Answers
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 - - 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 - - 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 - - 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.
,Exam 2: Cardiac Practice Questions NCLEX with
Answers
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 - - 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) - - 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 - - 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.
, Exam 2: Cardiac Practice Questions NCLEX with
Answers
Which of the following conditions is most commonly responsible for myocardial infarction?
1. Aneurysm
2. Heart failure
3. Coronary artery thrombosis
4. Renal failure - - 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 - - 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 - - 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?