NSG 320 50 HARD NCLEX PRACTICE QUESTIONS,
CARDIOVASCULAR AND ONCOLOGICAL NURSING LATEST
REVIEWED STUDY GUIDE QUESTIONS WITH CORRECT
ANSWERS AND RATIONALES
1. Topic 4: Hypertension, Coronary Artery Disease, & Dysrhythmias (Questions 1-18)
1. A nurse is evaluating a patient with a blood pressure of 162/94 mm Hg. The patient has a
heart rate of 90 bpm and a stroke volume of 70 mL. Which statement by the nurse accurately
explains the pathophysiology of this blood pressure based on the formula BP = (SV \times HR)
\times SVR?
A. "Your blood pressure is high because your cardiac output is currently 4.2 L/min."
B. "The pressure is elevated because your heart is pumping 6.3 L/min against the resistance in
your arteries."
C. "The resistance in your blood vessels has decreased to compensate for your heart rate."
D. "Your stroke volume is high, which directly causes the increase in your systolic pressure."
2. A patient is diagnosed with primary hypertension. Which finding in the patient's history
should the nurse identify as a contributing factor to this specific classification?
A. A recent diagnosis of obstructive sleep apnea.
B. Presence of an adrenal tumor secreting catecholamines.
C. Increased sympathetic nervous system (SNS) activity and insulin resistance.
D. Narrowing of the renal arteries leading to decreased perfusion.
3. The nurse is monitoring a patient’s ECG and notes a rhythm with a rate of 50 bpm, a normal
P wave before every QRS complex, and a PR interval of 0.18 seconds. The patient is awake
and denies any distress. What is the priority nursing action?
A. Administer 0.5 mg of atropine IV push.
B. Continue to monitor the patient for any symptomatic changes.
C. Prepare for immediate transcutaneous pacing.
D. Assess the patient’s blood pressure and oxygen saturation.
4. A patient’s ECG shows a "saw-tooth" P-wave configuration with an atrial rate of 300 bpm
and a regular ventricular rate of 75 bpm. The nurse understands that this patient is at the
highest risk for which complication?
A. Ventricular fibrillation.
B. Systemic thromboembolism and stroke.
,C. Sudden cardiac arrest.
D. Development of a first-degree AV block.
5. The nurse observes a chaotic ECG rhythm with no identifiable P waves, QRS complexes, or T
waves. The patient is unresponsive and has no palpable pulse. Which action should the nurse
perform first?
A. Administer epinephrine 1 mg IV.
B. Perform synchronized cardioversion at 100 J.
C. Begin chest compressions and prepare for defibrillation.
D. Provide 100% oxygen via a non-rebreather mask.
6. A nurse is assessing a patient with a long history of poorly controlled hypertension. Which
assessment finding most clearly indicates target organ damage in the eyes?
A. Increased intraocular pressure.
B. Conjunctival edema and redness.
C. Blurred vision and retinal hemorrhage.
D. Sudden loss of peripheral vision in one eye.
7. A patient with chronic stable angina reports chest pain that is "new and different,"
occurring at rest and lasting 20 minutes. The nurse should categorize this as which type of
angina?
A. Microvascular angina.
B. Prinzmetal’s angina.
C. Unstable angina.
D. Chronic stable angina.
8. The nurse is teaching a patient about the "response-to-injury" theory of Coronary Artery
Disease (CAD). Which statement by the nurse is most accurate?
A. "The disease begins when the lining of your heart valves becomes inflamed."
B. "Endothelial injury from smoking or high blood pressure allows lipids to enter the artery
wall."
C. "CAD is caused by the heart muscle becoming too thick to pump blood effectively."
, D. "High cholesterol causes the blood to become too thick to pass through the capillaries."
9. A patient is prescribed Simvastatin 40 mg daily. Which laboratory value should the nurse
monitor to identify a serious adverse effect of this medication?
A. Prothrombin time (PT).
B. Low-density lipoprotein (LDL).
C. Creatine kinase (CK-MM).
D. Blood urea nitrogen (BUN).
10. A patient taking Niacin for hyperlipidemia reports intense skin flushing and itching 15
minutes after the dose. Which instruction should the nurse provide?
A. "Stop the medication immediately as you are having an anaphylactic reaction."
B. "Take 325 mg of aspirin 30 minutes before your next Niacin dose."
C. "Decrease your fluid intake for two hours after taking the medication."
D. "This is a sign of liver damage; you must come in for blood work."
11. The nurse is titrating Sodium Nitroprusside for a patient in a hypertensive crisis. The
infusion has been running at 5 mcg/kg/min for 72 hours. The patient becomes restless,
agitated, and reports nausea. What is the nurse's priority action?
A. Increase the infusion rate to lower the Mean Arterial Pressure (MAP) by 40%.
B. Stop the infusion and notify the provider to request a serum thiocyanate level.
C. Place the patient in a Trendelenburg position.
D. Administer a PRN dose of an antiemetic for the nausea.
12. A patient with a history of asthma is diagnosed with hypertension. Which medication
should the nurse question if prescribed?
A. Metoprolol.
B. Amlodipine.
C. Propranolol.
D. Lisinopril.
CARDIOVASCULAR AND ONCOLOGICAL NURSING LATEST
REVIEWED STUDY GUIDE QUESTIONS WITH CORRECT
ANSWERS AND RATIONALES
1. Topic 4: Hypertension, Coronary Artery Disease, & Dysrhythmias (Questions 1-18)
1. A nurse is evaluating a patient with a blood pressure of 162/94 mm Hg. The patient has a
heart rate of 90 bpm and a stroke volume of 70 mL. Which statement by the nurse accurately
explains the pathophysiology of this blood pressure based on the formula BP = (SV \times HR)
\times SVR?
A. "Your blood pressure is high because your cardiac output is currently 4.2 L/min."
B. "The pressure is elevated because your heart is pumping 6.3 L/min against the resistance in
your arteries."
C. "The resistance in your blood vessels has decreased to compensate for your heart rate."
D. "Your stroke volume is high, which directly causes the increase in your systolic pressure."
2. A patient is diagnosed with primary hypertension. Which finding in the patient's history
should the nurse identify as a contributing factor to this specific classification?
A. A recent diagnosis of obstructive sleep apnea.
B. Presence of an adrenal tumor secreting catecholamines.
C. Increased sympathetic nervous system (SNS) activity and insulin resistance.
D. Narrowing of the renal arteries leading to decreased perfusion.
3. The nurse is monitoring a patient’s ECG and notes a rhythm with a rate of 50 bpm, a normal
P wave before every QRS complex, and a PR interval of 0.18 seconds. The patient is awake
and denies any distress. What is the priority nursing action?
A. Administer 0.5 mg of atropine IV push.
B. Continue to monitor the patient for any symptomatic changes.
C. Prepare for immediate transcutaneous pacing.
D. Assess the patient’s blood pressure and oxygen saturation.
4. A patient’s ECG shows a "saw-tooth" P-wave configuration with an atrial rate of 300 bpm
and a regular ventricular rate of 75 bpm. The nurse understands that this patient is at the
highest risk for which complication?
A. Ventricular fibrillation.
B. Systemic thromboembolism and stroke.
,C. Sudden cardiac arrest.
D. Development of a first-degree AV block.
5. The nurse observes a chaotic ECG rhythm with no identifiable P waves, QRS complexes, or T
waves. The patient is unresponsive and has no palpable pulse. Which action should the nurse
perform first?
A. Administer epinephrine 1 mg IV.
B. Perform synchronized cardioversion at 100 J.
C. Begin chest compressions and prepare for defibrillation.
D. Provide 100% oxygen via a non-rebreather mask.
6. A nurse is assessing a patient with a long history of poorly controlled hypertension. Which
assessment finding most clearly indicates target organ damage in the eyes?
A. Increased intraocular pressure.
B. Conjunctival edema and redness.
C. Blurred vision and retinal hemorrhage.
D. Sudden loss of peripheral vision in one eye.
7. A patient with chronic stable angina reports chest pain that is "new and different,"
occurring at rest and lasting 20 minutes. The nurse should categorize this as which type of
angina?
A. Microvascular angina.
B. Prinzmetal’s angina.
C. Unstable angina.
D. Chronic stable angina.
8. The nurse is teaching a patient about the "response-to-injury" theory of Coronary Artery
Disease (CAD). Which statement by the nurse is most accurate?
A. "The disease begins when the lining of your heart valves becomes inflamed."
B. "Endothelial injury from smoking or high blood pressure allows lipids to enter the artery
wall."
C. "CAD is caused by the heart muscle becoming too thick to pump blood effectively."
, D. "High cholesterol causes the blood to become too thick to pass through the capillaries."
9. A patient is prescribed Simvastatin 40 mg daily. Which laboratory value should the nurse
monitor to identify a serious adverse effect of this medication?
A. Prothrombin time (PT).
B. Low-density lipoprotein (LDL).
C. Creatine kinase (CK-MM).
D. Blood urea nitrogen (BUN).
10. A patient taking Niacin for hyperlipidemia reports intense skin flushing and itching 15
minutes after the dose. Which instruction should the nurse provide?
A. "Stop the medication immediately as you are having an anaphylactic reaction."
B. "Take 325 mg of aspirin 30 minutes before your next Niacin dose."
C. "Decrease your fluid intake for two hours after taking the medication."
D. "This is a sign of liver damage; you must come in for blood work."
11. The nurse is titrating Sodium Nitroprusside for a patient in a hypertensive crisis. The
infusion has been running at 5 mcg/kg/min for 72 hours. The patient becomes restless,
agitated, and reports nausea. What is the nurse's priority action?
A. Increase the infusion rate to lower the Mean Arterial Pressure (MAP) by 40%.
B. Stop the infusion and notify the provider to request a serum thiocyanate level.
C. Place the patient in a Trendelenburg position.
D. Administer a PRN dose of an antiemetic for the nausea.
12. A patient with a history of asthma is diagnosed with hypertension. Which medication
should the nurse question if prescribed?
A. Metoprolol.
B. Amlodipine.
C. Propranolol.
D. Lisinopril.
