Cardiology

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Sample questions from Cardiology

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

1. 1.A 68-year-old client in the emergency department reports crushing chest pain radiating to the jaw for 40 minutes. The client is pale and diaphoretic; BP is 88/54 mm Hg, HR 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.Apply oxygen at 2 L/min by nasal cannula
   • D.Give oral aspirin with a sip of water

   Rationale: A 12-lead ECG and rapid escalation identify a potentially time-critical myocardial infarction and guide immediate reperfusion care. Nitroglycerin can worsen this client's hypotension. Oxygen is not indicated solely for chest pain when saturation is 95%, and aspirin is important but should not delay ECG acquisition and escalation.

2. 2.A 74-year-old client on a telemetry unit has sudden dyspnea, crackles, and pink frothy sputum. BP is 172/96 mm Hg, HR 124/min, and oxygen saturation is 82% on room air. Which action should the nurse take first?

   • A.Place the client supine and reassess in 10 minutes
   • B.Sit the client upright and apply oxygen while summoning assistance
   • C.Encourage oral fluids to thin secretions
   • D.Administer the scheduled oral beta blocker

   Rationale: Upright positioning and immediate oxygen support reduce respiratory distress while the nurse summons help for likely acute pulmonary edema. Supine positioning worsens ventilation, and oral fluids may aggravate congestion. A scheduled oral beta blocker is not the priority during severe acute respiratory distress.

3. 3.A 65-year-old client with a history of heart failure is seen in the clinic. The client reports a 2.5-kg (5.5-lb) weight gain in 3 days and increasing ankle swelling; BP is 146/88 mm Hg, HR 92/min, and oxygen saturation is 94%. Which instruction is most appropriate?

   • A.Take an extra dose of furosemide whenever swelling occurs
   • B.Call the provider today to report the rapid weight gain and swelling
   • C.Increase dietary sodium to prevent dizziness
   • D.Stop weighing daily unless shortness of breath develops

   Rationale: Rapid weight gain and edema can signal worsening fluid retention and require prompt assessment and a treatment plan. The client should not independently change a diuretic dose without instructions. Increasing sodium can worsen congestion, and waiting for dyspnea or stopping daily weights delays recognition.

4. 4.A 79-year-old client with atrial fibrillation takes warfarin and is admitted after falling at home. The client is alert, has no visible injury, and has an INR of 4.8; vital signs are stable. Which action should the nurse take first?

   • A.Administer the next scheduled warfarin dose
   • B.Hold warfarin and notify the provider of the INR and fall
   • C.Encourage ambulation to assess balance
   • D.Give vitamin K without a prescription

   Answer and rationale are in the full material.

5. 5.A 71-year-old client in the emergency department has palpitations and dizziness. The monitor shows atrial fibrillation with a ventricular rate of 168/min; BP is 76/42 mm Hg, and the client is confused. Which intervention should the nurse anticipate?

   • A.Synchronized cardioversion
   • B.Oral metoprolol and discharge after rate control
   • C.Vagal maneuvers
   • D.Adenosine rapid IV push

   Answer and rationale are in the full material.