Cardiovascular Medications NCLEX

Practice Quiz (20 Items)



The NCLEX is examining your ability to think critically. Critical thinking involves observation,
identifying the problem, applying knowledge and evaluating according to the criteria established.
This 20-item practice questions will test your knowledge on cardiovascular medications.
Goodluck!

“Prayer is not asking. It is a longing of the soul. It is daily admission of one’s weakness. It is
better in prayer to have a heart without words than words without a heart.”
― Mahatma Gandhi

Topics

Topics or concepts included in this exam are:

 Cardiovascular Medications such as anticoagulant, thrombolytic, antiplatelet, cardiac

glycoside, antihypertensive, diuretic, antianginal, antilipemic, adrenergic
agonists, antidysrhythmic, calcium channel blockers, vasodilators, and β-adrenergic
blockers.
 Diseases such as myocardial infarction, atrial fibrillation, cardiac dysrhythmia,
hyperlipidemia, congestive heart failure, ventricular arrhythmia and deep vein
thrombosis.

Guidelines

To make the most out of this quiz, follow the guidelines below:

 Read each question carefully and choose the best answer.

 You are given one minute per question. Spend your time wisely!
 Answers and rationales (if any) are given below. Be sure to read them.
 If you need more clarifications, please direct them to the comments section.

Questions

Text Mode: All questions and answers are given on a single page for reading and answering at
your own pace. Be sure to grab a pen and paper to write down your answers.
1. A nurse is providing instructions to a client who is receiving warfarin sodium
(Coumadin). Which statement made by the client indicates the need for further
instruction?

A. “I will observe the color of my urine and stool”.

B. “I will take Ecotrin (Enteric coated aspirin) for my headaches”.
C. “I will avoid drinking alcohol”.
D. “I will take the medicine daily at the same time”.

2. A nurse is caring for a client receiving a heparin intravenous (IV) infusion. The nurse
expects that which of the following laboratory will be prescribed to monitor the therapeutic
effect of heparin?

A. Prothrombin time (PT).

B. Activated partial thromboplastin time (aPTT).
C. Hematocrit (Hgb).
D. Hemoglobin (Hct).

3. A client with atrial fibrillation is receiving a continuous heparin infusion at 1,000

units/hr. The nurse observes that the client is receiving the therapeutic effect based on
which of the following results?

A. Activated partial thromboplastin time of 30 seconds.

B. Activated partial thromboplastin time of 60 seconds.
C. Activated partial thromboplastin time of 120 seconds.
D. Activated partial thromboplastin time of 15 seconds.

4. A client is receiving intravenous heparin therapy. The nurse ensures the availability in
which of the following medication?

A. Acetylcysteine (Mucomyst).
B. Calcium gluconate.
C. Vitamin K (Mephyton).
D. Protamine sulfate.

5. A client is receiving a continuous infusion of streptokinase (Streptase). The client

suddenly complaints of a difficulty of breathing, itchiness, and nausea. Which of the
following should be the priority action of the nurse?

A. Stop the infusion and notify the physician.

B. Administer protamine sulfate and provide oxygen therapy.
C. Administer antihistamine then continue the infusion.
D. Slow the infusion and administer oxygen.

6. A client with deep vein thrombosis is receiving Streptokinase (Streptase). The nurse
would notify the physician if which of the following assessment is noted?
A. A temperature of 99.2° Fahrenheit.
B. A pulse rate of 99 beats per minute.
C. A respiratory rate of 25 breaths per minute.
D. A blood pressure of 185/110 mm Hg.

7. A client who is receiving streptokinase therapy suddenly had a nose bleeding. The nurse
ensures the availability in which of the following medication?

A. Vitamin K (Mephyton).
B. Deferoxamine (Desferal).
C. Aminocaproic acid (Amicar).
D. Diphenhydramine (Benadryl).

8. A nurse is providing health teachings regarding antiplatelet medications. Which of the

following is not true regarding the use of this medication?

A. Antiplatelet medication inhibits the aggregation of platelets in the clotting process, thereby
prolonging bleeding time.
B. Antiplatelet medications cannot be used with anticoagulants.
C. Take the medication with food to prevent gastrointestinal upset.
D. A routine bleeding time is monitored during the therapy.

9. A client is receiving Procainamide (Procanbid) for the treatment of ventricular

arrhythmia. The client suddenly complains of nausea and drowsiness. Which of the
intervention should the nurse do first?

A. Check the blood pressure and heart rate.

B. Do a 12-lead electrocardiogram right away.
C. Measure the heart rate on the rhythm strip.
D. Give hydralazine (Apresoline) per orem.

10. A client with myocardial infarction is receiving tissue plasminogen activator, alteplase
(Activase, tPA). While on the therapy, the nurse plans to prioritize which of the following?

A. Observe for neurological changes.

B. Monitor for any signs of renal failure.
C. Check the food diary.
D. Observe for signs of bleeding.

11. A nurse is caring a client who is taking digoxin (Lanoxin) 0.25mcg tab once a day. The
client suddenly complaints of anorexia, nausea, vomiting, and diarrhea. The physician is
ruling a digoxin toxicity. As a nurse, you know the therapeutic digoxin rate is?
A. 0.25-0.5 ng/ml.
B. 0.5-2 ng/ml.
C. 1.5-3 ng/ml.
D. 3.5-4.5 ng/ml.

12. A nurse is monitoring a client who is taking Carvedilol (Coreg CR). Which of the
following assessment made by the nurse would warrant a possible complication with the
use of this medication?

A. Baseline blood pressure of 160/100 mm hg followed by a blood pressure of 120/70 mm hg

after 3 doses.
B. Baseline heart rate of 97 bpm followed by a heart rate of 62 bpm after 3 doses.
C. Complaints of nightmares and insomnia.
D. Complaints of dyspnea.

13. A nurse is interviewing a client who is about to receive metoprolol. Upon the history
taking, the client is also taking insulin. Which of the following statements made by the
nurse will correctly explain the possible interaction of these medications?

A. “This medication will maintain the blood sugar level on a normal range”.
B. “This medication will have no effect in the blood sugar level”.
C. “This medication may mask some of the symptoms of hypoglycemia such as tremor,
palpitation, and rapid heartbeat.
D. “This medication may mask some of the symptoms of hyperglycemia such as headache,
increased thirst, and blurred vision”.

14. A client is about to receive Metolazone (Zaroxolyn). The nurse in charge understands
that which of the following laboratory results are related to the administration of the
medication?

A. Hyperkalemia and hypocalcemia.

B. Hyperkalemia and hypoglycemia.
C. Hypouricemia and hypoglycemia.
D. Hypokalemia and hyperglycemia.

15. A client with congestive heart failure is being treated with Torsemide (Demadex). The
nurse obtains the following vital signs: Blood pressure of 100/65 mm hg; pulse rate of 91
beats per minute; and respiration of 25 breaths per minute? Which of the following will be
the priority assessment of the nurse after the initiation of the dose?

A. Urine output.
B. Serum potassium and calcium.
C. Blood pressure.
D. Weight.
16. A nurse is giving instruction to a client who is receiving Cholestyramine (Questran) for
the treatment of hyperlipidemia. Which of the following statements made by the client
indicates the need for further instructions?

A. “This medication comes in a powder that must be mixed with juice or water before
administration”.
B. “I will avoid eating foods rich in saturated fats”.
C. “I will continue taking nicotinic acid as part of the treatment”.
D. “Constipation, belching and heartburn are some of the side effects”.

17. A nurse is providing instructions to a client who is on nicotinic acid for the treatment of
hyperlipidemia. Which statement made by the nurse indicates a comprehension of the
instructions?

A. “I should take aspirin 30 minutes before nicotinic acid”.

B. “I will drink alcohol in moderation”.
C. “Yellowing of the skin is a common side effect”.
D. “This medication is taken on an empty stomach”.

18. A nurse is monitoring a client who is taking Digoxin (Lanoxin). All of which are the side
effects associated with the medication, except?

A. Anorexia.
B. Blurred vision.
C. Diarrhea.
D. Tremors.

19. A nurse is interviewing a patient who is about to receive bumetanide (Bumex). Which of
the following is a concern related to the administration of the medication?

A. Penicillin allergy.
B. Sulfa allergy.
C. Soy containing allergy.
D. Cephalosporin allergy.

20. A client arrives in the emergency with complaints of chest pain and is diagnosed with
acute MI. A morphine 4mg IV was given 5 minutes ago. Which of the following assessment
made by the nurse indicates a further immediate action?

A. Respiratory rate from 20 bpm to 12 bpm.

B. Blood pressure from 120/70 to 100/60 mmHg.
C. The client still complains of chest pain with a pain scale of 2/10.
D. Cardiac rate of 103 bpm and a normal sinus rhythm of the ECG.

Answers and Rationale:

1. Answer: B. “I will take Ecotrin (Enteric coated aspirin) for my headaches”.

Ecotrin is an aspirin-containing product and should be avoided due to the risk of bleeding.

2. Answer: B. Activated partial thromboplastin time (aPTT).

Activated partial thromboplastin time assess the therapeutic level of heparin.

 Option A: Assess the therapeutic level of warfarin sodium (Coumadin).

 Options C and D: Measures the aspect of the red blood cells.

3. Answer: B. Activated partial thromboplastin time of 60 seconds.

The normal range for activated partial thromboplastin time is 20-36 seconds. The activated
partial thromboplastin time must be 1.5 to 2.5 times the normal value, the client’s Appt would be
considered therapeutic if it was 60 seconds.

4. Answer: D. Protamine sulfate.

Protamine sulfate is the antidote that reverses the anticoagulant effects of heparin by binding to
it.

 Option A is the antidote for acetaminophen toxicity.

 Option B is the antidote for magnesium sulfate toxicity.
 Option C is the antidote for warfarin sodium toxicity.

5. Answer: A. Stop the infusion and call the physician.

Severe allergic reaction to streptokinase requires immediate discontinuation of

Streptokinase,then notify the physician and administer an adrenergic, antihistamine, and/or
corticosteroid agents as ordered.

6. Answer: D. A blood pressure of 185/100 mm Hg.

Thrombolytic therapy is contraindicated with uncontrolled hypertension (systolic BP >180 mm

Hg and/or diastolic BP >110 mm Hg) because of the risk of cerebral hemorrhage.

 Options A, B, and C may be present during the therapy but will not warrant the
immediate knowledge of the physician before starting the therapy.

7. Answer: C. Aminocaproic acid (Amicar).

Bleeding can be reversed with the use of aminocaproic acid as an antidote for streptokinase.

 Option A is the antidote for warfarin sodium toxicity.

 Option B is the antidote for iron toxicity.
  Option D is an antihistamine that can be used for any allergic reaction.

8. Answer: B. Antiplatelet medications cannot be used with anticoagulants.

Antiplatelet and anticoagulant therapies are effective in keeping a clot from forming or stopping
the growth of one.

9. Answer: A. Check the blood pressure and heart rate.

The client is experiencing signs of procainamide toxicity, the priority nursing action is to obtain
vital signs immediately.

 Options B and C are done after checking the vital signs.

 Option D will cause hypotension.

10. Answer: D. Observe for signs of bleeding.

Bleeding is the priority concern for a client taking thrombolytic medication.

 Options A and B are monitored but are not the primary concern.
 Option C is not related to the use of medication.

11. Answer: B. 0.5-2 ng/ml.

The therapeutic level of digoxin is 0.5-2 ng/ml.

12. Answer: D. Complaints of dyspnea.

Complaints of dyspnea is a sign of bronchospasm which is one of the serious complication of

beta blockers.

 Options A and B shows a decrease in the blood pressure and heart rate which are
expected in this therapy.
 Option C is a side effect of this medication.

13. Answer: C. “This medication may mask some of the symptoms of hypoglycemia such as
tremor, palpitation, and rapid heartbeat.

Beta-blockers such as metoprolol may increase the risk of hypoglycemia in patients receiving
insulin. In addition, beta-blockers may mask some of the symptoms of hypoglycemia such as
tremor, palpitation, and rapid heartbeat, making it more difficult to recognize an oncoming
episode.

14. Answer: D. Hypokalemia and hyperglycemia.

Metolazone is a thiazide diuretic that may put clients risk for hypokalemia, hyperglycemia,
hyperlipidemia, hypercalcemia and hyperuricemia.

15. Answer: C. Blood pressure.

The priority assessment in this situation will be the monitoring of the blood pressure because
hypotension poses a risk in this medication.

 Options A, B, and D are monitored but they are not the priority.

16. Answer: C. “I will continue taking nicotinic acid as part of the treatment”.

A combination of Cholestyramine (Questran) and nicotinic acid damages the liver.

 Options A, B, and D are true regarding this medication.

17. Answer: A. “I should take aspirin 30 minutes before nicotinic acid”.

The use of aspirin or a nonsteroidal anti-inflammatory drug 30 minutes before decreases flushing
which is a side effect of taking nicotinic acid.

 Option B: Drinking alcohol will cause liver abnormalities.

 Option C is a sign of liver dysfunction and should be immediately informed the
physician.
 Option D: This medication is taken with meals to decrease gastrointestinal upset.

18. Answer: D. Tremors.

Signs of digoxin toxicity are as follows, anorexia, nausea, vomiting, diarrhea, and blurred vision.

19. Answer: B. Sulfa allergy.

Loop diuretics such as bumetanide are sulfa-based medications, and a client with sulfa allergy is
at risk for an allergic reaction.

20. Answer: C. The client still complains of chest pain with a pain scale of 2/10.

The goal for the client with an acute myocardial infarction is to eliminate the pain. Even pain
related at a level of 2/10 should be managed with an additional dose of morphine.

 Options A, B, and D: although hypotension, respiratory depression, and tachycardia are

the side effects of morphine but they do not require further action at this time.