NCLEX Cardiac Questions

The nurse is teaching the client diagnosed with angina about sublingual nitroglycerin. Which statement indicates the client needs more medication teaching?

• "I will always carry my nitroglycerin in a dark-colored bottle."

• "If I have chest pain, I will put a tablet underneath my tongue."

• "If my pain is not relieved with one tablet, I will get medical help."

• "I should expect to get a headache after taking my nitroglycerin."

Answer explanation

The client should put one tab under the tongue every 5 minutes and, if the chest pain is not relieved after taking three tabs, the client should seek medical attention.

A client diagnosed with coronary artery disease has been taking aspirin daily for more than a year. Which data warrants notifying the HCP?

• The client has lost 5 pounds in the last month.

• The client has trouble hearing low tones.

• The client reports having a funny taste in the mouth.

• The client has hard, dark, tarry stools.

Answer explanation

A complication of long-term aspirin use is gastric bleeding, which could result in dark, tarry stools. This data warrants further intervention.

Which assessment data should the nurse obtain prior to administering a calcium channel blocker?

• the serum calcium level

• the client's radial pulse

• the current telemetry reading

• the clients blood pressure

Answer explanation

The nurse should not administer this medication if the client's blood pressure is less than 90/60 because it will further decrease the blood pressure, resulting in the brain not being perfused with oxygen.

Medications are being administered to the following clients. Which client medication should be questioned?

• The client receiving a calcium channel blocker who drank a glass of grapefruit juice.

• The client receiving a beta blocker who has an apical pulse of 62 beats per minute.

• The client receiving a nitroglycerin patch who has a BP of 148/92.

• The client receiving an antiplatelet medication who has a platelet count of 150,000.

Answer explanation

The client receiving a calcium channel blocker should avoid grapefruit juice because it can cause the calcium channel blocker to rise to toxic levels.

The client being discharged after sustaining an acute MI is prescribed lisinopril. Which instruction should be given related to this medication.

• instruct the client to monitor blood pressure weekly.

• Encourage the client to take the medication on an empty stomach.

• Discuss the need to rise slowly from lying to a standing position.

• Teach the client to take the medication at night only.

Answer explanation

This medication can cause orthostatic hypotension, and the client should be instructed to rise slowly from lying to standing to prevent falls and injury.

The client with coronary artery disease (CAD) is instructed to take 81mg of aspirin. Which statement best describes the scientific rationale for prescribing this medication?

• This medication will help thin the client's blood.

• Daily aspirin will decrease the incidence of angina.

• This medication will prevent platelet aggregation.

• Baby aspirin will not cause gastric distress.

Answer explanation

When 81mg of aspirin, a baby aspirin, is taken daily, it helps prevent platelet aggregation, which, in turn, helps the blood pass through the narrowed arteries more easily.

A client with heart failure has been prescribed digoxin and furosemide. Which statements by the client indicate the medications are effective? Select all the apply.

• "I am able to walk next door now without being short of breath."

• "I keep my feet propped up as much as I can during the day."

• "I have not gained any weight since my last doctor's visit."

• "My blood pressure has been within normal limits."

• "I am staying on my diet, and I don't salt my foods anymore."

Answer explanation

Digoxin, a cardiac glycoside, and furosemide, a loop diuretic, are administered for client with CHF to improve contractility of the heart and decrease fluid volume. A symptom of CHF is shortness of breath. The fact that the client can ambulate without shortness of breath is an improvement of symptoms, which shows the medication is effective.

Weight gain would indicate that the client is retaining fluid and the medications are not effective. No weight gain indicates the medication is effective.

The HCP prescribed an angiotensin-converting enzyme (ACE) inhibitor for a client diagnosed with CHF. Which instruction should be provided to the client?

• "Eat a banana or drink orange juice at least twice a day."

• "Notify the HCP if you develop localized edematous areas that itch."

• "Expect to have a dry cough early in the morning on arising."

• "Your symptoms of CHF should improve rapidly."

Answer explanation

A condition in which there are localized edematous areas (wheals), accompanied by intense itching of the skin and mucous membranes is called angioedema. This is an adverse reaction to an ACE inhibitor and should be reported to the HCP.

The nurse is preparing to administer adenosine for the client diagnosed with supraventricular tachycardia (SVT). Which assessment finding would indicate the effectiveness of the medication?

• The client's ECG tracing shows normal sinus rhythm.

• The client's apical pulse is within normal limits.

• The client's blood pressure is above 100/60.

• The client's serum adenosine level is 1.8 mg/dL.

Answer explanation

Adenosine is an antidysrhythmic medication used to reverse SVT. The client with SVT must be continuously monitored on telemetry w medication is being administered. When SVT converts to sinus rhythm, the nurse knows the medication has been effective.

Which intervention should the nurse implement when administering sublingual medication?

• Place the medication between the gum line and the cheek.

• Assess the client's ability to swallow the medications.

• Instruct the client to allow the tablet to dissolve completely.

• Wear gloves when administering sublingual medication.

Answer explanation

Sublingual medication is placed under the tongue and should be kept there until the tablet is totally dissolved before swallowing the saliva.