Free Printable Med surg cardiovasc: HF, MI, CAD

1.

A 58-year-old patient with CAD says, "I've switched to e-cigarettes to protect my heart." Which nurse response is most appropriate?

a)

"That's a good step toward lowering your cardiac risk."

b)

"E-cigarettes still contain harmful chemicals that can damage your vessels."

c)

"You should avoid all nicotine products for at least 3 months."

d)

"You only need to stop if you have high blood pressure."

2.

A patient with CAD suddenly develops diaphoresis, pallor, and nausea. Which action should the nurse take first?

a)

Check blood glucose

b)

Administer oxygen

c)

Give aspirin

d)

Place patient in Trendelenburg position

3.

A CAD patient says, "I'll eat fish sticks for omega-3s." The best nurse response is:

a)

"That's a good choice for heart health."

b)

"Choose baked salmon or mackerel instead of processed fish sticks."

c)

"You should avoid fish because of cholesterol."

d)

"Any fish source is equally healthy."

4.

Which statement by a CAD patient indicates successful cardiac rehab?

a)

"I stopped walking when my heart rate reached 120 bpm."

b)

"I avoided exercise because I didn't want chest pain."

c)

"I walked briskly for 30 minutes without symptoms."

d)

"I only walk when my blood pressure is below 100/60 mmHg."

5.

A CAD patient's LDL is 170 mg/dL. The nurse should:

a)

Encourage more red meat for protein

b)

Teach dietary modifications and medication adherence

c)

Avoid statin therapy if HDL is normal

d)

Focus on exercise alone

6.

Which CAD patient symptom should trigger activation of the emergency response system?

a)

Pain relieved by nitroglycerin in 5 minutes

b)

Chest pain lasting >10 minutes after rest and nitroglycerin

c)

Occasional mild dizziness after activity

d)

Fatigue in the afternoon

7.

A nurse receives four patients. Which patient should be assessed first?

a)

Patient with chest pain, relieved by rest

b)

Patient with chest pain, new onset confusion and restlessness

c)

Post MI patient with mild nausea post–morning meds

d)

Post MI patient requesting sleeping medication

8.

After an MI, a patient states, "I'll take my beta-blocker only when I feel my heart racing." The nurse's best response:

a)

"That's fine as long as you monitor your blood pressure."

b)

"Beta-blockers must be taken daily to prevent further heart damage."

c)

"Take them only before stressful situations."

d)

"Stop them if you develop chest pain."

9.

Two days post-MI, a patient walks to the bathroom and develops dyspnea and tachycardia. The nurse should:

a)

Restrict activity and notify provider

b)

Encourage activity to build endurance

c)

Increase fluid intake before ambulation

d)

Give an extra beta-blocker dose

10.

A patient with anterior MI develops crackles in both lung bases. Which order should the nurse question?

a)

IV normal saline at 125 mL/hr

b)

Administer furosemide IV push

c)

Oxygen at 2 L/min

d)

Daily weight

11.

Which finding should be reported immediately in a patient post angioplasty?

a)

BP 118/72 mmHg

b)

Mild oozing at puncture site

c)

Absent distal pulses in the affected leg

d)

HR 88 bpm

12.

A nurse assesses four HF patients. Which requires immediate intervention?

a)

Mild ankle swelling

b)

2-pound weight gain overnight

c)

Fatigue after climbing stairs

d)

Occasional nocturnal cough

13.

A patient with HF on furosemide develops muscle weakness and an irregular pulse. Which lab value is most important to check?

a)

Sodium

b)

Potassium

c)

Creatinine

d)

BNP

14.

A patient with heart failure is placed on a 1.5 L/day fluid restriction. What is the best indicator that this intervention is effective?

a)

Urine specific gravity decreases

b)

Weight decreases by 1 kg in 24 hours

c)

Hematocrit increases

d)

BP returns to baseline

15.

Which meal choice by a patient with heart failure requires further teaching?

a)

Grilled salmon with steamed vegetables

b)

Turkey sandwich with relish

c)

Oatmeal with fresh fruit

d)

Baked chicken with brown rice

16.

A patient reports indigestion after climbing stairs. What should the nurse do?

a)

Suspect GI reflux and give antacids

b)

Treat as possible angina and assess further

c)

Recommend avoiding spicy food

d)

Document and recheck in 1 hour

17.

Identify the hormone released when ventricular walls stretch due to fluid overload.

a)

Troponin

b)

Myoglobin

c)

CK-MB

d)

BNP

18.

Morphine is used in myocardial infarction primarily to reduce pain and preload. True or false?

a)

True

b)

False

19.

A nurse assesses a patient diagnosed with chronic heart failure. Which findings are more consistent with right-sided heart failure rather than left-sided heart failure? Select all that apply.

a)

Jugular venous distention (JVD)

b)

Hepatomegaly

c)

Dependent pitting edema

d)

Ascites

20.

A 62-year-old male presents to the ED with severe chest pain radiating to the jaw, diaphoresis, and shortness of breath. A 12-lead ECG shows ST-segment elevation. Vital signs: BP $138/86$ mm Hg, HR $104$ bpm, RR $22$ , O $_2$ sat $93\%$ on room air. The patient has no history of bleeding disorders and is not on anticoagulants. Select the most likely potential condition.

a)

Heart failure

b)

Hypertensive urgency

c)

CAD

d)

Myocardial infarction

21.

A 62-year-old male presents to the ED with severe chest pain radiating to the jaw, diaphoresis, and shortness of breath. A 12-lead ECG shows ST-segment elevation. Vital signs: BP $138/86$ mm Hg, HR $104$ bpm, RR $22$ , O $_2$ sat $93\%$ on room air. The patient has no history of bleeding disorders and is not on anticoagulants. Select the two parameters to monitor.

a)

Blood pressure

b)

Capillary refill

c)

Cardiac rhythm

d)

Serum potassium

22.

A 62-year-old male presents to the ED with severe chest pain radiating to the jaw, diaphoresis, and shortness of breath. A 12-lead ECG shows ST-segment elevation. Vital signs: BP $138/86$ mm Hg, HR $104$ bpm, RR $22$ , O $_2$ sat $93\%$ on room air. The patient has no history of bleeding disorders and is not on anticoagulants. Select the two actions to take.

a)

Administer chewable aspirin

b)

Administer nitroglycerin regardless of b/p reading

c)

Give IV morphine

d)

Place supine with legs elevated

23.

Match the following

Categorize the following

Troponin and CK-MB elevated

Pain lasts longer than 20 min

Pain relieved by nitroglycerin

Pain caused by transient ischemia

MI

Angina Pectoris

Med surg cardiovasc: HF, MI, CAD

Total questions: 23

Worksheet time: 35mins

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