1
HESI Specialty Exam Prep:
Cardiovascular Nursing from MI to
CHF Management
Table of Contents
Subtopic 1: Acute Myocardial Infarction (AMI) – Immediate Care and
Complications..................................................................................................3
Subtopic 2: Post-MI Medications and Long-Term Management.......................10
Subtopic 3: Heart Failure Pathophysiology and Early Manifestations.............17
Subtopic 4: Advanced Diagnostics and Imaging in Cardiac Patients..............24
Subtopic 5: Cardiac Devices and Interventions (Pacemakers, ICDs, CABG,
Stents)...........................................................................................................31
Subtopic 6: Pharmacologic Management in CHF (Diuretics, Inotropes,
Vasodilators, and More).................................................................................38
Subtopic 7: Fluid and Electrolyte Balance in Cardiac Patients.......................46
Subtopic 8: Nursing Priorities in Acute Cardiac Decompensation (Pulmonary
Edema, Cardiogenic Shock, etc.)...................................................................53
Subtopic 9: Long-Term Management of CHF (Rehabilitation, Lifestyle,
Education, Home Care)..................................................................................60
Subtopic 10: Multisystem Considerations and Comorbidities in Cardiovascular
Nursing..........................................................................................................67
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Subtopic 1: Acute Myocardial Infarction
(AMI) – Immediate Care and
Complications
Questions 1–20
1. A client arrives at the emergency department with chest pain, diaphoresis,
and shortness of breath. Which action should the nurse prioritize?
A. Obtain a complete health history
B. Prepare the client for a chest X-ray
C. Administer oxygen via nasal cannula
D. Schedule a stress test
Rationale: Oxygen should be administered immediately to improve
myocardial oxygenation. It’s part of the MONA (Morphine, Oxygen, Nitrates,
Aspirin) protocol for initial MI management.
2. Which ECG finding is most indicative of an acute myocardial infarction?
A. Sinus tachycardia
B. ST segment elevation
C. Premature ventricular contractions
D. First-degree heart block
Rationale: ST segment elevation on an ECG is a hallmark of STEMI and
signifies ongoing myocardial injury requiring urgent intervention.
3. A nurse is monitoring a client post-MI. Which lab value is most specific for
confirming myocardial damage?
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A. Myoglobin
B. Creatine kinase-MB
C. Troponin I
D. D-dimer
Rationale: Troponin I is highly specific for cardiac muscle injury and remains
elevated for several days after an MI.
4. The nurse administers sublingual nitroglycerin to a client with chest pain.
What is the primary reason for this intervention?
A. Increase heart rate
B. Decrease myocardial oxygen demand
C. Enhance preload
D. Slow atrial conduction
Rationale: Nitroglycerin dilates coronary arteries and reduces preload and
afterload, which decreases myocardial oxygen demand.
5. A client with chest pain receives morphine sulfate. What is the main
reason morphine is given during an MI?
A. Decreases respiratory rate
B. Controls cardiac arrhythmias
C. Relieves pain and decreases cardiac workload
D. Stimulates heart contractility
Rationale: Morphine not only relieves pain but also reduces anxiety and
preload, thereby decreasing myocardial oxygen demand.
HESI Specialty Exam Prep:
Cardiovascular Nursing from MI to
CHF Management
Table of Contents
Subtopic 1: Acute Myocardial Infarction (AMI) – Immediate Care and
Complications..................................................................................................3
Subtopic 2: Post-MI Medications and Long-Term Management.......................10
Subtopic 3: Heart Failure Pathophysiology and Early Manifestations.............17
Subtopic 4: Advanced Diagnostics and Imaging in Cardiac Patients..............24
Subtopic 5: Cardiac Devices and Interventions (Pacemakers, ICDs, CABG,
Stents)...........................................................................................................31
Subtopic 6: Pharmacologic Management in CHF (Diuretics, Inotropes,
Vasodilators, and More).................................................................................38
Subtopic 7: Fluid and Electrolyte Balance in Cardiac Patients.......................46
Subtopic 8: Nursing Priorities in Acute Cardiac Decompensation (Pulmonary
Edema, Cardiogenic Shock, etc.)...................................................................53
Subtopic 9: Long-Term Management of CHF (Rehabilitation, Lifestyle,
Education, Home Care)..................................................................................60
Subtopic 10: Multisystem Considerations and Comorbidities in Cardiovascular
Nursing..........................................................................................................67
,2
, 3
Subtopic 1: Acute Myocardial Infarction
(AMI) – Immediate Care and
Complications
Questions 1–20
1. A client arrives at the emergency department with chest pain, diaphoresis,
and shortness of breath. Which action should the nurse prioritize?
A. Obtain a complete health history
B. Prepare the client for a chest X-ray
C. Administer oxygen via nasal cannula
D. Schedule a stress test
Rationale: Oxygen should be administered immediately to improve
myocardial oxygenation. It’s part of the MONA (Morphine, Oxygen, Nitrates,
Aspirin) protocol for initial MI management.
2. Which ECG finding is most indicative of an acute myocardial infarction?
A. Sinus tachycardia
B. ST segment elevation
C. Premature ventricular contractions
D. First-degree heart block
Rationale: ST segment elevation on an ECG is a hallmark of STEMI and
signifies ongoing myocardial injury requiring urgent intervention.
3. A nurse is monitoring a client post-MI. Which lab value is most specific for
confirming myocardial damage?
, 4
A. Myoglobin
B. Creatine kinase-MB
C. Troponin I
D. D-dimer
Rationale: Troponin I is highly specific for cardiac muscle injury and remains
elevated for several days after an MI.
4. The nurse administers sublingual nitroglycerin to a client with chest pain.
What is the primary reason for this intervention?
A. Increase heart rate
B. Decrease myocardial oxygen demand
C. Enhance preload
D. Slow atrial conduction
Rationale: Nitroglycerin dilates coronary arteries and reduces preload and
afterload, which decreases myocardial oxygen demand.
5. A client with chest pain receives morphine sulfate. What is the main
reason morphine is given during an MI?
A. Decreases respiratory rate
B. Controls cardiac arrhythmias
C. Relieves pain and decreases cardiac workload
D. Stimulates heart contractility
Rationale: Morphine not only relieves pain but also reduces anxiety and
preload, thereby decreasing myocardial oxygen demand.
