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Worksheets476 week 2 NCLEX-Style Cardiovascular Questions
Total questions: 25
Worksheet time: 13mins
A client is diagnosed with atherosclerosis. The nurse explains that this condition is primarily characterized by:
Inflammation of the pericardial sac.
Narrowed arteries due to plaque buildup, reducing blood flow.
A sudden spasm of the coronary arteries.
Degeneration of the heart muscle tissue.
A patient reports predictable chest pain that occurs with exertion, is described as 'heaviness,' and is relieved by rest. This clinical presentation is most consistent with:
Unstable Angina
Myocardial Infarction (STEMI)
Stable Angina (CAD)
Non-ST-Elevation Myocardial Infarction (NSTEMI)
Which characteristic best describes chest pain associated with Unstable Angina?
Predictable occurrence with exertion, relieved by rest or nitroglycerin.
Occurs at rest with increasing frequency and severity, lasting > 15 minutes.
Severe, crushing, substernal pain that is relieved by rest.
Mild discomfort that resolves within a few minutes with activity.
A nurse is reviewing the lab results for a patient suspected of having a Myocardial Infarction (NSTEMI). Which finding would be a key indicator for this diagnosis?
Normal cardiac enzyme levels.
Troponin I & T levels > 0.4 ng/mL.
EKG showing ST-segment elevation.
Lipid panel indicating low LDL cholesterol.
A patient is diagnosed with an ST-Elevation Myocardial Infarction (STEMI). The nurse understands that the pathophysiology of this condition involves:
Partial or temporary occlusion of a coronary artery by thrombus.
Myocardial injury limited to subendocardial layers.
Complete and persistent occlusion of a coronary artery by thrombus, leading to transmural myocardial necrosis.
Myocardial ischemia during periods of increased oxygen demand without permanent damage.
When administering Lisinopril to a patient, the nurse's most crucial assessment before and after the first dose is:
Blood glucose levels.
Peripheral pulse strength.
Blood pressure and pulse.
Respiratory rate and depth.
The nurse is providing discharge education to a patient prescribed Metoprolol. Which instruction is essential to include?
You may stop taking this medication once your blood pressure is within normal limits.
You can crush the extended-release tablets if you have difficulty swallowing.
It is important to rise slowly from a sitting or lying position to prevent dizziness.
Take potassium supplements daily to prevent electrolyte imbalance.
For a patient receiving Morphine for chest pain, the nurse's priority assessment is:
Bowel sounds and abdominal distension.
Pain level and sedation score.
Respiratory rate and effort.
Peripheral edema and skin integrity.
A patient is prescribed Aspirin for antiplatelet therapy. The nurse should instruct the patient to:
Take the medication on an empty stomach for best absorption.
Avoid taking it with food or milk to prevent drug interactions.
Report any signs of bleeding, such as bruising or bloody stools.
Continue using other NSAIDs as needed for pain relief.
A nurse is monitoring a patient taking Lovastatin. Which finding would indicate a potentially serious adverse effect and require immediate follow-up?
Mild dizziness upon standing.
Unexplained muscle pain or weakness.
Occasional dry cough.
Slight increase in appetite.
The nurse is teaching a patient about sublingual Nitroglycerin for acute chest pain. Which statement indicates the patient understands the 'rule of three'?
I should take one tablet every hour for three doses.
I can take up to three tablets, one every 5 minutes, and I must seek medical attention if pain persists after the first dose.
I will take three tablets at once when I feel chest pain.
I should wait 15 minutes after the onset of chest pain before taking any tablets.
A patient on Clopidogrel therapy should be educated about which important consideration?
The need for increased intake of Vitamin K-rich foods.
Informing all healthcare providers, including dentists, about the medication.
The importance of taking concurrent NSAIDs for pain relief.
Replacing the medication every 3-6 months for potency.
During a stress test, a patient with Stable Angina might exhibit which EKG changes, indicating myocardial ischemia?
ST-segment elevation.
Development of Q waves.
ST depression or T-wave inversion.
Prolonged PR interval.
A patient presenting with Unstable Angina would most likely receive which immediate intervention as part of their management plan?
Lifestyle modifications only.
Early coronary angiography with possible PCI.
Long-term cardiac rehabilitation.
Fibrinolytic therapy as a first-line treatment.
What is a key differentiating factor in laboratory findings between NSTEMI and Stable Angina?
Stable Angina typically shows elevated troponin levels, while NSTEMI does not.
NSTEMI shows elevated troponin levels, while Stable Angina typically has normal cardiac enzymes.
Both conditions consistently show significantly elevated CK-MB.
Lipid panels are abnormal only in NSTEMI, not Stable Angina.
The definitive diagnosis of an ST-Elevation Myocardial Infarction (STEMI) includes:
Normal EKG findings with elevated cardiac biomarkers.
ST-segment elevation on ECG in at least two contiguous leads, elevated cardiac biomarkers (troponin, CK-MB), and clinical symptoms.
ST depression or T-wave inversion with normal cardiac biomarkers.
Predictable chest pain relieved by rest or nitroglycerin.
Which lifestyle modification is a fundamental recommendation for a patient diagnosed with atherosclerosis?
Increasing consumption of processed foods.
Decreasing overall physical activity.
Implementing a low fat/high fiber diet.
Avoiding blood glucose management.
The nurse knows that troponin is considered a highly specific and sensitive biomarker for myocardial damage because it:
Is also elevated in conditions like skeletal muscle injury.
Increases within a couple of hours of injury and stays elevated for days.
Is typically normal in confirmed myocardial infarction.
Is primarily used to assess lipid imbalances.
The nurse should caution parents against administering Aspirin to children or teenagers with viral infections due to the potential risk of:
Angioedema.
Reye's syndrome.
Rhabdomyolysis.
Thrombocytopenia.
When a patient is prescribed Clopidogrel, the nurse should closely monitor for which laboratory abnormality, indicating a potential adverse effect?
Elevated liver enzymes.
Hyperkalemia.
Thrombocytopenia.
Elevated blood glucose.
In addition to severe chest pain, a patient experiencing a STEMI may also present with which 'other manifestations'?
Predictable chest pain relieved by rest.
Shortness of breath, nausea/vomiting, sweating, and anxiety/feeling of doom.
Chest pain that lasts less than 10 minutes.
Cardiac enzymes that are typically normal or minimally elevated.
A patient asks the nurse how to properly store sublingual nitroglycerin tablets. The nurse's best response is:
Keep the tablets in a plastic bag in the refrigerator.
Store them in their original dark glass bottle and replace them every 3-6 months for potency.
Keep them in your pocket for easy access.
It's fine to keep them in a weekly pill organizer with your other medications.
The nurse understands that Lisinopril, an ACE inhibitor, primarily exerts its therapeutic effect by:
Blocking beta-1 receptors in the heart.
Inhibiting an enzyme in the liver responsible for cholesterol synthesis.
Causing direct relaxation of vascular smooth muscle.
Blocking the conversion of angiotensin I to angiotensin II, leading to vasodilation.
According to the provided sources, what is identified as the foundational process of coronary artery disease (CAD) that can progress through various manifestations of myocardial ischemia and infarction?
Stable Angina.
Atherosclerosis.
Myocardial Infarction.
Unstable Angina.
The nurse is teaching a patient about potential side effects of Lisinopril. Which symptom should the patient report immediately as a sign of angioedema, a life-threatening side effect?
Dry, persistent cough.
Dizziness upon standing.
Swelling of the face, lips, or tongue.
Muscle pain and weakness.
