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NUR 254 Final Review
Comprehensive Practice
Question Bank
NCLEX-Style Practice Questions with Rationales
Topic Focus: Comprehensive Nursing — CAD, MI, Shock, & Cardiac Rhythms
Edition 1 · September 2026
Table of Contents
1. Instructions for Use 2
2. Practice Questions with Answers & Rationales — Comprehensive Nursing 2
NUR 254 · Galen College of Nursing Page 1
,NUR 254 FINAL REVIEW INSTRUCTIONS & PRACTICE QUESTIONS
How to Use This Guide
Read each stem, choose your answer, then check the rationale directly below it. The correct
option is marked, and each wrong option is explained so you understand why it's wrong — not
just that it is.
Category: Comprehensive Nursing — CAD, MI, Shock, & Cardiac Rhythms
1 The nurse is teaching a client about coronary artery disease (CAD). Which statement
best describes CAD?
A Narrowing of the heart vessels
B Dilation of the heart vessels
C Thickening of the heart muscle
D Weakening of the heart valves
Correct Answer: A Coronary artery disease (CAD) is characterized by narrowing of the heart
vessels due to atherosclerosis, which reduces blood flow to the myocardium.
B — Dilation of vessels is not CAD; CAD involves narrowing.
C — Thickening of the heart muscle is cardiomyopathy, not CAD.
D — Weakening of heart valves is valvular disease.
Tested Concept: CAD definition
Source Concept: What is CAD? Narrowing of heart vessels
,2 The nurse is providing health education to a community group. What is the number
one cause of death for men and women in the United States?
A Coronary artery disease (CAD)
B Cancer
C Stroke
D Diabetes mellitus
Correct Answer: A Coronary artery disease (CAD) is the number one cause of death for
both men and women in the United States.
B — Cancer is the second leading cause of death.
C — Stroke is a leading cause of death but not number one.
D — Diabetes is a significant cause of death but not number one.
Tested Concept: CAD — leading cause of death
Source Concept: What is the number one cause of death for men and women in the US? CAD
3 The nurse is teaching a client about the pathophysiology of CAD. What is the most
common cause of CAD?
A Atherosclerosis (plaque buildup)
B Congenital heart defects
C Valvular stenosis
D Myocarditis
Correct Answer: A The most common cause of CAD is atherosclerosis, which involves
plaque buildup within the coronary arteries, leading to narrowing and reduced blood flow.
B — Congenital heart defects are present at birth and are not the most common cause.
C — Valvular stenosis affects heart valves, not coronary arteries.
D — Myocarditis is inflammation of the heart muscle.
Tested Concept: CAD — most common cause
Source Concept: What is the most common cause of CAD? Atherosclerosis (plaque buildup)
, 4 A client asks the nurse when CAD typically begins to manifest symptoms. Which
response by the nurse is correct?
A Symptoms manifest at approximately 40% blockage
B Symptoms manifest at approximately 50% blockage
C Symptoms manifest at approximately 70% blockage
D Symptoms manifest at approximately 90% blockage
Correct Answer: A CAD typically manifests symptoms when there is approximately 40%
blockage of the coronary artery, as the vessel is significantly narrowed and blood flow is
compromised.
B — Symptoms may not wait until 50% blockage.
C — 70% blockage would cause severe symptoms.
D — 90% blockage would cause critical ischemia.
Tested Concept: CAD — symptom manifestation
Source Concept: When does CAD manifest symptoms? 40% blockage
5 The nurse is teaching a client about the difference between arteriosclerosis and
atherosclerosis. Which statement by the client indicates understanding?
A "Arteriosclerosis is narrowing of arteries due to hardening."
B "Arteriosclerosis is caused by plaque buildup."
C "Arteriosclerosis and atherosclerosis are the same condition."
D "Arteriosclerosis is a type of heart failure."
Correct Answer: A Arteriosclerosis is the narrowing of arteries due to hardening and loss of
elasticity. Atherosclerosis is a specific type of arteriosclerosis involving plaque buildup.
B — Plaque buildup is atherosclerosis, not arteriosclerosis.
C — They are related but not identical; atherosclerosis is a subtype.
D — Arteriosclerosis is a vascular condition, not heart failure.
Tested Concept: Arteriosclerosis vs. atherosclerosis
Source Concept: What is arteriosclerosis? Narrowing of artery due to hardening
NUR 254 Final Review
Comprehensive Practice
Question Bank
NCLEX-Style Practice Questions with Rationales
Topic Focus: Comprehensive Nursing — CAD, MI, Shock, & Cardiac Rhythms
Edition 1 · September 2026
Table of Contents
1. Instructions for Use 2
2. Practice Questions with Answers & Rationales — Comprehensive Nursing 2
NUR 254 · Galen College of Nursing Page 1
,NUR 254 FINAL REVIEW INSTRUCTIONS & PRACTICE QUESTIONS
How to Use This Guide
Read each stem, choose your answer, then check the rationale directly below it. The correct
option is marked, and each wrong option is explained so you understand why it's wrong — not
just that it is.
Category: Comprehensive Nursing — CAD, MI, Shock, & Cardiac Rhythms
1 The nurse is teaching a client about coronary artery disease (CAD). Which statement
best describes CAD?
A Narrowing of the heart vessels
B Dilation of the heart vessels
C Thickening of the heart muscle
D Weakening of the heart valves
Correct Answer: A Coronary artery disease (CAD) is characterized by narrowing of the heart
vessels due to atherosclerosis, which reduces blood flow to the myocardium.
B — Dilation of vessels is not CAD; CAD involves narrowing.
C — Thickening of the heart muscle is cardiomyopathy, not CAD.
D — Weakening of heart valves is valvular disease.
Tested Concept: CAD definition
Source Concept: What is CAD? Narrowing of heart vessels
,2 The nurse is providing health education to a community group. What is the number
one cause of death for men and women in the United States?
A Coronary artery disease (CAD)
B Cancer
C Stroke
D Diabetes mellitus
Correct Answer: A Coronary artery disease (CAD) is the number one cause of death for
both men and women in the United States.
B — Cancer is the second leading cause of death.
C — Stroke is a leading cause of death but not number one.
D — Diabetes is a significant cause of death but not number one.
Tested Concept: CAD — leading cause of death
Source Concept: What is the number one cause of death for men and women in the US? CAD
3 The nurse is teaching a client about the pathophysiology of CAD. What is the most
common cause of CAD?
A Atherosclerosis (plaque buildup)
B Congenital heart defects
C Valvular stenosis
D Myocarditis
Correct Answer: A The most common cause of CAD is atherosclerosis, which involves
plaque buildup within the coronary arteries, leading to narrowing and reduced blood flow.
B — Congenital heart defects are present at birth and are not the most common cause.
C — Valvular stenosis affects heart valves, not coronary arteries.
D — Myocarditis is inflammation of the heart muscle.
Tested Concept: CAD — most common cause
Source Concept: What is the most common cause of CAD? Atherosclerosis (plaque buildup)
, 4 A client asks the nurse when CAD typically begins to manifest symptoms. Which
response by the nurse is correct?
A Symptoms manifest at approximately 40% blockage
B Symptoms manifest at approximately 50% blockage
C Symptoms manifest at approximately 70% blockage
D Symptoms manifest at approximately 90% blockage
Correct Answer: A CAD typically manifests symptoms when there is approximately 40%
blockage of the coronary artery, as the vessel is significantly narrowed and blood flow is
compromised.
B — Symptoms may not wait until 50% blockage.
C — 70% blockage would cause severe symptoms.
D — 90% blockage would cause critical ischemia.
Tested Concept: CAD — symptom manifestation
Source Concept: When does CAD manifest symptoms? 40% blockage
5 The nurse is teaching a client about the difference between arteriosclerosis and
atherosclerosis. Which statement by the client indicates understanding?
A "Arteriosclerosis is narrowing of arteries due to hardening."
B "Arteriosclerosis is caused by plaque buildup."
C "Arteriosclerosis and atherosclerosis are the same condition."
D "Arteriosclerosis is a type of heart failure."
Correct Answer: A Arteriosclerosis is the narrowing of arteries due to hardening and loss of
elasticity. Atherosclerosis is a specific type of arteriosclerosis involving plaque buildup.
B — Plaque buildup is atherosclerosis, not arteriosclerosis.
C — They are related but not identical; atherosclerosis is a subtype.
D — Arteriosclerosis is a vascular condition, not heart failure.
Tested Concept: Arteriosclerosis vs. atherosclerosis
Source Concept: What is arteriosclerosis? Narrowing of artery due to hardening
