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1. Decrease anxiety
2. Enhance myocardial oxygenation
3. Administer sublingual nitroglycerin
4. Educate the client about his symptoms
1. Cardiac catheterization
2. Coronary artery bypass surgery
3. Oral medication therapy
4. Percutaneous transluminal coronary angioplasty
1. Chest pain
2. Dyspnea
3. Edema
4. Palpitations
1. Cardiac
2. Gastrointestinal
3. Musculoskeletal
4. Pulmonary
1. Lactate dehydrogenase
2. Complete blood count (CBC)
3. Troponin I
4. Creatine kinase (CK)
1. Aneurysm
2. Heart failure
3. Coronary artery thrombosis
4. Renal failure
1. Ventricular dilation
2. Systemic hypertension
3. Aortic valve malfunction
4. Increased atrial contractions
9. After an anterior wall myocardial infarction, which of the
following problems is indicated by auscultation of crackles in
the lungs?
1. Administer morphine
2. Administer oxygen
3. Administer sublingual nitroglycerin
4. Obtain an ECG
1. Beta-adrenergic blockers
2. Calcium channel blockers
3. Narcotics
4. Nitrates
1. Cardiogenic shock
2. Heart failure
3. arrhythmias
4. Pericarditis
1. Digoxin
2. Furosemide (Lasix)
3. Metoprolol (Lopressor)
4. Enalapril (Vasotec)
1. Crackles
2. Arrhythmias
3. Hepatic engorgement
4. Hypotension
1. Diabetes
2. Pulmonary emboli
3. Renal failure
4. Right-sided heart failure
1. Beta-adrenergic blockers
2. Calcium channel blockers
3. Diuretics
4. Inotropic agents
1. Bradycardia
2. Tachycardia
3. Hypotension
4. Decreased myocardial contractility
20. Which of the following conditions is most closely
associated with weight gain, nausea, and a decrease in urine
output?
1. Angina pectoris
2. Cardiomyopathy
3. Left-sided heart failure
4. Right-sided heart failure
1. Cardiomyopathy
2. Coronary artery disease
3. Myocardial infarction
4. Pericardial effusion
1. Dilated
2. Hypertrophic
3. Myocarditis
4. Restrictive
1. Congestive
2. Dilated
3. Hypertrophic
4. Restrictive
1. Heart failure
2. Diabetes
3. MI
4. Pericardial effusion
1. Dilated
2. Hypertrophic
3. Obliterative
4. Restrictive
1. Dilated aorta
2. Normally functioning heart
3. Decreased myocardial contractility
4. Failure of the ventricle to eject all of the blood during systole
1. Cardiac catheterization
2. Coronary artery bypass graft (CABG)
3. Heart transplantation
4. Intra-aortic balloon pump (IABP)
1. Anxiety
2. Stable angina
3. Unstable angina
4. Variant angina
31. Which of the following types of angina is most closely
related with an impending MI?
1. Angina decubitus
2. Chronic stable angina
3. Nocturnal angina
4. Unstable angina
1. Increased preload
2. Decreased afterload
3. Coronary artery spasm
4. Inadequate oxygen supply to the myocardium
1. Chest x-ray
2. Echocardiogram
3. Cardiac catheterization
4. 12-lead electrocardiogram (ECG)
34. Which of the following results is the primary treatment
goal for angina?
1. Reversal of ischemia
2. Reversal of infarction
3. Reduction of stress and anxiety
4. Reduction of associated risk factors
1. Anoxia
2. Hypercapnia
3. Hyperoxygenation
4. Hypocapnia
1. Afterload
2. Cardiac output
3. Overload
4. Preload
42. Acute pulmonary edema caused by heart failure is usually
a result of damage to which of the following areas of the
heart?
1. Left atrium
2. Right atrium
3. Left ventricle
4. Right ventricle
1. Anxiety
2. Ineffective tissue perfusion; cardiopulmonary
3. Acute pain
4. Ineffective therapeutic regimen management
46. A client comes into the E.R. with acute shortness of breath
and a cough that produces pink, frothy sputum. Admission
assessment reveals crackles and wheezes, a BP of 85/46, a HR
of 122 BPM, and a respiratory rate of 38 breaths/minute. The
client’s medical history included DM, HTN, and heart failure.
Which of the following disorders should the nurse suspect?
1. Pulmonary edema
2. Pneumothorax
3. Cardiac tamponade
4. Pulmonary embolus
47. The nurse coming on duty receives the report from the
nurse going off duty. Which of the following clients should
the on-duty nurse assess first?
1. The 58-year-old client who was admitted 2 days ago with heart
failure, BP of 126/76, and a respiratory rate of 21 breaths a
minute.
2. The 88-year-old client with end-stage right-sided heart failure,
BP of 78/50, and a DNR order.
3. The 62-year-old client who was admitted one day ago
with thrombophlebitis and receiving IV heparin.
4. A 76-year-old client who was admitted 1 hour ago with new-
onset atrial fibrillation and is receiving IV diltiazem (Cardizem).
1. Recent URI
2. Nutritional anemia
3. Peptic ulcer disease
4. A-Fib
1. Diltiazem (Cardizem)
2. Digoxin (Lanoxin)
3. Propranolol (Inderal)
4. Metoprolol (Lopressor)
1. Slightly anxious
2. Mildly anxious
3. Moderately anxious
4. Extremely anxious
1. Digoxin level
2. Sodium level
3. Potassium level
4. Creatinine level
53. A client who had cardiac surgery 24 hours ago has a urine
output averaging 19 ml/hr for 2 hours. The client 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 and the serum creatinine
is 2.2 mg/dL. A nurse interprets the client is at risk for:
1. Hypovolemia
2. UTI
3. Glomerulonephritis
4. Acute renal failure
1. Stable angina
2. Unstable angina
3. Variant angina
4. Nonanginal pain
1. Antipyretic action
2. Antithrombotic action
3. Antiplatelet action
4. Analgesic action
1. Liquids as ordered
2. Small, easily digested meals
3. Three regular meals per day
4. NPO
1. Vasopressor
2. Volume expander
3. Vasodilator
4. Potassium-sparing diuretic
67. Furosemide is administered intravenously to a client with
HF. How soon after administration should the nurse begin to
see evidence of the drugs desired effect?
1. 5 to 10 minutes
2. 30 to 60 minutes
3. 2 to 4 hours
4. 6 to 8 hours
1. Apples
2. Tomato juice
3. Whole wheat bread
4. Beef tenderloin
69. The nurse finds the apical pulse below the 5th intercostal
space. The nurse suspects:
1. Circumflex artery
2. Internal mammary artery
3. Left anterior descending artery
4. Right coronary artery
A. Nasal congestion
B. Nervousness
C. Lethargy
D. Hyperkalemia
A. Yellow
B. Green
C. Clear
D. Gray
A. Nausea or vomiting
B. Abdominal pain or diarrhea
C. Hallucinations or tinnitus
D. Lightheadedness or paresthesia
A. Leg movement
B. Finger movement
C. Lip movement
D. Fighting the ventilator
A. Acid-base balance
B. Arterial Blood
C. Arterial oxygen saturation
D. Alveoli
A. Exhale slowly
B. Stay very still
C. Inhale and exhale quickly
D. Perform the Valsalva maneuver
A. Stridor
B. Occasional pink-tinged sputum
C. A few basilar lung crackles on the right
D. Respiratory rate 24 breaths/min
A. Hypocapnia
B. A hyperinflated chest noted on the chest x-ray
C. Increased oxygen saturation with exercise
D. A widened diaphragm noted on the chest x-ray
A. Face tent
B. Venturi mask
C. Aerosol mask
D. Tracheostomy collar
A. Dyspnea
B. Chest pain
C. A bloody, productive cough
D. A cough with the expectoration of mucoid sputum
A. Bronchoscopy
B. Sputum culture
C. Chest x-ray
D. Tuberculin skin test
28. A nurse is caring for a male client with
emphysema who is receiving oxygen. The nurse
assesses the oxygen flow rate to ensure that it
does not exceed:
A. 1 L/min
B. 2 L/min
C. 6 L/min
D. 10 L/min
A. Pallor
B. Low arterial PaO2
C. Elevated arterial PaO2
D. Decreased respiratory rate
A. Limiting fluid
B. Having the client take deep breaths
C. Asking the client to spit into the collection container
D. Asking the client to obtain the specimen after eating
A. 1 minute
B. 5 seconds
C. 10 seconds
D. 30 seconds
A. Dyspnea
B. Bradypnea
C. Bradycardia
D. Decreased respirations
A. Resonant sounds.
B. Hyperresonant sounds.
C. Dull sounds.
D. Flat sounds.
A. 15 to 60 seconds.
B. 5 to 20 minutes.
C. 30 to 40 minutes.
D. 45 to 60 minutes.
A. Lips.
B. Mucous membranes.
C. Nail beds.
D. Earlobes.
A. Diaphragmatic breathing
B. Use of accessory muscles
C. Pursed-lip breathing
D. Controlled breathing
A. Lung vibrations.
B. Vocal sounds.
C. Breath sounds.
D. Chest movements.
A. Erythromycin (Erythrocin)
B. Rifampin (Rifadin)
C. Amantadine (Symmetrel)
D. Amphotericin B (Fungizone)
A. Pleural effusion.
B. Pulmonary edema.
C. Atelectasis.
D. Oxygen toxicity.
51. The nurse in charge is teaching a client with
emphysema how to perform pursed-lip breathing.
The client asks the nurse to explain the purpose of
this breathing technique. Which explanation should
the nurse provide?
A. In 30 minutes
B. In 1 hour
C. In 2.5 hours
D. In 4 hours
A. Apnea
B. Anginal pain
C. Respiratory alkalosis
D. Metabolic acidosis
58. At 11 p.m., a male client is admitted to the
emergency department. He has a respiratory rate
of 44 breaths/minute. He’s anxious, and wheezes
are audible. The client is immediately given oxygen
by face mask and methylprednisolone (Depo-
medrol) I.V. At 11:30 p.m., the client’s arterial
blood oxygen saturation is 86% and he’s still
wheezing. The nurse should plan to administer:
A. Alprazolam (Xanax).
B. Propranolol (Inderal)
C. Morphine.
D. Albuterol (Proventil).
A. Heightened alertness
B. Increased heart rate
C. Numbness and tingling of the extremities
D. Respiratory depression
60. The nurse in charge formulates a nursing
diagnosis of Activity intolerance related to
inadequate oxygenation and dyspnea for a client
with chronic bronchitis. To minimize this problem,
the nurse instructs the client to avoid conditions
that increase oxygen demands. Such conditions
include:
1. Bladder distension
2. Neurological deficit
3. Pulse ox readings
4. The client’s feelings about the injury
1. Autonomic dysreflexia
2. Hemorrhagic shock
3. Neurogenic shock
4. Pulmonary embolism
1. Acetazolamide (Diamox)
2. Furosemide (Lasix)
3. Methylprednisolone (Solu-Medrol)
4. Sodium bicarbonate
1. Headache
2. Lumbar spinal cord injury
3. Neurogenic shock
4. Noxious stimuli
1. Autonomic dysreflexia
2. Hypervolemia
3. Neurogenic shock
4. Sepsis
1. Dopamine
2. GABA
3. Histamine
4. Norepinephrine
1. Subdural hematoma
2. Subarachnoid hemorrhage
3. Epidural hematoma
4. Contusion
30. After falling 20’, a 36-year-old man sustains a
C6 fracture with spinal cord transaction. Which
other findings should the nurse expect?
1. Skull fracture
2. Concussion
3. Subdural hematoma
4. Epidural hematoma
1. A flattened abdomen
2. Hematest positive nasogastric tube drainage
3. Hyperactive bowel sounds
4. A history of diarrhea
1. Positive reflexes
2. Hyperreflexia
3. Inability to elicit a Babinski’s reflex
4. Reflex emptying of the bladder
1. Decerebrate posturing
2. Dilated nonreactive pupils
3. Deep tendon reflexes
4. Absent corneal reflex
A. 2 to 5 g of a simple carbohydrate.
B. 10 to 15 g of a simple carbohydrate.
C. 18 to 20 g of a simple carbohydrate.
D. 25 to 30 g of a simple carbohydrate.
6. A female client
with hypothyroidism (myxedema) is
receiving levothyroxine (Synthroid), 25 mcg P.O.
daily. Which finding should nurse Hans recognize
as an adverse drug effect?
A. Dysuria
B. Leg cramps
C. Tachycardia
D. Blurred vision
A. Diabetes mellitus
B. Diabetes insipidus
C. Hypoparathyroidism
D. Hyperparathyroidism
A. Trousseau’s sign.
B. Homans’ sign.
C. Hegar’s sign.
D. Goodell’s sign.
A. Acromegaly
B. Type 1 diabetes mellitus
C. Hypothyroidism
D. Deficient growth hormone
A. Thyroid storm.
B. Cretinism.
C. myxedema coma.
D. Hashimoto’s thyroiditis.
22. A male client with type 1 diabetes mellitus asks
the nurse about taking an oral antidiabetic agent.
Nurse Jack explains that these medications are
only effective if the client:
A. sulfisoxazole (Gantrisin)
B. mexiletine (Mexitil)
C. prednisone (Orasone)
D. lithium carbonate (Lithobid)
A. Hypotension.
B. Thick, coarse skin.
C. Deposits of adipose tissue in the trunk and
dorsocervical area.
D. Weight gain in arms and legs.
A. Hypocalcemia
B. Hyponatremia
C. Hypokalemia
D. Hypermagnesemia
A. Depression
B. Neuropathy
C. Hypoglycemia
D. Hyperthyroidism
A. Tetany
B. Hemorrhage
C. Thyroid storm
D. Laryngeal nerve damage
A. Primary hypothyroidism
B. Graves’ disease
C. Thyrotoxicosis
D. Euthyroidism
A. Tetanic contractions
B. Neck vein distention
C. Weight loss
D. Polyuria
36. A female client with a history of
pheochromocytoma is admitted to the hospital in
an acute hypertensive crisis. To reverse
hypertensive crisis caused by pheochromocytoma,
nurse Lyka expects to administer:
A. phentolamine (Regitine).
B. methyldopa (Aldomet).
C. mannitol (Osmitrol).
D. felodipine (Plendil).
A. Adrenal cortex
B. Pancreas
C. Adrenal medulla
D. Parathyroid
38. Nurse Troy is aware that the most appropriate
for a client with Addison’s disease?
A. Restricting fluids
B. Restricting sodium
C. Forcing fluids
D. Restricting potassium
A. Oral anticoagulants
B. Anabolic steroids
C. Beta-adrenergic blockers
D. Thiazide diuretics
A. Hypocalcemia
B. Hypercalcemia
C. Hypokalemia
D. Hyperkalemia
1. A male client has an abnormal result on a
Papanicolaou test. After admitting, he read his
chart while the nurse was out of the room, the
client asks what dysplasia means. Which definition
should the nurse provide?
A. breast self-examination.
B. mammography.
C. fine needle aspiration.
D. chest X-ray.
A. cancerous lumps.
B. areas of thickness or fullness.
C. changes from previous self-examinations.
D. fibrocystic masses.
9. A client, age 41, visits the gynecologist. After
examining her, the physician suspects cervical
cancer. The nurse reviews the client’s history for
risk factors for this disease. Which history finding
is a risk factor for cervical cancer?
A. probenecid (Benemid)
B. cytarabine (ara-C, cytosine arabinoside [Cytosar-U])
C. thioguanine (6-thioguanine, 6-TG)
D. leucovorin (citrovorum factor or folinic acid
[Wellcovorin])
11. The nurse is interviewing a male client about
his past medical history. Which preexisting
condition may lead the nurse to suspect that a
client has colorectal cancer?
A. Duodenal ulcers
B. Hemorrhoids
C. Weight gain
D. Polyps
A. Persistent nausea
B. Rash
C. Indigestion
D. Chronic ache or pain
A. Anticipatory grieving
B. Impaired swallowing
C. Disturbed body image
D. Chronic low self-esteem
A. Liver
B. Colon
C. Reproductive tract
D. White blood cells (WBCs)
A. 24 hours
B. 2 to 4 days
C. 7 to 14 days
D. 21 to 28 days
A. Monitoring temperature
B. Ambulation three times daily
C. Monitoring the platelet count
D. Monitoring for pathological fractures
38. Gio, a community health nurse, is instructing a
group of female clients about breast self-
examination. The nurse instructs the client to
perform the examination:
A. Increased calcium
B. Increased white blood cells
C. Decreased blood urea nitrogen level
D. Decreased number of plasma cells in the bone marrow
A. Dyspnea
B. Diarrhea
C. Sore throat
D. Constipation
A. Bed rest
B. Out of bed ad lib
C. Out of bed in a chair only
D. Ambulation to the bathroom only
A. Bowel sounds
B. Ability to ambulate
C. Incision appearance
D. Urine specific gravity
A. Fatigue
B. Weakness
C. Weight gain
D. Enlarged lymph nodes
53. During the admission assessment of a 35 year
old client with advanced ovarian cancer, the nurse
recognizes which symptom as typical of the
disease?
A. Diarrhea
B. Hypermenorrhea
C. Abdominal bleeding
D. Abdominal distention
A. Infection
B. Hemorrhage
C. Cervical stenosis
D. Ovarian perforation
A. Anger
B. Denial
C. Bargaining
D. Depression
A. Alcohol abuse
B. Cigarette smoking
C. Use of chewing tobacco
D. Exposure to air pollutants
A. Nausea
B. Alopecia
C. Vomiting
D. Hyperuricemia