CARDIOVASCULAR NCLEX QUESTIONS
WITH ANSWERS AND RATIONALES 2024
UPDATED LATEST GRADED A+.
Which of the following are most likely to be early signs of cardiac problems
in older persons? (Select all that apply.)
Mental status changes
Agitation
Frequent falls
Sudden changes in GI function - Answer Mental status changes
Agitation
Frequent falls
Rationale: Many cardiovascular functions are complicated in that they
involve many other systems. Mental status changes, agitation, and falls can
be early signs of cardiac problems in the older person. Changes in function
in the GI system are not typical signs of a cardiac problem.
A patient has been diagnosed with Right-Sided Congestive Heart Failure,
and is confused about return of deoxygenated blood from the tissue. To
clarify the confusion, which chamber of the heart receives blood from
systemic circulation?
Left atrium
Right atrium
Right ventricle
Left ventricle - Answer Right atrium
Rationale: The right atrium is a thin-walled structure that receives
deoxygenated blood from all the peripheral tissues by way of the superior
and inferior vena cava and from the heart muscle by way of the coronary
sinus.
It is important that the nurse be knowledgeable about cardiac output in
order to:
Evaluate blood flow to peripheral tissues.
Determine the electrical activity of the myocardium.
, Provide information on the immediate need for oxygen.
Implement nutritional changes. - Answer Evaluate blood flow to peripheral
tissues.
Rationale: Blood flow to the tissues is measured clinically as the cardiac
output, and assists to predict tissue perfusion. Electrical activity is
evaluated more effectively by EKG. While the cardiac output is important
for perfusion and oxygenation of tissues, the oxygen saturation would
provide more valuable information. Nutritional changes would be targeted
to sodium and would depend on symptoms of disease.
Integrated Process: Nursing Process; Planning
Cognitive Level: Evaluation
NCLEX-RN Test Plan: Health Promotion and Maintenance
Nurses can best help older clients prevent hypertension by teaching:
Low-fat, low-cholesterol diets.
The importance of exercise.
How to handle stressful situations.
How to maintain a normal blood pressure. - Answer How to maintain a
normal blood pressure.
Rationale: Hypertension is a major risk factor for other cardiovascular
conditions. In persons older than 50, systolic blood pressure greater than
140 mm Hg is a much more important cardiovascular disease risk factor
than is diastolic blood pressure. The risk of cardiovascular disease,
beginning at 115/75 mm Hg, doubles with each increment of 20/10 mm Hg.
Answers 1, 2, and 3 are important elements to include in education of a
patient with blood pressure elevation, and are included in the Answer.
Modification of lifestyle behaviors to help manage hypertension does not
include which of the following? (Select all that apply.)
Weight loss of even 10 pounds
The DASH diet
Fruits, vegetables, and whole grains
Alcohol intake with meals - Answer Alcohol intake with meals
\
,Rationale: Weight loss of even 10 pounds; fruits, vegetables, and whole
grains; the DASH diet; and a daily exercise regimen will help reduce high
blood pressure. Alcohol intake with meals should be reduced to help
manage high blood pressure.
A patient receiving the drug simvastatin (Zocor) should be taught this
medication helps to prevent coronary heart disease by:
Increasing lower-density lipoprotein.
Controlling lower-density lipoprotein.
Increasing triglycerides.
Increasing very low-density lipoprotein. - Answer Controlling lower-density
lipoprotein.
Rationale: The Heart Protective Study has also shown that controlling low-
density lipoprotein (LDL) with simvastatin (Zocor) assists in the prevention
of coronary heart disease by raising HDL. Responses 1, 3, and 4 are
incorrect.
Which of the following are direct causes of chronic ischemic pain? (Select
all that apply.)
Aortic stenosis
Acid reflux
Pulmonary embolus
Herpes zoster (shingles) - Answer Aortic stenosis
Acid reflux
Pulmonary embolus
Rationale: Herpes zoster (shingles) manifests as a vesicular rash along a
dermatome, not chronic ischemic pain.
Integrated Process: Nursing Process; Evaluation
Cognitive Level: Evaluation
NCLEX-RN Test Plan: Physiological Integrity; Physiological Adaptation
Rationale: Herpes zoster (shingles) manifests as a vesicular rash along a
dermatome, not chronic ischemic pain.
Older clients experiencing anginal pain with complaints of fatigue or
weakness usually are medicated with which of the following types of
medication?
, Sublingual nitroglycerin
Cardiac glycosides
HMG-CoA reductase inhibitors
Morphine sulfate - Answer Sublingual nitroglycerin
Rationale: Angina frequently is managed with sublingual nitroglycerin,
which causes vasodilation and increases blood flow to the coronary
arteries. Cardiac glycosides are used to treat heart failure, and morphine is
used to treat myocardial infarction. The HMG-CoA reductase inhibitors are
used for patients with type 2 diabetes mellitus.
Which of the following diagnostic studies most likely would confirm a
myocardial infarction?
Serum myoglobin level
Creatinine kinase (CK)
White blood cell count (WBC)
Troponin T levels - Answer Troponin T levels
Rationale: CK-MB elevates 4-6 hours after tissue necrosis. Troponin levels
rise 6-8 hours after the infarct (tissue necrosis) but also can occur with
other types of tissue damage. Myoglobin also elevates, but to a lesser
degree. WBC levels elevate with an inflammatory response. Troponin
levels are more elevated than are the other cardiac enzymes, are more
specific to cardiac tissue, and rise 6-8 hours after the infarct (tissue
necrosis).
A client with post-myocardial infarction develops acute bacterial
pericarditis. Which of the following medications would the physician most
likely prescribe as the primary drug?
Ticarcillin disodium (Ticar)
Acetaminophen (Tylenol)
Ibuprofen (Motrin)
Trioxsalen (Trisoralen) - Answer Ticarcillin disodium (Ticar)
Rationale: Acute bacterial pericarditis is a complication that can occur post-
myocardial infarction. Acute bacterial pericarditis usually requires
antibiotics. NSAIDs usually are prescribed to relieve pain from the
inflammatory process. If the NSAIDs do not relieve pain within 48 to 96
hours, corticosteroids are ordered. There is no mention of pain in the stem
WITH ANSWERS AND RATIONALES 2024
UPDATED LATEST GRADED A+.
Which of the following are most likely to be early signs of cardiac problems
in older persons? (Select all that apply.)
Mental status changes
Agitation
Frequent falls
Sudden changes in GI function - Answer Mental status changes
Agitation
Frequent falls
Rationale: Many cardiovascular functions are complicated in that they
involve many other systems. Mental status changes, agitation, and falls can
be early signs of cardiac problems in the older person. Changes in function
in the GI system are not typical signs of a cardiac problem.
A patient has been diagnosed with Right-Sided Congestive Heart Failure,
and is confused about return of deoxygenated blood from the tissue. To
clarify the confusion, which chamber of the heart receives blood from
systemic circulation?
Left atrium
Right atrium
Right ventricle
Left ventricle - Answer Right atrium
Rationale: The right atrium is a thin-walled structure that receives
deoxygenated blood from all the peripheral tissues by way of the superior
and inferior vena cava and from the heart muscle by way of the coronary
sinus.
It is important that the nurse be knowledgeable about cardiac output in
order to:
Evaluate blood flow to peripheral tissues.
Determine the electrical activity of the myocardium.
, Provide information on the immediate need for oxygen.
Implement nutritional changes. - Answer Evaluate blood flow to peripheral
tissues.
Rationale: Blood flow to the tissues is measured clinically as the cardiac
output, and assists to predict tissue perfusion. Electrical activity is
evaluated more effectively by EKG. While the cardiac output is important
for perfusion and oxygenation of tissues, the oxygen saturation would
provide more valuable information. Nutritional changes would be targeted
to sodium and would depend on symptoms of disease.
Integrated Process: Nursing Process; Planning
Cognitive Level: Evaluation
NCLEX-RN Test Plan: Health Promotion and Maintenance
Nurses can best help older clients prevent hypertension by teaching:
Low-fat, low-cholesterol diets.
The importance of exercise.
How to handle stressful situations.
How to maintain a normal blood pressure. - Answer How to maintain a
normal blood pressure.
Rationale: Hypertension is a major risk factor for other cardiovascular
conditions. In persons older than 50, systolic blood pressure greater than
140 mm Hg is a much more important cardiovascular disease risk factor
than is diastolic blood pressure. The risk of cardiovascular disease,
beginning at 115/75 mm Hg, doubles with each increment of 20/10 mm Hg.
Answers 1, 2, and 3 are important elements to include in education of a
patient with blood pressure elevation, and are included in the Answer.
Modification of lifestyle behaviors to help manage hypertension does not
include which of the following? (Select all that apply.)
Weight loss of even 10 pounds
The DASH diet
Fruits, vegetables, and whole grains
Alcohol intake with meals - Answer Alcohol intake with meals
\
,Rationale: Weight loss of even 10 pounds; fruits, vegetables, and whole
grains; the DASH diet; and a daily exercise regimen will help reduce high
blood pressure. Alcohol intake with meals should be reduced to help
manage high blood pressure.
A patient receiving the drug simvastatin (Zocor) should be taught this
medication helps to prevent coronary heart disease by:
Increasing lower-density lipoprotein.
Controlling lower-density lipoprotein.
Increasing triglycerides.
Increasing very low-density lipoprotein. - Answer Controlling lower-density
lipoprotein.
Rationale: The Heart Protective Study has also shown that controlling low-
density lipoprotein (LDL) with simvastatin (Zocor) assists in the prevention
of coronary heart disease by raising HDL. Responses 1, 3, and 4 are
incorrect.
Which of the following are direct causes of chronic ischemic pain? (Select
all that apply.)
Aortic stenosis
Acid reflux
Pulmonary embolus
Herpes zoster (shingles) - Answer Aortic stenosis
Acid reflux
Pulmonary embolus
Rationale: Herpes zoster (shingles) manifests as a vesicular rash along a
dermatome, not chronic ischemic pain.
Integrated Process: Nursing Process; Evaluation
Cognitive Level: Evaluation
NCLEX-RN Test Plan: Physiological Integrity; Physiological Adaptation
Rationale: Herpes zoster (shingles) manifests as a vesicular rash along a
dermatome, not chronic ischemic pain.
Older clients experiencing anginal pain with complaints of fatigue or
weakness usually are medicated with which of the following types of
medication?
, Sublingual nitroglycerin
Cardiac glycosides
HMG-CoA reductase inhibitors
Morphine sulfate - Answer Sublingual nitroglycerin
Rationale: Angina frequently is managed with sublingual nitroglycerin,
which causes vasodilation and increases blood flow to the coronary
arteries. Cardiac glycosides are used to treat heart failure, and morphine is
used to treat myocardial infarction. The HMG-CoA reductase inhibitors are
used for patients with type 2 diabetes mellitus.
Which of the following diagnostic studies most likely would confirm a
myocardial infarction?
Serum myoglobin level
Creatinine kinase (CK)
White blood cell count (WBC)
Troponin T levels - Answer Troponin T levels
Rationale: CK-MB elevates 4-6 hours after tissue necrosis. Troponin levels
rise 6-8 hours after the infarct (tissue necrosis) but also can occur with
other types of tissue damage. Myoglobin also elevates, but to a lesser
degree. WBC levels elevate with an inflammatory response. Troponin
levels are more elevated than are the other cardiac enzymes, are more
specific to cardiac tissue, and rise 6-8 hours after the infarct (tissue
necrosis).
A client with post-myocardial infarction develops acute bacterial
pericarditis. Which of the following medications would the physician most
likely prescribe as the primary drug?
Ticarcillin disodium (Ticar)
Acetaminophen (Tylenol)
Ibuprofen (Motrin)
Trioxsalen (Trisoralen) - Answer Ticarcillin disodium (Ticar)
Rationale: Acute bacterial pericarditis is a complication that can occur post-
myocardial infarction. Acute bacterial pericarditis usually requires
antibiotics. NSAIDs usually are prescribed to relieve pain from the
inflammatory process. If the NSAIDs do not relieve pain within 48 to 96
hours, corticosteroids are ordered. There is no mention of pain in the stem
