MEDICAL-SURGICAL NURSING EXAM 1: CARDIOVASCULAR NURSING

1. Mrs. Chua a 78 year old client is admitted with the diagnosis of mild chronic heart failure. The nurse expects to hear
when listening to clients lungs indicative of chronic heart failure would be:

a. Stridor b. Crackles c. Wheezes d. Friction rubs

2. Patrick who is hospitalized following a myocardial infarction asks the nurse why he is taking morphine. The nurse
explains that morphine:

a. Decrease anxiety and restlessness b. Prevents shock and relieves pain

c. Dilates coronary blood vessels d. Helps prevent fibrillation of the heart

3. Which of the following should the nurse teach the client about the signs of digitalis toxicity?

a. Increased appetite b. Elevated blood pressure

c. Skin rash over the chest and back d. Visual disturbances such as seeing yellow spots

4. Nurse Trisha teaches a client with heart failure to take oral Furosemide in the morning. The reason for this is to help

a. Retard rapid drug absorption b. Excrete excessive fluids accumulated at night

c. Prevents sleep disturbances during night d. Prevention of electrolyte imbalance

5. What would be the primary goal of therapy for a client with pulmonary edema and heart failure?

a. Enhance comfort b. Increase cardiac output c. Improve respiratory status d. Peripheral edema decreased

6. Nurse Linda is caring for a client with head injury and monitoring the client with decerebrate posturing. Which of the
following is a characteristic of this type of posturing?

a. Upper extremity flexion with lower extremity flexion b. Upper extremity flexion with lower extremity extension
c. Extension of the extremities after a stimulus d. Flexion of the extremities after stimulus

7. A female client is taking Cascara Sagrada. Nurse Betty informs the client that the following maybe experienced as side
effects of this medication:

a. GI bleeding b. Peptic ulcer disease c. Abdominal cramps d. Partial bowel obstruction

8. Dr. Marquez orders a continuous intravenous nitroglycerin infusion for the client suffering from myocardial infarction.
Which of the following is the most essential nursing action?

a. Monitoring urine output frequently b. Monitoring blood pressure every 4 hours

c. Obtaining serum potassium levels daily d. Obtaining infusion pump for the medication

9. During the second day of hospitalization of the client after a Myocardial Infarction. Which of the following is an
expected outcome?

a. Able to perform self-care activities without pain

b. Severe chest pain
c. Can recognize the risk factors of Myocardial Infarction
d. Can Participate in cardiac rehabilitation walking program

10. A 68 year old client is diagnosed with a right-sided brain attack and is admitted to the hospital. In caring for this
client, the nurse should plan to:

a. Application of elastic stockings to prevent flaccid by muscle

b. Use hand roll and extend the left upper extremity on a pillow to prevent contractions
c. Use a bed cradle to prevent dorsiflexion of feet
d. Do passive range of motion exercise

11. Nurse Liza is assigned to care for a client who has returned to the nursing unit after left nephrectomy. Nurse Lizas
highest priority would be

a. Hourly urine output b. Temperature c. Able to turn side to side d. Able to sips clear liquid
12. A 64 year old male client with a long history of cardiovascular problem including hypertension and angina is to be
scheduled for cardiac catheterization. During pre cardiac catheterization teaching, Nurse Cherry should inform the client
that the primary purpose of the procedure is..

a. To determine the existence of CHD b. To visualize the disease process in the coronary arteries
c. To obtain the heart chambers pressure d. To measure oxygen content of different heart chambers

13. During the first several hours after a cardiac catheterization, it would be most essential for nurse Cherry to

a. Elevate clients bed at 45 b. Instruct the client to cough and deep breathe every 2 hours
c. Frequently monitor clients apical pulse and blood pressure d. Monitor clients temperature every hour

14. Kate who has undergone mitral valve replacement suddenly experiences continuous bleeding from the surgical
incision during postoperative period. Which of the following pharmaceutical agents should Nurse Aiza prepare to
administer to Kate?

a. Protamine Sulfate b. Quinidine Sulfate c. Vitamin C d. Coumadin

15. In reducing the risk of endocarditis, good dental care is an important measure. To promote good dental care in client
with mitral stenosis in teaching plan should include proper use of

a. Dental floss b. Electric toothbrush c. Manual toothbrush d. Irrigation device

16. Among the following signs and symptoms, which would most likely be present in a client with mitral regurgitation?

a. Altered level of consciousness b. Exceptional Dyspnea

c. Increase creatine phosphokinase concentration d. Chest pain

17. Kris with a history of chronic infection of the urinary system complains of urinary frequency and burning sensation.
To figure out whether the current problem is in renal origin, the nurse should assess whether the client has discomfort or
pain in the

a. Urinary meatus b. Pain in the Labium c. Suprapubic area d. Right or left costovertebral angle

18. Nurse Perry is evaluating the renal function of a male client. After documenting urine volume and characteristics,
Nurse Perry assesses which signs as the best indicator of renal function.

a. Blood pressure b. Consciousness c. Distension of the bladder d. Pulse rate

19. John suddenly experiences a seizure, and Nurse Gina notice that John exhibits uncontrollable jerking movements.
Nurse Gina documents that John experienced which type of seizure?

a. Tonic seizure b. Absence seizure c. Myoclonic seizure d. Clonic seizure

20. Smoking cessation is critical strategy for the client with Burghers disease, Nurse Jasmin anticipates that the male
client will go home with a prescription for which medication?

a. Paracetamol b. Ibuprofen c. Nitroglycerin d. Nicotine (Nicotrol)

21. Nurse Lilly has been assigned to a client with Raynauds disease. Nurse Lilly realizes that the etiology of the disease
is unknown but it is characterized by:

a. Episodic vasospastic disorder of capillaries b. Episodic vasospastic disorder of small veins

c. Episodic vasospastic disorder of the aorta d. Episodic vasospastic disorder of the small arteries

22. Nurse Jamie should explain to male client with diabetes that self-monitoring of blood glucose is preferred to urine
glucose testing because

a. More accurate b. Can be done by the client c. It is easy to perform d. It is not influenced by drugs

23. Jessie weighed 210 pounds on admission to the hospital. After 2 days of diuretic therapy, Jessie weighs 205.5 pounds.
The nurse could estimate the amount of fluid Jessie has lost

a. 0.3 L b. 1.5 L c. 2.0 L d. 3.5 L

24. Nurse Donna is aware that the shift of body fluids associated with Intravenous administration of albumin occurs in the
process of:

a. Osmosis b. Diffusion c. Active transport d. Filtration

25. Myrna a 52 year old client with a fractured left tibia has a long leg cast and she is using crutches to ambulate. Nurse
Joy assesses for which sign and symptom that indicates complication associated with crutch walking?

a. Left leg discomfort b. Weak biceps brachii c. Triceps muscle spasm d. Forearm weakness

26. Which of the following statements should the nurse teach the neutropenic client and his family to avoid?

a. Performing oral hygiene after every meal b. Using suppositories or enemas

c. Performing perineal hygiene after each bowel movement d. Using a filter mask

27. A female client is experiencing painful and rigid abdomen and is diagnosed with perforated peptic ulcer. A surgery
has been scheduled and a nasogastric tube is inserted. The nurse should place the client before surgery in

a. Sims position b. Supine position c. Semi-fowlers position d. Dorsal recumbent position

28. Which nursing intervention ensures adequate ventilating exchange after surgery?

a. Remove the airway only when client is fully conscious b. Assess for hypoventilation by auscultating the lungs
c. Position client laterally with the neck extended d. Maintain humidified oxygen via nasal cannula

29. George who has undergone thoracic surgery has chest tube connected to a water-seal drainage system attached to
suction. Presence of excessive bubbling is identified in water-seal chamber, the nurse should

a. Strip the chest tube catheter b. Check the system for air leaks
c. Recognize the system is functioning correctly d. Decrease the amount of suction pressure

30. A client who has been diagnosed of hypertension is being taught to restrict intake of sodium. The nurse would know
that the teachings are effective if the client states that

a. I can eat celery sticks and carrots b. I can eat broiled scallops
c. I can eat shredded wheat cereal d. I can eat spaghetti on rye bread

31. A male client with a history of cirrhosis and alcoholism is admitted with severe dyspnea resulted to ascites. The nurse
should be aware that the ascites is most likely the result of increased

a. Pressure in the portal vein b. Production of serum albumin

c. Secretion of bile salts d. Interstitial osmotic pressure

32. A newly admitted client is diagnosed with Hodgkins disease undergoes an excisional cervical lymph node biopsy
under local anesthesia. What does the nurse assess first after the procedure?

a. Vital signs b. Incision site c. Airway d. Level of consciousness

33. A client has 15% blood loss. Which of the following nursing assessment findings indicates hypovolemic shock?

a. Systolic blood pressure less than 90mm Hg b. Pupils unequally dilated

c. Respiratory rate of 4 breath/min d. Pulse rate less than 60 bpm

34. Nurse Lucy is planning to give preoperative teaching to a client who will be undergoing rhinoplasty. Which of
the following should be included?

a. Results of the surgery will be immediately noticeable postoperatively

b. Normal saline nose drops will need to be administered preoperatively
c. After surgery, nasal packing will be in place 8 to 10 days
d. Aspirin containing medications should not be taken 14 days before surgery

35. Paul is admitted to the hospital due to metabolic acidosis caused by Diabetic ketoacidosis (DKA). The nurse prepares
which of the following medications as an initial treatment for this problem?

a. Regular insulin b. Potassium c. Sodium bicarbonate d. Calcium gluconate

36. Dr. Marquez tells a client that an increase intake of foods that are rich in Vitamin E and beta-carotene are important
for healthier skin. The nurse teaches the client that excellent food sources of both of these substances are:

a. Fish and fruit jam b. Oranges and grapefruit c. Carrots and potatoes d. Spinach and mangoes

37. A client has Gastroesophageal Reflux Disease (GERD). The nurse should teach the client that after every meals, the
client should

a. Rest in sitting position b. Take a short walk c. Drink plenty of water d. Lie down at least 30 minutes

38. After gastroscopy, an adaptation that indicates major complication would be:

a. Nausea and vomiting b. Abdominal distention c. Increased GI motility d. Difficulty in swallowing

39. A client who has undergone a cholecystectomy asks the nurse whether there are any dietary restrictions that must be
followed. Nurse Hilary would recognize that the dietary teaching was well understood when the client tells a family
member that:

a. Most people need to eat a high protein diet for 12 months after surgery
b. I should not eat those foods that upset me before the surgery
c. I should avoid fatty foods as long as I live
d. Most people can tolerate regular diet after this type of surgery

40. Nurse Rachel teaches a client who has been recently diagnosed with hepatitis A about untoward signs and symptoms
related to Hepatitis that may develop. The one that should be reported immediately to the physician is:

a. Restlessness b. Yellow urine c. Nausea d. Clay- colored stools

41. Which of the following antituberculosis drugs can damage the 8th cranial nerve?

a. Isoniazid (INH) b. Para Aminosalicylic acid (PAS)

c. Ethambutol hydrochloride (myambutol) d. Streptomycin

42. The client asks Nurse Annie the causes of peptic ulcer. Nurse Annie responds that recent research indicates that peptic
ulcers are the result of which of the following:

a. Genetic defect in gastric mucosa b. Stress c. Diet high in fat d. Helicobacter pylori infection

43. Ryan has undergone subtotal gastrectomy. The nurse should expect that nasogastric tube drainage will be what color
for about 12 to 24 hours after surgery?

a. Bile green b. Bright red c. Cloudy white d. Dark brown

44. Nurse Joan is assigned to come for client who has just undergone eye surgery. Nurse Joan plans to teach the client
activities that are permitted during the post operative period. Which of the following is best recommended for the client?

a. Watching circus b. Bending over c. Watching TV d. Lifting objects

45. A client suffered from a lower leg injury and seeks treatment in the emergency room. There is a prominent deformity
to the lower aspect of the leg, and the injured leg appears shorter that the other leg. The affected leg is painful, swollen
and beginning to become ecchymotic. The nurse interprets that the client is experiencing:

a. Fracture b. Strain c. Sprain d. Contusion

46. Nurse Jenny is instilling an otic solution into an adult male client left ear. Nurse Jenny avoids doing which of the
following as part of the procedure

a. Pulling the auricle backward and upward b. Warming the solution to room temperature
c. Pacing the tip of the dropper on the edge of ear canal d. Placing client in side lying position

47. Nurse Bea should instruct the male client with an ileostomy to report immediately which of the following symptom?

a. Absence of drainage from the ileostomy for 6 or more hours b. Passage of liquid stool in the stoma
c. Occasional presence of undigested food d. A temperature of 37.6 C
48. Jerry has diagnosed with appendicitis. He develops a fever, hypotension and tachycardia. The nurse suspects which of
the following complications?

a. Intestinal obstruction b. Peritonitis c. Bowel ischemia d. Deficient fluid volume

49. Which of the following compilations should the nurse carefully monitors a client with acute pancreatitis.

a. Myocardial Infarction b. Cirrhosis c. Peptic ulcer d. Pneumonia

50. Which of the following symptoms during the icteric phase of viral hepatitis should the nurse expect the client to
inhibit?

a. Watery stool b. Yellow sclera c. Tarry stool d. Shortness of breath

CARDIAC ARRHYTHMIAS PRACTICE QUIZ

1. A nurse is assessing an electrocardiogram rhythm strip. The P waves and QRS complexes are regular. The PR interval
is 0.16 second, and QRS complexes measure 0.06 second. The overall heart rate is 64 beats per minute. The nurse assesses
the cardiac rhythm as:

1. Normal sinus rhythm 2. Sinus bradycardia 3. Sick sinus syndrome 4. First-degree heart block.

2. A nurse notices frequent artifact on the ECG monitor for a client whose leads are connected by cable to a console at the
bedside. The nurse examines the client to determine the cause. Which of the following items is unlikely to be responsible
for the artifact?

1. Frequent movement of the client 2. Tightly secured cable connections

3. Leads applied over hairy areas 4. Leads applied to the limbs

3. A nurse is watching the cardiac monitor and notices that the rhythm suddenly changes. There are no P waves, the QRS
complexes are wide, and the ventricular rate is regular but over 100. The nurse determines that the client is experiencing:

1. Premature ventricular contractions 2. Ventricular tachycardia

3. Ventricular fibrillation 4. Sinus tachycardia

4. A nurse is viewing the cardiac monitor in a clients room and notes that the client has just gone into ventricular
tachycardia. The client is awake and alert and has good skin color. The nurse would prepare to do which of the following?

1. Immediately defibrillate 2. Prepare for pacemaker insertion

3. Administer amiodarone (Cordarone) intravenously 4. Administer epinephrine (Adrenaline) intravenously

5. A nurse is caring for a client with unstable ventricular tachycardia. The nurse instructs the client to do which of the
following, if prescribed, during an episode of ventricular tachycardia?

1. Breathe deeply, regularly, and easily. 2. Inhale deeply and cough forcefully every 1 to 3 seconds.
3. Lie down flat in bed 4. Remove any metal jewelry

6. A client is having frequent premature ventricular contractions. A nurse would place priority on assessment of which of
the following items?

1. Blood pressure and peripheral perfusion 2. Sensation of palpitations

3. Causative factors such as caffeine 4. Precipitating factors such as infection

7. A client has developed atrial fibrillation, which a ventricular rate of 150 beats per minute. A nurse assesses the client
for:

1. Hypotension and dizziness 2. Nausea and vomiting

3. Hypertension and headache 4. Flat neck veins

8. A nurse is watching the cardiac monitor, and a clients rhythm suddenly changes. There are no P waves; instead, there
are wavy lines. The QRS complexes measure 0.08 second, but they are irregular, with a rate of 120 beats a minute. The
nurse interprets this rhythm as:
1. Sinus tachycardia 2. Atrial fibrillation
3. Ventricular tachycardia 4. Ventricular fibrillation

9. A client with rapid rate atrial fibrillation asks a nurse why the physician is going to perform carotid massage. The nurse
responds that this procedure may stimulate the:

1. Vagus nerve to slow the heart rate 2. Vagus nerve to increase the heart rate; overdriving the rhythm.
3. Diaphragmatic nerve to slow the heart rate 4. Diaphragmatic nerve to overdrive the rhythm

10. A nurse notes that a client with sinus rhythm has a premature ventricular contraction that falls on the T wave of the
preceding beat. The clients rhythm suddenly changes to one with no P waves or definable QRS complexes. Instead, there
are coarse wavy lines of varying amplitude. The nurse assesses this rhythm to be:

1. Ventricular tachycardia 2. Ventricular fibrillation

3. Atrial fibrillation 4. Asystole

11. While caring for a client who has sustained an MI, the nurse notes eight PVCs in one minute on the cardiac monitor.
The client is receiving an IV infusion of D5W and oxygen at 2 L/minute. The nurses first course of action should be to:

1. Increase the IV infusion rate 2. Notify the physician promptly

3. Increase the oxygen concentration 4. Administer a prescribed analgesic

12. The adaptations of a client with complete heart block would most likely include:

1. Nausea and vertigo 2. Flushing and slurred speech

3. Cephalalgia and blurred vision 4. Syncope and slow ventricular rate

13. A client with a bundle branch block is on a cardiac monitor. The nurse should expect to observe:

1. Sagging ST segments 2. Absence of P wave configurations

3. Inverted T waves following each QRS complex 4. Widening of QRS complexes to 0.12 second or greater.

14. When ventricular fibrillation occurs in a CCU, the first person reaching the client should:

1. Administer oxygen 2. Defibrillate the client

3. Initiate CPR 4. Administer sodium bicarbonate intravenously

15. What criteria should the nurse use to determine normal sinus rhythm for a client on a cardiac monitor? Check all that
apply.

1. The RR intervals are relatively consistent 2. One P wave precedes each QRS complex
3. Four to eight complexes occur in a 6-second strip 4. The ST segment is higher than the PR interval
5. The QRS complex ranges from 0.12 to 0.20 second.

16. When auscultating the apical pulse of a client who has atrial fibrillation, the nurse would expect to hear a rhythm that
is characterized by:

1. The presence of occasional coupled beats 2. Long pauses in an otherwise regular rhythm
3. A continuous and totally unpredictable irregularity 4. Slow but strong and regular beats

MYOCARDIAL INFARCTION AND HEART FAILURE PRACTICE QUIZ

1. Which of the following actions is the first priority of care for a client exhibiting signs and symptoms of coronary artery
disease?

1. Decrease anxiety 2. Enhance myocardial oxygenation

3. Administer sublingual nitroglycerin 4. Educate the client about his symptoms

2. Medical treatment of coronary artery disease includes which of the following procedures?

1. Cardiac catheterization 2. Coronary artery bypass surgery

3. Oral medication therapy 4. Percutaneous transluminal coronary angioplasty
3. Which of the following is the most common symptom of myocardial infarction (MI)?

1. Chest pain 2. Dyspnea 3. Edema 4. Palpitations

4. Which of the following symptoms is the most likely origin of pain the client described as knifelike chest pain that
increases in intensity with inspiration?

1. Cardiac 2. Gastrointestinal 3. Musculoskeletal 4. Pulmonary

5. Which of the following blood tests is most indicative of cardiac damage?

1. Lactate dehydrogenase 2. Complete blood count (CBC) 3. Troponin I 4. Creatine kinase (CK)

6. What is the primary reason for administering morphine to a client with an MI?

1. To sedate the client 2. To decrease the clients pain

3. To decrease the clients anxiety 4. To decrease oxygen demand on the clients heart

7. Which of the following conditions is most commonly responsible for myocardial infarction?

1. Aneurysm 2. Heart failure 3. Coronary artery thrombosis 4. Renal failure

8. Which of the following complications is indicated by a third heart sound (S3)?

1. Ventricular dilation 2. Systemic hypertension 3. Aortic valve malfunction 4. Increased atrial contractions

9. After an anterior wall myocardial infarction, which of the following problems is indicated by auscultation of crackles in
the lungs?

1. Left-sided heart failure 2. Pulmonic valve malfunction

3. Right-sided heart failure 4. Tricupsid valve malfunction

10. What is the first intervention for a client experiencing MI?

1. Administer morphine 2. Administer oxygen 3. Administer sublingual nitroglycerin 4. Obtain an ECG

11. Which of the following classes of medications protects the ischemic myocardium by blocking catecholamines and
sympathetic nerve stimulation?

1. Beta-adrenergic blockers 2. Calcium channel blockers 3. Narcotics 4. Nitrates

12. What is the most common complication of an MI?

1. Cardiogenic shock 2. Heart failure 3. Arrhythmias 4. Pericarditis

13. With which of the following disorders is jugular vein distention most prominent?

1. Abdominal aortic aneurysm 2. Heart failure 3. MI 4. Pneumothorax

14. Toxicity from which of the following medications may cause a client to see a green-yellow halo around lights?

1. Digoxin 2. Furosemide (Lasix) 3. Metoprolol (Lopressor) 4. Enalapril (Vasotec)

15. Which of the following symptoms is most commonly associated with left-sided heart failure?

1. Crackles 2. Arrhythmias 3. Hepatic engorgement 4. Hypotension

16. In which of the following disorders would the nurse expect to assess sacral edema in a bedridden client?

1. Diabetes 2. Pulmonary emboli 3. Renal failure 4. Right-sided heart failure

17. Which of the following symptoms might a client with right-sided heart failure exhibit?

1. Adequate urine output 2. Polyuria 3. Oliguria 4. Polydipsia

18. Which of the following classes of medications maximizes cardiac performance in clients with heart failure by
increasing ventricular contractility?

1. Beta-adrenergic blockers 2. Calcium channel blockers 3. Diuretics 4. Inotropic agents

19. Stimulation of the sympathetic nervous system produces which of the following responses?

1. Bradycardia 2. Tachycardia 3. Hypotension 4. Decreased myocardial contractility

20. Which of the following conditions is most closely associated with weight gain, nausea, and a decrease in urine output?

1. Angina pectoris 2. Cardiomyopathy 3. Left-sided heart failure 4. Right-sided heart failure

21. Which of the following heart muscle diseases is unrelated to other cardiovascular disease?

1. Cardiomyopathy 2. Coronary artery disease 3. Myocardial infarction 4. Pericardial effusion

22. Which of the following types of cardiomyopathy can be associated with childbirth?

1. Dilated 2. Hypertrophic 3. Myocarditis 4. Restrictive

23. Septal involvement occurs in which type of cardiomyopathy?

1. Congestive 2. Dilated 3. Hypertrophic 4. Restrictive

24. Which of the following recurring conditions most commonly occurs in clients with cardiomyopathy?

1. Heart failure 2. Diabetes 3. MI 4. Pericardial effusion

25. Dyspnea, cough, expectoration, weakness, and edema are classic signs and symptoms of which of the following
conditions?

1. Pericarditis 2. Hypertension 3. MI 4. Heart failure

26. In which of the following types of cardiomyopathy does cardiac output remain normal?

1. Dilated 2. Hypertrophic 3. Obliterative 4. Restrictive

27. Which of the following cardiac conditions does a fourth heart sound (S4) indicate?

1. Dilated aorta 2. Normally functioning heart

3. Decreased myocardial contractility 4. Failure of the ventricle to eject all of the blood during systole

28. Which of the following classes of drugs is most widely used in the treatment of cardiomyopathy?

1. Antihypertensives 2. Beta-adrenergic blockers 3. Calcium channel blockers 4. Nitrates

29. If medical treatments fail, which of the following invasive procedures is necessary for treating cardiomyopathy?

1. Cardiac catheterization 2. Coronary artery bypass graft (CABG)

3. Heart transplantation 4. Intra-aortic balloon pump (IABP)

30. Which of the following conditions is associated with a predictable level of pain that occurs as a result of physical or
emotional stress?

1. Anxiety 2. Stable angina 3. Unstable angina 4. Variant angina

31. Which of the following types of angina is most closely related with an impending MI?

1. Angina decubitus 2. Chronic stable angina 3. Nocturnal angina 4. Unstable angina

32. Which of the following conditions is the predominant cause of angina?

1. Increased preload 2. Decreased afterload

3. Coronary artery spasm 4. Inadequate oxygen supply to the myocardium
33. Which of the following tests is used most often to diagnose angina?

1. Chest x-ray 2. Echocardiogram 3. Cardiac catheterization 4. 12-lead electrocardiogram (ECG)

34. Which of the following results is the primary treatment goal for angina?

1. Reversal of ischemia 2. Reversal of infarction

3. Reduction of stress and anxiety 4. Reduction of associated risk factors

35. Which of the following interventions should be the first priority when treating a client experiencing chest pain while
walking?

1. Sit the client down 2. Get the client back to bed 3. Obtain an ECG 4. Administer sublingual nitroglycerin

36. Myocardial oxygen consumption increases as which of the following parameters increase?

1. Preload, afterload, and cerebral blood flow 2. Preload, afterload, and renal blood flow
3. Preload, afterload, contractility, and heart rate. 4. Preload, afterload, cerebral blood flow, and heart rate.

37. Which of the following positions would best aid breathing for a client with acute pulmonary edema?

1. Lying flat in bed 2. Left side-lying 3. In high Fowlers position 4. In semi-Fowlers position

38. Which of the following blood gas abnormalities is initially most suggestive of pulmonary edema?

1. Anoxia 2. Hypercapnia 3. Hyperoxygenation 4. Hypocapnia

39. Which of the following is a compensatory response to decreased cardiac output?

1. Decreased BP 2. Alteration in LOC 3. Decreased BP and diuresis 4. Increased BP and fluid retention

40. Which of the following actions is the appropriate initial response to a client coughing up pink, frothy sputum?

1. Call for help 2. Call the physician 3. Start an I.V. line 4. Suction the client

41. Which of the following terms describes the force against which the ventricle must expel blood?

1. Afterload 2. Cardiac output 3. Overload 4. Preload

42. Acute pulmonary edema caused by heart failure is usually a result of damage to which of the following areas of the
heart?

1. Left atrium 2. Right atrium 3. Left ventricle 4. Right ventricle

43. An 18-year-old client who recently had an URI is admitted with suspected rheumatic fever. Which assessment
findings confirm this diagnosis?

1. Erythema marginatum, subcutaneous nodules, and fever 2. Tachycardia, finger clubbing, and a load S3
3. Dyspnea, cough, and palpitations 4. Dyspnea, fatigue, and syncope

44. A client admitted with angina complains of severe chest pain and suddenly becomes unresponsive. After establishing
unresponsiveness, which of the following actions should the nurse take first?

1. Activate the resuscitation team 2. Open the clients airway

3. Check for breathing 4. Check for signs of circulation

45. A 55-year-old client is admitted with an acute inferior-wall myocardial infarction. During the admission interview, he
says he stopped taking his metoprolol (Lopressor) 5 days ago because he was feeling better. Which of the following
nursing diagnoses takes priority for this client?

1. Anxiety 2. Ineffective tissue perfusion; cardiopulmonary

3. Acute pain 4. Ineffective therapeutic regimen management

46. A client comes into the E.R. with acute shortness of breath and a cough that produces pink, frothy sputum. Admission
assessment reveals crackles and wheezes, a BP of 85/46, a HR of 122 BPM, and a respiratory rate of 38 breaths/minute.
The clients medical history included DM, HTN, and heart failure. Which of the following disorders should the nurse
suspect?

1. Pulmonary edema 2. Pneumothorax 3. Cardiac tamponade 4. Pulmonary embolus

47. The nurse coming on duty receives the report from the nurse going off duty. Which of the following clients should the
on-duty nurse assess first?

1. The 58-year-old client who was admitted 2 days ago with heart failure, BP of 126/76, and a respiratory rate of 21
breaths a minute.
2. The 88-year-old client with end-stage right-sided heart failure, BP of 78/50, and a DNR order.
3. The 62-year-old client who was admitted one day ago with thrombophlebitis and receiving IV heparin.
4. A 76-year-old client who was admitted 1 hour ago with new-onset atrial fibrillation and is receiving IV diltiazem
(Cardizem).

48. When developing a teaching plan for a client with endocarditis, which of the following points is most essential for the
nurse to include?

1. Report fever, anorexia, and night sweats to the physician.

2. Take prophylactic antibiotics after dental work and invasive procedures.
3. Include potassium rich foods in your diet.
4. Monitor your pulse regularly.

49. A nurse is conducting a health history with a client with a primary diagnosis of heart failure. Which of the following
disorders reported by the client is unlikely to play a role in exacerbating the heart failure?

1. Recent URI 2. Nutritional anemia 3. Peptic ulcer disease 4. A-Fib

50. A nurse is preparing for the admission of a client with heart failure who is being sent directly to the hospital from the
physicians office. The nurse would plan on having which of the following medications readily available for use?

1. Diltiazem (Cardizem) 2. Digoxin (Lanoxin) 3. Propranolol (Inderal) 4. Metoprolol (Lopressor)

51. A nurse caring for a client in one room is told by another nurse that a second client has developed severe pulmonary
edema. On entering the 2nd clients room, the nurse would expect the client to be:

1. Slightly anxious 2. Mildly anxious 3. Moderately anxious 4. Extremely anxious

52. A client with pulmonary edema has been on diuretic therapy. The client has an order for additional furosemide (Lasix)
in the amount of 40 mg IV push. Knowing that the client also will be started on Digoxin (Lanoxin), a nurse checks the
clients most recent:

1. Digoxin level 2. Sodium level 3. Potassium level 4. Creatinine level

53. A client who had cardiac surgery 24 hours ago has a urine output averaging 19 ml/hr for 2 hours. The client received a
single bolus of 500 ml of IV fluid. Urine output for the subsequent hour was 25 ml. Daily laboratory results indicate the
blood urea nitrogen is 45 mg/dL and the serum creatinine is 2.2 mg/dL. A nurse interprets the client is at risk for:

1. Hypovolemia 2. UTI 3. Glomerulonephritis 4. Acute renal failure

54. A nurse is preparing to ambulate a client on the 3rd day after cardiac surgery. The nurse would plan to do which of the
following to enable the client to best tolerate the ambulation?

1. Encourage the client to cough and deep breathe

2. Premedicate the client with an analgesic
3. Provide the client with a walker
4. Remove telemetry equipment because it weighs down the hospital gown.

55. A clients electrocardiogram strip shows atrial and ventricular rates of 80 complexes per minute. The PR interval is
0.14 second, and the QRS complex measures 0.08 second. The nurse interprets this rhythm is:

1. Normal sinus rhythm 2. Sinus bradycardia 3. Sinus tachycardia 4. Sinus dysrhythmia

56. A client has frequent bursts of ventricular tachycardia on the cardiac monitor. A nurse is most concerned with this
dysrhythmia because:
1. It is uncomfortable for the client, giving a sense of impending doom.
2. It produces a high cardiac output that quickly leads to cerebral and myocardial ischemia.
3. It is almost impossible to convert to a normal sinus rhythm.
4. It can develop into ventricular fibrillation at any time.

57. A home care nurse is making a routine visit to a client receiving digoxin (Lanoxin) in the treatment of heart failure.
The nurse would particularly assess the client for:

1. Thrombocytopenia and weight gain 2. Anorexia, nausea, and visual disturbances

3. Diarrhea and hypotension 4. Fatigue and muscle twitching

58. A client with angina complains that the angina pain is prolonged and severe and occurs at the same time each day,
most often in the morning, On further assessment a nurse notes that the pain occurs in the absence of precipitating factors.
This type of anginal pain is best described as:

1. Stable angina 2. Unstable angina 3. Variant angina 4. Nonanginal pain

59. The physician orders continuous intravenous nitroglycerin infusion for the client with MI. Essential nursing actions
include which of the following?

1. Obtaining an infusion pump for the medication 2. Monitoring BP q4h

3. Monitoring urine output hourly 4. Obtaining serum potassium levels daily

60. Aspirin is administered to the client experiencing an MI because of its:

1. Antipyretic action 2. Antithrombotic action 3. Antiplatelet action 4. Analgesic action

61. Which of the following is an expected outcome for a client on the second day of hospitalization after an MI?

1. Has severe chest pain

2. Can identify risks factors for MI
3. Agrees to participate in a cardiac rehabilitation walking program
4. Can perform personal self-care activities without pain

62. Which of the following reflects the principle on which a clients diet will most likely be based during the acute phase
of MI?

1. Liquids as ordered 2. Small, easily digested meals 3. Three regular meals per day 4. NPO

63. An older, sedentary adult may not respond to emotional or physical stress as well as a younger individual because of:

1. Left ventricular atrophy 2. Irregular heartbeats 3. Peripheral vascular occlusion 4. Pacemaker placement

64. Which of the following nursing diagnoses would be appropriate for a client with heart failure? Select all that apply.

1. Ineffective tissue perfusion related to decreased peripheral blood flow secondary to decreased cardiac output.
2. Activity intolerance related to increased cardiac output.
3. Decreased cardiac output related to structural and functional changes.
4. Impaired gas exchange related to decreased sympathetic nervous system activity.

65. Which of the following would be a priority nursing diagnosis for the client with heart failure and pulmonary edema?

1. Risk for infection related to stasis of alveolar secretions 2. Impaired skin integrity related to pressure
3. Activity intolerance related to pump failure 4. Constipation related to immobility

66. Captopril may be administered to a client with HF because it acts as a:

1. Vasopressor 2. Volume expander 3. Vasodilator 4. Potassium-sparing diuretic

67. Furosemide is administered intravenously to a client with HF. How soon after administration should the nurse begin to
see evidence of the drugs desired effect?

1. 5 to 10 minutes 2. 30 to 60 minutes 3. 2 to 4 hours 4. 6 to 8 hours

68. Which of the following foods should the nurse teach a client with heart failure to avoid or limit when following a 2-
gram sodium diet?

1. Apples 2. Tomato juice 3. Whole wheat bread 4. Beef tenderloin

69. The nurse finds the apical pulse below the 5th intercostal space. The nurse suspects:

1. Left atrial enlargement 2. Left ventricular enlargement

3. Right atrial enlargement 4. Right ventricular enlargement

70. Which of the following arteries primarily feeds the anterior wall of the heart?

1. Circumflex artery 2. Internal mammary artery 3. Left anterior descending artery 4. Right coronary artery

CORONARY ARTERY DISEASE & HYPERTENSION PRACTICE QUIZ

1. A client is scheduled for a cardiac catheterization using a radiopaque dye. Which of the following assessments is most
critical before the procedure?

1. Intake and output 2. Baseline peripheral pulse rates 3. Height and weight 4. Allergy to iodine or shellfish

2. A client with no history of cardiovascular disease comes into the ambulatory clinic with flu-like symptoms. The client
suddenly complains of chest pain. Which of the following questions would best help a nurse to discriminate pain caused
by a non-cardiac problem?

1. Have you ever had this pain before?

2. Can you describe the pain to me?
3. Does the pain get worse when you breathe in?
4. Can you rate the pain on a scale of 1-10, with ten (10) being the worst?

3. A client with myocardial infarction has been transferred from a coronary care unit to a general medical unit with
cardiac monitoring via telemetry. A nurse plans to allow for which of the following client activities?

1. Strict bed rest for 24 hours after transfer

2. Bathroom privileges and self-care activities
3. Unsupervised hallway ambulation with distances under 200 feet
4. Ad lib activities because the client is monitored.

4. A nurse notes 2+ bilateral edema in the lower extremities of a client with myocardial infarction who was admitted two
(2) days ago. The nurse would plan to do which of the following next?

1. Review the intake and output records for the last two (2) days
2. Change the time of diuretic administration from morning to evening
3. Request a sodium restriction of one (1) g/day from the physician.
4. Order daily weight starting the following morning.

5. A client is wearing a continuous cardiac monitor, which begins to sound its alarm. A nurse sees no electrocardiogram
complexes on the screen. The first action of the nurse is to:

1. Check the client status and lead placement 2. Press the recorder button on the electrocardiogram console.
3. Call the physician 4. Call a code blue

6. A nurse is assessing the blood pressure of a client diagnosed with primary hypertension. The nurse ensures accurate
measurement by avoiding which of the following?

1. Seating the client with arm bared, supported, and at heart level.
2. Measuring the blood pressure after the client has been seated quietly for 5 minutes.
3. Using a cuff with a rubber bladder that encircles at least 80% of the limb.
4. Taking a blood pressure within 15 minutes after nicotine or caffeine ingestion.

7. IV heparin therapy is ordered for a client. While implementing this order, a nurse ensures that which of the following
medications is available on the nursing unit?
1. Vitamin K 2. Aminocaproic acid 3. Potassium chloride 4. Protamine sulfate

8. A client is at risk for pulmonary embolism and is on anticoagulant therapy with warfarin (Coumadin). The clients
prothrombin time is 20 seconds, with a control of 11 seconds. The nurse assesses that this result is:

1. The same as the clients own baseline level 2. Lower than the needed therapeutic level
3. Within the therapeutic range 4. Higher than the therapeutic range

9. A client who has been receiving heparin therapy also is started on warfarin. The client asks a nurse why both
medications are being administered. In formulating a response, the nurse incorporates the understanding that warfarin:

1. Stimulates the breakdown of specific clotting factors by the liver, and it takes two (2)- three (3) days for this to exert an
anticoagulant effect.
2. Inhibits synthesis of specific clotting factors in the liver, and it takes 3-4 days for this medication to exert an
anticoagulant effect.
3. Stimulates production of the bodys own thrombolytic substances, but it takes 2-4 days for this to begin.
4. Has the same mechanism of action as Heparin, and the crossover time is needed for the serum level of warfarin to be
therapeutic.

10. A 60-year-old male client comes into the emergency department with complaints of crushing chest pain that radiates
to his shoulder and left arm. The admitting diagnosis is acute myocardial infarction. Immediate admission orders include
oxygen by NC at 4L/minute, blood work, chest x-ray, an ECG, and two (2) mg of morphine given intravenously. The
nurse should first:

1. Administer the morphine 2. Obtain a 12-lead ECG 3. Obtain the lab work 4. Order the chest x-ray

11. When administered a thrombolytic drug to the client experiencing an MI, the nurse explains to him that the purpose of
this drug is to:

1. Help keep him well hydrated 2. Dissolve clots he may have

3. Prevent kidney failure 4. Treat potential cardiac arrhythmias.

12. When interpreting an ECG, the nurse would keep in mind which of the following about the P wave? Select all that
apply.

1. Reflects electrical impulse beginning at the SA node 2. Indicated electrical impulse beginning at the AV node
3. Reflects atrial muscle depolarization 4. Identifies ventricular muscle depolarization
5. Has a duration of normally 0.11 seconds or less.

13. A client has driven himself to the ER. He is 50 years old, has a history of hypertension, and informs the nurse that his
father died of a heart attack at 60 years of age. The client is presently complaining of indigestion. The nurse connects him
to an ECG monitor and begins administering oxygen at 2 L/minute per NC. The nurses next action would be to:

1. Call for the doctor 2. Start an intravenous line

3. Obtain a portable chest radiograph 4. Draw blood for laboratory studies

14. The nurse receives emergency laboratory results for a client with chest pain and immediately informs the physician.
An increased myoglobin level suggests which of the following?

1. Cancer 2. Hypertension 3. Liver disease 4. Myocardial infarction

15. When teaching a client about propranolol hydrochloride, the nurse should base the information on the knowledge that
propranolol hydrochloride:

1. Blocks beta-adrenergic stimulation and thus causes decreased heart rate, myocardial contractility, and conduction.
2. Increases norepinephrine secretion and thus decreases blood pressure and heart rate.
3. Is a potent arterial and venous vasodilator that reduces peripheral vascular resistance and lowers blood pressure.
4. Is an angiotensin-converting enzyme inhibitor that reduces blood pressure by blocking the conversion of angiotensin I
to angiotensin II.

16. The most important long-term goal for a client with hypertension would be to:

1. Learn how to avoid stress 2. Explore a job change or early retirement

3. Make a commitment to long-term therapy 4. Control high blood pressure
17. Hypertension is known as the silent killer. This phrase is associated with the fact that hypertension often goes
undetected until symptoms of other system failures occur. This may occur in the form of:

1. Cerebrovascular accident 2. Liver disease 3. Myocardial infarction 4. Pulmonary disease

18. During the previous few months, a 56-year-old woman felt brief twinges of chest pain while working in her garden
and has had frequent episodes of indigestion. She comes to the hospital after experiencing severe anterior chest pain while
raking leaves. Her evaluation confirms a diagnosis of stable angina pectoris. After stabilization and treatment, the client is
discharged from the hospital. At her follow-up appointment, she is discouraged because she is experiencing pain with
increasing frequency. She states that she is visiting an invalid friend twice a week and now cannot walk up the second
flight of steps to the friends apartment without pain. Which of the following measures that the nurse could suggest would
most likely help the client deal with this problem?

1. Visit her friend earlier in the day. 2. Rest for at least an hour before climbing the stairs.
3. Take a nitroglycerin tablet before climbing the stairs. 4. Lie down once she reaches the friends apartment.

19. Which of the following symptoms should the nurse teach the client with unstable angina to report immediately to her
physician?

1. A change in the pattern of her pain 2. Pain during sex

3. Pain during an argument with her husband 4. Pain during or after an activity such as lawn mowing

20. The physician refers the client with unstable angina for a cardiac catheterization. The nurse explains to the client that
this procedure is being used in this specific case to:

1. Open and dilate the blocked coronary arteries 2. Assess the extent of arterial blockage
3. Bypass obstructed vessels 4. Assess the functional adequacy of the valves and heart muscle.

21. As an initial step in treating a client with angina, the physician prescribes nitroglycerin tablets, 0.3mg given
sublingually. This drugs principal effects are produced by:

1. Antispasmodic effect on the pericardium 2. Causing an increased myocardial oxygen demand

3. Vasodilation of peripheral vasculature 4. Improved conductivity in the myocardium

22. The nurse teaches the client with angina about the common expected side effects of nitroglycerin, including:

1. Headache 2. High blood pressure 3. Shortness of breath 4. Stomach cramps

23. Sublingual nitroglycerin tablets begin to work within 1 to 2 minutes. How should the nurse instruct the client to use
the drug when chest pain occurs?

1. Take one (1) tablet every two (2) to five (5) minutes until the pain stops.
2. Take one (1) tablet and rest for ten (10) minutes. Call the physician if pain persists after ten (10) minutes.
3. Take one (1) tablet, then an additional tablet every 5 minutes for a total of three (3) tablets. Call the physician if pain
persists after three (3) tablets.
4. Take one (1) tablet. If pain persists after five (5) minutes, take two (2) tablets. If pain persists five (5) minutes later, call
the physician.

24. Which of the following arteries primarily feeds the anterior wall of the heart?

1. Circumflex artery 2. Internal mammary artery 3. Left anterior descending artery 4. Right coronary artery

25. When do coronary arteries primarily receive blood flow?

1. During inspiration 2. During diastolic 3. During expiration 4. During systole

26. Prolonged occlusion of the right coronary artery produces an infarction in which of the following areas of the heart?

1. Anterior 2. Apical 3. Inferior 4. Lateral

27. A murmur is heard at the second left intercostal space along the left sternal border. Which valve is this?

1. Aortic 2. Mitral 3. Pulmonic 4. Tricuspid

28. Which of the following blood tests is most indicative of cardiac damage?
1. Lactate dehydrogenase 2. Complete blood count (CBC) 3. Troponin I 4. Creatine kinase (CK)

29. Which of the following diagnostic tools is most commonly used to determine the location of myocardial damage?

1. Cardiac catheterization 2. Cardiac enzymes 3. Echocardiogram 4. Electrocardiogram (ECG)

30. Which of the following types of pain is most characteristic of angina?

1. Knifelike 2. Sharp 3. Shooting 4. Tightness

31. Which of the following parameters is the major determinant of diastolic blood pressure?

1. Baroreceptors 2. Cardiac output 3. Renal function 4. Vascular resistance

32. Which of the following factors can cause blood pressure to drop to normal levels?

1. Kidneys excretion of sodium only 2. Kidneys retention of sodium and water

3. Kidneys excretion of sodium and water 4. Kidneys retention of sodium and excretion of water

33. Baroreceptors in the carotid artery walls and aorta respond to which of the following conditions?

1. Changes in blood pressure 2. Changes in arterial oxygen tension

3. Changes in arterial carbon dioxide tension 4. Changes in heart rate

34. Which of the following terms describes the force against which the ventricle must expel blood?

1. Afterload 2. Cardiac output 3. Overload 4. Preload

35. Which of the following terms is used to describe the amount of stretch on the myocardium at the end of diastole?

1. Afterload 2. Cardiac index 3. Cardiac output 4. Preload

36. A 57-year-old client with a history of asthma is prescribed propranolol (Inderal) to control hypertension.
Before administered propranolol, which of the following actions should the nurse take first?

1. Monitor the apical pulse rate 2. Instruct the client to take medication with food
3. Question the physician about the order 4. Caution the client to rise slowly when standing.

37. One hour after administering IV furosemide (Lasix) to a client with heart failure, a short burst of ventricular
tachycardia appears on the cardiac monitor. Which of the following electrolyte imbalances should the nurse suspect?

1. Hypocalcemia 2. Hypermagnesemia 3. Hypokalemia 4. Hypernatremia

38. A client is receiving spironolactone to treat hypertension. Which of the following instructions should the nurse
provide?

1. Eat foods high in potassium. 2. Take daily potassium supplements.

3. Discontinue sodium restrictions. 4. Avoid salt substitutes.

39. When assessing an ECG, the nurse knows that the P-R interval represents the time it takes for the:

1. Impulse to begin atrial contraction 2. Impulse to transverse the atria to the AV node
3. SA node to discharge the impulse to begin atrial depolarization 4. Impulse to travel to the ventricles

40. Following a treadmill test and cardiac catheterization, the client is found to have coronary artery disease, which is
inoperative. He is referred to the cardiac rehabilitation unit. During his first visit to the unit he says that he doesnt
understand why he needs to be there because there is nothing that can be done to make him better. The best nursing
response is:

1. Cardiac rehabilitation is not a cure but can help restore you to many of your former activities.
2. Here we teach you to gradually change your lifestyle to accommodate your heart disease.
3. You are probably right but we can gradually increase your activities so that you can live a more active life.
4. Do you feel that you will have to make some changes in your life now?

41. To evaluate a clients condition following cardiac catheterization, the nurse will palpate the pulse:
1. In all extremities 2. At the insertion site 3. Distal to the catheter insertion 4. Above the catheter insertion

42. A clients physician orders nuclear cardiography and makes an appointment for a thallium scan. The purpose of
injecting radioisotope into the bloodstream is to detect:

1. Normal vs. abnormal tissue 2. Damage in areas of the heart

3. Ventricular function 4. Myocardial scarring and perfusion

43. A client enters the ER complaining of severe chest pain. A myocardial infarction is suspected. A 12 lead ECG appears
normal, but the doctor admits the client for further testing until cardiac enzyme studies are returned. All of the following
will be included in the nursing care plan. Which activity has the highest priority?

1. Monitoring vital signs 2. Completing a physical assessment

3. Maintaining cardiac monitoring 4. Maintaining at least one IV access site

44. A client is experiencing tachycardia. The nurses understanding of the physiological basis for this symptom is
explained by which of the following statements?

1. The demand for oxygen is decreased because of pleural involvement

2. The inflammatory process causes the body to demand more oxygen to meet its needs.
3. The heart has to pump faster to meet the demand for oxygen when there is lowered arterial oxygen tension.
4. Respirations are labored.

45. A client enters the ER complaining of chest pressure and severe epigastric distress. His VS are 158/90, 94, 24, and
99*F. The doctor orders cardiac enzymes. If the client were diagnosed with an MI, the nurse would expect which cardiac
enzyme to rise within the next 3 to 8 hours?

1. Creatine kinase (CK or CPK) 2. Lactic dehydrogenase (LDH) 3. LDH-1 4. LDH-2

46. A 45-year-old male client with leg ulcers and arterial insufficiency is admitted to the hospital. The nurse understands
that leg ulcers of this nature are usually caused by:

1. Decreased arterial blood flow secondary to vasoconstriction 2. Decreased arterial blood flow leading to hyperemia
3. Atherosclerotic obstruction of the arteries 4. Trauma to the lower extremities

47. Which of the following instructions should be included in the discharge teaching for a patient discharged with a
transdermal nitroglycerin patch?

1. Apply the patch to a non hairy, nonfatty area of the upper torso or arms.
2. Apply the patch to the same site each day to maintain consistent drug absorption.
3. If you get a headache, remove the patch for 4 hours and then reapply.
4. If you get chest pain, apply a second patch right next to the first patch.

48. In order to prevent the development of tolerance, the nurse instructs the patient to:

1. Apply the nitroglycerin patch every other day

2. Switch to sublingual nitroglycerin when the patients systolic blood pressure elevates to >140 mm Hg
3. Apply the nitroglycerin patch for 14 hours each and remove for 10 hours at night
4. Use the nitroglycerin patch for acute episodes of angina only

49. Direct-acting vasodilators have which of the following effects on the heart rate?

1. Heart rate decreases 2. Heart rate remains significantly unchanged

3. Heart rate increases 4. Heart rate becomes irregular

50. When teaching a patient why spironolactone (Aldactone) and furosemide (Lasix) are prescribed together, the nurse
bases teaching on the knowledge that:

1. Moderate doses of two different types of diuretics are more effective than a large dose of one type
2. This combination promotes diuresis but decreases the risk of hypokalemia
3. This combination prevents dehydration and hypovolemia
4. Using two drugs increases osmolality of plasma and the glomerular filtration rate
HOMEOSTASIS: FLUIDS AND ELECTROLYTES #1

1. Patient X is diagnosed with constipation. As a knowledgeable nurse, which nursing intervention is appropriate for
maintaining normal bowel function?

A. Assessing dietary intake B. Decreasing fluid intake

C. Providing limited physical activity D. Turning, coughing, and deep breathing

2. A 12-year-old boy was admitted in the hospital two days ago due to hyperthermia. His attending nurse, Dennis, is quite
unsure about his plan of care. Which of the following nursing intervention should be included in the care of plan for the
client?

A. Room temperature reduction B. Fluid restriction of 2,000 ml/day

C. Axillary temperature measurements every 4 hours D. Antiemetic agent administration

3. Tom is ready to be discharged from the medical-surgical unit after 5 days of hospitalization. Which client statement
indicates to the nurse that Tom understands the discharge teaching about cellular injury?

A. I do not have to see my doctor unless i have problems.

B. I can stop taking my antibiotics once I am feeling better.
C. If I have redness, drainage, or fever, I should call my healthcare provider.
D. I can return to my normal activities as soon as I go home.

4. Nurse Katee is caring for Adam, a 22-year-old client, in a long-term facility. Which nursing intervention would be
appropriate when identifying nursing interventions aimed at promoting and preventing contractures? Select all that apply.

A. Clustering activities to allow uninterrupted periods of rest

B. Maintaining correct body alignment at all times
C. Monitoring intake and output, using a urometer if necessary
D. Using a footboard or pillows to keep feet in correct position
E. Performing active and passive range-of-motion exercises
F. Weighing the client daily at the same time and in the same clothes

5. A 36-year-old male client is about to be discharged from the the hospital after 5 days due to surgery. Which
intervention should be included in the home health care nurses instructions about measures to prevent constipation?

A. Discouraging the client from eating large amounts of roughage-containing foods in the diet.
B. Encouraging the client to use laxatives routinely to ensure adequate bowel elimination.
C. Instructing the client to establish a bowel evacuation schedule that changes every day.
D. Instructing the client to fill a 2-L bottle with water every night and drink it the next day.

6. Mr. McPartlin suffered abrasions and lacerations after a vehicular accident. He was hospitalized and was treated for a
couple of weeks. When planning care for a client with cellular injury, the nurse should consider which scientific rationale?

A. Nutritional needs remain unchanged for the well-nourished adult.

B. Age is an insignificant factor in cellular repair.
C. The presence of infection may slow the healing process.
D. Tissue with inadequate blood supply may heal faster.

7. A 22-year-old lady is displaying facial grimaces during her treatment in the hospital due to burn trauma. Which
nursing intervention should be included for reducing pain due to cellular injury?

A. Administering anti-inflammatory agents as prescribed

B. Elevating the injured area to decrease venous return to the heart
C. Keeping the skin clean and dry
D. Applying warm packs initially to reduce edema

8. Lisa, a client with altered urinary function, is under the care of nurse Tine. Which intervention is appropriate to include
when developing a plan of care for Lisa who is experiencing urinary dribbling?

A. Inserting an indwelling Foley catheter B. Having the client perform Kegel exercises
C. Keeping the skin clean and dry D. Using pads or diapers on the client

9. Jeron is admitted in the hospital due to bacterial pneumonia. He is febrile, diaphoretic, and has shortness of breath and
asthma. Which goal is the most important for the client?
A. Prevention of fluid volume excess B. Maintenance of adequate oxygenation
C. Education about infection prevention D. Pain reduction

10. Rogelio, a 32-year-old patient, is about to be discharged from the acute care setting. Which nursing intervention is the
most important to include in the plan of care?

A. Stress-reduction techniques B. Home environment evaluation

C. Skin-care measures D. Participation in activities of daily living

11. Mrs. dela Riva is in her first trimester of pregnancy. She has been lying all day because her OB-GYN requested her to
have a complete bed rest. Which nursing intervention is appropriate when addressing the clients need to maintain skin
integrity?

A. Monitoring intake and output accurately B. Instructing the client to cough and deep-breathe every 2 hours
C. Keeping the linens dry and wrinkle free D. Using a foot board to maintain correct anatomic position

12. Maya, who is admitted in a hospital, is scheduled to have her general checkup and physical assessment. Nurse
Timothy observed a reddened area over her left hip. Which should the nurse do first?

A. Massage the reddened are for a few minutes B. Notify the physician immediately
C. Arrange for a pressure-relieving device D. Turn the client to the right side for 2 hours

13. Pierro was noted to be displaying facial grimaces after nurse Kara assessed his complaints of pain rated as 8 on a scale
of 1 (no pain) 10 10 (worst pain). Which intervention should the nurse do?

A. Administering the clients ordered pain medication immediately

B. Using guided imagery instead of administering pain medication
C. Using therapeutic conversation to try to discourage pain medication
D. Attempting to rule out complications before administering pain medication

14. Nurse Marthia is teaching her students about bacterial control. Which intervention is the most important factor in
preventing the spread of microorganism?

A. Maintenance of asepsis with indwelling catheter insertion

B. Use of masks, gowns, and gloves when caring for clients with infection
C. Correct handwashing technique
D. Cleanup of blood spills with sodium hydrochloride

15. A patient with tented skin turgor, dry mucous membranes, and decreased urinary output is under nurse Marks care.
Which nursing intervention should be included the care plan of Mark for his patient?

A. Administering I.V. and oral fluids B. Clustering necessary activities throughout the day
C. Assessing color, odor, and amount of sputum D. Monitoring serum albumin and total protein levels

16. Khaleesi is admitted in the hospital due to having lower than normal potassium level in her bloodstream. Her medical
history reveals vomiting and diarrhea prior to hospitalization. Which foods should the nurse instruct the client to increase?

A. Whole grains and nuts B. Milk products and green, leafy vegetables
C. Pork products and canned vegetables D. Orange juice and bananas

17. Mary Jean, a first year nursing student, was rushed to the clinic department due to hyperventilation. Which nursing
intervention is the most appropriate for the client who is subsequently developing respiratory alkalosis?

A. Administering sodium chloride I.V. B. Encouraging slow, deep breaths

C. Preparing to administer sodium bicarbonate D. Administer low-flow oxygen therapy

18. Nurse John Joseph is totaling the intake and output for Elena Reyes, a client diagnosed with septicemia who is on a
clear liquid diet. The client intakes 8 oz of apple juice, 850 ml of water, 2 cups of beef broth, and 900 ml of half-normal
saline solution and outputs 1,500 ml of urine during the shift. How many milliliters should the nurse document as the
clients intake.

A. 2,230 B. 2,740 C. 2,470 D. 2,320

19. Marie Joys lab test revealed that her serum calcium is 2.5 mEq/L. Which assessment data does the nurse document
when a client diagnosed with hypocalcemia develops a carpopedal spasm after the blood-pressure cuff is inflated?
A. Positive Trousseaus sign B. Positive Chvosteks sign C. Tetany D. Paresthesia

20. Lab tests revealed that patient Zs [Na+] is 170 mEq/L. Which clinical manifestation would nurse Natty expect to
assess?

A. Tented skin turgor and thirst B. Muscle twitching and tetany

C. Fruity breath and Kussmauls respirations D. Muscle weakness and paresthesia

21. Mang Teban has a history of chronic obstructive pulmonary disease and has the following arterial blood gas results:
partial pressure of oxygen (PO2), 55 mm Hg, and partial pressure of carbon dioxide (PCO2), 60 mm Hg. When attempting
to improve the clients blood gas values through improved ventilation and oxygen therapy, which is the clients primary
stimulus for breathing?

A. High PCO2 B. Low PO2 C. Normal pH D. Normal bicarbonate (HCO3)

22. A client with very dry mouth, skin and mucous membranes is diagnosed of having dehydration. Which intervention
should the nurse perform when caring for a client diagnosed with fluid volume deficit?

A. Assessing urinary intake and output B. Obtaining the clients weight weekly at different times of the day
C. Monitoring arterial blood gas (ABG) results D. Maintaining I.V. therapy at the keep-vein-open rate

23. Which client situation requires the nurse to discuss the importance of avoiding foods high in potassium?

A. 14-year-old Elena who is taking diuretics B. 16-year-old John Joseph with ileostomy
C. 16-year-old Gabriel with metabolic acidosis D. 18-year-old Albert who has renal disease

24. Genevieve is diagnosed with hypomagnesemia, which nursing intervention would be appropriate?

A. Instituting seizure precaution to prevent injury

B. Instructing the client on the importance of preventing infection
C. Avoiding the use of tight tourniquet when drawing blood
D. Teaching the client the importance of early ambulation

25. Which electrolyte would the nurse identify as the major electrolyte responsible for determining the concentration of
the extracellular fluid?

A. Potassium B. Phosphate C. Chloride D. Sodium

26. Jon has a potassium level of 6.5 mEq/L, which medication would nurse Wilma anticipate?

A. Potassium supplements B. Kayexalate C. Calcium gluconate D. Sodium tablets

27. Which clinical manifestation would lead the nurse to suspect that a client is experiencing hypermagnesemia?

A. Muscle pain and acute rhabdomyolysis B. Hot, flushed skin and diaphoresis
C. Soft-tissue calcification and hyperreflexia D. Increased respiratory rate and depth

28. Joshua is receiving furosemide and Digoxin, which laboratory data would be the most important to assess in planning
the care for the client?

A. Sodium level B. Magnesium level C. Potassium level D. Calcium level

29. Mr. Salcedo has the following arterial blood gas (ABG) values: pH of 7.34, partial pressure of arterial oxygen of 80
mm Hg, partial pressure of arterial carbon dioxide of 49 mm Hg, and a bicarbonate level of 24 mEq/L. Based on these
results, which intervention should the nurse implement?

A. Instructing the client to breathe slowly into a paper bag

B. Administering low-flow oxygen
C. Encouraging the client to cough and deep breathe
D. Nothing, because these ABG values are within normal limits.

30. A client is diagnosed with metabolic acidosis, which would the nurse expect the health care provider to order?

A. Potassium B. Sodium bicarbonate C. Serum sodium level D. Bronchodilator

Homeostasis: Fluids and Electrolytes #2

1. Lee Angelas lab test just revealed that her chloride level is 96 mEq/L. As a nurse, you would interpret this serum
chloride level as:

A. high B. low C. within normal range D. high normal

2. Which of the following conditions is associated with elevated serum chloride levels?

A. cystitis B. diabetes C. eclampsia D. hypertension

3. In the extracellular fluid, chloride is a major:

A. compound B. ion C. anion D. cation

4. Nursing intervention for the patient with hyperphosphatemia include encouraging intake of:

A. amphojel B. Fleets phospho-soda C. milk D. vitamin D

5. Etiologies associated with hypocalcemia may include all of the following except:

A. renal failure B. inadequate intake calcium C. metastatic bone lesions D. vitamin D deficiency

6. Which of the following findings would the nurse expect to asses in hypercalcemia?

A. prolonged QRS complex B. tetany C. petechiae D. urinary calculi

7. Which of the following is not an appropriate nursing intervention for a patient with hypercalcemia?

A. administering calcitonin B. administering calcium gluconate

C. administering loop diuretics D. encouraging ambulation

8. A patient in which of the following disorders is at high risk to develop hypermagnesemia?

A. insulin shock B. hyperadrenalism C. nausea and vomiting D. renal failure

9. Nursing interventions for a patient with hypermagnesemia include administering calcium gluconate to:

A. increase calcium levels B. antagonize the cardiac effects of magnesium

C. lower calcium levels D. lower magnesium levels

10. For a patient with hypomagnesemia, which of the following medications may become toxic?

A. Lasix B. Digoxin C. calcium gluconate D. CAPD

11. Which of the following is the most important physical assessment parameter the nurse would consider when assessing
fluid and electrolyte imbalance?

A. skin turgor B. intake and output C. osmotic pressure D. cardiac rate and rhythm

12. Insensible fluid losses include:

A. urine B. gastric drainage C. bleeding D. perspiration

13. Which of the following intravenous solutions would be appropriate for a patient with severe hyponatremia secondary
to syndrome of inappropriate antidiuretic hormone (SIADH)?

A. hypotonic solution B. hypertonic solution C. isotonic solution D. normotonic solution

14. Aldosterone secretion in response to fluid loss will result in which one of the following electrolyte imbalances?

A. hypokalemia B. hyperkalemia C. hyponatremia D. hypernatremia

15. When assessing a patient for signs of fluid overload, the nurse would expect to observe:
A. bounding pulse B. flat neck veins C. poor skin turgor D. vesicular

16. The physician has ordered IV replacement of potassium for a patient with severe hypokalemia. The nurse would
administer this:

A. by rapid bolus B. diluted in 100 cc over 1 hour C. diluted in 10 cc over 10 minutes D. IV push

17. Which of the following findings would the nurse exp[ect to assess in a patient with hypokalemia?

A. hypertension B. pH below 7.35 C. hypoglycemia D. hyporeflexia

18. Vien is receiving oral potassium supplements for his condition. How should the supplements be administered?

A. undiluted B. diluted C. on an empty stomach D. at bedtime

19. Normal venous blood pH ranges from:

A. 6.8 to 7.2 B. 7.31 to 7.41 C. 7.35 to 7.45 D. 7.0 to 8.0

20. Respiratory regulation of acids and bases involves:

A. hydrogen B. hydroxide C. oxygen D. carbon dioxide

21. To determine if a patients respiratory system is functioning, the nurse would assess which of the following
parameters:

A. respiratory rate B. pulse C. arterial blood gas D. pulse oximetry

22. Which of the following conditions is an equal decrease of extracellular fluid (ECF) solute and water volume?

A. hypotonic FVD B. isotonic FVD C. hypertonic FVD D. isotonic FVE

23. When monitoring the daily weight of a patient with fluid volume deficit (FVD), the nurse is aware that fluid loss may
be considered when weight loss begins to exceed:

A. 0.25 lb B. 0.50 lb C. 1 lb D. 1 kg

24. Dietary recommendations for a patient with a hypotonic fluid excess should include:

A. decreased sodium intake B. increased sodium intake

C. increased fluid intake D. intake of potassium-rich foods

25. Osmotic pressure is created through the process of:

A. osmosis B. diffusion C. filtration D. capillary dynamics

26. A rise in arterial pressure causes the baroreceptors and stretch receptors to signal an inhibition of the sympathetic
nervous system, resulting in:

A. decreased sodium reabsorption B. increased sodium reabsorption

C. decreased urine output D. increased urine output

27. Normal serum sodium concentration ranges from:

A. 120 to 125 mEq/L B. 125 to 130 mEq/L C. 136 to 145 mEq/L D. 140 to 148 mEq/L

28. When assessing a patient for electrolyte balance, the nurse is aware that etiologies for hyponatremia include:

A. water gain B. diuretic therapy C. diaphoresis D. all of the following

29. Nursing interventions for a patient with hyponatremia include:

A. administering hypotonic IV fluids B. encouraging water intake

C. restricting fluid intake D. restricting sodium intake
30. The nurse would analyze an arterial pH of 7.46 as indicating:

A. acidosis B. alkalosis C. homeostasis D. neutrality

PHARMACOLOGY: CARDIOVASCULAR DRUGS 1

1. Which of the following clients is at greatest risk for digital toxicity?

A. A 25-year-old client with congenital heart disease B. A 50-year-old client with CHF
C. A 60-year-old client after myocardial infarction D. An 80-year-old client with CHF

2. Which of the following is a contraindication for digoxin administration?

A. Blood pressure of 140/90 B. Heart rate above 80 C. Heart rate below 60 D. Respiratory rate above 20

3. The action of medication is inotropic when it:

A. Decreased afterload B. Increases heart rate C. Increases the force of contraction D. Is used to treat CHF

4. Which is the MOST appropriate action for the nurse to take before administering digoxin?

A. Monitor potassium level B. Assess blood pressure

C. Evaluate urinary output D. Avoid giving with thiazide diuretic

5. The therapeutic drug level for digoxin is:

A. 0.1-2.0 ng/mg B. 1.0-2.0 ng/mg

C. 0.1-0.5 ng/mg D. 0.5-2.0 ng/mg

6. Blurred vision or halos are signs of:

A. Subtherapeutic digoxin levels B. Digoxin toxicity

C. Nothing related to digoxin D. Corneal side effects of digoxin

7. Amrinone (Inocor) is used for short term therapy for CHF and acts by which of the following mechanisms?

A. Increasing stroke volume and heart rate

B. Slowing ventricular rate and increasing cardiac output
C. Vasodilating and increasing peripheral vascular resistance
D. Increasing cardiac output and enhancing renal perfusion

8. Before giving milrinone (Primacor) by an IV infusion to a client with symptoms of CHF, which of the following
nursing actions is necessary?

A. Record sodium level. B. Administer loading dose over 15 minutes.

C. Assess CV status. D. Review medication regimen to identify if client is on IV furosemide (Lasix).

9. Johanna has ventricular ectopy, which of the following drugs is the first line used to treat her condition?

A. quinidine (Cardioquin) B. digoxin (Lanoxin) C. procainamide ( Pronestyl) D. lidocaine (Xylocaine)

10. Class IA antiarrhythmic agents have little effect on:

A. AV node B. SA node C. Purkinje fibers D. Bundle of His

11. Which of the following drugs can cause severe hematologic disorders?

A. digoxin (Lanoxin) B. quinidine (Cardioquin) C. disopyramide (Norpace) D. procainamide (Pronestyl)

12. Which of the following ECG findings alerts the nurse that the client needs an antiarrhythmic?

A. Normal sinus rhythm B. Sinus bradycardia C. Sinus arrhythmia D. Frequent ventricular ectopy
13. When administering an antiarrhythmic agent, which of the following assessment parameters is the most important for
the nurse to evaluate?

A. ECG B. Pulse rate C. Respiratory rate D. Blood pressure

14. Which of the following blood tests will tell the nurse that an adequate amount of drug is present in the blood to
prevent arrhythmias?

A. Serum chemistries B. Complete blood counts C. Drug levels D. None of the above

15. Which of the following drugs should be used only in situations in which the client can be very closely monitored, such
as a critical care unit?

A. bretylium (Bretylol) B. digoxin (Lanoxin) C. quinidine (Cardioquin) D. inderal (Propranolol)

16. The most toxic antiarrhythmic agent is:

A. digoxin (Lanoxin) B. lidocaine (Xylocaine) C. amiodarone (Cordarone) D. quinidine (Cardioquin)

17. Epinephrine is used to treat cardiac arrest and status asthmaticus because of which of the following actions?

A. Increased speed of conduction and gluconeogenesis

B. Bronchodilation and increased heart rate, contractility, and conduction
C. Increased vasodilation and enhanced myocardial contractility
D. Bronchoconstriction and increased heart rate

18. Following norepinephrine (Levophed) administration, it is essential to the nurse to assess:

A. electrolyte status B. color and temperature of toes and fingers

C. capillary refill D. ventricular arrhythmias

19. Norepinephrine (Levophed) is contraindicated in which of the following conditions?

A. Hypovolemic shock B. Neurogenic shock

C. Blood pressures above 80-100 mmHg (systolic) D. Decreased renal perfusion

20. When administering dopamine (Intropin), it is most important for the nurse to know that:

A. the drugs action varies according to the dose.

B. the drug may be used instead of fluid replacement.
C. the drug cannot be directly mixed in solutions containing bicarbonate or aminophylline.
D. the lowest dose to produce the desired effect should be used.

21. Dobutamine (Dobutrex) improves cardiac output and is indicated for use in all of the following conditions except:

A. septic shock B. congestive heart failure C. arrhythmias D. pulmonary congestion

22. Conduction defects will most likely be an adverse associated with the use of:

A. verapamil B. nifedipine C. diltiazem D. felodipine

23. Which of the following calcium channel blockers has the most potent peripheral smooth muscle dilator effect?

A. diltiazem B. nifedipine C. nimodipine D. verapamil

24. Which of the following adverse reactions is found more often in volume-depleted elderly clients?

A. Bradycardia B. Conduction defects C. Ankle edema D. Hypotension

25. Which of the following calcium channel blockers is used to counteract or prevent cerebral vasospasm?

A. verapamil B. nimodipine C. nifedipine D. felodipine

26. Which of the following effects of calcium channel blockers causes a reduction in blood pressure?
A. Increased cardiac output B. Decreased peripheral vascular resistance
C. Decreased renal blood flow D. Calcium influx into cardiac muscles

27. Jason James is taking blockers, all of the following should be included in his assessment except:

A. Pulmonary function tests B. Baseline ECG C. Glucose level D. Blood pressure

28. Routine laboratory monitoring in clients taking blockers should include:

A. Sodium B. Glucose C. Thyrotropin D. Creatine phosphokinase

29. Competitive antagonism of which of the following occurs at receptor sites?

A. Catecholamines B. Adrenergic sites C. Acetylcholine D. Norepinephrine

30. blockers should be avoided in which of the following conditions?

A. Bronchoconstriction B. Hypertension C. Angina D. Myocardial infarction

ABG Analysis NCLEX Exam # 1

1. George Kent is a 54 year old widower with a history of chronic obstructive pulmonary disease and was rushed to the
emergency department with increasing shortness of breath, pyrexia, and a productive cough with yellow-green sputum.
He has difficulty in communicating because of his inability to complete a sentence. One of his sons, Jacob, says he has
been unwell for three days. Upon examination, crackles and wheezes can be heard in the lower lobes; he has a tachycardia
and a bounding pulse. Measurement of arterial blood gas shows pH 7.3, PaCO2 68 mm Hg, HCO3 28 mmol/L, and PaO2
60 mm Hg. How would you interpret this?

A. Respiratory Acidosis, Uncompensated B. Respiratory Acidosis, Partially Compensated

C. Metabolic Alkalosis, Uncompensated D. Metabolic Acidosis, Partially Compensated

2. Carl, an elementary student, was rushed to the hospital due to vomiting and a decreased level of consciousness. The
patient displays slow and deep (Kussmaul breathing), and he is lethargic and irritable in response to stimulation. He
appears to be dehydratedhis eyes are sunken and mucous membranes are dryand he has a two week history of
polydipsia, polyuria, and weight loss. Measurement of arterial blood gas shows pH 7.0, PaO2 90 mm Hg, PaCO2 23 mm
Hg, and HCO3 12 mmol/L; other results are Na+ 126 mmol/L, K+ 5 mmol/L, and Cl- 95 mmol/L. What is your
assessment?

A. Respiratory Acidosis, Uncompensated B. Respiratory Acidosis, Partially Compensated

C. Metabolic Alkalosis, Uncompensated D. Metabolic Acidosis, Partially Compensated

3. A cigarette vendor was brought to the emergency department of a hospital after she fell into the ground and hurt her left
leg. She is noted to be tachycardic and tachypneic. Painkillers were carried out to lessen her pain. Suddenly, she started
complaining that she is still in pain and now experiencing muscle cramps, tingling, and paraesthesia. Measurement of
arterial blood gas reveals pH 7.6, PaO2 120 mm Hg, PaCO2 31 mm Hg, and HCO3 25 mmol/L. What does this mean?

A. Respiratory Acidosis, Uncompensated B. Respiratory Acidosis, Partially Compensated

C. Metabolic Alkalosis, Uncompensated D. Metabolic Acidosis, Partially Compensated

4. Rickys grandmother is suffering from persistent vomiting for two days now. She appears to be lethargic and weak and
has myalgia. She is noted to have dry mucus membranes and her capillary refill takes >4 seconds. She is diagnosed as
having gastroenteritis and dehydration. Measurement of arterial blood gas shows pH 7.5, PaO2 85 mm Hg, PaCO2 40 mm
Hg, and HCO3 34 mmol/L. What acid-base disorder is shown?

A. Respiratory Acidosis, Uncompensated B. Respiratory Acidosis, Partially Compensated

C. Metabolic Alkalosis, Uncompensated D. Metabolic Acidosis, Partially Compensated

5. Mrs. Johansson, who had undergone surgery in the post-anesthesia care unit (PACU), is difficult to arouse two hours
following surgery. Nurse Florence in the PACU has been administering Morphine Sulfate intravenously to the client for
complaints of post-surgical pain. The clients respiratory rate is 7 per minute and demonstrates shallow breathing. The
patient does not respond to any stimuli! The nurse assesses the ABCs (remember Airway, Breathing, Circulation!) and
obtains ABGs STAT! Measurement of arterial blood gas shows pH 7.10, PaCO2 70 mm Hg and HCO3 24 mEq/L. What
does this mean?
A. Respiratory Acidosis, Uncompensated B. Respiratory Acidosis, Partially Compensated
C. Metabolic Alkalosis, Uncompensated D. Metabolic Acidosis, Partially Compensated

6. Baby Angela was rushed to the Emergency Room following her mothers complaint that the infant has been irritable,
difficult to breastfeed and has had diarrhea for the past 3 days. The infants respiratory rate is elevated and the fontanels
are sunken. The Emergency Room physician orders ABGs after assessing the ABCs. The results from the ABG results
show pH 7.39, PaCO2 27 mmHg and HCO3 19 mEq/L. What does this mean?

A. Respiratory Acidosis, Uncompensated B. Respiratory Acidosis, Partially Compensated

C. Metabolic Alkalosis, Uncompensated D. Metabolic Acidosis, Partially Compensated

7. Mr. Wales, who underwent post-abdominal surgery, has a nasogastric tube. The nurse on duty notes that the nasogastric
tube (NGT) is draining a large amount (900 cc in 2 hours) of coffee ground secretions. The client is not oriented to person,
place, or time. The nurse contacts the attending physician and STAT ABGs are ordered. The results from the ABGs show
pH 7.57, PaCO2 37 mmHg and HCO3 30 mEq/L. What is your assessment?

A. Respiratory Acidosis, Uncompensated B. Respiratory Acidosis, Partially Compensated

C. Metabolic Alkalosis, Uncompensated D. Metabolic Acidosis, Partially Compensated

8. Client Z is admitted to the hospital and is to undergo brain surgery. The client is very anxious and scared of the
upcoming surgery. He begins to hyperventilate and becomes very dizzy. The client loses consciousness and the STAT
ABGs reveal pH 7.61, PaCO2 22 mmHg and HCO3 25 mEq/L. What is the ABG interpretation based on the findings?

A. Respiratory Acidosis, Uncompensated B. Respiratory Acidosis, Partially Compensated

C. Metabolic Alkalosis, Uncompensated D. Metabolic Acidosis, Partially Compensated

9. Three-year-old Adrian is admitted to the hospital with a diagnosis of asthma and respiratory distress syndrome. The
mother of the child reports to the nurse on duty that she has witnessed slight tremors and behavioral changes in her child
over the past four days. The attending physician orders routine ABGs following an assessment of the ABCs. The ABG
results are pH 7.35, PaCO2 72 mmHg and HCO3 38 mEq/L. What acid-base disorder is shown?

A. Respiratory Acidosis, Uncompensated B. Respiratory Acidosis, Partially Compensated

C. Metabolic Alkalosis, Uncompensated D. Metabolic Acidosis, Partially Compensated

10. Anne, who is drinking beer at a party, falls and hits her head on the ground. Her friend Liza dials 911 because Anne
is unconscious, depressed ventilation (shallow and slow respirations), rapid heart rate, and is profusely bleeding from both
ears. Which primary acid-base imbalance is Anne at risk for if medical attention is not provided?

A. Respiratory Acidosis, Uncompensated B. Respiratory Acidosis, Partially Compensated

C. Metabolic Alkalosis, Uncompensated D. Metabolic Acidosis, Partially Compensated

ABG ANALYSIS NCLEX EXAM #3

In acid-base balance the normal plasma PCO2 and bicarbonate levels are disturbed. Match the changes in these
parameters given below with the disorders in the given choices.

1. Low plasma PaCO2

A. Metabolic Acidosis B. Respiratory Alkalosis C. Metabolic Alkalosis D. Respiratory Acidosis

2. High plasma PaCO2

A. Metabolic Acidosis B. Respiratory Alkalosis C. Metabolic Alkalosis D. Respiratory Acidosis

3. Decreased plasma bicarbonate (HCO3-)

A. Metabolic Acidosis B. Respiratory Alkalosis C. Metabolic Alkalosis D. Respiratory Acidosis

4. Increased plasma bicarbonate (HCO3-)

A. Metabolic Acidosis B. Respiratory Alkalosis C. Metabolic Alkalosis D. Respiratory Acidosis

5. What two organs in the body serve as a compensatory function to maintain acid base balance?
A. Kidneys and Lungs B. Lungs and Spleen C. Heart and Liver D. Gallbladder and Appendix

6. Arterial blood gas (ABG) measurement will give the information needed to determine if the primary disturbance of
acid-base balance is respiratory or metabolic in nature.

A. True B. False
C. Both Carbonic Acid Excess and Deficit Only D. Both Bicarbonate Excess and Deficit Only

7. The major effect of acidosis is overexcitement of the central nervous system.

A. True B. False
C. Maybe D. Both Acidosis and Alkalosis result in overexcitement of the central nervous system.

8. Alkalosis is characterized by overexcitement of the nervous system.

A. True
B. False
C. The major effect of Alkalosis is a depression of the central nervous system.
D. Both Acidosis and Alkalosis result in overexcitement of the central nervous system.

9. The human body functions optimally in a state of homeostasis.

A. True B. False
C. Maybe D. Homeostasis has nothing to do with metabolic balance.

10. Acids have no hydrogen ions and are able to bind in a solution.

A. True
B. False
C. Acid is a substance that is not capable of donating hydrogen ions.
D. Acids and bases have nothing to do with hydrogen ions.

Match the acid-base status of the following blood samples to the disorders in the given choices. (PaCO2 values are in mm
Hg and bicarbonate values in mmol/l).

11. pH 7.57, PaCO2 22, HCO3- 17

A. Respiratory Acidosis, Partially Compensated B. Respiratory Alkalosis, Uncompensated

C. Metabolic Acidosis, Partially Compensated D. Respiratory Alkalosis, Partially Compensated

12. pH 7.39, PaCO2 44, HCO3- 26

A. Respiratory Acidosis B. Metabolic Acidosis C. Respiratory Alkalosis D. Normal

13. pH 7.55, PaCO2 25, HCO3- 22

A. Respiratory Acidosis, Partially Compensated B. Respiratory Alkalosis, Uncompensated

C. Metabolic Acidosis, Partially Compensated D. Respiratory Alkalosis, Partially Compensated

14. pH 7.17, PaCO2 48, HCO3- 36

A. Respiratory Acidosis, Partially Compensated B. Respiratory Alkalosis, Uncompensated

C. Metabolic Acidosis, Partially Compensated D. Respiratory Alkalosis, Partially Compensated

15. pH 7.34, PaCO2 24, HCO3- 20

A. Respiratory Acidosis, Partially Compensated B. Respiratory Alkalosis, Uncompensated

C. Metabolic Acidosis, Partially Compensated D. Respiratory Alkalosis, Partially Compensated

16. pH 7.64, PaCO2 25, HCO3- 19

A. Respiratory Acidosis, Partially Compensated B. Respiratory Alkalosis, Uncompensated

C. Metabolic Acidosis, Partially Compensated D. Respiratory Alkalosis, Partially Compensated

17. pH 7.45, PaCO2 50, HCO3- 30

A. Respiratory Acidosis, Partially Compensated B. Respiratory Alkalosis, Uncompensated
C. Metabolic Acidosis, Partially Compensated D. Respiratory Alkalosis, Partially Compensated

18. pH 7.6, PaCO2 53, HCO3- 38

A. Respiratory Acidosis, Partially Compensated B. Respiratory Alkalosis, Uncompensated

C. Metabolic Acidosis, Partially Compensated D. Respiratory Alkalosis, Partially Compensated

19. pH 7.5, PaCO2 19, HCO3- 22

A. Respiratory Acidosis, Partially Compensated B. Respiratory Alkalosis, Uncompensated

C. Metabolic Acidosis, Partially Compensated D. Respiratory Alkalosis, Partially Compensated

20. pH 7.4, PaCO2 59, HCO3- 35

A. Respiratory Acidosis, Partially Compensated B. Respiratory Alkalosis, Uncompensated

C. Metabolic Acidosis, Partially Compensated D. Respiratory Alkalosis, Partially Compensated