CARDIOVASCULAR NCLEX EXAMS SCRIPT 2026/2027
QUESTIONS AND SOLUTIONS RATED A+
✔✔A patient receiving the drug simvastatin (Zocor) should be taught this medication
helps to prevent coronary heart disease by:
Increasing lower-density lipoprotein.
Controlling lower-density lipoprotein.
Increasing triglycerides.
Increasing very low-density lipoprotein. - ✔✔Controlling lower-density lipoprotein.
Rationale: The Heart Protective Study has also shown that controlling low-density
lipoprotein (LDL) with simvastatin (Zocor) assists in the prevention of coronary heart
disease by raising HDL. Responses 1, 3, and 4 are incorrect.
✔✔Which of the following are direct causes of chronic ischemic pain? (Select all that
apply.)
Aortic stenosis
Acid reflux
Pulmonary embolus
Herpes zoster (shingles) - ✔✔Aortic stenosis
Acid reflux
Pulmonary embolus
Rationale: Herpes zoster (shingles) manifests as a vesicular rash along a dermatome,
not chronic ischemic pain.
Integrated Process: Nursing Process; Evaluation
Cognitive Level: Evaluation
NCLEX-RN Test Plan: Physiological Integrity; Physiological Adaptation
Rationale: Herpes zoster (shingles) manifests as a vesicular rash along a dermatome,
not chronic ischemic pain.
✔✔Older clients experiencing anginal pain with complaints of fatigue or weakness
usually are medicated with which of the following types of medication?
Sublingual nitroglycerin
Cardiac glycosides
HMG-CoA reductase inhibitors
Morphine sulfate - ✔✔Sublingual nitroglycerin
Rationale: Angina frequently is managed with sublingual nitroglycerin, which causes
vasodilation and increases blood flow to the coronary arteries. Cardiac glycosides are
used to treat heart failure, and morphine is used to treat myocardial infarction. The
HMG-CoA reductase inhibitors are used for patients with type 2 diabetes mellitus.
,✔✔Which of the following diagnostic studies most likely would confirm a myocardial
infarction?
Serum myoglobin level
Creatinine kinase (CK)
White blood cell count (WBC)
Troponin T levels - ✔✔Troponin T levels
Rationale: CK-MB elevates 4-6 hours after tissue necrosis. Troponin levels rise 6-8
hours after the infarct (tissue necrosis) but also can occur with other types of tissue
damage. Myoglobin also elevates, but to a lesser degree. WBC levels elevate with an
inflammatory response. Troponin levels are more elevated than are the other cardiac
enzymes, are more specific to cardiac tissue, and rise 6-8 hours after the infarct (tissue
necrosis).
✔✔A client with post-myocardial infarction develops acute bacterial pericarditis. Which
of the following medications would the physician most likely prescribe as the primary
drug?
Ticarcillin disodium (Ticar)
Acetaminophen (Tylenol)
Ibuprofen (Motrin)
Trioxsalen (Trisoralen) - ✔✔Ticarcillin disodium (Ticar)
Rationale: Acute bacterial pericarditis is a complication that can occur post-myocardial
infarction. Acute bacterial pericarditis usually requires antibiotics. NSAIDs usually are
prescribed to relieve pain from the inflammatory process. If the NSAIDs do not relieve
pain within 48 to 96 hours, corticosteroids are ordered. There is no mention of pain in
the stem of the question. Trisoralen is used to repigment skin for persons with vitiligo.
✔✔Which of the following diagnostic tests is preferred for evaluating heart valve
function?
Chest x-ray
Duplex Doppler
Echocardiogram
Electrocardiogram - ✔✔Echocardiogram
Rationale: The echocardiogram is the preferred test to evaluate heart valves, because it
allows the visualization of the valves as they open and close. A chest x-ray will
determine the size of the heart, the duplex measures blood flow through major arteries,
and an electrocardiogram identifies electrical activity.
, ✔✔An elderly client is being monitored for evidence of congestive heart failure. To
detect early signs of heart failure, the nurse would instruct the certified nursing
attendant (CNA) to do which of the following during care of the patient?
Observe electrocardiogram readings and report deviations to the nurse.
Assist the client with ambulation three times during the shift.
Monitor vital signs every 15 minutes and report each reading to the nurse.
Accurately weigh the patient, and report and record the readings. - ✔✔Accurately
weigh the patient, and report and record the readings.
Rationale: Due to fluid accumulation, an expanded blood volume can result when the
heart fails. Body weight is a sensitive indicator of water and sodium retention, which will
manifest itself with edema, dyspnea - especially nocturnal - and pedal edema. Patients
also should be instructed about the need to perform daily weights upon discharge to
monitor body water. It is not within the role of the CNA to monitor ECG readings, and
ambulation is not an assessment. Vital signs every 15 minute are not necessary for this
level of patient care.
✔✔Which of the following drug classifications should the nurse question if prescribed for
a person with congested heart failure (CHF)?
Angiotensin-converting enzyme (ACE) inhibitor
Beta-adrenergic blocker
Alpha adrenergic antagonist
Rosiglitazone (Avandia) - ✔✔Rosiglitazone (Avandia)
Correct answer: Thiazolidinediones, like rosiglitazone (Avandia), are glucose-reducing
drugs that are prescribed for persons with type 2 diabetes mellitus. ACE inhibitors, such
as Lisinopril, are first-line drugs used to treat CHF. Propranolol (Inderal), a beta blocker,
has remained one of the most widely used beta-blocking drugs. It blocks both beta1 and
beta2 receptors in various organs, resulting in reduction of heart rate and the force of
contraction, and suppresses impulse conduction through the AV node, all of which
slows the progression of the disease process. Carvedilol (Coreg) is another beta-
adrenergic blocker used to treat heart failure.
✔✔A common arrhythmia found in some older clients is chronic atrial fibrillation. Based
on the nurse's knowledge of the disease pathology, which of the following prescriptions
should the nurse expect to be ordered?
Aspirin (acetylsalicylic acid)
Warfarin sodium (Coumadin)
Simvastatin (Zocor)
Vinorelbine tartrate (Navelbine) - ✔✔Warfarin sodium (Coumadin)
Rationale: Chronic atrial fibrillation places a patient at high risk for clot formation.
Warfarin sodium frequently is ordered as an anti-coagulant. Aspirin will not prevent clots
QUESTIONS AND SOLUTIONS RATED A+
✔✔A patient receiving the drug simvastatin (Zocor) should be taught this medication
helps to prevent coronary heart disease by:
Increasing lower-density lipoprotein.
Controlling lower-density lipoprotein.
Increasing triglycerides.
Increasing very low-density lipoprotein. - ✔✔Controlling lower-density lipoprotein.
Rationale: The Heart Protective Study has also shown that controlling low-density
lipoprotein (LDL) with simvastatin (Zocor) assists in the prevention of coronary heart
disease by raising HDL. Responses 1, 3, and 4 are incorrect.
✔✔Which of the following are direct causes of chronic ischemic pain? (Select all that
apply.)
Aortic stenosis
Acid reflux
Pulmonary embolus
Herpes zoster (shingles) - ✔✔Aortic stenosis
Acid reflux
Pulmonary embolus
Rationale: Herpes zoster (shingles) manifests as a vesicular rash along a dermatome,
not chronic ischemic pain.
Integrated Process: Nursing Process; Evaluation
Cognitive Level: Evaluation
NCLEX-RN Test Plan: Physiological Integrity; Physiological Adaptation
Rationale: Herpes zoster (shingles) manifests as a vesicular rash along a dermatome,
not chronic ischemic pain.
✔✔Older clients experiencing anginal pain with complaints of fatigue or weakness
usually are medicated with which of the following types of medication?
Sublingual nitroglycerin
Cardiac glycosides
HMG-CoA reductase inhibitors
Morphine sulfate - ✔✔Sublingual nitroglycerin
Rationale: Angina frequently is managed with sublingual nitroglycerin, which causes
vasodilation and increases blood flow to the coronary arteries. Cardiac glycosides are
used to treat heart failure, and morphine is used to treat myocardial infarction. The
HMG-CoA reductase inhibitors are used for patients with type 2 diabetes mellitus.
,✔✔Which of the following diagnostic studies most likely would confirm a myocardial
infarction?
Serum myoglobin level
Creatinine kinase (CK)
White blood cell count (WBC)
Troponin T levels - ✔✔Troponin T levels
Rationale: CK-MB elevates 4-6 hours after tissue necrosis. Troponin levels rise 6-8
hours after the infarct (tissue necrosis) but also can occur with other types of tissue
damage. Myoglobin also elevates, but to a lesser degree. WBC levels elevate with an
inflammatory response. Troponin levels are more elevated than are the other cardiac
enzymes, are more specific to cardiac tissue, and rise 6-8 hours after the infarct (tissue
necrosis).
✔✔A client with post-myocardial infarction develops acute bacterial pericarditis. Which
of the following medications would the physician most likely prescribe as the primary
drug?
Ticarcillin disodium (Ticar)
Acetaminophen (Tylenol)
Ibuprofen (Motrin)
Trioxsalen (Trisoralen) - ✔✔Ticarcillin disodium (Ticar)
Rationale: Acute bacterial pericarditis is a complication that can occur post-myocardial
infarction. Acute bacterial pericarditis usually requires antibiotics. NSAIDs usually are
prescribed to relieve pain from the inflammatory process. If the NSAIDs do not relieve
pain within 48 to 96 hours, corticosteroids are ordered. There is no mention of pain in
the stem of the question. Trisoralen is used to repigment skin for persons with vitiligo.
✔✔Which of the following diagnostic tests is preferred for evaluating heart valve
function?
Chest x-ray
Duplex Doppler
Echocardiogram
Electrocardiogram - ✔✔Echocardiogram
Rationale: The echocardiogram is the preferred test to evaluate heart valves, because it
allows the visualization of the valves as they open and close. A chest x-ray will
determine the size of the heart, the duplex measures blood flow through major arteries,
and an electrocardiogram identifies electrical activity.
, ✔✔An elderly client is being monitored for evidence of congestive heart failure. To
detect early signs of heart failure, the nurse would instruct the certified nursing
attendant (CNA) to do which of the following during care of the patient?
Observe electrocardiogram readings and report deviations to the nurse.
Assist the client with ambulation three times during the shift.
Monitor vital signs every 15 minutes and report each reading to the nurse.
Accurately weigh the patient, and report and record the readings. - ✔✔Accurately
weigh the patient, and report and record the readings.
Rationale: Due to fluid accumulation, an expanded blood volume can result when the
heart fails. Body weight is a sensitive indicator of water and sodium retention, which will
manifest itself with edema, dyspnea - especially nocturnal - and pedal edema. Patients
also should be instructed about the need to perform daily weights upon discharge to
monitor body water. It is not within the role of the CNA to monitor ECG readings, and
ambulation is not an assessment. Vital signs every 15 minute are not necessary for this
level of patient care.
✔✔Which of the following drug classifications should the nurse question if prescribed for
a person with congested heart failure (CHF)?
Angiotensin-converting enzyme (ACE) inhibitor
Beta-adrenergic blocker
Alpha adrenergic antagonist
Rosiglitazone (Avandia) - ✔✔Rosiglitazone (Avandia)
Correct answer: Thiazolidinediones, like rosiglitazone (Avandia), are glucose-reducing
drugs that are prescribed for persons with type 2 diabetes mellitus. ACE inhibitors, such
as Lisinopril, are first-line drugs used to treat CHF. Propranolol (Inderal), a beta blocker,
has remained one of the most widely used beta-blocking drugs. It blocks both beta1 and
beta2 receptors in various organs, resulting in reduction of heart rate and the force of
contraction, and suppresses impulse conduction through the AV node, all of which
slows the progression of the disease process. Carvedilol (Coreg) is another beta-
adrenergic blocker used to treat heart failure.
✔✔A common arrhythmia found in some older clients is chronic atrial fibrillation. Based
on the nurse's knowledge of the disease pathology, which of the following prescriptions
should the nurse expect to be ordered?
Aspirin (acetylsalicylic acid)
Warfarin sodium (Coumadin)
Simvastatin (Zocor)
Vinorelbine tartrate (Navelbine) - ✔✔Warfarin sodium (Coumadin)
Rationale: Chronic atrial fibrillation places a patient at high risk for clot formation.
Warfarin sodium frequently is ordered as an anti-coagulant. Aspirin will not prevent clots
