NCLEX-RN Cardiovascular Exam Questions with
accurate detailed answers and rationales
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 - correct answer✔✔a. 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. - correct answer✔✔c. 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. - correct answer✔✔b. 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. - correct answer✔✔a. 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. - correct answer✔✔a.
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. - correct answer✔✔a. 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?
accurate detailed answers and rationales
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 - correct answer✔✔a. 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. - correct answer✔✔c. 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. - correct answer✔✔b. 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. - correct answer✔✔a. 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. - correct answer✔✔a.
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. - correct answer✔✔a. 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?
