Cardiovascular NCLEX Questions 2022
LATEST.
A client admitted to the hospital with chest pain and a history of type 2 diabetes mellitus
is scheduled for cardiac catheterization. Which medication would need to be withheld
for 24 hours before the procedure and for 48 hours after the procedure?
1. Regular insulin
2. Glipizide (Glucotrol)
3. Repaglinide (Prandin)
4. Metformin (Glucophage) - answer4.
Metformin (Glucophage) needs to be withheld 24 hours before and for 48 hours after
cardiac catheterization because of the injection of contrast medium during the
procedure. If the contrast medium affects kidney function, with metformin in the system,
the client would be at increased risk for lactic acidosis. The medications in the
remaining options do not need to be withheld 24 hours before and 48 hours after
cardiac catheterization.
Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Planning
Content Area: Adult Health: Cardiovascular
Strategy(s): Comparable or Alike Options
Priority Concepts: Perfusion, Safety
The nurse is reviewing an electrocardiogram rhythm strip. The P waves and QRS
complexes are regular. The PR interval is 0.16 second, and QRS complexes measure
0.06 second. The overall heart rate is 64 beats/minute. Which would be a correct
interpretation based on these characteristics?
1.Sinus bradycardia
2.Sick sinus syndrome
3.Normal sinus rhythm
4.First-degree heart block - answer3.
Normal sinus rhythm is defined as a regular rhythm, with an overall rate of 60 to 100
beats/minute. The PR and QRS measurements are normal, measuring 0.12 to 0.20
second and 0.04 to 0.10 second, respectively.
Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Assessment
Content Area: Adult Health: Cardiovascular
Strategy(s): Subject
Priority Concepts: Clinical Judgment, Perfusion
A client is wearing a continuous cardiac monitor, which begins to sound its alarm. A
nurse sees no electrocardiographic complexes on the screen. Which is the priority
action of the nurse?
1.Call a code.
,Cardiovascular NCLEX Questions 2022
LATEST.
2.Call the health care provider.
3.Check the client's status and lead placement.
4.Press the recorder button on the electrocardiogram console. - answer3.
Sudden loss of electrocardiographic complexes indicates ventricular asystole or
possibly electrode displacement. Accurate assessment of the client and equipment is
necessary to determine the cause and identify the appropriate intervention. The
remaining options are secondary to client assessment.
Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Implementation
Content Area: Adult Health: Cardiovascular
Strategy(s): Strategic Words, Steps of the Nursing Process
A client is having frequent premature ventricular contractions. The nurse should place
priority on assessment of which item?
1.Sensation of palpitations
2.Causative factors, such as caffeine
3.Precipitating factors, such as infection
4.Blood pressure and oxygen saturation - answer4.
Premature ventricular contractions can cause hemodynamic compromise. Therefore,
the priority is to monitor the blood pressure and oxygen saturation. The shortened
ventricular filling time can lead to decreased cardiac output. The client may be
asymptomatic or may feel palpitations. Premature ventricular contractions can be
caused by cardiac disorders, states of hypoxemia, or by any number of physiological
stressors, such as infection, illness, surgery, or trauma, and by intake of caffeine,
nicotine, or alcohol.
Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Assessment
Content Area: Adult Health: Cardiovascular
Strategy(s): Strategic Words, ABCs—Airway, Breathing, Circulation
Priority Concepts: Clinical Judgment, Perfusion
The nurse is evaluating a client's response to cardioversion. Which observation would
be of highest priority to the nurse?
1.Blood pressure
2.Status of airway
3.Oxygen flow rate
4.Level of consciousness - answer2.
Nursing responsibilities after cardioversion include maintenance first of a patent airway,
and then oxygen administration, assessment of vital signs and level of consciousness,
and dysrhythmia detection.
,Cardiovascular NCLEX Questions 2022
LATEST.
Cognitive Ability: Evaluating
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Evaluation
Content Area: Adult Health: Cardiovascular
Strategy(s): Strategic Words, ABCs—Airway, Breathing, Circulation
Priority Concepts: Clinical Judgment, Perfusion
The nurse is caring for a client who has just had implantation of an automatic internal
cardioverter-defibrillator. The nurse immediately would assess which item based on
priority?
1.Anxiety level of the client and family
2.Presence of a Medic-Alert card for the client to carry
3.Knowledge of restrictions of postdischarge physical activity
4.Activation status of the device, heart rate cutoff, and number of shocks it is
programmed to deliver - answer4.
The nurse who is caring for the client after insertion of an automatic internal
cardioverter-defibrillator needs to assess device settings, similar to after insertion of a
permanent pacemaker. Specifically, the nurse needs to know whether the device is
activated, the heart rate cutoff above which it will fire, and the number of shocks it is
programmed to deliver. The remaining options are also nursing interventions but are not
the priority.
Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Assessment
Content Area: Adult Health: Cardiovascular
Strategy(s): Strategic Words, Maslow's Hierarchy of Needs Theory
Priority Concepts: Perfusion, Safety
A client's electrocardiogram strip shows atrial and ventricular rates of 110 beats/minute.
The PR interval is 0.14 second, the QRS complex measures 0.08 second, and the PP
and RR intervals are regular. How should the nurse correctly interpret this rhythm?
1.Sinus dysrhythmia
2.Sinus tachycardia
3.Sinus bradycardia
4.Normal sinus rhythm - answer2.
Sinus tachycardia has the characteristics of normal sinus rhythm, including a regular PP
interval and normal-width PR and QRS intervals; however, the rate is the differentiating
factor. In sinus tachycardia, the atrial and ventricular rates are greater than 100
beats/minute.
Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
, Cardiovascular NCLEX Questions 2022
LATEST.
Integrated Process: Nursing Process: Assessment
Content Area: Adult Health: Cardiovascular
Strategy(s): Subject
Priority Concepts: Clinical Judgment, Perfusion
The nurse is assessing the neurovascular status of a client who returned to the surgical
nursing unit 4 hours ago after undergoing aortoiliac bypass graft. The affected leg is
warm, and the nurse notes redness and edema. The pedal pulse is palpable and
unchanged from admission. How should the nurse correctly interpret the client's
neurovascular status?
1.The neurovascular status is normal because of increased blood flow through the leg.
2.The neurovascular status is moderately impaired, and the surgeon should be called.
3.The neurovascular status is slightly deteriorating and should be monitored for another
hour.
4.The neurovascular status is adequate from an arterial approach, but venous
complications are arising. - answer1.
An expected outcome of aortoiliac bypass graft surgery is warmth, redness, and edema
in the surgical extremity because of increased blood flow. The remaining options are
incorrect interpretations.
Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Assessment
Content Area: Adult Health: Cardiovascular
Strategy(s): Subject
Priority Concepts: Clinical Judgment, Perfusion
The nurse is evaluating the condition of a client after pericardiocentesis performed to
treat cardiac tamponade. Which observation would indicate that the procedure was
unsuccessful?
1.Rising blood pressure
2.Clearly audible heart sounds
3.Client expressions of relief
4.Rising central venous pressure - answer4.
Following pericardiocentesis, a rise in blood pressure and a fall in central venous
pressure are expected. The client usually expresses immediate relief. Heart sounds are
no longer muffled or distant.
Cognitive Ability: Evaluating
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Evaluation
Content Area: Adult Health: Cardiovascular
Strategy(s): Subject
Priority Concepts: Clinical Judgment, Perfusion
LATEST.
A client admitted to the hospital with chest pain and a history of type 2 diabetes mellitus
is scheduled for cardiac catheterization. Which medication would need to be withheld
for 24 hours before the procedure and for 48 hours after the procedure?
1. Regular insulin
2. Glipizide (Glucotrol)
3. Repaglinide (Prandin)
4. Metformin (Glucophage) - answer4.
Metformin (Glucophage) needs to be withheld 24 hours before and for 48 hours after
cardiac catheterization because of the injection of contrast medium during the
procedure. If the contrast medium affects kidney function, with metformin in the system,
the client would be at increased risk for lactic acidosis. The medications in the
remaining options do not need to be withheld 24 hours before and 48 hours after
cardiac catheterization.
Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Planning
Content Area: Adult Health: Cardiovascular
Strategy(s): Comparable or Alike Options
Priority Concepts: Perfusion, Safety
The nurse is reviewing an electrocardiogram rhythm strip. The P waves and QRS
complexes are regular. The PR interval is 0.16 second, and QRS complexes measure
0.06 second. The overall heart rate is 64 beats/minute. Which would be a correct
interpretation based on these characteristics?
1.Sinus bradycardia
2.Sick sinus syndrome
3.Normal sinus rhythm
4.First-degree heart block - answer3.
Normal sinus rhythm is defined as a regular rhythm, with an overall rate of 60 to 100
beats/minute. The PR and QRS measurements are normal, measuring 0.12 to 0.20
second and 0.04 to 0.10 second, respectively.
Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Assessment
Content Area: Adult Health: Cardiovascular
Strategy(s): Subject
Priority Concepts: Clinical Judgment, Perfusion
A client is wearing a continuous cardiac monitor, which begins to sound its alarm. A
nurse sees no electrocardiographic complexes on the screen. Which is the priority
action of the nurse?
1.Call a code.
,Cardiovascular NCLEX Questions 2022
LATEST.
2.Call the health care provider.
3.Check the client's status and lead placement.
4.Press the recorder button on the electrocardiogram console. - answer3.
Sudden loss of electrocardiographic complexes indicates ventricular asystole or
possibly electrode displacement. Accurate assessment of the client and equipment is
necessary to determine the cause and identify the appropriate intervention. The
remaining options are secondary to client assessment.
Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Implementation
Content Area: Adult Health: Cardiovascular
Strategy(s): Strategic Words, Steps of the Nursing Process
A client is having frequent premature ventricular contractions. The nurse should place
priority on assessment of which item?
1.Sensation of palpitations
2.Causative factors, such as caffeine
3.Precipitating factors, such as infection
4.Blood pressure and oxygen saturation - answer4.
Premature ventricular contractions can cause hemodynamic compromise. Therefore,
the priority is to monitor the blood pressure and oxygen saturation. The shortened
ventricular filling time can lead to decreased cardiac output. The client may be
asymptomatic or may feel palpitations. Premature ventricular contractions can be
caused by cardiac disorders, states of hypoxemia, or by any number of physiological
stressors, such as infection, illness, surgery, or trauma, and by intake of caffeine,
nicotine, or alcohol.
Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Assessment
Content Area: Adult Health: Cardiovascular
Strategy(s): Strategic Words, ABCs—Airway, Breathing, Circulation
Priority Concepts: Clinical Judgment, Perfusion
The nurse is evaluating a client's response to cardioversion. Which observation would
be of highest priority to the nurse?
1.Blood pressure
2.Status of airway
3.Oxygen flow rate
4.Level of consciousness - answer2.
Nursing responsibilities after cardioversion include maintenance first of a patent airway,
and then oxygen administration, assessment of vital signs and level of consciousness,
and dysrhythmia detection.
,Cardiovascular NCLEX Questions 2022
LATEST.
Cognitive Ability: Evaluating
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Evaluation
Content Area: Adult Health: Cardiovascular
Strategy(s): Strategic Words, ABCs—Airway, Breathing, Circulation
Priority Concepts: Clinical Judgment, Perfusion
The nurse is caring for a client who has just had implantation of an automatic internal
cardioverter-defibrillator. The nurse immediately would assess which item based on
priority?
1.Anxiety level of the client and family
2.Presence of a Medic-Alert card for the client to carry
3.Knowledge of restrictions of postdischarge physical activity
4.Activation status of the device, heart rate cutoff, and number of shocks it is
programmed to deliver - answer4.
The nurse who is caring for the client after insertion of an automatic internal
cardioverter-defibrillator needs to assess device settings, similar to after insertion of a
permanent pacemaker. Specifically, the nurse needs to know whether the device is
activated, the heart rate cutoff above which it will fire, and the number of shocks it is
programmed to deliver. The remaining options are also nursing interventions but are not
the priority.
Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Assessment
Content Area: Adult Health: Cardiovascular
Strategy(s): Strategic Words, Maslow's Hierarchy of Needs Theory
Priority Concepts: Perfusion, Safety
A client's electrocardiogram strip shows atrial and ventricular rates of 110 beats/minute.
The PR interval is 0.14 second, the QRS complex measures 0.08 second, and the PP
and RR intervals are regular. How should the nurse correctly interpret this rhythm?
1.Sinus dysrhythmia
2.Sinus tachycardia
3.Sinus bradycardia
4.Normal sinus rhythm - answer2.
Sinus tachycardia has the characteristics of normal sinus rhythm, including a regular PP
interval and normal-width PR and QRS intervals; however, the rate is the differentiating
factor. In sinus tachycardia, the atrial and ventricular rates are greater than 100
beats/minute.
Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
, Cardiovascular NCLEX Questions 2022
LATEST.
Integrated Process: Nursing Process: Assessment
Content Area: Adult Health: Cardiovascular
Strategy(s): Subject
Priority Concepts: Clinical Judgment, Perfusion
The nurse is assessing the neurovascular status of a client who returned to the surgical
nursing unit 4 hours ago after undergoing aortoiliac bypass graft. The affected leg is
warm, and the nurse notes redness and edema. The pedal pulse is palpable and
unchanged from admission. How should the nurse correctly interpret the client's
neurovascular status?
1.The neurovascular status is normal because of increased blood flow through the leg.
2.The neurovascular status is moderately impaired, and the surgeon should be called.
3.The neurovascular status is slightly deteriorating and should be monitored for another
hour.
4.The neurovascular status is adequate from an arterial approach, but venous
complications are arising. - answer1.
An expected outcome of aortoiliac bypass graft surgery is warmth, redness, and edema
in the surgical extremity because of increased blood flow. The remaining options are
incorrect interpretations.
Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Assessment
Content Area: Adult Health: Cardiovascular
Strategy(s): Subject
Priority Concepts: Clinical Judgment, Perfusion
The nurse is evaluating the condition of a client after pericardiocentesis performed to
treat cardiac tamponade. Which observation would indicate that the procedure was
unsuccessful?
1.Rising blood pressure
2.Clearly audible heart sounds
3.Client expressions of relief
4.Rising central venous pressure - answer4.
Following pericardiocentesis, a rise in blood pressure and a fall in central venous
pressure are expected. The client usually expresses immediate relief. Heart sounds are
no longer muffled or distant.
Cognitive Ability: Evaluating
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Evaluation
Content Area: Adult Health: Cardiovascular
Strategy(s): Subject
Priority Concepts: Clinical Judgment, Perfusion
