CARDIOVASCULAR NCLEX COMPREHENSIVE EXAM
2026/2027 QUESTIONS AND SOLUTIONS RATED A+
✔✔36) A 57-year-old client with a history of asthma is prescribed propanolol (Inderal) to
control hypertension. Before administered propranolol, which of the following actions
should the nurse take first?
Monitor the apical pulse rate
Instruct the client to take medication with food
Question the physician about the order
Caution the client to rise slowly when standing. - ✔✔3.
Propranolol and other beta-adrenergic blockers are contraindicated in a client with
asthma, so the nurse should question the physician before giving the dose. The other
responses are appropriate actions for a client receiving propranolol, but questioning the
physician takes priority. The client's apical pulse should always be checked before
giving propranolol; if the pulse rate is extremely low, the nurse should withhold the drug
and notify the physician.
✔✔37) One hour after administering IV furosemide (Lasix) to a client with heart failure,
a short burst of ventricular tachycardia appears on the cardiac monitor. Which of the
following electrolyte imbalances should the nurse suspect?
Hypocalcemia
Hypermagnesemia
Hypokalemia
Hypernatremia - ✔✔3.
Furosemide is a potassium-depleting diuretic than can cause hypokalemia. In turn,
hypokalemia increases myocardial excitability, leading to ventricular tachycardia.
✔✔38) A client is receiving spironolactone to treat hypertension. Which of the following
instructions should the nurse provide?
"Eat foods high in potassium."
"Take daily potassium supplements."
"Discontinue sodium restrictions."
"Avoid salt substitutes." - ✔✔4.
Because spironolactone is a potassium-sparing diuretic, the client should avoid salt
substitutes because of their high potassium content. The client should also avoid
potassium-rich foods and potassium supplements. To reduce fluid-volume overload,
sodium restrictions should continue.
✔✔39) When assessing an ECG, the nurse knows that the P-R interval represents the
time it takes for the:
Impulse to begin atrial contraction
, Impulse to transverse the atria to the AV node
SA node to discharge the impulse to begin atrial depolarization
Impulse to travel to the ventricles - ✔✔4.
The P-R interval is measured on the ECG strip from the beginning of the P wave to the
beginning of the QRS complex. It is the time it takes for the impulse to travel to the
ventricle.
✔✔40) Following a treadmill test and cardiac catheterization, the client is found to have
coronary artery disease, which is inoperative. He is referred to the cardiac rehabilitation
unit. During his first visit to the unit he says that he doesn't understand why he needs to
be there because there is nothing that can be done to make him better. The best
nursing response is:
"Cardiac rehabilitation is not a cure but can help restore you to many of your former
activities."
"Here we teach you to gradually change your lifestyle to accommodate your heart
disease."
"You are probably right but we can gradually increase your activities so that you can
live a more active life."
"Do you feel that you will have to make some changes in your life now?" - ✔✔1.
Such a response does not have false hope to the client but is positive and realistic. The
answer tells the client what cardiac rehabilitation is and does not dwell upon his
negativity about it.
✔✔41) To evaluate a client's condition following cardiac catheterization, the nurse will
palpate the pulse:
In all extremities
At the insertion site
Distal to the catheter insertion
Above the catheter insertion - ✔✔3.
Palpating pulses distal to the insertion site is important to evaluate for thrombophlebitis
and vessel occlusion. They should be bilateral and strong.
✔✔42) A client's physician orders nuclear cardiography and makes an appointment for
a thallium scan. The purpose of injecting radioisotope into the bloodstream is to detect:
Normal vs. abnormal tissue
Damage in areas of the heart
Ventricular function
Myocardial scarring and perfusion - ✔✔4.
This scan detects myocardial damage and perfusion, an acute or chronic MI. It is a
more specific answer than (1) or (2). Specific ventricular function is tested by a gated
cardiac blood pool scan.
, ✔✔43) A client enters the ER complaining of severe chest pain. A myocardial infarction
is suspected. A 12 lead ECG appears normal, but the doctor admits the client for further
testing until cardiac enzyme studies are returned. All of the following will be included in
the nursing care plan. Which activity has the highest priority?
Monitoring vital signs
Completing a physical assessment
Maintaining cardiac monitoring
Maintaining at least one IV access site - ✔✔3.
Even though initial tests seem to be within normal range, it takes at least 3 hours for
the cardiac enzyme studies to register. In the meantime, the client needs to be watched
for bradycardia, heart block, ventricular irritability, and other arrhythmias. Other activities
can be accomplished around the MI monitoring.
✔✔44) A client is experiencing tachycardia. The nurse's understanding of the
physiological basis for this symptom is explained by which of the following statements?
The demand for oxygen is decreased because of pleural involvement
The inflammatory process causes the body to demand more oxygen to meet its needs.
The heart has to pump faster to meet the demand for oxygen when there is lowered
arterial oxygen tension.
Respirations are labored. - ✔✔3.
The arterial oxygen supply is lowered and the demand for oxygen is increased, which
results in the heart's having to beat faster to meet the body's needs for oxygen.
.
✔✔45) A client enters the ER complaining of chest pressure and severe epigastric
distress. His VS are 158/90, 94, 24, and 99*F. The doctor orders cardiac enzymes. If
the client were diagnosed with an MI, the nurse would expect which cardiac enzyme to
rise within the next 3 to 8 hours?
Creatine kinase (CK or CPK)
Lactic dehydrogenase (LDH)
LDH-1
LDH-2 - ✔✔1.
Creatine kinase (CK, formally known as CPK) rises in 3-8 hours if an MI is present.
When the myocardium is damaged, CPK leaks out of the cell membranes and into the
blood stream. Lactic dehydrogenase rises in 24-48 hours, and LDH-1 and LDH-2 rises
in 8-24 hours.
✔✔46) A 45-year-old male client with leg ulcers and arterial insufficiency is admitted to
the hospital. The nurse understands that leg ulcers of this nature are usually caused by:
Decreased arterial blood flow secondary to vasoconstriction
Decreased arterial blood flow leading to hyperemia
2026/2027 QUESTIONS AND SOLUTIONS RATED A+
✔✔36) A 57-year-old client with a history of asthma is prescribed propanolol (Inderal) to
control hypertension. Before administered propranolol, which of the following actions
should the nurse take first?
Monitor the apical pulse rate
Instruct the client to take medication with food
Question the physician about the order
Caution the client to rise slowly when standing. - ✔✔3.
Propranolol and other beta-adrenergic blockers are contraindicated in a client with
asthma, so the nurse should question the physician before giving the dose. The other
responses are appropriate actions for a client receiving propranolol, but questioning the
physician takes priority. The client's apical pulse should always be checked before
giving propranolol; if the pulse rate is extremely low, the nurse should withhold the drug
and notify the physician.
✔✔37) One hour after administering IV furosemide (Lasix) to a client with heart failure,
a short burst of ventricular tachycardia appears on the cardiac monitor. Which of the
following electrolyte imbalances should the nurse suspect?
Hypocalcemia
Hypermagnesemia
Hypokalemia
Hypernatremia - ✔✔3.
Furosemide is a potassium-depleting diuretic than can cause hypokalemia. In turn,
hypokalemia increases myocardial excitability, leading to ventricular tachycardia.
✔✔38) A client is receiving spironolactone to treat hypertension. Which of the following
instructions should the nurse provide?
"Eat foods high in potassium."
"Take daily potassium supplements."
"Discontinue sodium restrictions."
"Avoid salt substitutes." - ✔✔4.
Because spironolactone is a potassium-sparing diuretic, the client should avoid salt
substitutes because of their high potassium content. The client should also avoid
potassium-rich foods and potassium supplements. To reduce fluid-volume overload,
sodium restrictions should continue.
✔✔39) When assessing an ECG, the nurse knows that the P-R interval represents the
time it takes for the:
Impulse to begin atrial contraction
, Impulse to transverse the atria to the AV node
SA node to discharge the impulse to begin atrial depolarization
Impulse to travel to the ventricles - ✔✔4.
The P-R interval is measured on the ECG strip from the beginning of the P wave to the
beginning of the QRS complex. It is the time it takes for the impulse to travel to the
ventricle.
✔✔40) Following a treadmill test and cardiac catheterization, the client is found to have
coronary artery disease, which is inoperative. He is referred to the cardiac rehabilitation
unit. During his first visit to the unit he says that he doesn't understand why he needs to
be there because there is nothing that can be done to make him better. The best
nursing response is:
"Cardiac rehabilitation is not a cure but can help restore you to many of your former
activities."
"Here we teach you to gradually change your lifestyle to accommodate your heart
disease."
"You are probably right but we can gradually increase your activities so that you can
live a more active life."
"Do you feel that you will have to make some changes in your life now?" - ✔✔1.
Such a response does not have false hope to the client but is positive and realistic. The
answer tells the client what cardiac rehabilitation is and does not dwell upon his
negativity about it.
✔✔41) To evaluate a client's condition following cardiac catheterization, the nurse will
palpate the pulse:
In all extremities
At the insertion site
Distal to the catheter insertion
Above the catheter insertion - ✔✔3.
Palpating pulses distal to the insertion site is important to evaluate for thrombophlebitis
and vessel occlusion. They should be bilateral and strong.
✔✔42) A client's physician orders nuclear cardiography and makes an appointment for
a thallium scan. The purpose of injecting radioisotope into the bloodstream is to detect:
Normal vs. abnormal tissue
Damage in areas of the heart
Ventricular function
Myocardial scarring and perfusion - ✔✔4.
This scan detects myocardial damage and perfusion, an acute or chronic MI. It is a
more specific answer than (1) or (2). Specific ventricular function is tested by a gated
cardiac blood pool scan.
, ✔✔43) A client enters the ER complaining of severe chest pain. A myocardial infarction
is suspected. A 12 lead ECG appears normal, but the doctor admits the client for further
testing until cardiac enzyme studies are returned. All of the following will be included in
the nursing care plan. Which activity has the highest priority?
Monitoring vital signs
Completing a physical assessment
Maintaining cardiac monitoring
Maintaining at least one IV access site - ✔✔3.
Even though initial tests seem to be within normal range, it takes at least 3 hours for
the cardiac enzyme studies to register. In the meantime, the client needs to be watched
for bradycardia, heart block, ventricular irritability, and other arrhythmias. Other activities
can be accomplished around the MI monitoring.
✔✔44) A client is experiencing tachycardia. The nurse's understanding of the
physiological basis for this symptom is explained by which of the following statements?
The demand for oxygen is decreased because of pleural involvement
The inflammatory process causes the body to demand more oxygen to meet its needs.
The heart has to pump faster to meet the demand for oxygen when there is lowered
arterial oxygen tension.
Respirations are labored. - ✔✔3.
The arterial oxygen supply is lowered and the demand for oxygen is increased, which
results in the heart's having to beat faster to meet the body's needs for oxygen.
.
✔✔45) A client enters the ER complaining of chest pressure and severe epigastric
distress. His VS are 158/90, 94, 24, and 99*F. The doctor orders cardiac enzymes. If
the client were diagnosed with an MI, the nurse would expect which cardiac enzyme to
rise within the next 3 to 8 hours?
Creatine kinase (CK or CPK)
Lactic dehydrogenase (LDH)
LDH-1
LDH-2 - ✔✔1.
Creatine kinase (CK, formally known as CPK) rises in 3-8 hours if an MI is present.
When the myocardium is damaged, CPK leaks out of the cell membranes and into the
blood stream. Lactic dehydrogenase rises in 24-48 hours, and LDH-1 and LDH-2 rises
in 8-24 hours.
✔✔46) A 45-year-old male client with leg ulcers and arterial insufficiency is admitted to
the hospital. The nurse understands that leg ulcers of this nature are usually caused by:
Decreased arterial blood flow secondary to vasoconstriction
Decreased arterial blood flow leading to hyperemia
