ANCC Cardiovascular Certification Practice Questions

ANCC Cardiovascular Certification Practice Questions Related

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An infant with a ventricular septal defect is receiving digoxin (Lanoxin). Which intervention by the nurse is most appropriate before digoxin administration?

  • A. Take the infant's blood pressure.
  • B. Check the infant's respiratory rate for 1 minute.
  • C. Check the infant's radial pulse for 1 minute.
  • D. Check the infant's apical pulse for 1 minute.
Correct Answer: D

Rationale: The correct answer is D: Check the infant's apical pulse for 1 minute. Before administering digoxin, it is crucial to assess the apical pulse for a full minute to ensure the heart rate is within the appropriate range (usually above 100 bpm in infants). Digoxin can cause bradycardia, so monitoring the apical pulse is essential to prevent potential adverse effects.

A: Taking the infant's blood pressure is not the most appropriate intervention before administering digoxin as the focus should be on assessing the heart rate specifically.

B: Checking the infant's respiratory rate is not directly related to the administration of digoxin, and assessing the pulse rate is more relevant.

C: Checking the infant's radial pulse is not as accurate as assessing the apical pulse when monitoring for potential digoxin-induced changes in heart rate.

In summary, the most appropriate intervention before digoxin administration is to check the infant's apical pulse for 1 minute to

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A second 12 lead ECG performed on a patient 4 hours after the onset of chest pain reveals ST segment elevation. The nurse recognizes that this finding indicates

  • A. Transient ischemia typical of unstable angina
  • B. Lack of permanent damage to myocardial cells
  • C. Myocardial infarction associated with prolonged and complete coronary thrombosis
  • D. Myocardial infarction associated with transient or incomplete coronary artery occlusion
Correct Answer: C

Rationale: Chest pain accompanied by ST segment elevation is associated with prolonged and complete coronary thrombosis and is treated with reperfusion therapy.

The client is preparing to have a cardiac stress test. What does the nurse tell the client to do in order to have the test?

  • A. The client must lie still throughout the test.
  • B. The client will have an EKG after the test.
  • C. The client will run on a treadmill.
  • D. The test hurts for only a moment.
Correct Answer: C

Rationale: The correct answer is C: The client will run on a treadmill. During a cardiac stress test, the client is required to exercise on a treadmill to increase the heart rate and monitor the heart's response to physical activity. This helps in diagnosing heart conditions such as coronary artery disease. Choice A is incorrect as the client needs to be physically active during the test. Choice B is incorrect as the EKG is typically done before and during the test, not after. Choice D is incorrect as the test involves continuous exercise and monitoring, not a momentary pain.

Which lifestyle changes should a client diagnosed with coronary artery disease consider?

  • A. Smoking cessation
  • B. Establishing a regular exercise routine
  • C. Weight reduction
  • D. All of the Above
Correct Answer: D

Rationale: The correct answer is D (All of the Above). Smoking cessation reduces cardiovascular risks. Regular exercise improves heart health. Weight reduction can lower blood pressure and cholesterol levels. Each lifestyle change targets a specific risk factor for coronary artery disease, making all the choices essential for managing the condition effectively. Therefore, selecting all the options is the most comprehensive approach to address the client's coronary artery disease.

A client is prescribed diltiazem (Cardizem) to manage his hypertension. The nurse should tell the client the diltiazem will:

  • A. lower his blood pressure only.
  • B. Lower his heart rate and blood pressure.
  • C. Lower his blood pressure and increase his urine output
  • D. lower his heart rate and blood pressure and increase his urine output.
Correct Answer: B

Rationale: The correct answer is B because diltiazem is a calcium channel blocker that primarily works by lowering both heart rate and blood pressure. It does not directly affect urine output. Therefore, choice A is incorrect as it only mentions blood pressure. Choice C is incorrect because diltiazem does not increase urine output. Choice D is incorrect because while it mentions heart rate and blood pressure, the increase in urine output is not a direct effect of diltiazem.

The client is taking an ACE inhibitor. What is a contraindication to taking this drug?

  • A. Hypertension
  • B. Bronchospasm
  • C. Renal artery stenosis
  • D. Heart failure
Correct Answer: C

Rationale: The correct answer is C: Renal artery stenosis. ACE inhibitors can lead to decreased renal blood flow, which can worsen renal artery stenosis. This can result in decreased kidney function and potentially lead to renal failure.

A: Hypertension is not a contraindication to taking ACE inhibitors, as they are commonly used to treat hypertension.
B: Bronchospasm is not a contraindication to taking ACE inhibitors, as they are not known to worsen bronchospasm.
D: Heart failure is not a contraindication to taking ACE inhibitors, as they are commonly used to treat heart failure by reducing strain on the heart.