Coronary Artery Disease Exam
Coronary Artery Disease Exam
Coronary Artery Disease Exam
1) Medical treatment of coronary artery disease includes which of the following procedures?
A. Cardiac catheterization
B. Coronary artery bypass surgery
C. Oral medication administration
D. Percutaneous transluminal coronary angioplasty
2) Atherosclerosis impedes coronary blood flow by which of the following mechanisms?
A. Apnea
B. Anginal pain
C. Respiratory alkalosis
D. Metabolic acidosis
4) Which of the following risk factors for coronary artery disease cannot be corrected?
A. Cigarette smoking
B. DM
C. Heredity
D. HPN
5) Preventable factors that increase the risk of CAD include:
A. Obesity.
B. Heredity.
C. Gender.
D. Age.
7) A male client admitted to an acute care facility with pneumonia is receiving supplemental
oxygen, 2 L/minute via nasal cannula. The client’s history includes chronic obstructive pulmonary
disease (COPD) and coronary artery disease. Because of these history findings, the nurse closely
monitors the oxygen flow and the client’s respiratory status. Which complication may arise if the
client receives a high oxygen concentration?
A. Apnea
B. Anginal pain
C. Respiratory alkalosis
D. Metabolic acidosis
8) Women in the lower socioeconomic group have the highest contribution to CAD related
events for their gender.
A. True
B. False
9) Prolonged occlusion of the right coronary artery produces an infarction in which of he
following areas of the heart?
A. Anterior
B. Apical
C. Inferior
D. Lateral
10) When teaching a client with coronary artery disease about nutrition, the nurse should
emphasize
A. Headache
B. Sleep problems
C. Pain or discomfort in the chest, arms or lower jaw
D. Diarrhea
12) Which of the following illnesses is the leading cause of death in the US?
A. Cancer
B. Coronary artery disease
C. Liver failure
D. Renal failure
13) Which of the following conditions most commonly results in CAD?
A. Atherosclerosis
B. DM
C. MI
D. Renal failure
14) Which of the following diagnostic tools is most commonly used to determine the location of
myocardial damage?
A. Cardiac catheterization
B. Cardiac enzymes
C. Echocardiogram
D. Electrocardiogram
15) One possible treatment for CAD is coronary angioplasty. What does it involve?
A. Decrease anxiety
B. Enhance myocardial oxygenation
C. Administer sublignual nitroglycerin
D. Educate the client about his symptoms
17) Exceeding which of the following serum cholesterol levels significantly increases the risk of
coronary artery disease?
A. 100 mg/dl
B. 150 mg/dl
C. 175 mg/dl
D. 200 mg/dl
18) Which procedure or test is used to diagnose CAD?
A. Electrocardiogram
B. Treadmill stress test
C. Cardiac catheterization
D. All of the above
19) A client is scheduled for a cardiac catherization using a radiopaque dye. Which of the
following assessments is most critical before the procedure?
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.
23) 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. 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.
25) 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. Aminocaporic acid
C. Potassium chloride
D. Protamine sulfate
26) A client is at risk for pulmonary embolism and is on anticoagulant therapy with warfarin
(Coumadin). The client’s prothrombin time is 20 seconds, with a control of 11 seconds. The nurse
assesses that this result is:
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 body’s 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.
28) 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 2mg of morphine given intravenously. The nurse should first:
A. Cancer
B. Hypertension
C. Liver disease
D. Myocardial infarction
33) 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.
34) 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
35) 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
36) 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 friend’s apartment without pain. Which of
the following measures that the nurse could suggest would most likely help the client deal with
this problem?
A. Headache
B. High blood pressure
C. Shortness of breath
D. Stomach cramps
41) 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. Circumflex artery
B. Internal mammary artery
C. Left anterior descending artery
D. Right coronary artery
43) When do coronary arteries primarily receive blood flow?
A. During inspiration
B. During diastolic
C. During expiration
D. During systole
44) A murmur is heard at the second left intercostal space along the left sternal border. Which
valve is this?
A. Aortic
B. Mitral
C. Pulmonic
D. Tricupsid
45) Which of the following blood tests is most indicative of cardiac damage?
A. Lactate dehydrogenase
B. Complete blood count (CBC)
C. Troponin I
D. Creatine kinase (CK)
46) Which of the following types of pain is most characteristic of angina?
A. Knifelike
B. Sharp
C. Shooting
D. Tightness
47) Which of the following parameters is the major determinate of diastolic blood pressure?
A. Baroreceptors
B. Cardiac output
C. Renal function
D. Vascular resistance
48) Which of the following factors can cause blood pressure to drop to normal levels?
A. Kidneys’ excretion of sodium only
B. Kidneys’ retention of sodium and water
C. Kidneys’ excretion of sodium and water
D. Kidneys’ retention of sodium and excretion of water
49) Baroreceptors in the carotid artery walls and aorta respond to which of the following
conditions?
A. Afterload
B. Cardiac output
C. Overload
D. Preload
51) Which of the following terms is used to describe the amount of stretch on the myocardium
at the end of diastole?
A. Afterload
B. Cardiac index
C. Cardiac output
D. Preload
52) A 57-year-old client with a history of asthma is prescribed propanolol (Inderal) to control
hypertension. Before administered propranolol, which of the following actions should the nurse
take first?
A. Hypocalcemia
B. Hypermagnesemia
C. Hypokalemia
D. Hypernatremia
54) A client is receiving spironolactone to treat hypertension. Which of the following instructions
should the nurse provide?
A. “Cardiac rehabilitation is not a cure but can help restore you to many of your former
activities.”
B. “Here we teach you to gradually change your lifestyle to accommodate your heart
disease.”
C. “You are probably right but we can gradually increase your activities so that you can live a
more active life.”
D. “Do you feel that you will have to make some changes in your life now?”
57) To evaluate a client’s condition following cardiac catheterization, the nurse will palpate the
pulse:
A. In all extremities
B. At the insertion site
C. Distal to the catheter insertion
D. Above the catheter insertion
58) A client’s physician orders nuclear cardiography and makes an appointment for a thallium
scan. The purpose of injecting radioisotope into the bloodstream is to detect:
A. “Apply the patch to a nonhairy, nonfatty area of the upper torso or arms.”
B. “Apply the patch to the same site each day to maintain consistent drug absorption.”
C. “If you get a headache, remove the patch for 4 hours and then reapply.”
D. “If you get chest pain, apply a second patch right next to the first patch.”
64) In order to prevent the development of tolerance, the nurse instructs the patient to:
A. Moderate doses of two different types of diuretics are more effective than a large dose of
one type
B. This combination promotes diuresis but decreases the risk of hypokalemia
C. This combination prevents dehydration and hypovolemia
D. Using two drugs increases osmolality of plasma and the glomerular filtration rate
Answers and Rationales