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Exam 2: Cardiac Practice Questions NCLEX With complete solutions
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Exam 2: Cardiac Practice QuestionsNCLEX With complete solutions
Which of the following actions is the first priority of care for a pt exhibiting signs & symptoms of
coronary artery disease?
1. Decrease anxiety
2. Enhance myocardial oxygenation
3. Administer sublingual nitroglycerin
4. Educate the pt about his symptoms - correct answer ✔✔2. Enhancing myocardial oxygenation is
always the first priority when a pt exhibits signs or symptoms of cardiac compromise. W/out adequate
oxygenation, the myocardium suffers damage. Sublingual nitroglycerin is administered to treat acute
angina, but administration isn't the first priority. Although educating the pt & decreasing anxiety are
important in care delivery, neither are priorities when a pt is compromised.
Medical treatment of coronary artery disease includes which of the following procedures?
1. Cardiac catherization
2. Coronary artery bypass surgery
3. Oral med therapy
4. Percutaneous transluminal coronary angioplasty - correct answer ✔✔3. Oral med administration is a
noninvasive, medical treatment for coronary artery disease. Cardiac catherization isn't a treatment, but a
diagnostic tool. Coronary artery bypass surgery & percutaneous transluminal coronary angioplasty are
invasive, surgical treatments.
Which of the following is the most common symptom of myocardial infarction (MI)?
1. Chest pain
2. Dyspnea
3. Edema
4. Palpitations - correct answer ✔✔1. The most common symptom of an MI is chest pain, resulting from
deprivation of oxygen to the heart. Dyspnea is the second most common symptom, related to an
increase in the metabolic needs of the body during an MI. Edema is a later sign of heart failure, often
seen after an MI. Palpitations may result from reduced cardiac output, producing arrhythmias.
,Which of the following symptoms is the most likely origin of pain the pt described as knifelike chest pain
that increases in intensity with inspiration?
1. Cardiac
2. Gastrointestinal
3. Musculoskeletal
4. Pulmonary - correct answer ✔✔4. Pulmonary pain is generally described by these symptoms.
Musculoskeletal pain only increases w/ movement. Cardiac & GI pains don't change w/ respiration.
Which of the following blood tests is most indicative of cardiac damage?
1. Lactate dehydrogenase
2. Complete blood count (CBC)
3. Troponin I
4. Creatine kinase (CK) - correct answer ✔✔3. Troponin I levels rise rapidly & are detectable w/in 1 hour
of myocardial injury. Troponin I levels aren't detectable in people w/out cardiac injury. Lactate
dehydrogenase (LDH) is present in almost all body tissues & not specific to heart muscle. LDH
isoenzymes are useful in diagnosing cardiac injury. CBC is obtained to review blood counts, & a complete
chemistry is obtained to review electrolytes. Because CK levels may rise w/ skeletal muscle injury, CK
isoenzymes are required to detect cardiac injury
What is the primary reason for administering morphine to a pt with an MI?
1. To sedate the pt
2. To decrease the pt's pain
3. To decrease the pt's anxiety
4. To decrease oxygen demand on the pt's heart - correct answer ✔✔4. Morphine is administered
because it decreases myocardial oxygen demand. Morphine will also decrease pain & anxiety while
causing sedation, but it isn't primarily given for those reasons.
Which of the following conditions is most commonly responsible for myocardial infarction?
1. Aneurysm
2. Heart failure
3. Coronary artery thrombosis
, 4. Renal failure - correct answer ✔✔3. Coronary artery thrombosis causes an inclusion of the artery,
leading to myocardial death. An aneurysm is an outpouching of a vessel & doesn't cause an MI. Renal
failure can be associated w/ MI but isn't a direct cause. Heart failure is usually a result from an MI.
Which of the following complications is indicated by a third heart sound (S3)?
1. Ventricular dilation
2. Systemic hypertension
3. Aortic valve malfunction
4. Increased atrial contractions - correct answer ✔✔1. Rapid filling of the ventricle causes vasodilation
that is auscultated as S3. Increased atrial contraction or systemic hypertension can result in a fourth
heart sound. Aortic valve malfunction is heard as a murmur.
After an anterior wall myocardial infarction, which of the following problems is indicated by auscultation
of crackles in the lungs?
1. Left-sided heart failure
2. Pulmonic valve malfunction
3. Right-sided heart failure
4. Tricupsid valve malfunction - correct answer ✔✔1. The left ventricle is responsible for most of the
cardiac output. An anterior wall MI may result in a decrease in left ventricular function. When the left
ventricle doesn't function properly, resulting in left-sided heart failure, fluid accumulates in the
interstitial & alveolar spaces in the lungs & causes crackles. Pulmonic & tricuspid valve malfunction
causes right sided heart failure.
What is the first intervention for a pt experiencing MI?
1. Administer morphine
2. Administer oxygen
3. Administer sublingual nitroglycerin
4. Obtain an ECG - correct answer ✔✔2. Administering supplemental oxygen to the pt is the first priority
of care. The myocardium is deprived of oxygen during an infarction, so additional oxygen is administered
to assist in oxygenation & prevent further damage. Morphine & nitro are also used to treat MI, but
they're more commonly administered after the oxygen. An ECG is the most common diagnostic tool used
to evaluate MI.
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