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Cardiovascular Nursing: Comprehensive NCLEX Practice Exam

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This extensive document provides a robust collection of NCLEX-style practice questions focused on cardiovascular nursing. Covering a wide range of topics from basic cardiac anatomy and physiology to the management of complex conditions like heart failure, myocardial infarction, and dysrhythmias, this resource is ideal for nursing students preparing for the NCLEX-RN or for practicing nurses seeking a comprehensive review of cardiac care. The exam includes over 250 questions that test knowledge on EKG interpretation, pharmacology (e.g., digoxin, heparin, nitroglycerin), patient education, and priority nursing interventions for clients with various cardiovascular and peripheral vascular disorders.

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Ateneo de Zamboanga University
College of Nursing

ANATOMY AND PHYSIOLOGY OF CARDIO C. The AV node conducts action potentials
1. Specialized cell membrane structures that decrease rapidly through it.
electrical resistance between the cells allowing D. Action potentials are carried slowly through
action potentials to pass efficiently from one cell to the atrioventricular bundle.
adjacent cells are the:
A. Extensive capillary network 6. In a normal electrocardiogram (ECG or EKG),
B. Intercalated disks A. The P wave results from repolarization of the
C. Mitochondria atria.
D. Gap junctions B. The QRS complex results from
depolarization of the ventricles.
2. Complete the diagram so that it will show the C. The T wave represents repolarization of the
correct route of blood in the heart. auricles.
A. (1) Tricuspid Valve, (2) Aortic Valve, (3) D. During the P-R interval, the ventricle
Pulmonary Circulation, (4) Mitral Valve, (5) contract.
Pulmonic Valve
B. (1) Mitral Valve, (2) Pulmonic Valve, (3) 7. During the Ventricular Systole, atrioventricular
Pulmonary Circulation, (4) Tricuspid Valve, (5) valves open, semilunar valves close. The statement
Aortic Valve is:
C. (1) Mitral Valve, (2) Aortic Valve, (3) A. True
Pulmonary Circulation, (4) Tricuspid Valve, (5) B. False
Pulmonic Valve C. Partially true
D. (1) Tricuspid Valve, (2) Pulmonic Valve, (3) D. Partially false
Pulmonary Circulation, (4) Mitral Valve, (5)
Aortic Valve 8. This sound is produced during the closure of the
semilunar valves.
3. It is considered as the bluntly rounded portion of A. lubb
the heart B. dupp
A. Aorta C. lubb dupp
B. Apex D. lubb duppshhh
C. Base
D. Pericardium 9. Which of these statements correctly applies to
intrinsic regulation of the heart?
4. Which event will NOT occur during depolarization A. Starling’s law of the heart has a major
phase? influence on cardiac output.
A. Na+ channels open B. As venous return increases, cardiac output
B. Ca+ channels open decreases.
C. K+ channels open C. In response to stretch, cardiac muscle fibers
D. None of the above contract with less force.
D. In response to stretch, there is a slight
5. Which of these statements regarding the decrease in heart rate.
conduction system of the heart is TRUE?
A. The sinoatrial (SA) node of the heart acts as 10. Repolarization of the ventricles is shown as the
the pacemaker. __________ on an ECG or EKG.
B. The SA node is located on the upper wall of A. P wave
the left atrium. B. P-Q or P-R interval
Prepared by: SAHIOL, N.

, C. QRS complex 15. A nurse is caring for a client with unstable
D. Q-T interval ventricular tachycardia. The nurse instructs the
E. T wave client to do which of the following, if prescribed,
during an episode of ventricular tachycardia?
Dysrhythmias & EKG Interpretation: A. Breathe deeply, regularly, and easily.
11. A nurse is assessing an electrocardiogram rhythm B. Inhale deeply and cough forcefully every 1
strip. The P waves and QRS complexes are regular. to 3 seconds.
The PR interval is 0.16 second, and QRS complexes C. Lie down flat in bed.
measure 0.06 second. The overall heart rate is 64 D. Remove any metal jewelry.
beats per minute. The nurse assesses the cardiac
rhythm as: 16. A client is having frequent premature ventricular
A. Normal sinus rhythm contractions. A nurse would place a priority on the
B. Sinus bradycardia assessment of which of the following items?
C. Sick sinus syndrome A. Blood pressure and peripheral perfusion.
D. First-degree heart block B. Sensation of palpitations.
C. Causative factors such as caffeine.
12. A nurse notices frequent artifacts on the ECG D. Precipitating factors such as infection.
monitor for a client whose leads are connected by
cable to a console at the bedside. The nurse 17. A client has developed atrial fibrillation, which has a
examines the client to determine the cause. Which ventricular rate of 150 beats per minute. A nurse
of the following items is unlikely to be responsible assesses the client for:
for the artifact? A. Hypotension and dizziness
A. Frequent movement of the client. B. Nausea and vomiting
B. Tightly secured cable connections. C. Hypertension and headache
C. Leads applied over hairy areas. D. Flat neck veins
D. Leads applied to the limbs.
18. A nurse is watching the cardiac monitor, and a
13. A nurse is watching the cardiac monitor and notices client’s rhythm suddenly changes. There are no P
that the rhythm suddenly changes. There are no P waves; instead, there are wavy lines. The QRS
waves, the QRS complexes are wide, and the complexes measure 0.08 second, but they are
ventricular rate is regular but over 100. The nurse irregular, with a rate of 120 beats a minute. The
determines that the client is experiencing: nurse interprets this rhythm as:
A. Premature ventricular contractions A. Sinus tachycardia
B. Ventricular tachycardia B. Atrial fibrillation
C. Ventricular fibrillation C. Ventricular tachycardia
D. Sinus tachycardia D. Ventricular fibrillation

14. A nurse is viewing the cardiac monitor in a client’s 19. A client with rapid rate atrial fibrillation asks a nurse
room and notes that the client has just gone into why the physician is going to perform carotid
ventricular tachycardia. The client is awake and massage. The nurse responds that this procedure
alert and has good skin color. The nurse would may stimulate the:
prepare to do which of the following? A. Vagus nerve to slow the heart rate.
A. Immediately defibrillate. B. Vagus nerve to increase the heart rate;
B. Prepare for pacemaker insertion. overdriving the rhythm.
C. Administer amiodarone (Cordarone) C. Diaphragmatic nerve to slow the heart rate.
intravenously. D. Diaphragmatic nerve to overdrive the
D. Administer epinephrine (Adrenaline) rhythm.
intravenously.

, 20. A nurse notes that a client with sinus rhythm has a 25. What criteria should the nurse use to determine
premature ventricular contraction that falls on the T normal sinus rhythm for a client on a cardiac
wave of the preceding beat. The client’s rhythm monitor? Select all that apply.
suddenly changes to one with no P waves or A. The RR intervals are relatively consistent.
definable QRS complexes. Instead, there are coarse B. One P wave precedes each QRS complex.
wavy lines of varying amplitude. The nurse assesses C. Four to eight complexes occur in a 6-second
this rhythm to be: strip.
A. Ventricular tachycardia D. The ST segment is higher than the PR
B. Ventricular fibrillation interval.
C. Atrial fibrillation E. The QRS complex ranges from 0.12 to 0.20
D. Asystole second.

21. While caring for a client who has sustained an MI, 26. When auscultating the apical pulse of a client who
the nurse notes eight PVCs in one minute on the has atrial fibrillation, the nurse would expect to
cardiac monitor. The client is receiving an IV hear a rhythm that is characterized by:
infusion of D5W and oxygen at 2 L/minute. The A. The presence of occasional coupled beats.
nurse’s first course of action should be to: B. Long pauses in an otherwise regular rhythm.
A. Increase the IV infusion rate. C. A continuous and totally unpredictable
B. Notify the physician promptly. irregularity.
C. Increase the oxygen concentration. D. Slow but strong and regular beats.
D. Administer a prescribed analgesic.
Incorrect 27. Atherosclerosis impedes coronary blood flow by
which of the following mechanisms?
22. The adaptations of a client with complete heart A. Plaques obstruct the vein.
block would most likely include: B. Plaques obstruct the artery.
A. Nausea and vertigo C. Blood clots form outside the vessel wall.
B. Flushing and slurred speech D. Hardened vessels dilate to allow blood to
C. Cephalalgia and blurred vision flow through.
D. Syncope and slow ventricular rate
28. A paradoxical pulse occurs in a client who had a
23. A client with a bundle branch block is on a cardiac coronary artery bypass graft (CABG) surgery two (2)
monitor. The nurse should expect to observe: days ago. Which of the following surgical
A. Sagging ST segments. complications should the nurse suspect?
B. Absence of P wave configurations. A. Left-sided heart failure
C. Inverted T waves following each QRS B. Aortic regurgitation
complex. C. Complete heart block
D. Widening of QRS complexes to 0.12 second D. Pericardial tamponade
or greater.
29. After cardiac surgery, a client’s blood pressure
24. When ventricular fibrillation occurs in a CCU, the measures 126/80. The nurse determines that the
first person reaching the client should: mean arterial pressure (MAP) is which of the
A. Administer oxygen. following?
B. Defibrillate the client. A. 46 mm Hg
C. Initiate CPR. B. 80 mm Hg
D. Administer sodium bicarbonate C. 95 mm Hg
intravenously. D. 90 mm Hg

30. A woman with severe mitral stenosis and mitral
regurgitation has a pulmonary artery catheter

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