CV BC MASTER STUDY GUIDE 200
PRACTICE QUESTIONS WITH FULL
RATIONALES (2024-2025 ANCC PREP)
## Cardiac Vascular Nursing (CV-BC™) Practice Exam
1. A patient presents with a sharp, stabbing chest pain that
worsens with inspiration and is relieved by leaning
forward. Which condition is most likely?
A) Myocardial Infarction
B) Acute Pericarditis
C) Pulmonary Embolism
D) Stable Angina
Rationale: Pleuritic chest pain that is positional (relieved by
sitting up/leaning forward) is a hallmark sign of pericarditis.
2. Which heart sound is considered a classic sign of heart
failure and fluid volume overload in an adult?
A) S1
B) S2
C) S3 (Ventricular Gallop)
D) S4 (Atrial Gallop)
Rationale: The S3 heart sound occurs during rapid ventricular
filling and indicates decreased ventricular compliance or fluid
overload.
3. When assessing a patient with Peripheral Artery Disease
(PAD), which clinical finding is most expected?
A) Brawny edema and stasis dermatitis
B) Intermittent claudication and diminished pedal pulses
C) Warm, ruddy skin in the lower extremities
D) Compression stockings as the primary treatment
Rationale: PAD is characterized by arterial insufficiency, leading
to muscle pain during exercise (claudication) and weak pulses.
4. A patient’s EKG shows a PR interval of 0.24 seconds, but
every P wave is followed by a QRS complex. This rhythm
is:
A) First-degree AV Block
, B) Second-degree Type I (Wenckebach)
C) Second-degree Type II
D) Third-degree AV Block
Rationale: First-degree block is defined by a consistent PR
interval greater than 0.20 seconds with no dropped beats.
5. Which medication class is the "gold standard" for
reducing mortality and preventing cardiac remodeling in
Heart Failure with Reduced Ejection Fraction (HFrEF)?
A) Calcium Channel Blockers
B) ACE Inhibitors or ARNs
C) Loop Diuretics
D) Nitrates
Rationale: ACE inhibitors and ARBs/ARNIs block the RAAS
system, preventing the harmful structural changes (remodeling)
of the heart muscle.
6. The nurse is caring for a patient post-cardiac
catheterization. Which assessment is the absolute
priority?
A) Assessing for hunger
B) Checking the insertion site for hematoma and distal
pulses
C) Monitoring the patient's temperature
D) Encouraging the patient to walk immediately
Rationale: Post-procedure nursing focuses on preventing
hemorrhage at the puncture site and ensuring adequate limb
perfusion.
7. A patient with a history of Atrial Fibrillation (Afib) has a
CHADS2-VASc score of 4. What is the primary goal of
care?
A) Controlling the heart rate to under 60 bpm
B) Anticoagulation to prevent embolic stroke
C) Immediate synchronized cardioversion
D) Fluid restriction
Rationale: A high CHADS2-VASc score indicates a high risk for
thrombus formation; anticoagulation is vital to prevent stroke.
8. Which electrolyte imbalance is most commonly
associated with Digoxin toxicity?
A) Hypernatremia
, B) Hypermagnesemia
C) Hypokalemia
D) Hypocalcemia
Rationale: Low potassium levels increase the sensitivity of the
heart to Digoxin, leading to life-threatening arrhythmias.
9. B-type Natriuretic Peptide (BNP) levels are primarily
used to diagnose:
A) Acute MI
B) Heart Failure exacerbation
C) Pulmonary hypertension
D) Renal failure
Rationale: BNP is released by the ventricles in response to
stretching/pressure; it is a key marker for fluid overload.
10. A patient reports sudden, severe "tearing" back pain
and has a blood pressure discrepancy between the left
and right arms. The nurse suspects:
A) Myocardial Infarction
B) Aortic Dissection
C) Tension Pneumothorax
D) Esophageal Spasm
Rationale: Tearing pain and unequal BP in the upper extremities
are classic indicators of a dissecting aortic aneurysm.
11. What is the definitive treatment for a patient in
Ventricular Fibrillation (V-fib)?
A) Cardioversion
B) Defibrillation
C) Atropine administration|D) Adenosine push
Rationale: V-fib is a pulseless rhythm that requires
unsynchronized high-energy shock (defibrillation) immediately.
12.The nurse notes "hemosiderin staining" (brownish
discoloration) on a patient’s lower shins. This is
indicative of:
A) Arterial insufficiency
B) Chronic Venous Insufficiency (CVI)
C) Deep Vein Thrombosis (DVT)
D) Cellulitis
Rationale: In CVI, red blood cells leak into the tissue and break
down, leaving iron (hemosiderin) deposits that stain the skin.
, 13.Which instruction is critical for a patient starting
Nitroglycerin sublingual tablets?
A) Swallow the pill with a full glass of water
B) Sit down before taking the dose due to risk of
orthostatic hypotension
C) Take up to 5 tablets before calling emergency services
D) Store the tablets in a clear plastic container on the windowsill
Rationale: Nitro is a potent vasodilator that can cause sudden
drops in BP and fainting; it must be stored in its original dark
glass bottle.
14.A "Beck’s Triad" (muffled heart sounds, JVD, and
hypotension) indicates which emergency?
A) Heart Failure
B) Cardiac Tamponade
C) Pulmonary Embolism
D) Constrictive Pericarditis
Rationale: Beck's Triad describes the classic signs of fluid
accumulation in the pericardial sac compressing the heart.
15. Which modifiable risk factor has the greatest impact on
reducing the progression of Atherosclerosis?
A) Age
B) Smoking cessation
C) Family history
D) Gender
Rationale: Smoking causes direct endothelial damage and
vasoconstriction, significantly accelerating plaque buildup.
16.A patient has an Ankle-Brachial Index (ABI) of 0.65. How
is this interpreted?
A) Normal arterial flow
B) Moderate Peripheral Artery Disease
C) Severe limb-threatening ischemia
D) Venous insufficiency
Rationale: A normal ABI is 1.0–1.4. Values between 0.5 and 0.8
indicate moderate PAD.
17. ST-segment elevation in leads II, III, and aVF indicates an
MI in which wall of the heart?
A) Anterior
B) Lateral
PRACTICE QUESTIONS WITH FULL
RATIONALES (2024-2025 ANCC PREP)
## Cardiac Vascular Nursing (CV-BC™) Practice Exam
1. A patient presents with a sharp, stabbing chest pain that
worsens with inspiration and is relieved by leaning
forward. Which condition is most likely?
A) Myocardial Infarction
B) Acute Pericarditis
C) Pulmonary Embolism
D) Stable Angina
Rationale: Pleuritic chest pain that is positional (relieved by
sitting up/leaning forward) is a hallmark sign of pericarditis.
2. Which heart sound is considered a classic sign of heart
failure and fluid volume overload in an adult?
A) S1
B) S2
C) S3 (Ventricular Gallop)
D) S4 (Atrial Gallop)
Rationale: The S3 heart sound occurs during rapid ventricular
filling and indicates decreased ventricular compliance or fluid
overload.
3. When assessing a patient with Peripheral Artery Disease
(PAD), which clinical finding is most expected?
A) Brawny edema and stasis dermatitis
B) Intermittent claudication and diminished pedal pulses
C) Warm, ruddy skin in the lower extremities
D) Compression stockings as the primary treatment
Rationale: PAD is characterized by arterial insufficiency, leading
to muscle pain during exercise (claudication) and weak pulses.
4. A patient’s EKG shows a PR interval of 0.24 seconds, but
every P wave is followed by a QRS complex. This rhythm
is:
A) First-degree AV Block
, B) Second-degree Type I (Wenckebach)
C) Second-degree Type II
D) Third-degree AV Block
Rationale: First-degree block is defined by a consistent PR
interval greater than 0.20 seconds with no dropped beats.
5. Which medication class is the "gold standard" for
reducing mortality and preventing cardiac remodeling in
Heart Failure with Reduced Ejection Fraction (HFrEF)?
A) Calcium Channel Blockers
B) ACE Inhibitors or ARNs
C) Loop Diuretics
D) Nitrates
Rationale: ACE inhibitors and ARBs/ARNIs block the RAAS
system, preventing the harmful structural changes (remodeling)
of the heart muscle.
6. The nurse is caring for a patient post-cardiac
catheterization. Which assessment is the absolute
priority?
A) Assessing for hunger
B) Checking the insertion site for hematoma and distal
pulses
C) Monitoring the patient's temperature
D) Encouraging the patient to walk immediately
Rationale: Post-procedure nursing focuses on preventing
hemorrhage at the puncture site and ensuring adequate limb
perfusion.
7. A patient with a history of Atrial Fibrillation (Afib) has a
CHADS2-VASc score of 4. What is the primary goal of
care?
A) Controlling the heart rate to under 60 bpm
B) Anticoagulation to prevent embolic stroke
C) Immediate synchronized cardioversion
D) Fluid restriction
Rationale: A high CHADS2-VASc score indicates a high risk for
thrombus formation; anticoagulation is vital to prevent stroke.
8. Which electrolyte imbalance is most commonly
associated with Digoxin toxicity?
A) Hypernatremia
, B) Hypermagnesemia
C) Hypokalemia
D) Hypocalcemia
Rationale: Low potassium levels increase the sensitivity of the
heart to Digoxin, leading to life-threatening arrhythmias.
9. B-type Natriuretic Peptide (BNP) levels are primarily
used to diagnose:
A) Acute MI
B) Heart Failure exacerbation
C) Pulmonary hypertension
D) Renal failure
Rationale: BNP is released by the ventricles in response to
stretching/pressure; it is a key marker for fluid overload.
10. A patient reports sudden, severe "tearing" back pain
and has a blood pressure discrepancy between the left
and right arms. The nurse suspects:
A) Myocardial Infarction
B) Aortic Dissection
C) Tension Pneumothorax
D) Esophageal Spasm
Rationale: Tearing pain and unequal BP in the upper extremities
are classic indicators of a dissecting aortic aneurysm.
11. What is the definitive treatment for a patient in
Ventricular Fibrillation (V-fib)?
A) Cardioversion
B) Defibrillation
C) Atropine administration|D) Adenosine push
Rationale: V-fib is a pulseless rhythm that requires
unsynchronized high-energy shock (defibrillation) immediately.
12.The nurse notes "hemosiderin staining" (brownish
discoloration) on a patient’s lower shins. This is
indicative of:
A) Arterial insufficiency
B) Chronic Venous Insufficiency (CVI)
C) Deep Vein Thrombosis (DVT)
D) Cellulitis
Rationale: In CVI, red blood cells leak into the tissue and break
down, leaving iron (hemosiderin) deposits that stain the skin.
, 13.Which instruction is critical for a patient starting
Nitroglycerin sublingual tablets?
A) Swallow the pill with a full glass of water
B) Sit down before taking the dose due to risk of
orthostatic hypotension
C) Take up to 5 tablets before calling emergency services
D) Store the tablets in a clear plastic container on the windowsill
Rationale: Nitro is a potent vasodilator that can cause sudden
drops in BP and fainting; it must be stored in its original dark
glass bottle.
14.A "Beck’s Triad" (muffled heart sounds, JVD, and
hypotension) indicates which emergency?
A) Heart Failure
B) Cardiac Tamponade
C) Pulmonary Embolism
D) Constrictive Pericarditis
Rationale: Beck's Triad describes the classic signs of fluid
accumulation in the pericardial sac compressing the heart.
15. Which modifiable risk factor has the greatest impact on
reducing the progression of Atherosclerosis?
A) Age
B) Smoking cessation
C) Family history
D) Gender
Rationale: Smoking causes direct endothelial damage and
vasoconstriction, significantly accelerating plaque buildup.
16.A patient has an Ankle-Brachial Index (ABI) of 0.65. How
is this interpreted?
A) Normal arterial flow
B) Moderate Peripheral Artery Disease
C) Severe limb-threatening ischemia
D) Venous insufficiency
Rationale: A normal ABI is 1.0–1.4. Values between 0.5 and 0.8
indicate moderate PAD.
17. ST-segment elevation in leads II, III, and aVF indicates an
MI in which wall of the heart?
A) Anterior
B) Lateral
