NCLEX-RN.515q
Number: NCLEX-
RN Passing Score:
800 Time Limit:
120 min File
Version: 1
NCLEX-RN
National Council Licensure Examination(NCLEX-RN)
Sections
1. Questions Set A
2. Question Set B
3. Questions Set C
4. Questions Set D
5. Questions Set E
6. Questions Set F
7. Questions Set G
,Exam A
QUESTION 1
To appropriately monitor therapy and client progress, the nurse should be aware that
increased myocardial work and O2 demand will occur with which of the following?
A. Positive inotropic therapy
B. Negative chronotropic therapy
C. Increase in balance of myocardial O2 supply and demand
D. Afterload reduction therapy
Correct Answer: A
Section: Questions Set A
Explanation
Explanation/Reference:
Explanation:
(A) Inotropic therapy will increase contractility, which will increase myocardial O2 demand.
(B) Decreased heart rate to the point of bradycardia will increase coronary artery filling time.
This should be used cautiously because tachycardia may be a compensatory mechanism to
increase cardiac output. (C) The goal in the care of the MI client with angina is to maintain a
balance between myocardial O2 supply and demand. (D) Decrease in systemic vascular
resistance by drug therapy, such as IV nitroglycerin or nitroprusside, or intra-aortic balloon
pump therapy, would decrease myocardial work and O2 demand.
QUESTION 2
The nurse would need to monitor the serum glucose levels of a client receiving which of the
following medications, owing to its effects on glycogenolysis and insulin release?
A. Norepinephrine (Levophed)
B. Dobutamine (Dobutrex)
C. Propranolol (Inderal)
D. Epinephrine (Adrenalin)
Correct Answer: D
Section: Questions Set A
Explanation
Explanation/Reference:
Explanation:
(A) Norepinephrine’s side effects are primarily related to safe, effective care environment
and include decreased peripheral perfusion and bradycardia. (B) Dobutamine’s side effects
include increased heart rate and blood pressure, ventricular ectopy, nausea, and headache.
(C) Propranolol’s side effects include elevated blood urea nitrogen, serum transaminase,
alkaline phosphatase, and lactic dehydrogenase. (D) Epinephrine increases serum glucose
levels by increasing glycogenolysis and inhibiting insulin release. Prolonged use can elevate
serum lactate levels, leading to metabolic acidosis, increased urinary catecholamines, false
elevation of blood urea nitrogen, and decreased coagulation time.
QUESTION 3
Which of the following medications requires close observation for bronchospasm in the client
with chronic obstructive pulmonary disease or asthma?
A. Verapamil (Isoptin)
B. Amrinone (Inocor)
C. Epinephrine (Adrenalin)
D. Propranolol (Inderal)
Correct Answer: D
,Section: Questions Set A
Explanation
Explanation/Reference:
Explanation:
(A) Verapamil has the respiratory side effect of nasal or chest congestion, dyspnea, shortness
of breath (SOB), and wheezing. (B) Amrinone has the effect of increased contractility and
dilation of the vascular smooth muscle. It has no noted respiratory side effects. (C)
Epinephrine has the effect of bronchodilation through β stimulation. (D) Propranolol, esmolol,
and labetalol are all β- blocking agents, which can increase airway resistance and cause
bronchospasms.
QUESTION 4
The following medications were noted on review of the client’s home medication profile. Which
of the medications would most likely potentiate or elevate serum digoxin levels?
A. KCl
B. Thyroid agents
C. Quinidine
D. Theophylline
Correct Answer: C
Section: Questions Set A
Explanation
Explanation/Reference:
Explanation:
(A) Hypokalemia can cause digoxin toxicity. Administration of KCl would prevent this. (B)
Thyroid agents decrease digoxin levels. (C) Quinidine increases digoxin levels dramatically.
(D) Theophylline is not noted to have an effect on digoxin levels.
QUESTION 5
In the client with a diagnosis of coronary artery disease, the nurse would anticipate the
complication of bradycardia with occlusion of which coronary artery?
A. Right coronary artery
B. Left main coronary artery
C. Circumflex coronary artery
D. Left anterior descending coronary artery
Correct Answer: A
Section: Questions Set A
Explanation
Explanation/Reference:
Explanation:
(A) Sinus bradycardia and atrioventricular (AV) heart block are usually a result of right
coronary artery occlusion. The right coronary artery perfuses the sinoatrial and AV nodes in
mostindividuals. (B) Occlusion of the left main coronary artery causes bundle branch blocks
and premature ventricular contractions. (C) Occlusion of the circumflex artery does not
cause bradycardia. (D) Sinus tachycardia occurs primarily with left anterior descending
coronary artery occlusion because this form of occlusion impairs left ventricular function.
QUESTION 6
When inspecting a cardiovascular client, the nurse notes that he needs to sit upright to
breathe. This behavior is most indicative of:
, A. Pericarditis
B. Anxiety
C. Congestive heart failure
D. Angina
Correct Answer: C
Section: Questions Set A
Explanation
Explanation/Reference:
Explanation:
(A) Pericarditis can cause dyspnea but primarily causes chest pain. (B) Anxiety can cause
dyspnea resulting in SOB, yet it is not typically influenced by degree of head elevation. (C)
The inability to oxygenate well without being upright is most indicative of congestive heart
failure, due to alveolar drowning. (D) Angina causes primarily chest pain; any SOB associated
with angina is not influenced by body position.
QUESTION 7
When a client questions the nurse as to the purpose of exercise electrocardiography (ECG)
in the diagnosis of cardiovascular disorders, the nurse’s response should be based on the
fact that:
A. The test provides a baseline for further tests
B. The procedure simulates usual daily activity and myocardial performance
C. The client can be monitored while cardiac conditioning and heart toning are done
D. Ischemia can be diagnosed because exercise increasesO2 consumption and demand
Correct Answer: D
Section: Questions Set A
Explanation
Explanation/Reference:
Explanation:
(A) The purpose of the study is not to provide a baseline for further tests. (B) The test causes
an increase in O2 demand beyond that required to perform usual daily activities. (C)
Monitoring does occur, but the test is not for the purpose of cardiac toning and conditioning.
(D) Exercise ECG, or stress testing, is designed to elevate the peripheral and myocardial
needs for O2 to evaluate the ability of the myocardium and coronary arteries to meet the
additional demands.
QUESTION 8
In assessing cardiovascular clients with progression of aortic stenosis, the nurse should be
aware that there is typically:
A. Decreased pulmonary blood flow and cyanosis
B. Increased pressure in the pulmonary veins and pulmonary edema
C. Systemic venous engorgement
D. Increased left ventricular systolic pressures and hypertrophy
Correct Answer: D
Section: Questions Set A
Explanation
Explanation/Reference:
Explanation:
(A) These signs are seen in pulmonic stenosis or in response to pulmonary congestion and
edema and mitral stenosis. (B) These signs are seen primarily in mitral stenosis or as a late
sign in aortic stenosis after left ventricular failure. (C) These signs are seen primarily in right-
Number: NCLEX-
RN Passing Score:
800 Time Limit:
120 min File
Version: 1
NCLEX-RN
National Council Licensure Examination(NCLEX-RN)
Sections
1. Questions Set A
2. Question Set B
3. Questions Set C
4. Questions Set D
5. Questions Set E
6. Questions Set F
7. Questions Set G
,Exam A
QUESTION 1
To appropriately monitor therapy and client progress, the nurse should be aware that
increased myocardial work and O2 demand will occur with which of the following?
A. Positive inotropic therapy
B. Negative chronotropic therapy
C. Increase in balance of myocardial O2 supply and demand
D. Afterload reduction therapy
Correct Answer: A
Section: Questions Set A
Explanation
Explanation/Reference:
Explanation:
(A) Inotropic therapy will increase contractility, which will increase myocardial O2 demand.
(B) Decreased heart rate to the point of bradycardia will increase coronary artery filling time.
This should be used cautiously because tachycardia may be a compensatory mechanism to
increase cardiac output. (C) The goal in the care of the MI client with angina is to maintain a
balance between myocardial O2 supply and demand. (D) Decrease in systemic vascular
resistance by drug therapy, such as IV nitroglycerin or nitroprusside, or intra-aortic balloon
pump therapy, would decrease myocardial work and O2 demand.
QUESTION 2
The nurse would need to monitor the serum glucose levels of a client receiving which of the
following medications, owing to its effects on glycogenolysis and insulin release?
A. Norepinephrine (Levophed)
B. Dobutamine (Dobutrex)
C. Propranolol (Inderal)
D. Epinephrine (Adrenalin)
Correct Answer: D
Section: Questions Set A
Explanation
Explanation/Reference:
Explanation:
(A) Norepinephrine’s side effects are primarily related to safe, effective care environment
and include decreased peripheral perfusion and bradycardia. (B) Dobutamine’s side effects
include increased heart rate and blood pressure, ventricular ectopy, nausea, and headache.
(C) Propranolol’s side effects include elevated blood urea nitrogen, serum transaminase,
alkaline phosphatase, and lactic dehydrogenase. (D) Epinephrine increases serum glucose
levels by increasing glycogenolysis and inhibiting insulin release. Prolonged use can elevate
serum lactate levels, leading to metabolic acidosis, increased urinary catecholamines, false
elevation of blood urea nitrogen, and decreased coagulation time.
QUESTION 3
Which of the following medications requires close observation for bronchospasm in the client
with chronic obstructive pulmonary disease or asthma?
A. Verapamil (Isoptin)
B. Amrinone (Inocor)
C. Epinephrine (Adrenalin)
D. Propranolol (Inderal)
Correct Answer: D
,Section: Questions Set A
Explanation
Explanation/Reference:
Explanation:
(A) Verapamil has the respiratory side effect of nasal or chest congestion, dyspnea, shortness
of breath (SOB), and wheezing. (B) Amrinone has the effect of increased contractility and
dilation of the vascular smooth muscle. It has no noted respiratory side effects. (C)
Epinephrine has the effect of bronchodilation through β stimulation. (D) Propranolol, esmolol,
and labetalol are all β- blocking agents, which can increase airway resistance and cause
bronchospasms.
QUESTION 4
The following medications were noted on review of the client’s home medication profile. Which
of the medications would most likely potentiate or elevate serum digoxin levels?
A. KCl
B. Thyroid agents
C. Quinidine
D. Theophylline
Correct Answer: C
Section: Questions Set A
Explanation
Explanation/Reference:
Explanation:
(A) Hypokalemia can cause digoxin toxicity. Administration of KCl would prevent this. (B)
Thyroid agents decrease digoxin levels. (C) Quinidine increases digoxin levels dramatically.
(D) Theophylline is not noted to have an effect on digoxin levels.
QUESTION 5
In the client with a diagnosis of coronary artery disease, the nurse would anticipate the
complication of bradycardia with occlusion of which coronary artery?
A. Right coronary artery
B. Left main coronary artery
C. Circumflex coronary artery
D. Left anterior descending coronary artery
Correct Answer: A
Section: Questions Set A
Explanation
Explanation/Reference:
Explanation:
(A) Sinus bradycardia and atrioventricular (AV) heart block are usually a result of right
coronary artery occlusion. The right coronary artery perfuses the sinoatrial and AV nodes in
mostindividuals. (B) Occlusion of the left main coronary artery causes bundle branch blocks
and premature ventricular contractions. (C) Occlusion of the circumflex artery does not
cause bradycardia. (D) Sinus tachycardia occurs primarily with left anterior descending
coronary artery occlusion because this form of occlusion impairs left ventricular function.
QUESTION 6
When inspecting a cardiovascular client, the nurse notes that he needs to sit upright to
breathe. This behavior is most indicative of:
, A. Pericarditis
B. Anxiety
C. Congestive heart failure
D. Angina
Correct Answer: C
Section: Questions Set A
Explanation
Explanation/Reference:
Explanation:
(A) Pericarditis can cause dyspnea but primarily causes chest pain. (B) Anxiety can cause
dyspnea resulting in SOB, yet it is not typically influenced by degree of head elevation. (C)
The inability to oxygenate well without being upright is most indicative of congestive heart
failure, due to alveolar drowning. (D) Angina causes primarily chest pain; any SOB associated
with angina is not influenced by body position.
QUESTION 7
When a client questions the nurse as to the purpose of exercise electrocardiography (ECG)
in the diagnosis of cardiovascular disorders, the nurse’s response should be based on the
fact that:
A. The test provides a baseline for further tests
B. The procedure simulates usual daily activity and myocardial performance
C. The client can be monitored while cardiac conditioning and heart toning are done
D. Ischemia can be diagnosed because exercise increasesO2 consumption and demand
Correct Answer: D
Section: Questions Set A
Explanation
Explanation/Reference:
Explanation:
(A) The purpose of the study is not to provide a baseline for further tests. (B) The test causes
an increase in O2 demand beyond that required to perform usual daily activities. (C)
Monitoring does occur, but the test is not for the purpose of cardiac toning and conditioning.
(D) Exercise ECG, or stress testing, is designed to elevate the peripheral and myocardial
needs for O2 to evaluate the ability of the myocardium and coronary arteries to meet the
additional demands.
QUESTION 8
In assessing cardiovascular clients with progression of aortic stenosis, the nurse should be
aware that there is typically:
A. Decreased pulmonary blood flow and cyanosis
B. Increased pressure in the pulmonary veins and pulmonary edema
C. Systemic venous engorgement
D. Increased left ventricular systolic pressures and hypertrophy
Correct Answer: D
Section: Questions Set A
Explanation
Explanation/Reference:
Explanation:
(A) These signs are seen in pulmonic stenosis or in response to pulmonary congestion and
edema and mitral stenosis. (B) These signs are seen primarily in mitral stenosis or as a late
sign in aortic stenosis after left ventricular failure. (C) These signs are seen primarily in right-
