CAD
A nurse is teaching a patient about coronary artery disease (CAD). Which statement by the patient indicates a need for further teaching?
A. "CAD occurs when plaque builds up in the coronary arteries, reducing blood flow to the heart."
B. "If a clot completely blocks a coronary artery, it can lead to a heart attack."
C. "High cholesterol and high blood pressure increase my risk for CAD."
D. "Once plaque forms in my arteries, there is nothing I can do to prevent heart attacks."
Answer: D. (Lifestyle changes, medications, and interventions can help prevent complications.)
A nurse is teaching a patient newly diagnosed with CAD about lifestyle changes. Which recommendation is most important?
A. "Drink a glass of red wine every night to improve heart health."
B. "Start an intense exercise routine immediately."
C. "Reduce saturated fats and increase fiber intake in your diet."
D. "Only take your medications when you experience chest pain."
Answer: C. (Dietary changes help lower cholesterol and reduce CAD risk.)
A nurse is assessing a patient with known heart failure and notes the following: JVD, 3+ pitting edema to the sacrum, weight gain of 6 lbs over 3 days, and the patient reports sleeping on 3 pillows at night. The patient's current medications include furosemide and lisinopril. Which nursing action is the highest priority?
A. Restrict fluid intake to 1,000 mL/day and reweigh the patient tomorrow
B. Elevate both legs above the level of the heart to reduce peripheral edema
C. Notify the provider immediately, as these findings suggest acute decompensated heart failure
D. Educate the patient about sodium restriction and medication compliance
C Rationale: This patient is showing signs of acute decompensated heart failure (ADHF) — rapid weight gain (6 lbs in 3 days), worsening peripheral and systemic edema, JVD, and orthopnea (using 3 pillows). Despite being on furosemide and lisinopril, the patient is decompensating and requires urgent provider notification and likely IV diuresis or medication adjustment. Using the nursing process, assessment and escalation take priority before independent nursing interventions like fluid restriction (A), positioning (B), or education (D).
A nurse is assessing a patient with aortic stenosis. Which symptom is most concerning?
A. Fatigue and exercise intolerance
B. Syncope with exertion
C. A systolic murmur heard over the aortic area
D. Peripheral edema and weight gain
B. (Syncope with exertion suggests severe aortic stenosis and decreased cardiac output.)
Which patient is at highest risk for developing dilated cardiomyopathy?
A. A 40-year-old woman with lupus
B. A 60-year-old man with a history of chronic alcoholism
C. A 55-year-old woman with osteoporosis
D. A 35-year-old with seasonal allergies
Answer: B. (Chronic alcohol use is a major risk factor for dilated cardiomyopathy.)
Which of the following patients is at highest risk for developing CAD?
A. A 45-year-old woman who walks 30 minutes daily and has a BMI of 22
B. A 38-year-old man with a total cholesterol of 160 mg/dL and no family history of heart disease
C. A 52-year-old man with hypertension, diabetes, and a history of smoking
D. A 28-year-old woman who eats a high-fat diet but exercises regularly
Answer: C. (Hypertension, diabetes, and smoking are major risk factors.)
A patient is recovering from a myocardial infarction. Which statement by the patient requires further teaching?
A. "I will take my aspirin every day to prevent another heart attack."
B. "I should stop exercising to avoid straining my heart."
C. "I will monitor my blood pressure and cholesterol regularly."
D. "I should call 911 if I experience severe chest pain that doesn’t go away with rest."
Answer: B. (Exercise should be resumed gradually with provider guidance.)
A nurse is providing discharge teaching to a patient with heart failure. Which statement by the patient indicates a need for further teaching?
A. "I will weigh myself every morning before eating."
B. "I should call my doctor if I gain 2–3 pounds in a day."
C. "I can eat whatever I want as long as I take my water pill."
D. "I will pace my activities and rest when I feel tired."
C Rationale: Patients with heart failure must follow a low-sodium diet to prevent fluid retention and exacerbations. Diuretics alone do not compensate for a high-sodium diet. Daily weight monitoring, reporting rapid weight gain, and pacing activities are all correct and important self-management behaviors.
A patient with mitral stenosis reports increasing dyspnea and fatigue. Which additional assessment finding would the nurse expect?
A. Bounding peripheral pulses
B. Crackles in the lungs and pink frothy sputum
C. A widened pulse pressure
D. Increased urine output
Answer: B. (Left-sided heart failure symptoms occur due to blood backing up into the lungs.)
A patient with cardiomyopathy is admitted with severe dyspnea and pink frothy sputum. What is the nurse’s priority action?
A. Place the patient in high Fowler’s position
B. Start an IV for fluid resuscitation
C. Encourage the patient to drink fluids
D. Perform deep suctioning
Answer: A. (Elevating the head of the bed improves oxygenation and reduces pulmonary congestion.)
A patient with known CAD reports new-onset chest discomfort that occurs when walking up the stairs but resolves with rest. The nurse recognizes this as:
A. Stable angina
B. Unstable angina
C. Myocardial infarction
D. Pericarditis
Answer: A. (Stable angina occurs with exertion and improves with rest.)
A nurse is monitoring a patient with CAD for complications. Which of the following symptoms would indicate a possible myocardial infarction (MI)? A. Sudden severe chest pain, shortness of breath, diaphoresis, and nausea
B. Sharp chest pain that worsens with deep breathing and is relieved by sitting up
C. Localized chest pain that improves with antacids and worsens after eating spicy foods
D. Intermittent stabbing chest pain that occurs only at night
Answer: A. (Classic symptoms of an MI include chest pain, SOB, sweating, and nausea.)
A patient with right-sided heart failure is admitted to the unit. Which of the following assessment findings would the nurse most likely observe?
A. Pulmonary crackles and pink frothy sputum
B. Tachypnea and decreased oxygen saturation
C. Jugular vein distention and dependent edema
D. S3 gallop and nocturnal cough
Answer: C Rationale: Right-sided heart failure causes blood to back up into the systemic venous circulation, resulting in jugular vein distention (JVD), peripheral/dependent edema, hepatomegaly, and weight gain. Options A, B, and D are associated with left-sided heart failure and pulmonary congestion.
A patient is suspected of having mitral regurgitation. Which diagnostic test would the nurse anticipate being ordered?
A. 12-lead ECG
B. Chest X-ray
C. Echocardiogram
D. Pulmonary function test
Answer: C. (An echocardiogram evaluates valve function and regurgitation severity.)
A nurse is teaching a patient with cardiomyopathy about dietary modifications. Which statement indicates successful teaching?
A. "I should increase my salt intake to maintain blood pressure."
B. "I should eat small, frequent meals and avoid high-sodium foods."
C. "A high-fat, high-calorie diet will help improve my energy levels."
D. "I should avoid all sources of protein to reduce heart strain."
Answer: B. (A low-sodium diet helps reduce fluid retention and improve heart function in cardiomyopathy.)
A nurse is educating a patient with CAD about nitroglycerin (NTG) for angina. Which statement by the patient indicates correct understanding?
A. "I should take nitroglycerin with food to prevent stomach upset."
B. "If my chest pain is not relieved after one tablet, I should wait 30 minutes before taking another."
C. "I should store my nitroglycerin in a cool, dry place and replace it every 6 months."
D. "If I develop a headache after taking nitroglycerin, I should stop using it immediately."
Answer: C. (NTG should be stored properly and replaced regularly.)
A nurse is reviewing laboratory results for a patient suspected of having a myocardial infarction. Which result is the most concerning?
A. Troponin level of 3.2 ng/mL
B. Total cholesterol of 200 mg/dL
C. C-reactive protein (CRP) of 2.0 mg/L D. LDL cholesterol of 130 mg/dL
D. LDL cholesterol of 130 mg/dL
Answer: A. (Elevated troponin indicates myocardial damage.)
A nurse is caring for a 72-year-old woman with a history of chronic hypertension who is admitted with worsening dyspnea. Her echocardiogram reveals an ejection fraction of 55%. Her BNP is elevated, and she has bilateral ankle edema. Which type of heart failure does this presentation most likely represent, and what is the underlying pathophysiologic mechanism?
A. HFrEF, because the ventricle is unable to contract forcefully enough to eject blood
B. HFpEF, because the stiff ventricle cannot relax adequately, impairing ventricular filling
C. High-output heart failure, because metabolic demands exceed cardiac output
D. Right-sided heart failure, because increased venous pressure is causing peripheral edema
Answer: B Rationale: This patient's preserved EF (55%) with symptoms of heart failure in the context of chronic hypertension is classic for HFpEF (diastolic dysfunction). The ventricle becomes stiff and non-compliant, impairing relaxation and filling during diastole — despite squeezing normally. HFpEF is most common in older women with hypertension. HFrEF (A) would show a reduced EF (<40%). High-output HF (C) results from states like sepsis or hyperthyroidism. Option D may coexist but does not explain the preserved EF finding.
A nurse is teaching a patient with mitral valve prolapse about lifestyle modifications. Which statement by the patient indicates further teaching is needed?
A. "I should avoid caffeine and alcohol."
B. "I need antibiotics before every dental procedure."
C. "I should drink plenty of fluids and avoid dehydration."
D. "I may experience occasional palpitations and dizziness."
Answer: B. (Routine antibiotic prophylaxis is not required for mitral valve prolapse unless infective endocarditis risk is high.)
What is the best way to prevent rheumatic heart disease?
A. Take aspirin daily
B. Maintain a high-protein diet
C. Complete full course of antibiotics for strep throat
D. Get an annual flu vaccine
Answer: C. (Untreated strep throat can lead to rheumatic fever and rheumatic heart disease.)
A nurse is caring for a patient experiencing chest pain. What is the nurse’s priority intervention?
A. Administer sublingual nitroglycerin
B. Place the patient in a supine position
C. Assess vital signs and obtain an ECG
D. Encourage the patient to take deep breaths
Answer: C. (Assessing vital signs and obtaining an ECG are the priority to determine the severity of the situation.)
A nurse is administering medications to a patient with CAD. Which medication is prescribed to reduce myocardial oxygen demand and lower heart rate and blood pressure?
A. Atorvastatin
B. Metoprolol
C. Clopidogrel
D. Furosemide
B. (Metoprolol is a beta-blocker that lowers HR and BP.
A patient with right-sided heart failure secondary to left ventricular failure is admitted with worsening symptoms. The nurse notes anorexia, nausea, abdominal distention, and jaundice. The patient asks, "Why is my stomach and liver involved if this is a heart problem?" Which response by the nurse is most accurate?
A. "Your kidneys are not filtering properly, which is causing toxins to back up into your digestive system."
B. "When the right ventricle fails, blood backs up into the systemic venous circulation, increasing pressure in the veins that drain the liver and GI tract, causing congestion and dysfunction."
C. "Your left ventricle is not pumping enough blood to the liver, causing it to become ischemic and inflamed."
D. "The medications you are taking for heart failure can cause liver and stomach side effects."
B Rationale: Right-sided heart failure causes blood to back up into the systemic venous system, elevating venous pressure in the hepatic and portal circulation. This leads to hepatomegaly, congestive hepatopathy, and GI congestion — manifesting as anorexia, nausea, abdominal distention, and potentially jaundice from impaired hepatic function. Option A incorrectly attributes the cause to the kidneys. Option C describes left-sided ischemia, not right-sided venous congestion. Option D may have some truth but does not explain the clinical picture presented.
A nurse is caring for a patient who had a mechanical valve replacement. Which statement by the patient requires further teaching?
A. "I will need to take blood thinners for the rest of my life."
B. "I should avoid foods high in vitamin K."
C. "I will have to come in regularly for INR checks."
D. "I can stop taking my anticoagulant once my valve heals."
Answer: D. (Patients with mechanical valves require lifelong anticoagulation to prevent clots.)
Which nursing diagnosis is most appropriate for a patient with myocarditis?
A. Activity Intolerance
B. Risk for Infection
C. Disturbed Sensory Perception
D. Ineffective Airway Clearance
A. (Myocarditis weakens the heart, leading to fatigue and activity intolerance).