Which of the following actions is the first priority

of care for a client exhibiting signs and symptoms

of coronary artery disease?
A. Decrease anxiety 45%

B. Enhance myocardial
oxygenation 27%
23%
C. Administer
sublingual 5%
nitroglycerin
D. Educate the client

ty

..
xie

..
..

t.
y.

ni
an

ou
ox

al
about his symptoms

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 Medical treatment of coronary artery disease
includes which of the following procedures?

A. Cardiac cath
27% 27%
B. Coronary artery 23% 23%
bypass surgery
C. Oral medication
therapy
D. Coronary
angioplasty

ty
y
t

ap
.. .
ca

as
ss

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ac

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ry

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on
ed
ar

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m

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ry

al
a

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on
r
Co
 Which of the following is the most common
symptom of myocardial infarction (MI)?

A. Chest pain
82%
B. Dyspnea
C. Edema
D. Palpitations

14%
5%
0%

a
a
n

ns
em
ne
ai

t io
tp

sp

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lp
Ch

Pa
 Which of the following symptoms is the most likely
origin of pain the client described as knifelike chest
pain that increases in intensity with inspiration?
A. Cardiac
55%
B. Gastrointestinal
41%
C. Musculoskeletal
D. Pulmonary

5%
0%

ac

al

y
l
ta

ar
tin
di

le

on
r

e
s
Ca

te

sk

lm
n

lo

Pu
oi

cu
r
st

us
Ga

M
 Which of the following blood tests is
most indicative of cardiac damage?
A. Lactate
64%
dehydrogenase
B. CBC
C. Troponin I
23%
D. Creatine kinase 14%

0%

e
I
e

CB

as
n
as

i
on

kin
n
ge

op

e
o

in
Tr
dr

at
hy

e
de

Cr
ate
ct
La
 What is the primary reason for administering
morphine to a client with an MI?

A. To sedate the client 55%

B. To decrease the
client’s pain
C. To decrease the 23%
14%
client’s anxiety 9%

D. To decrease oxygen
demand on the

n
en

..
i

.. .
pa

a.
c li

m
t’s
t’s

de
he
client’s heart

en
en
et

en
c li
c li
t

yg
da

e
e

ox
th
th
se

se
se

se
To

ea
ea

ea
cr
cr

cr
de
de

de
To
To

To
 Which of the following conditions is most
commonly responsible for myocardial infarction?

A. Aneurysm 86%
B. Heart failure
C. Coronary artery
thrombosis
D. Coronary artery 14%
0% 0%
thrombosis

re

s is

s is
ys

lu

bo

bo
i
r

fa
eu

om

om
rt
An

r
th

th
He

ry

ry
te

te
ar

ar
ry

ry
a

a
on

on
r

r
Co

Co
Which of the following complications is indicated
by a third heart sound (S3)?

A. Ventricular dilation 59%

B. Systemic hypertensi
on
C. Aortic valve 18%
14%
malfunction 9%
D. Increased atrial
contractions

n
n

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io
tio

io

...
ns

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t
la

nc

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te
di

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on
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lar

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m

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hy
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Ve

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Ao

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In
 What is the first intervention for a
client experiencing MI?
A. Administer 59%
morphine
B. Administer oxygen
27%
C. Administer
sublingual 9%
5%
nitroglycerin
D. Obtain an ECG

G
en
e

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in

EC
n.
yg
ph

an
al
ox
or

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m

lin

ta
ist
er

Ob
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ist

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Ad
m

ist
Ad

in
m
Ad
Which of the following classes of medications protects
the ischemic myocardium by blocking catecholamines
and sympathetic nerve stimulation?
A. Beta-adrenergic 64%
blockers
B. Calcium channel
blockers
18%
C. Narcotics 14%
5%
D. Nitrates

s
rs
rs

ic

te
ke
e

ot

tra
ck

rc
lo
o

Ni
Na
bl

lb
gic

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er

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ch
dr

m
-a

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Be

Ca
 What is the most common
complication of an MI?
A. Cardiogenic Shock 45%

B. Heart failure
32%
C. Arrhythmias
D. Pericarditis 18%

5%

tis
re

s
k

ia
oc

lu

i
hm

rd
Sh

i
fa

a
yt

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c

rt
ni

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Pe
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Ar
og
di
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Ca
 Toxicity from which of the following medications
may cause a client to see a green-yellow halo
around lights?
A. Digoxin
73%
B. Furosemide
C. Metoprolol
D. Enalapril

14%
9%
5%
n

ril
lo
id
i
ox

ap
ol
m

r
g

al
op
e
Di

En
os

et
r
Fu

M
 Which of the following classes of medications
maximizes cardiac performance in clients with
heart failure by increasing
ventricular contractility?
A. Beta-adrenergic 55%
blockers
B. Calcium channel
blockers 23%
18%
C. Diuretics
5%
D. Inotropic agents

ic s

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rs
rs

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ke
e

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ck

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en

In
ch
dr

m
-a

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ta

l
Be

Ca
 Which of the following types of angina is most
closely related with an impending MI?

A. Angina decubitus 50%

B. Chronic stable
angina 32%

C. Nocturnal angina
D. Unstable angina 9% 9%

na
a
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No
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ron
Ch
 Which of the following tests is used
most often to diagnose angina?
A. Chest xray
64%
B. Echocardiogram
C. Cardiac cath
D. 12 Lead ECG 32%

5%
0%

G
h
m
a

EC
t
xr

ra

ca
og

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ca

12
Ca
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 The client diagnosed with rule-out myocardial infarction is
experiencing chest pain while walking to the bathroom. Which
action should the nurse implement first?

A. Administer 50%
sublingual
nitroglycerin
27%
B. Obtain a stat 12
Lead ECG 14%
9%
C. Have the client sit
down immediately
D. Assess the client's

ns
G
.

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EC
..

sig
n.
ni

ad

l
al

ta
do
Le
gu
vital signs

vi
it
12
lin

t's
ts
b

en
t

en
su

ta

cli
c li
as
er

e
ist

he
in

th
ta
in

et

ss
m

Ob

se
Ad

Ha

As
The client who has had a myocardial infarction is admitted to
the telementry unit from intensive care. Which referral would
be most appropriate for the client?

A. Social worker
91%
B. Physical therapy
C. Cardiac
rehabilitation
D. Occupation therapy
5% 5%
0%

y
ke

ap

p
tio

ra
or

ta
he

e
lw

th
ili
lt

ab
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n
ic a

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So

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pa
Ph

ac

cu
di

Oc
r
Ca
 The nurse is administering a calcium channel
blocker to the client diagnosed with a myocardial
infarction. Which assessment data would cause the
nurse to question administering this medication?
A. The client's apical
55%
pulse is 64
B. The client's calcium
level is elevated
C. The client's 18%
14% 14%
telemetry shows
occasional PVCs
D. The client's blood

l ..

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.

.
i. .

o.

ur
ve
se

sh

ss
le
ul

e
ry
m

pr
pressure is 90/62 lp

et
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ic a

od
em
l
ca
ap

o
l

bl
te
's
's

's
nt

's
nt

nt
nt
lie
lie

lie
lie
ec
ec

ec
ec
Th
Th

Th
Th
 The client diagnosed with a myocardial infarction
asks the nurse, "why do I have to rest and take it
easy? My chest doesn't hurt anymore." Which
statement would be the nurse's best response?
68%
A. "Your heart is damaged and
needs about 4 to 6 weeks to
heal“
B. "There is necrotic
myocardial tissue that puts
you at risk for dysrhythmias“ 14%
9% 9%
C. "Your doctor has ordered
bedrest. Therefore, you
must stay in bed.“

.. .

.
..

t..
. ..

e.
ca

es
d

er
yo
e

ch
D. "Just because your chest

rd
ag

so

ur
am

tic

yo
ha
sd

o
cr

se
doesn't hurt anymore

r
ti

to
ne

au
r

oc
ea

is

ec
rd
rh

re

tb
doesn't mean you are out of
ou
he
ou

us
"Y
"T
"Y

"J
danger"
 A client is wearing a continuous cardiac monitor,
which begins to sound its alarm. A nurse sees no
electrocardiographic complexes on the screen.
Which is the priority action of the nurse?
A. Call a code. 86%
B. Call the health care
provider.
C. Check the client's
status and lead
placement. 14%
D. Press the recorder 0% 0%
button on the

.
de

.. .
..
v..
electrocardiogram
co

to
o

us
la

ut
pr

at

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l

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Ca

st
ca

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t's

rd
console
lt h

en

co
c li
a

re
he

he
e
th
he

st
ck
lt

es
l

e
Ca

Pr
Ch
 A client with angina complains that the anginal pain is
prolonged and severe and occurs at the same time each day,
most often at rest in the absence of precipitating factors. How
would the nurse best describe this type of anginal pain?
A. Stable angina 50%

B. Variant angina
C. Unstable angina 32%

D. Non anginal pain 18%

0%

na
a

in
in
gin

pa
gi
g

an
an

an

al
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nt

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ab

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r
St

st
Va

n
Un

No
The nurse is caring for a client who has been hospitalized with
a diagnosis of angina pectoris. The client is receiving oxygen
via nasal cannula at 2 L/min. The client asks why the oxygen is
necessary. The nurse should provide which information to the
client?
A. Oxygen has a calming
effect 68%
B. Oxygen will prevent the
development of any
thrombus.
C. Oxygen dilates the blood
vessels so that they can 18%
supply more nutrients to 9%
the heart muscle. 5%
D. The pain of angina
pectoris occurs because of

r. .
c

...
ffe
a decreased oxygen

. ..

to
d
he

oo
ge

ec
tt

ap
bl
in
supply to heart cells.

en
m

in
th
l

ev

ng
ca

s
pr

a
te
a

of
la
s

ill
ha

di
w

n
ai
en

en
en

ep
yg

yg
yg

Th
Ox

Ox
Ox
The nurse is performing an admission assessment on a client
with a diagnosis of angina pectoris who takes nitroglycerin for
chest pain at home. During the assessment the client
complains of chest pain. The nurse should immediately ask
the client which question?
A. "Where is the pain 45% 45%
located?“
B. Are you having any
nausea?“
C. "Are you allergic to
any medications?“ 5% 5%

D. "Do you have your

nitroglycerin with

..
.

...
t..

s..

o.
y
ca

it r
u

an
na
lo

rn
you?"

to
ny
in

ou
ic
pa

ga

ey
rg
he

le
vin

v
al

ha
t

ha
is

u
yo
e

yo
r

yo
he

re

o
"W

"D
"A
Ar
 The nurse is reviewing laboratory results for a
patient admitted with acute chest pain. Which
laboratory value should cause the nurse the most
concern?
A. AST 65 units/L 50%

B. CK 320 units/L
C. Hematocrit 35%
27%
D. APTT 35 seconds
18%

5%

L
L

ds
/
/

35
ts
ts

on
i
i

un
un

it

c
se
r
oc
0
65

35
32

at
T

TT
CK
AS

He

AP
 Which of the following reflects the principle on
which a client's diet will most likely be based during
the acute phase of MI?
A. Liquids as ordered 55%
B. Small, easily
digested meals
27%
C. Three regular meals
per day 9% 9%
D. NPO

O
d

ls

y
e

NP
da
ea
er

m
rd

er
d

sp
so

e
st

l
a

ea
ge
ds

m
di
ui

ar
L iq

y
sil

l
gu
ea

re
,
all

e
re
Sm

Th
 The client is 3 hours post myocardial infarction.
Which data would warrant immediate intervention
by the nurse?
A. Bilateral peripheral 45%
pulses 2+
B. The pulse oximeter 27%
reading is 96% 23%

C. The urine output is

240 mL in the last 4 5%
hours
D. Cool, clammy,

...

...

..
...

t i.
m
n
se

di

e
ul

40

or
ea
lp

s2

ph
diaphoretic skin

r
ra

er

ia
ti
he

et

d
u
tp
im
r ip

y,
m
ou
ox
pe

m
e
se

la
al

rin

l, c
ul
r
te

eu
ep

o
la

Co
Th
Bi

Th
 The nurse is transcribing the doctor's 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 55%
B. Take the client's apical
pulse rate before
administering
C. Check the client's 18% 18%
potassium level before 9%
giving the medication
D. Determine if a digoxin

...
...
...

...
level has been drawn

le
lp
th

ss

n
ca

ta
it h

i
ox
i

po
ap
w

g
di
t's
er

t 's

en

a
d

en
or

if
c li
c li

e
he

in
e
e

th
st

m
th

er
us

ck
ke

t
sc

De
Ta

Ch
Di
 A client admitted with angina compains of severe
chest pain and suddenly becomes unresponsive.
After establishing unresponsiveness, which of the
following actions should the nurse take first?
A. Activate the
36%
resuscitation team 32%

B. Open the client's

18%
airway 14%
C. Check for breathing
D. Check for signs of
circulation

g
ay

. ..
...

in
rw

ul
th
io

irc
at

ai

ea
it

c
t's

br
sc

of
en

r
su

fo

ns
c li
re

ck

sig
e
e

e
th
th

r
Ch

fo
en
e

ck
at

Op
t iv

e
Ch
Ac
 The physician orders continuous intravenous
nitroglycerin infusion for the client with MI.
Essential nursing actions include which of the
following?
A. Obtaining an
36%
infusion pump for
the medication 27%
23%
B. Monitoring BP q4h
14%
C. Monitoring urine
output hourly
D. Obtaining serum
potassium levels

..
q4

i..
u.
..

ss
p.

tp
gB

ta
ou
n
daily

po
s io

r in

e
fu

r in

um
it o
in

gu
on

er
n

gs
r in
ga

in
it o
in

in
in

on

ta
ta

Ob
Ob
 Aspirin is administered to the client
experiencing an MI because of its:
A. Antipyrectic action 45%

B. Antithrombotic
action
23%
C. Antiplatelet action 18%
14%
D. Analgesic action

n
n
n

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tio
tio

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ac
ac
ac

ac

sic
t
t ic

t ic

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ge
ec

te
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yr

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om

An
t ip
t ip

hr

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An

t it
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