Question 5031)
An adult who is admitted for a cardiac catheterization asks the nurse if she will be
asleep during the cardiac catheterization. What is the best initial response for the nurse to make?
A. “You will be given a general anesthesia.”
B. “You will be sedated but not asleep.”
C. “The doctor will give you an anesthetic if you are having too much pain.”
D. “Why do you want to be asleep?”
Answer: B
Explanation: Persons who are undergoing cardiac catheterization will receive a sedative but are not put to sleep.
Their cooperation is needed during the procedure. Asking “why” makes the client defensive and is not appropriate
for this client at this time. Give the client the information asked for.
Question 5032)
During the admission interview, a client who is admitted for a cardiac
catheterization says, “Every time I eat shrimp I get a rash.” What action is essential for the nurse
to take at this time?
A. Notify the physician.
B. Ask the client if she gets a rash from any other foods.
C. Instruct the dietary department not to give the client shrimp.
D. Teach the client the dangers of eating shrimp and other shellfish. Allergy to shellfish is indicative of an allergy to
iodine. The dye used in a cardiac catheterization
Answer: A
Explanation: Allergy to shellfish is indicative of an allergy to iodine. The dye used in a cardiac catheterization
occur. Because the exam is scheduled for the morning, the nurse should notify the physician immediately. The
other actions might have relevance but are not essential (safety related) at this time.
Question 5033)
The nurse is preparing a client for a cardiac catheterization. Which action would
the nurse expect to take?
A. Administer a radioisotope as ordered.
B. Give the client a cleansing enema.
C. Locate and mark peripheral pulses.
D. Encourage high fluid intake before the test.
Answer: C
Explanation: It is essential to monitor peripheral pulses after the procedure. They should be assessed before the
procedure to determine location and baseline levels. An iodine dye is used during a cardiac catheterization, not a
radioisotope. There is no need to give the client an enema. Fluids may be encouraged after the test. The client will
be NPO for eight hours before the test.
Question 5034)
A young adult with a history of rheumatic fever as a child is to have a cardiac
catheterization. She asks the nurse why she must have a cardiac catheterization. The nurse’s
response is based on the understanding that cardiac catheterization can accomplish all of the
following EXCEPT:
A. assessing heart structures.
B. determining oxygen levels in the heart chambers.
C. evaluating cardiac output.
D. obtaining a biopsy specimen.
Answer: D
Explanation: A biopsy specimen cannot be obtained during a cardiac catheterization. Heart structures can be
assessed, oxygen levels in the heart chambers can be determined, and cardiac output can be measured during a
cardiac catheterization
Question 5035)
When a client returns from undergoing a cardiac catheterization, it is most
essential for the nurse to:
A. check peripheral pulses.
B. maintain NPO.
C. apply heat to the insertion site.
D. start range of motion exercises immediately.
Answer: A
Explanation: Checking peripheral pulses is of highest priority. The complications most likely to occur are
hemorrhage and obstruction of the vessel. The client is NPO before the procedure, not after. Cold may be applied
to the insertion site to vasoconstrict. Heat vasodilates and is contraindicated because it might cause bleeding.
Range of motion exercises might cause bleeding. The extremity used for the insertion site is kept quiet
immediately following a cardiac catheterization.
Question 5036)
A male client with angina pectoris has been having an increased number of
episodes of pain recently. He is admitted for observation. During the admission interview, he tells
the nurse that he has been having chest pain during the last week. Which statement by the client
would be of greatest concern to the nurse?
A. “I had chest pain while I was walking in the snow on Thursday.”
B. “We went out for a big dinner to celebrate my wife’s birthday, but I couldn’t enjoy it because I got the pain
before we got home from the restaurant.”
C. “I had chest pain yesterday while I was sitting in the living room watching television.”
D. “I felt pain all the way down my left arm after I was playing with my grandson on Monday.”
Answer: C
Explanation: This answer indicates pain at rest, which suggests a progression of the angina. The other answers all
indicate pain with known causes of angina, such as exercise, cold environment, or eating.
Question 5037)
The nurse responds to the call light of a client who has a history of angina
pectoris. He tells the nurse that he has just taken a nitroglycerin tablet sublingually for anginal
pain. What action should the nurse take next?
A. If the pain does not subside within five minutes, place a second tablet under his tongue
B. Position him with head lower than feet
C. Administer a narcotic as needed (PRN) for pain if he still has pain in 10 minutes
D. Call his physician and alert the code team for possible intervention
Answer: A
Explanation: Nitroglycerin can be given at five-minute intervals for up to three doses if the pain is not relieved.
Positioning with head lower than feet increases cardiac workload and would make the client worse. PRN narcotics
are not usually ordered for clients who have anginal pain. Nitroglycerin, a vasodilator, is usually the medication of
choice. At some point, the physician will need to be called, but there is no need to alert the code team for possible
intervention.
Question 5038)
The nurse is teaching an adult who has angina about taking nitroglycerin. The
nurse tells him he will know the nitroglycerin is effective when:
A. he experiences tingling under the tongue.
B. his pulse rate increases.
C. his pain subsides
D. his activity tolerance increases
Answer: C
Explanation: Pain relief is the expected outcome when taking nitroglycerin. Vasodilation of coronary vessels will
increase the blood supply to the heart muscle, decreasing pain caused by ischemia. Tingling under the tongue and
a headache indicate that the medication is potent. His pulse rate should decrease when the pain is relieved.
Increase in activity tolerance is nice, but nitroglycerin is given to relieve anginal pain.
Question 5039)
A client with angina will have to make lifestyle modifications. Which of the
following statements by the client would indicate that he understands the necessary modifications
in lifestyle to prevent angina attacks?
A. “I know that I will need to eat less, so I will only eat one meal a day.”
B. “I will need to stay in bed all the time so I won’t have the pain.”
C. “I’ll stop what I’m doing whenever I have pain and take a pill.”
D. “I will need to walk more slowly and rest frequently to avoid the angina.”
Answer: D
Explanation: Walking more slowly and resting decreases energy expenditure and prevents an attack. Answer 3
treats an attack. By the time he has pain, he is experiencing angina. To prevent angina, he needs to walk slowly
and rest frequently. He should eat small, frequent meals—not one large meal. He should exercise within his
tolerance level. Staying in bed predisposes the client to the complications of immobility, such as clots and
pneumonia.
Question 5040)
A client who has been treated for angina is discharged in stable condition. At a
clinic visit, he tells the nurse he has anginal pain when he has sexual intercourse with his wife.
What is the best response for the nurse to make?
A. “Do you have ambivalent feelings toward your wife?”
B. “Many persons with angina have less pain when their partner assumes the top position.”
C. “Be sure that you attempt intercourse only when you are well rested and relaxed.”
D. “You might try having a cocktail before sexual activity to help you relax.”
Answer: B
Explanation: Reducing his physical activity reduces the cardiac workload. This response suggests a way that he can
engage in sexual activity with minimum strain on the heart. Ambivalent feelings toward his wife are unlikely to
cause anginal pain. There is some truth to being well rested and relaxed, but telling him that this is the only time
he should have intercourse is not realistic. The nurse should not advise the client to have an alcoholic beverage
before sexual activity.
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