CARDIAC NCLEX COMPREHENSIVE EXAM SCRIPT COMPLETE QUESTIONS VERIFIED
SOLUTIONS
Cardiac Nclex Comprehensive Study Paper
2026/2027 Questions and Answers Verified Solutions
Latest Update
Question:
Which of the following assessments would be an important finding for a patient with arterial
disease? Intermittent claudication with exercise Brownish discoloration around the ankles
Non-pitting edema on the lower extremities Altered sensation to touch.
Answer:
Intermittent claudication with exercise Rationale: Intermittent claudication is a common finding in
persons with arterial disease, usually due to progression of atherosclerosis and alteration of tissue
perfusion to the extremities. In venous disease, valves of the veins in the extremities become
incompetent, resulting in higher pressures than normal in the veins. The pressure is transmitted to
the capillaries of the lower extremities, resulting in thickening and non-pitting edema of tissues
around the ankles. Prolonged thickening results in the red blood cells' being pressed outside the
capillaries. The cells eventually break down, resulting in collection of hemosiderin deposits being
collected in the area. Altered sensation to touch would be due to neuropathic changes commonly
found with diabetes mellitus.
Question:
1) A client is scheduled for a cardiac catherization using a radiopaque dye. Which of the following
assessments is most critical before the procedure? Intake and output Baseline peripheral pulse rates
Height and weight Allergy to iodine or shellfish.
Answer:
4. This procedure requires an informed consent because it involves injection of a radiopaque dye
into the blood vessel. The risk of allergic reaction and possible anaphylaxis is serious and must be
assessed before the procedure.
Question:
2) A client with no history of cardiovascular disease comes into the ambulatory clinic with flulike
symptoms. The client suddenly complains of chest pain. Which of the following questions would
best help a nurse to discriminate pain caused by a non-cardiac problem? "Have you ever had this
,pain before?" "Can you describe the pain to me?" "Does the pain get worse when you breathe in?"
"Can you rate the pain on a scale of 1-10, with 10 being the worst?".
Answer:
3. Chest pain is assessed by using the standard pain assessment parameters. Options 1, 2, and 4 may
or may not help discriminate the origin of pain. Pain of pleuropulmonary origin usually worsens on
inspiration.
Question:
3) A client with myocardial infarction has been transferred from a coronary care unit to a general
medical unit with cardiac monitoring via telemetry. A nurse plans to allow for which of the
following client activities? Strict bed rest for 24 hours after transfer Bathroom privileges and
self-care activities Unsupervised hallway ambulation with distances under 200 feet Ad lib activities
because the client is monitored.
Answer:
2. On transfer from the CCU, the client is allowed self-care activities and bathroom privileges.
Supervised ambulation for brief distances are encouraged, with distances gradually increased (50,
100, 200 feet).
Question:
4) A nurse notes 2+ bilateral edema in the lower extremities of a client with myocardial infarction
who was admitted 2 days ago. The nurse would plan to do which of the following next? Review the
intake and output records for the last 2 days Change the time of diuretic administration from
morning to evening Request a sodium restriction of 1 g/day from the physician. Order daily weights
starting the following morning.
Answer:
1. Edema, the accumulation of excess fluid in the interstitial spaces, can be measured by intake
greater than output and by a sudden increase in weight. Diuretics should be given in the morning
whenever possible to avoid nocturia. Strict sodium restrictions are reserved for clients with severe
symptoms.
Question:
5) A client is wearing a continuous cardiac monitor, which begins to sound its alarm. A nurse sees
no electrocardiogram complexes on the screen. The first action of the nurse is to: Check the client
,status and lead placement Press the recorder button on the electrocardiogram console. Call the
physician Call a code blue.
Answer:
1. Sudden loss of electrocardiogram complexes indicates ventricular asystole or possible electrode
displacement. Accurate assessment of the client and equipment is necessary to determine the cause
and identify the appropriate intervention.
Question:
6) A nurse is assessing the blood pressure of a client diagnosed with primary hypertension. The
nurse ensures accurate measurement by avoiding which of the following? Seating the client with
arm bared, supported, and at heart level. Measuring the blood pressure after the client has been
seated quietly for 5 minutes. Using a cuff with a rubber bladder that encircles at least 80% of the
limb. Taking a blood pressure within 15 minutes after nicotine or caffeine ingestion.
Answer:
4. BP should be taken with the client seated with the arm bared, positioned with support and at heart
level. The client should sit with the legs on the floor, feet uncrossed, and not speak during the
recording. The client should not have smoked tobacco or taken in caffeine in the 30 minutes
preceding the measurement. The client should rest quietly for 5 minutes before the reading is taken.
The cuff bladder should encircle at least 80% of the limb being measured. Gauges other than a
mercury sphygmomanometer should be calibrated every 6 months to ensure accuracy.
Question:
7) IV heparin therapy is ordered for a client. While implementing this order, a nurse ensures that
which of the following medications is available on the nursing unit? Vitamin K Aminocaporic acid
Potassium chloride Protamine sulfate.
Answer:
4. The antidote to heparin is protamine sulfate and should be readily available for use if excessive
bleeding or hemorrhage should occur. Vitamin K is an antidote for warfarin.
Question:
8) A client is at risk for pulmonary embolism and is on anticoagulant therapy with warfarin
(Coumadin). The client's prothrombin time is 20 seconds, with a control of 11 seconds. The nurse
assesses that this result is: The same as the client's own baseline level Lower than the needed
, therapeutic level Within the therapeutic range Higher than the therapeutic range.
Answer:
3. The therapeutic range for prothrombin time is 1.5 to 2 times the control for clients at risk for
thrombus. Based on the client's control value, the therapeutic range for this individual would be 16.5
to 22 seconds. Therefore the result is within therapeutic range.
Question:
9) A client who has been receiving heparin therapy also is started on warfarin. The client asks a
nurse why both medications are being administered. In formulating a response, the nurse
incorporates the understanding that warfarin: Stimulates the breakdown of specific clotting factors
by the liver, and it takes 2-3 days for this to exert an anticoagulant effect. Inhibits synthesis of
specific clotting factors in the liver, and it takes 3-4 days for this medication to exert an
anticoagulant effect. Stimulates production of the body's own thrombolytic substances, but it takes
2-4 days for this to begin. Has the same mechanism of action as Heparin, and the crossover time is
needed for the serum level of warfarin to be therapeutic.
Answer:
2. Warfarin works in the liver and inhibits synthesis of four vitamin K- dependent clotting factors
(X, IX, VII, and II), but it takes 3 to 4 days before the therapeutic effect of warfarin is exhibited.
Question:
10) A 60-year-old male client comes into the emergency department with complaints of crushing
chest pain that radiates to his shoulder and left arm. The admitting diagnosis is acute myocardial
infarction. Immediate admission orders include oxygen by NC at 4L/minute, blood work, chest
x-ray, an ECG, and 2mg of morphine given intravenously. The nurse should first: Administer the
morphine Obtain a 12-lead ECG Obtain the lab work Order the chest x-ray.
Answer:
1. Although obtaining the ECG, chest x-ray, and blood work are all important, the nurse's priority
action would be to relieve the crushing chest pain.
Question:
11) When administered a thrombolytic drug to the client experiencing an MI, the nurse explains to
him that the purpose of this drug is to: Help keep him well hydrated Dissolve clots he may have
Prevent kidney failure Treat potential cardiac arrhythmias.
SOLUTIONS
Cardiac Nclex Comprehensive Study Paper
2026/2027 Questions and Answers Verified Solutions
Latest Update
Question:
Which of the following assessments would be an important finding for a patient with arterial
disease? Intermittent claudication with exercise Brownish discoloration around the ankles
Non-pitting edema on the lower extremities Altered sensation to touch.
Answer:
Intermittent claudication with exercise Rationale: Intermittent claudication is a common finding in
persons with arterial disease, usually due to progression of atherosclerosis and alteration of tissue
perfusion to the extremities. In venous disease, valves of the veins in the extremities become
incompetent, resulting in higher pressures than normal in the veins. The pressure is transmitted to
the capillaries of the lower extremities, resulting in thickening and non-pitting edema of tissues
around the ankles. Prolonged thickening results in the red blood cells' being pressed outside the
capillaries. The cells eventually break down, resulting in collection of hemosiderin deposits being
collected in the area. Altered sensation to touch would be due to neuropathic changes commonly
found with diabetes mellitus.
Question:
1) A client is scheduled for a cardiac catherization using a radiopaque dye. Which of the following
assessments is most critical before the procedure? Intake and output Baseline peripheral pulse rates
Height and weight Allergy to iodine or shellfish.
Answer:
4. This procedure requires an informed consent because it involves injection of a radiopaque dye
into the blood vessel. The risk of allergic reaction and possible anaphylaxis is serious and must be
assessed before the procedure.
Question:
2) A client with no history of cardiovascular disease comes into the ambulatory clinic with flulike
symptoms. The client suddenly complains of chest pain. Which of the following questions would
best help a nurse to discriminate pain caused by a non-cardiac problem? "Have you ever had this
,pain before?" "Can you describe the pain to me?" "Does the pain get worse when you breathe in?"
"Can you rate the pain on a scale of 1-10, with 10 being the worst?".
Answer:
3. Chest pain is assessed by using the standard pain assessment parameters. Options 1, 2, and 4 may
or may not help discriminate the origin of pain. Pain of pleuropulmonary origin usually worsens on
inspiration.
Question:
3) A client with myocardial infarction has been transferred from a coronary care unit to a general
medical unit with cardiac monitoring via telemetry. A nurse plans to allow for which of the
following client activities? Strict bed rest for 24 hours after transfer Bathroom privileges and
self-care activities Unsupervised hallway ambulation with distances under 200 feet Ad lib activities
because the client is monitored.
Answer:
2. On transfer from the CCU, the client is allowed self-care activities and bathroom privileges.
Supervised ambulation for brief distances are encouraged, with distances gradually increased (50,
100, 200 feet).
Question:
4) A nurse notes 2+ bilateral edema in the lower extremities of a client with myocardial infarction
who was admitted 2 days ago. The nurse would plan to do which of the following next? Review the
intake and output records for the last 2 days Change the time of diuretic administration from
morning to evening Request a sodium restriction of 1 g/day from the physician. Order daily weights
starting the following morning.
Answer:
1. Edema, the accumulation of excess fluid in the interstitial spaces, can be measured by intake
greater than output and by a sudden increase in weight. Diuretics should be given in the morning
whenever possible to avoid nocturia. Strict sodium restrictions are reserved for clients with severe
symptoms.
Question:
5) A client is wearing a continuous cardiac monitor, which begins to sound its alarm. A nurse sees
no electrocardiogram complexes on the screen. The first action of the nurse is to: Check the client
,status and lead placement Press the recorder button on the electrocardiogram console. Call the
physician Call a code blue.
Answer:
1. Sudden loss of electrocardiogram complexes indicates ventricular asystole or possible electrode
displacement. Accurate assessment of the client and equipment is necessary to determine the cause
and identify the appropriate intervention.
Question:
6) A nurse is assessing the blood pressure of a client diagnosed with primary hypertension. The
nurse ensures accurate measurement by avoiding which of the following? Seating the client with
arm bared, supported, and at heart level. Measuring the blood pressure after the client has been
seated quietly for 5 minutes. Using a cuff with a rubber bladder that encircles at least 80% of the
limb. Taking a blood pressure within 15 minutes after nicotine or caffeine ingestion.
Answer:
4. BP should be taken with the client seated with the arm bared, positioned with support and at heart
level. The client should sit with the legs on the floor, feet uncrossed, and not speak during the
recording. The client should not have smoked tobacco or taken in caffeine in the 30 minutes
preceding the measurement. The client should rest quietly for 5 minutes before the reading is taken.
The cuff bladder should encircle at least 80% of the limb being measured. Gauges other than a
mercury sphygmomanometer should be calibrated every 6 months to ensure accuracy.
Question:
7) IV heparin therapy is ordered for a client. While implementing this order, a nurse ensures that
which of the following medications is available on the nursing unit? Vitamin K Aminocaporic acid
Potassium chloride Protamine sulfate.
Answer:
4. The antidote to heparin is protamine sulfate and should be readily available for use if excessive
bleeding or hemorrhage should occur. Vitamin K is an antidote for warfarin.
Question:
8) A client is at risk for pulmonary embolism and is on anticoagulant therapy with warfarin
(Coumadin). The client's prothrombin time is 20 seconds, with a control of 11 seconds. The nurse
assesses that this result is: The same as the client's own baseline level Lower than the needed
, therapeutic level Within the therapeutic range Higher than the therapeutic range.
Answer:
3. The therapeutic range for prothrombin time is 1.5 to 2 times the control for clients at risk for
thrombus. Based on the client's control value, the therapeutic range for this individual would be 16.5
to 22 seconds. Therefore the result is within therapeutic range.
Question:
9) A client who has been receiving heparin therapy also is started on warfarin. The client asks a
nurse why both medications are being administered. In formulating a response, the nurse
incorporates the understanding that warfarin: Stimulates the breakdown of specific clotting factors
by the liver, and it takes 2-3 days for this to exert an anticoagulant effect. Inhibits synthesis of
specific clotting factors in the liver, and it takes 3-4 days for this medication to exert an
anticoagulant effect. Stimulates production of the body's own thrombolytic substances, but it takes
2-4 days for this to begin. Has the same mechanism of action as Heparin, and the crossover time is
needed for the serum level of warfarin to be therapeutic.
Answer:
2. Warfarin works in the liver and inhibits synthesis of four vitamin K- dependent clotting factors
(X, IX, VII, and II), but it takes 3 to 4 days before the therapeutic effect of warfarin is exhibited.
Question:
10) A 60-year-old male client comes into the emergency department with complaints of crushing
chest pain that radiates to his shoulder and left arm. The admitting diagnosis is acute myocardial
infarction. Immediate admission orders include oxygen by NC at 4L/minute, blood work, chest
x-ray, an ECG, and 2mg of morphine given intravenously. The nurse should first: Administer the
morphine Obtain a 12-lead ECG Obtain the lab work Order the chest x-ray.
Answer:
1. Although obtaining the ECG, chest x-ray, and blood work are all important, the nurse's priority
action would be to relieve the crushing chest pain.
Question:
11) When administered a thrombolytic drug to the client experiencing an MI, the nurse explains to
him that the purpose of this drug is to: Help keep him well hydrated Dissolve clots he may have
Prevent kidney failure Treat potential cardiac arrhythmias.
