NAME:_____________________
Start range of motion exercises
Cardiovascular Practice Exams
1. The nurse is caring for an adult who has a
clotting time of 20 minutes. What should the
nurse do because of the lab values?
1. Observe the client carefully for thrombus
formation.
2. Protect the client from sources of
infection.
3. Assure the client has adequate rest.
*4. Avoid giving the client injections.
2. A client who is receiving heparin asks the
nurse why it cannot be given by mouth. The
nurse’s reply is based on which knowledge?
Heparin is given parenterally because:
*1. It is destroyed by gastric secretions.
2. It irritates the gastric mucosa.
3. It irritates the intestinal lining.
4. Therapeutic levels can be achieved more
quickly.
3. An adult is admitted for a cardiac
catheterization. The client asks the nurse if
she will be asleep during the cardiac
catheterization. What is the best answer for
the nurse to give?
1. “You will be given a light general
anesthesia.”
*2. ” You will be sedated but not asleep.”
3. “The doctor will give you an anesthetic if
you are having too much pain.”
4. “Is it important for you to be asleep?”
4. An adult has just returned following a left
heart catheterization. What is it essential for
the nurse to do?
*1. Check her peripheral pulses.
2. Maintain her NPO.
3. Apply heat to the insertion site.
4.
immediately.
SCORE:_____________
5. The nurse is caring for an adult who is
admitted with a history of angina pectoris.
He calls the nurse and says he has just taken
a nitroglycerin tablet sublingually for
anginal pain. What action should the nurse
take next?
*1. Monitor ECG. If the pain does not
subside within five minutes, place a second
tablet under his tongue.
2. Assist him into bed and position him in
Trendelenburg position. Record vital signs
every five minutes.
3. Notify the physician immediately. Start an
IV so there will be a route for cardiac
medications.
4. Administer xylocaine (Lidocaine) IV.
Prepare for defibrillation.
6. A low sodium, low cholesterol weight
reducing diet is prescribed for an adult
client. The nurse knows the client
understands his diet when he chooses which
of the following meals?
*1. Baked chicken and mashed potatoes.
2. Stir-fried Chinese vegetables and rice.
3. Tuna fish salad with celery sticks.
4. Lean steak with carrots.
7. A 70-year-old is admitted to the intensive
care unit with cardiogenic shock. The nurse
prepares an infusion of dobutamine as
prescribed by the physician. The nurse
recognizes an essential safety measure to be
taken with this drug is to
1. Obtain a 12 lead electrocardiograph.
2. Assess electrolyte levels.
3. Administer the drug through a large vein.
4. Monitor for increase in temperature.
8. A client with atrial fibrillation is receiving
warfarin sodium (coumadin) daily. What is
the action of this drug?
1. Inactivates protamine sulfate.
2. Prevents new clots from forming.
3. Dissolves existing clots.
4. Slows the heart rate.
9. A client is receiving enalapril (Vasotec) 5
mg po daily for hypertension. Other
medications include estrogen, lithium
carbonate, and lorazepam. Which
complaints should alert the nurse that
medication interactions are present?
1. Recent memory loss, muscle weakness,
and hyperreflexia.
2. Blood pressure 140/90, reports of mood
swings, and restful night sleep.
3. Slight kyphosis, occasional hot flashes,
and menstrual cramps.
4. Feelings of panic and anxiety, retrograde
amnesia, and sleepiness.
10. A 68-year-old is admitted with a
diagnosis of right-sided congestive heart
failure. What assessment findings would the
nurse expect in this client?
1. Distended neck veins.
2. Slight ankle edema.
3. Hypotension.
4. Premature ventricular contractions.
11. Digoxin and Lasix (Furosemide) are
ordered for an adult client. Which of the
following would the nurse expect to be
ordered for this client?
1. Potassium.
2. Calcium.
3. Aspirin.
4. Warfarin.
12. An adult client is receiving digoxin. One
morning when the nurse goes to give the
client his digoxin he says, “I think I need to
see the eye doctor. Things seem to look
green today.” The nurse takes his vital signs
and finds them to be: B.P. 150/94; P 60; R.
28. What is the most appropriate initial
action for the nurse to take at this time?
1. Record the findings on the client’s chart.
2. Withhold the digoxin and report the
findings.
3. Request an appointment with the
ophthalmologist.
4. Reassure the client he is experiencing a
normal reaction to his medication.
13. The nurse is caring for an adult who
underwent a mitral valve replacement.
Following cardiac surgery, clients often
experience periods of disorientation. Which
of the following nursing actions may help
prevent this disorientation?
1. Keep the client heavily sedated.
2. Keep the ICU well lighted 24 hours a day.
3. Restrict visitors to 5 minutes at a time.
4. Position the cardiac monitor so that it is
out of the client’s view.
14. An adult had open heart surgery today
for a mitral valve replacement. He has a
central venous pressure catheter. The CVP is
recorded every 15 minutes. The nurse has
observed a marked increase in the CVP over
the last 2 hours. The latest reading is above
normal. Which nursing action would be
appropriate before the surgeon is called?
1. Increase the IV slightly to improve
cardiac output.
2. Elevate the client’s feet to increase venous
return.
3. Decrease the IV to a “keep open” rate.
4. Check the specific gravity of the urine.
15. For which of the following surgical
procedures is it essential for the nurse to
note the presence or absence of the dorsalis
pedis and posterior tibial pulses?
1. Carotid endartarectomy.
2. Iliofemoral bypass.
3. Vein ligation.
4. Pacemaker implantation.
16. The nurse knows that the reason a client
who has had a myocardial infarction is
getting heparin is to:
1. Prevent extension of a thrombus.
2. Dissolve small thrombi that have lodged
in the coronary arteries.
3. Enhance the action of thrombin in the
bloodstream.
4. Decrease the amount of time it takes the
blood to clot.
17. The nurse is caring for a client receiving
heparin sodium. Which medication should
the nurse have readily available because the
client is receiving heparin?
1. Vitamin K.
2. Magnesium sulfate.
3. Warfarin sodium.
4. Protamine sulfate.
18. A 60-year-old client is admitted to the
hospital with peripheral vascular disease of
the lower extremities. He has had diabetes
mellitus for 22 years. He smokes two packs
of cigarettes per day and is employed in a
job where he must stand for 7 or more hours
each day. Which of the following would the
nurse expect to elicit when assessing this
client?
1. Diminished pedal pulses.
2. Warm tender calves.
3. Tremors of the feet bilaterally.
4. Difference in blood pressure when sitting
and standing.
19. A 60-year-old man has several ischemic
ulcers on each ankle and lower leg area.
Other parts of his skin are shiny and taut
with loss of hair. A primary nursing goal for
this client should be to
1. Increase activity tolerance.
2. Relieve anxiety.
3. Protect from injury.
4. Help build a positive body image.
20. A 48-year-old is found on a routine
physical examination to have a blood
pressure of 170/98. Follow up studies
confirm a diagnosis of hypertension. He is
prescribed hydrochlorothiazide. What
nursing instruction is it essential for him to
receive?
1. Use a calcium based salt substitute.
2. Avoid hard cheeses.
3. Drink orange juice or eat a banana daily.
4. Do not take aspirin.
21. A low sodium diet has been ordered for
an adult client. Which menu is the lowest in
sodium?
1. Tossed salad, carrot sticks, steak.
2. Baked chicken, mashed potatoes, green
beans.
3. Hot dog, roll, coleslaw.
4. Chicken noodle soup, applesauce, cottage
cheese.
22. An adult client was admitted to the
coronary care unit following a
subendocardial myocardial infarction. A
balloon-tipped pulmonary artery catheter
was inserted when the client began to
exhibit signs of cardiogenic shock. The
nurse measures the client’s pulmonary
capillary wedge pressure and finds it to be
27 mm Hg. The nurse knows that this
pressure is
1. Within normal limits.
2. Elevated above normal.
3. Less than normal.
4. Life threatening.
23. An elderly client with a long history of
heart disease was brought to the emergency
department of a local hospital following a 30
minute episode of chest pain unrelieved by
nitroglycerin. The client’s
electrocardiograph has an inverted T wave.
The nurse caring for the client knows this
finding indicates
1. First-degree heart block.
2. Second-degree heart block.
3. Atrial flutter.
4. Myocardial ischemia.

24. A client is admitted with

thrombophlebitis of the right leg. Which
findings would the nurse expect when
assessing this client?
1. Diminished pedal pulses.
2. Color changes in the extremities when
elevated.
3. Red, shiny skin.
4. Pain when the leg is elevated.

25. Heparin via IV infusion is ordered for a

client. Which of the following test results
should the nurse monitor frequently?
1. Hemoglobin and hematocrit.
2. Activated Partial Thromboplastin Time
(APTT)
3. Prothrombin time.
4. Platelet count.
 4. The nurse is caring for a client who
had a total thyroidectomy. Postoperative
nursing care after his return to the nursing
care unit should include observing for
Endocrine
1. Hoarseness.
1. The client is admitted with a 2. Signs of hypercalcemia.
tentative diagnosis of diabetes insipidus. 3. Loss of reflexes
What should the nurse assess for while 4. Mental confusion
taking a nursing history?
5. The nurse is teaching a client who
1. An increased appetite. had a total thyroidectomy in preparation for
2. Excessive urine output. discharge. Which is of highest priority in the
3. Recent rapid weight gain. teaching plan?
4. Gynecomastia.
1. “Report any signs of inflammation at
2. A client has a transphenoidal the incision site.”
hypophysectomy for a pituitary tumor. 2. “Take your thyroid medication every
When he returns to the nursing unit day.”
following surgery the head of his bed is 3. “Continue with coughing and deep
elevated 300. The primary purpose for this breathing exercises.”
position is to: 4. “Maintain strict bedrest for the first
week at home.”
1. Promote respiratory effort and
prevent atelectasis. 6. Which of the following is most likely
2. Reduce pressure on the sella turcica to develop if hyperthyroidism remains
and reduce headache. untreated?
3. Prevent acidosis and development of
cerebral edema. 1. Pulmonary embolism.
4. Promote oxygenation and prevent 2. Respiratory acidosis.
cerebral ischemia. 3. Cerebral vascular accident.
4. Heart failure
3. The nurse is discussing discharge
plans with a client who had a transphenoidal 7. A diagnosis of toxic hyperthyroidism
hypophysectomy. Which statement made by is made in the client. Propylthiouracil 100
the client indicates a need for more mg po tid is ordered. Which of the
teaching? following is the expected effect of this drug?

1. I won’t brush my teeth until the 1. Increased perspiration and decreased

doctor removes the stitches. appetite.
2. I will wear loafers instead of tie 2. Increased basal metabolic rate.
shoes. 3. Increase in protein bound iodine.
3. Where can I get a Medic Alert 4. Weight gain and reduced pulse.
bracelet?
4. I will take all these new medicines 8. A client, who has just had a
until I feel better. thyroidectomy, returns to the unit in stable
condition. What equipment is it essential for 1. Shock can occur in clients who have
the nurse to have readily available? decreased amounts of adrenocortical
steroids.
1. Tracheostomy set. 2. Increased aldosterone levels cause
2. Thoracotomy tray. sodium retention and potassium excretion in
3. Sphygmomanometer. the kidneys.
4. Ice collar. 3. Excessive cortisone production
causes hypertension.
9. The client develops 4. Decreased amounts of
hypoparathyroidism after a total corticosteroids cause electrolyte imbalances.
thyroidectomy. What treatment should the
nurse anticipate? 13. The nurse is caring for a client who
is on a low sodium, high potassium diet.
1. Emergency tracheostomy. Which foods, if selected by the client,
2. Administration of calcium. indicate an understanding of the prescribed
3. Oxygen administration. diet?
4. IV potassium.
1. Baked macaroni and cheese, carrot
10. Which of the following diets would and raisin salad, and chocolate layer cake.
most likely be ordered for the client with 2. Shrimp salad, spinach salad, and
hypothyroidism? strawberries.
3. Cheese omelet, buttermilk biscuits
1. High protein, high calorie. and chocolate pudding.
2. Restricted fluids, low protein. 4. Fresh asparagus spears, broiled
3. High roughage, low calorie. chicken breast, and lettuce and tomato salad.
4. High carbohydrate, low roughage.
14. Diagnostic tests indicate that a 54-
11. A woman with myxedema is started year-old woman has bilateral adrenal
on thyroid replacement therapy and hyperplasia. She undergoes a bilateral
discharged. She returns to clinic one week adrenalectomy. The postoperative nursing
later. Which statement she makes is most care plan states to observe for adrenal crisis.
indicative of an adverse reaction to the Which of the following symptoms, if
medication? observed, would be most critical and need to
be reported immediately?
1. “My chest hurt when I was sweeping
the floor this morning.” 1. Pitting edema of the ankles.
2. “I had severe cramps last night.” 2. Lowering of the blood pressure.
3. “I am loosing weight.” 3. Oliguria.
4. “My pulse rate has been more rapid 4. Glucosuria.
lately.”
15. Fludrocortisone acetate (Florinef) 0.1
12. A client with Cushing’s syndrome is mg daily po has been ordered for a client
on a low sodium, high potassium diet for following bilateral adrenalectomy for which
which of the following reasons? of the following purposes?
1. To restore sodium and potassium
balance.
2. To prevent hypertension.
3. To stimulate protein catabolism.
4. To replace deficient adrenocortical
androgens.
16. The nurse is doing discharge
teaching with a client who has had a
bilateral adrenalectomy. What should be
included in the teaching plan?
1. Telling her that after 1-2 years she
will likely not need to take medication.
2. Explaining that she will need to take
corticosteroids for the rest of her life.
3. Reinforcing that steroids should be
slowly tapered if she decides to stop taking
them.
4. Teaching her urine and blood testing
to help in the regulation of steroid dosages.
17. A client who has had an
adrenalectomy is being discharged on
Florinef 0.1 mg daily and prednisone 7.5 mg
daily. What instruction must be given to the
client?
1. Increase salt intake to prevent salt
deprivation.
2. Take the medication on an empty
stomach to aid in absorption.
3. Expect a 3 to 5 pound weight
increase for about 6 weeks.
4. Avoid exposure to infection, because
she is susceptible.
18. A woman with a tumor of the adrenal
cortex says to the nurse, “Will I always look
this ugly? I hate having a beard.” What is
the best response for the nurse to make?
1. “After surgery you will not develop
any more symptoms, but the changes you
now have will linger.”
2. “That varies from person to person.
You should ask your physician.”
3. “After surgery your appearance
should gradually return to normal.”
4. “Electrolysis and plastic surgery
should make your appearance normal.”
19. The client is ready for discharge
following a unilateral adrenalectomy. Which
statement she makes indicates the best
understanding of her condition?
1. “I will continue on a low sodium,
low potassium diet.”
2. “My husband has arranged for a
marriage counselor because of our fights.”
3. “I will stay out of the sun so I will
not turn splotchy brown.”
4. “I will take all of those pills every
day.”
20. The nurse’s next door neighbor
calls. He says he cannot awaken his 21-
year-old wife. The nurse notes that the
client is unconscious and is having deep
respirations. Her breath has a fruity smell to
it. The husband says that his wife has been
eating and drinking a lot and that last night
she vomited before lying down. Which of
the following is the most appropriate initial
action for the nurse to take?
1. Start cardiopulmonary resuscitation.
2. Get her to a hospital immediately.
3. Try to rouse her by giving her coffee.
4. Give her sweetened orange juice.
21. An adolescent with newly diagnosed
IDDM asks the nurse if he can continue to
play football. What is the best answer for the
nurse to give?
1. “Now that you have diabetes, you
should not play football as you may get a cut
which will not heal.”
2. “If you work with your physician to
regulate the insulin dosage and your diet you
should be able to play football.” 3. Eructation.
3. “It would be better for you to work 4. Singultus.
as equipment manager so you will not be
under as much stress. Stress can aggravate 25. An elderly client with NIDDM
diabetes.” develops an ingrown toenail. What is the
4. “You can probably continue to play best action for the nurse to take?
football if you can regulate it so that you
have the same amount of exercise each day.” 1. Put cotton under the nail and clip the
nail straight across.
22. An adolescent with IDDM is 2. Elevate the foot immediately.
learning about a diabetic diet. He asks the 3. Apply warm, moist soaks.
nurse if he will ever be able to go out to eat 4. Notify the physician.
with his friends again. What is the best
response for the nurse to make?

1. “You can go out with them but you

should take your own snack.”
2. “Yes. You will learn to use the
exchange lists so you can eat with your
friends.”
3. “When you get food out in a
restaurant be sure to order diet soft drinks.”
4. “Eating out will not be possible on a
diabetic diet. Why don’t you plan to invite
your friends to your house?”

23. One morning at 10 a.m. a client with

IDDM becomes very irritable and starts to
yell at the nurse. Which initial nursing
assessment should take priority?

1. Blood pressure and pulse.

2. Color and temperature of skin.
3. Reflexes and muscle tone.
4. Serum electrolytes.

24. An elderly client has been recently

diagnosed as having non-insulin dependent
diabetes mellitus (NIDDM). Which of the
following complaints she has is most likely
to be related to the diagnosis of diabetes
mellitus?

1. Pruritus vulvae.
2. Cough.
 unhindered by kinks.
4. Mark the time and level of drainage in the
collection chamber.

4. An adult client had a left thoracotomy. He

has portable water seal chest drainage. On
the first postoperative day the fluid in the
Respiratory Questions water seal chamber stops fluctuating. What
does this most likely indicate?
1. An adult client is admitted for diagnosis
1. The chest tube is clogged by fibrin or a
and treatment of a left lung lesion. A
clot.
bronchoscopy was performed under local
2. There is an air leak in the system.
anesthesia. What nursing action is of highest
3. Pulmonary edema has occurred due to
priority when he returns following the
increased blood volumes in remaining lung
bronchoscopy?
tissue.
1. Collect all sputum for examination.
4. The client’s left lung has reexpanded.
2. Assess level of consciousness frequently.
3. Withhold food and fluids until gag reflex
5. An adult client had a left lower
has returned.
lobectomy. Passive exercises are started on
4. Monitor blood pressure and pulse at 10
his left arm after surgery. The exercises are
minute intervals.
designed to prevent
1. Hyperflexion of the wrist.
2. A lower left lobectomy was performed on
2. Ankylosis of the shoulder.
an adult client. He was returned to his room
3. Flexion contractures of the elbow.
following an uneventful stay in the recovery
4. Spasticity of the intercostal muscle
room. It is most important for the nurse to
1. Encourage him to perform deep breathing
6. An adult client is admitted to the acute
and coughing exercises.
care hospital with bacterial pneumonia. On
2. Assist him with arm exercises to prevent
admission she was pale to dusky in color.
shoulder ankylosis.
Her respirations were 32, temperature 1030F
3. Help him perform leg exercises to prevent
and pulse 110. Auscultation revealed
thrombophlebitis.
decreased or absent lung sounds in both
4. Position him in semi-Fowler’s position on
bases and rhonchi in both upper lung fields.
his left side.
She was oriented to person, time and place,
but her responses were brief. Oxygen per
3. A client who has had a lobectomy returns
nasal cannula is started at 7 l / minute. IV
to the nursing unit. He has a chest tube
antibiotics were started. While checking the
attached to portable water seal drainage
client one hour after admission the nurse
system and oxygen per nasal cannula. The
notes that she is less responsive, answering
first nursing measure concerning the water
only yes or no questions. Her respirations
seal drainage is to
are somewhat more shallow and have
1. Milk the tubing to prevent accumulation
decreased to 27 per minute. What is the best
of fibrin and clots.
INITIAL action for the nurse to take?
2. Raise the drainage apparatus to bed height
1. Increase the IV infusion rate to increase
to accurately assess the meniscus level.
the amount of circulating antibiotics.
3. Attach the chest tubes to the bed linen to
2. Notify the physician of the client’s
assure that airflow and drainage are
changed mental status and await further
orders.
3. Increase the oxygen flow rate to 10 liters /
minute.
4. Continue to stimulate her until she
responds appropriately.
7. A tracheostomy tube is inserted in a
patient who is in respiratory distress as a
result of pneumonia. The family asks why
the tube is inserted. What should the nurse
include when explaining to the patient and
family? The purpose of a tracheostomy tube
is to
1. Decrease the client’s anxiety by
increasing the size of the airway.
2. Provide increased cerebral oxygenation
thereby preventing further respiratory
depression.
3. Facilitate nursing care since tracheal tubes
have fewer side effects than nasotracheal
tubes.
4. Provide more controlled ventilation and
ease removal of secretions the client is
unable to handle.
8. An adult is about to have a tracheostomy
performed. Which action is of highest
priority for the nurse before the procedure is
done?
1. Establishing means of postoperative
communication.
2. Drawing blood for serum electrolytes and
blood gases.
3. Inserting an indwelling catheter and
attaching it to dependent drainage.
4. Doing a surgical prep of the neck and
upper chest wall.
9. The nurse is performing tracheal
suctioning. Which action is essential to
prevent hypoxemia during suctioning?
1. Removal of oral and nasal secretions.
2. Encouraging the client to deep breathe
and cough.
3. Administer 100% oxygen before
suctioning.
4. Auscultate the lungs.
10. An adult is admitted to the hospital with
progressive dyspnea on exertion, which has
become increasingly severe during the last
six months. Physical examination reveals
crackles at the base of the lung and clubbing
of fingers. The client has asbestosis that has
caused fibrosis in the alveoli. Soon after
admission, the nurse helps the client to the
bathroom. Before he returns to bed, he is
very short of breath. Considering the
severity of his symptoms, it is essential for
the nurse to include which of the following
in the plan of care.
1. Give continuous oxygen via nasal
catheter.
2. Allow the client to move at his own pace.
3. Give bronchodilators to increase his
ability to breathe.
4. Keep the client in bed to prevent further
episodes of dyspnea.
11. An order is written for oxygen by nasal
cannula at 2 liters per minute. In assessing
the adequacy of the oxygen therapy, which
of the following is most effective?
1. Checking the respiratory rate.
2. Checking the color of mucous
membranes.
3. Measurement of pulmonary functions.
4. Measurement of arterial blood gasses.
12. A client with asbestosis must see his
doctor regularly for a check up. What is the
primary reason for him to have frequent
checkups?
1. Patients with asbestosis are at high risk
for developing bronchogenic cancer.
2. His doctor is monitoring him closely to
look for signs of improvement.
3. Patients who use low flow oxygen for
long periods are at high risk for developing
neurological symptoms.
4. Periodic sputum samples are needed to
follow the progress of the disease.
13. An adult male has had a hacking cough
and shortness of breath for several months.
He now has chest pain. His family has
pressured him into seeking medical
consultation. He continues to say, “It is just
a smoker’s cough.” The physician examines
the client and arranges for hospital
admission for a diagnostic work-up. The
nurse is explaining several types of tests that
are ordered. Which of these tests is most
definitive in the process of ruling out a
malignancy?
1. Needle biopsy.
2. Thoracentesis.
3. Bronchogram.
4. Sputum analysis.
14. Preoperative teaching for the client who
is to have a pneumonectomy should include
all of the following. Which is of highest
priority?
1. Management of postoperative pain.
2. Turning, coughing and deep breathing
exercises.
3. How to move with the least pain.
4. Leg exercises.
15. An adult client has just arrived in the
recovery room following a pneumonectomy.
What is the most appropriate initial action
for the nurse?
1. Take his vital signs for baseline data.
2. Check the IV solution for rate and correct
solution.
3. Administer oxygen through an appropriate
device.
4. Auscultate for the presence of breath
sounds.
16. What action is essential because the
client had a pneumonectomy?
1. Observe the tracheal position.
2. Auscultate bilateral breath sounds.
3. Assess for hypertension.
4. Assess for blood streaked sputum.
17. The nurse is positioning an adult who
has just returned to the surgical nursing care
unit following a pneumonectomy. What is
the most appropriate position in which to
place the client?
1. Semi-Fowler’s on the unaffected side.
2. Semi-Fowler’s on the affected side.
3. Sims position on the unaffected side.
4. Semi-Fowler’s on his back.
18. Which of the following nursing
interventions should be instituted the day
after surgery for the client who has had a
pneumonectomy?
1. Provide range of motion exercises to
affected arm.
2. Strip chest tubes every hour.
3. Force fluids to 3500 cc / day.
4. Monitor intermittent positive pressure
breathing therapy.
19. An adult has been diagnosed as having
pulmonary tuberculosis. Which test(s)
would the nurse expect to be ordered before
the client is started on Isoniazid (INH)
therapy?
1. LDH, SGOT (AST)
2. BUN, serum creatinine
3. Skin test for allergy
4. Chest X-ray
20. A patient is admitted with
histoplasmosis. Which item in the patient’s
history is most likely related to the onset of
the disease?
1. He works in a factory.
2. He likes to explore caves.
3. He has three cats.
4. He smokes four packs of cigarettes a
week.