CARDIAC NCLEX EXAM /NCLEX CARDIAC EXAM ACTUAL EXAM 300 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
The student nurse is preparing a teaching plan for a patient being discharged status post MI.
What should the student include in the teaching plan? (Mark all that apply.)
A. Need for increased fluid intake
B. Need for early resumption of prediagnosis activity
C. Need for careful monitoring for cardiac symptoms
D. Need for dietary modifications
E. Need for carefully regulated exercise - (answer) C. Need for careful monitoring for cardiac
symptoms
D. Need for dietary modifications
E. Need for carefully regulated exercise
Dietary modifications, exercise, weight loss, and careful monitoring are important strategies for
managing three major cardiovascular risk factors: hyperlipidemia, hypertension, and diabetes.
There is no need to increase fluid intake and activity should be slowly and deliberately increased
The nurse is caring for an 84-year-old man who has just returned from the OR after inguinal
hernia repair. The OR report indicates that the patient received large volumes of IV fluids during
surgery and the nurse recognizes that the patient is at risk for left-sided heart failure. What
signs and symptoms would indicate left-sided heart failure?
A. Jugular vein distention
B. Bibasilar fine crackles
C. Right upper quadrant pain
D. Dependent edema - (answer) B. Bibasilar fine crackles
,CARDIAC NCLEX EXAM /NCLEX CARDIAC EXAM ACTUAL EXAM 300 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
Bibasilar fine crackles are a sign of alveolar fluid, a sequela of left ventricular fluid, or pressure
overload. Jugular vein distention, right upper quadrant pain (hepatomegaly), and dependent
edema are caused by right-sided heart failure, usually a chronic condition.
The nurse is reviewing a newly admitted patient's electronic health record, which notes a
history of orthopnea? What nursing action is most clearly indicated?
A. Avoid positioning the patient supine.
B. Limit the patient's activity level.
C. Teach the patient deep breathing and coughing exercises.
D. Administer supplemental oxygen at all times. - (answer) A. Avoid positioning the patient
supine.
Orthopnea is defined as difficulty breathing while lying flat. This is a possible complication of HF
and, consequently, the nurse should avoid positioning the patient supine. Oxygen
supplementation may or may not be necessary and activity does not always need to be
curtailed. Deep breathing and coughing exercises do not directly address this symptom.
The nurse is caring for an adult patient with HF who is prescribed digoxin. When assessing the
patient for adverse effects, the nurse should assess for which of the following signs and
symptoms?
A. Numbness and tingling in the extremities
B. Confusion and bradycardia
C. Uncontrolled diuresis and tachycardia
D. Chest pain and shortness of breath - (answer) B. Confusion and bradycardia
,CARDIAC NCLEX EXAM /NCLEX CARDIAC EXAM ACTUAL EXAM 300 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
A key concern associated with digitalis therapy is digitalis toxicity. Symptoms include anorexia,
nausea, visual disturbances, confusion, and bradycardia. The other listed signs and symptoms
are not characteristic of digitalis toxicity.
The ED nurse is caring for a patient with a suspected MI. What drug should the nurse anticipate
administering to this patient?
A. Warfarin
B. Oxycodone
C. Morphine
D. Acetaminophen - (answer) C. Morphine
The patient with suspected MI is given aspirin, nitroglycerin, morphine, an IV beta- blocker, and
other medications, as indicated, while the diagnosis is being confirmed. Tylenol, warfarin, and
oxycodone are not typically used.
A patient is admitted to the critical care unit (CCU) with a diagnosis of cardiomyopathy. When
reviewing the patient's most recent laboratory results, the nurse should prioritize assessment of
which of the following?
A. Sodium
B. AST, ALT, and bilirubin
C. BUN
D. White blood cell differential - (answer) A. Sodium
Sodium is the major electrolyte involved with cardiomyopathy. Cardiomyopathy often leads to
heart failure which develops, in part, from fluid overload. Fluid overload is often associated with
elevated sodium levels. Consequently, sodium levels are followed more closely than other
important laboratory values, including BUN, leukocytes, and liver function tests.
, CARDIAC NCLEX EXAM /NCLEX CARDIAC EXAM ACTUAL EXAM 300 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
The nurse is caring for a patient admitted with unstable angina. The laboratory result for the
initial troponin I is elevated in this patient. The nurse should recognize what implication of this
assessment finding?
A. This result indicates muscle injury, but does not specify the source.
B. This is an accurate indicator of myocardial injury.
C. This is only an accurate indicator of myocardial damage when it reaches its peak in 24 hours.
D. Because the patient has a history of unstable angina, this is a poor indicator of myocardial
injury. - (answer) B. This is an accurate indicator of myocardial injury.
Troponin I, which is specific to cardiac muscle, is elevated within hours after myocardial injury.
Even with a diagnosis of unstable angina, this is an accurate indicator of myocardial injury.
The nurse is providing discharge education to a patient diagnosed with HF. What should the
nurse teach this patient to do to assess her fluid balance in the home setting?
A. Monitor her weight daily
B. Monitor her bowel movements
C. Monitor her blood pressure daily
D. Assess her radial pulses daily - (answer) A. Monitor her weight daily
To assess fluid balance at home, the patient should monitor daily weights at the same time
every day. Assessing radial pulses and monitoring the blood pressure may be done, but these
measurements do not provide information about fluid balance. Bowel function is not indicative
of fluid balance
DETAILED ANSWERS WITH RATIONALES
The student nurse is preparing a teaching plan for a patient being discharged status post MI.
What should the student include in the teaching plan? (Mark all that apply.)
A. Need for increased fluid intake
B. Need for early resumption of prediagnosis activity
C. Need for careful monitoring for cardiac symptoms
D. Need for dietary modifications
E. Need for carefully regulated exercise - (answer) C. Need for careful monitoring for cardiac
symptoms
D. Need for dietary modifications
E. Need for carefully regulated exercise
Dietary modifications, exercise, weight loss, and careful monitoring are important strategies for
managing three major cardiovascular risk factors: hyperlipidemia, hypertension, and diabetes.
There is no need to increase fluid intake and activity should be slowly and deliberately increased
The nurse is caring for an 84-year-old man who has just returned from the OR after inguinal
hernia repair. The OR report indicates that the patient received large volumes of IV fluids during
surgery and the nurse recognizes that the patient is at risk for left-sided heart failure. What
signs and symptoms would indicate left-sided heart failure?
A. Jugular vein distention
B. Bibasilar fine crackles
C. Right upper quadrant pain
D. Dependent edema - (answer) B. Bibasilar fine crackles
,CARDIAC NCLEX EXAM /NCLEX CARDIAC EXAM ACTUAL EXAM 300 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
Bibasilar fine crackles are a sign of alveolar fluid, a sequela of left ventricular fluid, or pressure
overload. Jugular vein distention, right upper quadrant pain (hepatomegaly), and dependent
edema are caused by right-sided heart failure, usually a chronic condition.
The nurse is reviewing a newly admitted patient's electronic health record, which notes a
history of orthopnea? What nursing action is most clearly indicated?
A. Avoid positioning the patient supine.
B. Limit the patient's activity level.
C. Teach the patient deep breathing and coughing exercises.
D. Administer supplemental oxygen at all times. - (answer) A. Avoid positioning the patient
supine.
Orthopnea is defined as difficulty breathing while lying flat. This is a possible complication of HF
and, consequently, the nurse should avoid positioning the patient supine. Oxygen
supplementation may or may not be necessary and activity does not always need to be
curtailed. Deep breathing and coughing exercises do not directly address this symptom.
The nurse is caring for an adult patient with HF who is prescribed digoxin. When assessing the
patient for adverse effects, the nurse should assess for which of the following signs and
symptoms?
A. Numbness and tingling in the extremities
B. Confusion and bradycardia
C. Uncontrolled diuresis and tachycardia
D. Chest pain and shortness of breath - (answer) B. Confusion and bradycardia
,CARDIAC NCLEX EXAM /NCLEX CARDIAC EXAM ACTUAL EXAM 300 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
A key concern associated with digitalis therapy is digitalis toxicity. Symptoms include anorexia,
nausea, visual disturbances, confusion, and bradycardia. The other listed signs and symptoms
are not characteristic of digitalis toxicity.
The ED nurse is caring for a patient with a suspected MI. What drug should the nurse anticipate
administering to this patient?
A. Warfarin
B. Oxycodone
C. Morphine
D. Acetaminophen - (answer) C. Morphine
The patient with suspected MI is given aspirin, nitroglycerin, morphine, an IV beta- blocker, and
other medications, as indicated, while the diagnosis is being confirmed. Tylenol, warfarin, and
oxycodone are not typically used.
A patient is admitted to the critical care unit (CCU) with a diagnosis of cardiomyopathy. When
reviewing the patient's most recent laboratory results, the nurse should prioritize assessment of
which of the following?
A. Sodium
B. AST, ALT, and bilirubin
C. BUN
D. White blood cell differential - (answer) A. Sodium
Sodium is the major electrolyte involved with cardiomyopathy. Cardiomyopathy often leads to
heart failure which develops, in part, from fluid overload. Fluid overload is often associated with
elevated sodium levels. Consequently, sodium levels are followed more closely than other
important laboratory values, including BUN, leukocytes, and liver function tests.
, CARDIAC NCLEX EXAM /NCLEX CARDIAC EXAM ACTUAL EXAM 300 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
The nurse is caring for a patient admitted with unstable angina. The laboratory result for the
initial troponin I is elevated in this patient. The nurse should recognize what implication of this
assessment finding?
A. This result indicates muscle injury, but does not specify the source.
B. This is an accurate indicator of myocardial injury.
C. This is only an accurate indicator of myocardial damage when it reaches its peak in 24 hours.
D. Because the patient has a history of unstable angina, this is a poor indicator of myocardial
injury. - (answer) B. This is an accurate indicator of myocardial injury.
Troponin I, which is specific to cardiac muscle, is elevated within hours after myocardial injury.
Even with a diagnosis of unstable angina, this is an accurate indicator of myocardial injury.
The nurse is providing discharge education to a patient diagnosed with HF. What should the
nurse teach this patient to do to assess her fluid balance in the home setting?
A. Monitor her weight daily
B. Monitor her bowel movements
C. Monitor her blood pressure daily
D. Assess her radial pulses daily - (answer) A. Monitor her weight daily
To assess fluid balance at home, the patient should monitor daily weights at the same time
every day. Assessing radial pulses and monitoring the blood pressure may be done, but these
measurements do not provide information about fluid balance. Bowel function is not indicative
of fluid balance
