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Cardiac Nursing Scenario Quiz

Total questions: 91

Worksheet time: 46mins

Name
Class
Date
1.

A nurse is monitoring a patient with atrial fibrillation and notes an irregular rhythm with no visible P waves. The ventricular rate is 120 bpm. Which finding is the priority?

a)

Blood pressure 138/82 mmHg

b)

Oxygen saturation 92%

c)

Patient reports shortness of breath and dizziness

d)

Heart rate 120 bpm

2.

A patient with new-onset atrial fibrillation is prescribed warfarin. Which lab should the nurse monitor for therapeutic effectiveness?

a)

aPTT

b)

INR

c)

Platelet count

d)

Troponin

3.

A patient’s telemetry shows ventricular tachycardia at 160 bpm with a pulse. What is the nurse’s first action?

a)

Begin chest compressions

b)

Prepare for synchronized cardioversion

c)

Administer epinephrine

d)

Defibrillate immediately

4.

A patient is receiving digoxin for heart failure. Which finding requires immediate intervention?

a)

HR 60 bpm

b)

HR 48 bpm

c)

BP 110/70 mmHg

d)

Potassium 4.0 mEq/L

5.

A patient with chest pain receives nitroglycerin. The nurse should monitor for which expected side effect?

a)

Bradycardia

b)

Hypertension

c)

Headache

d)

Pallor

6.

Which ECG rhythm requires immediate defibrillation?

a)

Ventricular fibrillation

b)

Atrial fibrillation

c)

First-degree AV block

d)

Sinus tachycardia

7.

A patient with a history of heart failure reports weight gain of 4 lbs in one week. What is the nurse’s best response?

a)

Encourage fluid intake

b)

Notify the healthcare provider

c)

Reassess in 2 days

d)

Restrict potassium intake

8.

Which of the following best describes preload?

a)

Resistance the left ventricle must pump against

b)

Volume of blood in the ventricles at the end of diastole

c)

Strength of cardiac contraction

d)

Electrical impulse initiation in the SA node

9.

A nurse notes an elevated BNP of 560 pg/mL. This finding is most consistent with:

a)

Stable angina

b)

Heart failure

c)

Myocardial infarction

d)

Hypertension

10.

A patient in sinus bradycardia with a heart rate of 40 bpm and dizziness should receive which initial medication?

a)

Epinephrine

b)

Atropine

c)

Adenosine

d)

Amiodarone

11.

Which statement by the patient taking furosemide (Lasix) indicates the need for further teaching?

a)

I’ll change positions slowly to avoid dizziness.

b)

I’ll eat foods rich in potassium.

c)

I’ll take my medication at bedtime.

d)

I’ll monitor my weight daily.

12.

The nurse identifies which finding as an early sign of digoxin toxicity?

a)

Chest pain

b)

Yellow-green halos

c)

Constipation

d)

Polyuria

13.

A patient with heart failure has an ejection fraction (EF) of 30%. What does this indicate?

a)

Normal ventricular function

b)

Reduced ventricular contractility

c)

Increased cardiac output

d)

Improved stroke volume

14.

A nurse is teaching a patient about beta blockers. Which statement shows understanding?

a)

This will increase my heart rate.

b)

I should stop the medication if I feel tired.

c)

I should check my pulse before taking the medication.

d)

I can take it with any over-the-counter cold medicine.

15.

A patient with right-sided heart failure is likely to exhibit which symptom?

a)

Pulmonary crackles

b)

Dyspnea

c)

Jugular vein distension

d)

Orthopnea

16.

A patient has a new permanent pacemaker. Which action by the nurse is appropriate?

a)

Apply a heating pad over the incision

b)

Keep the left arm below shoulder level

c)

Place telemetry leads over the pacemaker site

d)

Schedule an MRI to verify function

17.

The nurse recognizes which lab value as a sign of myocardial infarction?

a)

Troponin 0.02 ng/mL

b)

CK-MB 2%

c)

Troponin 0.9 ng/mL

d)

Myoglobin 25 ng/mL

18.

A patient with chest pain reports relief after one sublingual nitroglycerin tablet. The pain returns 10 minutes later. What is the next nursing action?

a)

Call 911 immediately

b)

Give a second nitroglycerin tablet

19.

Which dysrhythmia is characterized by a “sawtooth” pattern on ECG?

a)

Atrial flutter

b)

Ventricular tachycardia

c)

Atrial fibrillation

d)

Sinus tachycardia

20.

A patient in the ICU suddenly becomes unresponsive, pulseless, and apneic. The ECG shows asystole. What is the nurse’s first action?

a)

Defibrillate immediately

b)

Start CPR and give epinephrine

c)

Check for a pulse again

d)

Prepare for cardioversion

21.

A patient on digoxin has a potassium level of 2.8 mEq/L. What is the nurse’s priority?

a)

Hold the digoxin and notify the provider

b)

Administer digoxin as ordered

c)

Encourage sodium intake

d)

Restrict fluids

22.

The nurse recognizes which as a compensatory mechanism in heart failure?

a)

Decreased preload

b)

Decreased afterload

c)

Activation of the RAAS system

d)

Decreased sympathetic activity

23.

A patient with stable angina is instructed to take nitroglycerin prophylactically. When should it be taken?

a)

After chest pain starts

b)

Every morning

c)

Before physical activity

d)

At bedtime

24.

A patient presents with chest pain radiating to the left arm, diaphoresis, and nausea. Which intervention should the nurse do first?

a)

Obtain a 12-lead ECG

b)

Start an IV line

c)

Administer morphine

d)

Administer nitroglycerin

25.

A nurse is assessing a patient with left-sided heart failure. Which finding is expected?

a)

Peripheral edema

b)

Jugular vein distention

c)

Crackles in the lungs

d)

Weight gain

26.

A patient is receiving IV furosemide. Which assessment finding requires immediate attention?

a)

BP 112/70 mmHg

b)

Potassium 3.0 mEq/L

c)

Urine output 600 mL

d)

Mild thirst

27.

A nurse interprets a PR interval of 0.24 seconds. Which condition does this indicate?

a)

First-degree AV block

b)

Sinus bradycardia

c)

Atrial fibrillation

d)

Ventricular tachycardia

28.

Which of the following is the most life-threatening rhythm?

a)

Ventricular fibrillation

b)

Atrial fibrillation

c)

PACs

d)

Sinus tachycardia

29.

Which medication is contraindicated with nitroglycerin use?

a)

Aspirin

b)

Sildenafil (Viagra)

c)

Furosemide

d)

Metoprolol

30.

A patient with heart failure is prescribed lisinopril. The nurse should monitor for:

a)

Hypokalemia

b)

Cough

c)

Tachycardia

d)

Hyponatremia

31.

The nurse is reviewing labs. Which combination suggests heart failure exacerbation?

a)

BNP 520 pg/mL, Troponin 0.02

b)

BNP 80 pg/mL, CK-MB 5%

c)

Troponin 1.2 ng/mL, BNP 50 pg/mL

d)

Myoglobin 25 ng/mL, BNP 30 pg/mL

32.

A nurse should withhold metoprolol if which vital sign is present?

a)

HR 56 bpm

b)

HR 74 bpm

c)

BP 138/80 mmHg

d)

RR 20/min

33.

A patient with atrial fibrillation is prescribed amiodarone. Which effect is expected?

a)

Increases heart rate

b)

Converts to normal sinus rhythm

c)

Decreases afterload

d)

Prevents fluid retention

34.

A patient develops acute pulmonary edema. Which finding is most concerning?

a)

Orthopnea

b)

Crackles

c)

Pink, frothy sputum

d)

Fatigue

35.

A patient with a pacemaker reports dizziness and HR of 38 bpm. What should the nurse do?

a)

Increase oxygen

b)

Assess for pacemaker malfunction

c)

Give atropine

d)

Place on right side

36.

Which lab value confirms myocardial infarction?

a)

CK-MB 8%

b)

Troponin 0.02

c)

BNP 60 pg/mL

d)

HDL 50 mg/dL

37.

A patient with HF is placed on a low-sodium diet. Which food should be avoided?

a)

Fresh apple

b)

Grilled chicken

c)

Canned soup

d)

Oatmeal

38.

A nurse identifies the “sawtooth” pattern on ECG as:

a)

Atrial flutter

b)

Sinus tachycardia

c)

Atrial fibrillation

d)

PVC

39.

Which assessment is priority after administering IV adenosine for SVT?

a)

Check blood glucose

b)

Monitor ECG rhythm

c)

Measure urine output

d)

Assess pain scale

40.

A patient with CAD reports chest pain relieved by rest. This is best described as:

a)

Unstable angina

b)

Stable angina

c)

Silent ischemia

d)

Variant angina

41.

A patient presents with chest pain lasting 30 minutes unrelieved by rest or nitroglycerin. What condition should the nurse suspect?

a)

Stable angina

b)

Unstable angina

c)

Prinzmetal angina

d)

Silent ischemia

42.

A patient post-MI is prescribed a statin. What is the purpose of this drug?

a)

Increase LDL levels

b)

Decrease cholesterol synthesis

c)

Reduce preload

d)

Control heart rate

43.

A patient with a new ICD should be taught to:

a)

Avoid using a cell phone on the left side

b)

Avoid air travel

c)

Remove the bandage daily

d)

Sleep with a magnet nearby

44.

A nurse is caring for a patient with second-degree type II AV block. What is the priority?

a)

Administer atropine

b)

Monitor for complete heart block

c)

Give nitroglycerin

d)

Increase fluids

45.

The nurse prepares to administer lisinopril. The BP is 88/54 mmHg. What should the nurse do?

a)

Administer medication as ordered

b)

Hold medication and notify provider

c)

Give with extra fluids

d)

Recheck in 2 hours

46.

A patient with left-sided HF reports shortness of breath when lying flat. What term describes this?

a)

Dyspnea

b)

Orthopnea

c)

Apnea

d)

Paroxysmal dyspnea

47.

A nurse reviews lab results. Which finding supports digoxin toxicity?

a)

HR 100 bpm

b)

Potassium 5.0 mEq/L

c)

Digoxin 3.0 ng/mL

d)

Sodium 138 mEq/L

48.

The nurse should teach a patient with CAD to avoid which behavior?

a)

Eating small, frequent meals

b)

Resting after meals

c)

Exercising daily

d)

Shoveling snow in cold weather

49.

A nurse identifies ST elevation on ECG. What should the nurse prepare for?

a)

Thrombolytic therapy or PCI

b)

Beta-blocker administration

c)

Holter monitoring

d)

Echocardiogram

50.

A patient taking carvedilol for HF reports dizziness when standing. What should the nurse teach?

a)

Take medication on an empty stomach

b)

Stand up slowly

c)

Increase fluid intake

d)

Avoid all physical activity

51.

A nurse is caring for a patient with heart failure taking furosemide. Which finding indicates the drug is effective?

a)

Weight gain of 3 lbs

b)

Decreased crackles in the lungs

c)

Increased jugular vein distention

d)

Edema in both legs

52.

Which of the following patients is at highest risk for developing coronary artery disease (CAD)?

a)

25-year-old woman who runs daily

b)

45-year-old man with hypertension and smoking history

c)

50-year-old woman with HDL 70 mg/dL

d)

32-year-old man with normal BMI

53.

The nurse should hold digoxin if the apical pulse is:

a)

58 bpm

b)

72 bpm

c)

84 bpm

d)

68 bpm

54.

A nurse identifies which of the following as a potential cause of pulseless electrical activity (PEA)?

a)

Hyperkalemia

b)

Normal potassium levels

c)

Hypertension

d)

Hyperglycemia

55.

The nurse recognizes which finding as a complication of untreated atrial fibrillation?

a)

Pulmonary embolism

b)

Myxedema

c)

Pericarditis

d)

Hypoglycemia

56.

A patient with left-sided HF is placed in high Fowler’s position. What is the purpose?

a)

To improve venous return

b)

To reduce preload and improve ventilation

c)

To promote blood flow to the brain

d)

To decrease cardiac output

57.

A nurse prepares to administer morphine to a patient with acute MI. What is the purpose?

a)

Decrease cardiac workload and anxiety

b)

Increase preload

c)

Reduce coronary artery dilation

d)

Increase afterload

58.

Which finding indicates the patient's nitroglycerin tablets have lost potency?

a)

Tablets cause tingling under tongue

b)

Tablets stored in dark bottle

c)

No burning sensation when taken

d)

Slight dizziness after taking

59.

A patient receiving a statin should have which lab monitored regularly?

a)

BUN and creatinine

b)

ALT and AST

c)

Troponin

d)

BNP

60.

Which of the following is a sign of right-sided heart failure (HF)?

a)

Crackles

b)

Dyspnea

c)

Ascites

d)

Orthopnea

61.

A patient with coronary artery disease (CAD) is prescribed aspirin. The nurse knows the purpose is to:

a)

Reduce pain

b)

Prevent platelet aggregation

c)

Increase HDL

d)

Decrease heart rate

62.

Which ECG rhythm requires synchronized cardioversion if the patient is unstable?

a)

Atrial flutter

b)

Asystole

c)

Normal sinus rhythm

d)

Ventricular fibrillation

63.

A patient's troponin I level is 1.2 ng/mL. What should the nurse do?

a)

Repeat in 8 hours

b)

Document as normal

c)

Notify provider immediately

d)

Schedule an echocardiogram in a week

64.

Which medication should be held 48 hours before cardioversion?

a)

Digoxin

b)

Furosemide

c)

Aspirin

d)

Metoprolol

65.

A nurse is providing discharge teaching after an MI. Which statement by the patient requires further teaching?

a)

I’ll take my nitroglycerin if I have chest pain.

b)

I can stop my beta-blocker if my heart rate feels slow.

c)

I’ll report any chest pain that is not relieved after 3 doses.

d)

I’ll attend cardiac rehab after discharge.

66.

Which of the following should the nurse assess before giving an ACE inhibitor?

a)

Heart rate

b)

Blood pressure and potassium level

c)

BUN and glucose

d)

Respiratory rate

67.

A patient with a BNP of 950 pg/mL likely has:

a)

Normal cardiac function

b)

Dehydration

c)

Heart failure

d)

Hypokalemia

68.

A patient receiving IV amiodarone for ventricular tachycardia should be monitored for:

a)

Hypertension

b)

Bradycardia

c)

Tachypnea

d)

Hyperglycemia

69.

A patient presents with ST depression and T-wave inversion on ECG. What does this indicate?

a)

Myocardial ischemia

b)

Normal sinus rhythm

c)

Ventricular fibrillation

d)

Myocardial infarction

70.

Which statement by the nurse correctly explains the action of digoxin?

a)

It decreases the strength of contraction.

b)

It increases myocardial contractility.

c)

It decreases stroke volume.

d)

It increases heart rate.

71.

A patient with CAD reports chest pain. The nurse should first:

a)

Obtain vital signs

b)

Administer oxygen

c)

Administer nitroglycerin

d)

Obtain 12-lead ECG

72.

A patient with atrial fibrillation has a ventricular rate of 150 bpm and BP 80/50 mmHg. What is the priority intervention?

a)

Administer amiodarone

b)

Prepare for cardioversion

c)

Give digoxin

d)

Administer beta blocker

73.

Which statement indicates effective patient teaching about statins?

a)

I can stop taking it when my cholesterol is normal.

b)

I should avoid grapefruit juice.

c)

It helps raise my triglycerides.

d)

I can take it at any time of the day.

74.

A patient in ventricular fibrillation receives a defibrillation shock. What should the nurse do next?

a)

Assess pulse

b)

Start CPR immediately

c)

Give amiodarone

d)

Recheck leads

75.

Which assessment finding is most concerning in a patient with heart failure taking furosemide?

a)

Potassium 3.1 mEq/L

b)

Sodium 140 mEq/L

c)

HR 82 bpm

d)

BP 118/72 mmHg

76.

A nurse recognizes that an S3 heart sound in a patient with heart failure indicates:

a)

Pulmonary embolism

b)

Decreased ventricular filling

c)

Volume overload

d)

Mitral valve stenosis

77.

Which patient should the nurse see first?

a)

Stable angina reporting mild fatigue

b)

Atrial fibrillation with HR 90 bpm

c)

Post-MI patient with new ST elevation

d)

CHF patient with +1 edema

78.

Which medication can cause a dry, persistent cough?

a)

Beta blocker

b)

ACE inhibitor

c)

Calcium channel blocker

d)

Nitrate

79.

The nurse identifies which as a major modifiable risk factor for CAD?

a)

Age

b)

Family history

c)

Hypertension

d)

Ethnicity

80.

Which action should the nurse take after defibrillating a patient in VFib?

a)

Assess for a pulse

b)

Administer atropine

c)

Begin chest compressions

d)

Check blood pressure

81.

A nurse reviews a patient's ECG showing a long PR interval but no dropped QRS complexes. The nurse identifies this as:

a)

Second-degree AV block type II

b)

First-degree AV block

c)

Third-degree AV block

d)

Normal sinus rhythm

82.

A patient has sinus tachycardia related to fever. The nurse anticipates which intervention?

a)

Administer beta blocker

b)

Treat the fever

c)

Administer atropine

d)

Perform cardioversion

83.

Which dietary instruction is appropriate for a patient with HF?

a)

Avoid high-protein foods

b)

Restrict sodium to less than 2 g/day

c)

Increase fluid intake

d)

Use salt substitutes containing potassium freely

84.

A nurse identifies jugular venous distention and 2+ pitting edema in a patient with HF. These are signs of:

a)

Left-sided failure

b)

Right-sided failure

c)

Pulmonary edema

d)

Atrial fibrillation

85.

A patient with CAD is prescribed nitroglycerin patches. What teaching is essential?

a)

Remove the patch before sleep

b)

Apply patch to same site daily

c)

Use heating pad over patch for absorption

d)

Keep patch on 24 hours

86.

Which lab confirms therapeutic digoxin level?

a)

0.2 ng/mL

b)

1.2 ng/mL

c)

2.8 ng/mL

d)

4.0 ng/mL

87.

Which of the following findings after a PCI requires immediate intervention?

a)

Mild soreness at insertion site

b)

Oozing of blood at puncture site

c)

Small bruise around site

d)

BP 120/70 mmHg

88.

Which heart rhythm is expected after successful defibrillation of VFib?

a)

Asystole

b)

Normal sinus rhythm

c)

Atrial fibrillation

d)

PEA

89.

Which symptom differentiates unstable angina from stable angina?

a)

Occurs only with exertion

b)

Relieved by rest

c)

Occurs at rest

d)

Associated with digestion

90.

A patient is prescribed metoprolol. Which assessment finding would cause the nurse to hold the dose?

a)

HR 54 bpm

b)

BP 120/78 mmHg

c)

HR 76 bpm

d)

BP 138/84 mmHg

91.

A patient with chronic HF reports increased fatigue and shortness of breath. What is the priority action?

a)

Administer PRN morphine

b)

Assess weight and lung sounds

c)

Restrict fluids

d)

Give an extra diuretic dose

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