CARDIAC NCLEX PRACTICE EXAM /NCLEX CARDIAC
PRACTICE EXAM ACTUAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS WITH RATIONALES
Which of the following actions is the first priority of care for a pt exhibiting signs &
symptoms of coronary artery disease?
1. Decrease anxiety
2. Enhance myocardial oxygenation
3. Administer sublingual nitroglycerin
4. Educate the pt about his symptoms -correct answer2. Enhancing myocardial
oxygenation is always the first priority when a pt exhibits signs or symptoms of cardiac
compromise. W/out adequate oxygenation, the myocardium suffers damage. Sublingual
nitroglycerin is administered to treat acute angina, but administration isn't the first
priority. Although educating the pt & decreasing anxiety are important in care delivery,
neither are priorities when a pt is compromised.
Medical treatment of coronary artery disease includes which of the following
procedures?
1. Cardiac catherization
2. Coronary artery bypass surgery
3. Oral med therapy
4. Percutaneous transluminal coronary angioplasty -correct answer3. Oral med
administration is a noninvasive, medical treatment for coronary artery disease. Cardiac
catherization isn't a treatment, but a diagnostic tool. Coronary artery bypass surgery &
percutaneous transluminal coronary angioplasty are invasive, surgical treatments.
Which of the following is the most common symptom of myocardial infarction (MI)?
1. Chest pain
2. Dyspnea
3. Edema
4. Palpitations -correct answer1. The most common symptom of an MI is chest pain,
resulting from deprivation of oxygen to the heart. Dyspnea is the second most common
symptom, related to an increase in the metabolic needs of the body during an MI.
Edema is a later sign of heart failure, often seen after an MI. Palpitations may result
from reduced cardiac output, producing arrhythmias.
,Which of the following symptoms is the most likely origin of pain the pt described as
knifelike chest pain that increases in intensity with inspiration?
1. Cardiac
2. Gastrointestinal
3. Musculoskeletal
4. Pulmonary -correct answer4. Pulmonary pain is generally described by these
symptoms. Musculoskeletal pain only increases w/ movement. Cardiac & GI pains don't
change w/ respiration.
Which of the following blood tests is most indicative of cardiac damage?
1. Lactate dehydrogenase
2. Complete blood count (CBC)
3. Troponin I
4. Creatine kinase (CK) -correct answer3. Troponin I levels rise rapidly & are
detectable w/in 1 hour of myocardial injury. Troponin I levels aren't detectable in people
w/out cardiac injury. Lactate dehydrogenase (LDH) is present in almost all body tissues
& not specific to heart muscle. LDH isoenzymes are useful in diagnosing cardiac injury.
CBC is obtained to review blood counts, & a complete chemistry is obtained to review
electrolytes. Because CK levels may rise w/ skeletal muscle injury, CK isoenzymes are
required to detect cardiac injury
What is the primary reason for administering morphine to a pt with an MI?
1. To sedate the pt
2. To decrease the pt's pain
3. To decrease the pt's anxiety
4. To decrease oxygen demand on the pt's heart -correct answer4. Morphine is
administered because it decreases myocardial oxygen demand. Morphine will also
decrease pain & anxiety while causing sedation, but it isn't primarily given for those
reasons.
Which of the following conditions is most commonly responsible for myocardial
infarction?
1. Aneurysm
2. Heart failure
3. Coronary artery thrombosis
4. Renal failure -correct answer3. Coronary artery thrombosis causes an inclusion
of the artery, leading to myocardial death. An aneurysm is an outpouching of a vessel &
doesn't cause an MI. Renal failure can be associated w/ MI but isn't a direct cause.
Heart failure is usually a result from an MI.
Which of the following complications is indicated by a third heart sound (S3)?
1. Ventricular dilation
2. Systemic hypertension
3. Aortic valve malfunction
4. Increased atrial contractions -correct answer1. Rapid filling of the ventricle
causes vasodilation that is auscultated as S3. Increased atrial contraction or systemic
, hypertension can result in a fourth heart sound. Aortic valve malfunction is heard as a
murmur.
After an anterior wall myocardial infarction, which of the following problems is indicated
by auscultation of crackles in the lungs?
1. Left-sided heart failure
2. Pulmonic valve malfunction
3. Right-sided heart failure
4. Tricupsid valve malfunction -correct answer1. The left ventricle is responsible for
most of the cardiac output. An anterior wall MI may result in a decrease in left
ventricular function. When the left ventricle doesn't function properly, resulting in left-
sided heart failure, fluid accumulates in the interstitial & alveolar spaces in the lungs &
causes crackles. Pulmonic & tricuspid valve malfunction causes right sided heart failure.
What is the first intervention for a pt experiencing MI?
1. Administer morphine
2. Administer oxygen
3. Administer sublingual nitroglycerin
4. Obtain an ECG -correct answer2. Administering supplemental oxygen to the pt is
the first priority of care. The myocardium is deprived of oxygen during an infarction, so
additional oxygen is administered to assist in oxygenation & prevent further damage.
Morphine & nitro are also used to treat MI, but they're more commonly administered
after the oxygen. An ECG is the most common diagnostic tool used to evaluate MI.
Which of the following classes of meds protects the ischemic myocardium by blocking
catecholamines & sympathetic nerve stimulation?
1. Beta-adrenergic blockers
2. Calcium channel blockers
3. Narcotics
4. Nitrates -correct answer1. Beta-adrenergic blockers work by blocking beta
receptors in the myocardium, reducing the response to catecholamines & sympathetic
nerve stimulation. They protect the myocardium, helping to reduce the risk of another
infarction by decreasing myocardial oxygen demand. Calcium channel blockers reduce
the workload of the heart by decreasing the heart rate. Narcotics reduce myocardial
oxygen demand promote vasodilation, & decrease anxiety. Nitrates reduce myocardial
oxygen consumption by decreasing left ventricular end-diastolic pressure (preload) &
systemic vascular resistance (afterload).
What is the most common complication of an MI?
1. Cardiogenic shock
2. Heart failure
3. arrhythmias
4. Pericarditis -correct answer3. Arrhythmias, caused by oxygen deprivation to the
myocardium, are the most common complication of an MI. Cardiogenic shock, another
complication of an MI, is defined as the end stage of left ventricular dysfunction. This
condition occurs in approximately 15% of pts w/ MI. Because the pumping function of
PRACTICE EXAM ACTUAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS WITH RATIONALES
Which of the following actions is the first priority of care for a pt exhibiting signs &
symptoms of coronary artery disease?
1. Decrease anxiety
2. Enhance myocardial oxygenation
3. Administer sublingual nitroglycerin
4. Educate the pt about his symptoms -correct answer2. Enhancing myocardial
oxygenation is always the first priority when a pt exhibits signs or symptoms of cardiac
compromise. W/out adequate oxygenation, the myocardium suffers damage. Sublingual
nitroglycerin is administered to treat acute angina, but administration isn't the first
priority. Although educating the pt & decreasing anxiety are important in care delivery,
neither are priorities when a pt is compromised.
Medical treatment of coronary artery disease includes which of the following
procedures?
1. Cardiac catherization
2. Coronary artery bypass surgery
3. Oral med therapy
4. Percutaneous transluminal coronary angioplasty -correct answer3. Oral med
administration is a noninvasive, medical treatment for coronary artery disease. Cardiac
catherization isn't a treatment, but a diagnostic tool. Coronary artery bypass surgery &
percutaneous transluminal coronary angioplasty are invasive, surgical treatments.
Which of the following is the most common symptom of myocardial infarction (MI)?
1. Chest pain
2. Dyspnea
3. Edema
4. Palpitations -correct answer1. The most common symptom of an MI is chest pain,
resulting from deprivation of oxygen to the heart. Dyspnea is the second most common
symptom, related to an increase in the metabolic needs of the body during an MI.
Edema is a later sign of heart failure, often seen after an MI. Palpitations may result
from reduced cardiac output, producing arrhythmias.
,Which of the following symptoms is the most likely origin of pain the pt described as
knifelike chest pain that increases in intensity with inspiration?
1. Cardiac
2. Gastrointestinal
3. Musculoskeletal
4. Pulmonary -correct answer4. Pulmonary pain is generally described by these
symptoms. Musculoskeletal pain only increases w/ movement. Cardiac & GI pains don't
change w/ respiration.
Which of the following blood tests is most indicative of cardiac damage?
1. Lactate dehydrogenase
2. Complete blood count (CBC)
3. Troponin I
4. Creatine kinase (CK) -correct answer3. Troponin I levels rise rapidly & are
detectable w/in 1 hour of myocardial injury. Troponin I levels aren't detectable in people
w/out cardiac injury. Lactate dehydrogenase (LDH) is present in almost all body tissues
& not specific to heart muscle. LDH isoenzymes are useful in diagnosing cardiac injury.
CBC is obtained to review blood counts, & a complete chemistry is obtained to review
electrolytes. Because CK levels may rise w/ skeletal muscle injury, CK isoenzymes are
required to detect cardiac injury
What is the primary reason for administering morphine to a pt with an MI?
1. To sedate the pt
2. To decrease the pt's pain
3. To decrease the pt's anxiety
4. To decrease oxygen demand on the pt's heart -correct answer4. Morphine is
administered because it decreases myocardial oxygen demand. Morphine will also
decrease pain & anxiety while causing sedation, but it isn't primarily given for those
reasons.
Which of the following conditions is most commonly responsible for myocardial
infarction?
1. Aneurysm
2. Heart failure
3. Coronary artery thrombosis
4. Renal failure -correct answer3. Coronary artery thrombosis causes an inclusion
of the artery, leading to myocardial death. An aneurysm is an outpouching of a vessel &
doesn't cause an MI. Renal failure can be associated w/ MI but isn't a direct cause.
Heart failure is usually a result from an MI.
Which of the following complications is indicated by a third heart sound (S3)?
1. Ventricular dilation
2. Systemic hypertension
3. Aortic valve malfunction
4. Increased atrial contractions -correct answer1. Rapid filling of the ventricle
causes vasodilation that is auscultated as S3. Increased atrial contraction or systemic
, hypertension can result in a fourth heart sound. Aortic valve malfunction is heard as a
murmur.
After an anterior wall myocardial infarction, which of the following problems is indicated
by auscultation of crackles in the lungs?
1. Left-sided heart failure
2. Pulmonic valve malfunction
3. Right-sided heart failure
4. Tricupsid valve malfunction -correct answer1. The left ventricle is responsible for
most of the cardiac output. An anterior wall MI may result in a decrease in left
ventricular function. When the left ventricle doesn't function properly, resulting in left-
sided heart failure, fluid accumulates in the interstitial & alveolar spaces in the lungs &
causes crackles. Pulmonic & tricuspid valve malfunction causes right sided heart failure.
What is the first intervention for a pt experiencing MI?
1. Administer morphine
2. Administer oxygen
3. Administer sublingual nitroglycerin
4. Obtain an ECG -correct answer2. Administering supplemental oxygen to the pt is
the first priority of care. The myocardium is deprived of oxygen during an infarction, so
additional oxygen is administered to assist in oxygenation & prevent further damage.
Morphine & nitro are also used to treat MI, but they're more commonly administered
after the oxygen. An ECG is the most common diagnostic tool used to evaluate MI.
Which of the following classes of meds protects the ischemic myocardium by blocking
catecholamines & sympathetic nerve stimulation?
1. Beta-adrenergic blockers
2. Calcium channel blockers
3. Narcotics
4. Nitrates -correct answer1. Beta-adrenergic blockers work by blocking beta
receptors in the myocardium, reducing the response to catecholamines & sympathetic
nerve stimulation. They protect the myocardium, helping to reduce the risk of another
infarction by decreasing myocardial oxygen demand. Calcium channel blockers reduce
the workload of the heart by decreasing the heart rate. Narcotics reduce myocardial
oxygen demand promote vasodilation, & decrease anxiety. Nitrates reduce myocardial
oxygen consumption by decreasing left ventricular end-diastolic pressure (preload) &
systemic vascular resistance (afterload).
What is the most common complication of an MI?
1. Cardiogenic shock
2. Heart failure
3. arrhythmias
4. Pericarditis -correct answer3. Arrhythmias, caused by oxygen deprivation to the
myocardium, are the most common complication of an MI. Cardiogenic shock, another
complication of an MI, is defined as the end stage of left ventricular dysfunction. This
condition occurs in approximately 15% of pts w/ MI. Because the pumping function of
