NURS 120 | Medical-Surgical Nursing: Cardiovascular Disorders &
Nursing Care 2026 |WCU
1. A patient presents with chest pain that increases with deep inspiration and is
relieved when leaning forward. The nurse notes a high-pitched, scratchy sound
on auscultation. Which condition should the nurse suspect?
A. Acute Myocardial Infarction
B. Acute Pericarditis
C. Pulmonary Embolism
D. Mitral Valve Prolapse
Answer: B
Rationale: Acute pericarditis is characterized by sharp chest pain that improves when the
patient leans forward (orthopneic position) and a pericardial friction rub, which is a
scratchy sound heard at the left lower sternal border.
2. A nurse is caring for a patient with left-sided heart failure. Which clinical
manifestation is the priority assessment finding?
A. Jugular Venous Distension (JVD)
B. Peripheral edema in the lower extremities
C. Crackles in the lung bases
D. Hepatosplenomegaly
Answer: C
Rationale: Left-sided heart failure results in pulmonary congestion. Crackles (rales)
indicate fluid in the alveoli, which is a priority as it affects gas exchange. JVD and peripheral
edema are signs of right-sided heart failure.
,3. Which lab value is most specific for diagnosing a myocardial infarction (MI)?
A. Creatine Kinase (CK-MB)
B. Troponin I
C. B-type Natriuretic Peptide (BNP)
D. Myoglobin
Answer: B
Rationale: Troponin I and T are highly specific to cardiac muscle and remain elevated
longer than CK-MB, making them the gold standard for MI diagnosis.
4. The nurse is teaching a patient with heart failure about their new prescription
for Digoxin. Which statement by the patient indicates a need for further
teaching?
A. I will check my pulse for one full minute before taking the pill.
B. I should call my doctor if I see yellow halos around lights.
C. I will increase my intake of potassium-rich foods like bananas.
D. I can take my dose even if my heart rate is 52 beats per minute.
Answer: D
Rationale: Digoxin should be held if the apical pulse is less than 60 bpm in adults. Yellow
halos are a sign of toxicity, and low potassium increases the risk of Digoxin toxicity.
5. A patient with hypertension is prescribed Spironolactone. Which electrolyte
imbalance must the nurse monitor for?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypocalcemia
Answer: B
Rationale: Spironolactone is a potassium-sparing diuretic. It inhibits aldosterone, which
leads to the retention of potassium and excretion of sodium.
, 6. During a cardiac assessment, the nurse hears a harsh systolic murmur best
heard at the second intercostal space, right sternal border. This likely indicates:
A. Aortic Stenosis
B. Mitral Regurgitation
C. Tricuspid Stenosis
D. Aortic Regurgitation
Answer: A
Rationale: Aortic stenosis produces a crescendo-decrescendo systolic murmur at the
‘Aortic’ area (2nd ICS, right sternal border).
7. A patient is scheduled for a cardiac catheterization. Which allergy is the
priority for the nurse to assess?
A. Penicillin
B. Latex
C. Sulfa drugs
D. Iodine or Shellfish
Answer: D
Rationale: Contrast dye used in cardiac catheterization usually contains iodine. Patients
with shellfish or iodine allergies are at high risk for anaphylactic reactions.
8. What is the primary goal of administering Nitroglycerin to a patient with
stable angina?
A. Increase heart rate to improve output
B. Constrict coronary arteries to increase pressure
C. Thin the blood to prevent clot formation
D. Dilate veins and arteries to decrease preload and afterload
Answer: D
Rationale: Nitroglycerin is a vasodilator that reduces myocardial oxygen demand by
decreasing preload (venous dilation) and afterload (arterial dilation).
Nursing Care 2026 |WCU
1. A patient presents with chest pain that increases with deep inspiration and is
relieved when leaning forward. The nurse notes a high-pitched, scratchy sound
on auscultation. Which condition should the nurse suspect?
A. Acute Myocardial Infarction
B. Acute Pericarditis
C. Pulmonary Embolism
D. Mitral Valve Prolapse
Answer: B
Rationale: Acute pericarditis is characterized by sharp chest pain that improves when the
patient leans forward (orthopneic position) and a pericardial friction rub, which is a
scratchy sound heard at the left lower sternal border.
2. A nurse is caring for a patient with left-sided heart failure. Which clinical
manifestation is the priority assessment finding?
A. Jugular Venous Distension (JVD)
B. Peripheral edema in the lower extremities
C. Crackles in the lung bases
D. Hepatosplenomegaly
Answer: C
Rationale: Left-sided heart failure results in pulmonary congestion. Crackles (rales)
indicate fluid in the alveoli, which is a priority as it affects gas exchange. JVD and peripheral
edema are signs of right-sided heart failure.
,3. Which lab value is most specific for diagnosing a myocardial infarction (MI)?
A. Creatine Kinase (CK-MB)
B. Troponin I
C. B-type Natriuretic Peptide (BNP)
D. Myoglobin
Answer: B
Rationale: Troponin I and T are highly specific to cardiac muscle and remain elevated
longer than CK-MB, making them the gold standard for MI diagnosis.
4. The nurse is teaching a patient with heart failure about their new prescription
for Digoxin. Which statement by the patient indicates a need for further
teaching?
A. I will check my pulse for one full minute before taking the pill.
B. I should call my doctor if I see yellow halos around lights.
C. I will increase my intake of potassium-rich foods like bananas.
D. I can take my dose even if my heart rate is 52 beats per minute.
Answer: D
Rationale: Digoxin should be held if the apical pulse is less than 60 bpm in adults. Yellow
halos are a sign of toxicity, and low potassium increases the risk of Digoxin toxicity.
5. A patient with hypertension is prescribed Spironolactone. Which electrolyte
imbalance must the nurse monitor for?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypocalcemia
Answer: B
Rationale: Spironolactone is a potassium-sparing diuretic. It inhibits aldosterone, which
leads to the retention of potassium and excretion of sodium.
, 6. During a cardiac assessment, the nurse hears a harsh systolic murmur best
heard at the second intercostal space, right sternal border. This likely indicates:
A. Aortic Stenosis
B. Mitral Regurgitation
C. Tricuspid Stenosis
D. Aortic Regurgitation
Answer: A
Rationale: Aortic stenosis produces a crescendo-decrescendo systolic murmur at the
‘Aortic’ area (2nd ICS, right sternal border).
7. A patient is scheduled for a cardiac catheterization. Which allergy is the
priority for the nurse to assess?
A. Penicillin
B. Latex
C. Sulfa drugs
D. Iodine or Shellfish
Answer: D
Rationale: Contrast dye used in cardiac catheterization usually contains iodine. Patients
with shellfish or iodine allergies are at high risk for anaphylactic reactions.
8. What is the primary goal of administering Nitroglycerin to a patient with
stable angina?
A. Increase heart rate to improve output
B. Constrict coronary arteries to increase pressure
C. Thin the blood to prevent clot formation
D. Dilate veins and arteries to decrease preload and afterload
Answer: D
Rationale: Nitroglycerin is a vasodilator that reduces myocardial oxygen demand by
decreasing preload (venous dilation) and afterload (arterial dilation).
