CARDIOVASCULAR NCLEX FINAL EXAM 2026/2027
QUESTIONS AND SOLUTIONS RATED A+
✔✔11) When administered a thrombolytic drug to the client experiencing an MI, the
nurse explains to him that the purpose of this drug is to:
Help keep him well hydrated
Dissolve clots he may have
Prevent kidney failure
Treat potential cardiac arrhythmias. - ✔✔2.
Thrombolytic drugs are administered within the first 6 hours after onset of a MI to lyse
clots and reduce the extent of myocardial damage.
✔✔12) When interpreting an ECG, the nurse would keep in mind which of the following
about the P wave? Select all that apply.
Reflects electrical impulse beginning at the SA node
Indicated electrical impulse beginning at the AV node
Reflects atrial muscle depolarization
Identifies ventricular muscle depolarization
Has duration of normally 0.11 seconds or less. - ✔✔1, 3, 5.
In a client who has had an ECG, the P wave represents the activation of the electrical
impulse in the SA node, which is then transmitted to the AV node. In addition, the P
wave represents atrial muscle depolarization, not ventricular depolarization. The normal
duration of the P wave is 0.11 seconds or less in duration and 2.5 mm or more in height.
✔✔13) A client has driven himself to the ER. He is 50 years old, has a history of
hypertension, and informs the nurse that his father died of a heart attack at 60 years of
age. The client is presently complaining of indigestion. The nurse connects him to an
ECG monitor and begins administering oxygen at 2 L/minute per NC. The nurse's next
action would be to:
Call for the doctor
Start an intravenous line
Obtain a portable chest radiograph
Draw blood for laboratory studies - ✔✔2.
Advanced cardiac life support recommends that at least one or two intravenous lines be
inserted in one or both of the antecubital spaces. Calling the physician, obtaining a
portable chest radiograph, and drawing blood are important but secondary to starting
the intravenous line.
✔✔14) The nurse receives emergency laboratory results for a client with chest pain and
immediately informs the physician. An increased myoglobin level suggests which of the
following?
, Cancer
Hypertension
Liver disease
Myocardial infarction - ✔✔4.
Detection of myoglobin is one diagnostic tool to determine whether myocardial damage
has occurred. Myoglobin is generally detected about one hour after a heart attack is
experienced and peaks within 4 to 6 hours after infarction (Remember, less than 90
mg/L is normal).
✔✔15) When teaching a client about propranolol hydrochloride, the nurse should base
the information on the knowledge that propranolol hydrochloride:
Blocks beta-adrenergic stimulation and thus causes decreased heart rate, myocardial
contractility, and conduction.
Increases norepinephrine secretion and thus decreases blood pressure and heart rate.
Is a potent arterial and venous vasodilator that reduces peripheral vascular resistance
and lowers blood pressure.
Is an angiotensin-converting enzyme inhibitor that reduces blood pressure by blocking
the conversion of angiotensin I to angiotensin II. - ✔✔1.
Propranolol hydrochloride is a beta-adrenergic blocking agent. Actions of propranolol
hydrochloride include reducing heart rate, decreasing myocardial contractility, and
slowing conduction.
✔✔16) The most important long-term goal for a client with hypertension would be to:
Learn how to avoid stress
Explore a job change or early retirement
Make a commitment to long-term therapy
Control high blood pressure - ✔✔3.
Compliance is the most critical element of hypertensive therapy. In most cases,
hypertensive clients require lifelong treatment and their hypertension cannot be
managed successfully without drug therapy. Stress management and weight
management are important components of hypertension therapy, but the priority goal is
related to compliance.
✔✔17) Hypertension is known as the silent killer. This phrase is associated with the fact
that hypertension often goes undetected until symptoms of other system failures occur.
This may occur in the form of:
Cerebrovascular accident
Liver disease
Myocardial infarction
Pulmonary disease - ✔✔1.
Hypertension is referred to as the silent killer for adults, because until the adult has
significant damage to other systems, the hypertension may go undetected. CVA's can
, be related to long-term hypertension. Liver or pulmonary disease is generally not
associated with hypertension. Myocardial infarction is generally related to coronary
artery disease.
✔✔18) During the previous few months, a 56-year-old woman felt brief twinges of chest
pain while working in her garden and has had frequent episodes of indigestion. She
comes to the hospital after experiencing severe anterior chest pain while raking leaves.
Her evaluation confirms a diagnosis of stable angina pectoris. After stabilization and
treatment, the client is discharged from the hospital. At her follow-up appointment, she
is discouraged because she is experiencing pain with increasing frequency. She states
that she is visiting an invalid friend twice a week and now cannot walk up the second
flight of steps to the friend's apartment without pain. Which of the following measures
that the nurse could suggest would most likely help the client deal with this problem?
Visit her friend earlier in the day.
Rest for at least an hour before climbing the stairs.
Take a nitroglycerin tablet before climbing the stairs. - ✔✔3.
Nitroglycerin may be used prophylactically before stressful physical activities such as
stair climbing to help the client remain pain free. Visiting her friend early in the day
would have no impact on decreasing pain episodes. Resting before or after an activity is
not as likely to help prevent an activity-related pain episode.
✔✔19) Which of the following symptoms should the nurse teach the client with unstable
angina to report immediately to her physician?
A change in the pattern of her pain
Pain during sex
Pain during an argument with her husband
Pain during or after an activity such as lawnmowing - ✔✔1.
The client should report a change in the pattern of chest pain. It may indicate increasing
severity of CAD.
✔✔20) The physician refers the client with unstable angina for a cardiac catherization.
The nurse explains to the client that this procedure is being used in this specific case to:
Open and dilate the blocked coronary arteries
Assess the extent of arterial blockage
Bypass obstructed vessels
Assess the functional adequacy of the valves and heart muscle. - ✔✔2.
Cardiac catherization is done in clients with angina primarily to assess the extent and
severity of the coronary artery blockage, A decision about medical management,
angioplasty, or coronary artery bypass surgery will be based on the catherization
results.
QUESTIONS AND SOLUTIONS RATED A+
✔✔11) When administered a thrombolytic drug to the client experiencing an MI, the
nurse explains to him that the purpose of this drug is to:
Help keep him well hydrated
Dissolve clots he may have
Prevent kidney failure
Treat potential cardiac arrhythmias. - ✔✔2.
Thrombolytic drugs are administered within the first 6 hours after onset of a MI to lyse
clots and reduce the extent of myocardial damage.
✔✔12) When interpreting an ECG, the nurse would keep in mind which of the following
about the P wave? Select all that apply.
Reflects electrical impulse beginning at the SA node
Indicated electrical impulse beginning at the AV node
Reflects atrial muscle depolarization
Identifies ventricular muscle depolarization
Has duration of normally 0.11 seconds or less. - ✔✔1, 3, 5.
In a client who has had an ECG, the P wave represents the activation of the electrical
impulse in the SA node, which is then transmitted to the AV node. In addition, the P
wave represents atrial muscle depolarization, not ventricular depolarization. The normal
duration of the P wave is 0.11 seconds or less in duration and 2.5 mm or more in height.
✔✔13) A client has driven himself to the ER. He is 50 years old, has a history of
hypertension, and informs the nurse that his father died of a heart attack at 60 years of
age. The client is presently complaining of indigestion. The nurse connects him to an
ECG monitor and begins administering oxygen at 2 L/minute per NC. The nurse's next
action would be to:
Call for the doctor
Start an intravenous line
Obtain a portable chest radiograph
Draw blood for laboratory studies - ✔✔2.
Advanced cardiac life support recommends that at least one or two intravenous lines be
inserted in one or both of the antecubital spaces. Calling the physician, obtaining a
portable chest radiograph, and drawing blood are important but secondary to starting
the intravenous line.
✔✔14) The nurse receives emergency laboratory results for a client with chest pain and
immediately informs the physician. An increased myoglobin level suggests which of the
following?
, Cancer
Hypertension
Liver disease
Myocardial infarction - ✔✔4.
Detection of myoglobin is one diagnostic tool to determine whether myocardial damage
has occurred. Myoglobin is generally detected about one hour after a heart attack is
experienced and peaks within 4 to 6 hours after infarction (Remember, less than 90
mg/L is normal).
✔✔15) When teaching a client about propranolol hydrochloride, the nurse should base
the information on the knowledge that propranolol hydrochloride:
Blocks beta-adrenergic stimulation and thus causes decreased heart rate, myocardial
contractility, and conduction.
Increases norepinephrine secretion and thus decreases blood pressure and heart rate.
Is a potent arterial and venous vasodilator that reduces peripheral vascular resistance
and lowers blood pressure.
Is an angiotensin-converting enzyme inhibitor that reduces blood pressure by blocking
the conversion of angiotensin I to angiotensin II. - ✔✔1.
Propranolol hydrochloride is a beta-adrenergic blocking agent. Actions of propranolol
hydrochloride include reducing heart rate, decreasing myocardial contractility, and
slowing conduction.
✔✔16) The most important long-term goal for a client with hypertension would be to:
Learn how to avoid stress
Explore a job change or early retirement
Make a commitment to long-term therapy
Control high blood pressure - ✔✔3.
Compliance is the most critical element of hypertensive therapy. In most cases,
hypertensive clients require lifelong treatment and their hypertension cannot be
managed successfully without drug therapy. Stress management and weight
management are important components of hypertension therapy, but the priority goal is
related to compliance.
✔✔17) Hypertension is known as the silent killer. This phrase is associated with the fact
that hypertension often goes undetected until symptoms of other system failures occur.
This may occur in the form of:
Cerebrovascular accident
Liver disease
Myocardial infarction
Pulmonary disease - ✔✔1.
Hypertension is referred to as the silent killer for adults, because until the adult has
significant damage to other systems, the hypertension may go undetected. CVA's can
, be related to long-term hypertension. Liver or pulmonary disease is generally not
associated with hypertension. Myocardial infarction is generally related to coronary
artery disease.
✔✔18) During the previous few months, a 56-year-old woman felt brief twinges of chest
pain while working in her garden and has had frequent episodes of indigestion. She
comes to the hospital after experiencing severe anterior chest pain while raking leaves.
Her evaluation confirms a diagnosis of stable angina pectoris. After stabilization and
treatment, the client is discharged from the hospital. At her follow-up appointment, she
is discouraged because she is experiencing pain with increasing frequency. She states
that she is visiting an invalid friend twice a week and now cannot walk up the second
flight of steps to the friend's apartment without pain. Which of the following measures
that the nurse could suggest would most likely help the client deal with this problem?
Visit her friend earlier in the day.
Rest for at least an hour before climbing the stairs.
Take a nitroglycerin tablet before climbing the stairs. - ✔✔3.
Nitroglycerin may be used prophylactically before stressful physical activities such as
stair climbing to help the client remain pain free. Visiting her friend early in the day
would have no impact on decreasing pain episodes. Resting before or after an activity is
not as likely to help prevent an activity-related pain episode.
✔✔19) Which of the following symptoms should the nurse teach the client with unstable
angina to report immediately to her physician?
A change in the pattern of her pain
Pain during sex
Pain during an argument with her husband
Pain during or after an activity such as lawnmowing - ✔✔1.
The client should report a change in the pattern of chest pain. It may indicate increasing
severity of CAD.
✔✔20) The physician refers the client with unstable angina for a cardiac catherization.
The nurse explains to the client that this procedure is being used in this specific case to:
Open and dilate the blocked coronary arteries
Assess the extent of arterial blockage
Bypass obstructed vessels
Assess the functional adequacy of the valves and heart muscle. - ✔✔2.
Cardiac catherization is done in clients with angina primarily to assess the extent and
severity of the coronary artery blockage, A decision about medical management,
angioplasty, or coronary artery bypass surgery will be based on the catherization
results.
