1.

Myra is ordered laboratory tests after she is admitted to the hospital

for angina. The isoenzyme test that is the most reliable early indicator
of myocardial insult is:

a. SGPT
b. LDH
c. CK-MB
d. AST

2. Joey is a 46 year-old radio technician who is admitted because of

mild chest pain. He is 5 feet, 8 inches tall and weighs 190 pounds. He is
diagnosed with a myocardial infarct. Morphine sulfate, Diazepam (Valium)
and Lidocaine are prescribed. The physician orders 8 mg of Morphine
Sulfate to be given IV. The vial on hand is labeled 1 ml/ 10 mg. The
nurse should administer:

a. 8 minims
b. 10 minims
c. 12 minims
d. 15 minims

3. An early finding in the EKG of a client with an infarcted mycardium

would be:

a. Disappearance of Q waves
b. Elevated ST segments
c. Absence of P wave
d. Flattened T waves

4. Mr. Ong, a client with CHF, has been receiving a cardiac glycoside, a
diuretic, and a vasodilator drug. His apical pulse rate is 44 and he is on
bed rest. The nurse concludes that his pulse rate is most likely the result
of the:

a. Diuretic
b. Vasodilator
c. Bed-rest regimen
d. Cardiac glycoside

5. After the acute phase of congestive heart failure, the nurse should
expect the dietary management of the client to include the restriction of:

a. Magnesium
b. Sodium
c. Potassium
d. Calcium

6. Mr. Ong is admitted to the hospital with a diagnosis of Left-sided CHF.

In the assessment, the nurse should expect to find:

a. Crushing chest pain

b. Dyspnea on exertion
c. Extensive peripheral edema
d. Jugular vein distention

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7. What would be the primary goal of therapy for a client with

pulmonary edema and heart failure?

a. Enhance comfort
b. Increase cardiac output
c. Improve respiratory status
d. Peripheral edema decreased

8. During the second day of hospitalization of the client after

a Myocardial Infarction. Which of the
following is an expected outcome?

a. Able to perform self-care activities without pain

b. Severe chest pain
c. Can recognize the risk factors of Myocardial Infarction
d. Can Participate in cardiac rehabilitation walking program

9. Upon admission to an intensive care unit, a client diagnosed with an

acute myocardial
infarction is ordered oxygen. The nurse knows that the major reason that
oxygen

a. saturate the red blood cells

b. relieve dyspnea
c. decrease cyanosis
d. increase oxygen level in the myocardium

10. A 66 year-old client is admitted for mitral valve replacement surgery.

The client has a
history of mitral valve regurgitation and mitral stenosis since her teenage
years. During the
admission assessment, the nurse should ask the client if as a child she
had

a. measles
b. rheumatic fever
c. hay fever
d. encephalitis

11. Electrocardiogarphy (ECG) is a diagnostic tool used to evaluate the

electrical activity of the heart. Which of the following ECG results would
reveal that there is myocardial ischemia?

a. ST segment elevation and peaked T wave

b. ST segment elevation and inverted T wave
c. ST segment depression and peaked T wave
d. ST segment depression and abnormal Q wave

12. A client has been diagnosed with hypertension. The nurse priority
nursing diagnosis would be

a. Ineffective health maintenance

b. Impaired Skin Integrity
c. Deficient Fluid Volume
d. Pain

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13. Which of the following represents a significant risk immediately after

surgery for repair of aortic aneurysm?

a. Potential wound infection

b. Potential ineffective coping
c. Potential electrolyte imbalance
d. Potential alteration in renal perfusion

14. The following are lipid abnormalities. Which of the following is a risk
factor for the development of atherosclerosis and PVD?

a. High levels of low density lipid (LDL) cholesterol

b. High levels of high density lipid (HDL) cholesterol
c. Low concentration triglycerides
d. Low levels of LDL cholesterol.

15. Patrick who is hospitalized following a myocardial infarction asks

the nurse why he is taking morphine. The nurse explains that morphine:

a. Decrease anxiety and restlessness

b. Prevents shock and relieves pain
c. Dilates coronary blood vessels
d. Helps prevent fibrillation of the heart

16. Nurse Trisha teaches a client with heart failure to take oral
Furosemide in the morning. The reason for this is to help.

a. Retard rapid drug absorption

b. Excrete excessive fluids accumulated at night
c. Prevents sleep disturbances during night
d. Prevention of electrolyte imbalance

17. Dr. Marquez orders a continuous intravenous nitroglycerin infusion for

the client suffering from myocardial infarction. Which of the following is
the most essential nursing action?

a. Monitoring urine output frequently

b. Monitoring blood pressure every 4 hours
c. Obtaining serum potassium levels daily
d. Obtaining infusion pump for the medication

18. Nurse Maureen would expect the client with mitral stenosis would
demonstrate symptoms associated with congestion in the:

a. Right atrium
b. Superior vena cava
c. Aorta
d. Pulmonary

19. A client who has been diagnosed of hypertension is being taught to

restrict intake of sodium. The nurse would know that the teachings are
effective if the client states that

a. I can eat celery sticks and carrots

b. I can eat broiled scallops
c. I can eat shredded wheat cereal
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d. I can eat spaghetti on rye bread

20. Which of the following should the nurse teach the client about the
signs of digitalis toxicity?

a. Increased appetite
b. Elevated blood pressure
c. Skin rash over the chest and back
d. Visual disturbances such as seeing yellow spots

21. A client received digoxin (Lanoxin) therapy o treat the irregular

beating of his heart. The nurse knows that the therapy has been
effective when the client with atrial fibrillation has an ECG tracing
showing:

a. A heart rate of 50 beats per minute

b. Mobitz II heart block
c. A heart rate of 105 beats per minute
d. A heart rate of 70 beats per minute

22. Cardiomyopathy is a serious disease in which the heart muscle

weakens and there is an evident change in the cardiac structure. There
are three types of cardiomyopathy namely: dilated, hypertonic and
restrictive. When assessing a client with left-sided heart failure, the
nurse would observe:

a. Ascites and orthopnea

b. Pitting edema and pulmonary congestion
c. Air hunger and tachypnea
d. Jugular vein distention and neck vein distention

23. You are providing care for a patient with Arterial Occlusive Disease,
and writing a Nursing Care Plan. One of your interventions is to position
the patient's legs below the level of the heart. From which of the
following Nursing Diagnoses is the above intervention MOST LIKELY derived
from:

a. Potential for Activity Intolerance

b. High risk for pain
c. Potential for Altered Respiratory Function
d. Altered Tissue Perfusion

24. An 18 month old with Tetralogy of Fallot has a "tet" spell after
having an invasive procedure. To improve the child's cardiac status
which of the following interventions should the nurse do initially:

a. Place the child in a knee chest position

b. Begin chest compressions
c. Administer oxygen
d. Position with HOB elevated

25. A patient has received thromboembolytic therapy following a

Myocardial Infarction with Streoptokinase. Which of the following drugs
should the nurse have on hand if the patient develops excessive bleeding
or hemorrhage?
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a. Protamine Sulfate
b. Aminocaproic Acid (Amicar)
c. Vitamin K
d. Heparin

26. Valsalva maneuver can result in bradycardia. Which of the following

activities will not stimulate Valsalvas maneuver?

a. Use of stool softeners.

b. Enema administration
c. Gagging while toothbrushing.
d. Lifting heavy objects

27. A 66 year-old client is admitted for mitral valve replacement surgery.

The client has a
history of mitral valve regurgitation and mitral stenosis since her teenage
years. During the
admission assessment, the nurse should ask the client if as a child she
had

a. measles
b. rheumatic fever
c. hay fever
d. encephalitis

28. A woman in her third trimester complains of severe heartburn. What

is appropriate teaching by the nurse to help the woman alleviate these
symptoms?

a. Drink small amounts of liquids frequently

b. Eat the evening meal just before retiring
c. Take sodium bicarbonate after each meal
d. Sleep with head propped on several pillows

29. A nurse is caring for a 2 year-old child after corrective surgery for
Tetralogy of Fallot. The mother reports that the child has suddenly begun
seizing. The nurse recognizes this problem is probably due to

a. A cerebral vascular accident

b. Postoperative meningitis
c. Medication reaction
d. Metabolic alkalosis

30. A client is scheduled for a percutaneous transluminal coronary

angioplasty (PTCA). The nurse knows that a PTCA is the

a. Surgical repair of a diseased coronary artery

b. Placement of an automatic internal cardiac defibrillator
c. Procedure that compresses plaque against the wall of the diseased
coronary artery to improve blood flow
d. Non-invasive radiographic examination of the heart

31. To prevent a valsalva maneuver in a client recovering from an acute

myocardial infarction, the nurse would
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a. Assist the client to use the bedside commode

b. Administer stool softeners every day as ordered
c. Administer antidysrhythmics prn as ordered
d. Maintain the client on strict bed rest

32. Which of the ff. statements by the client to the nurse indicates a
risk factor for CAD?

a. I exercise every other day.

b. My father died of Myasthenia Gravis.
c. My cholesterol is 180.
d. I smoke 1 1/2 packs of cigarettes per day.

33. The nurse is teaching the patient regarding his permanent artificial
pacemaker. Which information given by the nurse shows her knowledge
deficit about the artificial cardiac pacemaker?

a. take the pulse rate once a day, in the morning upon awakening
b. may be allowed to use electrical appliances
c. have regular follow up care
d. may engage in contact sports

34. A client with chronic heart failure has been placed on a diet
restricted to 2000mg. of sodium per day. The client demonstrates
adequate knowledge if behaviors are evident such as not salting food and
avoidance of which food?

a. Whole milk
b. Canned sardines
c. Plain nuts
d. Eggs

35. A patient with angina pectoris is being discharged home with

nitroglycerine tablets. Which of the following instructions does the
nurse include in the teaching?

a. When your chest pain begins, lie down, and place one tablet under
your tongue. If the pain continues, take another tablet in 5 minutes.
b. Place one tablet under your tongue. If the pain is not relieved in 15
minutes, go to the hospital.
c. Continue your activity, and if the pain does not go away in 10
minutes, begin taking the nitro tablets one every 5 minutes for 15
minutes, then go lie down.
d. Place one Nitroglycerine tablet under the tongue every five minutes
for three doses. Go to the hospital if the pain is unrelieved.

36. Dr. Marquez orders a continuous intravenous nitroglycerin infusion for

the client suffering from myocardial infarction. Which of the following is
the most essential nursing action?

a. Monitoring urine output frequently

b. Monitoring blood pressure every 4 hours
c. Obtaining serum potassium levels daily
d. Obtaining infusion pump for the medication

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37. Mr. Ong, a client with CHF, has been receiving a cardiac glycoside, a
diuretic, and a vasodilator drug. His apical pulse rate is 44 and he is on
bed rest. The nurse concludes that his pulse rate is most likely the result
of the:

A. Diuretic
B. Vasodilator
C. Bed-rest regimen
D. Cardiac glycoside

38. The physician orders on a client with CHF a cardiac glycoside, a

vasodilator, and furosemide (Lasix). The nurse understands Lasix exerts is
effects in the:

a. Distal tubule
b. Collecting duct
c. Glomerulus of the nephron
d. Ascending limb of the loop of Henle

39. Mr. Ong is admitted to the hospital with a diagnosis of Left-sided

CHF. In the assessment, the nurse should expect to find:

a. Crushing chest pain

b. Dyspnea on exertion
c. Extensive peripheral edema
d. Jugular vein distention

40. After the acute phase of congestive heart failure, the nurse should
expect the dietary management of the client to include the restriction of:

a. Magnesium
b. Sodium
c. Potassium
d. Calcium

41. The diet ordered for a client with CHF permits him to have a 190 g
of carbohydrates, 90 g of fat and 100 g of protein. The nurse
understands that this diet contains approximately:

a. 2200 calories
b. 2000 calories
c. 2800 calories
d. 1600 calories

42. Twenty four hours after admission for an Acute MI, Joses
temperature is noted at 39.3 C. The nurse monitors him for other
adaptations related to the pyrexia, including:

a. Shortness of breath
b. Chest pain
c. Elevated blood pressure
d. Increased pulse rate

43. Jose, who had a myocardial infarction 2 days earlier, has been
complaining to the nurse about issues related to his hospital stay. The
best initial nursing response would be to:
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a. Allow him to release his feelings and then leave him alone to allow
him to regain his composure
b. Refocus the conversation on his fears, frustrations and anger about his
condition
c. Explain how his being upset dangerously disturbs his need for rest
d. Attempt to explain the purpose of different hospital routines

44. An early finding in the EKG of a client with an infarcted mycardium

would be:

a. Disappearance of Q waves
b. Elevated ST segments
c. Absence of P wave
d. Flattened T waves

45. Myra is ordered laboratory tests after she is admitted to the hospital
for angina. The isoenzyme test that is the most reliable early indicator
of myocardial insult is:

a. SGPT
b. LDH
c. CK-MB
d. AST

46. Joey asks the nurse why he is receiving the injection of Morphine
after he was hospitalized for severe anginal pain. The nurse replies that
it:

a. Will help prevent erratic heart beats

b. Relieves pain and decreases level of anxiety
c. Decreases anxiety
d. Dilates coronary blood vessels

47. Following mitral valve replacement surgery a client develops PVCs.

The health care provider orders a bolus of Lidocaine followed by a
continuous Lidocaine infusion at a rate of 2 mgm/minute. The IV solution
contains 2 grams of Lidocaine in 500 ccs of D5W. The infusion pump
delivers 60 microdrops/cc. What rate would deliver 4 mgm of
Lidocaine/minute?

a. 60 microdrops/minute
b. 20 microdrops/minute
c. 30 microdrops/minute
d. 40 microdrops/minute

48. Which is irrelevant in the pharmacologic management of a client with

CVA?

a. Osmotic diuretics and corticosteroids are given to decrease cerebral

edema
b. Anticonvulsants are given to prevent seizures
c. Thrombolytics are most useful within three hours of an occlusive CVA
d. Aspirin is used in the acute management of a completed stroke.

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49. A client diagnosed with cerebral thrombosis is scheduled for cerebral

angiography. Nursing care of the client includes the following EXCEPT

a. Inform the client that a warm, flushed feeling and a salty taste may
be
b. Maintain pressure dressing over the site of puncture and check for
c. Check pulse, color and temperature of the extremity distal to the site
of
d. Kept the extremity used as puncture site flexed to prevent bleeding.

50. Joey is a 46 year-old radio technician who is admitted because of

mild chest pain. He is 5 feet, 8 inches tall and weighs 190 pounds. He is
diagnosed with a myocardial infarct. Morphine sulfate, Diazepam (Valium)
and Lidocaine are prescribed. The physician orders 8 mg of Morphine
Sulfate to be given IV. The vial on hand is labeled 1 ml/ 10 mg. The
nurse should administer:

a. 8 minims
b. 10 minims
c. 12 minims
d. 15 minims

51. A patient with angina pectoris is being discharged home with

nitroglycerine tablets. Which of the following instructions does the nurse
include in the teaching?

a. When your chest pain begins, lie down, and place one tablet under
your tongue. If the pain continues, take another tablet in 5 minutes.
b. Place one tablet under your tongue. If the pain is not relieved in 15
minutes, go to the hospital.
c. Continue your activity, and if the pain does not go away in 10
minutes, begin taking the nitro tablets one every 5 minutes for 15
minutes, then go lie down.

d. Place one Nitroglycerine tablet under the tongue every five minutes
for three doses. Go to the hospital if the pain is unrelieved.

52. Valsalva maneuver can result in bradycardia. Which of the following

activities will not stimulate Valsalva's maneuver?

a. Use of stool softeners.

b. Enema administration
c. Gagging while toothbrushing.
d. Lifting heavy objects

53. The nurse is teaching the patient regarding his permanent artificial
pacemaker. Which information given by the nurse shows her knowledge
deficit about the artificial cardiac pacemaker?

a. take the pulse rate once a day, in the morning upon awakening
b. may be allowed to use electrical appliances
c. have regular follow up care
d. may engage in contact sports

54. Mr. Braga was ordered Digoxin 0.25 mg. OD. Which is poor knowledge
regarding this drug?
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a. It has positive inotropic and negative chronotropic effects

b. The positive inotropic effect will decrease urine output
c. Toxixity can occur more easily in the presence of hypokalemia, liver
and renal problems
d. Do not give the drug if the apical rate is less than 60 beats per
minute.

55. Which client would most likely be misdiagnosed for having a

myocardial infarction?

a. A 55-year-old Caucasian male with crushing chest pain and diaphoresis.

b. A 60-year-old Native American male with an elevated troponin level.
c. A 40-year-old Hispanic female with a normal electrocardiogram.
d. An 80-year-old Peruvian female with a normal CPK-MB at 12 hours.

56. The telemetry nurse notes a peaked T-wave for the client diagnosed
with congestive heart failure. Which laboratory data should the nurse
assess?

a. CPK-M2.
b. Troponin.
c. BNP (beta-type natriuretic peptide).
d. Potassium.

57. Which medical client problem should the nurse include in the plan of
care for a client diagnosed with cardiomyopathy?

a. Heart failure.
b. Activity intolerance.
c. Powerlessness.
d. Anticipatory grieving.

58. The client is three (3) hours post-myocardial infarction. Which data
would warrant immediate intervention by the nurse?

a. Bilateral peripheral pulses two (2) _.

b. The pulse oximeter reading is 96%.
c. The urine output is 240 mL in the last four (4) hours.
d. Cool, clammy, diaphoretic skin.

59. The nurse is told in report that the client has aortic stenosis. Which
anatomical position should the nurse auscultate to assess the murmur?

a. Second intercostal space, right sternal notch.

b. Erbs point.
c. Second intercostal space, left sternal notch.
d. Fourth intercostal space, left sternal border.

60. Which meal would indicate the client understands the discharge
teaching concerning the recommended diet for coronary artery disease?

a. Baked fish, steamed broccoli, and garden salad.

b. Enchilada dinner with fried rice and refried beans.
c. Tuna salad sandwich on white bread and whole milk.
d. Fried chicken, mashed potatoes, and gravy.
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61. The nurse assessing the client with pericardial effusion at 1600 notes
the apical pulse is 72 and the BP is 138/94. At 1800, the client has neck
vein distention, the apical pulse is 70, and the BP is 106/94. Which
action would the nurse implement first?

a. Stay with the client and use a calm voice.

b. Notify the health-care provider immediately.
c. Place the client left lateral recumbent.
d. Administer morphine intravenous push slowly.

62. Which data would cause the nurse to question administering digoxin to
a client diagnosed with congestive heart failure?

a. The potassium level is 3.2 mEq/L.

b. The digoxin level is 1.2 mcg/mL.
c. The clients apical pulse is 64.
d. The client denies yellow haze.

63. What is the priority problem in the client diagnosed with congestive
heart failure?

a. Fluid volume overload.

b. Decreased cardiac output.
c. Activity intolerance.
d. Knowledge deficit.

64. The client comes to the emergency department saying, I am having a

heart attack.
Which question is most pertinent when assessing the client?

a. Can you describe your chest pain?

b. What were you doing when the pain started?
c. Did you have a high-fat meal today?
d. Does the pain get worse when you lie down?

65. Which laboratory data confirm the diagnosis of congestive heart

failure?

a. Chest x-ray (CXR).

b. Liver function tests.
c. Blood urea nitrogen (BUN).
d. Beta-type natriuretic peptide (BNP).

66. The client is diagnosed with pericarditis. When assessing the client,
the nurse is unable to auscultate a friction rub. Which action should the
nurse implement?

a. Notify the health-care provider.

b. Document that the pericarditis has resolved.
c. Ask the client to lean forward and listen again.
d. Prepare to insert a unilateral chest tube.

67. The unlicensed nursing assistant comes and tells the primary nurse
that the client diagnosed with coronary artery disease is having chest
pain. Which action should the nurse take first?
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a. Tell the assistant to go take the clients vital signs.

b. Ask the assistant to have the telemetry nurse read the strip.
c. Notify the clients health-care provider.
d. Go to the room and assess the clients chest pain.

68. Which pre-procedure information should be taught to the female

client having an exercise stress test in the morning?

a. Wear open-toed shoes to the stress test.

b. Inform the client not to wear a bra.
c. Do not eat anything for four (4) hours.
d. Take the beta blocker one (1) hour before the test.

69. The client with coronary artery disease is prescribed transdermal

nitroglycerin, a coronary vasodilator. Which behavior indicates the client
understands the discharge teaching concerning this medication?

a. The client places the medication under the tongue.

b. The client removes the old patch before placing the new.

c. The client applies the patch to a hairy area.

d. The client changes the patch every 36 hours.

70. The nurse is transcribing the doctors orders for a client with
congestive heart failure. The order reads 2.5 mg of Lanoxin daily. Which
action should the nurse implement?

a. Discuss the order with the health-care provider.

b. Take the clients apical pulse rate before administering.
c. Check the clients potassium level before giving the medication.
d. Determine if a digoxin level has been drawn.

71. The nurse is caring for clients on a cardiac floor. Which client
should the nurse assess first?

a. The client with three (3) unifocal PVCs in a minute.

b. The client diagnosed with coronary artery disease that wants to
ambulate.
c. The client diagnosed with mitral valve prolapse with an audible S3.
d. The client diagnosed with pericarditis that is in normal sinus rhythm.

72. The client has an implantable cardioverter defibrillator (ICD). Which

discharge instructions should the nurse teach the client?

a. Do not lift or carry more than 23 kg.

b. Have someone drive the car for the rest of your life.
c. Carry the cell phone on the opposite side of the ICD.
d. Avoid using the microwave oven in the home.

73. Which intervention should the nurse implement with the client
diagnosed with dilated cardiomyopathy?

a. Keep the client in the supine position with the legs elevated.
b. Discuss a heart transplant, which is the definitive treatment.
c. Prepare the client for coronary artery bypass graft.
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d. Teach the client to take a calcium-channel blocker in the morning.

74. The nurse is caring for a client who goes into ventricular
tachycardia. Which intervention should the nurse implement first?

a. Call a code immediately.

b. Assess the client for a pulse.
c. Begin chest compressions.
d. Continue to monitor the client.

75. The nurse is assisting with a synchronized cardioversion on a client

in atrial fibrillation.
When the machine is activated, there is a pause. What action should the
nurse take?

a. Wait until the machine discharges.

b. Shout all clear and dont touch the bed.
c. Make sure the client is all right.
d. Increase the joules and redischarge.

76. The nurse is teaching the Dietary Approaches to Stop Hypertension

(DASH) diet to a client diagnosed with essential hypertension. Which
statement indicates that the client understands the client teaching
concerning the DASH diet?

a. I should eat at least four (4) to five (5) servings of vegetables a

day.
b. I should eat meat that has a lot of white streaks in it.
c. I should drink no more than two (2) glasses of whole milk a day.
d. I should decrease my grain intake to no more than twice a week.

77. The male client diagnosed with essential hypertension has been
prescribed an alphaadrenergic blocker. Which intervention should the nurse
discuss with the client?

a. Eat at least one (1) banana a day to help increase the potassium
level.
b. Explain that impotence is an expected side effect of the medication.
c. Take the medication on an empty stomach to increase absorption.
d. Change position slowly when going from lying to sitting position.

78. The client diagnosed with essential hypertension is taking a loop

diuretic daily. Which assessment data would require immediate intervention
by the nurse?

a. The telemetry reads normal sinus rhythm.

b. The client has a weight gain of 2 kg within 12 days.
c. The clients blood pressure is 148/92.
d. The clients serum potassium level is 4.5 mEq.

79. The nurse is assessing the client diagnosed with long-term arterial
occlusive disease.
Which assessment data support the diagnosis?

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a. Hairless skin on the legs.

b. Brittle, flaky toe nails.
c. Petechiae on the soles of feet.
d. Nonpitting ankle edema.

80. Which assessment data would warrant immediate intervention in the

client diagnosed with arterial occlusive disease?

a. The client has 2_ pedal pulses.

b. The client is able to move the toes.
c. The client has numbness and tingling.
d. The clients feet are red when standing

81. The nurse is administering a beta blocker to the client diagnosed with
essential hypertension.
Which intervention should the nurse implement?

a. Notify the health-care provider if the potassium level is 3.8 mEq.

b. Question administering the medication if the blood pressure is _90/60
mmHg.
c. Do not administer the medication if the clients radial pulse is _100.
d. Monitor the clients blood pressure while he or she is lying, standing,
and sitting.

82. The nurse and an unlicensed nursing assistant are caring for a 64-
year-old client who is 4 hours post-operative bilateral femoralpopliteal
bypass surgery. Which nursing task should be delegated to the unlicensed
nursing assistant?

a. Monitor the continuous passive motion machine.

b. Assist the client to the bedside commode.
c. Feed the client the evening meal.
d. Elevate the foot of the clients bed.

83. Which instruction should be included when a client diagnosed with

peripheral arterial disease is being discharged?

a. Encourage the client to use a heating pad on lower extremities.

b. Demonstrate to the client the correct way to apply elastic support
hose.
c. Instruct the client to walk daily for at least 30 minutes.
d. Tell the client to check both feet for red areas at least once a week.

84. The nurse is unable to assess a pedal pulse in the client diagnosed
with arterial occlusive disease. Which intervention should the nurse
implement first?

a. Complete a neurovascular assessment.

b. Use the Doppler device.
c. Instruct the client to hang the feet off the side of the bed.
d. Wrap the legs in a blanket.

85. The nurse is teaching a class on atherosclerosis. Which statement

describes the scientific rationale as to why diabetes is a risk factor for
developing atherosclerosis?

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a. Glucose combines with carbon monoxide, instead of with oxygen, and

this leads to oxygen deprivation of tissues.
b. Diabetes stimulates the sympathetic nervous system, resulting in
peripheral constriction that increases the development of atherosclerosis.
c. Diabetes speeds the atherosclerotic process by thickening the basement
membrane of both large and small vessels.
d. The increased glucose combines with the hemoglobin, which causes
deposits of plaque in the lining of the vessels.

86. The health-care provider ordered a femoral angiogram for the client
diagnosed with arterial occlusive disease. Which intervention should the
nurse implement?

a. Explain that this procedure will be done at the bedside.

b. Discuss with the client that he or she will be on bed rest with
bathroom privileges.
c. Inform the client that no intravenous access will be needed.
d. Inform the client that fluids will be increased after the procedure.

87. Which assessment data would cause the nurse to suspect the client
has atherosclerosis?

a. Change in bowel movements.

b. Complaints of a headache.
c. Intermittent claudication.
d. Venous stasis ulcers.

88. The client asks the nurse, My doctor just told me that
atherosclerosis is why my legs hurt when I walk. What does that mean?
Which response by the nurse would be the best response?

a. The muscle fibers and endothelial lining of your arteries have become
thickened.
b. The next time you see your HCP ask what atherosclerosis means.
c. The valves in the veins of your legs are incompetent so your legs
hurt.
d. You have a hardening of your arteries that decreases the oxygen to
your legs.

89. Which assessment data would support the diagnosis of abdominal

aortic aneurysm?

a. Shortness of breath.
b. Abdominal bruit.
c. Ripping abdominal pain.
d. Decreased urinary output.

90. Which client problem would be priority in a client diagnosed with

arterial occlusive disease who is admitted to the hospital with a foot
ulcer?

a. Impaired skin integrity.

b. Activity intolerance.
c. Ineffective health maintenance.
d. Risk for peripheral neuropathy.

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91. The client comes to the clinic complaining of muscle cramping and
pain in both legs when walking for short periods of time. Which medical
term would the nurse document in the clients record?

a. Peripheral vascular disease (PVD).

b. Intermittent claudication.
c. Deep vein thrombosis (DVT).
d. Dependent rubor.

92. The health-care provider prescribes an ACE inhibitor for the client
diagnosed with essential hypertension. Which statement is the most
appropriate rationale for administering this medication?

a. ACE inhibitors prevent the beta-receptor stimulation in the heart.

b. This medication blocks the alpha receptors in the vascular smooth
muscle.
c. ACE inhibitors prevent vasoconstriction and sodium and water retention.
d. ACE inhibitors decrease blood pressure by relaxing vascular smooth
muscle.

93. The client diagnosed with arterial occlusive disease is one (1) day
post-operative right femoral popliteal bypass. Which intervention should
the nurse implement?

a. Keep the right leg in the dependent position.

b. Apply sequential compression devices to lower extremities.
c. Monitor the clients pedal pulses every shift.
d. Assess the clients leg dressing every four (4) hours

94. The client tells the nurse that his cholesterol level is 240 mg/dL.
Which action should the nurse implement?

a. Praise the client for having a normal cholesterol level.

b. Explain that the client needs to lower the cholesterol level.

c. Discuss dietary changes that could help increase the level.

d. Allow the client to ventilate feelings about the blood test result.

95. The nurse knows the client understands the teaching concerning a
low-fat, low cholesterol diet when the client selects which meal?

a. Fried fish, garlic mashed potatoes, and iced tea.

b. Ham and cheese on white bread and whole milk.
c. Baked chicken, baked potato, and skim milk.
d. A hamburger, French fries, and carbonated beverage.

96. The client is diagnosed with an abdominal aortic aneurysm. Which

statement would the nurse expect the client to make during the admission
assessment?

a. I have stomach pain every time I eat a big, heavy meal.

b. I dont have any abdominal pain or any type of problems.
c. I have periodic episodes of constipation and then diarrhea.
d. I belch a lot, especially when I lay down after eating.

97. The client is admitted for surgical repair of an 8-cm abdominal

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aortic aneurysm.
Which sign/symptom would make the nurse suspect the client has an
expanding Abdominal Aortic Aneurysm?

a. Complaints of low back pain.

b. Weakened radial pulses.
c. Decreased urine output.
d. Increased abdominal girth.

98. The client is one (1) day post-operative abdominal aortic aneurysm
repair. Which information from the unlicensed nursing assistant would
require immediate intervention from the nurse?

a. The client refuses to turn from the back to the side.

b. The clients urinary output is 90 mL in six (6) hours.
c. The client wants to sit on the side of the bed.
d. The clients vital signs are T 98, P 90, R 18, and BP 130/70.

99. The client had an abdominal aortic aneurysm repair 2 days ago.
Which intervention should the nurse implement first?

a. Assess the clients bowel sounds.

b. Administer an IV prophylactic antibiotic.
c. Encourage the client to splint the incision.
d. Ambulate the client in the room with assistance.

100. Which health-care providers order should the nurse question in a

client diagnosed with an expanding abdominal aortic aneurysm who is
scheduled for surgery in the morning?

a. Type and cross-match for two (2) units of blood.

b. Tap water enema until clear fecal return.
c. Bed rest with bathroom privileges.
d. Keep NPO after midnight.

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