COMPETENCY APPRAISAL 2 (CARDIOVASCULAR-OXYGENATION)
LICEO DE CAGAYAN UNIVERSITY
PASEO DEL RIO CAMPUS
MACASANDIG, CAGAYAN DE ORO CITY
COLLEGE OF NURSING
COMPETENCY APPRAISAL 2
CARDIOVASCULAR-OXYGENATION
Name:
Date:
Score: Percentage:
GENERAL INSTRUCTIONS:
1. This questionnaire contains 100 test
questions.
2. Shade only one (1) box for each question
on your answer sheets. Two or more
boxes shaded will invalidate your answer.
3. Read the questions very carefully and
choose the BEST answer.
4. STRICTLY NO ERASURES. DISCIPLINE IS
WHAT MATTERS.
ASSIGNMENT PART III (201-300 ITEMS)
1. The nurse explains that hypertension increases the
work of the heart because of increasing:
a. preload.
b. stroke volume.
c. contractility.
d. afterload.
2. The heart sound the nurse would record as normal
would be:
a. ventricular gallop in a 20-year-old.
b. atrial gallop in a 25-year-old.
c. friction rub in a 45-year-old.
d. medium diastolic murmur in a 50-year-old.
3. A 49-year-old patient has multiple risk factors for
coronary artery disease. A modifiable risk factor that
the patient can focus on is:
a. family history.
b. age.
c. smoking.
d. male gender.
4. When the patient asks what a TEE is and what it is
expected to do, the nurse explains that the TEE is a
transesophageal echocardiogram, which:
a. measures conductivity.
b. records force of contraction.
c. evaluates efficiency of the valves.
d. checks volume of the preload.
5. The nurse records the finding of normal sinus
rhythm (NSR) when the P, Q, R, S, and T are all
present in the electrocardiographic complex and
a(an):
a. rate of 82.
b. PR interval of 0.36 second.
JOSEPH B. ABANG
c. QRS of 0.16 second.
d. inverted T.
6. The nurse would anticipate that a patient on
Vasotec (ACE inhibitor) would have as a positive
outcome to this drug:
a. increased fluid retention.
b. decreased blood pressure.
c. decreased urine output.
d. increased appetite.
7. A 29-year-old patient is to receive cardioversion for
his dysrhythmia. The nurse will instruct the patient to
expect:
a. administration of a short-acting sedative.
b. his digoxin dose to be taken as scheduled.
c. the procedure to be completely safe.
d. pacemaker spikes to be monitored
carefully.
8. A 68-year-old patient is scheduled for open heart
surgery in the morning and is crying. The appropriate
response from the nurse would be:
a. “Everything will go great! Dr. C is the best!”
b. “I know how you feel, so do not cry.”
c. “Tell me what concerns you the most.”
d. “I will call the physician for a sedative. You
are too upset.”
9. The nurse explains that when fibrous plaques of
atherosclerosis are laid down in the vessels, they
serve as a(an):
a. stent to keep the vessel open.
b. trap to which other substances adhere.
c. a threat to the integrity of the vessel wall.
d. embolus.
10. A patient with an irregular SA node conduction has
a permanent pacemaker with the code “A A I O O” and
now is going home. The patient asks, “What happens
when my real SA node fires on its own?” The nurse
responds that the pacemaker will:
a. not fire.
b. fire only the ventricles.
c. change the rate of firing.
d. fire both the atria and the ventricles.
11. When the angina pectoris patient complains of
chest pain at rest that takes three nitroglycerin (NTG)
pills to relieve, the nurse assesses this as a major
symptom of:
a. stable angina.
b. unstable angina.
c. full-blown acute MI.
d. pulmonary embolus.
12. The nurse explains that cardiac rehabilitation lasts
from the end of acute care to the return home and
beyond. This service includes:
a. one-on-one individualized care.
b. focus on the patient, rather than the family.
c. telemetry-monitored exercise.
d. rejection from the program for
noncompliance.
13. On auscultation, the nurse detects a heart
murmur. The nurse knows that a heart murmur
indicates:
a. the valves are not closing correctly.
b. the pericardium is inflamed.
 COMPETENCY APPRAISAL 2 (CARDIOVASCULAR-OXYGENATION)
c. there is a decrease in pacemaker cells.
d. a loud ventricular gallop.
14. An important teaching point for a patient with mitral
stenosis is to:
a. obtain a place on the heart transplant list.
b. balance activity with O2 supply.
c. increase fluid intake to over 2000 mL/day.
d. have an electrocardiogram annually.
15. The physician has ordered continuous pulse
oximetry. The nurse explains to the patient that the
procedure:
a. involves a single prick.
b. measures the amount of oxygen in the
blood.
c. is applied to the wrist.
d. identifies damaged cells in the myocardium.
16. A stress test is scheduled for a 41-year-old patient.
To prepare for the examination, the nurse would:
a. have the patient sign a consent.
b. give the patient a special heart diet.
c. prepare the patient for sedation.
d. remove all metal objects.
17. When a patient returns from a cardiac
catheterization, the nurse would expect to:
a. ambulate the patient in the hall.
b. check the puncture site.
c. monitor the gag reflex.
d. remove the gel from all sites on the skin.
18. When the nurse assesses an inverted T wave on
the ECG of a patient who is 2 days post–acute MI, the
nurse interprets this as ______of the myocardium.
a. irritability.
b. regenerations.
c. tissue death.
d. bleeding.
19. Laboratory tests are performed to identify damage
to the heart muscle. The test that is elevated the
earliest with heart damage is:
a. CPK-MB.
b. LDH.
c. lipid profile.
d. troponin.
20. A patient is scheduled for a heart catheterization.
In preparation for this examination, the nurse would:
a. ask if the patient is allergic to seafood or
iodine.
b. remove all metal objects.
c. give the patient a special heart diet.
d. test arterial blood gases.
21. To treat a dysrhythmia, atropine sulfate has been
administered intravenously. The nurse would monitor
for:
a. weight gain.
b. tachycardia.
c. muscle twitching.
d. incontinence of urine.
22. A dopamine infusion is being administered to a
patient with shock. The nurse should be alert for:
a. a sharp spike in blood pressure.
b. tremor of the hands.
c. increasing urinary output.
JOSEPH B. ABANG
d. hyperirritability of the patient.
23. The patient with atrial fibrillation is placed on
amiodarone for the dysrhythmia. The nurse should
report the adverse reaction of:
a. ataxia.
b. decreasing pulse rate.
c. decreasing blood pressure.
d. increase in cardiac output.
24. A medication, simvastatin (Zocor), is administered
to lower a patient’s cholesterol level. Follow-up lipid
levels are reviewed by the nurse. The level that
indicates the desired therapeutic range is:
a. HDL, 29 mg/dL; LDL, 160 mg/dL.
b. HDL, 38 mg/dL; LDL, 120 mg/dL.
c. HDL, 56 mg/dL; LDL, 106 mg/dL.
d. HDL, 42 mg/dL; LDL, 98 mg/dL.
25. A patient has had an acute MI. The nurse should
include in the discharge instructions:
a. cautions about use of morphine.
b. detailed symptoms that indicate impending
MI.
c. written instructions on diet and follow-up
appointments.
d. high-energy exercise program directions.
26. A patient with acute congestive heart failure
presents with jugular vein distention, crackles
bilaterally, and dyspnea. The nursing diagnosis with
the highest priority would be:
a. activity intolerance.
b. excess fluid volume.
c. anxiety.
d. ineffective coping.
27. A patient has acute congestive heart failure. A
nursing intervention to decrease the workload of the
heart would be to:
a. place the patient in a supine position.
b. encourage group activities to promote rest.
c. have the patient cough and deep breathe
every 2 hours.
d. encourage large meals for extra needed
calories.
28. A diuretic medication is being administered for
congestive heart failure. The nurse should monitor for
an adverse effect of:
a. increased urinary output.
b. weight loss.
c. thirst.
d. muscle weakness.
29. A patient is receiving digoxin, 0.25 mg daily.
Before giving the medication, the nurse would:
a. count an apical pulse for 15 seconds.
b. hold the dose if the apical rate is 57
beats/min.
c. give the dose if the apical rate is 59
beats/min.
d. double the dose if the rate is 62 beats/min.
30. A 46-year-old patient is receiving propranolol
(Inderal), a nonselective beta-adrenergic blocker for
his heart condition. The nurse would teach the patient
to:
a. sit or lie down when taking the drug.
b. limit caffeine intake.
 COMPETENCY APPRAISAL 2 (CARDIOVASCULAR-OXYGENATION)
c. double the dose if symptoms occur.
d. not stop the drug abruptly.
31. The nurse caring for a patient on lidocaine to
increase ventricular conduction is alarmed when
assessments reveal:
a. a slowed ventricular rate.
b. occasional PVCs.
c. increase in temperature to 102º F.
d. nausea and vomiting.
32. The nurse takes a blood pressure with the 65-
year-old patient lying down and then again with the
patient standing, with the resultant readings of 152/92
and 130/62. The nurse should record:
a. normal blood pressure for age.
b. orthostatic hypotension.
c. age-related hypertension.
d. exertional hypertension.
33. The nurse records a 1 for the pulse quality of the
pedal pulse. This means that the pulse is:
a. absent.
b. normal.
c. thready.
d. forceful.
34. The nurse explains that factors that affect stroke
volume are (select all that apply):
1. contractility.
2. climate.
3. age.
4. preload.
5. afterload.
A. 1,2,3,4,5 B. 1,4,5 C. 1,3,4,5
D. 1,3,4,5
35. The nurse takes into consideration the age-related
changes in the heart, which are (select all that apply):
1. Decrease in contractility
2. Thickened valves
3. Stiffened valves
4. Decreased SA node cells
5. Increased nerve fibers in ventricles
A. 1,2,3,4,5 B. 1,4,5 C. 1,3,4,5
D. 1,3,4,5
36. A normal age-related change in older adults that
makes them susceptible to cardiovascular disease is:
a. increasing cardiac output.
b. an increase in stroke volume.
c. stiff peripheral vessels.
d. oxygen capacity improvement.
37. The nurse asks for a relevant piece of information
from a patient who presents with a DVT that would
predispose the patient to a development of a more
serious condition. The nurse inquires about the
presence or history of a(n):
a. aneurysm.
b. arthritis.
c. peptic ulcer.
d. chest pain.
38. A 69-year-old patient reports burning, aching pain
in the legs when walking to the mailbox. These
symptoms are relieved with rest. The nurse would
suspect:
a. venous insufficiency.
b. claudication.
JOSEPH B. ABANG
c. phlebitis.
d. rest pain.
39. A 42-year-old patient has a vascular disorder and
presents with a decrease in temperature in his right
leg. The nurse would identify this as:
a. decreased capillary refill.
b. pulselessness.
c. poikilothermy.
d. pallor.
40. The nurse reports adequate capillary refill if the
blanched nail bed returns to a pink color within:
a. 1 second.
b. less than 3 seconds.
c. 5 seconds.
d. 7 seconds.
41. The nurse performs Homans’ maneuver by flexing
the knee and sharply dorsiflexing the foot. A positive
Homans’ sign would be:
a. cramping of the toes.
b. resisting dorsiflexion.
c. pain in the calf area.
d. blanching of the sole.
42. A nurse performs Allen’s test to evaluate the
adequacy of circulation in the radial artery by:
a. asking the patient to relax the hand by the
side.
b. compress only the ulnar artery to blanch the
hand.
c. releasing pressure on both arteries at the
same time.
d. color returning to hand indicates perfusion.
43. The nurse records that the patient has a 3+ edema
to the right foot, which means that the nurse’s thumb
depressed the edematous area to a depth of:
a. more than 1 inch.
b. 1/2 to 1 inch.
c. 1/4 to 1/2 inch.
d. less than 1/4 inch.
44. The nurse notes ulcerations on the surfaces of the
patient’s toes and assesses this as an indication of:
a. skin breakdown from pressure.
b. nutritional deficit.
c. venous stasis.
d. arterial stasis.
45. The nurse cautions a patient that one of the
characteristics of a venous stasis ulcer is:
a. painlessness.
b. poikilothermy.
c. pale color.
d. location near the groin.
46. Following an angiogram, the nurse will make a
point of care to assess and document:
a. fluid intake.
b. peripheral pulses in effected leg.
c. inquiring about allergy to iodine.
d. decreased blood pressure.
47. The nurse would include in the instruction related
to a stress test on a treadmill that the test is a
noninvasive procedure that:
a. is monitored continuously by blood
pressure and EKG
 COMPETENCY APPRAISAL 2 (CARDIOVASCULAR-OXYGENATION)
b. will last about 1 hour.
c. is meant to stimulate claudication and
dyspnea.
d. will require a period of bed rest afterward.
48. When the patient inquires how something as
simple as walking could help his venous vascular
disorder, the nurse explains that walking will:
a. improve the strength of the vascular walls.
b. boost venous circulation through leg
muscle activity.
c. increase cardiac output.
d. clear plaques from the veins.
49. The patient performing the Buerger-Allen
exercise:
a. lies on the stomach.
b. raises the legs for 2 minutes until they
blanch.
c. lowers the legs until color returns.
d. brings the legs flat for 5 minutes and then
repeats the exercise.
50. 15. The nurse cautions the patient with PVD that
his continued smoking causes detrimental
vasoconstriction for up to ______ after only one
cigarette.
a. 10 minutes
b. 20 minutes
c. 30 minutes
d. 1 hour
51. While doing an intake examination on a patient
with PVD, the nurse identifies a factor that aggravates
vascular disease, which is that the patient:
a. rides a bicycle to work.
b. drinks red wine every day.
c. is employed as an air traffic controller.
d. eats chocolate candy every day.
52. Vascular disease disorders often require the use
of elastic stockings. When caring for a patient with
elastic stockings, the nurse should:
a. apply the stockings in the late afternoon.
b. remove the stockings weekly.
c. remove the stockings when the patient is
ambulating.
d. inspect the skin for pressure or irritation
daily.
53. A patient with arterial insufficiency should be
instructed to:
a. frequently allow the legs to dangle
dependently.
b. rub the legs vigorously.
c. stand often to keep blood flow in the legs.
d. walk barefoot.
54. The nurse injecting low-molecular-weight heparin
for anticoagulant therapy should:
a. give the injection as a deep IM injection.
b. aspirate to avoid injecting in a vessel.
c. leave a bubble in the syringe when giving
the injection.
d. alternate dose times.
55. The nurse assesses that the teaching plan for the
use of warfarin was not effective when the patient
says:
a. “I don’t take aspirin anymore.”
JOSEPH B. ABANG
b. “I read that grapefruit interferes with
warfarin.”
c. “I'm drinking too much tea. My urine looks
like tea.”
d. “I wear my medical alert bracelet all the
time.”
56. A patient has returned from a vein ligation and
stripping. Nursing care would include:
a. dangling the legs to prevent edema.
b. crossing the legs to apply pressure.
c. compression stockings to promote
circulation.
d. removing the drain after 24 hours.
57. A patient is receiving antiplatelet therapy.
Symptoms of tinnitus are reported. The nurse would
suspect the medication:
a. ticlopidine (Ticlid).
b. cilostazol (Pletal).
c. warfarin (Coumadin).
d. aspirin.
58. The obese postsurgical patient complains of
sudden discomfort in her leg. The nurse assesses the
leg and finds it cold and pale, with no pedal or popliteal
pulse. These are signs of:
a. venous thrombosis.
b. arterial occlusion.
c. vascular spasm.
d. paresthesia.
59. An important postoperative sign to report
immediately when caring for a patient with an
endarterectomy with a synthetic graft is:
a. daily weight.
b. fever.
c. edema.
d. pain.
60. The patient with Raynaud’s disease has a nursing
diagnosis of “Ineffective tissue perfusion related to
vasoconstriction” is being given discharge
instructions. The nurse would caution the patient to:
a. avoid defrosting the freezer.
b. wear gloves and warm socks when
outdoors.
c. chafe hands frequently to warm them.
d. wash dishes in warm water.
61. Following surgery to repair an abdominal aortic
aneurysm, the nurse would assess the patient for:
a. periorbital edema.
b. tremor or facial twitching.
c. rising blood pressure.
d. bowel sounds.
62. Patient teaching for the patient with varicose veins
should include:
a. weight reduction.
b. decreasing exercise.
c. wearing a panty girdle.
d. standing in one place frequently.
63. The nurse explains that older persons adapt more
slowly to changes in the peripheral vascular system
because of (select all that apply):
1. slowing of heart rate.
2. decrease in cardiac output.
3. decrease in stroke volume.
 COMPETENCY APPRAISAL 2 (CARDIOVASCULAR-OXYGENATION)
4. stiffening of blood vessels.
5. thickening of aorta.
A. 1,2,3,4,5 B. 1,4,5 C. 1,3,4,5
D. 1,3,4,5
64. The nurse who suspects a circulatory disorder in
one leg should compare it with the other for the
assessment of (select all that apply):
1. color.
2. warmth.
3. muscle strength.
4. pulse quality.
5. hair loss on extremity.
A. 1,2,3,4,5 B. 1,4,5 C. 1,3,4,5
D. 1,2,4,5
Subeg Ka, age 52, experiences retrosternal chest
pain that radiates down his left arm when he is
engaged in strenuous physical activity. A resting
elecetrocardiogram (ECG) is normal, but a stress
ECG shows ST depression.
65. As the nurse takes a history, which of the following
questions is most relevant?
A. “Can you describe the pain and the
events that led up to it?”
B. “Are you taking any medications for
chest pain?”
C. “How many packs of cigarettes do you
smoke daily?”
D. “Is the pain radiate to your jaw or
neck?”
66. Cardiac isoenzymes are drawn. Why were they
ordered?
A. To identify the causative agent
B. To identify how well the blood is being
oxygenated
C. To rule out gas or indigestion
D. To determine the presence of tissue
damage
67. A client asks what does the coronary arteries have
to do with angina. In determining the answer, the
nurse should take into consideration that coronary
arteries:
A. Carry reduced oxygen-content blood
to the lungs
B. Carry blood from the aorta to the
myocardium
C. Supply blood to the endocardium
D. Carry high-oxygen-content blood from
the lungs toward the heart
Sinju Mung, a 35 year old is employed as a cook in a
local restaurant. He awakens one night with crushing
substernal chest pain, diaphoresis, and nausea. His
wife calls the paramedics and Mr. Mung is taken to the
closest emergency room. He has the classic signs of
myocardial infarction.
68. Mr. Mung arrives in the emergency room, still in
pain. He is quickly assessed by the nurse and the
physician. The best initial nursing action is to:
A. Start an IV
B. Give the pain medication as ordered
by the physician
C. Prepare him for immediate transfer to
the coronary care unit
JOSEPH B. ABANG
D. Get a complete history from his wife
69. Mr. Mung was transferred to the coronary care unit
after an ECG indicated a posterior wall infarction.
Upon arriving at the unit, he complained of a chest
pain. In assessing the pain, which of the following is
not a characteristic of the pain of an acute myocardial
infarction?
A. Intense and crushing
B. Relieved by nitroglycerin
C. May radiated to one or both arms,
neck or jaw
D. Is of so long duration and not relieved
by rest
70. What is the most lethal complication in the period
after myocardial infarction?
A. Cardiogenic shock
B. Ventricular dysrhythmias
C. Pulmonary embolus
D. Cardiac tamponade
71. Valsalva's maneuver can result in bradycardia
which can be very dangerous for the client with
myocardial infarction client. Which nursing action will
prevent Valsalva's maneuver?
A. Administer oral laxatives PRN
B. Teach the client to hold his breath
when changing position
C. Service liquids at room temperature
D. Encourage the client to deep-breath
frequently
Henry Hubo, a 50 year old white man, awakens in the
middle of the night severe dyspnea, bilateral basilar
rales, and expectoration of a frothy, blood tinged
sputum. He is brought to the hospital in congestive
heart failure complicated with pulmonary edema.
72. Dyspnea is a characteristic sign of congestive
heart failure. This is primarily the result of:
A. Accumulation of serous fluid in
alveolar spaces
B. Obstruction of bronchi by mucoid
secretion
C. Compression of lung tissue by a
dilated heart
D. Restriction of respiratory movement
by ascites
73. What is the optional bed position for the client with
congestive heart failure?
A. Position of comfort to relax the client
B. Semirecumbent, to ease dyspnea and
metabolic demands on the heart
C. Upright, to decrease danger of pulmonary
edema
D. Flat, to decrease edema formation in the
extremities
74. How do rotating tourniquets relieve the symptoms
of acute pulmonary edema?
A. Cause vasoconstriction
B. Cause vasodilation
C. Decrease the amount of circulating
blood
D. Increase the amount of circulating
blood
 COMPETENCY APPRAISAL 2 (CARDIOVASCULAR-OXYGENATION)
75. When tourniquets are applied to extremities to
relieve the symptoms of pulmonary edema, one
tourniquet is rotated, in order every:
A. 5 min
B. 15min
C. 30min
D. 60 min
76. The client experiences a cardiac arrest. What
would be the nursing action in this situation?
A. Call the physician on duty
B. Establish an airway
C. Start closed-chest massage
D. Give a bolus of sodium bicarbonate
Margareta Evangelista is hospitalized with coronary
heart disease. Medications, including digitalis and a
sedative are prescribed. She does not seem to be
accurately ill but her prognosis is guarded.
77. The nurse who has been caring for Mrs.
Evangelista for several days notes cyanosis and a
change in respiration. The nurse starts oxygen
administration immediately. In this situation:
a. Oxygen had not been ordered and therefore
should not be administered
b. The physician should have been called for
an order before oxygen was begun
c. The symptoms were too vague for the nurse
to diagnose a need of oxygen
d. The nurse's observations were sufficient to
begin administration of oxygen
78. In addition to a decreased apical rate, the nurse
should teach Mrs. Evangelista to withhold the digitalis
if she experiences:
A. Decreased urinary output
B. Tinnitus
C. Chest pain
D. Blurred vision
79. The nurse prepares a client for insertion of a
Swan-Gans catheter. The use teaches the client that
the catheter will be inserted to provide information
about:
A. Stroke Volume
B. Left-sided failure
C. Venous pressure
D. Cardiac output
Joseph Yan, a 55 year old black man, is admitted to
the hospital with a diagnosis of hypertension. While
taking his history, the nurse learns that he is employed
as a sales manager for a larger video business. His
hypertension was discovered on a routine visit to the
medical department at work.
80. Which of these findings would constitute a
significant index of hypertension?
A. A pulse pressure at 10 mmHg
B. A regular pulse of 90 beats per min
C. A sustained diastolic pressure greater
than 90 mmHg
D. A systolic pressure fluctuating
between 135 and 140 mmHg
JOSEPH B. ABANG
81. A 2-year-old has a congenital right-to-left shunt
defect of the heart. The nurse would expect to
observe:
A. Orthopnea
B. An elevated hematocrit
C. Absence of pedal pulses
D. Edema in the extremities
82. After discussion with the pediatric cardiologist, the
parents of an infant ask the nurse to explain once
again what patent ductus arteriosus is. The nurse tells
them that it is:
A. A narrowing of the pulmonary artery
B. An enlarged aorta and pulmonary
artery
C. A connection between the pulmonary
artery and the aorta
D. An abnormal opening between the
right and left ventricles
83. A young child has coarctation of the aorta when
taking the child’s vital signs, the nurse can expect to
observe:
A. Notching of the clavicle
B. Bounding femoral pulses
C. Weak, thready radial pulses
D. Higher BP in upper extremities
84. Which statement does accurately describe
Raynaud's disease?
A. It is characterized by episodic digital
vasospasm associated with skin color
changes
B. It is precipitated by exposure to cold or by
emotional stress
C. It typically seen in the fingers and toes
D. It usually occurs in men ages 40 to 60
85. While caring for a patient who recently had
surgery, the nurse realizes that he is at risk for venous
thrombosis. Which measure would help prevent
venous thrombosis?
A. Avoiding ambulation
B. Hyperflexing the knees
C. Moving and exercising the legs
frequently
D. Avoiding the use of supportive
stockings
86. Mr. Molano, a 65 year old diabetic patient with
arterial insufficiency in the legs, complains that his feet
are cold. Which nursing measure is contraindicated?
A. Applying a heating pad up to the
patient's feet
B. Applying warm socks
C. Encouraging exercise
D. Increasing the room temperature
slightly
87. Assessment data that supports the diagnosis of
varicose veins include:
A. Dilated, twisting, discolored vein and
nocturnal cramping
B. Intermittent claudication and nor
palpable pedal pulses
C. Positive Homan's Sign and
edematous,reddened calf
 COMPETENCY APPRAISAL 2 (CARDIOVASCULAR-OXYGENATION)
D. Marked limb enlargement and nor
pitting edema
Larry Green, age 37, is admitted with gangrenous
lesion of his right great toe. He has a history of
thromboangitis obliteerans (Buerger's disease).
88. When obtaining data from the client, the nurse
would expect the assessment to demonstrate or the
client to report:
A. Burning pain precipitated by cold
exposure, fatigue, blanching of the skin
B. Easy fatigue of part, continuous
claidiaction
C. General blanching of the skin, intermittent
claudication
D. Intermittent claudication, burning pain
after exposure to cold
89. The etiology of thromboangitis obliterans
(Buerger's disease) is unknown. However to limit the
blood vessels distruction in a patient with this disorder,
the nurse instruct the patient to:
A. Limit fluid intake
B. Exercise regularly
C. Elevate regularly
D. Stop smoking
Mr. Obet, age 26, visits the physician complaining of
severe indigestion and lower back pain. His physician
palpated an abdominal mass and auscultates an
abdominal bruit. Mr. Obet is immediately admitted to
a surgical unit for evaluation. An anteriogram reveals
an aneurysm.
90. Which finding would the nurse expect when
examining a patient with diagnosis of abdominal aortic
aneurysm?
A. Tachycardia
B. Pulsatile abdominal mass
C. Paresis of the legs
D. Carotid bruits
91. Which complication represents the greatest threat
to Mr. Obet before his abdominal aortic aneurysm is
surgically repaired?
A. Rupture
B. Embolism
C. Aortic dissection
D. Cerebrovascular accident
92. Which statement best describes the
pathophysiology of mitral valve stenosis?
A. The mitral valve atrophies, leading to atrial
dilation and hypertrophy
B. A fibrous ring forms around the mitral
valve, causing backflow of the blood into
the atrium
C. Chordae tendineae become shorter and
thicker, and valve leaflets fuse
D. The mitral valve leaflets widen and the
flaps are unable to close completely
93. Physical assessment of a client with mitral valve
stenosis reveal all of the following findings except:
A. A loud S1 heart sound
B. Adventitious lung sound
JOSEPH B. ABANG
C. A loud S2 heart sound
D. Peripheral edema
94. When providing patient teaching for a person
susceptible to the development of ineffective
endocarditis, the nurse should include information on
the use:
A. Prophylactic antibiotic therapy
B. Prophylactic immunosuppressive
therapy
C. Diuretic for weight gain
D. Face mask with family members
95. After an anginal attack, a client is discharged and
referred to the outpatient clinic for a stress test and
cardiac angiography. What is the rationale for the
cardiac angiography?
A. To dilate the coronary blood vessels
B. To confirm a diagnosis of heart
disease
C. To force oxygen under pressure to the
myocardium
D. To bypass the diseased coronary
artery
96. Among the last signs of heart failure in the infant
and child is:
A. Orthopnea
B. Tachypnea
C. Tachycardia
D. Peripheral edema
97. A male client has end-stage congestive heart
failure and exhibits signs of impending cardiac arrest.
The client requests a full code even though he knows
it probably won't save his life. The client's physician
explains to the nurse that there is no reason to call a
“code” because the client has no viable heart muscle
left. What would be the nurse's most appropriate
course of action in this situation?
a. Do what the physician requests and not
called a code
b. Follow through with a code if cardiac arrest
occurs
c. Intervene on behalf of the client and
persuade the physician to initiate a code
d. Ignore the situation
98. Nitroglycerin will produce dilation of the coronary
arteries in 1 to 2 minutes after being put under the
tongue. Which of these statements correctly
describes the procedure for administering
nitroglycerin when one tablet does relieve the pain?
A. Administer one tablet q2 min for five
doses
B. Administer one tablet q5 min for ten
doses
C. Administer one tablet q5 min for three
doses
D. Administer one tablet q10 min for five
doses
99. Evaluation of the effectiveness of cardiac nitrates
is based on:
A. Relief of anginal pectoris
B. A decreased in blood pressure
C. Improved cardiac pressure
 COMPETENCY APPRAISAL 2 (CARDIOVASCULAR-OXYGENATION)

D. Dilation of the superficial blood

vessels

100. The physician adjusts a client’s dosages of

Digoxin and Warfarin sodium (Coumadin). The
antidote for Coumadin that the nurse should keep in
the client’s medicine drawer is:
A. Vitamin K
B. Fibrinogen
C. Prothrombin
D. Protamine sulfate

“Don’t make excuses for why you can’t get it

done.
Focus on all the reasons why you must make it
happen.”

JOSEPH B. ABANG