Cardiac Questions

1. A nurse is assessing a client with heart failure who has been prescribed digoxin (Lanoxin)
for therapy. Which finding indicates an issue with the medication management?

A. Regular heart rate of 88 beats/min

B. Serum Potassium level, 2.9 mEq/L
C. Weight Decreases by 1 lb daily
D. Serum sodium level, 138 mEq/L

2. The nurse is caring for a client with an ischemic stroke who has a prescription for tissue
plasminogen activator (t-PA) IV. Which action(s) should the nurse expect to implement?
(Select all that apply.)

A. Administer aspirin with tissue plasminogen activator (t-PA).

B. Complete the National Institute of Health Stroke Scale (NIHSS)
C. Assess the client for signs of bleeding during and after the infusion
D. Start t-PA within 6 hours after the onset of stroke symptoms
E. Initiate multidisciplinary consult for potential rehabilitation

3. Which of the following cardiac rhythms is represented in the image?

A. Normal Sinus Rhythm

B. Sinus tachycardia
C. Ventricular Fibrillation
D. Atrial fibrillation

4. A 67 year old male comes into the ED experiencing sub-sternal chest pain and shortness
of breath. A 12 lead EKG is ordered. The MD and nurse determine that the patient is
having a myocardial infarction. What is the first action the nurse should take?
A. Administer oxygen via nasal cannula at 3L/min
B. Administer IV morphine sulfate 2mg
C. Educate patient on what they are experiencing
D. Administer Nitroglycerin 0.5mg sublingual

5. Which of the following classes of medications protects the ischemic myocardium by

blocking catecholamines and sympathetic nerve stimulation?
A. Beta-Blockers
B. Calcium Channel Blockers
C. Narcotics
D. Nitrates

6. Toxicity from which of the following medications may cause a client to see a yellow halo
around lights?
A. Enalapril (Vasotec)
B. Metoprolol (Lopressor)
C. Furosemide (Lasix) C
D. Digoxin

7. A nurse should teach a client with Angina about the common side effects of
nitroglycerin, including:
A. Headache
B. Hypertension
C. Shock
D. Flushing
E. Dizziness
F. Shortness of breath
G. Abdominal cramps

8. Which clinical feature found on assessment should indicate to a nurse that a client has
congestive heart failure?
A. Fatigue and dyspnea
B. Cheyne-Stokes breathing and orthostatic hypotension
C. Liver tenderness and peripheral edema
D. Pulmonary crackles and weak pulses

9. A client, admitted to the emergency department with a myocardial infarction (MI), is

experiencing chest pain and becomes profusely diaphoretic and apprehensive. What
should be the initial intervention by the RN?
A. Increase nasal oxygen from 2 L/min to 6 L/min
B. Check the troponin and myoglobin levels on the chart
C. Give the PRN dose of morphine sulfate 3 mg IV push
D. Get a 12 lead ECG

10. The nurse is caring for a client with acute coronary syndrome (ACS) and atrial fibrillation
who has a new prescription for metoprolol (Toprol). Which monitoring is essential when
administering the medication?
A. ST segment
B. Heart rate
C. Troponin
D. Myoglobin

11. The nurse is caring for a client on a telemetry unit with a regular heart rhythm and rate of
60 beats/min; a P wave precedes each QRS complex, and the PR interval is 0.20 second.
 Additional vital signs are as follows: blood pressure 118/68 mm Hg, respiratory rate 16
breaths/min, and temperature 98.8 F. All of these medications are available on the
medication record. What action does the nurse take?
A. Administer atropine.
B. Administer digoxin.
C. Administer clonidine.
D. Continue to monitor

12. A client with atrial fibrillation with rapid ventricular response has received medication to
slow the ventricular rate. The pulse is now 88 beats/min. For which additional therapy
does the nurse plan?
A. Synchronized cardioversion
B. Electrophysiology studies (EPS)
C. Anticoagulation
D. Radiofrequency ablation therapy

13. After an anterior wall myocardial infarction, which of the following problems is indicated
by auscultation of crackles in the lungs?
A. Left sided heart failure
B. Pulmonic valve malfunction
C. Right sided heart failure
D. Tricuspid valve malfunction

14. Which of the following classes of drugs is the most widely used in the treatment of
cardiomyopathy?
A. Antihypertensive
B. Beta-adrenergic blockers
C. Calcium channel blockers
D. Nitrates

15. Mark asks the nurse about his medications, chlorothiazide (Diuril) and atenolol
(Tenormin). The nurse reviews the medications, the side effects, and the
importance of taking the medications on a daily basis. In evaluating Marks understanding,
which statement(s) indicate that Mark understands the nurses instructions about his
medications? (Select all that
apply).
A. I will need to take diuril early in the day
B. I will be taking these medications for the rest of my life
C. I can expect my heart rate to increase as my blood pressure goes down
D. I may experience impotence with this drug regimen
E. An irritating cough often develops but will subside in a few days