NCLEX-RN: Cardiovascular Practice
Questions and answers 2025/2026 latest
update
A nurse assesses clients on a cardiac unit. Which client should the nurse identify as being at greatest risk
for the development of left-sided heart failure?
a. A 36-year-old woman with aortic stenosis
b. A 42-year-old man with pulmonary hypertension
c. A 59-year-old woman who smokes cigarettes daily
d. A 70-year-old man who had a cerebral vascular accident - answera. A 36-year-old woman with aortic
stenosis
Although most people with heart failure will have failure that progresses from left to right, it is possible
to have left-sided failure alone for a short period. It is also possible to have heart failure that progresses
from right to left. Causes of left ventricular failure include mitral or aortic valve disease, coronary artery
disease, and hypertension. Pulmonary hypertension and chronic cigarette smoking are risk factors for
right ventricular failure. A cerebral vascular accident does not increase the risk of heart failure.
A nurse assesses a client in an outpatient clinic. Which statement alerts the nurse to the possibility of
left-sided heart failure?
a. I have been drinking more water than usual.
b. I am awakened by the need to urinate at night.
c. I must stop halfway up the stairs to catch my breath.
d. I have experienced blurred vision on several occasions. - answerc. I must stop halfway up the stairs to
catch my breath.
Clients with left-sided heart failure report weakness or fatigue while performing normal activities of
daily living, as well as difficulty breathing, or catching their breath. This occurs as fluid moves into the
alveoli. Nocturia is often seen with right-sided heart failure. Thirst and blurred vision are not related to
heart failure.
,A nurse assesses a client admitted to the cardiac unit. Which statement by the client alerts the nurse to
the possibility of right-sided heart failure?
a. I sleep with four pillows at night.
b. My shoes fit really tight lately.
c. I wake up coughing every night.
d. I have trouble catching my breath. - answerb. My shoes fit really tight lately.
Signs of systemic congestion occur with right-sided heart failure. Fluid is retained, pressure builds in the
venous system, and peripheral edema develops. Left-sided heart failure symptoms include respiratory
symptoms. Orthopnea, coughing, and difficulty breathing all could be results of left-sided heart failure.
While assessing a client on a cardiac unit, a nurse identifies the presence of an S3 gallop. Which action
should the nurse take next?
a. Assess for symptoms of left-sided heart failure.
b. Document this as a normal finding.
c. Call the health care provider immediately.
d. Transfer the client to the intensive care unit. - answera. Assess for symptoms of left-sided heart
failure.
The presence of an S3 gallop is an early diastolic filling sound indicative of increasing left ventricular
pressure and left ventricular failure. The other actions are not warranted.
A nurse cares for a client with right-sided heart failure. The client asks, Why do I need to weigh myself
every day? How should the nurse respond?
a. Weight is the best indication that you are gaining or losing fluid.
b. Daily weights will help us make sure that you're eating properly.
c. The hospital requires that all inpatients be weighed daily.
d. You need to lose weight to decrease the incidence of heart failure. - answera. Weight is the best
indication that you are gaining or losing fluid.
, Daily weights are needed to document fluid retention or fluid loss. One liter of fluid equals 2.2 pounds.
The other responses do not address the importance of monitoring fluid retention or loss.
A nurse is teaching a client with heart failure who has been prescribed enalapril (Vasotec). Which
statement should the nurse include in this clients teaching?
a. Avoid using salt substitutes.
b. Take your medication with food.
c. Avoid using aspirin-containing products.
d. Check your pulse daily. - answera. Avoid using salt substitutes.
Angiotensin-converting enzyme (ACE) inhibitors such as enalapril inhibit the excretion of potassium.
Hyperkalemia can be a life-threatening side effect, and clients should be taught to limit potassium
intake. Salt substitutes are composed of potassium chloride. ACE inhibitors do not need to be taken with
food and have no impact on the clients pulse rate. Aspirin is often prescribed in conjunction with ACE
inhibitors and is not contraindicated.
After administering newly prescribed captopril (Capoten) to a client with heart failure, the nurse
implements interventions to decrease complications. Which priority intervention should the nurse
implement for this client?
a. Provide food to decrease nausea and aid in absorption.
b. Instruct the client to ask for assistance when rising from bed.
c. Collaborate with unlicensed assistive personnel to bathe the client.
d. Monitor potassium levels and check for symptoms of hypokalemia. - answerb. Instruct the client to
ask for assistance when rising from bed.
Administration of the first dose of angiotensin-converting enzyme (ACE) inhibitors is often associated
with hypotension, usually termed first-dose effect. The nurse should instruct the client to seek
assistance before arising from bed to prevent injury from postural hypotension. ACE inhibitors do not
need to be taken with food. Collaboration with unlicensed assistive personnel to provide hygiene is not
a priority. The client should be encouraged to complete activities of daily living as independently as
Questions and answers 2025/2026 latest
update
A nurse assesses clients on a cardiac unit. Which client should the nurse identify as being at greatest risk
for the development of left-sided heart failure?
a. A 36-year-old woman with aortic stenosis
b. A 42-year-old man with pulmonary hypertension
c. A 59-year-old woman who smokes cigarettes daily
d. A 70-year-old man who had a cerebral vascular accident - answera. A 36-year-old woman with aortic
stenosis
Although most people with heart failure will have failure that progresses from left to right, it is possible
to have left-sided failure alone for a short period. It is also possible to have heart failure that progresses
from right to left. Causes of left ventricular failure include mitral or aortic valve disease, coronary artery
disease, and hypertension. Pulmonary hypertension and chronic cigarette smoking are risk factors for
right ventricular failure. A cerebral vascular accident does not increase the risk of heart failure.
A nurse assesses a client in an outpatient clinic. Which statement alerts the nurse to the possibility of
left-sided heart failure?
a. I have been drinking more water than usual.
b. I am awakened by the need to urinate at night.
c. I must stop halfway up the stairs to catch my breath.
d. I have experienced blurred vision on several occasions. - answerc. I must stop halfway up the stairs to
catch my breath.
Clients with left-sided heart failure report weakness or fatigue while performing normal activities of
daily living, as well as difficulty breathing, or catching their breath. This occurs as fluid moves into the
alveoli. Nocturia is often seen with right-sided heart failure. Thirst and blurred vision are not related to
heart failure.
,A nurse assesses a client admitted to the cardiac unit. Which statement by the client alerts the nurse to
the possibility of right-sided heart failure?
a. I sleep with four pillows at night.
b. My shoes fit really tight lately.
c. I wake up coughing every night.
d. I have trouble catching my breath. - answerb. My shoes fit really tight lately.
Signs of systemic congestion occur with right-sided heart failure. Fluid is retained, pressure builds in the
venous system, and peripheral edema develops. Left-sided heart failure symptoms include respiratory
symptoms. Orthopnea, coughing, and difficulty breathing all could be results of left-sided heart failure.
While assessing a client on a cardiac unit, a nurse identifies the presence of an S3 gallop. Which action
should the nurse take next?
a. Assess for symptoms of left-sided heart failure.
b. Document this as a normal finding.
c. Call the health care provider immediately.
d. Transfer the client to the intensive care unit. - answera. Assess for symptoms of left-sided heart
failure.
The presence of an S3 gallop is an early diastolic filling sound indicative of increasing left ventricular
pressure and left ventricular failure. The other actions are not warranted.
A nurse cares for a client with right-sided heart failure. The client asks, Why do I need to weigh myself
every day? How should the nurse respond?
a. Weight is the best indication that you are gaining or losing fluid.
b. Daily weights will help us make sure that you're eating properly.
c. The hospital requires that all inpatients be weighed daily.
d. You need to lose weight to decrease the incidence of heart failure. - answera. Weight is the best
indication that you are gaining or losing fluid.
, Daily weights are needed to document fluid retention or fluid loss. One liter of fluid equals 2.2 pounds.
The other responses do not address the importance of monitoring fluid retention or loss.
A nurse is teaching a client with heart failure who has been prescribed enalapril (Vasotec). Which
statement should the nurse include in this clients teaching?
a. Avoid using salt substitutes.
b. Take your medication with food.
c. Avoid using aspirin-containing products.
d. Check your pulse daily. - answera. Avoid using salt substitutes.
Angiotensin-converting enzyme (ACE) inhibitors such as enalapril inhibit the excretion of potassium.
Hyperkalemia can be a life-threatening side effect, and clients should be taught to limit potassium
intake. Salt substitutes are composed of potassium chloride. ACE inhibitors do not need to be taken with
food and have no impact on the clients pulse rate. Aspirin is often prescribed in conjunction with ACE
inhibitors and is not contraindicated.
After administering newly prescribed captopril (Capoten) to a client with heart failure, the nurse
implements interventions to decrease complications. Which priority intervention should the nurse
implement for this client?
a. Provide food to decrease nausea and aid in absorption.
b. Instruct the client to ask for assistance when rising from bed.
c. Collaborate with unlicensed assistive personnel to bathe the client.
d. Monitor potassium levels and check for symptoms of hypokalemia. - answerb. Instruct the client to
ask for assistance when rising from bed.
Administration of the first dose of angiotensin-converting enzyme (ACE) inhibitors is often associated
with hypotension, usually termed first-dose effect. The nurse should instruct the client to seek
assistance before arising from bed to prevent injury from postural hypotension. ACE inhibitors do not
need to be taken with food. Collaboration with unlicensed assistive personnel to provide hygiene is not
a priority. The client should be encouraged to complete activities of daily living as independently as
