NCLEX RN Cardiovascular Q&As 1
NCLEX RN Cardiovascular Q&As
1. A client admitted to the hospital with chest pain and a history of type 2 diabetes mellitus is
scheduled for cardiac catheterization. Which medication would need to be withheld for 24
hours before the procedure and for 48 hours after the procedure?
1. Glipizide
2. Metformin
3. Repaglinide
4. Regular insulin
2. A client who had cardiac surgery 24 hours ago has had a urine output averaging 20 mL/hour
for 2 hours. The client received a single bolus of 500 mL of intravenous fluid. Urine output for
the subsequent hour was 25 mL. Daily laboratory results indicate that the blood urea nitrogen
level is 45 mg/dL (16 mmol/L) and the serum creatinine level is 2.2 mg/dL (194 mcmol/L). On
the basis of these findings, the nurse would anticipate that the client is at risk for which
problem?
1. Hypovolemia
2. Acute kidney injury
3. Glomerulonephritis
4. Urinary tract infection
3. The nurse is reviewing an electrocardiogram rhythm strip. The P waves and QRS complexes
are regular. The PR interval is 0.16 seconds, and QRS complexes measure 0.06 seconds. The
overall heart rate is 64 beats/minute. Which action should the nurse take?
1. Check vital signs.
2. Check laboratory test results.
3. Notify the health care provider.
4. Continue to monitor for any rhythm change.
4. A client is wearing a continuous cardiac monitor, which begins to sound its alarm. The nurse
sees no electrocardiographic complexes on the screen. Which is the priority nursing action?
1. Call a code.
2. Call the health care provider.
3. Check the client's status and lead placement.
4. Press the recorder button on the electrocardiogram console.
,NCLEX RN Cardiovascular Q&As 2
5. The nurse is evaluating a client's response to cardioversion. Which assessment would be the
priority?
1. Blood pressure
2. Status of airway
3. Oxygen flow rate
4. Level of consciousness
6. The nurse is caring for a client who has just had implantation of an automatic internal
cardioverter-defibrillator. The nurse should assess which item based on priority?
1. Anxiety level of the client and family
2. Presence of a Medic-Alert card for the client to carry
3. Knowledge of restrictions on post-discharge physical activity
4. Activation status of the device, heart rate cutoff, and number of
shocks it is programmed to deliver
7. A client's electrocardiogram strip shows atrial and ventricular rates of 110 beats/minute. The
PR interval is 0.14 seconds, the QRS complex measures 0.08 seconds, and the PP and RR
intervals are regular. How should the nurse correctly interpret this rhythm?
1. Sinus tachycardia
2. Sinus bradycardia
3. Sinus dysrhythmia
4. Normal sinus rhythm
8. The nurse is assessing the neurovascular status of a client who returned to the surgical
nursing unit 4 hours ago after undergoing aortoiliac bypass graft. The affected leg is warm, and
the nurse notes redness and edema. The pedal pulse is palpable and unchanged from
admission. How should the nurse correctly interpret the client's neurovascular status?
1. The neurovascular status is normal because of increased blood
flow through the leg.
2. The neurovascular status is moderately impaired, and the surgeon
should be called.
3. The neurovascular status is slightly deteriorating and should be
monitored for another hour.
4. The neurovascular status is adequate from an arterial approach,
but venous complications are arising.
9. The nurse is evaluating the condition of a client after pericardiocentesis performed to treat
cardiac tamponade. Which observation would indicate that the procedure was effective?
1. Muffled heart sounds
2. A rise in blood pressure
,NCLEX RN Cardiovascular Q&As 3
3. Jugular venous distention
4. Client expressions of dyspnea
10. A client with variant angina is scheduled to receive an oral calcium channel blocker twice daily.
Which statement by the client indicates theneed for further teaching?
1. "I should notify my doctor if my feet or legs start to swell."
2. "My doctor told me to call his office if my pulse rate decreases
below 60."
3. "Avoiding grapefruit juice will definitely be a challenge for me,
since I usually drink it every morning with breakfast."
4. "My spouse told me that since I have developed this problem, we
are going to stop walking in the mall every morning."
11. The nurse is monitoring a client with acute pericarditis for signs of cardiac tamponade. Which
assessment finding indicates the presence of this complication?
1. Flat neck veins
2. A pulse rate of 60 beats/minute
3. Muffled or distant heart sounds
4. Wheezing on auscultation of the lungs
12. The home care nurse is providing instructions to a client with an arterial ischemic leg ulcer
about home care management and self-care management. Which statement, if made by the
client, indicates a need for further instruction?
1. "I need to be sure not to go barefoot around the house."
2. "If I cut my toenails, I need to be sure that I cut them straight
across."
3. "It is all right to apply lanolin to my feet, but I shouldn't place it
between my toes."
4. "I need to be sure that I elevate my leg above the level of my heart
for at least an hour every day."
13. The nurse is providing instructions to a client with a diagnosis of hypertension regarding high-
sodium items to be avoided. The nurse instructs the client to avoid consuming which item?
1. Bananas
2. Broccoli
3. Antacids
4. Cantaloupe
14. The nurse is preparing discharge instructions for a client with Raynaud's disease. The nurse
should plan to provide which instruction to the client?
, NCLEX RN Cardiovascular Q&As 4
1. Use nail polish to protect the nail beds from injury.
2. Wear gloves for all activities involving the use of both hands.
3. Stop smoking because it causes cutaneous blood vessel spasm.
4. Always wear warm clothing, even in warm climates, to prevent
vasoconstriction.
15. The nurse is developing a plan of care for a client with varicose veins in whom skin breakdown
occurred over the varicosities as a result of secondary infection. Which is a priority
intervention?
1. Keep the legs aligned with the heart.
2. Elevate the legs higher than the heart.
3. Clean the skin with alcohol every hour.
4. Position the client onto the side during every shift.
Rationale:
In the client with a venous disorder, the legs are elevated above the level of the heart to assist with
the return of venous blood to the heart. Alcohol is very irritating and drying to tissues and should not
be used in areas of skin breakdown. Option 4 specifies infrequent care intervals, so it is not the
priority intervention.
16. The nurse in the medical unit is reviewing the laboratory test results for a client who has been
transferred from the intensive care unit (ICU). The nurse notes that a cardiac troponin T assay
was performed while the client was in the ICU. The nurse determines that this test was
performed to assist in diagnosing which condition?
1 Heart failure
.
2 Atrial fibrillation
.
3 Myocardial infarction
.
4 Ventricular tachycardia
. 17. The nurse is caring for a client with cardiac disease who has been
placed on a cardiac monitor. The nurse notes that the client has
developed atrial fibrillation and has a rapid ventricular rate of 150
beats/minute. The nurse should next assess the client for which
finding?
1. Hypotension
2. Flat neck veins
3. Complaints of nausea
4. Complaints of headache
Rationale:
The client with uncontrolled atrial fibrillation with a ventricular rate greater than 100 beats/minute is at
risk for low cardiac output because of loss of atrial kick. The nurse assesses the client for palpitations,
NCLEX RN Cardiovascular Q&As
1. A client admitted to the hospital with chest pain and a history of type 2 diabetes mellitus is
scheduled for cardiac catheterization. Which medication would need to be withheld for 24
hours before the procedure and for 48 hours after the procedure?
1. Glipizide
2. Metformin
3. Repaglinide
4. Regular insulin
2. A client who had cardiac surgery 24 hours ago has had a urine output averaging 20 mL/hour
for 2 hours. The client received a single bolus of 500 mL of intravenous fluid. Urine output for
the subsequent hour was 25 mL. Daily laboratory results indicate that the blood urea nitrogen
level is 45 mg/dL (16 mmol/L) and the serum creatinine level is 2.2 mg/dL (194 mcmol/L). On
the basis of these findings, the nurse would anticipate that the client is at risk for which
problem?
1. Hypovolemia
2. Acute kidney injury
3. Glomerulonephritis
4. Urinary tract infection
3. The nurse is reviewing an electrocardiogram rhythm strip. The P waves and QRS complexes
are regular. The PR interval is 0.16 seconds, and QRS complexes measure 0.06 seconds. The
overall heart rate is 64 beats/minute. Which action should the nurse take?
1. Check vital signs.
2. Check laboratory test results.
3. Notify the health care provider.
4. Continue to monitor for any rhythm change.
4. A client is wearing a continuous cardiac monitor, which begins to sound its alarm. The nurse
sees no electrocardiographic complexes on the screen. Which is the priority nursing action?
1. Call a code.
2. Call the health care provider.
3. Check the client's status and lead placement.
4. Press the recorder button on the electrocardiogram console.
,NCLEX RN Cardiovascular Q&As 2
5. The nurse is evaluating a client's response to cardioversion. Which assessment would be the
priority?
1. Blood pressure
2. Status of airway
3. Oxygen flow rate
4. Level of consciousness
6. The nurse is caring for a client who has just had implantation of an automatic internal
cardioverter-defibrillator. The nurse should assess which item based on priority?
1. Anxiety level of the client and family
2. Presence of a Medic-Alert card for the client to carry
3. Knowledge of restrictions on post-discharge physical activity
4. Activation status of the device, heart rate cutoff, and number of
shocks it is programmed to deliver
7. A client's electrocardiogram strip shows atrial and ventricular rates of 110 beats/minute. The
PR interval is 0.14 seconds, the QRS complex measures 0.08 seconds, and the PP and RR
intervals are regular. How should the nurse correctly interpret this rhythm?
1. Sinus tachycardia
2. Sinus bradycardia
3. Sinus dysrhythmia
4. Normal sinus rhythm
8. The nurse is assessing the neurovascular status of a client who returned to the surgical
nursing unit 4 hours ago after undergoing aortoiliac bypass graft. The affected leg is warm, and
the nurse notes redness and edema. The pedal pulse is palpable and unchanged from
admission. How should the nurse correctly interpret the client's neurovascular status?
1. The neurovascular status is normal because of increased blood
flow through the leg.
2. The neurovascular status is moderately impaired, and the surgeon
should be called.
3. The neurovascular status is slightly deteriorating and should be
monitored for another hour.
4. The neurovascular status is adequate from an arterial approach,
but venous complications are arising.
9. The nurse is evaluating the condition of a client after pericardiocentesis performed to treat
cardiac tamponade. Which observation would indicate that the procedure was effective?
1. Muffled heart sounds
2. A rise in blood pressure
,NCLEX RN Cardiovascular Q&As 3
3. Jugular venous distention
4. Client expressions of dyspnea
10. A client with variant angina is scheduled to receive an oral calcium channel blocker twice daily.
Which statement by the client indicates theneed for further teaching?
1. "I should notify my doctor if my feet or legs start to swell."
2. "My doctor told me to call his office if my pulse rate decreases
below 60."
3. "Avoiding grapefruit juice will definitely be a challenge for me,
since I usually drink it every morning with breakfast."
4. "My spouse told me that since I have developed this problem, we
are going to stop walking in the mall every morning."
11. The nurse is monitoring a client with acute pericarditis for signs of cardiac tamponade. Which
assessment finding indicates the presence of this complication?
1. Flat neck veins
2. A pulse rate of 60 beats/minute
3. Muffled or distant heart sounds
4. Wheezing on auscultation of the lungs
12. The home care nurse is providing instructions to a client with an arterial ischemic leg ulcer
about home care management and self-care management. Which statement, if made by the
client, indicates a need for further instruction?
1. "I need to be sure not to go barefoot around the house."
2. "If I cut my toenails, I need to be sure that I cut them straight
across."
3. "It is all right to apply lanolin to my feet, but I shouldn't place it
between my toes."
4. "I need to be sure that I elevate my leg above the level of my heart
for at least an hour every day."
13. The nurse is providing instructions to a client with a diagnosis of hypertension regarding high-
sodium items to be avoided. The nurse instructs the client to avoid consuming which item?
1. Bananas
2. Broccoli
3. Antacids
4. Cantaloupe
14. The nurse is preparing discharge instructions for a client with Raynaud's disease. The nurse
should plan to provide which instruction to the client?
, NCLEX RN Cardiovascular Q&As 4
1. Use nail polish to protect the nail beds from injury.
2. Wear gloves for all activities involving the use of both hands.
3. Stop smoking because it causes cutaneous blood vessel spasm.
4. Always wear warm clothing, even in warm climates, to prevent
vasoconstriction.
15. The nurse is developing a plan of care for a client with varicose veins in whom skin breakdown
occurred over the varicosities as a result of secondary infection. Which is a priority
intervention?
1. Keep the legs aligned with the heart.
2. Elevate the legs higher than the heart.
3. Clean the skin with alcohol every hour.
4. Position the client onto the side during every shift.
Rationale:
In the client with a venous disorder, the legs are elevated above the level of the heart to assist with
the return of venous blood to the heart. Alcohol is very irritating and drying to tissues and should not
be used in areas of skin breakdown. Option 4 specifies infrequent care intervals, so it is not the
priority intervention.
16. The nurse in the medical unit is reviewing the laboratory test results for a client who has been
transferred from the intensive care unit (ICU). The nurse notes that a cardiac troponin T assay
was performed while the client was in the ICU. The nurse determines that this test was
performed to assist in diagnosing which condition?
1 Heart failure
.
2 Atrial fibrillation
.
3 Myocardial infarction
.
4 Ventricular tachycardia
. 17. The nurse is caring for a client with cardiac disease who has been
placed on a cardiac monitor. The nurse notes that the client has
developed atrial fibrillation and has a rapid ventricular rate of 150
beats/minute. The nurse should next assess the client for which
finding?
1. Hypotension
2. Flat neck veins
3. Complaints of nausea
4. Complaints of headache
Rationale:
The client with uncontrolled atrial fibrillation with a ventricular rate greater than 100 beats/minute is at
risk for low cardiac output because of loss of atrial kick. The nurse assesses the client for palpitations,
