Coronary Artery Disease & Hypertension NCLEX 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?
A) Intake and output
B) Baseline peripheral pulse rates
C) Height and weight
D) Allergy to iodine or shellfish
2. A client with no history of cardiovascular disease comes into the ambulatory clinic with flulike 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?
A) Have you ever had this pain before?
B) Can you describe the pain to me?
C) Does the pain get worse when you breathe in?
D) Can you rate the pain on a scale of 1-10, with 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?
A) Strict bed rest for 24 hours after transfer
B) Bathroom privileges and self-care activities
C) Unsupervised hallway ambulation with distances under 200 feet
D) 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 2 days ago. The nurse would plan to do which of the following
next?
A) Review the intake and output records for the last 2 days
B) Change the time of diuretic administration from morning to evening
C) Request a sodium restriction of 1 g/day from the physician.
D) Order daily weights 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:
A) Check the client status and lead placement
B) Press the recorder button on the electrocardiogram console.
C) Call the physician
D) 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?
A) Seating the client with arm bared, supported, and at heart level.
B) Measuring the blood pressure after the client has been seated quietly for 5 minutes.
C) Using a cuff with a rubber bladder that encircles at least 80% of the limb.
D) 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?
A) Vitamin K
B) Aminocaproic acid
C) Potassium chloride
D) 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:
A) The same as the clients own baseline level
B) Lower than the needed therapeutic level
C) Within the therapeutic range
D) 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:
A) Stimulates the breakdown of specific clotting factors by the liver, and it takes 2-3 days for
this to exert an anticoagulant effect.
B) Inhibits synthesis of specific clotting factors in the liver, and it takes 3-4 days for this
medication to exert an anticoagulant effect.
C) Stimulates production of the bodys own thrombolytic substances, but it takes 2-4 days for
this to begin.
D) 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 2 mg of morphine given intravenously. The nurse should first:
A) Administer the morphine
B) Obtain a 12-lead ECG
C) Obtain the lab work
D) 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:
A) Help keep him well hydrated
B) Dissolve clots he may have
C) Prevent kidney failure
D) 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.

A) Reflects electrical impulse beginning at the SA node

B) Indicated electrical impulse beginning at the AV node
C) Reflects atrial muscle depolarization
D) Identifies ventricular muscle depolarization
E) Has 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:
A) Call for the doctor
B) Start an intravenous line
C) Obtain a portable chest radiograph
D) 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?
A) Cancer
B) Hypertension
C) Liver disease
D) Myocardial infarction
15. When teaching a client about propranolol hydrochloride, the nurse should base the
information on the knowledge that propranolol hydrochloride:
A) Blocks beta-adrenergic stimulation and thus causes decreased heart rate, myocardial
contractility, and conduction.
B) Increases norepinephrine secretion and thus decreases blood pressure and heart rate.
C) Is a potent arterial and venous vasodilator that reduces peripheral vascular resistance and
lowers blood pressure.
D) 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:
A) Learn how to avoid stress
B) Explore a job change or early retirement
C) Make a commitment to long-term therapy
D) 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:
A) Cerebrovascular accident
B) Liver disease
C) Myocardial infarction
D) 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?
A) Visit her friend earlier in the day.
B) Rest for at least an hour before climbing the stairs.
C) Take a nitroglycerin tablet before climbing the stairs.
D) 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?
A) A change in the pattern of her pain
B) Pain during sex
C) Pain during an argument with her husband
D) 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:
A) Open and dilate the blocked coronary arteries
B) Assess the extent of arterial blockage
C) Bypass obstructed vessels
D) 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:
A) Antispasmodic effect on the pericardium
B) Causing an increased myocardial oxygen demand
C) Vasodilation of peripheral vasculature
D) Improved conductivity in the myocardium
22. The nurse teaches the client with angina about the common expected side effects of
nitroglycerin, including:
A) Headache
B) High blood pressure
C) Shortness of breath
D) 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?
A) Take one tablet every 2 to 5 minutes until the pain stops.
B) Take one tablet and rest for 10 minutes. Call the physician if pain persists after 10 minutes.

C) Take one tablet, then an additional tablet every 5 minutes for a total of 3 tablets. Call the
physician if pain persists after three tablets.
D) Take one tablet. If pain persists after 5 minutes, take two tablets. If pain still persists 5
minutes later, call the physician.
24. Which of the following arteries primarily feeds the anterior wall of the heart?
A) Circumflex artery
B) Internal mammary artery
C) Left anterior descending artery
D) Right coronary artery
25. When do coronary arteries primarily receive blood flow?
A) During inspiration
B) During diastolic
C) During expiration
D) During systole
http://nurseslabs.com/nclex-exam-coronary-artery-disease-hypertension-50-items/