Deck 1: Intervention

Question 1

A cardiac care nurse is explaining a triple bypass surgery and obtaining consent for the surgery. Which of the following should the nurse ensure have been explained to the patient and the family?

A)Risk involved in the surgery
B)Benefits of the surgery
C)Serious complications of surgery like stroke, myocardial infarction, or death
D)All of above

Answer 1

All of above

Question 2

A patient presents with post-operative hemorrhage after cardiac surgery. What initial steps should the attending nurse take?

A)Measure clotting factors stat: INR, PTT, fibrinogen, platelet count, activated clotting time
B)Correct with fresh frozen plasma, cryoprecipitate, platelets, DDAVP
C)Administer protamine to reverse heparinization
D)Give tranexamic acid bolus (50 mg/kg)

Answer 2

Measure clotting factors stat: INR, PTT, fibrinogen, platelet count, activated clotting time

Question 3

A patient known to have AF (atrial fibrillation) presents with acute pain in his left lower limb and over the course of several hours he experiences a loss of sensation in the area and the limb becomes numb and cold. What is the first treatment the nurse should take?

A)Send the patient for arteriography
B)Immediate heparinization
C)Prepare the patient for embolectomy
D)Identify and treat the underlying cause

Answer 3

Immediate heparinization

Question 4

A patient presents with post-operative hemorrhage after undergoing cardiac surgery. Which of the following should prompt the attending nurse to consult the cardiothoracic surgeon for surgical exploration?

A)A pulse rate > 100
B)Excess mediastinal tube drainage
C)Patient with history of bleeding disorders
D)Patient who has undergone multiple surgeries

Question 5

A patient recovering from CABG surgery develops renal failure. What measures should the attending nurse take to maintain urine output?

A)Administer IV fluids to hydrate the patient
B)Send the patient for hemodialysis
C)Low-dose dopamine infusion, furosemide by IV bolus or continuous infusion.
D)Send the patient for peritoneal dialysis

Question 6

A patient is scheduled to undergo CABG surgery. Which of the following tests would the nurse not order as a part of pre-operative assessment?

A)CBC, PTT, INR, electrolytes, glucose, BUN, creatinine
B)Stool for occult blood
C)PA and lateral CXR
D)ECG to diagnose heart rhythm abnormalities and myocardial ischemia

Question 7

A patient is scheduled to have mitral valve replacement surgery. He has been taking warfarin therapy because he has atrial fibrillation (AF). What changes to the patient's anticoagulant therapy should the nurse consider?

A)Stop warfarin on the day of surgery
B)Stop warfarin 4-5 days before surgery
C)Stop warfarin 4-5 days prior to surgery; give a heparin product prior to surgery.
D)Continue warfarin therapy

Question 8

A patient has undergone aortic valve replacement surgery. An EKG done post-operatively demonstrates a junctional rhythm. What parameters should the nurse assess before consulting a cardiologist to consider A-V sequential pacing?

A)Rule out digoxin toxicity and myocardial ischemia
B)Rule out hypomagnesemia
C)Make sure that patient is not hypokalemic
D)All of the above

Question 9

A patient presents to an emergency room with acute pain in abdomen; there is a high degree of suspicion that he has a ruptured abdominal aortic aneurysm. What measures should be initiated immediately?

A)Send the patient for abdominal CT scan
B)Start resuscitation after ensuring immediate vascular access
C)Start blood transfusion after grouping and cross-matching
D)Immediate laparotomy

Question 10

A 64-year-old male patient was scheduled to undergo CABG surgery after a coronary angiogram. During pre-cardiac surgery education, the nurse should explain to the patient that the objective of the bypass surgery is:

A)Revascularization of selected area of myocardium
B)Complete revascularization of the myocardium
C)Correction of the abnormalities of the coronary arteries
D)Removal of the diseased part of the coronary artery

Question 11

A nurse is taking care of a 50-year-old patient who has undergone mitral valve replacement surgery. The patient develops a perioperative myocardial infarction, and the doctor orders a continuous IV infusion of nitroglycerin. Which of the following is the most important action to be taken by this nurse?

A)Start the medication using an infusion pump
B)Frequent monitoring of urine output
C)Frequent monitoring of blood pressure
D)Measure the patient's serum potassium

Question 12

A patient who has undergone mitral valve replacement surgery complains of bleeding from the surgical incision. Which of the following medications should the attending nurse be prepared to administer to the patient?

A)Vitamin K
B)Vitamin C
C)Protamine Sulfate
D)Coumadin

Question 13

A patient presents to an emergency room after trauma to his left lower limb. Which of the following is the most important P of the 6 Ps that are used to assess the severity of trauma to an extremity?

A)Pain
B)Paralysis
C)Pulselessness
D)Pallor

Question 14

A patient presents with acute arterial occlusion of one of his upper limbs. Which of the following drugs should the nurse prepared to administer to the patient?

A)Clopidogrel
B)Heparin
C)Warfarin
D)Urokinase

Question 15

The patient was on cardiopulmonary bypass while undergoing CABG surgery. What should be the first parameter the nurse should assess before weaning the patient from cardiopulmonary bypass?

A)Serum magnesium
B)Pulmonary status
C)Body temperature
D)Urine output

Question 16

A patient with history of arterial trauma presents to emergency with severe pain in right lower limb. Which of the following findings during the nursing assessment indicates arterial occlusion?

A)Paraesthesia
B)Paralysis
C)Pulselessness
D)All of above

Question 17

A nurse is planning to give pre-procedure teaching to a patient about the benefits of percutaneous transluminal coronary angioplasty (PTCA ). Which of the following is the most important for the patient to be taught?

A)The stent helps to increase the coronary blood flow
B)The procedure is done through distal arteries.
C)Balloon pressure decreases plaque size and stretches the vessel.
D)The goal is to increase blood flow by reducing plaque build-up.

Question 18

A 60-year-old patient had undergone embolectomy for arterial emboli. What anticoagulant drug modification should the attending nurse do post-operatively?

A)Stop heparin and start aspirin.
B)Continue heparin infusion only
C)Continue heparin post-operatively and start warfarin
D)Stop all anticoagulant medication after surgery

Question 19

A patient with venous insufficiency has questions about the anatomy of venous system. What are the important parts of venous system that the nurse should explain?

A)The superficial venous system, communicating venous system, deep venous system, and venous valves
B)The deep venous system
C)The superficial venous system
D)The valves

Question 20

A patient is being discharged from the hospital after undergoing PTCA. What advice should the nurse give to the patient about follow up tests?

A)Repeat INR every month for 6 months
B)Cardiac stress testing to be performed 2-6 months after the procedure
C)Repeat cardiac enzymes every month for 6 months
D)Repeat cardiac enzymes, hematocrit, INR every month

Question 21

The nurse is going to assist the interventionist during PCTA. Which drugs should the nurse be prepared to administer?

A)Heparin, streptokinase
B)Heparin, nitroglycerin, abciximab
C)Heparin, warfarin
D)Heparin, warfarin, aspirin

Question 22

A patient is scheduled to undergo coronary atherectomy. What should the nurse explain to patient about the procedure during pre-procedure teaching?

A)The procedure is done via the femoral, brachial or radial artery
B)Coronary atherectomy uses a grinding/cutting tool to clear plaque from diseased coronary arteries. It can be combined with percutaneous transluminal coronary angioplasty and/or a stent procedure
C)A grinding/cutting tool is used to clear plaque from diseased coronary arteries
D)Tell the patient about different types of atherectomies

Question 23

What are the possible post-operative complications of PCTA of a lower extremity that a nurse must be aware of?

A)Myocardial infarction, angina
B)Vasospasm, thrombus formation, arterial dissection, vessel perforation, compartment syndrome
C)Aneurysmal rupture, dissection of the aorta
D)Circulatory shock, renal failure

Question 24

What medications should the nurse give to a patient being prepared for PCTA of the carotid artery?

A)Heparin, atropine, nifedipine
B)Heparin, aspirin, clopidogrel
C)Heparin, warfarin, aspirin
D)Heparin, clopidogrel, warfarin

Question 25

A nurse is counseling a patient who has had balloon valvuloplasty of the mitral valve. Which of the following is the correct post-operative follow-up interval and post-operative test?

A)Consult the clinician 1 month post-procedure: an echocardiogram 3 to 6 months post-procedure
B)Consult the clinician 1 week post-procedure: an echocardiogram 3 to 6 months post-procedure
C)Consult the clinician 1 week post-procedure: an echocardiogram 1 month post-procedure
D)Consult the clinician 1 month post-procedure: an echocardiogram 1 month post-procedure

Question 26

Which of the following is the most accurate information to tell a patient about how artificial pacemakers work?

A)Artificial pacemakers generate electricity
B)Artificial pacemakers provide electrical stimulation to the heart when its own pacemaker cannot meet the metabolic needs of the body
C)Artificial pacemakers help the heart muscles to contract
D)Artificial pacemakers increase the cardiac output

Question 27

Which of the following signs and symptoms would the attending nurse expect to observe in a patient who has a ruptured aneurysm?

A)Pain abdomen, hypertension, bradycardia
B)Hypotension, tachycardia, nausea, vomiting, shortness of breath, chest pain/lower back/abdominal pain
C)Headache, nausea, vomiting, vertigo
D)Hypertension, chest pain, syncope

Question 28

What lifestyle modifications should the nurse recommend to a patient who has atherosclerotic disease and dyslipidemia?

A)Restriction of physical activity, dietary supplementation, smoking cessation
B)Physical exercise, healthy diet, smoking cessation
C)Physical exercise, healthy diet, dietary supplementation, smoking cessation
D)Restriction of physical activity, diet rich in saturated fat, smoking cessation

Question 29

Which of the following is true as per the code of ethics for nurses?

A)Nurses are moral agents when providing care
B)Nurses keep person receiving care, families, and employers informed about potential and actual change to delivery of care
C)Nurses respect the wishes of capable persons to decline to receive information about their health condition
D)All of the above

Question 30

The 3 domains of adult learning include which of the following?

A)Cognitive learning, sensory learning, motor learning,
B)Cognitive learning, psychomotor learning, affective learning
C)Psychomotor learning, psychosocial learning, behavioral learning
D)Cognitive learning, psychosocial learning, motor learning

Question 31

The nurse enters the room of a patient who has otosclerosis and significant hearing loss. What is the most appropriate action for the nurse?

A)Speak loudly immediately after entering the room
B)Speak to the patient directly in a simple language
C)Announce his/her presence in a normal voice and explain what he/she is doing
D)Sit/stand close to the patient and speak slowly and clearly

Question 32

A nurse is giving an educational pamphlet to a patient with reduced visual acuity. What is the most appropriate way to print the pamphlet?

A)Letters in normal size font, printed in black ink on a white paper
B)Letters in large font, printed in black ink on a white paper
C)Letters in large font, printed with black ink on yellow colored paper
D)Letters in large font, printed with a contrast color ink on paper of any color

Question 33

Which of the following examinations are parts of the post-operative neurological assessment of a patient who has undergone carotid endarterectomy during post-op period?

A)Level of consciousness, response to verbal stimuli, orientation to time and place
B)Level of consciousness, response to verbal stimuli, sensation to touch
C)Level of consciousness, sensation, motor strength and reflexes, pupil size and reaction to light
D)Level of consciousness, vibration and position sense, function of the vocal cords

Question 34

What should be the focus of the team taking pre-operative care of a patient who will be undergoing cardiac transplant surgery?

A)Immunosuppression, acute renal failure, arrhythmia, left ventricular dysfunction
B)Immunosuppression, acute renal failure, tachycardia, right ventricular dysfunction
C)Immunosuppression, acute renal failure, bradycardia, and right ventricular dysfunction
D)Immunosuppression, cardiac failure, left ventricular dysfunction, arrhythmia

Question 35

According to current guidelines, to which of the following patients should the nurse explain the routine screening for aneurysms?

A)70-year-old non-smoker male patient
B)62-year-old male patient whose father died of aneurysmal rupture
C)65-year-old diabetic female patient
D)55-year-old male patient with family history of aneurysm

Question 36

A patient is being released from hospital after treatment of congestive heart failure. His son is anxious to know if the progression and severity of the disease can be prevented by lifestyle modification or prophylactic medications. What advice should the attending nurse give him?

A)Avoid alcohol and smoking, maintain proper blood pressure, reduce salt and fluid intake, and maintain an active lifestyle
B)Treatment of co-morbidities can significantly help prevent progression of disease
C)Avoiding alcohol and smoking and diet containing low sodium and fat are enough
D)Nothing needs to be done except for maintaining an active lifestyle

Question 37

A 75-year-old male who has diabetes presents to emergency with sudden onset of chest pain radiating to the arms. The pain has persisted for 2 hours; he is also diaphoretic. His EKG shows ST-T elevation changes in precordial leads. Which of the following medications would be the first ones the nurse should be prepared to administer to this patient?

A)Streptokinase, nitroglycerin, heparin, morphine
B)Streptokinase, angiotensin receptor blocker
C)Heparin, ACE inhibitor, furosemide
D)Tirofiban, hydrochlorothiazide, clopidogrel

Question 38

A patient is has been diagnosed as having DVT. Which of the following set of investigations should the nurse order to establish the cause of his condition?

A)CT angiogram, impedance plethysmography
B)Platelet count, bleeding and clotting time, prothrombin time
C)Antithrombin III, protein C, protein S, factor V Leiden, prothrombin 2020a mutation, lupus anticoagulant and anticardiolipin antibodies
D)Tests for endothelial dysfunction, venous doppler

Question 39

After undergoing aortic valve replacement, a 70-year-old male complains of palpitations and dizziness. The nurse records his blood pressure as 110/70 mm Hg. The nurse also records an EKG. Which of the following EKG findings would prompt the nurse to consider a diagnosis of atrial fibrillation?

A)Presence of abnormal P waves with irregular R-R intervals
B)Absent P waves with regular R-R interval
C)Absent P waves, irregular R-R interval, and fibrillatory waves
D)Inverted P waves, regular R-R interval

Question 40

A patient who has hypertension states that after eating he experiences dizziness, fatigue, syncope/ fainting, mental confusion, and lightheadedness. The nurse records a fall in blood pressure after the patient finishes eating. What advice should the nurse give the patient about lifestyle modification to help this condition?

A)Stop taking all antihypertensive medications
B)Exercise after taking meals
C)Eating smaller meals low in carbohydrates
D)Stay in prone position after meals

Question 41

A patient of peripheral arterial disease is being released from hospital. What advice should the nurse give to the patient about foot care?

A)Wash and moisturize feet daily; wear thick socks and comfortable shoes
B)Clean the foot by rubbing with pumice stone
C)Clean feet using soft scrubber and keep dry
D)Clean feet and regularly walk barefoot in morning

Question 42

The nurse calculates the ankle-brachial index (ABI) of a patient as 0.65. The patient wants to know the significance of this value. What is the correct answer given by the nurse?

A)Ankle-brachial index gives the percentage of blockage in the artery of foot
B)Ankle-brachial index is calculated to estimate the degree of arterial occlusion in patients suspected of having peripheral arterial disease. Values between 0.5 and 0.8 suggest moderate degree of peripheral arterial disease
C)Ankle-brachial index gives the estimate of power in the muscles of lower limb
D)Ankle-brachial index gives an idea about the oxygenation of tissues

Question 43

What are the investigations a nurse should order/perform for a patient who recently had implantation of a pacemaker?

A)Exercise ECG testing, echocardiogram, CT scan of chest
B)Echocardiogram, coronary angiography, chest x-ray
C)Exercise ECG testing, stress echocardiogram, chest x-ray
D)Electrocardiogram, echocardiogram, look for swelling, physical assessment

Question 44

A patient is being released after pacemaker implantation. What instruction should the nurse give the patient about follow-up?

A)Patients should be instructed to followup 1 week after permanent pacemaker placement and then every month to check programming and setting of the device
B)Patients should be instructed to followup with 1 week after permanent pacemaker placement and then every 3 to 6 months to check programming and setting of the device
C)Patients should be instructed to followup 1 week after permanent pacemaker placement and then every 3 to 6 months to check battery status of the device
D)Patients should be instructed to followup 1 week after permanent pacemaker placement and then every month to check battery status of the device

Question 45

Which leadership style involves minimal guidance from a leader and provides little feedback to team members?

A)Autocratic
B)Laissez-faire
C)Transactional
D)Transformational

Question 46

Which of the following statements correctly represents the significance of outcome evaluation?

A)It helps in better recovery and follow-up of the patient
B)Outcome evaluation is often useful in evaluating the effectiveness of interventions and identifies areas of improvement
C)Outcome evaluation is a useful tool for ensuring regular follow-up of patient
D)Outcome evaluation is useful in identifying factors which influence recovery

Question 47

In which leadership style is power used to influence team members?

A)Laissez-faire
B)Autocratic
C)Transactional
D)Transformational

Question 48

Team causes, team processes, team effectiveness, and team building are variables of which team building models?

A)Cognitive motivational model of team effectiveness
B)Traditional model of team effectiveness
C)Interventional model of team effectiveness
D)Philosophical model of team effectiveness

Question 49

A patient is wearing a Holter monitor. What instructions should the nurse give to the patient during monitoring?

A)Stop all his regular medications
B)Maintain an activity diary of his physical activities
C)Restrict physical activity
D)Do strenuous exercise

Question 50

The nurse is assessing the tests of a patient with a diagnosis of acute right-sided heart failure. What parameter would be elevated in right-sided heart failure?

A)Central venous pressure (CVP)
B)Cardiac output
C)Left-ventricular end-diastolic pressure
D)Pulmonary capillary wedge pressure (PCWP)

Question 51

The nurse is evaluating the arterial blood oxygenation level on a patient who had a myocardial infarction 2 days ago. What would be the minimal oxygenation saturation level that would reflect adequate oxygen supply to the tissues?

A)88%
B)90%
C)92%
D)95%

Question 52

You are caring for a 47-year-old female who has been admitted to the cardiac care unit. On your rounds you notice that her mean arterial blood pressure (MAP) is decreasing. What is the mean arterial blood pressure?

A)The systolic pressure
B)The point of disappearance of the sounds
C)The average pressure in the circulatory system
D)The increase in the cardiac output

Question 53

What tests should be performed to evaluate a patient after PCTA?

A)Electrocardiogram, echocardiogram, hematocrit, serum creatinine
B)Electrocardiogram, echocardiogram, cardiac enzymes
C)Electrocardiogram, echocardiogram, physical assessment, monitoring of peripheral blood flow
D)Physical assessment and evaluation of cardiac pain

Question 54

A nurse is explaining the post-operative follow-up procedure to a patient who has undergone carotid endarterectomy. Which of the following are the correct instructions?

A)1 week post-procedure and then follow-up after 6 months
B)1 week post-procedure and then follow-up after 1 month
C)1 week post-procedure and then follow-up after 1 month in first month and then after 3 months
D)1 week post-procedure and then follow-up after 3 months

Question 55

The nurse is recording blood pressure and counting pulse rate of a patient who uses cocaine. What is the expected finding in this patient?

A)Hypertension and decreased heart rate
B)Hypertension and increased heart rate
C)Hypotension and increased heart rate
D)Hypotension and decreased heart rate