CARDIAC NCLEX PRACTICE EXAM /NCLEX CARDIAC
PRACTICE EXAM ACTUAL EXAM 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 - (ANSWERS)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 - (ANSWERS)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.
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. - (ANSWERS)A. Avoid positioning the patient
supine.
,CARDIAC NCLEX PRACTICE EXAM /NCLEX CARDIAC
PRACTICE EXAM ACTUAL EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
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 - (ANSWERS)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?
A. Warfarin
B. Oxycodone
C. Morphine
D. Acetaminophen - (ANSWERS)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 - (ANSWERS)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
,CARDIAC NCLEX PRACTICE EXAM /NCLEX CARDIAC
PRACTICE EXAM ACTUAL EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
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.
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. - (ANSWERS)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 - (ANSWERS)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.
D. Exercise increases the heart's oxygen demands. - (ANSWERS)D. Exercise increases the
heart's oxygen demands.
Physical exertion increases the myocardial oxygen demand. If the patient has arteriosclerosis
of the coronary arteries, then blood supply is diminished to the myocardium. Exercise does not
, CARDIAC NCLEX PRACTICE EXAM /NCLEX CARDIAC
PRACTICE EXAM ACTUAL EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
cause vasoconstriction or interfere with drug metabolism. Exercise does not shunt blood flow
!@#$%%%%%
away from the heart. %%%%%%
A resident of a long-term care facility has complained to the nurse of chest pain. What aspect
of the resident's pain would be most suggestive of angina as the cause?
A. The pain is most severe when the resident moves his upper body.
B. The pain is worse when the resident coughs.
C. The pain is worse when the resident inhales deeply.
D. The pain occurs immediately following physical exertion. - (ANSWERS)D. The pain occurs
immediately following physical exertion.
Chest pain associated with angina is often precipitated by physical exertion. The other listed
aspects of chest pain are more closely associated with noncardiac etiologies.
A patient who has undergone valve replacement surgery is being prepared for discharge home.
Because the patient will be discharged with a prescription for warfarin (Coumadin), the nurse
should educate the patient about which of the following?
A. The need to learn to sleep in a semi-Fowler's position for the first 6 to 8 weeks to prevent
emboli
B. The need for regularly scheduled testing of the patient's International Normalized Ratio (INR)
C. The need to take enteric-coated ASA on a daily basis
D. The need to avoid foods that contain vitamin K - (ANSWERS)B. The need for regularly
scheduled testing of the patient's International Normalized Ratio (INR)
Patients who take warfarin (Coumadin) after valve replacement have individualized target inrs;
usually between 2 and 3.5 for mitral valve replacement and 1.8 and 2.2 for aortic valve
replacement. Natural sources of vitamin K do not normally need to be avoided and ASA is not
indicated. Sleeping upright is unnecessary.
The nurse is performing an initial assessment of a client diagnosed with HF. The nurse also
assesses the patient's sensorium and LOC. Why is the assessment of the patient's sensorium
and LOC important in patients with HF?
A. Decreased LOC causes an exacerbation of the signs and symptoms of HF.
B. The most significant adverse effect of medications used for HF treatment is altered LOC.
C. Patients with HF are susceptible to overstimulation of the sympathetic nervous system.
D. HF ultimately affects oxygen transportation to the brain. - (ANSWERS)D. HF ultimately affects
oxygen transportation to the brain
PRACTICE EXAM ACTUAL EXAM 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 - (ANSWERS)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 - (ANSWERS)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.
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. - (ANSWERS)A. Avoid positioning the patient
supine.
,CARDIAC NCLEX PRACTICE EXAM /NCLEX CARDIAC
PRACTICE EXAM ACTUAL EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
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 - (ANSWERS)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?
A. Warfarin
B. Oxycodone
C. Morphine
D. Acetaminophen - (ANSWERS)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 - (ANSWERS)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
,CARDIAC NCLEX PRACTICE EXAM /NCLEX CARDIAC
PRACTICE EXAM ACTUAL EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
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.
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. - (ANSWERS)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 - (ANSWERS)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.
D. Exercise increases the heart's oxygen demands. - (ANSWERS)D. Exercise increases the
heart's oxygen demands.
Physical exertion increases the myocardial oxygen demand. If the patient has arteriosclerosis
of the coronary arteries, then blood supply is diminished to the myocardium. Exercise does not
, CARDIAC NCLEX PRACTICE EXAM /NCLEX CARDIAC
PRACTICE EXAM ACTUAL EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
cause vasoconstriction or interfere with drug metabolism. Exercise does not shunt blood flow
!@#$%%%%%
away from the heart. %%%%%%
A resident of a long-term care facility has complained to the nurse of chest pain. What aspect
of the resident's pain would be most suggestive of angina as the cause?
A. The pain is most severe when the resident moves his upper body.
B. The pain is worse when the resident coughs.
C. The pain is worse when the resident inhales deeply.
D. The pain occurs immediately following physical exertion. - (ANSWERS)D. The pain occurs
immediately following physical exertion.
Chest pain associated with angina is often precipitated by physical exertion. The other listed
aspects of chest pain are more closely associated with noncardiac etiologies.
A patient who has undergone valve replacement surgery is being prepared for discharge home.
Because the patient will be discharged with a prescription for warfarin (Coumadin), the nurse
should educate the patient about which of the following?
A. The need to learn to sleep in a semi-Fowler's position for the first 6 to 8 weeks to prevent
emboli
B. The need for regularly scheduled testing of the patient's International Normalized Ratio (INR)
C. The need to take enteric-coated ASA on a daily basis
D. The need to avoid foods that contain vitamin K - (ANSWERS)B. The need for regularly
scheduled testing of the patient's International Normalized Ratio (INR)
Patients who take warfarin (Coumadin) after valve replacement have individualized target inrs;
usually between 2 and 3.5 for mitral valve replacement and 1.8 and 2.2 for aortic valve
replacement. Natural sources of vitamin K do not normally need to be avoided and ASA is not
indicated. Sleeping upright is unnecessary.
The nurse is performing an initial assessment of a client diagnosed with HF. The nurse also
assesses the patient's sensorium and LOC. Why is the assessment of the patient's sensorium
and LOC important in patients with HF?
A. Decreased LOC causes an exacerbation of the signs and symptoms of HF.
B. The most significant adverse effect of medications used for HF treatment is altered LOC.
C. Patients with HF are susceptible to overstimulation of the sympathetic nervous system.
D. HF ultimately affects oxygen transportation to the brain. - (ANSWERS)D. HF ultimately affects
oxygen transportation to the brain
