Cardiac/Vascular Nurse Exam Secrets Study Guide (37 page)

15. If a patient has an ankle systolic pressure of 90 and a brachial systolic pressure of 120, what is the ankle–brachial index?

a. 0.75

b. 1.33

c. 0.13

d. 7.5

16. A nurse mistakenly documents a treatment on the wrong chart. Which of the following corrective measures must be taken?

a. Indicate below the entry that it was documented on the wrong chart.

b. Draw a line through the entry, and write “error.”

c. White out the entry so it is not legible.

d. Recopy the entire page, and omit the entry.

17. Which heart sound indicates atrial gallop, which is often associated with left ventricular hypertrophy, hypertension, or aortic stenosis?

a. S1

b. S2

c. S3

d. S4

18. Anticoagulation therapy should be given before which of the following procedures?

a. Emergency defibrillation

b. Direct current cardioversion

c. Direct current and chemical cardioversion

d. Chemical cardioversion

19. Is a person who drinks heavily on one occasion in danger of cardiovascular impairment?

a. No, only chronic drinking leads to cardiovascular impairment.

b. Yes, but only if there is underlying cardiac disease.

c. Yes, but only if alcohol use is combined with drugs, such as cocaine.

d. Yes, drinking heavily on one occasion can cause cardiovascular impairment.

20. After cardiac surgery, urinary output should be monitored to ensure adequate renal perfusion. Urinary output should be:

1. 20 mL/hr
   
2. 25 mL/hr
   
3. 50 mL/hr
   
4. 75 mL/hr
   

21. Which of the following cardiac symptoms are typical of cocaine use?

a. Hypertension and increased heart rate

b. Hypertension and decreased heart rate

c. Hypotension and increased heart rate

d. Hypotension and decreased heart rate

22. Which members of a health care institution are responsible for identifying performance improvement projects?

a. Administrative staff members

b. Nursing team leaders

c. All staff members

d. Physicians

23. Venous ulcers commonly have which of the following characteristics?

a. They are deep and circular.

b. They are superficial and irregularly shaped.

c. They are often necrotic.

d. They appear primarily on the toes and toe webs.

24. What preparation is necessary for a patient scheduled for a radionuclide ventriculogram?

a. No special preparation is needed.

b. Patients must fast for 4–6 hours.

c. Cardiac medications are withheld for 4 hours.

d. Patients should be on bed rest for 8 hours before the exam.

25. Physical changes that suggest a severe cardiovascular disorder, such as pulmonary edema and congestive heart failure, include:

a. peripheral cyanosis of the nails and skin of the nose, lips, and extremities.

b. pallor.

c. central cyanosis of the tongue and buccal mucosa.

d. xanthelasma.

26. Angiotensin-converting enzyme inhibitors are contraindicated in patients with:

a. hypertension.

b. diabetes mellitus.

c. heart failure.

d. renal failure.

27. A patient on mechanical ventilation who is retaining carbon dioxide is at risk for:

a. metabolic acidosis.

b. respiratory acidosis.

c. metabolic alkalosis.

d. respiratory alkalosis.

28. Sexual activity after recovery from a myocardial infarction (MI) can be considered:

a. low risk as sexual activity provides physical and psychological benefits.

b. high risk as sexual activity could precipitate another MI.

c. very high risk, especially in patients who also use nitroglycerine for angina.

d. no risk as sexual activity has no effect on cardiovascular disease

29. Patients with Raynaud’s disease usually experience:

a. unilateral pain in an extremity.

b. pain and numbness in the hands only.

c. pain and numbness in the hands and feet after exposure to heat.

d. pallor of the extremities followed by cyanosis and rubor.

30. When wearing a Holter monitor, a patient should:

a. refrain from taking cardiac medications.

b. restrict activities.

c. maintain an activity diary.

d. turn it off during the night.

31. The best approach to be used with a 35-year old woman who has Marfan syndrome as well as severe mitral valve prolapse and heart failure is to:

a. delay surgery as long as possible.

b. repair the valve rather than replace it.

c. replace the valve rather than repair it.

d. avoid surgery because of life-threatening complications.

32. Using a standard blood pressure (BP) cuff in a very obese patient, when the cuff just reaches around the patient’s arm, may result in:

a. a false high reading since the cuff is somewhat small.

b. an accurate reading since the cuff fits around the arm.

c. a false low reading since the cuff is somewhat small.

d. variable readings since the cuff is somewhat small.

33. According to Knowles’ principles of adult learning, adult learners tend to:

a. lack motivation.

b. lack self-direction.

c. be practical and goal-oriented.

d. be insecure.

34. When a person believes that a health action will prevent a negative outcome and then takes that action, what behavioral change model can be applied to this behavior?

a. Theory of reasoned action

b. Theory of planned behavior

c. Stress appraisal and coping theory

d. Health belief model

35. When assessing nicotine dependence, which action listed below indicates a serious dependence?

a. Smoking even if bedridden with illness

b. Smoking the first cigarette within 5 minutes of awakening

c. Smoking 11–20 cigarettes daily

d. Smoking in places where it is prohibited

36. An atrial-septal defect is characterized by:

a. shunting of blood returning from the lungs from the left atrium back to the right atrium and into the pulmonary circulation.

b. left-to-right shunt and increased pulmonary hypertension and right-sided heart failure.

c. right ventricular hypertrophy from increased pressure in the right ventricle and decreased pulmonary blood flow.

d. left ventricular wall hypertrophy as it increases pressure to overcome valvular resistance.

37. Sclerotherapy is primarily used to treat:

a. coronary artery occlusion.

b. varicose veins.

c. aneurysms.

d. phlebitis.

38. Which smoking cessation medication must be monitored carefully because of dangerous side effects?

a. Nicotine nasal spray

b. Bupropion (Zyban)

c. Varenicline (Chantix)

d. Nicotine inhaler

39. A 66-year-old man who lives with his grandson is discharged from the hospital with a draining chest wound for which he is unable to change dressings because of poor vision. The best solution in this situation is to:

a. transfer the patient to an extended care facility until his wound heals.

b. keep the patient in the hospital until the wound heals.

c. teach the man’s 14-year old grandson to do wound care.

d. make a referral to a home health agency to provide in-home care.

40. A patient with an internal locus of control probably believes that:

a. his family will take care of him.

b. his health is a matter of fate.

c. he is in control of his health.

d. physicians and nurses are in control of the outcome of his disease.

41. Clinical pathways should be based on:

a. a survey of current practices in the area.

b. evidence-based research.

c. committee recommendations.

d. staff preferences.

42. Which of the following statements describes the benefits of drug-eluting coronary stents as compared to standard stents?

a. They inhibit cell proliferation and inflammation and reduce restenosis.

b. They provide antibiotics to decrease infection.

c. They provide anticoagulants to prevent clot formation.

d. They prevent rejection.

43. Which teaching method listed below is probably the most effective and efficient for teaching a group of patients about lifestyle modifications related to hypertension?

a. Computer-assisted instruction

b. Group lectures only

c. Group lectures and discussion

d. One-on-one instruction

44. The best time to initiate conflict resolution is:

a. when those in conflict have had time to resolve their differences.

b. when conflict first emerges.

c. when conflict interferes with function.

d. when those involved ask for conflict resolution.

45. The “dietary approaches to stop hypertension” (DASH), sponsored by the National Institutes of Health and the National Heart, Lung, and Blood Institute, include a 2100-calorie diet. What percentage of this diet is total fat?

a. 27%

b. 55%

c. 18%

d. 6%

46. Absolute hypovolemic shock is characterized by:

a. vasodilation.

b. external loss of fluid only.

c. internal shifting of fluid or external loss of fluid.

d. decreased colloidal osmotic pressure.

47. Which educational tool listed below is appropriate for a patient who speaks English but is illiterate?

a. A children’s book.

b. Handouts prepared at a third-grade level.

c. Computerized instruction.

d. Video.

48. A patient spends half the year in one state and half in another state but wants to complete an advance directive. The best approach is to:

a. complete separate advance directives to comply with each state’s regulations.

b. complete one advance directive as all states have the same regulations.

c. inform family members of specific wishes only so an advance directive is not necessary.

d. store the original advance directive in a safety deposit box.

49. Which blood pressure (BP) listed below poses the greatest risk of cardiovascular disease for people over 50 years of age?

a. Diastolic pressure > 80 mm Hg.

b. Increased BP after exercise.

c. Systolic pressure > 140 mm Hg.

d. Pulse pressure of 40 mm Hg.

50. A patient who has been treated with unfractionated heparin over5 days develops a sudden drop in platelets from 120,000 mm3 to 45,000 mm3, suggesting heparin-induced thrombocytopenia, which places this patient at risk for:

a. hemorrhage.

b. thrombosis and vessel occlusion.

c. shock.

d. infection.

51. A patient with type 1 diabetes mellitus and a fasting blood sugar of 130 mg/dL 3 months previously is evaluated for the outcome of nutritional intervention. Which laboratory result listed below indicates compliance with the dietary recommendations?

a. Fasting blood sugar of 106 mg/dL

b. Hemoglobin A1C (HbA1C) of 6.6%

c. Fasting blood sugar of 150 mg/dL

d. HbA1C of 5.5%