FLORIDA BOARD OF NURSING
CARDIOVASCULAR NURSING
CERTIFICATION EXAM WITH ACTUAL
QUESTIONS AND VERIFIED ANSWERS,
PLUS EXPLAINED RATIONALES/EXPERT
VERIFIED FOR GUARANTEED 100% PASS
2026/LATEST UPDATE/INSTANT
DOWNLOAD PDF
1. A 67-year-old patient arrives in the emergency department
reporting crushing substernal chest pressure that began 45 minutes
ago while mowing the lawn. The discomfort radiates to the left arm
and jaw and is associated with diaphoresis, nausea, and dyspnea.
The patient's blood pressure is 154/92 mmHg, heart rate 104/min,
respiratory rate 24/min, and oxygen saturation 95% on room air.
Which nursing action is the highest priority?
A. Administer oxygen at 4 L/min by nasal cannula
B. Obtain a 12-lead ECG as rapidly as possible
C. Place the patient in Trendelenburg position
D. Administer a prescribed opioid before obtaining diagnostic testing
Answer: B. Obtain a 12-lead ECG as rapidly as possible
Rationale: A patient with symptoms strongly suggestive of acute
coronary syndrome requires rapid ECG evaluation to identify ischemic
changes and determine whether STEMI is present. Oxygen is not
routinely indicated when oxygen saturation is adequate, and
unnecessary opioid administration may complicate assessment. Rapid
identification and treatment of ACS is time-sensitive.
1
,2. A patient with suspected acute myocardial infarction has a 12-
lead ECG showing ST-segment elevation in leads II, III, and aVF.
The patient becomes hypotensive after administration of
nitroglycerin. Which complication should the nurse suspect?
A. Right ventricular infarction
B. Acute pulmonary edema
C. Left ventricular hypertrophy
D. Aortic dissection
Answer: A. Right ventricular infarction
Rationale: Inferior myocardial infarctions involving the right
coronary artery may extend to the right ventricle. Right ventricular
infarction causes impaired right-sided filling and is highly preload
dependent. Nitroglycerin decreases preload and can precipitate
significant hypotension in these patients. The nurse should recognize
the pattern and promptly notify the provider while supporting
hemodynamic stabilization.
3. A patient with acute decompensated heart failure has severe
dyspnea, bilateral crackles, an oxygen saturation of 86%, pink
frothy sputum, and a blood pressure of 178/104 mmHg. Which
finding requires the most immediate intervention?
A. Bilateral dependent edema
B. Weight gain of 3 kg over 1 week
C. Pink frothy sputum and severe respiratory distress
D. Elevated jugular venous pressure
Answer: C. Pink frothy sputum and severe respiratory distress
Rationale: Pink frothy sputum with severe dyspnea and hypoxemia
strongly suggests acute pulmonary edema, a life-threatening
manifestation of left-sided heart failure. Immediate priorities are
2
,airway, breathing, oxygenation, positioning, and rapid initiation of
prescribed therapies. Peripheral edema and weight gain indicate fluid
retention but are less immediately life-threatening.
4. A patient with atrial fibrillation has a ventricular rate of 168/min,
blood pressure of 78/46 mmHg, altered mental status, chest
discomfort, and signs of poor perfusion. Which intervention should
the nurse anticipate?
A. Oral anticoagulation only
B. Synchronized cardioversion
C. Vagal maneuvers
D. Observation for spontaneous conversion
Answer: B. Synchronized cardioversion
Rationale: Atrial fibrillation with rapid ventricular response
accompanied by hypotension, altered mental status, ischemic chest
discomfort, or other signs of instability requires urgent electrical
therapy. Synchronized cardioversion delivers the shock in
coordination with the cardiac cycle, reducing the risk of inducing
ventricular fibrillation.
5. A patient receiving digoxin for heart failure reports nausea,
anorexia, and yellow-green visual disturbances. The apical pulse is
48/min. What is the nurse's priority action?
A. Administer the medication with food
B. Hold the digoxin and notify the provider
C. Give an additional dose to improve cardiac output
D. Encourage increased potassium restriction
Answer: B. Hold the digoxin and notify the provider
3
, Rationale: Bradycardia, gastrointestinal symptoms, and visual
disturbances are classic warning signs of digoxin toxicity. The nurse
should withhold the medication and promptly notify the provider.
Electrolyte abnormalities, especially hypokalemia, can increase
susceptibility to digoxin toxicity.
6. A patient with chronic heart failure is prescribed furosemide.
Which laboratory value is most important for the nurse to monitor?
A. Potassium
B. Hemoglobin
C. Platelet count
D. Serum amylase
Answer: A. Potassium
Rationale: Loop diuretics such as furosemide can cause significant
potassium loss. Hypokalemia increases the risk of dysrhythmias and
can worsen toxicity in patients receiving digoxin. Sodium, renal
function, fluid status, and magnesium should also be monitored, but
potassium is particularly important because of its direct cardiovascular
implications.
7. A patient with chest pain has a prescription for sublingual
nitroglycerin. Before administering the medication, which
assessment finding requires the nurse to withhold it and contact the
provider?
A. Heart rate of 92/min
B. Blood pressure of 88/54 mmHg
C. Respiratory rate of 20/min
D. Chest pain rated 8/10
Answer: B. Blood pressure of 88/54 mmHg
4
CARDIOVASCULAR NURSING
CERTIFICATION EXAM WITH ACTUAL
QUESTIONS AND VERIFIED ANSWERS,
PLUS EXPLAINED RATIONALES/EXPERT
VERIFIED FOR GUARANTEED 100% PASS
2026/LATEST UPDATE/INSTANT
DOWNLOAD PDF
1. A 67-year-old patient arrives in the emergency department
reporting crushing substernal chest pressure that began 45 minutes
ago while mowing the lawn. The discomfort radiates to the left arm
and jaw and is associated with diaphoresis, nausea, and dyspnea.
The patient's blood pressure is 154/92 mmHg, heart rate 104/min,
respiratory rate 24/min, and oxygen saturation 95% on room air.
Which nursing action is the highest priority?
A. Administer oxygen at 4 L/min by nasal cannula
B. Obtain a 12-lead ECG as rapidly as possible
C. Place the patient in Trendelenburg position
D. Administer a prescribed opioid before obtaining diagnostic testing
Answer: B. Obtain a 12-lead ECG as rapidly as possible
Rationale: A patient with symptoms strongly suggestive of acute
coronary syndrome requires rapid ECG evaluation to identify ischemic
changes and determine whether STEMI is present. Oxygen is not
routinely indicated when oxygen saturation is adequate, and
unnecessary opioid administration may complicate assessment. Rapid
identification and treatment of ACS is time-sensitive.
1
,2. A patient with suspected acute myocardial infarction has a 12-
lead ECG showing ST-segment elevation in leads II, III, and aVF.
The patient becomes hypotensive after administration of
nitroglycerin. Which complication should the nurse suspect?
A. Right ventricular infarction
B. Acute pulmonary edema
C. Left ventricular hypertrophy
D. Aortic dissection
Answer: A. Right ventricular infarction
Rationale: Inferior myocardial infarctions involving the right
coronary artery may extend to the right ventricle. Right ventricular
infarction causes impaired right-sided filling and is highly preload
dependent. Nitroglycerin decreases preload and can precipitate
significant hypotension in these patients. The nurse should recognize
the pattern and promptly notify the provider while supporting
hemodynamic stabilization.
3. A patient with acute decompensated heart failure has severe
dyspnea, bilateral crackles, an oxygen saturation of 86%, pink
frothy sputum, and a blood pressure of 178/104 mmHg. Which
finding requires the most immediate intervention?
A. Bilateral dependent edema
B. Weight gain of 3 kg over 1 week
C. Pink frothy sputum and severe respiratory distress
D. Elevated jugular venous pressure
Answer: C. Pink frothy sputum and severe respiratory distress
Rationale: Pink frothy sputum with severe dyspnea and hypoxemia
strongly suggests acute pulmonary edema, a life-threatening
manifestation of left-sided heart failure. Immediate priorities are
2
,airway, breathing, oxygenation, positioning, and rapid initiation of
prescribed therapies. Peripheral edema and weight gain indicate fluid
retention but are less immediately life-threatening.
4. A patient with atrial fibrillation has a ventricular rate of 168/min,
blood pressure of 78/46 mmHg, altered mental status, chest
discomfort, and signs of poor perfusion. Which intervention should
the nurse anticipate?
A. Oral anticoagulation only
B. Synchronized cardioversion
C. Vagal maneuvers
D. Observation for spontaneous conversion
Answer: B. Synchronized cardioversion
Rationale: Atrial fibrillation with rapid ventricular response
accompanied by hypotension, altered mental status, ischemic chest
discomfort, or other signs of instability requires urgent electrical
therapy. Synchronized cardioversion delivers the shock in
coordination with the cardiac cycle, reducing the risk of inducing
ventricular fibrillation.
5. A patient receiving digoxin for heart failure reports nausea,
anorexia, and yellow-green visual disturbances. The apical pulse is
48/min. What is the nurse's priority action?
A. Administer the medication with food
B. Hold the digoxin and notify the provider
C. Give an additional dose to improve cardiac output
D. Encourage increased potassium restriction
Answer: B. Hold the digoxin and notify the provider
3
, Rationale: Bradycardia, gastrointestinal symptoms, and visual
disturbances are classic warning signs of digoxin toxicity. The nurse
should withhold the medication and promptly notify the provider.
Electrolyte abnormalities, especially hypokalemia, can increase
susceptibility to digoxin toxicity.
6. A patient with chronic heart failure is prescribed furosemide.
Which laboratory value is most important for the nurse to monitor?
A. Potassium
B. Hemoglobin
C. Platelet count
D. Serum amylase
Answer: A. Potassium
Rationale: Loop diuretics such as furosemide can cause significant
potassium loss. Hypokalemia increases the risk of dysrhythmias and
can worsen toxicity in patients receiving digoxin. Sodium, renal
function, fluid status, and magnesium should also be monitored, but
potassium is particularly important because of its direct cardiovascular
implications.
7. A patient with chest pain has a prescription for sublingual
nitroglycerin. Before administering the medication, which
assessment finding requires the nurse to withhold it and contact the
provider?
A. Heart rate of 92/min
B. Blood pressure of 88/54 mmHg
C. Respiratory rate of 20/min
D. Chest pain rated 8/10
Answer: B. Blood pressure of 88/54 mmHg
4
