Cardiac Exams Relias

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Sample questions from Cardiac Exams Relias

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A 62-year-old client arrives at the emergency department with 30 minutes of crushing chest pressure, diaphoresis, and nausea. Blood pressure is 88/54 mm Hg, heart rate is 112/min, and oxygen saturation is 95% on room air. Which action should the nurse take first?

   • A.Obtain a 12-lead ECG and activate the acute coronary syndrome response
   • B.Administer sublingual nitroglycerin
   • C.Give oral aspirin with a full glass of water
   • D.Apply oxygen at 2 L/min by nasal cannula

   Rationale: A rapid 12-lead ECG and activation of the response team support timely identification and treatment of a possible myocardial infarction. Nitroglycerin may further lower this client's already low blood pressure, and oral intake is not the priority during an unstable presentation. Oxygen is not routinely indicated with an oxygen saturation of 95% unless hypoxemia or respiratory distress develops.

2. 2.A 70-year-old client is admitted to the telemetry unit with acute chest pain. The ECG shows ST elevation in leads II, III, and aVF; blood pressure is 126/74 mm Hg and oxygen saturation is 97%. Which order should the nurse implement first?

   • A.Prepare the client for emergent coronary reperfusion
   • B.Schedule an exercise stress test
   • C.Administer a dose of oral atorvastatin and reassess in 4 hours
   • D.Obtain a fasting lipid panel before notifying the provider

   Rationale: ST elevation in contiguous leads with acute symptoms requires immediate reperfusion planning, such as activation of the cardiac catheterization team. A stress test is inappropriate during an acute infarction, and a statin or lipid panel must not delay reperfusion. The exam takeaway is to prioritize time-sensitive treatment over routine risk assessment.

3. 3.A 58-year-old client is 2 hours post femoral cardiac catheterization on a telemetry unit. The client reports sudden back pain and becomes pale; blood pressure is 82/48 mm Hg and heart rate is 124/min. What should the nurse do first?

   • A.Apply firm pressure to the access site and activate emergency assistance
   • B.Elevate the head of the bed and reassess in 15 minutes
   • C.Encourage oral fluids and document the findings
   • D.Assist the client to ambulate to relieve discomfort

   Rationale: Hypotension, tachycardia, pallor, and back pain after femoral access suggest serious bleeding, including possible retroperitoneal hemorrhage, so emergency help and bleeding control are needed. Waiting to reassess or encouraging fluids delays treatment of potential shock. Ambulation is unsafe and could worsen bleeding.

4. 4.A 66-year-old client with heart failure reports worsening shortness of breath while lying flat. The nurse finds crackles, oxygen saturation of 88%, and a respiratory rate of 30/min. Which action is the priority?

   • A.Sit the client upright and apply oxygen as prescribed
   • B.Obtain the client's daily weight
   • C.Offer a low-sodium snack
   • D.Teach the client to restrict fluids at home

   Answer and rationale are in the full material.

5. 5.A 74-year-old client with heart failure is taking digoxin and furosemide. Before the morning medications, the nurse notes nausea, yellow-green visual halos, and an apical pulse of 52/min; potassium is 3.0 mEq/L. Which action should the nurse take?

   • A.Hold digoxin and notify the provider
   • B.Administer digoxin with food to reduce nausea
   • C.Give the furosemide and recheck the pulse in 1 hour
   • D.Encourage a high-sodium meal before giving both medications

   Answer and rationale are in the full material.