CARDIOLOGY UWORLD DRILLS

1. The nurse is assessing a client 15 minutes after initiating nitroglycerin infusion for suspected acute coronary
syndrome. Which clinical finding is the priority?
a. The client reports a headache
b. The client reports feeling dizzy and lightheaded
c. The client reports feeling flushed
d. The client reports feeling nervous

2. A nurse auscultates a loud cardiac murmur on a newborn with suspected trisomy 21 (down syndrome). A
genetic screen and an echocardiogram are scheduled that day. The neonate’s vital signs are shown in the
exhibit. What would be an appropriate action for the nurse to complete next?

Vital signs
Temperature 98.6 F (37 C)
Heart rate 146/min
Respirations 42/min
O2 saturation 98%

a. Call the HCP immediately

3. The nurse assesses pitting edema of the extremeties, dyspnea, bilateral crackles posteriorly, and a serum
sodium level of 130 mEq/L in a client with chronic heart failure. The nurse should question which prescription?
a. Furosemide 20 mg IV push twice daily
b. Maintenance IV line of 0.9% normal saline at 85 mL/h
c. Potassium chloride 20 mEq orally twice daily
d. Sodium-restricted diet

4. A client with unstable angina and chronic kidney disease is receiving a continuous infusion of unfractionated
heparin. Which value for activated partial thromboplastin time (aPTT) would indicate to the nurse that the
heparin therapy is at an optimal therapeutic level?
a. 30 seconds
b. 35 seconds
c. 60 seconds
d. 85 seconds

5. The nurse has just completed discharge teaching for a client who had aortic valve replacement with a
mechanical health valve. Which statement by the client indicates that teaching has been effective?
a. “I’m glad that I can continue taking my Ginkgo biloba.”
b. “I will increase my intake of leafy green vegetables.”
c. “I will start applying vitamin E to my chest incision after showering.”
d. “I will shave with an electric razor from now on.”

6. A graduate student, who has been studying for final exams and using energy drinks to stay awake, comes to
the clinic reporting a fluttering feeling in the chest. The student is connected to the cardiac monitor that
displays the rhythm in the exhibit. The nurse recognizes this as which rhythm?

a. Atrial flutter
b. Sinus rhythm with premature atrial contractions (PACs)
c. Sinus rhythm with premature ventricular contractions (PVCs)
d. Ventricular tachycardia
7. The nurse is caring for a client on IV heparin infusion and oral warfarin. Current laboratory values indicate that
the client’s aPTT is 5 times the control value and the PT/INR is 2 times the control value. What action does
the nurse anticipate?
a. Clarify vegetable consumption with client
b. Decrease the heparin rate
c. Decrease the warfarin dose
d. Obtain an order for Vitamin K injection
8. A client is diagnosed with a small thoracic aortic aneurysm during a routine chest x-ray and follows up 6
months later with the HCP. Which assessment data is most important for the nurse to report to the HCP?
a. Blood pressure of 140/86 mm Hg
b. Difficulty swallowing
c. Dry, hacking cough
d. Low back pain

9. A nurse is teaching the parents of an infant with tetralogy of fallot. Which of the following actions should the
nurse include to reduce the incidence of hypercyanotic spells? Select all that apply.
a. Encourage smaller, frequent feedings
b. Offer a pacifier when the infant begins to cry
c. Promote a quiet period upon walking in the morning
d. Swaddle the infant during procedures
e. Turn the infant frequently during sleep

10. The nurse is preparing to administer 160 mg of furosemide via IV piggyback to a client with chronic kidney
disease and fluid overload. The nurse plans to give the dose slowly 40 minutes to prevent which adverse
effect?
a. Bradycardia
b. Hypokalemia
c. Nephrotoxicity
d. Ototoxicity

11. A client is admitted with palpitations. The ECG shows supraventricular tachycardia with a rate of 220/min. the
nurse has received an order to administer adenosine 6 mg IV. Which action should the nurse take?
a. Adenosine is contraindicated for SVT. Verify the order with the HCP
b. Administer medication only through a central venous access
c. Administer medication rapidly over 1-2 seconds followed by a saline flush
d. Mix medication in 50 mL normal saline and administer over 10 minutes

12. The nurse on the step-down cardiothoracic unit receives the change-of-shift hand-off report. Which client
should the nurse assess first?
a. 2 days postabdominal aortic aneurysm repair with a pedal pulse decreased from baseline
b. 2 days postcoronary bypass graft surgery with a white blood cell count of 18,000/mm3 (18.0 x 10 9/)
c. Cardiomyopathy with an injection fraction of 25% and dyspnea on exertion
d. Pneumothorax with a chest tube to negative suction and subcutaneous emphysema

13. The nurse is assessing a client with hypertension and essential tremor 2 hours after receiving first dose of
propranolol. Which assessment is most concerning to the nurse?
a. Client reports a headache
b. Current blood pressure is 160/80mmHg
c. Heart rate has dropped from 70/min to 60/min
d. Slight wheezes auscultated during inspiration

14. The nurse evaluates morning laboratory results for several clients who were admitted 24 hours earlier. Which
laboratory report requires priority follow-up?
a. Client with chronic obstructive pulmonary disease who has a PaCO2 of 52 mmHg
b. Client with heart failure who has a brain natriuretic peptide level of 800 pg/mL
c. Client with infected pressure ulcer who has a WBC of 13,000/mm3
d. Client with pulmonary embolism who has a partial thromboplastin time of 127 seconds

15. The nurse prepares to administer morning medications to assigned clients. Which prescription should the
nurse clarify with the HCP?
a. Clopidogrel for client with history of stroke and platelet count of 154,000/mm3
b. Losartan for client with hypertension who is 8 weeks pregnant
c. Prednisone for client with herpes simplex lesions and bells palsy
d. Tiotropium for client pneumonia and COPD
16. The nurse on a medical surgical unit enters a room, finds a client unresponsive with no pulse and starts 2
minutes of CPR. The nurse receives and attaches an automated external defibrillator, but no shock is advised.
Which action should the nurse perform next?
a. Check for a carotid pulse for at least 10 seconds
b. Provide rescue breaths at a rate of 10-12/min
c. Resume chest compressions at a rate of 100/min
d. Use the jaw-thrust maneuver to assess the airway

17. A client with mitral valve prolapse has been experiencing occasional palpitations, lightheadedness, and
dizziness. The HCP prescribes a beta blocker. What additional teaching should the nurse include for this
client?
a. Avoid aerobic exercise
b. Ensure you receive antibiotics prior to dental work
c. Stay well hydrated and avoid caffeine
d. Wear a medical alert bracelet

18. The nurse is teaching a client who is scheduled to have an inferior vena cava filter inserted via the right
femoral vein. Which statement by the client requires further teaching?
a. “I need to make all HCP aware of my filter before I have body scans.”
b. “I need to stay active and avoid crossing my legs for extended periods when I get home.”
c. “I should call the HCP if I develop numbness, tingling, and swelling in my right leg.”
d. “It is normal to have some chest or back discomfort for a few days after filter placement.”

19. Which prescriptions for these clients does the nurse question? Select all that apply.
a. Client with C. difficile colitis, prescribed vancomycin 125 mg PO
b. Client with diabetes and elevated mealtime glucose, prescribed lispro insulin scale 6 units subcutaneously
c. Client with gastrointestinal bleed and NGT, prescribed pantroprazole 40 mg intravenous
d. Client with hypertension and blood pressure 94/40 mmHg, prescribed metoprolol succinate SR 50 mg PO
e. Client with otitis media and penicillin allergy, prescribed ampicillin 500 mg PO

20. A client admitted with acute myocardial infarction suddenly displays air hunger, dyspnea, and coughing with
frothy, pink-tinged sputum. What would the nurse anticipate when auscultating the breath sounds of this
client?
a. Bronchial breath sounds at lung periphery
b. Clear vesicular breath sounds at lung bases
c. Diffuse bilateral crackles at lung bases
d. Stridor in upper airways

21. What clinical symptoms might the nurse expect to find in a client with a central venous pressure of 24 mmHg?
Select all that apply.
a. Crackles in lungs
b. Dry mucous membranes
c. Hypotension
d. Jugular venous distension
e. Pedal edema

22. An experienced nurse is mentoring a new registered nurse on the telemetry unit. The new RN is measuring
orthostatic blood pressure for a client. Which situation would warrant intervention by the experienced nurse?
a. Nurse has client lie supine for 5-10 minutes prior to starting procedure
b. Nurse interprets a decrease in systolic BP by 10 mm Hg as a normal finding
c. Nurse starts by measuring BP and heart rate with the client standing
d. Nurse takes BP and HR after standing at 1- and 3-minute intervals

23. The cardiac unit has standing instructions that the HCP should be notified of an abnormal mean arterial
pressure. The nurse will need to notify the HCP about which client?
a. A client from the cardiac catheterization lab with a blood pressure of 102/58 mmHg
b. A client just admitted from the emergency department with a BP of 150/72 mmHg
c. A client with a BP of 92/60 mm Hg who just received a dose of nitroglycerin
d. A client with heart failure on metoprolol with a BP of 106/42 mm Hg
24. A client is in the cardiovascular clinic for a 3-month follow-up visit. At the first visit, the client was prescribed
hydrochlorothiazide and amlodipine for hypertension. Which statement by the client would be concerning to
the nurse and should be reported to the primary HCP?
a. “I like to have a banana every morning with my breakfast.”
b. “I occasionally experience slight dizziness when I get up in the morning.”
c. “I started taking licorice root for my occasional heartburn.”
d. “I usually take my hydrochlorothiazide first thing in the morning.”

25. A nurse caring for a client with a central venous catheter enters the client’s room and notes that the CVC is
dislodged and lying in the client’s bed linens. The client appears cyanotic and is tachypneic and diaphoretic.
Which of the following actions by the nurse are appropriate? Select all that apply.
a. Administer oxygen via non-rebreather mask
b. Apply an occlusive dressing over the insertion site
c. Assist the client to high Fowler position
d. Monitor vital signs and respiratory effort
e. Notify the HCP

26. The nurse should plan to teach which client about the need for prophylactic antibiotics prior to dental
procedures?
a. Client who had a large anterior wall myocardial infarction with subsequent heart failure
b. Client who had a mitral valvuloplasty repair
c. Client with a mechanical aortic valve replacement
d. Client with mitral valve prolapse wit regurgitation

27. A client with hypertension and type 2 diabetes has recently started taking chlorthalidone. Which report by the
client is most concerning to the nurse?
a. Dizziness on standing
b. Fasting blood glucose of 160 mg/dL
c. Presence of muscle cramps
d. Sunburn on both arms

28. The nurse is caring for a client with cardiomyopathy and coronary artery disease. The client is reporting
increasing chest pain and has bilateral lung crackles on auscultation. The HCP has written several new
prescriptions. Which new prescription should the nurse clarify? Select all that apply.

Vital signs
Blood pressure 84/58 mmHg
Heart rate 108/min
Respirations 28/min
Oxygen saturation 90%
a. Administer 2,000 mL normal saline bolus
b. Administer IV nitroglycerin
c. Apply 4 L oxygen by nasal cannula
d. Obtain a STAT 12-lead ECG
e. Obtain blood for cardiac enzyme testing

29. The nurse cares for a client who had an abdominal aortic aneurysm repair 6 hours ago. Which assessment
findings would indicate possible graft leakage and require a report to the HCP? Select all that apply.
a. Ecchymosis of the scrotum
b. Increased abdominal girth
c. Increased urinary output
d. Report of groin pain
e. Report of increased thirst and appetite loss

30. A client diagnosed with heart failure has an 8-hour urine output of 200 mL. What is the nurse’s first action?
a. Auscultate the client’s breath sounds
b. Encourage the client to increase fluid intake
c. Report the findings to the HCP
d. Start an intravenous line for diuretic administration

“All our dreams will come true if we have the courage to pursue them” – Walt Disney