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
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.
,CARDIAC NCLEX EXAM /NCLEX CARDIAC EXAM ACTUAL EXAM 300 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
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
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?
,CARDIAC NCLEX EXAM /NCLEX CARDIAC EXAM ACTUAL EXAM 300 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
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.
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.
, CARDIAC NCLEX EXAM /NCLEX CARDIAC EXAM ACTUAL EXAM 300 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
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
When discussing angina pectoris secondary to atherosclerotic disease with a patient, the patient asks
why he tends to experience chest pain when he exerts himself. The nurse should describe which of
the following phenomena?
A. Exercise increases the metabolism of cardiac medications.
B. Exercise causes vasoconstriction of the coronary arteries.
C. Exercise shunts blood flow from the heart to the mesenteric area.
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
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.
,CARDIAC NCLEX EXAM /NCLEX CARDIAC EXAM ACTUAL EXAM 300 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
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
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?
,CARDIAC NCLEX EXAM /NCLEX CARDIAC EXAM ACTUAL EXAM 300 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
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.
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.
, CARDIAC NCLEX EXAM /NCLEX CARDIAC EXAM ACTUAL EXAM 300 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
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
When discussing angina pectoris secondary to atherosclerotic disease with a patient, the patient asks
why he tends to experience chest pain when he exerts himself. The nurse should describe which of
the following phenomena?
A. Exercise increases the metabolism of cardiac medications.
B. Exercise causes vasoconstriction of the coronary arteries.
C. Exercise shunts blood flow from the heart to the mesenteric area.
