CARDIAC NCLEX EXAM /NCLEX CARDIAC EXAM 2023-2024 ACTUAL EXAM 300 QUESTIONS AND CORRECT
DETAILED ANSWERS
The student nurse is preparing a teaching plan for a patient being discharged status post MI. What
should the student include in the teaching plan? (Mark all that apply.)
A. Need for increased fluid intake
B. Need for early resumption of prediagnosis activity
C. Need for careful monitoring for cardiac symptoms
D. Need for dietary modifications
E. Need for carefully regulated exercise - (answer) C. Need for careful monitoring for cardiac symptoms
D. Need for dietary modifications
E. Need for carefully regulated exercise
Dietary modifications, exercise, weight loss, and careful monitoring are important strategies for
managing three major cardiovascular risk factors: hyperlipidemia, hypertension, and diabetes. There is
no need to increase fluid intake and activity should be slowly and deliberately increased
The nurse is caring for an 84-year-old man who has just returned from the OR after inguinal hernia
repair. The OR report indicates that the patient received large volumes of IV fluids during surgery and the
nurse recognizes that the patient is at risk for left-sided heart failure. What signs and symptoms would
indicate left-sided heart failure?
A. Jugular vein distention
B. Bibasilar fine crackles
C. Right upper quadrant pain
D. Dependent edema - (answer) B. Bibasilar fine crackles
Bibasilar fine crackles are a sign of alveolar fluid, a sequela of left ventricular fluid, or pressure overload.
Jugular vein distention, right upper quadrant pain (hepatomegaly), and dependent edema are caused by
right-sided heart failure, usually a chronic condition.
The nurse is reviewing a newly admitted patient's electronic health record, which notes a history of
orthopnea? What nursing action is most clearly indicated?
,CARDIAC NCLEX EXAM /NCLEX CARDIAC EXAM 2023-2024 ACTUAL EXAM 300 QUESTIONS AND CORRECT
DETAILED ANSWERS
A. Avoid positioning the patient supine.
B. Limit the patient's activity level.
C. Teach the patient deep breathing and coughing exercises.
D. Administer supplemental oxygen at all times. - (answer) A. Avoid positioning the patient supine.
Orthopnea is defined as difficulty breathing while lying flat. This is a possible complication of HF and,
consequently, the nurse should avoid positioning the patient supine. Oxygen supplementation may or
may not be necessary and activity does not always need to be curtailed. Deep breathing and coughing
exercises do not directly address this symptom.
The nurse is caring for an adult patient with HF who is prescribed digoxin. When assessing the patient
for adverse effects, the nurse should assess for which of the following signs and symptoms?
A. Numbness and tingling in the extremities
B. Confusion and bradycardia
C. Uncontrolled diuresis and tachycardia
D. Chest pain and shortness of breath - (answer) B. Confusion and bradycardia
A key concern associated with digitalis therapy is digitalis toxicity. Symptoms include anorexia, nausea,
visual disturbances, confusion, and bradycardia. The other listed signs and symptoms are not
characteristic of digitalis toxicity.
The ED nurse is caring for a patient with a suspected MI. What drug should the nurse anticipate
administering to this patient?
A. Warfarin
B. Oxycodone
C. Morphine
D. Acetaminophen - (answer) C. Morphine
,CARDIAC NCLEX EXAM /NCLEX CARDIAC EXAM 2023-2024 ACTUAL EXAM 300 QUESTIONS AND CORRECT
DETAILED ANSWERS
The patient with suspected MI is given aspirin, nitroglycerin, morphine, an IV beta- blocker, and other
medications, as indicated, while the diagnosis is being confirmed. Tylenol, warfarin, and oxycodone are
not typically used.
A patient is admitted to the critical care unit (CCU) with a diagnosis of cardiomyopathy. When reviewing
the patient's most recent laboratory results, the nurse should prioritize assessment of which of the
following?
A. Sodium
B. AST, ALT, and bilirubin
C. BUN
D. White blood cell differential - (answer) A. Sodium
Sodium is the major electrolyte involved with cardiomyopathy. Cardiomyopathy often leads to heart
failure which develops, in part, from fluid overload. Fluid overload is often associated with elevated
sodium levels. Consequently, sodium levels are followed more closely than other important laboratory
values, including BUN, leukocytes, and liver function tests.
The nurse is caring for a patient admitted with unstable angina. The laboratory result for the initial
troponin I is elevated in this patient. The nurse should recognize what implication of this assessment
finding?
A. This result indicates muscle injury, but does not specify the source.
B. This is an accurate indicator of myocardial injury.
C. This is only an accurate indicator of myocardial damage when it reaches its peak in 24 hours.
D. Because the patient has a history of unstable angina, this is a poor indicator of myocardial injury. -
(answer) B. This is an accurate indicator of myocardial injury.
Troponin I, which is specific to cardiac muscle, is elevated within hours after myocardial injury. Even with
a diagnosis of unstable angina, this is an accurate indicator of myocardial injury.
, CARDIAC NCLEX EXAM /NCLEX CARDIAC EXAM 2023-2024 ACTUAL EXAM 300 QUESTIONS AND CORRECT
DETAILED ANSWERS
The nurse is providing discharge education to a patient diagnosed with HF. What should the nurse teach
this patient to do to assess her fluid balance in the home setting?
A. Monitor her weight daily
B. Monitor her bowel movements
C. Monitor her blood pressure daily
D. Assess her radial pulses daily - (answer) A. Monitor her weight daily
To assess fluid balance at home, the patient should monitor daily weights at the same time every day.
Assessing radial pulses and monitoring the blood pressure may be done, but these measurements do not
provide information about fluid balance. Bowel function is not indicative of fluid balance
When discussing angina pectoris secondary to atherosclerotic disease with a patient, the patient asks
why he tends to experience chest pain when he exerts himself. The nurse should describe which of the
following phenomena?
A. Exercise increases the metabolism of cardiac medications.
B. Exercise causes vasoconstriction of the coronary arteries.
C. Exercise shunts blood flow from the heart to the mesenteric area.
D. Exercise increases the heart's oxygen demands. - (answer) D. Exercise increases the heart's oxygen
demands.
Physical exertion increases the myocardial oxygen demand. If the patient has arteriosclerosis of the
coronary arteries, then blood supply is diminished to the myocardium. Exercise does not cause
vasoconstriction or interfere with drug metabolism. Exercise does not shunt blood flow away from the
heart.
A resident of a long-term care facility has complained to the nurse of chest pain. What aspect of the
resident's pain would be most suggestive of angina as the cause?
A. The pain is most severe when the resident moves his upper body.
DETAILED ANSWERS
The student nurse is preparing a teaching plan for a patient being discharged status post MI. What
should the student include in the teaching plan? (Mark all that apply.)
A. Need for increased fluid intake
B. Need for early resumption of prediagnosis activity
C. Need for careful monitoring for cardiac symptoms
D. Need for dietary modifications
E. Need for carefully regulated exercise - (answer) C. Need for careful monitoring for cardiac symptoms
D. Need for dietary modifications
E. Need for carefully regulated exercise
Dietary modifications, exercise, weight loss, and careful monitoring are important strategies for
managing three major cardiovascular risk factors: hyperlipidemia, hypertension, and diabetes. There is
no need to increase fluid intake and activity should be slowly and deliberately increased
The nurse is caring for an 84-year-old man who has just returned from the OR after inguinal hernia
repair. The OR report indicates that the patient received large volumes of IV fluids during surgery and the
nurse recognizes that the patient is at risk for left-sided heart failure. What signs and symptoms would
indicate left-sided heart failure?
A. Jugular vein distention
B. Bibasilar fine crackles
C. Right upper quadrant pain
D. Dependent edema - (answer) B. Bibasilar fine crackles
Bibasilar fine crackles are a sign of alveolar fluid, a sequela of left ventricular fluid, or pressure overload.
Jugular vein distention, right upper quadrant pain (hepatomegaly), and dependent edema are caused by
right-sided heart failure, usually a chronic condition.
The nurse is reviewing a newly admitted patient's electronic health record, which notes a history of
orthopnea? What nursing action is most clearly indicated?
,CARDIAC NCLEX EXAM /NCLEX CARDIAC EXAM 2023-2024 ACTUAL EXAM 300 QUESTIONS AND CORRECT
DETAILED ANSWERS
A. Avoid positioning the patient supine.
B. Limit the patient's activity level.
C. Teach the patient deep breathing and coughing exercises.
D. Administer supplemental oxygen at all times. - (answer) A. Avoid positioning the patient supine.
Orthopnea is defined as difficulty breathing while lying flat. This is a possible complication of HF and,
consequently, the nurse should avoid positioning the patient supine. Oxygen supplementation may or
may not be necessary and activity does not always need to be curtailed. Deep breathing and coughing
exercises do not directly address this symptom.
The nurse is caring for an adult patient with HF who is prescribed digoxin. When assessing the patient
for adverse effects, the nurse should assess for which of the following signs and symptoms?
A. Numbness and tingling in the extremities
B. Confusion and bradycardia
C. Uncontrolled diuresis and tachycardia
D. Chest pain and shortness of breath - (answer) B. Confusion and bradycardia
A key concern associated with digitalis therapy is digitalis toxicity. Symptoms include anorexia, nausea,
visual disturbances, confusion, and bradycardia. The other listed signs and symptoms are not
characteristic of digitalis toxicity.
The ED nurse is caring for a patient with a suspected MI. What drug should the nurse anticipate
administering to this patient?
A. Warfarin
B. Oxycodone
C. Morphine
D. Acetaminophen - (answer) C. Morphine
,CARDIAC NCLEX EXAM /NCLEX CARDIAC EXAM 2023-2024 ACTUAL EXAM 300 QUESTIONS AND CORRECT
DETAILED ANSWERS
The patient with suspected MI is given aspirin, nitroglycerin, morphine, an IV beta- blocker, and other
medications, as indicated, while the diagnosis is being confirmed. Tylenol, warfarin, and oxycodone are
not typically used.
A patient is admitted to the critical care unit (CCU) with a diagnosis of cardiomyopathy. When reviewing
the patient's most recent laboratory results, the nurse should prioritize assessment of which of the
following?
A. Sodium
B. AST, ALT, and bilirubin
C. BUN
D. White blood cell differential - (answer) A. Sodium
Sodium is the major electrolyte involved with cardiomyopathy. Cardiomyopathy often leads to heart
failure which develops, in part, from fluid overload. Fluid overload is often associated with elevated
sodium levels. Consequently, sodium levels are followed more closely than other important laboratory
values, including BUN, leukocytes, and liver function tests.
The nurse is caring for a patient admitted with unstable angina. The laboratory result for the initial
troponin I is elevated in this patient. The nurse should recognize what implication of this assessment
finding?
A. This result indicates muscle injury, but does not specify the source.
B. This is an accurate indicator of myocardial injury.
C. This is only an accurate indicator of myocardial damage when it reaches its peak in 24 hours.
D. Because the patient has a history of unstable angina, this is a poor indicator of myocardial injury. -
(answer) B. This is an accurate indicator of myocardial injury.
Troponin I, which is specific to cardiac muscle, is elevated within hours after myocardial injury. Even with
a diagnosis of unstable angina, this is an accurate indicator of myocardial injury.
, CARDIAC NCLEX EXAM /NCLEX CARDIAC EXAM 2023-2024 ACTUAL EXAM 300 QUESTIONS AND CORRECT
DETAILED ANSWERS
The nurse is providing discharge education to a patient diagnosed with HF. What should the nurse teach
this patient to do to assess her fluid balance in the home setting?
A. Monitor her weight daily
B. Monitor her bowel movements
C. Monitor her blood pressure daily
D. Assess her radial pulses daily - (answer) A. Monitor her weight daily
To assess fluid balance at home, the patient should monitor daily weights at the same time every day.
Assessing radial pulses and monitoring the blood pressure may be done, but these measurements do not
provide information about fluid balance. Bowel function is not indicative of fluid balance
When discussing angina pectoris secondary to atherosclerotic disease with a patient, the patient asks
why he tends to experience chest pain when he exerts himself. The nurse should describe which of the
following phenomena?
A. Exercise increases the metabolism of cardiac medications.
B. Exercise causes vasoconstriction of the coronary arteries.
C. Exercise shunts blood flow from the heart to the mesenteric area.
D. Exercise increases the heart's oxygen demands. - (answer) D. Exercise increases the heart's oxygen
demands.
Physical exertion increases the myocardial oxygen demand. If the patient has arteriosclerosis of the
coronary arteries, then blood supply is diminished to the myocardium. Exercise does not cause
vasoconstriction or interfere with drug metabolism. Exercise does not shunt blood flow away from the
heart.
A resident of a long-term care facility has complained to the nurse of chest pain. What aspect of the
resident's pain would be most suggestive of angina as the cause?
A. The pain is most severe when the resident moves his upper body.
