Medical-Surgical Nursing 2025: NCLEX-Style Questions & Verified
Answers
Comprehensive Question Quiz for NCLEX Preparation
QUESTIONS 1-25: CARDIOVASCULAR SYSTEM
1. A client is admitted with acute myocardial infarction (MI). Which laboratory
value is most specific for diagnosing MI?
A) Creatine kinase (CK) B) Troponin I C) Lactate dehydrogenase (LDH) D) Aspartate
aminotransferase (AST)
Answer: B Rationale: Troponin I is the most specific and sensitive cardiac marker
for myocardial infarction, remaining elevated for 7-10 days after MI.
2. A client with heart failure is prescribed furosemide (Lasix). Which electrolyte
imbalance should the nurse monitor for?
A) Hypernatremia B) Hyperkalemia C) Hypokalemia D) Hypercalcemia
Answer: C Rationale: Furosemide is a loop diuretic that causes potassium loss,
leading to hypokalemia, which can cause dangerous cardiac arrhythmias.
3. The nurse is caring for a client with atrial fibrillation. Which assessment finding
requires immediate intervention?
A) Irregular pulse B) Blood pressure 90/60 mmHg C) Heart rate 110 bpm D) Chest
pain and shortness of breath
Answer: D Rationale: Chest pain and shortness of breath may indicate decreased
cardiac output or embolization, requiring immediate intervention.
4. A client is receiving heparin therapy. Which laboratory test should the nurse
monitor?
A) Prothrombin time (PT) B) International normalized ratio (INR) C) Activated
partial thromboplastin time (aPTT) D) Platelet count only
,Answer: C Rationale: aPTT monitors heparin effectiveness. Therapeutic range is
typically 1.5-2.5 times the control value.
5. Which symptom is most characteristic of left-sided heart failure?
A) Peripheral edema B) Jugular vein distention C) Pulmonary congestion D)
Hepatomegaly
Answer: C Rationale: Left-sided heart failure causes blood to back up into the
pulmonary circulation, resulting in pulmonary congestion and dyspnea.
6. A client with hypertension asks about lifestyle modifications. Which
recommendation is most important?
A) Increase sodium intake to 4000 mg daily B) Limit alcohol consumption C) Avoid
all physical activity D) Increase caffeine intake
Answer: B Rationale: Limiting alcohol consumption (≤2 drinks/day for men, ≤1
drink/day for women) helps reduce blood pressure.
7. The nurse is teaching a client about warfarin (Coumadin). Which food should be
consumed consistently?
A) Foods high in vitamin K B) Foods high in sodium C) Foods high in potassium D)
Foods high in calcium
Answer: A Rationale: Vitamin K affects warfarin's effectiveness. Clients should
maintain consistent vitamin K intake rather than avoiding it completely.
8. A client develops chest pain during cardiac catheterization. What is the nurse's
priority action?
A) Administer sublingual nitroglycerin B) Stop the procedure immediately C)
Increase oxygen flow rate D) Document the occurrence
Answer: B Rationale: Chest pain during cardiac catheterization may indicate
coronary artery spasm or perforation, requiring immediate cessation of the
procedure.
9. Which finding indicates successful treatment of cardiogenic shock?
, A) Urine output <30 mL/hour B) Blood pressure 90/60 mmHg C) Improved mental
status D) Heart rate 120 bpm
Answer: C Rationale: Improved mental status indicates better cerebral perfusion
and cardiac output, suggesting successful treatment.
10. A client is prescribed metoprolol (Lopressor). Which assessment is most
important before administration?
A) Blood glucose level B) Apical pulse rate C) Respiratory rate D) Temperature
Answer: B Rationale: Beta-blockers decrease heart rate. Withhold if apical pulse is
less than 60 bpm unless otherwise ordered.
11. The nurse is caring for a client with pericarditis. Which position provides the
most comfort?
A) Supine with legs elevated B) Left side-lying C) Right side-lying D) Sitting upright
and leaning forward
Answer: D Rationale: Sitting upright and leaning forward relieves pressure on the
pericardium and reduces chest pain.
12. A client with deep vein thrombosis (DVT) is on bed rest. Which intervention is
most appropriate?
A) Massage the affected leg B) Apply heat to the affected area C) Perform passive
range of motion D) Elevate the affected extremity
Answer: D Rationale: Elevating the affected extremity promotes venous return and
reduces swelling. Massage is contraindicated as it may dislodge the clot.
13. Which diagnostic test is most definitive for diagnosing coronary artery
disease?
A) Electrocardiogram (ECG) B) Echocardiogram C) Cardiac catheterization D) Stress
test
Answer: C Rationale: Cardiac catheterization provides direct visualization of
coronary arteries and is the gold standard for diagnosing CAD.
Answers
Comprehensive Question Quiz for NCLEX Preparation
QUESTIONS 1-25: CARDIOVASCULAR SYSTEM
1. A client is admitted with acute myocardial infarction (MI). Which laboratory
value is most specific for diagnosing MI?
A) Creatine kinase (CK) B) Troponin I C) Lactate dehydrogenase (LDH) D) Aspartate
aminotransferase (AST)
Answer: B Rationale: Troponin I is the most specific and sensitive cardiac marker
for myocardial infarction, remaining elevated for 7-10 days after MI.
2. A client with heart failure is prescribed furosemide (Lasix). Which electrolyte
imbalance should the nurse monitor for?
A) Hypernatremia B) Hyperkalemia C) Hypokalemia D) Hypercalcemia
Answer: C Rationale: Furosemide is a loop diuretic that causes potassium loss,
leading to hypokalemia, which can cause dangerous cardiac arrhythmias.
3. The nurse is caring for a client with atrial fibrillation. Which assessment finding
requires immediate intervention?
A) Irregular pulse B) Blood pressure 90/60 mmHg C) Heart rate 110 bpm D) Chest
pain and shortness of breath
Answer: D Rationale: Chest pain and shortness of breath may indicate decreased
cardiac output or embolization, requiring immediate intervention.
4. A client is receiving heparin therapy. Which laboratory test should the nurse
monitor?
A) Prothrombin time (PT) B) International normalized ratio (INR) C) Activated
partial thromboplastin time (aPTT) D) Platelet count only
,Answer: C Rationale: aPTT monitors heparin effectiveness. Therapeutic range is
typically 1.5-2.5 times the control value.
5. Which symptom is most characteristic of left-sided heart failure?
A) Peripheral edema B) Jugular vein distention C) Pulmonary congestion D)
Hepatomegaly
Answer: C Rationale: Left-sided heart failure causes blood to back up into the
pulmonary circulation, resulting in pulmonary congestion and dyspnea.
6. A client with hypertension asks about lifestyle modifications. Which
recommendation is most important?
A) Increase sodium intake to 4000 mg daily B) Limit alcohol consumption C) Avoid
all physical activity D) Increase caffeine intake
Answer: B Rationale: Limiting alcohol consumption (≤2 drinks/day for men, ≤1
drink/day for women) helps reduce blood pressure.
7. The nurse is teaching a client about warfarin (Coumadin). Which food should be
consumed consistently?
A) Foods high in vitamin K B) Foods high in sodium C) Foods high in potassium D)
Foods high in calcium
Answer: A Rationale: Vitamin K affects warfarin's effectiveness. Clients should
maintain consistent vitamin K intake rather than avoiding it completely.
8. A client develops chest pain during cardiac catheterization. What is the nurse's
priority action?
A) Administer sublingual nitroglycerin B) Stop the procedure immediately C)
Increase oxygen flow rate D) Document the occurrence
Answer: B Rationale: Chest pain during cardiac catheterization may indicate
coronary artery spasm or perforation, requiring immediate cessation of the
procedure.
9. Which finding indicates successful treatment of cardiogenic shock?
, A) Urine output <30 mL/hour B) Blood pressure 90/60 mmHg C) Improved mental
status D) Heart rate 120 bpm
Answer: C Rationale: Improved mental status indicates better cerebral perfusion
and cardiac output, suggesting successful treatment.
10. A client is prescribed metoprolol (Lopressor). Which assessment is most
important before administration?
A) Blood glucose level B) Apical pulse rate C) Respiratory rate D) Temperature
Answer: B Rationale: Beta-blockers decrease heart rate. Withhold if apical pulse is
less than 60 bpm unless otherwise ordered.
11. The nurse is caring for a client with pericarditis. Which position provides the
most comfort?
A) Supine with legs elevated B) Left side-lying C) Right side-lying D) Sitting upright
and leaning forward
Answer: D Rationale: Sitting upright and leaning forward relieves pressure on the
pericardium and reduces chest pain.
12. A client with deep vein thrombosis (DVT) is on bed rest. Which intervention is
most appropriate?
A) Massage the affected leg B) Apply heat to the affected area C) Perform passive
range of motion D) Elevate the affected extremity
Answer: D Rationale: Elevating the affected extremity promotes venous return and
reduces swelling. Massage is contraindicated as it may dislodge the clot.
13. Which diagnostic test is most definitive for diagnosing coronary artery
disease?
A) Electrocardiogram (ECG) B) Echocardiogram C) Cardiac catheterization D) Stress
test
Answer: C Rationale: Cardiac catheterization provides direct visualization of
coronary arteries and is the gold standard for diagnosing CAD.
