Adult 3 Final

Part2 Adult 3 Q & A (final)
Assessment Of Cardiovascular Function
Management Of Dysrhythmias
Management Of Coronary Vascular Disorders
Head Injury
1.The neurologic finding that would be considered abnormal in an 88-year-old patient would be:
1. smaller pupils, bilaterally.
2. bilateral slow pupillary response to light.
3. dizziness and problems with balance.
4. absence of Achilles’ tendon jerk.
2.The most reliable indicator of neurologic status is:
1. blood pressure.
2. pulse rate.
3. temperature.
4. level of consciousness.
3.A patient with a severe head injury begins to assume a posture of flexed upper extremities, with
plantar-flexed lower extremities. These assessments indicate:
1. increasing intracranial pressure with decorticate posturing.
2. decreasing intracranial pressure with decerebrate posturing.
3. decreasing intracranial pressure with decorticate posturing.
4. increasing intracranial pressure with decerebrate posturing.
4.The assessment indicating that mannitol therapy for cerebral edema is effective in a patient with
increased intracranial pressure (ICP) is:
1. increased blood pressure.
2. increased urinary output.
3. decreased pulse.
4. widening pulse pressure.
1 Prepared By : Mohanad Omar Hamad Adult3

5.In caring for the postcraniotomy patient, the nurse can help reduce ICP by:
1. keeping the patient flat in bed.
2. elevating the head of the bed 30 degrees.
3. closely monitoring the IV rate.
4. turning the patient to her or his right side.
6.A 49-year-old patient has multiple risk factors for coronary artery disease. A modifiable risk factor that
the patient can focus on is:
1. family history.
2. age.
3. smoking.
4. male gender.
7.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):
1. rate of 82.
2. PR interval of 0.36 second.
3. QRS of 0.16 second.
4. inverted T.
8.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:
1. stable angina.
2. unstable angina.
3. full-blown acute MI.
4. pulmonary embolus.

9.Laboratory tests are performed to identify damage to the heart muscle. The test that is elevated the
earliest with heart damage is:
1. CPK-MB.
2. LDH.
3. lipid profile.
4. troponin.
10.To treat a dysrhythmia, atropine sulfate has been administered intravenously. The nurse would
monitor for:
1. weight gain.
2. tachycardia.
3. muscle twitching.
4. incontinence of urine.
11.A patient has had an acute MI. The nurse should include in the discharge instructions:
1. cautions about use of morphine.
2. detailed symptoms that indicate impending MI.
3. written instructions on diet and follow-up appointments.
4. high-energy exercise program directions.
12. The total time for ventricular depolarization and repolarization is represented on an
electrocardiogram (ECG) reading as the:
a. QRS complex.
b. QT interval.
c. ST segment.
d. TP interval

13. Ventricular rate and rhythm can be determined by examining what interval on an ECG strip?
a. PP interval
b. QT interval
c. RR interval
d. TP interval
14. The PR interval on an ECG strip that reflects normal sinus rhythm would be between:
a. 0.05 and 0.10 seconds.
b. 0.12 and 0.20 seconds.
c. 0.15 and 0.30 seconds.
d. 0.25 and 0.40 seconds.
15. Characteristics of sinus bradycardia include all of the following except :
a. a P wave precedes every QRS complex.
b. every QRS complex is normal.
c. the rate is 40 to 60 bpm.
d. the rhythm is altered.
16. A dysrhythmia common in normal hearts and described by patients as “my heart skipped a beat” is:
a. premature atrial complex.
b. atrial flutter.
c. sinus tachycardia.
d. ventricular fibrillation.
17. A “sawtooth” P wave is seen on an ECG strip with:
a. sinus bradycardia.
b. atrial flutter.
c. atrioventricular nodal reentry.
d. premature junctional complex.

18. Atrial fibrillation is associated with a heart rate up to:
a. 300 bpm.
b. 400 bpm.
c. 500 bpm.
d. 600 bpm.
19. Ventricular bigeminyrefers to a conduction defect in which:
a. conduction is primarily from the AV node.
b. every other beat is premature.
c. rhythm is regular but fast.
d. the rate is between 150 and 250 bpm.
20. With ventricular tachycardia:
a. conduction originates in the ventricle.
b. electrical defibrillation is used immediately.
c. the P wave usually is normal.
d. the ventricular rate is twice the normal atrial rate.
21. Ventricular fibrillation is associated with an absence of:
a. heartbeat.
b. palpable pulse.
c. respirations.
d. all of the above.
22. First-degree AV block is characterized by:
a. a variable heart rate, usually fewer than 60 bpm.
b. an irregular rhythm.
c. delayed conduction, producing a prolonged PR interval.
d. P waves hidden with the QRS complex.

23. A conduction abnormality whereby no atrial impulse travels through the AV node is known as:
a. first-degree AV block.
b. second-degree AV block, type 1.
c. second-degree AV block, type 2.
d. third-degree AV block.
24. The coronary arteries arise from the:
a. aorta near the origin of the left ventricle.
b. pulmonary artery at the apex of the right ventricle.
c. pulmonary vein near the left atrium.
d. superior vena cava at the origin of the right atrium
25. The pacemaker for the entire myocardium is the:
a. atrioventricular junction.
b. bundle of His.
c. Purkinje fibers.
d. sinoatrial node.
26. So that blood may flow from the right ventricle to the pulmonary artery, which of the following
condi-tions is not required?
a. The atrioventricular valves must be closed.
b. The pulmonic valve must be open.
c. Right ventricular pressure must be less than pulmonary arterial pressure.
d. Right ventricular pressure must rise with systole.
27. Heart rate is stimulated by all of the following except :
a. excess thyroid hormone.
b. increased levels of circulating catecholamines.
c. the sympathetic nervous system.
d. the vagus nerve.

28. Stroke volume of the heart is determined by:
a. the degree of cardiac muscle strength (precontraction).
b. the intrinsic contractility of the cardiac muscle.
c. the pressure gradient against which the muscle ejects blood during contraction.
d. all of the above factors.
29. A nonmodifiable risk factor for atherosclerosis is:
a. stress.
b. obesity.
c. positive family history.
d. hyperlipidemia
30. Lumen narrowing with atherosclerosis is caused by:
a. atheroma formation on the intima.
b. scarred endothelium.
c. thrombus formation.
d. all of the above
31. A healthy level of serum cholesterol would be a reading of:
a. 160 to 190 mg/dL.
b. 210 to 240 mg/dL.
c. 250 to 275 mg/dL.
d. 280 to 300 mg/dL.
32. The pain of angina pectoris is produced primarily by:
a. coronary vasoconstriction.
b. movement of thromboemboli.
c. myocardial ischemia.
d. the presence of atheromas.

33. The nurse advises a patient that sublingual nitroglycerin should alleviate angina pain within:
a. 3 to 4 minutes.
b. 10 to 15 minutes.
c. 30 minutes.
d. 60 minutes
34. Patient education includes telling someone who takes nitroglycerin sublingually that he or she
should take 1, then go quickly to the nearest emergency department if no relief has been obtained after
taking ______ tablet(s) at 5-minute intervals.
a. 1
b. 2
c. 3
d. 4 to 5
35. The scientific rationale supporting the administration of beta-adrenergic blockers is the drugs’ ability
to:
a. block sympathetic impulses to the heart.
b. elevate blood pressure.
c. increase myocardial contractility.
d. induce bradycardia.
36. Calcium channel blockers act by:
a. decreasing SA node automaticity.
b. increasing AV node conduction.
c. increasing the heart rate.
d. creating a positive inotropic effect.
37. The classic ECG changes that occur with an MI include all of the following except:
a. an absent P wave.
b. an abnormal Q wave.
c. T-wave inversion.
d. ST-segment elevation.

38. The most common site of myocardial infarction is the:
a. left atrium.
b. left ventricle.
c. right atrium.
d. right ventricle.
39. Which of the following statements about myocardial infarction pain is incorrect ?
a. It is relieved by rest and inactivity.
b. It is substernal in location.
c. It is sudden in onset and prolonged in duration.
d. It is viselike and radiates to the shoulders and arms.
40. Myocardial cell damage can be reflected by high levels of cardiac enzymes. The cardiac-specific
isoenzyme is:
a. alkaline phosphatase.
b. creatine kinase (CK-MB).
c. myoglobin.
d. troponin.
41. The most common vasodilator used to treat myocardial pain is:
a. amyl nitrite.
b. Inderal.
c. nitroglycerine.
d. Pavabid HCl.
42. An intravenous analgesic frequently administered to relieve chest pain associated with myocardial
infarction is:
a. meperidine hydrochloride.
b. hydromorphone hydrochloride.
c. morphine sulfate.
d. codeine sulfate

43. A candidate for coronary artery bypass grafting (CABG) must meet which of the following criteria?
a. A blockage that cannot be treated by PTCA
b. Greater than 60% blockage in the left main coronary artery.
c. Unstable angina.
d. All of the above.
CASE STUDY: Angina Pectoris
Ermelina, a 64-year-old retired secretary, is admitted to the medical–surgical area for

management of chest pain caused by angina pectoris.
44. The nurse knows that the basic cause of angina pectoris is believed to be:
a. dysrhythmias triggered by stress.
b. insufficient coronary blood flow.
c. minute emboli discharged through the narrowed lumens of the coronary vessels.
d. spasms of the vessel walls owing to excessive secretion of epinephrine (adrenaline).
45. The medical record lists a probable diagnosis of chronic stable angina. The nurse knows that
Ermelina’s pain:
a. has increased progressively in frequency and duration.
b. is incapacitating.
c. is relieved by rest and is predictable.
d. usually occurs at night and may be relieved by sitting upright.
46. Ermelina has nitroglycerin at her bedside to take PRN. The nurse knows that nitroglycerin acts in all
of the following ways except :
a. causing venous pooling throughout the body.
b. constricting arterioles to lessen peripheral blood flow.
c. dilating the coronary arteries to increase the oxygen supply.
d. lowering systemic blood pressure.

CASE STUDY: Decreased Myocardial Tissue Perfusion
Mr. Lillis, a 46-year-old bricklayer, is brought to the emergency department by ambulance

with a suspected diagnosis of myocardial infarction. He appears ashen, is diaphoretic and
tachycardiac, and has severe chest pain. The nursing diagnosis is decreased cardiac
output, related to decreased myocardial tissue perfusion.
47. The nurse knows that the most critical time period for his diagnosis is:
a. the first hour after symptoms begin.
b. within 24 hours after the onset of symptoms.
c. within the first 48 hours after the attack.
d. between the third and fifth day after the attack.
48. Because the area of infarction develops over minutes to hours, the nurse knows to interpret the
following ECG results as indicative of initial myocardial injury:
a. abnormal Q waves.
b. enlarged T wave.
c. inverted T wave.
d. ST segment depression.
49. The nurse evaluates a series of laboratory tests within the first few hours. She knows that a positive
indica-tor of cell damage is:
a. decreased level of troponin.
b. elevated creatine kinase (CK-MB).
c. lower level of myoglobin.
50. The nurse needs to look for symptoms associated with one of the major causes of sudden death
during the first 48 hours, which is:
a. cardiogenic shock.
b. pulmonary edema.
c. pulmonary embolism.
d. ventricular rupture.

51. For discharge planning, Mr. Lillis is advised to:
a. avoid large meals.
b. exercise daily.
c. restrict caffeine-containing beverages.
d. do all of the above.
52. A nurse assesses the patient’s level of consciousness using the Glasgow Coma Scale. What score
indicates severe impairment of neurologic function?
a. 3
b. 6
c. 9
d. 12
53. The normal range of intracranial pressure (ICP) is:
a. 5 to 8 mm Hg.
b. 0 to 10 mm Hg.
c. 20 to 30 mm Hg.
d. 25 to 40 mm Hg.
54. ICP can be increased by a:
a. decrease in venous outflow.
b. dilation of the cerebral blood vessels.
c. rise in PaCO2.
d. change in all of the above
55. Initial compensatory vital sign changes with increased ICP include all of the following except :
a. a slow, bounding pulse.
b. an increased systemic blood pressure.
c. a decreased temperature.
d. respiratory rate irregularities.

56. The earliest sign of serious impairment of brain circulation related to increasing ICP is:
a. a bounding pulse.
b. bradycardia.
c. hypertension.
d. lethargy and stupor.
57. As ICP rises, the nurse knows that she may be asked to give a commonly used osmotic diuretic:
a. glycerin.
b. isosorbide.
c. mannitol.
d. urea
58. A cerebral hemorrhage located within the brain is classified as:
a. an epidural hematoma.
b. an extradural hematoma.
c. an intracerebral hematoma.
d. a subdural hematoma.
59. The Glasgow Coma Scale is used to determine the level of consciousness. A score considered
indicative of a coma is:
a. 1.
b. 3.
c. 5.
d. 7.
60. Assessing the level of consciousness is an important nursing measure postinjury. Signs of increasing
intracranial pressure (ICP) include:
a. bradycardia.
b. increased systolic blood pressure.
c. widening pulse pressure.

61. Comatose patients are mechanically ventilated to control ICP. Hypocapnia is a goal that can be
achieved with a PaCO2 in the range of:
a. 10 to 25 mm Hg.
b. 25 to 30 mm Hg.
c. 30 to 35 mm Hg.
d. 35 to 40 mm Hg.
62. An indicator of elevated body temperature in a head-injured patient is:
a. cerebral irritation from hemorrhage.
b. damage to the hypothalamus.
c. infection.
d. all of the above
63.The test that’s most specific for myocardial damage is:
a. CK.
b. CK-MB.
c. troponin I.
d. myoglobin.
64.Modifiable risk factors associated with CAD include:
a. age, weight, and cholesterol level.
b. smoking, diet, and blood pressure.
c. family history, weight, and blood pressure.
d. blood glucose level, activity level, and family history.
65.A primary goal in the treatment of MI is to:
a. prevent blood loss.
b. decrease blood pressure.
c. relieve pain.
d. administer I.V. fluids.

66. What accurately describes the pathophysiology of CAD?
a. Partial or total occlusion of the coronary artery occurs during the stage of raised fibrous plaque
b. Endothelial alteration may be caused by chemical irritants such as hyperlipidemia or by tobacco use
c. Collateral circulation in the coronary circulation is more lik ely to be present in the young patient with
CAD
d. The leading theory of atherogenesis proposes that infection and f atty dietary intake are the basic
underlying causes of atherosclerosis
67. The nurse suspects stable angina rather than MI pain in the patient who reports that his chest pain
a. is relie ved by nitroglycerin.
b. does not radiate to the neck, back, or arms.
c. is a sensation of tightness or squeezing.
d. is precipitated by physical or emotional exertion.
68. A 52-year-old man is admitted to the emergency department with severe chest pain. On what basis
would the nurse suspect an MI?
a. He has pale, cool, clammy skin.
b. He reports nausea and vomited once at home.
c. He says he is anxious and has a feeling of impending doom.
d. He reports he has had no relief of the pain with rest or position change.
69. The patient has hypertension and just experienced an MI. Which type of medication would be
expected to be added to decrease the workload on his heart?
a. ACE inhibitor
b. Calcium channel blocker
c. β-adrenergic blocker
d. Angiotensin II receptor block er (ARB)
70. What describes the SA node’s ability to discharge an electrical impulse spontaneously?
a. Excitability
b. Contractility
c. Conductivity
d. Automaticity

71. The patient’ s PR interval comprises six small boxes on the ECG graph. What does the nurse
determine that this indicates?
a. A normal finding
b. A problem with ventricular depolarization
c. A disturbance in the repolarization of the atria
d. A problem with conduction from the SA node to the ventricular cells
72. What should the nurse reading the monitor strip call a rhythm with a regular PR interval but a
blocked QRS complex?
a. Asystole
b. Atrial f ibrillation
c. First-degree AV block
d. Type II second-degree AV block
73. The nurse is evaluating the telemetry ECG rhythm strip. How should the nurse document the
distorted P wave causing an irregular rhythm?
a. Atrial flutter
b. Sinus bradycardia
c. Premature atrial contraction (PAC)
d. Paroxysmal supraventricular tachycardia (PSVT)
74. A patient with an acute myocardial infarction (MI) develops the following ECG pattern: atrial rate of
82 and regular; ventricular rate of 46 and regular; P wave and QRS complex are normal but there is no
relationship between the P wave and the QRS complex. What dysrhythmia does the nurse identify this
as and what treatment is expected?
a. Sinus bradycardia treated with atropine
b. Third-degree heart block treated with a pacemaker
c. Atrial f ibrillation treated with electrical cardioversion
d. Type I second-degree AV block treated with observation

75. Which rhythm abnormality has an increased risk of ventricular tachycardia and ventricular
fibrillation?
a. PAC
b. PVC on the T wave
c. Accelerated idioventricular rhythm
d. Premature v entricular contraction (PVC) couplet
76. A patient with no history of heart disease has a rh ythm strip that shows an occasional distorted P
wave followed by normal AV and ventricular conduction. What should the nurse question the patient
about?
a. The use of caffeine
b. The use of sedatives
c. Any aerobic training
d. Holding of breath during exertion
77. Which rhythm pattern finding is indicative of PVCs?
a. A QRS complex ≥0.12 second followed by a P wave
b. Continuous wide QRS complexes with a ventricular rate of 160 bpm
c. P waves hidden in QRS complexes with a regular rhythm of 120 bpm
d. Saw-toothed P waves with no measurable PR interval and an irregular rhythm
78. In the patient e xperiencing ventricular fibrillation (VF), what is the rationale for using cardiac
defibrillation?
a. Enhance repolarization and relaxation of ventricular myocardial cells
b. Provide an electrical impulse that stimulates normal myocardial contractions
c. Depolarize the cells of the myocardium to allow the SA node to resume pacemaker function
d. Deliver an electrical impulse to the heart at the time of ventricular contraction to convert the heart to a
sinus rhythm

79. A patient with chest pain that is unrelieved by nitroglycerin is admitted to the coronary care unit for
observation and diagnosis. While the patient has continuous ECG monitoring, what finding would most
concern the nurse?
a. Occasional PVCs
b. An inverted T wave
c. ST segment elevation
d. A PR interv al of 0.18 second
80. The patient is brought to the emergency department with acute coronary syndrome (ACS). What
changes should the nurse expect to see on the ECG if only myocardial injury has occurred?
a. Absent P wave
b. A wide Q wave
c. Inverted T wave
d. ST segment elevation
81. Identify the following cardiac rhythms. All rhythm strips are 6 seconds
a. Sinus bradycardia
b. Third-degree block
c. First-degree block
d. Normal sinus

a. Atrial flutter
b. Atrial fibrillation
c. Sinus tachycardia
d. PAC
a. PAC
b. PVC
c. Third-degree block
d. Atrial fibrillation
a. Second-degree block
b. Normal sinus rhythm
c. Sinus bradycardia
d. Atrial flutter

a. PAC
b. Sinus tachycardia
c. Ventricular fibrillation
d. PVC
a. Ventricular fibrillation
b. ventricular tachycardia
d. PAC
a. Second-degree block
b. PVC
c. Atrial fibrillation
d. PAC

a. Sinus tachycardia
b. Sinus bradycardia
c. Normal sinus rhythm
d. First-degree block
a. Ventricular fibrillation
b. ventricular tachycardia
d. First-degree block
a. First-degree block
b. PAC
c. PVC
d. ventricular tachycardia

82. Why is the Glasgow Coma Scale (GCS) used?
a. To quickly assess the LOC
b. To assess the patient’s ability to communicate
c. To assess the patient’s ability to respond to commands
d. To assess the patient’s coordination with motor responses
83. A patient with an intracranial problem does not open his eyes to any stimulus, has no verbal
response except moaning and muttering when stimulated, and flexes his arm in response to painful
stimuli. What should the nurse record as the patient’s GCS score?
a. 6
b. 9
c. 7
d. 11
84. The patient has been diagnosed with a cerebral concussion. What should the nurse expect to see in
this patient?
a. Deafness, loss of taste, and CSF otorrhea
b. CSF otorrhea, vertigo, and Battle’s sign with a dural tear
c. Boggy temporal muscle because of e xtravasation of blood
d. Headache, retrograde amnesia, and transient reduction in LOC
85. The client is admitted to the medical floor with a diagnosis of closed head injury. Which nursing
intervention has priority?
a. Assess neurological status.
b. Monitor pulse, respiration, and blood pressure.
c. Initiate an intravenous access.
d. Maintain an adequate airway.
86. The client diagnosed with a closed head injury is admitted to the rehabilitation department. Which
medication order would the nurse question?
a. A subcutaneous anticoagulant.
b. An intravenous osmotic diuretic.
c. An oral anticonvulsant.
d. An oral proton pump inhibitor.

87. Which cardiac enzyme would the nurse expect to elevate first in a client diagnosed with a myocardial
infarction ?
a. Creatine kinase (CK-MB).
b. Lactate dehydrogenase (LDH).
c. Troponin.
d. White blood cells (WBCs).
88. Along with persistent, crushing chest pain, which signs/symptoms would make the nurse suspect
that the client is experiencing a myocardial infarction ?
a. Midepigastric pain and pyrosis.
b. Diaphoresis and cool clammy skin.
c. Intermittent claudication and pallor.
d. Jugular vein distention and dependent edema.
89. The client with coronary artery disease asks the nurse, “Why do I get chest pain?” Which statement
would be the most appropriate response by the nurse?
a. “Chest pain is caused by decreased oxygen to the heart muscle.”
b. “There is ischemia to the myocardium as a result of hypoxemia.”
c. “The heart muscle is unable to pump effectively to perfuse the body.”
d. “Chest pain occurs when the lungs cannot adequately oxygenate the blood.”
90. The nurse is discussing angina with a client who is diagnosed with coronary artery disease. Which
action should the client take first when experiencing angina ?
a. Put a nitroglycerin tablet under the tongue.
b. Stop the activity immediately and rest.
c. Document when and what activity caused angina.
d. Notify the health-care provider immediately.
91. The client is exhibiting ventricular tachycardia. Which intervention should the nurse implement first
a. Administer lidocaine, an antidysrhythmic, IVP.
b. Prepare to defibrillate the client.
c. Assess the client’s apical pulse and blood pressure.
d. Start basic cardiopulmonary resuscitation.

92. The client is in complete heart block. Which intervention should the nurse implement first ?
a. Prepare to insert a pacemaker.
b. Administer atropine, an antidysrhythmic.
c. Obtain a STAT electrocardiogram (ECG).
d. Notify the health-care provider.
93. Which client problem has priority for the client with a cardiac dysrhythmia?
a. Alteration in comfort.
b. Decreased cardiac output.
c. Impaired gas exchange.
d. Activity intolerance.
94.Which of the following findings will help a nurse distinguish angina from an MI?
A. Angina can be relieved by rest and nitroglycerin.
B. An MI will with relieved with nitroglycerin.
C. An MI will have cardiac enzyme levels within the expected reference range.
D. Angina can occur for longer than 30 min.
95. A client who has angina reports that he is not able to make all of the lifestyle changes recommended.
Which of the following changes should the nurse suggest that the client work on first?
A. Diet modification
B. Relaxation exercises
C. Smoking cessation
D. Taking omega-3 capsules
96. The patient is experiencing chest pain and pain radiating to his arms, jaw and back. His physician
diagnosed his condition as a myocardial infarction. The patient asks what happened to him. The best
nresponse is:
a.You had a heart attack.
b.Your aortic valve was malformed at birth causing a disruption in blood flow.
c. All patients who are as overweight as you will have a heart attack.
d. One or more arteries that supply blood to your heart is blocked, thereby preventing blood from
flowing to your cardiac muscles.

97 .When administering a thrombolytic drug to the client experiencing a myocardial infarction (MI ,)
the nurse explains that the purpose of the drug is to:
a. Help keep him well hydrated.
b Dissolve clots that he may have.
c. Prevent kidney failure.
d. Treat potential cardiac arrhythmias.
98. When teaching the client with myocardial infarction (MI), the nurse explains that the pain
associated with MI is caused by:
a. Left ventricular overload.
b. Impending circulatory collapse.
c. Extracellular electrolyte imbalances.
d. Insufficient oxygen reaching the heart muscle.
99. The nurse is assessing a client who has had a myocardial infarction. The nurse notes the cardiac
rhythm shown on the electrocardiogram strip below. The nurse identifi es this rhythm as which of the
following?
a. Atrial fi brillation.
b. Ventricular tachycardia.
c. Premature ventricular contractions.
d. Sinus tachycardia.

100 .The nurse receives emergency laboratory results for a client with chest pain and immediately
informs the physician. An increased myoglobin level suggests which of the following?
a.Cancer.
b.Hypertension.
c. Liver disease.
d.Myocardial damage.
101. Which of the following symptoms should the nurse teach the client with unstable angina to report
immediately to her physician?
a. A change in the pattern of her pain.
b. Pain during sexual activity.
c. Pain during an argument with her husband.
d. Pain during or after an activity such as lawn-mowing.
102. The physician refers the client with unstable angina for a cardiac catheterization. The nurse
explains to the client that this procedure is being used in this specifi c case to:
a. Open and dilate blocked coronary arteries.
b. Assess the extent of arterial blockage.
c. Bypass obstructed vessels.
d. Assess the functional adequacy of the valves and heart muscle.
103. Which of the following is not a risk factor for the development of atherosclerosis?
a. Family history of early heart attack.
b. Late onset of puberty.
c. Total blood cholesterol level greater than 220 mg/dL.
d. Elevated fasting blood glucose concentration

104. As an initial step in treating a client with angina, the physician prescribes nitroglycerin tab-lets, 0.3
mg given sublingually. This drug’s principal effects are produced by:
a. Antispasmodic effects on the pericardium.
b. Causing an increased myocardial oxygen demand.
c. Vasodilation of peripheral vasculature.
d. Improved conductivity in the myocardium.
105. Which of the following describes decerebrate posturing?
a. Internal rotation and adduction of arms with flexion of elbows, wrists, and fingers.
b. Back hunched over, rigid flexion of all four extremities with supination of arms and plan-tar flexion of
feet.
c. Supination of arms, dorsiflexion of the feet.
d. Back arched, rigid extension of all four extremities
106.A nurse admits a client to a telemetry unit and ob-tains the following electrocardiogram (ECG) strip
of the client’s heart rhythm. What should be the nurse’s interpretation of this rhythm strip
a. Atrial flutter
b. Atrial fibrillation
c. Sinus bradycardia
d. Sinus rhythm with premature atrial contractions(PACs)

107.abnormal posture associated with severe brain injury characterized by abnormal flexion :
a.Decortication
b.Decerebration
c.ataxia
d.scoliosis
108.a slight limitation of ordinary activities when they are performed rapidly :
a.class 0 angina
b.class 1 angina
c.class 2 angina
d.class 4 angina
109.pain at rest with reversible ST-segment elevation :
a.unstable angina
b.stable angina
c.prinzmetal angina
d.silent angina

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Part2 Adult 3 Q & A (final)

Assessment Of Cardiovascular Function

Management Of Coronary Vascular Disorders

1. smaller pupils, bilaterally.

2. bilateral slow pupillary response to light.

3. dizziness and problems with balance.

4. absence of Achilles’ tendon jerk.

2.The most reliable indicator of neurologic status is:

1. increasing intracranial pressure with decorticate posturing.

2. decreasing intracranial pressure with decerebrate posturing.

3. decreasing intracranial pressure with decorticate posturing.

4. increasing intracranial pressure with decerebrate posturing.

1. increased blood pressure.

2. increased urinary output.

4. widening pulse pressure.

1 Prepared By : Mohanad Omar Hamad Adult3

1. keeping the patient flat in bed.

2. elevating the head of the bed 30 degrees.

3. closely monitoring the IV rate.

4. turning the patient to her or his right side.

2. PR interval of 0.36 second.

3. QRS of 0.16 second.

3. full-blown acute MI.

2 Prepared By : Mohanad Omar Hamad Adult3

1. cautions about use of morphine.

2. detailed symptoms that indicate impending MI.

3. written instructions on diet and follow-up appointments.

4. high-energy exercise program directions.

3 Prepared By : Mohanad Omar Hamad Adult3

a. 0.05 and 0.10 seconds.

b. 0.12 and 0.20 seconds.

c. 0.15 and 0.30 seconds.

d. 0.25 and 0.40 seconds.

15. Characteristics of sinus bradycardia include all of the following except :

a. a P wave precedes every QRS complex.

b. every QRS complex is normal.

c. the rate is 40 to 60 bpm.

d. the rhythm is altered.

a. premature atrial complex.

17. A “sawtooth” P wave is seen on an ECG strip with:

c. atrioventricular nodal reentry.

d. premature junctional complex.

4 Prepared By : Mohanad Omar Hamad Adult3

19. Ventricular bigeminyrefers to a conduction defect in which:

a. conduction is primarily from the AV node.

b. every other beat is premature.

c. rhythm is regular but fast.

d. the rate is between 150 and 250 bpm.

20. With ventricular tachycardia:

a. conduction originates in the ventricle.

b. electrical defibrillation is used immediately.

c. the P wave usually is normal.

d. the ventricular rate is twice the normal atrial rate.

21. Ventricular fibrillation is associated with an absence of:

d. all of the above.

22. First-degree AV block is characterized by:

a. a variable heart rate, usually fewer than 60 bpm.

c. delayed conduction, producing a prolonged PR interval.

d. P waves hidden with the QRS complex.

5 Prepared By : Mohanad Omar Hamad Adult3

b. second-degree AV block, type 1.

c. second-degree AV block, type 2.

24. The coronary arteries arise from the: