1.

  Mr. Martinez is diagnosed with coronary artery disease and is prescribed sublingual
nitroglycerin. The following health teachings would be implemented for the client
a.       Decrease the salt intake to 2g a day
b.       Encourage a low fat, low cholesterol diet-----------------------
c.       Refer to counselor for stress reduction techniques--------------
d.       Increase fiber in the diet---------------------------------
e.       Instruct client to walk 30 mins a day--------------------------

 para makita agad 

8. Mr. Martinez is diagnosed with coronary artery disease and is prescribed with sublingual
nitroglycerin. Which of the following interventions should the nurse discuss with the client.
(Select all that apply).
a. Eat food high in monounsaturated fats
b. Teach about coronary vasodilators-------------------------
c. Encourage the client to exercise three days a week--------------------------
d. Instruct the client to stop smoking---------------------------
e. Prepare client for a carotid endarterectomy

6. Mr. martinez, 66 years old has a blood pressure of 168/98. He consulted a physician and
was told atherosclerosis. Which of the following interventions should the nurse teach the
client? (Select all that apply)
a. Maintain a sedentary lifestyle as much as possible---- mali
b. Daily isometric exercise are important--- mali
c. Avoid stressful situations ----- mali
d. Stop smoking or using any type of tobacco products --------------------------
e. Include significant other in the discussion  

2.       A nursing diagnosis of “decreased cardiac output related to inability of the heart to pump
effectively” was written in the nursing care plan. The nurse is developing a discharge teaching
plan for the client. Which intervention should be incorporated in the plan? (Select all that
apply)
a.    Teach the client how to count the radial pulse when taking digoxin, a cardiac
glycoside---------------------------
B. Discuss the importance of taking the loop diuretic furosemide at bedtime
C. Encourage client to monitor urine output for change in color to become dark
D. Notify a health care provider of a weight gain of more than one (1) pound in a week
E. Instruct the client to remove the saltshaker from the diner table------------------
 

3.       Mr. Martinez consulted the emergency room for assessment of possible right ventricular
failure. What clinical indicators is the nurse most likely to identify when taking admission history.
Select all that apply.
a.       Palpitations----------
b.       Polyuria------ mali
 c.       Vertigo---- mali
d.       Edema---------------
e.       Dyspnea-----------------

 
4.        The intensive care department nurse on duty is caring for a client who is 12 hours post
myocardial infarction. The nurse assess a S3 heart sound. Which of the following intervention
should be implemented if the client experiences chest pain? (Select all that apply).
a. Administer an aspirin orally----------------------------
b. Administer nitroglycerin subcutaneously
c. Place the client in a supine position
d. Administer morphine intramuscularly
e. Apply oxygen via a nasal cannula-------------------------------

5. Digoxin (Lanoxin) 0.25 mg was administered Mr. Ariel diagnosed with left ventricular heart failure.
What changes does the nurse expect to find if this medication therapeutically effective? Select
all that apply.
a. Decreased pulse rate-----------------
b. Tachycardia
c. Diuresis-----------------------------
d. Reduced heart murmur
e. Decreased edema---------------------

7. Nurse Maria is conducting health teaching to a client with ischemic heart disease regarding
foods that should be avoided. The nurse determines that the client understands the dietary
instructions when the client identifies the following foods. (Select all that apply)
a. Vegetables and whole grains
b. Olive Oil
c. Chicken Broth-------------
d. Enriched whole milk----------
e. Red Meat, such as beef-----------

9. A Normal Angina was considered but nitroglycerin spray offered no relief. Electrocardiogram
was requested with the following tracing. The following are the correct findings. SATA 
A. Heart Rate 160
B. Regular Rhythm --------------------------
C. T wave inversion in Lead II, III, aVF--------------------------- 
D. ST depression in aVR
 E. Sinus Tachycardia------------------------- 

10. Mr. Enriquez, diagnosed with hypertension , was recommended to take Amlodipine
(Norvasc). Which reaction to the medication should the nurse instruct the client to report to the
health care provider? 
A. Excessive urination 
B. Difficulty breathing------------------------------ 
C. Blurred Vision 
D. Dizziness on rising

11. Mr. Q was admitted to the critical care unit with a diagnosis of chest pain. rule out
myocardial Infarction. After returning from the bathroom, he complains of severe indigestion in
the retrosternal area of his chest. An ECG were done with the tracing. The nurse interpreted the
ECG with the following findings. 

 ST. aoleot elevation in V3 and V4 

12. A 35-year-old woman is seen in clinic for evaluation of dyspnea. Corona artery disease was
considered. The priority care for this client is which of the following?

  Decrease anxiety
 Administer sublingual nitroglycerin
 Enhance myocardial oxygenation----------------------------------------------
 Educate the client about his symptoms

13. Which of the following responses of a client regarding vasodilator treatment effectiveness
does not need further instructions from the nurse?
a. Pulse rate decreases from 110 to 75
b. Absence of adventitious breath sounds
c. Increase in the daily amount of urine produced
d, Blood pressure changes from 154/90 to 126/72----------------

14. A nurse educator is leading a discussion in a webinar attended by senior citizens about the
probability for developing coronary heart disease (CHD) for women versus men. What should
the nurse respond when asked to identify the most significant factor
a. Obesity
b. High levels of HDL-C
c. Diabetes--------------------
 d. Elevated CRP levels

15. The lower extremities of a patient at Philippine Heart Center is being assessed for right
ventricular heart failure. Pitting edema is expected of the coronary unit nurse because of which
of the following?
a. Decrease in the plasma colloid osmotic pressure
b. Elevation in the plasma hydrostatic pressure at the venous end of the capillary
bed-----------------------
c. Increase in tissue colloid osmotic pressure
d. Increase in the tissue hydrostatic pressure at the arterial end of the capillary bed

16. A 65 years old country vice president complains of cough, dyspnea and frothy mucoid and is
admitted in the coronary care unit. Nursing Management's goal is to maximise cardiac
performance by increasing ventricular contractility. Which of the following medications would be
given by the nurse?
a. Calcium channel blockers
b. Diuretic
c. Inotropic agents-----------------
d. No answer text provided

17. When assessing an 85-year-old client’s vital signs, the nurse should remember that a
number of expected changes in cardiac output results from the aging process. The finding that
would be consistent with a pathologic condition rather that the aging process would be:
a. Pulse rate irregularity---------------
b. A pulse rate of 60 beats per minute
c. An apical obtainable at fifth intercostal space and midclavicular line
d. An equal apical and radial pulse

18. A 50-year-old client seeks consultation because of chest pain. After several diagnostic
procedures, he was then treated for a coronary artery disease. The nurse practitioner on duty
was asked by the client “Why do I get chest pain?” Which of the following statements would be
the most appropriate response by the nurse practitioner?
a.  “there is ischemia to the myocardium as a result of hypoxemia”
b. The heart muscle is unable to pump effectively to perfuse the body
c. Chest pain is caused by decreased oxygen to the heart muscle--------------
d. Chest pain occurs when the lungs cannot adequately oxygenate the blood

19. Mr. Wilson, a 75-year-old man would undergo routine cardiac catheterization for evaluation
of stable angina that has not responded to medical therapy. His wife is inquiring about the risks
associated with the procedure. Which of the following is the most common complication of the
procedure?
a. Vascular access site bleeding--------------------
b. Myocardial infarction
c. Acute renal failure
d. Tachyarrhythmias
e. Bradyarrhythmias

20. The nurse is conducting health teaching to medical clients in the outpatient department/
Which of the following needs further instructions regarding edema in congestive cardiac failure?
a. Initially noticed in the morning--------------
 b. Pitting edema
c. Starts in the dependent part
d. Sacral edema in non-ambulatory patients

22. When assessing an 85-year-old client’s vital signs, the nurse should remember that a
number of expected changes in cardiac-out put results from aging process. The finding that
would be consistent with pathologic condition rather than the aging process would be:
A. Pulse rate irregularity --------------------------------
B. A pulse rate of 60 beats per minute 
C. An apical rate obtainable at fifth intercostal space and midclavicular line 
D. An equal apical and radial pulse

23. Mr. Martinez is diagnosed with coronary artery disease and is prescribed sublingual
nitroglycerin. The client recognizes the discharge teaching concerning the recommended diet if
he eats which of the following?
a. Fried chicken, mashed potatoes, and gravy
b. Baked fish, steamed broccoli, and garden salad
c. Tuna salad sandwich on white bread and whole milk
d. Enchilada dinner with fried rice and refried beans

24. Mr. Wilson, a 75 y/o would undergo routine cardiac catheterization for evaluation of stable
angina that has not responded to medical therapy. His wife is inquiring about the risks
associated with the procedure. Which of the following is the most common complications of
procedure?
a. Vascular access site bleeding---------------------------
b. Myocardial infarction 
c. Acute renal failure 
d. Tachyarrhythmias
e. bradyarrhythmias

4.

2
 Bl23ood pressure changes from 154/90 to 126/72