CARDIAC NCLEX PRACTICE QUESTIONS WITH 100% CORRECT ANSWERS GRADED A+ 2024-2025 UPDATED (AC, Exams of Nursing

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CARDIAC NCLEX PRACTICE QUESTIONS

WITH 100% CORRECT ANSWERS GRADED

A+ 2024-2025 UPDATED (ACTUAL EXAM).

The nurse is preparing to teach the pt newly diagnosed with angina pectoris how to self-administer nitroglycerine (NTG) tablets. What pt teaching should the nurse emphasize? select all that apply A. stop all activities immediately and sit down if chest pain occurs B. if the pain is unrelieved after three NTG tablets, continue to rest and call the prescriber right away C. After discharge, keep NTG tablets on your bedside table day and night D. immediately after chest pain begins, notify your personal prescriber E. the NTG tablet should tingle when placed under the tongue - Answer A,B,E the pt states, "I always put my nitroglycerine patch in the same place so I do not forget to take it off." Which of the following is the best response by the nurse? A. change the patch every 24 hours B. massage into the skin if ointment comes in contact with your hands C. rotate the NTG patch to a different hairless area each day D. after removing the patch, scrub the are vigorously with soap and water - Answer C A healthcare provider orders NTG to be administered by IV drip. The nurse carrying out the order would monitor for which of the following as a priority specific to medication? A. shortness of breath when raising head of bed B. urine output C. blood pressure and heart rate D. facial flushing and headache - Answer C Before a pt receives metoprolol (Lopressor) for hypertension, the nurse should ask the pt about a history of which of the following? A. bronchospasms B. seizures C. peripheral vascular disease

D. myasthenia gravis - Answer A The nurse provides discharge instructions to a pt about the use of amiodarone. Which of the following statements indicates that the pt has the knowledge necessary to safely administer the drug? A. as soon as the physician says I can stop taking this medication, I will be able to enjoy the sun again B. the side effects of this med may not begin to show up for several weeks or even months after I start taking it C. If my pulse drops below 100 beats/minute, I should call the physician right away D. If I miss a dose of me, I should take it as soon as I remember it - Answer B The nurse is scheduled to administer a dose of digoxin to and adult pt with atrial fibrillation. The pt has a potassium level of 4.3 mEq/L. The nurse should perform which of the following activities next? A. withhold dose only for that day B. obtain order for dose of potassium before giving digoxin C. withhold dose and notify prescriber D. administer dose as ordered - Answer D A pt is taking digoxin and furosemide (Lasix) to manage congestive heart failure. The nurse determiens that the pt understands diet therapy when the pt makes which meal choice? A. veggie beef soup, mac and cheese, and a roll B. beef ravioli w/ bread C. baked white fish, mashed potatoes, and carrot salad D. roasted chicken, brown rice, and stewed tomatoes - Answer C After a healthcare provider prescribed propranolol for a pt with frequent premature ventricular contractions, the nurse should include with of the following in the care plan? A. inform pt that excessive respiratory response to activity should gradually decrease B. measure heart rate daily before taking dose C. Pt will have increased resistance to infection D. current skin eruptions will improve within 30 days - Answer B

A pt with atrial fibrillation is receiving continuous heparin infusion at 1000 units/hr. The nurse would determine that the pt is receiving the therapeutic effect based on which of the following results? A. prothrombin time of 12.5 seconds B. apt time of 60 seconds C. apt time of 28 seconds D. apt time longer than 120 sec - Answer B A nurse provides discharge instructions to a post op pt who is taking warfarin sodium (Coumadin). Which statement, if made by the pt, reflects the need for further teaching? A. I will take my pills every day at the same time B. I will be certain to limit my alcohol consumption C. I have already called my family to pick up my Medic-Alert bracelet D. I will take enteric-coated Aspirin for my headaches - Answer D A nurse is caring for a pt receiving heparin IV. The nurse anticipates that which lab study will be prescribed to monitor the therapeutic effect of heparin? A. hematocrit B. hemoglobin C. prothrombin time D. activated partial thromboplastin time - Answer D A pt is diagnosed with an acute myocardial infarction and is receiving tissue plasminogen activator, alteplase (Activase). Which of the following is a priority nursing intervention? A. monitor for renal failure B. monitor for psychosocial status C. monitor for signs of bleeding D. have heparin sodium available - Answer C A home health nurse instructs a pt about the use of a nitrate patch. The nurse tells the pt that which of the following will prevent pt tolerance to nitrates? A. do not remove the patches B. have a 12-hr no-nitrate time C. have a 24-hr no-nitrate time D. keep nitrates on 48 hrs, then off 24 hrs - Answer B

a pt is receiving thrombolytic therapy with a continuous infusion of streptokinase. The pt suddenly becomes extremely anxious with complaints of itching. A nurse hears stridor and on examination of the pt notes generalized urticarial and hypotension. Which of the following should be the priority action? A. administer oxygen and protamine sulfate B. stop the infusion and call the physician C. cut the infusion rate in half and sit the pt up in bed D. administer benadryl and continue the infusion slowly - Answer B Which of the following pts is at greatest risk for digital toxicity? A. a 25 y/o pt with congestive heart disease B. a 50 y/o pt with CHF C. a 60 y/o pt who had an MI D. an 80 y/o pt with CHF - Answer D Which of the following is a contraindication for digoxin administration? A. BP of 140/ B. HR> C. HR< D. RR>18 - Answer C The action of medication is inotropic when it: A. decreases afterload B. increases heart rate C. increases the force of contraction D. is uses to treat CHF - Answer C' Which is the most important action for the nurse to take before administering digoxin? A. monitor the potassium level B. assess the BP C. evaluate urinary output D. avoid giving with a thiazide diuretic - Answer A The therapeutic drug level for digoxin is: A. 0.1-2. B. 1.0-2. C. 0.1-0. D. 0.5-2.0 - Answer D

Blurred vision or halos are signs of: A. beta blocker toxicity B. digoxin toxicity C. diuretic toxicity D. ACE inhibitor toxicity - Answer B beta blockers should be avoided in which of the following conditions: A. bronchoconstriction B. hypertension C. Angina D. myocardial infarction - Answer A You know that the action of nitrates is: A. smooth muscle contraction B. vasoconstriction C. smooth muscle relaxation D. increase preload - Answer C A 50 y/o pt is prescribed to take nitrate each day for his condition. You know the result of nitrate administration is: A. decreased myocardial oxygen demand B. increased myocardial oxygen demand C. increased left ventricular end-diastolic volume D. increased atrial pressure - Answer A A student nurse is asked to give an example of a long-acting nitrate. She is correct by saying: A. Nitroglycerin sublingual B. nitroglycerin IV C. isosorbide PO D. Nitroglycerin transmucosal - Answer C When nitrates are administered early to the acute MI pt, the result is: A. Hypotension B. Bradycardia C. reduced mortality D. reduced morbidity - Answer C

When teaching about nitrate administration, the nurse should instruct the pt to: A. change positions slowly B. take pulse weekly C. reduce salt intake D. chew the sustained-release tablets - Answer A Nurse Margie just administered an ACE inhibitor to her pt. Before ambulating the pt for the first time after administration, the nurse should monitor for: A. hypokalemia B. irregular heartbeat C. edema D. hypotension - Answer D Mira is managing her hypertension with an ACE inhibitor. Which of the following statements stated by her indicates a need for further teaching? A. I should not take my pills with food B. I need to increase my intake of orange juice, bananas, and green veggies C. I will avoid coffee, tea, and cola D. I will avoid salt substitutes - Answer B The action of an ACE inhibitor interrupts the renin-angiotensin-aldosterone mechanism, thereby producing which of the following? A. reduced renal blood flow B. reduced sodium and water retention C. increased peripheral vascular resistance D. increased sodium excretion and potassium reabsorption - Answer D Raymund is reviewing on cardio drugs for his upcoming exam. For a well- prepared student, he should know that vasodilators are agents that: A. relax smooth muscle B. are used to treat hypotension C. stimulate the adrenergic receptors D. cause respiratory depression - Answer A As a competent nurse, you are aware that vasodilators are used mainly to treat: A. diabetes

B. hypertension C. atrial fibrillation D. hypotension - Answer B Which of the following is a potential side effect of IV furosemide (Lasix)? A. drowsiness B. diarrhea C. cystitis D. hearing loss - Answer D All potassium-sparing diuretics: A. are required during blood transfusions B. enhance aldosterone action C. cause hypokalemia D. are weak diuretics - Answer B Which of the following pts is most likely to experience adverse effects from tx with diuretics? A. a 21 y/o college student B. a 40 y/o unmarried man C. a 60 y/o widower D. a 75 y/o man - Answer D SC heparin should be administered in the: A. flank B. abdominal fat C. thigh D. buttock - Answer B The half-life of heparin is: A. 10 minutes B. 1-1.5 hrs C. 8-12 hrs D. 1-2 days - Answer B When teaching the pt about the signs and symptoms of cardiac glycoside toxicity, the nurse should alert the pt to watch for: A. visual changes B. flickering lights or halos C. dizziness when standing up

D. increased urine output - Answer B during assessment of a pt who is receiving digoxin, which finding would indicate an increased possibility of toxicity? A. apical pulse rate of 60 bpm B. digoxin level of 1. C. serum potassium level of 2. D. serum potassium level of 4.8 - Answer C When a pt is experiencing digitalis toxicity, in which of the following situations would it be appropriate to treat with digoxin immune Fab (Digibind)? A. hypokalemia B. hyperkalemia C. apical heart rate of 60 bpm D. supraventricular dysrhythmias - Answer B A pt with a rapid, irregular heart rhythm is being treated in the ER with adenosine. During administration of this drug, the nurse should be prepared to monitor the pt for which effect? A. nausea and vomiting B. transitory asystole C. muscle tetany D. hypertension - Answer B When assessing a pt who has been taking amiodarone for 6 months, which adverse reaction might the nurse identify? A. glycosuria B. dysphagia C. photophobia D. urticaria - Answer C A pt has a new prescription from transdermal nitroglycerin patches. The nurse teaches the pt that these patches are most appropriately used for which of the following? A. to relieve exertional angina B. to prevent palpatations C. to prevent the occurrence of angina D. to reduce the severity of anginal episodes - Answer C

A nurse with adequate knowledge about the administration of IV nitroglycerin will recognize that which of the following statements is correct? A. the intravenous form is given by bolus injection B. because the IV forms are short-lived, the dosing must be every 2 hours C. IV nitroglycerin must be protected form exposure to light through use of special tubing D. IV nitroglycerin can be given via gravity drip infusions - Answer C A nurse with adequate knowledge about the administration of IV nitroglycerin will recognize that which of the following statements is correct? A. the intravenous form is given by bolus injection B. because the IV forms are short-lived, the dosing must be every 2 hours C. IV nitroglycerin must be protected form exposure to light through use of special tubing D. IV nitroglycerin can be given via gravity drip infusions - Answer C Which statement by the pt reflects the need for additional pt education about the CCB diltiazem (Cardizem)? A. I can take this drug to stop acute anginal attacks B. I understand that food and antacids alter the absorption of this oral drug C. when the long-acting forms are taken, the drug cannot be crushed D. this drug may cause my blood pressure to drop, so I should be careful when getting up - Answer A While assessing a pt with angina who is to start Beta Blocker therapy, the nurse is aware that the presence of which condition may be a problem if these drugs are used: A. hypertension B. essential tremors C. exertional angina D. asthma - Answer D A 68 y/o man has been taking the nitrate isosorbide for 2 years for angina. He recently has been experiencing erectile dysfunction and wants a prescription for sildenafil (Viagra). Which response would the nurse most likely hear from the prescriber? A. He will have to be switched to isosorbide mononitrate if he wants to take sildenafil

B. taking sildenafil with the nitrate may result in severe hypotension C. I'll write a prescription, but if he uses it, he needs to stop talking the isosorbide for one dose D. these drugs are compatible with each other, and so I'll write a prescription - Answer B Which of the following adverse effects is of most concern for the older adult pt taking anti-hypertensive drugs A. dry mouth B. hypotension C. restlessness D. constipation - Answer B when giving antihypertensives drugs, the nurse must consider giving the first dose at bedtime for which of the following classes of drugs? A. alpha blockers B. diuretics C. ACE inhibitors D. vasodilators - Answer A A 56 y/o man started antihypertensive drug therapy 3 months earlier and is in the office for a follow-up visit. While the nurse is taking his BP, he informs the nurse that he has had some problems with sexual intercourse. Which of the following would be the most appropriate response by the nurse: A. not to worry. Tolerance will develop B. the physician can work with you on changing the dose or drug C. sexual dysfunction happens with this therapy, and you must lean to accept it D. this is an unusual occurrence, but it is important to stay on your meds - Answer B when a pt is being taught about the potential adverse effects of an ACE inhibitor, which of the following should be mentioned as possibly occurring when this drug is taken to treat hypertension A. hypokalemia B. nausea C. dry, nonproductive cough D. sedation - Answer C

When applying a nitro patch it should be placed on A. non hairy part of the chest B. thigh C. upper back D. buttocks - Answer A a pt with congestive heart failure is receiving digoxin. What is the desired effect: A. neck vein distention B. decreased appetite C. increased urinary output D. increased pedal edema - Answer C a pt has a new prescription for an adrenergic drug. During a review of the pt's list of current meds, which would cause concern about a possible interaction with this new prescription: A. a benzodiazepine taken as needed for allergies B. a multivitamin with iron C. an oral anticoagulant D. NSAIDS - Answer A A pt has a potassium level of 6.0 and a digoxin level of 3.0. What medication would the nurse be giving: A. digibind B. sodium citrate C. epinephrine D. lidocaine - Answer A positive inotropic action does which of the following? A. decreases heart rate B. decreases cellular conduction C. increases contractility - Answer C what is the digitalizing dose of Digoxin (Lanoxin)? A. 0.125-0. B. 0.5- C. 0.5-3 - Answer B

Hypokalemia is a potential side effect of Digoxin. You need to educate your pt on consuming potassium-rich foods. Which of the following will you include in your list of potassium-rich foods? A. Eggs B. strawberries C. whole grain bread - Answer B a pt has been admitted with chest pain. He states that it began while he was watching tv on his couch. Which kind of angina does he likely have? A. stable B. unstable C. variant - Answer C which of the following is NOT a nursing intervention relevant to administration of nitroglycerin? A. inform the pt there may be a burning sensation under their tongue upon ingestion B. inform the pt that this med must be kept in its original bottle C. inform the pt that a headache is the most common side effect associated with this drug - Answer C Which group of drugs can be either selective or non-selective? a. sodium channel blockers B. beta blockers C. calcium channel blockers - Answer B which of the following is a class of antidysrhythmic drug? A. osmotic B. carbonic-anhydrase inhibitor C. beta adrenergic blocker - Answer C When administering hydrochlorothiazide, which labs must be monitored? A. BUN, creatinine B. INR, electrolytes C. APPT, PTT - Answer A which of the following is the serum abnormality with thiazides? A. hyperkalemia B. hyperglycemia C. hyperchloremia - Answer B

Which of the following serum abnormalities is unique to loop diuretics? A. hypokalemia B. hypomagnesia C. hyponatremia - Answer C potassium sparing diuretics work where? A. collecting distal tubules B. ascending loop of henle C. descending loop of henle - Answer A What is the antidote for heparin? A. vitamin K B. immunefab C. protamine sulfate - Answer C which of the following anticoagulants is used prophylactically? A. heparin B. lovenox B. coumadin - Answer B which of the following drugs are known as "clot busters"? A. anticoagulants B. antiplatelets C. thrombolytics - Answer C Which of the following must be given within 3 hours of the beginning of an MI or stroke? A. thrombolytics B. antiplatelets C. cardiac glycosides - Answer A Which drug category has intermittent claudication as a characteristic side effect? A. peripheral vasodilators B. diuretics C. antilipidemics - Answer A what is the most common side effect of ACE inhibitors? A. headache

B. persistent dry cough C. visual disturbances - Answer B Your pt is on coumadin. You must instruct them to limit their intake of what? A. milk B. juice C. tea - Answer C A pt is on Spironolactone (Aldactone) and has a potassium level of 5.9. What should the nurse do? A. hold the med and contact the physician B. give the med as prescribed C. give the pt half the prescribed dose D. give the pt a banana - Answer A Which of the following is a potential side effect of IV furosemide (lasix)? A. drowsiness B. diarrhea C. cystitis D. hearing loss - Answer D the nurse reviews lab studies of a pt receiving digoxin (Lanoxin). Intervention by the nurse is required if the results include which of the following laboratory values? A. serum digoxin level of 1.2 ng/dL B. Serum potassium level of 3 mEq/L C. hemoglobin of 14.4 g/ dL D. serum sodium level of 140 mEq/L - Answer B A nurse teaching a pt on correct self administration of sublingual nitroglycerin (Nitrostat) tablets realizes the pt requires further teaching when they state: A. I will call an ambulance while administering the 3rd tablet B. I will not drive while taking nitroglycerin tablets C. I will keep my tablets in a clear bottle D. I will not take nitroglycerin with erectile dysfunction medication - Answer C Your pt is currently taking Digoxin. What should you, as a nurse be prepared to administer in the event of digitalis toxicity?

A. potassium B. digibind C. protamine sulfate D. heparin - Answer B Your pt starts showing signs of gynecomastia, which diuretic would you suspect they are on? A. potassium-sparing B. thiazide C. loop D. calcium channel blockers - Answer A The nurse is monitoring a pt taking digoxin (Lanoxin) for treatment of heart failure. Which assessment finding indicates a therapeutic effect of the drug? A. HR 110 beats/minute B. HR 58 beats/minute C. urinary output 40 mL/hr D. BP 90/50 mm Hg - Answer B the nurse knows that the mechanism of action of Clopidogrel (Plavix) is to: A. inhibit the actions of vitamin K B. turn plasminogen to plasmin C. inhibit the aggregation of platelets D. inhibit angiotensin I from converting to angiotensin II - Answer C nursing interventions for a pt receiving enoxaparin (Lovenox) may include: A. monitoring multiple lab tests and values B. monitoring for development of deep vein thrombosis C. teaching the pt or family to give subcutaneous injections at home D. teaching to observe for excessive bleeding - Answer C a client who has been taking warfarin (Coumadin) is admitted with coffee- ground emesis. What is the nurse's primary action? A. Administer vitamin E B. Administer vitamin K C. Administer protamine sulfate D. Administer calcium gluconate - Answer B all potassium-sparing diuretics:

A. are required during blood transfusions B. enhance aldosterone action C. cause hypokalemia D. are weak diuretics - Answer D when a pt is experiencing digitalis toxicity, in which of the following situations would it be appropriate to treat with digoxin immune Fab (digibind) A. hypokalemia B. hyperkalemia C. apical heart rate of 60 bpm D. supraventricular arrhythmias - Answer B A client receives a dose of furosemid (Lasix) 120 mg intravenously for treatment of congestive heart failure. Which symptom indicates that an adverse reaction is most likely occurring? A. bradycardia B. weight gain C. hypotension D. crackles - Answer C Sublingual nitroglycerin is given to a client who experiences chest pain. Which symptom can occur with nitroglycerin? A. tachycardia B. tinnitus C. diarrhea D. Diplopia - Answer A An elderly client receives instructions regarding the use of warfarin sodium (Coumadin). Which statement indicates the client understands the possible food interactions which may occur with this medication? A. I'm going to miss having my evening glass of wine now B. I told my daughter to buy bananas for me. I'll have to eat more of those now C. I will have to watch my intake of salads, something that I really love D. I am going to begin eating more fish and pork and leave beef alone now

• Answer C

An elderly pt is prescribed spironolactone (Aldactone) with the addition of potassium chloride (Kaochlor). Which statement is a true statement regarding the use of these two meds together? A. spironolactone should not have potassium chloride added to the regimen b/c it is a potassium-sparing diuretic B. potassium is necessary when clients are placed on spironlocatone b/c it is a loop diuretic C. spironolactone and potassium chloride have no additive or antagonistic effects with each other D. potassium chloride added to spironolactone causes renal failure - Answer A A 62 y/o male pt has nitroglycerin (Nitrostat) added to his med regimen. Which statement made by this pt indicates that further education is needed? A. I will take this med if I have an episode of chest pain B. I will wait at least 1 hour after I take my sildanefil (Viagra) before using Nitrostat C. I can take up to 3 tablets every 5 minutes if my angina occurs D. I know that I must put this tablet under my tongue for it to work - Answer B which dietary change must a pt make when starting treatment with the med spironolactone? A. eat extra helpings of bananas B. increase intake of water C. avoid salt substitutes D. increase intake of green leafy veggies - Answer C a 68 y/o male is experiencing severe hypotension after receiving IV nitroglycerin. What is the most probable cause for this reaction? A. pt is having a MI B. the pt has a high potassium level C. the pt routinely exercises, but has not be active in over a week D. the pt failed to report that he is on Viagra - Answer D a pt receives a nitroglycerin drip. Which is the true statement regarding the use of this med in IV therapy? A. vented tubing is needed to administer this med B. a glass bottle and vented tubing are needed to administer this med

C. admixture must be done under a laminar flow hood with proper handling techniques D. this med cannot be given through small diameter catheters in elderly pts

• Answer B nitroglycerin is ordered for an elderly pt who is having an episode of chest pain. Which is a correct statement regarding the use of nitroglycerin spray instead of nitroglycerin tablets in this age group? A. there is increased absorption in the older client with the spray B. older clients attempt to chew the tablet C. tablets dissolve slower in this population D. the spray lasts longer in the system - Answer A alpha-adrenergic blocking agents include medications such as doxazosin and prazosin hydrochloride. The mechanism of action for these meds is to: A. inhibit the parasympathetic system B. stimulate the sympathetic system C. inhibit the sympathetic system D. stimulate the parasympathetic system - Answer C Warfarin works by obstructing certain clotting factors in the clotting cascade. Which info is correct regarding this mechanism of action? A. interference with calcium occurs within the clotting cascade B. increased solubility of vitamin D occurs in the mucosal lining of the stomach C. decreased functioning of vitamin K occurs within the production sites D. binding with magnesium occurs in the hepatic cells - Answer C a nurse gives a subq injection of heparin sodium (heparin). Which is a true statement regarding this injection? A. massage the area after heparin is administered subq B. aspiration before injection can cause hematoma formation C. give the injection each time in the same general area D. hold the skin taut when giving the injection - Answer B A pt who is being discharged home will be giving his own enoxaparin sodium (Lovenox) subq. Which statement by the client indicates the need for further education? A. i remember that i need to hold the needle at a 45 degree angle B. i know to pinch the skin up for the injection

C. i will not pull back on the plunger before injecting the med D. i am going to use the right side of my lower abdomen all the time - Answer D