Cardiovascular/Respiratory 1. A client states that angina pain increase after activity.

The nurse should realize that angina pectoris is a sign of A. Mitral insufficiency C. Myocardial infraction B. Myocardial ischemia D. Coronary thrombosis 2. The nurse realizes that the pain associated with a coronary occlusion is caused primarily by: A. Arterial spasm B. Ischemia of the heart muscle C. Blocking of the coronary veins D. Irritation of nerve endings in eth cardiac plexus 3. When caring for a client after cardiac catheterization, it is most important that the nurse: A. Provide for rest C. Check the ECG every 30 minutes B. Administer oxygen D. Check pulse distal to the insertion site 4. The nurse in the coronary care unit (CCU) should observe for one of the more common complications of myocardial infraction , which is: A. Hypokalemia C. Cardiac dysrhythmias B. Anaphylactic shock D. Cardiac enlargement 5. The laboratory tests the nurse would expect the physician to order to confirm a diagnosis of myocardial infarction include: A. Serum calcium, APTT C. LDH, CK-MB, troponin B. Sedimentation rate, ALT D. Paul-Bunnel, serum potassium 6. A client is receiving Digoxin (Lanoxin) and will continue taking the drug after discharge. The nurse should be primarily concerned with A. Monitoring vital sign and encouraging gradual increase in activities of daily living B. Taking the apical pulse before drug administration and teaching the client how to count the pulse C. Observing the client for changes in cardiac rhythm and planning activities at home based on tolerance 7. When a client is receiving anticoagulants, the nursing care should include observation for: A. Nausea B. Epistaxis C. Headache C. Chest Pain 8. The nurse suspects a client is in cardiogenic shock. The nurse understands that this type of shock is A. An irreversible phenomenon C. Usually a fleeting reaction to tissue injury B. A failure of the circulatory pump D. Generally caused by decreased blood volume 9. A client who has a myocardial infarction is in the coronary unit on a cardiac monitor. The nurse observes ventricular irritability on the screen. The nurse should prepare to administer. A. Digoxin (Lanoxin) B. Furosemide (Lasix) C. Lidocaine (Xylocaine) D. Levarterenol bitartrate (Levophed) 10. During a cardiac arrest the nurse and the arrest team must keep in mind the: A. Age of the client C. Emergency medications available B. Time the client was anoxic D. Heart rate of the client before the arrest 11. A client is found unconscious and unresponsive. The nurse should first: A. Initiate a code C. Give four full lung inflations B. Check for a radial pulse D. Compress the lower sternum 15 times 12. A client has edema during the day, and it disappears at night. The client states it is not painful and is located in the lower extremities. The nurse should suspect: A. Lung disease C. Myocardial infraction B. Pulmonary edema D. Right ventricular failure. 13. The nurse can be assess the extent of edema in an extremity by A. Weighing the client B. Monitoring intake and output C. Checking for the degree of edema D. Performing the Trendelenburg test 14. A client is admitted to the hospital and has edematous ankles. The best limit edema of the feet the purse should prepare to: A. Restrict fluids C. Apply elastic bandages B. Elevate the legs D. Do range-of-motion 15. When taking an admission history of a client with right ventricular heart failure the nurse would expect the client to complain of: A. Dyspnea, edema, fatigue C. Weakness, palpitations, nausea B. Fatigue, vertigo, headache D. A feeling of distress when breathing

16. The nurse attempts to allay the anxiety of a client with heart failure because restlessness A. Increase the cardiac workload C. Produces an elevation in temperature B. Interferes with normal respiration D. Decreases the amount of oxygen available 17. To help alleviate the distress of a client with heart failure and pulmonary edema, the nurse should: A. Elevate the lower extremities C. Prepare for modified postural drainage B. Encourage frequent coughing D. Place the client in an orthopneic position 18. A disorder, following a streptococcal infection, characterized by swollen joints, fever and the possibility of endocarditis and death is: A. Tetanus B. Measles C. Rheumatic Fever D. Whooping cough 19. Advice to a patient on how to control future angina attack should include which instruction? Advising him to: A. Change his job C. avoid sexual activity B. Maintain a low sodium diet D. set up a regular program of exercise 20. A client diagnosed with angina pectoris expresses concern about engaging in sexual intercourse. The nurse should emphasize that: A. Impotence is a major side effect related to nitroglycerin B. Sexual intercourse is contraindicated because of the stress to the heart C. Nitroglycerin should be taken before engaging in sexual intercourse D. Before resuming sexual relations, counseling should be sought 21. A client with lower lobe pneumonia is prescribed percussion and postural drainage. When performing percussion and postural drainage, the nurse should position the client: A. Bent at the waist leaning slightly forward. B. Prone or supine with the foot of the bed elevated higher than the head. C. Right side-lying with the foot of the bed elevated. D. In semi-Fowlers position with the knees bent. 22. A client has chronic bronchitis. The nurse is teaching him breathing exercises. Which instruction should the nurse include in the teaching? A. Use chest breathing C. make inhalation longer than exhalation B. Use diaphragmatic breathing D. exhale through an open mouth 23. In a client with emphysema, the initiative to breathe is triggered by: A. low CO2 levels C. high CO2 levels B. low O2 levels D. high O2 levels 24. Following a pneumothorax, a client receives a chest tube attached to a three-chamber chest drainage system. During the night, the client becomes disoriented, gets out of bed, and steps on the drainage device, causing it to crack open and lose its seal. The nurse should immediately: A. clamp the chest tube close to the clients thorax B. place the device on a sterile field and call the physician C. place the end of the chest tube in a container of sterile water D. attach the chest tube directly to low wall suction 25. Clients with chronic illnesses are more likely to get pneumonia when which of the following situations is present? A. severe periodontal disease C. Dehydration B. group living D. Malnutrition 26. Which of the following path physiological mechanisms that occur in the lung parenchyma allows pneumonia to develop? A. Effusion B. Bronchiectasis C. Atelectasis D. inflammation 27. Which of the following organisms most commonly causes community-acquired pneumonia in adults? A. Haemophilus influenza C. streptococcus pneumonia B. Klebsiella pneumonia D. staphylococcus aureus 28. An elderly client with pneumonia may achieved by which of the following diagnostic test? A. Fever and chills C. Pleuritic chest pain and cough B. Hemoptysis and dyspnea D. Altered mental status and dehydration 29. A diagnosis of pneumonia is typically achieved by which of the following diagnostic test? A. Arterial blood gas (ABG) analysis C. Blood culture B. Sputum culture and sensitivity D. Chest x-ray

30. A client with acute sinusitis is examined in an ambulatory clinic. The Nurse can anticipate the use of which of the following medications in the client treatment plan A. Antibiotics C. Bronco dilators B. Repeated swallowing D. Oral corticosteroids 31. A 27-year old woman has had elective nasal surgery for a deviated septum. Which of the following would be an important initial clue that bleeding was occurring even if the nasal drip pad remained dry and intact? A. Complaints of nausea C. Increase respiratory rate B. Repeated swallowing D. Increased pain 32. Which of the following assessment would be a priority immediately after nasal surgery? A. Assessing the clients pain C. Assessing respiratory status B. Inspecting for periorbital ecchymosis D. Measuring intake and output 33. A client is being charge with nasal packing in place. He should be told to implement which of the following activities into his home care? A. Perform frequent mouth care C. Sneeze and cough with mouth closed B. Use normal saline nose drops daily D. Gargle every 4 hours with salt water 34. The nurse is teaching a client how to manage a nosebleed. Which of the following instruction would be appropriate to give the client? A. Tilt the head backward and pinch your nose B. Lie down flat and place an ice compress over the bridge of the nose C. blow your nose gently with your neck flexed D. Sit down, lean forward and pinch the soft portion of your nose 35. Which of the following signs and symptoms would the nurse include an a teaching plan as an early warning sign of laryngeal cancer? A. Dysphagia C. Airway obstruction B. Hoarseness D. Stomatitis