1
ATI Cardiovascular Targeted Exam Actual
Exam 2026/2027: Comprehensive Multiple
Choice Questions with Verified & Revised
Answers for Nursing Success – Pass
Guaranteed - A+ Graded
SECTION 1: CARDIOVASCULAR ASSESSMENT & DIAGNOSTICS (10 Questions)
Q1: A nurse is assessing a client with suspected heart failure. Which finding indicates elevated
left ventricular end-diastolic pressure?
• A. Flat jugular veins in supine position
• B. Distended internal jugular veins at 45-degree elevation [CORRECT]
• C. Bounding peripheral pulses
• D. Decreased respiratory rate
Correct Answer: B
Rationale: Jugular venous distention (JVD) at 45 degrees or greater indicates elevated central
venous pressure and left ventricular end-diastolic pressure, a hallmark of heart failure. Flat
jugular veins (A) indicate hypovolemia. Bounding pulses (C) may indicate increased cardiac
output or aortic regurgitation. Respiratory rate (D) typically increases with heart failure due to
pulmonary congestion.
Q2: Which heart sound is associated with the closure of the semilunar valves (aortic and
pulmonic)?
• A. S1
• B. S2 [CORRECT]
• C. S3
• D. S4
Correct Answer: B
,2
Rationale: S2 represents closure of the aortic and pulmonic valves at the end of systole. S1 (A)
represents mitral and tricuspid valve closure at the beginning of systole. S3 (C) is an abnormal
ventricular filling sound in early diastole. S4 (D) is an abnormal atrial contraction sound in late
diastole.
Q3: A nurse auscultates a blowing, swishing sound immediately after S1 at the cardiac apex.
This finding indicates:
• A. Aortic stenosis
• B. Mitral regurgitation [CORRECT]
• C. Normal heart sound
• D. Tricuspid stenosis
Correct Answer: B
Rationale: A holosystolic (pansystolic) murmur at the apex radiating to the axilla indicates
mitral regurgitation. Aortic stenosis (A) produces a crescendo-decrescendo systolic murmur at
the right sternal border. This is not a normal sound (C). Tricuspid stenosis (D) produces a
diastolic murmur at the lower left sternal border.
Q4: Which laboratory value is the MOST specific indicator of myocardial cell damage occurring
3-6 hours after symptom onset?
• A. Total CK (creatine kinase)
• B. CK-MB
• C. Troponin I or T [CORRECT]
• D. Myoglobin
Correct Answer: C
Rationale: Troponin I and T are cardiac-specific proteins with high sensitivity and specificity for
myocardial damage, rising 3-6 hours after MI and remaining elevated for 7-10 days. CK-MB (B)
is less specific (also found in skeletal muscle). Myoglobin (D) rises earlier (1-3 hours) but is less
specific. Total CK (A) is nonspecific.
Q5: A nurse is caring for a client undergoing cardiac catheterization via the femoral artery. Post-
procedure, which finding requires IMMEDIATE intervention?
, 3
• A. Blood pressure 138/88 mmHg
• B. Absent distal pulse in the catheterized extremity [CORRECT]
• C. Mild discomfort at insertion site
• D. Warm, pink extremity
Correct Answer: B
Rationale: Absent distal pulse indicates arterial occlusion from thrombus, dissection, or
hematoma—compartment syndrome or limb ischemia requiring immediate physician notification
and potential surgical intervention. Options A, C, and D are normal or expected findings.
Vascular complications are priorities due to limb-threatening potential.
Q6: Which EKG change indicates myocardial ischemia?
• A. Tall, peaked T waves
• B. ST-segment depression or T-wave inversion [CORRECT]
• C. Q waves in leads II, III, aVF
• D. Prolonged PR interval
Correct Answer: B
Rationale: ST-segment depression (≥1 mm) and T-wave inversion indicate subendocardial
ischemia. Tall, peaked T waves (A) indicate hyperkalemia or early MI. Q waves (C) indicate
established infarction (necrosis). Prolonged PR interval (D) indicates first-degree AV block.
Q7: A nurse is preparing a client for an exercise stress test. Which instruction is MOST
important?
• A. "Take your beta-blocker as usual this morning"
• B. "Avoid eating or drinking for 4 hours before the test"
• C. "Withhold medications as ordered by your physician" [CORRECT]
• D. "Wear restrictive clothing for the treadmill"
Correct Answer: C
Rationale: Medications (especially beta-blockers, nitrates, calcium channel blockers) may be
withheld to achieve target heart rate and unmask ischemia. Taking beta-blockers (A) may prevent
ATI Cardiovascular Targeted Exam Actual
Exam 2026/2027: Comprehensive Multiple
Choice Questions with Verified & Revised
Answers for Nursing Success – Pass
Guaranteed - A+ Graded
SECTION 1: CARDIOVASCULAR ASSESSMENT & DIAGNOSTICS (10 Questions)
Q1: A nurse is assessing a client with suspected heart failure. Which finding indicates elevated
left ventricular end-diastolic pressure?
• A. Flat jugular veins in supine position
• B. Distended internal jugular veins at 45-degree elevation [CORRECT]
• C. Bounding peripheral pulses
• D. Decreased respiratory rate
Correct Answer: B
Rationale: Jugular venous distention (JVD) at 45 degrees or greater indicates elevated central
venous pressure and left ventricular end-diastolic pressure, a hallmark of heart failure. Flat
jugular veins (A) indicate hypovolemia. Bounding pulses (C) may indicate increased cardiac
output or aortic regurgitation. Respiratory rate (D) typically increases with heart failure due to
pulmonary congestion.
Q2: Which heart sound is associated with the closure of the semilunar valves (aortic and
pulmonic)?
• A. S1
• B. S2 [CORRECT]
• C. S3
• D. S4
Correct Answer: B
,2
Rationale: S2 represents closure of the aortic and pulmonic valves at the end of systole. S1 (A)
represents mitral and tricuspid valve closure at the beginning of systole. S3 (C) is an abnormal
ventricular filling sound in early diastole. S4 (D) is an abnormal atrial contraction sound in late
diastole.
Q3: A nurse auscultates a blowing, swishing sound immediately after S1 at the cardiac apex.
This finding indicates:
• A. Aortic stenosis
• B. Mitral regurgitation [CORRECT]
• C. Normal heart sound
• D. Tricuspid stenosis
Correct Answer: B
Rationale: A holosystolic (pansystolic) murmur at the apex radiating to the axilla indicates
mitral regurgitation. Aortic stenosis (A) produces a crescendo-decrescendo systolic murmur at
the right sternal border. This is not a normal sound (C). Tricuspid stenosis (D) produces a
diastolic murmur at the lower left sternal border.
Q4: Which laboratory value is the MOST specific indicator of myocardial cell damage occurring
3-6 hours after symptom onset?
• A. Total CK (creatine kinase)
• B. CK-MB
• C. Troponin I or T [CORRECT]
• D. Myoglobin
Correct Answer: C
Rationale: Troponin I and T are cardiac-specific proteins with high sensitivity and specificity for
myocardial damage, rising 3-6 hours after MI and remaining elevated for 7-10 days. CK-MB (B)
is less specific (also found in skeletal muscle). Myoglobin (D) rises earlier (1-3 hours) but is less
specific. Total CK (A) is nonspecific.
Q5: A nurse is caring for a client undergoing cardiac catheterization via the femoral artery. Post-
procedure, which finding requires IMMEDIATE intervention?
, 3
• A. Blood pressure 138/88 mmHg
• B. Absent distal pulse in the catheterized extremity [CORRECT]
• C. Mild discomfort at insertion site
• D. Warm, pink extremity
Correct Answer: B
Rationale: Absent distal pulse indicates arterial occlusion from thrombus, dissection, or
hematoma—compartment syndrome or limb ischemia requiring immediate physician notification
and potential surgical intervention. Options A, C, and D are normal or expected findings.
Vascular complications are priorities due to limb-threatening potential.
Q6: Which EKG change indicates myocardial ischemia?
• A. Tall, peaked T waves
• B. ST-segment depression or T-wave inversion [CORRECT]
• C. Q waves in leads II, III, aVF
• D. Prolonged PR interval
Correct Answer: B
Rationale: ST-segment depression (≥1 mm) and T-wave inversion indicate subendocardial
ischemia. Tall, peaked T waves (A) indicate hyperkalemia or early MI. Q waves (C) indicate
established infarction (necrosis). Prolonged PR interval (D) indicates first-degree AV block.
Q7: A nurse is preparing a client for an exercise stress test. Which instruction is MOST
important?
• A. "Take your beta-blocker as usual this morning"
• B. "Avoid eating or drinking for 4 hours before the test"
• C. "Withhold medications as ordered by your physician" [CORRECT]
• D. "Wear restrictive clothing for the treadmill"
Correct Answer: C
Rationale: Medications (especially beta-blockers, nitrates, calcium channel blockers) may be
withheld to achieve target heart rate and unmask ischemia. Taking beta-blockers (A) may prevent
