Med-Surg Cardiovascular Exam

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Sample questions from Med-Surg Cardiovascular Exam

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

1. 1.In the emergency department, a 67-year-old client reports crushing chest pressure radiating to the jaw that began 20 minutes ago. The client is diaphoretic, and the initial ECG shows ST-segment elevation in leads II, III, and aVF. Which action should the nurse take first?

   • A.Obtain a 12-lead ECG and activate the facility's reperfusion protocol
   • B.Encourage the client to walk to determine whether activity worsens the pain
   • C.Administer sublingual nitroglycerin before checking the client's blood pressure
   • D.Collect a fasting lipid panel before initiating treatment

   Rationale: The ECG and symptoms indicate an acute inferior STEMI, which requires rapid recognition and activation of reperfusion care. Nitroglycerin may be prescribed, but blood pressure and contraindications must be assessed first, and it must not delay reperfusion. A lipid panel is not time-critical, and ambulation could increase myocardial oxygen demand. The exam takeaway is to prioritize rapid ECG-based STEMI response over routine testing or activity.

2. 2.During a home visit, a 72-year-old client with heart failure reports gaining 2.3 kg (5 lb) in 3 days and needing extra pillows to sleep. Which instruction is the priority?

   • A.Increase daily fluid intake to help the kidneys remove excess sodium
   • B.Stop taking the prescribed diuretic until the breathing improves
   • C.Wait one week and report the weight at the next scheduled appointment
   • D.Contact the health care provider promptly to report the weight gain and worsening orthopnea

   Rationale: Rapid weight gain and worsening orthopnea suggest fluid retention and possible decompensation, so the client should promptly contact the provider for evaluation and treatment adjustment. Stopping a diuretic can worsen fluid overload, and increasing fluids can add to it. Waiting a week delays response to a meaningful change. Teach clients with heart failure to track daily weight and report rapid gains and worsening symptoms.

3. 3.Refer to the client's chart. Which actions should the nurse anticipate or implement promptly in response to the documented changes? Select all that apply.

   • A.Document the rhythm change and reassess at the next routine observation time
   • B.Encourage the client to ambulate to reduce the ventricular rate
   • C.Notify the provider of the new irregular tachycardia and falling blood pressure
   • D.Assess for signs of impaired perfusion, including chest discomfort and altered mental status
   • E.Prepare for prescribed rate-control treatment while monitoring blood pressure and ECG

   Rationale: The chart shows a new irregular rhythm with the heart rate rising from 88 to 142/min and blood pressure falling from 126/76 to 94/58 mm Hg, requiring prompt provider notification and assessment for impaired perfusion. The nurse should anticipate prescribed rate-control therapy while closely monitoring the ECG and hemodynamic response. Ambulation is unsafe with tachycardia and hypotension, and waiting until routine observations risks delaying treatment. A new symptomatic rhythm change calls for timely action and reassessment.

4. 4.A 16-year-old client taking digoxin for a congenital heart condition reports nausea and seeing yellow halos around lights. The apical pulse is 54/min. What should the nurse do?

   • A.Give the dose with food and reassess in one hour
   • B.Hold the dose and notify the health care provider
   • C.Encourage the client to take an extra dose to correct the slow pulse
   • D.Document the findings as expected effects of digoxin

   Answer and rationale are in the full material.

5. 5.A client at 2 hours postpartum suddenly develops severe dyspnea, pleuritic chest pain, and an SpO2 of 86%. Which action should the nurse take first?

   • A.Assist the client to walk to improve circulation
   • B.Offer oral fluids and reassess the oxygen saturation in 30 minutes
   • C.Apply oxygen and activate the emergency response system
   • D.Massage the lower legs to reduce venous stasis

   Answer and rationale are in the full material.