CARDIOVASCULAR NCLEX
QUESTIONS
Which68of68the68following68are68most68likely68to68be68early68signs68of68cardiac68problems
68in68older68persons?68(Select68all68that68apply.)
68
68Mental68status68changes
68Agitation
68Frequent68falls
68Sudden68changes68in68GI68function68-68answer--Mental68status68changes
68Agitation
68Frequent68falls
Rationale:68Many68cardiovascular68functions68are68complicated68in68that68they68involve6
8many68other68systems.68Mental68status68changes,68agitation,68and68falls68can68be68earl
y68signs68of68cardiac68problems68in68the68older68person.68Changes68in68function68in68the
68GI68system68are68not68typical68signs68of68a68cardiac68problem.
A68patient68has68been68diagnosed68with68Right-
Sided68Congestive68Heart68Failure,68and68is68confused68about68return68of68deoxygenate
d68blood68from68the68tissue.68To68clarify68the68confusion,68which68chamber68of68the68he
art68receives68blood68from68systemic68circulation?
68
68Left68atrium
68Right68atrium
68Right68ventricle
68Left68ventricle68-68answer--Right68atrium
Rationale:68The68right68atrium68is68a68thin-
walled68structure68that68receives68deoxygenated68blood68from68all68the68peripheral68tiss
ues68by68way68of68the68superior68and68inferior68vena68cava68and68from68the68heart68mus
cle68by68way68of68the68coronary68sinus.
It68is68important68that68the68nurse68be68knowledgeable68about68cardiac68output68in68orde
r68to:
68
68Evaluate68blood68flow68to68peripheral68tissues.
68Determine68the68electrical68activity68of68the68myocardium.
68Provide68information68on68the68immediate68need68for68oxygen.
68Implement68nutritional68changes.68-68answer--
Evaluate68blood68flow68to68peripheral68tissues.
68
,Rationale:68Blood68flow68to68the68tissues68is68measured68clinically68as68the68cardiac68ou
tput,68and68assists68to68predict68tissue68perfusion.68Electrical68activity68is68evaluated68m
ore68effectively68by68EKG.68While68the68cardiac68output68is68important68for68perfusion68a
nd68oxygenation68of68tissues,68the68oxygen68saturation68would68provide68more68valuabl
e68information.68Nutritional68changes68would68be68targeted68to68sodium68and68would68d
epend68on68symptoms68of68disease.
Integrated68Process:68Nursing68Process;68Planning
Cognitive68Level:68Evaluation
NCLEX-RN68Test68Plan:68Health68Promotion68and68Maintenance
Nurses68can68best68help68older68clients68prevent68hypertension68by68teaching:
68
68Low-fat,68low-cholesterol68diets.
68The68importance68of68exercise.
68How68to68handle68stressful68situations.
68How68to68maintain68a68normal68blood68pressure.68-68answer--
How68to68maintain68a68normal68blood68pressure.
68
Rationale:68Hypertension68is68a68major68risk68factor68for68other68cardiovascular68conditio
ns.68In68persons68older68than6850,68systolic68blood68pressure68greater68than6814068mm68
Hg68is68a68much68more68important68cardiovascular68disease68risk68factor68than68is68dias
tolic68blood68pressure.68The68risk68of68cardiovascular68disease,68beginning68at68115/756
8mm68Hg,68doubles68with68each68increment68of6820/1068mm68Hg.68Answers681,682,68and
68368are68important68elements68to68include68in68education68of68a68patient68with68blood68p
ressure68elevation,68and68are68included68in68the68correct68answer.
Modification68of68lifestyle68behaviors68to68help68manage68hypertension68does68not68inclu
de68which68of68the68following?68(Select68all68that68apply.)
68
68Weight68loss68of68even681068pounds
68The68DASH68diet
68Fruits,68vegetables,68and68whole68grains
68Alcohol68intake68with68meals68-68answer--Alcohol68intake68with68meals
68\
Rationale:68Weight68loss68of68even681068pounds;68fruits,68vegetables,68and68whole68grai
ns;68the68DASH68diet;68and68a68daily68exercise68regimen68will68help68reduce68high68bloo
d68pressure.68Alcohol68intake68with68meals68should68be68reduced68to68help68manage68hi
gh68blood68pressure.
A68patient68receiving68the68drug68simvastatin68(Zocor)68should68be68taught68this68medic
ation68helps68to68prevent68coronary68heart68disease68by:
68
68Increasing68lower-density68lipoprotein.
68Controlling68lower-density68lipoprotein.
68Increasing68triglycerides.
68Increasing68very68low-density68lipoprotein.68-68answer--Controlling68lower-
density68lipoprotein.
,68
Rationale:68The68Heart68Protective68Study68has68also68shown68that68controlling68low-
density68lipoprotein68(LDL)68with68simvastatin68(Zocor)68assists68in68the68prevention68of6
8coronary68heart68disease68by68raising68HDL.68Responses681,683,68and68468are68incorre
ct.
Which68of68the68following68are68direct68causes68of68chronic68ischemic68pain?
68(Select68all68that68apply.)
68
68Aortic68stenosis
68Acid68reflux
68Pulmonary68embolus
68Herpes68zoster68(shingles)68-68answer--Aortic68stenosis
Acid68reflux
Pulmonary68embolus
68Rationale:68Herpes68zoster68(shingles)68manifests68as68a68vesicular68rash68along68a68
dermatome,68not68chronic68ischemic68pain.
Integrated68Process:68Nursing68Process;68Evaluation
Cognitive68Level:68Evaluation
NCLEX-RN68Test68Plan:68Physiological68Integrity;68Physiological68Adaptation
Rationale:68Herpes68zoster68(shingles)68manifests68as68a68vesicular68rash68along68a68de
rmatome,68not68chronic68ischemic68pain.
Older68clients68experiencing68anginal68pain68with68complaints68of68fatigue68or68weaknes
s68usually68are68medicated68with68which68of68the68following68types68of68medication?
68
68Sublingual68nitroglycerin
68Cardiac68glycosides
68HMG-CoA68reductase68inhibitors
68Morphine68sulfate68-68answer--Sublingual68nitroglycerin
68
Rationale:68Angina68frequently68is68managed68with68sublingual68nitroglycerin,68which68c
auses68vasodilation68and68increases68blood68flow68to68the68coronary68arteries.68Cardiac
68glycosides68are68used68to68treat68heart68failure,68and68morphine68is68used68to68treat68
myocardial68infarction.68The68HMG-
CoA68reductase68inhibitors68are68used68for68patients68with68type68268diabetes68mellitus.
Which68of68the68following68diagnostic68studies68most68likely68would68confirm68a68myocar
dial68infarction?
68
68Serum68myoglobin68level
68Creatinine68kinase68(CK)
68White68blood68cell68count68(WBC)
68Troponin68T68levels68-68answer--Troponin68T68levels
68
Rationale:68CK-MB68elevates684-
668hours68after68tissue68necrosis.68Troponin68levels68rise686-
868hours68after68the68infarct68(tissue68necrosis)68but68also68can68occur68with68other68typ
, es68of68tissue68damage.68Myoglobin68also68elevates,68but68to68a68lesser68degree.68WBC
68levels68elevate68with68an68inflammatory68response.68Troponin68levels68are68more68ele
vated68than68are68the68other68cardiac68enzymes,68are68more68specific68to68cardiac68tiss
ue,68and68rise686-868hours68after68the68infarct68(tissue68necrosis).
A68client68with68post-
myocardial68infarction68develops68acute68bacterial68pericarditis.68Which68of68the68followi
ng68medications68would68the68physician68most68likely68prescribe68as68the68primary68dru
g?
68
68Ticarcillin68disodium68(Ticar)
68Acetaminophen68(Tylenol)
68Ibuprofen68(Motrin)
68Trioxsalen68(Trisoralen)68-68answer--Ticarcillin68disodium68(Ticar)
68
Rationale:68Acute68bacterial68pericarditis68is68a68complication68that68can68occur68post-
myocardial68infarction.68Acute68bacterial68pericarditis68usually68requires68antibiotics.68N
SAIDs68usually68are68prescribed68to68relieve68pain68from68the68inflammatory68process.68
If68the68NSAIDs68do68not68relieve68pain68within684868to689668hours,68corticosteroids68are
68ordered.68There68is68no68mention68of68pain68in68the68stem68of68the68question.68Trisoral
en68is68used68to68repigment68skin68for68persons68with68vitiligo.
Which68of68the68following68diagnostic68tests68is68preferred68for68evaluating68heart68valve
68function?
68
68Chest68x-ray
68Duplex68Doppler
68Echocardiogram
68Electrocardiogram68-68answer--Echocardiogram
68
Rationale:68The68echocardiogram68is68the68preferred68test68to68evaluate68heart68valves,6
8because68it68allows68the68visualization68of68the68valves68as68they68open68and68close.68
A68chest68x-
ray68will68determine68the68size68of68the68heart,68the68duplex68measures68blood68flow68thr
ough68major68arteries,68and68an68electrocardiogram68identifies68electrical68activity.
An68elderly68client68is68being68monitored68for68evidence68of68congestive68heart68failure.6
8To68detect68early68signs68of68heart68failure,68the68nurse68would68instruct68the68certified6
8nursing68attendant68(CNA)68to68do68which68of68the68following68during68care68of68the68pa
tient?
68
68Observe68electrocardiogram68readings68and68report68deviations68to68the68nurse.
68Assist68the68client68with68ambulation68three68times68during68the68shift.
68Monitor68vital68signs68every681568minutes68and68report68each68reading68to68the68nurse.
68Accurately68weigh68the68patient,68and68report68and68record68the68readings.68-
68answer--Accurately68weigh68the68patient,68and68report68and68record68the68readings.
68
QUESTIONS
Which68of68the68following68are68most68likely68to68be68early68signs68of68cardiac68problems
68in68older68persons?68(Select68all68that68apply.)
68
68Mental68status68changes
68Agitation
68Frequent68falls
68Sudden68changes68in68GI68function68-68answer--Mental68status68changes
68Agitation
68Frequent68falls
Rationale:68Many68cardiovascular68functions68are68complicated68in68that68they68involve6
8many68other68systems.68Mental68status68changes,68agitation,68and68falls68can68be68earl
y68signs68of68cardiac68problems68in68the68older68person.68Changes68in68function68in68the
68GI68system68are68not68typical68signs68of68a68cardiac68problem.
A68patient68has68been68diagnosed68with68Right-
Sided68Congestive68Heart68Failure,68and68is68confused68about68return68of68deoxygenate
d68blood68from68the68tissue.68To68clarify68the68confusion,68which68chamber68of68the68he
art68receives68blood68from68systemic68circulation?
68
68Left68atrium
68Right68atrium
68Right68ventricle
68Left68ventricle68-68answer--Right68atrium
Rationale:68The68right68atrium68is68a68thin-
walled68structure68that68receives68deoxygenated68blood68from68all68the68peripheral68tiss
ues68by68way68of68the68superior68and68inferior68vena68cava68and68from68the68heart68mus
cle68by68way68of68the68coronary68sinus.
It68is68important68that68the68nurse68be68knowledgeable68about68cardiac68output68in68orde
r68to:
68
68Evaluate68blood68flow68to68peripheral68tissues.
68Determine68the68electrical68activity68of68the68myocardium.
68Provide68information68on68the68immediate68need68for68oxygen.
68Implement68nutritional68changes.68-68answer--
Evaluate68blood68flow68to68peripheral68tissues.
68
,Rationale:68Blood68flow68to68the68tissues68is68measured68clinically68as68the68cardiac68ou
tput,68and68assists68to68predict68tissue68perfusion.68Electrical68activity68is68evaluated68m
ore68effectively68by68EKG.68While68the68cardiac68output68is68important68for68perfusion68a
nd68oxygenation68of68tissues,68the68oxygen68saturation68would68provide68more68valuabl
e68information.68Nutritional68changes68would68be68targeted68to68sodium68and68would68d
epend68on68symptoms68of68disease.
Integrated68Process:68Nursing68Process;68Planning
Cognitive68Level:68Evaluation
NCLEX-RN68Test68Plan:68Health68Promotion68and68Maintenance
Nurses68can68best68help68older68clients68prevent68hypertension68by68teaching:
68
68Low-fat,68low-cholesterol68diets.
68The68importance68of68exercise.
68How68to68handle68stressful68situations.
68How68to68maintain68a68normal68blood68pressure.68-68answer--
How68to68maintain68a68normal68blood68pressure.
68
Rationale:68Hypertension68is68a68major68risk68factor68for68other68cardiovascular68conditio
ns.68In68persons68older68than6850,68systolic68blood68pressure68greater68than6814068mm68
Hg68is68a68much68more68important68cardiovascular68disease68risk68factor68than68is68dias
tolic68blood68pressure.68The68risk68of68cardiovascular68disease,68beginning68at68115/756
8mm68Hg,68doubles68with68each68increment68of6820/1068mm68Hg.68Answers681,682,68and
68368are68important68elements68to68include68in68education68of68a68patient68with68blood68p
ressure68elevation,68and68are68included68in68the68correct68answer.
Modification68of68lifestyle68behaviors68to68help68manage68hypertension68does68not68inclu
de68which68of68the68following?68(Select68all68that68apply.)
68
68Weight68loss68of68even681068pounds
68The68DASH68diet
68Fruits,68vegetables,68and68whole68grains
68Alcohol68intake68with68meals68-68answer--Alcohol68intake68with68meals
68\
Rationale:68Weight68loss68of68even681068pounds;68fruits,68vegetables,68and68whole68grai
ns;68the68DASH68diet;68and68a68daily68exercise68regimen68will68help68reduce68high68bloo
d68pressure.68Alcohol68intake68with68meals68should68be68reduced68to68help68manage68hi
gh68blood68pressure.
A68patient68receiving68the68drug68simvastatin68(Zocor)68should68be68taught68this68medic
ation68helps68to68prevent68coronary68heart68disease68by:
68
68Increasing68lower-density68lipoprotein.
68Controlling68lower-density68lipoprotein.
68Increasing68triglycerides.
68Increasing68very68low-density68lipoprotein.68-68answer--Controlling68lower-
density68lipoprotein.
,68
Rationale:68The68Heart68Protective68Study68has68also68shown68that68controlling68low-
density68lipoprotein68(LDL)68with68simvastatin68(Zocor)68assists68in68the68prevention68of6
8coronary68heart68disease68by68raising68HDL.68Responses681,683,68and68468are68incorre
ct.
Which68of68the68following68are68direct68causes68of68chronic68ischemic68pain?
68(Select68all68that68apply.)
68
68Aortic68stenosis
68Acid68reflux
68Pulmonary68embolus
68Herpes68zoster68(shingles)68-68answer--Aortic68stenosis
Acid68reflux
Pulmonary68embolus
68Rationale:68Herpes68zoster68(shingles)68manifests68as68a68vesicular68rash68along68a68
dermatome,68not68chronic68ischemic68pain.
Integrated68Process:68Nursing68Process;68Evaluation
Cognitive68Level:68Evaluation
NCLEX-RN68Test68Plan:68Physiological68Integrity;68Physiological68Adaptation
Rationale:68Herpes68zoster68(shingles)68manifests68as68a68vesicular68rash68along68a68de
rmatome,68not68chronic68ischemic68pain.
Older68clients68experiencing68anginal68pain68with68complaints68of68fatigue68or68weaknes
s68usually68are68medicated68with68which68of68the68following68types68of68medication?
68
68Sublingual68nitroglycerin
68Cardiac68glycosides
68HMG-CoA68reductase68inhibitors
68Morphine68sulfate68-68answer--Sublingual68nitroglycerin
68
Rationale:68Angina68frequently68is68managed68with68sublingual68nitroglycerin,68which68c
auses68vasodilation68and68increases68blood68flow68to68the68coronary68arteries.68Cardiac
68glycosides68are68used68to68treat68heart68failure,68and68morphine68is68used68to68treat68
myocardial68infarction.68The68HMG-
CoA68reductase68inhibitors68are68used68for68patients68with68type68268diabetes68mellitus.
Which68of68the68following68diagnostic68studies68most68likely68would68confirm68a68myocar
dial68infarction?
68
68Serum68myoglobin68level
68Creatinine68kinase68(CK)
68White68blood68cell68count68(WBC)
68Troponin68T68levels68-68answer--Troponin68T68levels
68
Rationale:68CK-MB68elevates684-
668hours68after68tissue68necrosis.68Troponin68levels68rise686-
868hours68after68the68infarct68(tissue68necrosis)68but68also68can68occur68with68other68typ
, es68of68tissue68damage.68Myoglobin68also68elevates,68but68to68a68lesser68degree.68WBC
68levels68elevate68with68an68inflammatory68response.68Troponin68levels68are68more68ele
vated68than68are68the68other68cardiac68enzymes,68are68more68specific68to68cardiac68tiss
ue,68and68rise686-868hours68after68the68infarct68(tissue68necrosis).
A68client68with68post-
myocardial68infarction68develops68acute68bacterial68pericarditis.68Which68of68the68followi
ng68medications68would68the68physician68most68likely68prescribe68as68the68primary68dru
g?
68
68Ticarcillin68disodium68(Ticar)
68Acetaminophen68(Tylenol)
68Ibuprofen68(Motrin)
68Trioxsalen68(Trisoralen)68-68answer--Ticarcillin68disodium68(Ticar)
68
Rationale:68Acute68bacterial68pericarditis68is68a68complication68that68can68occur68post-
myocardial68infarction.68Acute68bacterial68pericarditis68usually68requires68antibiotics.68N
SAIDs68usually68are68prescribed68to68relieve68pain68from68the68inflammatory68process.68
If68the68NSAIDs68do68not68relieve68pain68within684868to689668hours,68corticosteroids68are
68ordered.68There68is68no68mention68of68pain68in68the68stem68of68the68question.68Trisoral
en68is68used68to68repigment68skin68for68persons68with68vitiligo.
Which68of68the68following68diagnostic68tests68is68preferred68for68evaluating68heart68valve
68function?
68
68Chest68x-ray
68Duplex68Doppler
68Echocardiogram
68Electrocardiogram68-68answer--Echocardiogram
68
Rationale:68The68echocardiogram68is68the68preferred68test68to68evaluate68heart68valves,6
8because68it68allows68the68visualization68of68the68valves68as68they68open68and68close.68
A68chest68x-
ray68will68determine68the68size68of68the68heart,68the68duplex68measures68blood68flow68thr
ough68major68arteries,68and68an68electrocardiogram68identifies68electrical68activity.
An68elderly68client68is68being68monitored68for68evidence68of68congestive68heart68failure.6
8To68detect68early68signs68of68heart68failure,68the68nurse68would68instruct68the68certified6
8nursing68attendant68(CNA)68to68do68which68of68the68following68during68care68of68the68pa
tient?
68
68Observe68electrocardiogram68readings68and68report68deviations68to68the68nurse.
68Assist68the68client68with68ambulation68three68times68during68the68shift.
68Monitor68vital68signs68every681568minutes68and68report68each68reading68to68the68nurse.
68Accurately68weigh68the68patient,68and68report68and68record68the68readings.68-
68answer--Accurately68weigh68the68patient,68and68report68and68record68the68readings.
68
