaker spikes appearing only if the heart rate is over 72.
12. Which strategy by the nurse provides safety during a defibrillation attempt?
A. A verbal and visual check of "all clear".
B. No lubricant on the paddles.
C. Placing paddles lightly on the chest.
D. Standing in alignment with the bed while administering the shock.
13. An adult client has experienced a cardiac arrest and the nurse is performing CPR.
The correct position of the nurse's hands on the client's chest is
A. over the upper half of the sternum.
B. two finger widths below the sternal notch.
C. two finger widths above the xiphoid process.
D. over the xiphoid process.
4. A client with a history of a myocardial infarction two days ago reports chest pain that is
worse on inspiration but is relieved on sitting forward. Based on this finding, the nurse
suspects the client is experiencing the pain of
A. endocarditis.
B. angina pectoris.
C. pericarditis.
D. recurrent myocardial infarction.
15. Mr. J. has prazocin hydrochloride (Minipress) prescribed to treat hypertension. The
nurse should instruct him to
A. take the medication with meals.
B. take the first dose at bedtime.
C. report a pulse rate below 50 to the physician.
D. check his ankles daily for edema.
16. An adult is receiving a nonsteroidal anti-inflammatory drug (NSAID). The nurse is to
assess him for side-effects. Which of the following would the nurse observe if the client
is experiencing no side-effects?
A. The client is somnolent and hard to arouse.
B. The client is having dark, tarry stools.
C. There is no complaint of nausea or vomiting.
D. The pain is still a 6 on a scale of 1 - 10.
17. An adult has essential hypertension. She is being treated with a thiazide diuretic and
dietary and lifestyle modifications. The nurse knows that she understands the treatment
if she makes which of the following statements?
A. "I will use soy sauce or mustard instead of salt on my food."
B. "I need to cut back to two, four - ounce glasses of wine a day."
C. "I will stop riding my bike because vigorous exercise will raise my blood
pressure."
D. "Smoking helped cause my hypertension, but quitting won't reverse the damage."
18. Ms. R. has chlorothiazide (Diuril) prescribed to treat high blood pressure. The nurse
knows that Ms. R. understands the dietary modifications she needs to make if she states
that she will increase her intake of
A. fresh oranges.
B. cold cereals.
C. cola drinks.
D. cranberry juice.
19. A client reports an aching pain and cramping sensation that occurs while walking.
The pain disappears after cessation of walking. The pain is in both legs. Based on these
clinical findings, the nurse suspects the client has (a)
A. deep vein thrombosis (DVT).
B. Raynauds' disease.
C. arteriosclerosis obliterans.
D. thrombophlebitis.
20. Ms. M. has severe arteriosclerosis obliterans and complains of intermittent
claudication after walking 20 feet. How should the nurse plan to position Ms. M. when
she is in bed?
A. Supine with legs elevated.
B. In semi - Fowler's position with knees extended.
C. In reverse Trendelenburg position.
D. In Trendelenburg position.
21. An adult female experiences painful arterial spasms in her hands due to Raynaud's
phenomenon. Which of the following should the nurse include in the teaching plan for
her?
A. Drink a hot beverage, such as tea or coffee, to relieve spasms.
B. Reduce intake of high fat or high cholesterol foods.
C. Raise the hands above the head to relieve spasms.
D. Wear gloves when handling refrigerated foods.
22. Which assessment finding by the nurse would indicate an abdominal aortic
aneurysm?
A. Knifelike pain in the back.
B. Pulsatile mass in the abdomen.
C. Unequal femoral pulses.
D. Boardlike rigid abdomen.
23. A nurse is assessing a post-op femoral popliteal bypass client. Which of the following
assessment findings indicates a complication?
A. BP 110/80, HR 86, RR 20.
B. Small amount of dark-red blood on dressing.
C. A decrease in pulse quality in the operated leg.
D. Swelling of the operative leg.
24. An adult has just returned to the surgical unit after a femoral - popliteal bypass on
the right leg. The nurse should place the client in what position?
A. Fowler's position with the right leg extended.
B. Supine with the right knee flexed 45 ° .
C. Supine with the right leg extended and flat on the bed.
D. Semi - Fowler's position with the right leg elevated on two pillows.
25. The client has a large, venous stasis ulcer on her left ankle. Wound care is
performed three times a week by a home health nurse. The nurse should teach her to
A. dangle the legs for 5 - 10 minutes several times a day.
B. wear heavy cotton or wool socks when going outdoors.
C. soak the feet in tepid water three or four times daily.
D. take frequent rest periods with her legs elevated.
26. An adult is hospitalized with deep vein thrombophlebitis. During the first few days of
therapy, the nurse should
A. keep the client in Trendelenburg position.
B. apply ice packs three or four times daily to relieve pain.
C. massage the affected leg once a shift.
D. encourage the client to perform active range of motion exercises with both legs
each shift.
27. An adult is to receive an intramuscular (IM) injection of morphine for post-op pain.
Which of the following is necessary for the nurse to assess prior to giving a narcotic
analgesic?
A. The client's level of alertness and respiratory rate.
B. The last time the client ate or drank something.
C. The client's bowel habits and last bowel movement.
D. The client's history of addictions.
28. Ms. R. is being discharged after treatment of deep vein thrombosis. Coumadin
(warfarin) 2.5 mg daily is prescribed for her. The nurse recognizes that which of the
following statements by Ms. R. indicates that she understands the effects of Coumadin?
A. "I'll use an electric razor to shave my legs."
B. "I'll have a podiatrist cut my toenails."
C. "I need to eat more salads and fresh fruits."
D. "I will take aspirin instead of Tylenol for headaches."
29. An adult, who was admitted four hours ago with thrombophlebitis in the left leg,
suddenly becomes confused and dyspneic. She begins coughing up blood-streaked
sputum and complains of chest pain that worsens on inspiration. The nurse should first
A. apply soft restraints to prevent excessive movement.
B. perform a Heimlich maneuver.
C. place her in bed in Semi - Fowler's position.
D. place her in Trendelenburg position on her left side.
30. A client is admitted to rule out pulmonary embolism (PE) from a deep vein
thrombosis. A Dextran 70 infusion is ordered for the client. The nurse understands the
Dextran is administered to
A. increase blood viscosity.
B. decrease platelet adhesion.
C. decrease plasma volume.
D. increase the hemoglobin.
31. Mr. B. had an above-the-knee amputation of the left leg two days ago. The nurse
should include which of the following in the care plan for him?
A. Resting in a prone or supine position with the stump extended several times a
day.
B. Using a rolled towel or small pillow to elevate the stump at all times.
C. Applying warm soaks to the stump to reduce phantom limb pain.
D. Avoiding turning to the left side until the stump has healed completely.
32. An adult male had a below-the-knee amputation of the right foot two days ago. He is
complaining of pain in his right foot. The best response by the nurse is to
A. explain to him that this is a common sensation after amputation.
B. remind him that that foot was amputated and therefore cannot have pain.
C. tell him that such pain is a common psychological response to loss of a limb.
D. show him the stump so he will realize his right foot is gone.
33. Mr. J. has been diagnosed with some type of anemia. The results of his blood tests
showed: Decreased WBC, normal RBC, decreased Hct, decreased Hgb. Based on
these data, which of the following nursing diagnoses should the nurse prioritize as being
the most important?
A. Potential for infection.
B. Alteration in nutrition.
C. Self-care deficit.
D. Fluid volume excess.
34. A client has the following blood lab values
platelets 50,000/ul
RBCs 3.5 (X 10 6 )
Hemoglobin 10 g/dl
Hematocrit 30%
WBCs 10,000/ul
Which nursing instruction should be included in the teaching plan?
A. Bleeding precautions.
B. Seizure precautions.
C. Isolation to prevent infection.
D. Control of pain with analgesics.
35. A hospitalized client has the following blood lab values:
WBC 3,000/ul
RBC 5.0 (X 10 6 )
platelets 300,000
Nursing interventions should be aimed at
A. preventing infection.
B. controlling blood loss.
C. alleviating pain.
D. monitoring blood transfusion reactions.
36. Mr. L.'s blood type is AB and he requires a blood transfusion. To prevent
complications of blood incompatibilities, the nurse knows that this client may receive
A. type A or B blood only.
B. type AB blood only.
C. type O blood only.
D. either type A, B, AB, or O blood.
37. An adult is to receive narcotic analgesic via a patient-controlled analgesia (PCA).
The nurse is evaluating the client's understanding of the procedure. Which of the
following statements by the client indicates that she understands PCA?
A. "When I press this button the machine will always give me more medicine."
B. "I will press the button whenever I begin to experience pain."
C. "I should press this button every hour so the pain doesn't come back."
D. "With this machine I will experience no more pain."
38. Which nursing intervention is appropriate for the nurse to take when setting up
supplies for a client who requires a blood transfusion?
A. Add any needed IV medication in the blood bag within one half hour of planned
infusion.
B. Obtain blood bag from laboratory and leave at room temperature for at least one
hour prior to infusion.
C. Prime tubing of blood administration set with 0.9% NS solution, completely filling
filter.
D. Use a small-bore catheter to prevent rapid infusion of blood products that may
lead to a reaction.
39. A client who is receiving a blood transfusion begins to experience chills, shortness
of breath, nausea, excessive perspiration, and a vague sense of uneasiness. The best
action for the nurse to initially take is to
A. report the signs and symptoms to the physician.
B. stop the transfusion.
C. monitor the client's vital signs.
D. assess respiratory status.
40. A client with iron deficiency anemia is ordered parental iron to be given
intramuscularly. Which of the following actions should the nurse take in the
preparation/administration of this medication?
A. Use the same large (19 - 20) gauge needle for drawing up the medication
and injecting it.
B. Massage the site after the injection is given to promote absorption.
C. Use a 1-in needle to administer the medication.
D. Use the Z-track technique to administer the medication.
41. The nurse has been teaching Ms. T., who has iron deficiency anemia, about those
foods that she needs to include in her meal plans. Which of the following, if selected by
Ms. T., would indicate to the nurse that she understands the dietary instructions?
A. Citrus fruits and green leafy vegetables.
B. Bananas and nuts.
C. Coffee and tea.
D. Dairy products.
42. In assessing clients for pernicious anemia, the nurse should be alert for which of the
following risk factors?
A. Positive family history.
B. Acute or chronic blood loss.
C. Infectious agents or toxins.
D. Inadequate dietary intake.
43. Mr. S. is a client who has been scheduled for a Schilling's test. The nurse should
instruct the client to
A. take nothing by mouth for 12 hours prior to the test.
B. collect his urine for 12 hours.
C. administer a fleets enema the evening before the test.
D. empty his bladder immediately before the test.
44. A 40-year-old woman with aplastic anemia is prescribed estrogen with progesterone.
The nurse can expect that these medications are given for which of the following
reasons?
A. To stimulate bone growth.
B. To regulate fluid balance.
C. To enhance sodium and potassium absorption.
D. To promote utilization and storage of fluids.
45. Which of the following lab value profiles should the nurse know to be consistent with
hemolytic anemia?
A. Increased RBC, decreased bilirubin, decreased hemoglobin and hematocrit,
increased reticulocytes.
B. Decreased RBC, increased bilirubin, decreased hemoglobin and hematocrit,
increased reticulocytes.
C. Decreased RBC, decreased bilirubin, increased hemoglobin and hematocrit,
decreased reticulocytes.
D. Increased RBC, increased bilirubin, increased hemoglobin and hematocrit,
decreased reticulocytes.
46. In planning care for a client who has had a splenectomy, the nurse should be aware
that this client is most prone to developing
A. infection.
B. congestive heart failure.
C. urinary retention.
D. viral hepatitis.
47. Mr. C. is diagnosed with disseminated intramuscular coagulation (DIC). The nurse
should identify that Mr. C. is at risk for which of the following nursing diagnoses?
A. Risk for increased cardiac output related to fluid volume excess.
B. Diminished sensory perception related to bleeding into tissues.
C. Alteration in tissue perfusion related to bleeding and diminished blood flow.
D. High risk for aspiration related to constriction of the respiratory musculature.
48. An adult suffered second and third degree burns over 20% of his body two days ago.
The nurse knows that the best way to assess fluid balance is to
A. maintain strict records of intake and output.
B. weigh the client daily.
C. monitor skin turgor.
D. check for edema.
49. The nurse should understand that a heparin order for a client with DIC is given to
A. prevent clot formation.
B. increase blood flow to target organs.
C. increase clot formation.
D. decrease blood flow to target organs.
50. Mr. H. is a 34 - year - old client diagnosed with AIDS. His pharmacologic
management includes zidovudine (AZT). During a home visit, Mr. H. states, "I don't
understand how this medication works. Will it stop the infection?" The nurse's best
response is
A. "The medication helps to slow the disease process, but it won't cure or stop it
totally."
B. "The medication blocks reverse transcriptase, the enzyme required for HIV
replication."
C. "Don't you know? There aren't any medications to stop or cure HIV."
D. "No, it won't stop the infection. In fact, sometimes the HIV can become immune
to the drug itself."
51. Which statement, from a participant attending a class on AIDS prevention, indicates
an understanding of how to reduce transmission of HIV?
A. "Mothers who are HIV - positive should still be encouraged to breast feed
their babies because breast milk is superior to cow's milk."
B. "I think a needle exchange program, where clean needles are exchanged
for dirty needles, should be offered in every city."
C. "Orgasms are necessary for the heterosexual transmission of the virus."
D. "It's okay to use natural skin condoms since they offer the same
protection as the latex condoms."
52. In planning care for a client with multiple myeloma, the nurse should be aware that
the client may have orders for
A. bedrest.
B. corticosteroid therapy.
C. fluid restrictions.
D. calcium replacement therapy.
53. Which client statement would indicate to the nurse that the client with polycythemia
vera is in need of further instruction?
A. "I'll be flying overseas to see my son and grandchildren for the holidays."
B. "I plan to do my leg exercises at least three times a week."
C. "I'm going to be walking in the mall every day to build up my strength."
D. "At night when I sleep, I like to use two pillows to raise my head up."

Ms. Lyn Cheung is admitted to the hospital with left sided congestive heart failure.
54. When obtaining a health story from Ms. Cheung, the nurse is most likely to find
that when her illness began, Ms Cheung first noticed that she had dyspnea and
a. anorexia
b. fatigue
c. nausea
d. headaches
55. Ms. Cheung is to receive oxygen by mask. After attaching the tubing to the
oxygen supply the nurse should start the flow of oxygen to the mask
a. Before applying the mask to the client’s face
b. After the mask is placed on the client’s face
c. Just as the mask is placed o the client’s face
d. If the client cannot feel the room air on her face
56. When auscultating Mr. Cheung’s lung sounds. The nurse is most likely to hear
a. grating sounds
b. growling sounds
c. crackling sounds
d. rumbling sounds
57. The position the nurse should plan to use to help Ms. Cheung feel most
comfortable would be a:
a. Back-lying position
b. Face-lying position
c. Side-lying position
d. Semi-sitting position
58. The nurse would expect that emotionally Ms. Cheung would be feeding:
a. depressed
b. anxious
c. defensive
d. aggressive
59. The care plan for Ms. Cheung indicates that her apical-radial pulse rate must
assessed daily. Which one of the following describes the correct technique for
performing this assessment?
a. The nurse counts the apical and then the radial pulse rate
b. The nurse listens to the heat while feeling the pulse
c. One nurse counts the apical rate at the same time another counts the radial rate
d. One nurse counts the apical and radial rate, and a second nurse watches the
time.
Mr. Terry Onor, who works as a secretary, has had hypertension for more than 10 years.
A nurse who is taking care of some personal business observes her collapse at her
desk.
60. The best method the nurse can use to open Mr. Onor’s airway is to:
a. Elevate her neck
b. Lift her chin
c. Press on her jaws
d. Clear her mouth
61. To deliver an optimum amount of air into the \victim’s lungs, the nurse should:
a. Press on the victim’s trachea
b. Remove the victim’s dentures
c. Pinch the victim’s nose shut
d. Squeeze the victim’s cheeks
62. The first action the nurse should take is to:
a. Open her airway
b. Give two breaths
c. Shake her gently
d. Lay her on the floor
63. The best method for determining if rescue breathing should be performed is to:
a. Observe the victim’s skin color
b. Feel for pulsations at the neck
c. Listen for spontaneous breathing
d. Blow air into the victim’s mouth
Ms. Onor remains unresponsive and pulse less.
64. The correct placement for the nurse’s hands before administering cardiac
compression is:
a. On the lower half of the sternum
b. Below the tip o ft he xiphoid process
c. Over the costal cartilage
d. directly above the manubrium
65. The nurse should compress the chest of an adult victim at a rate no less than:
a. 15 compressions per minute
b. 40 compressions per minute
c. 60 compressions per minute
d. 80 compressions per minute
Eventually, a second person arrives to assist the nurse with cardiopulmonary
resuscitation (CPR).
66. When two rescuers perform CPR, the rate of compressions to ventilations should
be:
a. 15 compressions to two breaths
b. Five compressions to one breath
c. A pulse can be palpated
d. The victim begins to vomit
A nurse volunteers to assess blood pressure on people participating in a local
community hospital’s annual health fair.
67. Which one of the following adult blood pressure recordings would the nurse
consider to be hypertensive?
a. 138/88 mm Hg
b. 132/96 mm Hg
c. 120/80 mm Hg
d. 90/60 mm Hg
68. A woman who weighs 225 lbs approaches the nurse to have her blood pressure
checked. What modification should the nurse make when taking her blood pressure?
The nurse should:
a. Take the blood pressure on her thigh
b. Pump the manometer up to 225 mm Hg
c. Use an extra large blood pressure cuff
d. Have her lie down during the assessment
The nurse finds that another person at the health fair has a blood pressure of 146/82.
69. Which of the following recommendations would be most appropriate for the nurse
to make based on this blood pressure recording? It would be best for the nurse to
recomment that the client:
a. See a physician immediately
b. Have it rechecked in 1 month
c. Evaluate it again next year
d. Delay action at this time
While awaiting transport to the hospital, the physician tells the nurse to apply blood
pressure cuffs to each of Mr. Jacob’s four extremities to simulate the use of rotating
tourniquets.
70. What guidelines is best for the nurse to use for monitoring that the blood
pressure cuffs are properly inflated?
a. A distal pulse can be palpated
b. His fingers and toes look pale
c. He can feel the nurse’s touch
d. Capillary refill is delayed
71. If the simulated tourniquets are rotated on a 15-minute schedule, how long in 1
hour is there an inflated blood pressure cuff on each of Mr. Jacob’s extremities?
a. 15 minutes
b. 30 minutes
c. 45 minutes
d. 60 minutes
Mr. Philip Morris, a 53-year-old businessman, is admitted to the hospital with severe
chest pain. The admitting diagnosis is possible myocardial infarction.
72. As the nurse assesses Mr. Morris, which additional finding often sis associated
with myocardial infarction?
a. The client is sweating profusely
b. The client’s face is flushed
c. The client says he is thirsty
d. The client has a moist cough
73. Which of the following statements should the nurse expect Mr. Morris to use
when describing his pain?
a. :The pain comes and goes
b. the pain came on slowly
c. the pain is tingling in nature
d. the pain has remained continuous
74. If Mr. Morris is typical of other people who experience a myocardial infarction, he
is likely to tell the nurse that his discomfort radiates to his:
a. flank
b. groin
c. abdomen
d. shoulder
75. Which one of the following prescribed Medications would the nurse plan to give to
relieve Mr. Morris’ discomfort
a. A nonsteroid, such as ibuprofen (Advil)
b. A nonsalicylate, such as acetaminophen (Tylenol)
c. A salicylate, such as acetylsalicylic acid (Aspirin)
d. A narcotic, such as meperidine hydrochloride (Demerol)
76. Which of the following questions is least helpful when assessing Mr. Morris about
his pain?
a. “How long have you been in pin?”
b. “Where is you pain located?”
c. “What were you doing when your pain started?”
d. “Do you think an injection for pain would help?”
Although Mr. Morris’ wife pleaded that he go to emergency department when his pain
began, he delayed seeking medical attention. He said he was not having a heart attack
but rather attributed his discomfort to having strained muscles doing yard work.
77. The nurse continues to gather information about Mr. Morris fro his wife while the
physician us examining her husband. If she reports all of the following, which one is at
least likely to have predisposed Mr. Morris to having a myocardial infarction?
a. Smoking cigarettes
b. Eating fatty foods
c. Working under emotional stress
d. Drinking a n occasional cocktail
78. The nurse would be most correct in explaining to Mr. Morris’s wife that her
husband’s hesitation in going to the hospital was an example of a coping technique
called:
a. regression
b. projection
c. denial
d. undoing
Mr. Erick Mayer comes to the emergency department for what he says in acute
indigestion or food poisoning which he states began several hours ago.
79. If Mr. Mayer’s symptoms are due to an acute myocardial infarction, which one of
the following laboratory test results the nurse expect to be abnormally high?
a. Alkaline phosphate
b. Alphafetoprotein(AFP)
c. Creatinine phosphokinase (CPK)
d. Gamma-glutamyl transferase
Because Mr. Mayer has been experiencing symptoms for only a few hours , the
physician plans to administer the drug streptokinase (Streptase).
80. Which one of the following findings would indicate to the nurse that Mr. Mayer is
having an allergic reaction to the streptokinase (Streptase)?
a. Urticaria
b. Dysuria
c. Hemoptysis
d. Dyspepsia
81. The nurse would be most correct in explaining to Mr. Mayer that streptokinase is
given to:
a. Dissolve blood clots
b. Slow his heart rate
c. Improve heart contraction
d. Lower his blood pressure
82. For which adverse effect should the nurse plan to monitor when a client recieves
streptokinase or another similar drug?
a. Hypertension
b. Constipation
c. Bleeding
d. Vomiting
A person at the health fair hands a notebook containing a record of his blood pressure
measurements to the nurse. He points to one entry and asks the nurse that the third
number recorded in the blood pressure measurement of 136/72/60 represents.
83. The best explanation for the third number in the series of recorded numbers Is
that it was at that pressure that:
a. The sound became muffled
b. The last sound as heard
c. The sound intensified
d. The sound became faint
84. A client with an elevated blood pressure says to the nurse, “I feel fine even
though my blood pressure is elevated. What signs and symptoms should I look for?” The
nurse would be most accurate in telling this person that some hypertensive people
experience:
a. fatigue
b. nausea
c. anorexia
d. polyuria
85. A client who is being treated for hypertension comes to the health fair. He
indicates to the nurse that he performs all of the following listed activities. Avoiding which
one would help most to reduce his blood pressure?
a. Eating brown rice
b. Walking his dog
c. Playing the piano
d. Smoking cigarettes
 CVD HEMA CIRCULATORY PRETEST 001 2024

1. The nurse is monitoring a client who has recently undergone pericardiocentesis. The nurse suspects
A. A rapid increase in blood pressure and flushing
B. Jugular vein distention (JVD) and narrowing pulse pressure
C. Bradycardia and bilateral crackles
D. Louder and harsher heart sounds
2. A 54 -year-old male client was recently diagnosed with subacute bacterial endocarditis (SBE). The
nurse determines that the client understands the discharge teaching when he does which of the following?
A. Asks for a referral to a dietician for a low-sodium diet
B. Explains to his wife why he needs antibiotics before seeing the dentist
C. Asks when he can start to take his antibiotics cardiac
in pilltamponade
form after observing which of the following?
D. Explains his plans to quit smoking
3. The nurse on a cardiac unit is caring for a client admitted with an acute exacerbation of heart failure.
The nurse concludes that the client is developing pulmonary edema after observing which change in the
client?
A. Bradycardia
B. Increased urination
C. Cough with pink frothy sputum
D. Increased sleepiness
4. A client is scheduled for a cardiac angiography. In reviewing the client's record what significant
finding needs to be reported to the physician before the exam?
A. The client reported allergy to shrimp.
B. The client 's ECG shows atrial fibrillation.
C. The potassium level is 5.0 mEq/L.
D. The client has a history of chronic renal failure.
5. The nurse is developing a plan for a client who is going home with a new diagnosis of heart failure.
The nurse is teaching the client to monitor fluid status. The best instruction is to teach the client to do which
of the following?
A. Restrict fluid intake to 800 mL per day
B. Increase the dose of diuretics if there is decreased urination
C. Record body weight every day before breakfast and report a weight gain of 3 or more pounds in a
week
D. Keep track of daily output and call the doctor for if it is less than 1 L on any day
6. The nurse is caring for a client who has just had a cardiac catheterization. The client insists on getting
up to go to the bathroom to urinate immediately when he is brought back to his room. Which of the following
would be the nurse's best response?
A. "You can't walk yet. You ma y be too weak after the procedure and may fall."
B. "If you bend your leg, you will risk bleeding from the insertion site. It is an artery, and it could lead to
complications."
C. "If you get out of bed, you may have an arrhythmia from the catheterization. Your heart has to rest
after this procedure."
D. "The doctor has ordered that you stay on bedrest for the next 6 hours. It is important that you follow
these orders."
7. A client is getting ready to go home after a myocardial infarction (MI). The client is asking questions
about his medications, and wants to know why metoprolol (Lopressor) was prescribed. The nurse's best
response would be which of the following?
A. "Your heart was beating too slowly, and Lopressor increases your heart rate."
B. "Lopressor helps to increase the blood supply to the heart by dilating your coronary arteries."
C. "This medication helps make your heart beat stronger 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."
8. A client is taking digoxin (Lanoxin) and furosemide (Lasix) for heart failure. Which of the following
would be the best menu choices for this client?
A. Chicken with baked potato and banana
B. Eggs and ham
C. Grilled cheese sandwich and French fried potatoes
D. Pizza with pepperoni
9. A nurse is preparing to admit a client with restrictive cardiomyopathy to the hospital for the

diagnosis for this client?

A. Fear related to new onset of symptoms
B. Hopelessness related to lack of cure and debilitating symptoms
C. Knowledge deficit related to medication regime
D. Activity intolerance related to decreased cardiac output
10 . The nurse is preparing to utilize an external pacemaker for a client with a dysrhythmia. The nurse
knows that this pacemaker is often necessary when a client is in which of the following cardiac rhythms?
A. Ventricular fibrillation
B. Atrial fibrillation
C. Ventricular tachycardia
D. Second-degree heart block
11 . A client asks the nurse why vitamin B12 is important for red blood cell formation. The
nurse responds with the knowledge that Vitamin B12 deficiency causes which of the following
changes in the red blood cell?
A. Decreased mean corpuscular volume (MCV)
B. Increased hemoglobin in the red blood cell
C. Makes the cell irregular and oval-shaped
D. Makes the cell smaller in shape and deficient in hemoglobin
12 . A nurse is discussing the role of hypoxia in red blood cell (RBC) production. Which of the
following statements is accurate?
A. Hypoxia stimulates the hemoglobin content of the RBC to increase.
B. Hypoxia stimulates the release of erythropoietin in the kidneys.
C. Reticulocytes become erythrocytes faster with hypoxia.
D. RBC destruction is increased with hypoxia therefore stimulating RBC production.
13 . The destruction of old red blood cells occurs as senescent cells decrease their ATP
content. Which statement accurately describes what happens to the heme molecule during this
phase?
A. It is converted to bilirubin that is conjugated and excreted as bile.
B. It binds with a plasma protein to form haptoglobin.
C. The kidneys excrete the heme molecule.
D. The heme molecule is conjugated with glucorinide in the spleen.
14 . A client with a hemolytic blood disorder presents to the primary care center with jaundice.
The nurse explains to the client that the jaundice is most likely caused by which of the following?
A. Increased bilirubin in plasma
B. Increased haptoglobin in plasma
C. Hepatitis infection
D. Loss of plasma proteins
15 . A nurse is evaluating the response of a patient with anemia to therapy. Which of the
following laboratory tests would the nurse look to that best reflects bone marrow production of red
blood cells?
A. Hematocrit
B. Hemoglobin
C. Serum ferritin
D. Reticulocyte count
16 . The nurse who is assessing a client with iron-deficiency anemia notes that the tongue is
inflamed. The nurse documents this observation as:
A. Cheilitis
B. Achlorhydria
C. Glossitis
D. Cheilosis
17 . The nurse is teaching a client about measures to increase the absorption of the prescribed
oral iron preparation. Which of the following instructions would the nurse give to the client?
A. Take the medicine with milk.
B. Take the pill with a drink that contains vitamin C.
C. Take the iron with meals.
D. Take the iron after meals.
18 . Which of the following statements made by a client with iron-deficiency anemia indicates
the need for further teaching?
A. "I should stop taking the medicine if my stools turn black."
B. " I should dilute the liquid iron preparation and use a straw when taking it."
C. "I can prevent the constipation by increasing the intake of fluids and fiber."
D. " I should return to the clinic if my stomach upset worsens with this medication."
19 . Which of the following food choices made by a client with anemia best indicates that the
teaching regarding selection of foods high in iron has been successful?
A. Citrus fruits
B. Green leafy vegetables
C. Eggs, milk, and milk products
D. Liver and muscle meats
20 . A nurse is preparing to administer an intramuscular (IM) dose of iron to a client with
anemia. Which of the following precautions should the nurse take?
A. Administer the drug utilizing a Z tract technique.
B. Use a 1-inch, 19-gauge needle.
C. Administer the drug deep in the deltoid muscle.
D. Massage the area vigorously after administering the iron