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Nclex Cardiovascular Exam Questions with
Simplified Solution
1. The nurse is teaching the client with angina pectoris about disease manage-ment
and lifestyle changes that are necessary in order to control disease pro-gression. Which statements by the client indicate a need for further teaching? Select all that apply.: "I am going to switch to electronic cigarettes." "It is best to exercise once a week for an hour."
2. A client being seen in the emergency department for complaints of chest pain
confides in the nurse about regular use of cocaine as a recreational drug. The nurse takes which important action in delivering holistic nursing care to this client?: Teaches about the ettects of cocaine on the heart and otters referral for further help
3. The nurse is caring for a client with coronary artery disease, and a topical
nitrate is prescribed for the client. Why is acetaminophen usually prescribed to be taken before the administration of the topical nitrate?: Headache is a common side ettect of nitrates.
4. The nurse is collecting data on a client with a diagnosis of right-sided heart
failure. The nurse should expect to note which specific characteristic of this condition?: Dependent edema
5. The health care provider is discharging a client with a diagnosis of chronic heart
2 / 30 failure. Which health maintenance instructions should the nurse rein-force in the discharge teaching plan? Select all that apply.: Obtain annual influenza vaccination. Avoid adding salt to foods or in cooking. Report a weight gain of 3 or more pounds in a week
6. A client has just returned from the cardiac catheterization laboratory. The left
femoral vessel was used as the access site. After returning the client to bed and conducting an initial assessment, the nurse assisting in caring for the client expects the cardiologist to write a prescription for the client to remain on bed rest. In which position should the bed be positioned?: With the head of bed elevated no more than 30 degrees
7. A client diagnosed with thrombophlebitis 1 day ago suddenly complains of chest
pain and shortness of breath, and the client is visibly anxious. Which is a life- threatening complication that could be occurring?: Pulmonary embolism
8. About which laboratory values should the nurse be immediately concerned
because they could cause cardiac arrest? Select all that apply.: Calcium 7.9 mg/L Potassium 5.9 mEq/L
9. The nurse is checking the neurovascular status of a client who returned to the
surgical nursing unit 4 hours ago, after undergoing an aortoiliac bypass graft. The affected leg is warm, and the nurse notes redness and edema. The pedal pulse is
4 / 30 is receiving an intravenous infusion of 1000 mL 5% dextrose with 40 mEq of potassium chloride. Which occurrence observed on the cardiac monitor indicates the presence of hyperkalemia?: Tall, peaked T waves
17. The nurse is caring for a client with a new onset of atrial fibrillation. Which
prescribed treatments should the nurse expect? Select all that apply: Digoxin Warfarin Electrical cardioversion
18. The nurse has completed nutritional counseling with an overweight client
about weight reduction to modify the risk for coronary artery disease (CAD). The nurse should determine the teaching is successful if the client states that which weight loss goal is safe?: Two pounds per week
19. The nurse is collecting data on a client with a diagnosis of angina pectoris
who takes nitroglycerin for chest pain. During the admission, the client re-ports chest pain. The nurse immediately asks the client which question?: "Where is the pain located?"
20. The nurse is planning adaptations needed for activities of daily living for a
client with cardiac disease. The nurse should incorporate which instruction in discussion with the client?: Take in adequate daily fiber to prevent straining during a bowel movement.
21. The nurse is assisting a client who will wear a Holter monitor for
5 / 30 continuous cardiac monitoring over the next 24 hours. The nurse takes which action to assist the client?: Gives the client a device holder to wear around the waist
22. The licensed practical nurse (LPN) is assisting in caring for a client with a
diagnosis of myocardial infarction (MI). The client is experiencing chest pain that is unrelieved by the administration of nitroglycerin. The registered nurse administers morphine sulfate to the client as prescribed by the health care provider. Following administration of the morphine sulfate, the LPN plans to monitor which indicator(s)?: Respirations and blood pressure
23. The nurse is told during shift report that a client is having occasional
ventricular dysrhythmias. The nurse reviews the client's laboratory results, recalling that which electrolyte imbalance could be responsible for this devel- opment?: Hypokalemia
24. The nurse is collecting data from a client with varicose veins. Which finding
would the nurse identify as an indication of a potential complication associat-ed with this disorder?: The client complains of leg edema, and skin breakdown has started.
25. The nurse is caring for a client who is developing pulmonary edema. The
client exhibits respiratory distress, but the blood pressure is unchanged from the client's baseline. As an immediate action before help arrives, the nurse should perform which action?: Place the client in high-Fowler's position.
26. A client with left-sided heart failure has been admitted to the hospital. The
nurse is reviewing the medical record and notes which signs and symptoms? Select
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30. The nurse is discussing smoking cessation with a client diagnosed with
coronary artery disease (CAD). Which statement should the nurse make to the client to try to motivate the client to quit smoking?: "If you quit now, your risk of cardiovascular disease will decrease to that of a nonsmoker in 3 to 4 years."
31. The nurse is assisting a hospitalized client who is newly diagnosed with
coronary artery disease (CAD) to make appropriate selections from the dietary menu. The nurse encourages the client to select which meal?: Fresh strawberries, steamed vegetables, and baked fish
32. An older client with ischemic heart disease has experienced an episode of
dizziness and shortness of breath. The nurse reviews the plan of care and notices documentation of decreased cardiac output, dyspnea, and syncopal episodes. The nurse plans to take which important action?: Place the client on a cardiac monitor.
33. A hypertensive client who has been taking metoprolol has been prescribed
to decrease the dose of the medication. The client asks the nurse why this must be done over a period of 1 to 2 weeks. In formulating a response, the nurse incorporates the understanding that abrupt withdrawal could affect the client in which way?: Precipitate rebound hypertension
34. The nurse has reinforced dietary instructions to a client with coronary
artery disease. Which statement by the client indicates an understanding of the dietary instructions?: "I should routinely use polyunsaturated oils in my diet."
35. A client is admitted to the hospital with possible rheumatic endocarditis.
8 / 30 The nurse should check for a history of which type of infection?: Streptococcal infection
36. The client scheduled for a right femoropopliteal bypass graft is at risk for
compromised tissue perfusion to the extremity. The nurse takes which action before surgery to address this risk?: Marking the location of the pedal pulses on the right leg
37. The nurse finds a client tensing while lying in bed staring at the cardiac
monitor. The client states, "There sure are a lot of wires around there. I sure hope we don't get hit by lightning!" Which is the nurse's best response?: "Yes, this equipment is a little scary. Can we talk about how the cardiac monitor works?"
10 / 30 flu-like symptoms. The client suddenly develops chest pain. Which question best assists the nurse to discriminate pain caused by a noncardiac problem?: "Does the pain get worse when you breathe in?"
42. The nurse has reinforced instructions to the family of an older client who
seems anxious about being discharged after cardiac surgery. The nurse un-derstands further teaching is needed if a family member makes which state-ment?: "A daily, half- mile-long, brisk walk generally helps people bounce back more quickly and provides more of a sense of control."
43. The nurse is collecting data on a client who was just admitted to the
hospital with a diagnosis of coronary artery disease (CAD). The client reveals having been under a great deal of stress recently. Which should the nurse do next?: Explore with the client the sources of stress in life.
44. A client with infective endocarditis is at risk for heart failure. The nurse
monitors the client for which signs and symptoms of heart failure?: Lung crackles, peripheral edema, and weight gain
45. The nurse is preparing for a health fair about tobacco use and the develop-ment
of coronary heart disease. Which information should the nurse include? Select all that apply.: Nicotine decreases oxygen to the heart. Hypnosis may be helpful to stop smoking. Avoid exposure to environmental tobacco smoke.
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46. A client has been diagnosed with Prinzmetal's angina. The nurse reviews
the medical record and notes which accompanying characteristics? Select all that apply.: Prolonged severe pain Happens at the same time each day
47. A client is scheduled for a cardiac catheterization using a radiopaque dye. The
nurse checks which most critical item before the procedure?: Prior reaction to contrast media
48. The nurse has reinforced home care instructions to a client who had a
permanent pacemaker inserted. Which educational outcome has the greatest impact on the client's long-term cardiac health?: The ability to take an accurate pulse in either the wrist or neck
49. The nurse is preparing to care for a client who will be arriving from the
recovery room after an above-the-knee amputation. The nurse ensures that which priority item is available for emergency use?: Surgical tourniquet
50. A client with heart failure is scheduled to be discharged to home with digox-
in and furosemide as ongoing prescribed medications. The nurse teaches the client to report which sign/symptom that indicates the medications are not producing the intended effect?: Weight gain of 2 to 3 pounds in a few days
51. The nurse is monitoring a client with an abdominal aortic aneurysm (AAA).
Which finding is probably unrelated to the AAA?: Hyperactive bowel sounds in the area
52. A client with hyperlipidemia is seen in the clinic for a follow-up visit. Which
dietary modifications should the nurse include to lower the risk of coronary heart
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58. A client is admitted to the hospital with a venous stasis leg ulcer. The nurse
is reviewing the physical examination in the medical record. Which symptom is least likely to be noted by the primary health care provider?: Sharp pain in the leg
59. The nurse reinforces instructions to a client at risk for thrombophlebitis
regarding measures to minimize its occurrence. Which statement by the client indicates an understanding of this information?: "I should avoid sitting in one position for long periods of time."
60. A client has just completed an information session about measures to
minimize the progression of coronary artery disease (CAD). Which statement indicates an initial understanding of lifestyle alterations?: I should eat a diet that is low in fat and cholesterol.
61. The nurse has given simple instructions on preventing some of the com-
plications of bed rest to a client who experienced a myocardial infarction. The nurse should intervene if the client were performing which of these contraindicated activities?: Isometric exercises of the arms and legs
62. A female client complains of an "odd, left-sided, twinge-like pain" along the
anterior axillary line and states she has had this feeling for the past 3 days. Which is the initial action?: Determine if the pain is cardiac in origin.
63. A client is seen in the health care provider's office for a physical examination
after experiencing unusual fatigue over the last several weeks. Height is 5 feet, 8 inches, with a weight of 220 pounds. Vital signs are temperature 98.6° F oral, pulse
14 / 30 86 beats per minute, respirations 18 breaths per minute, and blood pressure 184/ mm Hg. Random blood glucose is 110 mg/dL. In order to best collect relevant data, which question should the nurse ask the client first?: "When was the last time you had your blood pressure checked?"
64. The health care provider is discharging a client with a diagnosis of primary
hypertension. Which health maintenance instructions should the nurse rein-force in the discharge teaching plan? Select all that apply.: Monitor the blood pressure at home. Restrict sodium intake as prescribed. Eye examinations with an ophthalmoscope should be routine. Follow-up appointments for blood pressure checks are important.
65. The nurse is talking with a client with angina about factors that can
precipi-tate an angina attack. Which statement by the client indicates an understand-ing of the precipitating events?: "I will pay my neighbor to shovel my snow this winter."
66. A client asks the nurse about metabolic syndrome and what it means.
The teaching plan should include which characteristics that define metabolic syndrome? Select all that apply.: Blood pressure is elevated with systolic values greater than 130 mm Hg and diastolic values greater than 85 mm Hg. The client has abdominal obesity with a waist greater than 40 inches in males and greater 35 inches in females.
16 / 30 tions should be of highest priority to the nurse?: Status of airway
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73. A client diagnosed with angina pectoris returns to the nursing unit after
experiencing an angioplasty. The nurse reinforces instructions to the client regarding the procedure and home care measures. Which statement by the client indicates an understanding of the instructions?: "I need to adhere to my dietary restrictions."
74. The nurse is teaching a hospitalized client who has had aortoiliac bypass
grafting about measures to improve circulation. The nurse should tell the client to do which?: Keep the ankles uncrossed.
75. The nurse is planning a dietary menu for a client with heart failure who is
being treated with digoxin and furosemide. Which would be the best dinner choice from the daily menu?: Baked fish, mashed potatoes, and carrot-raisin salad
76. In order to assess the dorsalis pedis pulse of a client diagnosed with arterial
vascular disease, the nurse palpates which anatomical location? Refer to figure.: D
77. The nurse is providing discharge teaching for a post-myocardial infarction
(MI) client who will be taking 1 baby aspirin a day. The nurse determines that the client understands the use of this medication if the client makes which statement?: "I will take this medication every day."
78. The nurse is caring for a client diagnosed with Buerger's disease. Which
finding should the nurse determine is a potential complication associated with this disease?: Numbness and tingling in the legs
79. The nurse monitors the laboratory data on a client at risk for coronary
artery disease. A fasting blood glucose reading of 200 mg/dL is recorded on the chart.
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85. A hospitalized client with a history of angina pectoris is ambulating in the
corridor. The client suddenly complains of severe substernal chest pain. The nurse should take which action first?: Assist the client to sit or lie down.
86. The client's B-type natriuretic peptide (BNP) level is 691 pg/mL. Which
intervention should the nurse institute when providing care for the client?: Take daily weights and monitor trends.
87. A client returns to the nursing unit after an above-knee amputation of the
right leg. In which position should the nurse place the client?: With the foot of the bed elevated
88. The nurse in a medical unit is caring for a client with heart failure. The
client suddenly develops extreme dyspnea, tachycardia, and lung crackles, and the nurse suspects pulmonary edema. The nurse immediately notifies the regis-tered nurse (RN) and expects which interventions to be prescribed?: Administering oxygen Inserting a Foley catheter Administering furosemide Administering morphine sulfate intravenously
89. A client with myocardial infarction (MI) has been transferred from the
coronary care unit (CCU) to the general medical unit with cardiac monitoring via telemetry. The nurse assisting in caring for the client expects to note which type of activity prescribed?: Bathroom privileges and self-care activities
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90. A postcardiac surgery client with a blood urea nitrogen (BUN) level of
45 mg/dL (16.2 mmol/L) and a serum creatinine level of 2.2 mg/dL (193. mcmol/L) has a total 2-hour urine output of 25 mL. The nurse understands that the client is at risk for which condition?: Acute kidney injury
91. The nurse is assisting with caring for the client immediately after insertion
of a permanent demand pacemaker via the right subclavian vein. The nurse prevents dislodgement of the pacing catheter by implementing which inter-vention?: Limiting movement and abduction of the right arm
92. A client with coronary artery disease has selected guided imagery to help
cope with psychological stress. Which statement by the client indicates un- derstanding of this stress reduction measure?: "The best thing about this is that I can use it anywhere, anytime."
93. The nurse is asked to assist another health care member in providing care
to a client who is placed in a modified Trendelenburg's position. The nurse interprets that the client is likely being treated for which condition?: Shock
94. A client with a diagnosis of myocardial infarction has a new activity prescrip-
tion allowing the client to have bathroom privileges. As the client stands and begins to walk, the client begins to complain of chest pain. The nurse should take which action?: Assist the client to get back into bed.
95. A client brings the following medications to the clinic for a yearly physical.
The nurse realizes which medication has been prescribed to treat heart fail-ure?:
