CMSRN FREE CMSRN Cardiac Vascular Questions and Answers 2 — Questions and Answers
Question 1: A patient with peripheral arterial disease (PAD) reports intermittent claudication in the left calf. Which assessment finding would the nurse expect?
- Diminished or absent pedal pulses in the affected extremity (Correct answer)
- Warm, erythematous skin with pitting edema
- Distended superficial veins in the lower leg
- Positive Homans sign with dorsiflexion
Correct answer: Diminished or absent pedal pulses in the affected extremity
Intermittent claudication from PAD results from arterial insufficiency, which presents with diminished or absent peripheral pulses distal to the occlusion.
Question 2: A nurse is caring for a patient 6 hours after percutaneous coronary intervention (PCI) via the right femoral artery. Which finding requires immediate intervention?
- Heart rate 78 bpm with normal sinus rhythm
- Patient reports mild soreness at the groin site
- Expanding ecchymosis and firmness at the access site (Correct answer)
- Blood pressure 132/84 mmHg in the left arm
Correct answer: Expanding ecchymosis and firmness at the access site
Expanding ecchymosis with firmness at the femoral access site suggests retroperitoneal bleeding or hematoma formation, requiring urgent evaluation.
Question 3: Which laboratory value is most critical for the nurse to monitor in a patient receiving a continuous heparin infusion for deep vein thrombosis?
- Activated partial thromboplastin time (aPTT) (Correct answer)
- Prothrombin time (PT)
- International normalized ratio (INR)
- Platelet count and fibrinogen level
Correct answer: Activated partial thromboplastin time (aPTT)
The aPTT is the primary lab value used to monitor therapeutic effectiveness and dosing of unfractionated heparin infusions.
Question 4: A patient with a new diagnosis of heart failure has a B-type natriuretic peptide (BNP) level of 1,200 pg/mL. How should the nurse interpret this result?
- The value is within normal limits and requires no action
- The elevation indicates significant ventricular volume overload and myocardial wall stress (Correct answer)
- The result suggests chronic kidney disease rather than heart failure
- The level is only mildly elevated and unlikely to be clinically significant
Correct answer: The elevation indicates significant ventricular volume overload and myocardial wall stress
A BNP level of 1,200 pg/mL is markedly elevated (normal <100 pg/mL) and reflects significant ventricular wall stress consistent with heart failure.
Question 5: A patient with an abdominal aortic aneurysm (AAA) suddenly develops severe, tearing back pain and hypotension. What is the nurse's priority action?
- Administer an oral analgesic and reposition the patient for comfort
- Prepare the patient for emergent surgical intervention (Correct answer)
- Obtain a 12-lead electrocardiogram to rule out myocardial infarction
- Encourage ambulation to assess for orthostatic changes
Correct answer: Prepare the patient for emergent surgical intervention
Sudden severe back pain with hypotension in a patient with AAA strongly suggests rupture, which is a surgical emergency requiring immediate intervention.
Question 6: A nurse is teaching a patient about warfarin therapy after mechanical valve replacement. Which patient statement indicates correct understanding?
- I should double my dose if I miss one day to catch up
- I need to have my INR checked regularly and maintain consistent vitamin K intake (Correct answer)
- I can stop taking this medication once my symptoms improve
- I should take aspirin along with warfarin whenever I have a headache
Correct answer: I need to have my INR checked regularly and maintain consistent vitamin K intake
Patients on warfarin require regular INR monitoring and consistent dietary vitamin K intake to maintain stable anticoagulation levels.
CMSRN FREE CMSRN Cardiac Vascular Questions and Answers 2
A patient with peripheral arterial disease (PAD) reports intermittent claudication in the left calf.
Which assessment finding would the nurse expect?