NSG 320 NCLEX Cardiovascular System
Exam with 120 Verified Questions And
Answers
A client with heart failure is prescribed digoxin. Which assessment
finding indicates digoxin toxicity?
A) Heart rate of 68 bpm
B) Serum potassium level of 3.2 mEq/L
C) Blood pressure of 130/80 mmHg
D) Respiratory rate of 16 breaths/min
**Answer: B**
**Rationale:** Hypokalemia (potassium < 3.5 mEq/L) increases the
risk of digoxin toxicity. Digoxin competes with potassium for binding
sites on the sodium-potassium ATPase pump. Low potassium levels
allow more digoxin to bind, increasing toxicity risk. Signs of toxicity
include GI disturbances, visual changes (yellow-green halos), and
cardiac dysrhythmias. Option A is normal, C is slightly elevated but
not indicative of toxicity, and D is normal.
---
**Question 2**
,A nurse is caring for a client with acute myocardial infarction. Which
laboratory value is most specific for diagnosing an MI?
A) Creatinine kinase (CK)
B) Myoglobin
C) Troponin I
D) Lactate dehydrogenase (LDH)
**Answer: C**
**Rationale:** Troponin I and T are the most specific and sensitive
cardiac markers for myocardial injury. They rise within 3-4 hours of
MI onset and remain elevated for 7-14 days. CK-MB is specific but not
as sensitive as troponin. Myoglobin rises early but lacks specificity.
LDH is less specific and outdated for MI diagnosis.
---
**Question 3**
A client with hypertension is prescribed hydrochlorothiazide. Which
electrolyte imbalance should the nurse monitor?
A) Hyperkalemia
B) Hyponatremia
C) Hypokalemia
D) Hypercalcemia
,**Answer: C**
**Rationale:** Hydrochlorothiazide is a thiazide diuretic that causes
potassium wasting in the distal convoluted tubule. The nurse should
monitor for hypokalemia, which can lead to cardiac dysrhythmias,
muscle weakness, and fatigue. Clients should be encouraged to eat
potassium-rich foods (bananas, oranges) and have serum potassium
levels monitored regularly.
---
**Question 4**
A client reports chest pain that radiates to the left arm, accompanied
by diaphoresis and nausea. What is the priority nursing action?
A) Administer sublingual nitroglycerin
B) Obtain a 12-lead ECG
C) Administer oxygen at 2 L/min via nasal cannula
D) Assess pain level using a 0-10 scale
**Answer: C**
**Rationale:** Airway, Breathing, Circulation (ABC) prioritization
indicates that administering oxygen is the priority intervention to
increase myocardial oxygen supply and reduce ischemia. While all
options are appropriate, oxygen administration addresses the
physiological need for oxygenation. Nitroglycerin should be given
after oxygen if pain persists and blood pressure is adequate.
, ---
**Question 5**
A client is receiving IV heparin for a pulmonary embolism. Which
laboratory test should the nurse monitor to evaluate therapeutic
effectiveness?
A) International Normalized Ratio (INR)
B) Activated Partial Thromboplastin Time (aPTT)
C) Prothrombin Time (PT)
D) Platelet count
**Answer: B**
**Rationale:** Heparin therapy is monitored using aPTT, with
therapeutic levels typically 1.5-2.5 times the normal control value. PT
and INR monitor warfarin therapy. Platelet count monitors for
heparin-induced thrombocytopenia (HIT), a complication of heparin
therapy, but does not evaluate therapeutic effectiveness.
---
**Question 6**
A nurse is assessing a client with peripheral arterial disease (PAD).
Which clinical manifestation is expected?
A) Bilateral leg edema
Exam with 120 Verified Questions And
Answers
A client with heart failure is prescribed digoxin. Which assessment
finding indicates digoxin toxicity?
A) Heart rate of 68 bpm
B) Serum potassium level of 3.2 mEq/L
C) Blood pressure of 130/80 mmHg
D) Respiratory rate of 16 breaths/min
**Answer: B**
**Rationale:** Hypokalemia (potassium < 3.5 mEq/L) increases the
risk of digoxin toxicity. Digoxin competes with potassium for binding
sites on the sodium-potassium ATPase pump. Low potassium levels
allow more digoxin to bind, increasing toxicity risk. Signs of toxicity
include GI disturbances, visual changes (yellow-green halos), and
cardiac dysrhythmias. Option A is normal, C is slightly elevated but
not indicative of toxicity, and D is normal.
---
**Question 2**
,A nurse is caring for a client with acute myocardial infarction. Which
laboratory value is most specific for diagnosing an MI?
A) Creatinine kinase (CK)
B) Myoglobin
C) Troponin I
D) Lactate dehydrogenase (LDH)
**Answer: C**
**Rationale:** Troponin I and T are the most specific and sensitive
cardiac markers for myocardial injury. They rise within 3-4 hours of
MI onset and remain elevated for 7-14 days. CK-MB is specific but not
as sensitive as troponin. Myoglobin rises early but lacks specificity.
LDH is less specific and outdated for MI diagnosis.
---
**Question 3**
A client with hypertension is prescribed hydrochlorothiazide. Which
electrolyte imbalance should the nurse monitor?
A) Hyperkalemia
B) Hyponatremia
C) Hypokalemia
D) Hypercalcemia
,**Answer: C**
**Rationale:** Hydrochlorothiazide is a thiazide diuretic that causes
potassium wasting in the distal convoluted tubule. The nurse should
monitor for hypokalemia, which can lead to cardiac dysrhythmias,
muscle weakness, and fatigue. Clients should be encouraged to eat
potassium-rich foods (bananas, oranges) and have serum potassium
levels monitored regularly.
---
**Question 4**
A client reports chest pain that radiates to the left arm, accompanied
by diaphoresis and nausea. What is the priority nursing action?
A) Administer sublingual nitroglycerin
B) Obtain a 12-lead ECG
C) Administer oxygen at 2 L/min via nasal cannula
D) Assess pain level using a 0-10 scale
**Answer: C**
**Rationale:** Airway, Breathing, Circulation (ABC) prioritization
indicates that administering oxygen is the priority intervention to
increase myocardial oxygen supply and reduce ischemia. While all
options are appropriate, oxygen administration addresses the
physiological need for oxygenation. Nitroglycerin should be given
after oxygen if pain persists and blood pressure is adequate.
, ---
**Question 5**
A client is receiving IV heparin for a pulmonary embolism. Which
laboratory test should the nurse monitor to evaluate therapeutic
effectiveness?
A) International Normalized Ratio (INR)
B) Activated Partial Thromboplastin Time (aPTT)
C) Prothrombin Time (PT)
D) Platelet count
**Answer: B**
**Rationale:** Heparin therapy is monitored using aPTT, with
therapeutic levels typically 1.5-2.5 times the normal control value. PT
and INR monitor warfarin therapy. Platelet count monitors for
heparin-induced thrombocytopenia (HIT), a complication of heparin
therapy, but does not evaluate therapeutic effectiveness.
---
**Question 6**
A nurse is assessing a client with peripheral arterial disease (PAD).
Which clinical manifestation is expected?
A) Bilateral leg edema
