NCLEX RN Exam Bank: Cardiac Emergencies, CHF, MI, Shock Types & Hemodynamics

1


NCLEX RN Exam Bank: Cardiac Emergencies, MI, CHF,
Shock States & Hemodynamics




Table of Contents
Subtopic 1: Acute Myocardial Infarction (MI) Recognition, Management & Post-Care ......... 2
Subtopic 2: Congestive Heart Failure (CHF)—Pathophysiology, Nursing Management &
Pharmacologic Interventions ....................................................................................... 11
Subtopic 3: Cardiogenic, Hypovolemic, and Distributive Shock—Recognition & Intervention
.................................................................................................................................. 20
Subtopic 4: Hemodynamic Monitoring, Interpretation & Nursing Implications ................. 30
Subtopic 5: Hypovolemic Shock—Fluid Resuscitation and Blood Loss Management ....... 39
Subtopic 6: Advanced Hemodynamic Monitoring and Interpretation (Q101–Q120) .......... 47
Subtopic 7: Pharmacologic Management of Cardiac Emergencies .................................. 55
Subtopic 8: Pharmacologic Management in Cardiac Emergencies .................................. 62
Subtopic 9: Management of Cardiogenic Shock & Mechanical Support ........................... 70
Subtopic 10: Post-Cardiac Arrest Care and Neurological Outcomes ............................... 78

, 2


Subtopic 1: Acute Myocardial Infarction (MI) Recognition,
Management & Post-Care
Questions 1–20



Question 1

A 62-year-old male presents with chest pain radiating to the left arm, shortness of breath,
and diaphoresis. Which diagnostic test should the nurse prioritize to confirm an acute MI?



A. Chest X-ray

B. 12-lead ECG

C. Transthoracic echocardiogram

D. Serum calcium level



Correct Answer: B. 12-lead ECG

Rationale: A 12-lead ECG is the first-line diagnostic tool for identifying ST-elevation
myocardial infarction (STEMI) or other ischemic changes. It's critical for rapid triage and
treatment initiation.



Question 2

Which laboratory value is most specific for myocardial cell injury?



A. BNP

B. CK-MB

C. Troponin I

D. D-dimer

, 3


Correct Answer: C. Troponin I

Rationale: Troponin I is highly specific to myocardial tissue and increases within hours of
injury, remaining elevated for several days, making it ideal for diagnosing acute MI.



Question 3

What is the primary goal of administering morphine to a patient with an acute MI?



A. Increase cardiac output

B. Relieve pain and reduce myocardial oxygen demand

C. Lower blood pressure

D. Stimulate respiratory effort



Correct Answer: B. Relieve pain and reduce myocardial oxygen demand

Rationale: Morphine relieves chest pain and anxiety, both of which lower sympathetic
activity and reduce the heart’s oxygen demand during ischemia.



Question 4

A patient is diagnosed with an inferior wall MI. Which complication is most closely
associated with this type of MI?



A. Ventricular aneurysm

B. Bradyarrhythmias due to AV node involvement

C. Pericardial effusion

D. Pulmonary embolism



Correct Answer: B. Bradyarrhythmias due to AV node involvement

, 4


Rationale: Inferior wall MIs often affect the right coronary artery, which supplies the AV
node, potentially causing bradyarrhythmias or heart blocks.



Question 5

Which medication should be administered first in the emergency management of ST-
elevation MI (STEMI)?



A. Aspirin

B. Beta-blocker

C. Statin

D. Heparin



Correct Answer: A. Aspirin

Rationale: Aspirin should be given immediately to inhibit platelet aggregation and limit
thrombus formation in coronary arteries.



Question 6

The nurse monitors a patient post-MI for signs of left ventricular failure. Which finding is
most indicative?



A. Jugular venous distension

B. Bibasilar crackles

C. Warm extremities

D. Right upper quadrant pain



Correct Answer: B. Bibasilar crackles