1. Atherosclerosis impedes coronary blood flow by which of the following mechanisms?

A. Plaques obstruct the vein.
B. Plaques obstruct the artery.
C. Blood clots form outside the vessel wall.
D. Hardened vessels dilate to allow blood to flow through.

2. 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.

3. What criteria should the nurse use to determine normal sinus rhythm for a client on a cardiac monitor? Select all that apply.

A. The RR intervals are relatively consistent.
B. One P wave precedes each QRS complex.
C. Four to eight complexes occur in a 6-second strip.
D. The ST segment is higher than the PR interval.

4. A client with no history of cardiovascular disease comes into the ambulatory clinic with flu-like 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 ten (10) being the worst?”

5. A nurse is assessing an electrocardiogram rhythm strip. The P waves and QRS complexes are regular. The PR interval is 0.16 second, and QRS complexes measure 0.06 second. The overall heart rate is 64 beats per minute. The nurse assesses the cardiac rhythm as:

A. Normal sinus rhythm
B. Sinus bradycardia
C. Sick sinus syndrome
D. First-degree heart block

6. A nurse notes 2+ bilateral edema in the lower extremities of a client with myocardial infarction who was admitted two (2) days ago. The nurse would plan to do which of the following next?

A. Review the intake and output records for the last two (2) days.
B. Change the time of diuretic administration from morning to evening.
C. Request a sodium restriction of one (1) g/day from the physician.
D. Order daily weight starting the following morning.

8. When auscultating the apical pulse of a client who has atrial fibrillation, the nurse would expect to hear a rhythm that is characterized by:

A. The presence of occasional coupled beats.
B. Long pauses in an otherwise regular rhythm.
C. A continuous and totally unpredictable irregularity.
D. Slow but strong and regular beats.

9. When auscultating the apical pulse of a client who has atrial fibrillation, the nurse would expect to hear a rhythm that is characterized by:

A. The presence of occasional coupled beats.
B. Long pauses in an otherwise regular rhythm.
C. A continuous and totally unpredictable irregularity.
D. Slow but strong and regular beats.

10. A paradoxical pulse occurs in a client who had a coronary artery bypass graft (CABG) surgery two (2) days ago. Which of the following surgical complications should the nurse suspect?

A. Left-sided heart failure
B. Aortic regurgitation
C. Complete heart block
D. Pericardial tamponade

10. When ventricular fibrillation occurs in a CCU, the first person reaching the client should:

A. Administer oxygen.
B. Defibrillate the client.
C. Initiate CPR.
D. Administer sodium bicarbonate intravenously.

11. A client with a bundle branch block is on a cardiac monitor. The nurse should expect to observe:

A. Sagging ST segments.
B. Absence of P wave configurations.
C. Inverted T waves following each QRS complex.
D. Widening of QRS complexes to 0.12 second or greater.

12. 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