Exam 2 Cardiac Practice Questions NCLEX

Exam 2 Cardiac Practice Questions NCLEX Latest Version Questions and Verified Accurate Answers Guaranteed A+ A 55-year-old pt is admitted with an acute inferior-wall myocardial infarction. During the admission interview, he says he stopped taking his metoprolol (Lopressor) 5 days ago because he was feeling better. Which of the following nursing diagnoses takes priority for this pt?

• Anxiety
• Ineffective tissue perfusion; cardiopulmonary
• Acute pain
• Ineffective therapeutic regimen management - Correct Answer:2. MI results from

prolonged myocardial ischemia caused by reduced blood flow through the coronary arteries. Therefore, the priority nursing diagnosis for this pt is Ineffective tissue perfusion (cardiopulmonary). Anxiety, acute pain, & ineffective therapeutic regimen management are appropriate but don't take priority.

A home care nurse is making a routine visit to a pt receiving digoxin (Lanoxin) in the

treatment of heart failure. The nurse would particularly assess the pt for:

• Thrombocytopenia & weight gain
• Anorexia, nausea, & visual disturbances
• Diarrhea & hypotension
• Fatigue & muscle twitching - Correct Answer:2. The first signs & symptoms of digoxin

toxicity in adults include abdominal pain, N/V, visual disturbances (blurred, yellow, or green vision, halos around lights), bradycardia, & other dysrhythmias.

A nurse caring for a pt in one room is told by another nurse that a second pt has developed severe pulmonary edema. On entering the 2nd pt's room, the nurse would

expect the pt to be:

• Slightly anxious
• Mildly anxious
• Moderately anxious

4. Extremely anxious - Correct Answer:4. Pulmonary edema causes the pt to be

extremely agitated & anxious. The pt may complain of a sense of drowning, suffocation, or smothering.

A nurse is conducting a health history with a pt with a primary diagnosis of heart failure.Which of the following disorders reported by the pt is unlikely to play a role in exacerbating the heart failure?

• Recent URI
• Nutritional anemia
• Peptic ulcer disease
• A-Fib - Correct Answer:3. Heart failure is precipitated or exacerbated by physical or

emotional stress, dysrhythmias, infections, anemia, thyroid disorders, pregnancy, 1 / 3

Paget's disease, nutritional deficiencies (thiamine, alcoholism), pulmonary disease, & hypervolemia.

A nurse is preparing for the admission of a pt with heart failure who is being sent directly to the hospital from the physician's office. The nurse would plan on having which of the following meds readily available for use?

• Diltiazem (Cardizem)
• Digoxin (Lanoxin)
• Propranolol (Inderal)
• Metoprolol (Lopressor) - Correct Answer:2. Digoxin exerts a positive inotropic effect

on the heart while slowing the overall rate through a variety of mechanisms. Digoxin is the med of choice to treat heart failure. Diltiazem (calcium channel blocker) & propranolol & metoprolol (beta blockers) have a negative inotropic effect & would worsen the failing heart.

A nurse is preparing to ambulate a pt on the 3rd day after cardiac surgery. The nurse would plan to do which of the following to enable the pt to best tolerate the ambulation?

• Encourage the pt to cough & deep breathe
• Premedicate the pt with an analgesic
• Provide the pt with a walker
• Remove telemetry equipment because it weighs down the hospital gown. - Correct

Answer:2. The nurse should encourage regular use of pain med for the first 48 to 72 hours after cardiac surgery because analgesia will promote rest, decrease myocardial oxygen consumption resulting from pain, & allow better participation in activities such as coughing, deep breathing, & ambulation. Options 1 & 3 will not help in tolerating ambulation. Removal of telemetry equipment is contraindicated unless prescribed.

A pt admitted with angina compains of severe chest pain & suddenly becomes unresponsive. After establishing unresponsiveness, which of the following actions should the nurse take first?

• Activate the resuscitation team
• Open the pt's airway
• Check for breathing
• Check for signs of circulation - Correct Answer:1. Immediately after establishing

unresponsiveness, the nurse should activate the resuscitation team. The next step is to open the airway using the head-tilt, chin-lift maneuver & check for breathing (looking, listening, & feeling for no more than 10-seconds). If the pt isn't breathing, give two slow breaths using a bag mask or pocket mask. Next, check for signs of circulation by palpating the carotid pulse.

A pt comes into the E.R. with acute shortness of breath & a cough that produces pink, frothy sputum. Admission assessment reveals crackles & wheezes, a BP of 85/46, a HR of 122 BPM, & a respiratory rate of 38 breaths/minute. The pt's medical history included DM, HTN, & heart failure. Which of the following disorders should the nurse suspect?

• Pulmonary edema
• Pneumothorax 2 / 3

• Cardiac tamponade

4. Pulmonary embolus - Correct Answer:1. SOB, tachypnea, low BP, tachycardia,

crackles, & a cough producing pink, frothy sputum are late signs of pulmonary edema.

A pt has frequent bursts of ventricular tachycardia on the cardiac monitor. A nurse is

most concerned with this dysrhythmia because:

• It is uncomfortable for the pt, giving a sense of impending doom.
• It produces a high cardiac output that quickly leads to cerebral & myocardial

ischemia.

• It is almost impossible to convert to a normal sinus rhythm.
• It can develop into ventricular fibrillation at any time. - Correct Answer:4. Ventricular

tachycardia is a life-threatening dysrhythmia that results from an irritable ectopic focus that takes over as the pacemaker for the heart. The low cardiac output that results can lead quickly to cerebral & myocardial ischemia. Pt's frequently experience a feeling of impending death. Ventricular tachycardia is treated w/ antidysrhythmic meds or magnesium sulfate, cardioversion (pt awake), or defibrillation (loss of consciousness), Ventricular tachycardia can deteriorate into ventricular defibrillation at any time.

A pt who had cardiac surgery 24 hours ago has a urine output averaging 19 ml/hr for 2 hours. The pt received a single bolus of 500 ml of IV fluid. Urine output for the subsequent hour was 25 ml. Daily laboratory results indicate the blood urea nitrogen is 45 mg/dL & the serum creatinine is 2.2 mg/dL. A nurse interprets the pt is at risk for:

• Hypovolemia

2. UTI

• Glomerulonephritis
• Acute renal failure - Correct Answer:4. The pt who undergoes cardiac surgery is at

risk for renal injury from poor perfusion, hemolysis, low cardiac output, or vasopressor med therapy. Renal insult is signaled by decreased urine output, & increased BUN & creatinine levels. The pt may need meds such as dopamine (Intropin) to increase renal perfusion & possibly could need peritoneal dialysis or hemodialysis.

A pt with angina complains that the angina pain is prolonged & severe & occurs at the same time each day, most often in the morning, On further assessment a nurse notes that the pain occurs in the absence of precipitating factors. This type of anginal pain is

best described as:

• Stable angina
• Unstable angina
• Variant angina
• Nonanginal pain - Correct Answer:3. Stable angina is induced by exercise & is

relieved by rest or nitroglycerin tablets. Unstable angina occurs at lower & lower levels of activity & rest, is less predictable, & is often a precursor of myocardial infarction.Variant angina, or Prinzmetal's angina, is prolonged & severe & occurs at the same time each day, most often in the morning.

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