NCLEX Cardiovascular Questions

1. Which of the following arteries primarily feeds the anterior wall of the heart?

a. Circumflex artery

b. Internal mammary artery

c. Left anterior descending artery

d. Right coronary artery

2. When do coronary arteries primarily receive blood flow?

a. During inspiration

b. During diastole

c. During expiration

d. During systole

3. Which of the following illnesses is the leading cause of death in the US?

a. Cancer

b. Coronary artery disease

c. Liver failure

d. Renal failure

4. Which of the following conditions most commonly results in CAD?

a. Atherosclerosis

b. DM

c. MI

d. Renal failure

5. Atherosclerosis impedes coronary blood flow by which of the following mechanisms?

a. Plaques obstruct the vein

b. Plaques obstruct the artery

c. Blood clots form outside the vessel wall

d. Hardened vessels dilate to allow the blood to flow through

6. Which of the following risk factors for coronary artery disease cannot be corrected?

a. Cigarette smoking

b. DM

c. Heredity

d. HPN

7. Exceeding which of the following serum cholesterol levels significantly increases the risk of coronary artery disease?

a. 100 mg/dl

b. 150 mg/dl

c. 175 mg/dl

d. 200 mg/dl

8. Which of the following actions is the first priority care for a client exhibiting signs and symptoms of coronary artery disease?

a. Decrease anxiety

b. Enhance myocardial oxygenation

c. Administer sublignual nitroglycerin

d. Educate the client about his symptoms

9. Medical treatment of coronary artery disease includes which of the following procedures?

a. Cardiac catheterization

b. Coronary artery bypass surgery

c. Oral medication administration

d. Percutaneous transluminal coronary angioplasty

10. Prolonged occlusion of the right coronary artery produces an infarction in which of he following areas of the heart?

a. Anterior

b. Apical

c. Inferior

d. Lateral

11. Which of the following is the most common symptom of myocardial infarction?

a. Chest pain

b. Dyspnea

c. Edema

d. Palpitations

12. Which of the following landmarks is the corect one for obtaining an apical pulse?

a. Left intercostal space, midaxillary line

b. Left fifth intercostal space, midclavicular line

c. Left second intercostal space, midclavicular line

d. Left seventh intercostal space, midclavicular line

13. Which of the following systems is the most likely origin of pain the client describes as knifelike chest pain that increases in intensity with inspiration?

a. Cardiac

b. Gastrointestinal

c. Musculoskeletal

d. Pulmonary

14. A murmur is heard at the second left intercostal space along the left sternal border. Which valve area is this?

a. Aortic

b. Mitral

c. Pulmonic

d. Tricuspid

15. Which of the following blood tests is most indicative of cardiac damage?

a. Lactate dehydrogenase

b. Complete blood count

c. Troponin I

d. Creatine kinase

16. What is the primary reason for administering morphine to a client with myocardial infarction?

a. To sedate the client

b. To decrease the client’s pain

c. To decrease the client’s anxiety

d. To decrease oxygen demand on the client’s heart

17. Which of the followng conditions is most commonly responsible for myocardial infarction?

a. Aneurysm

b. Heart failure

c. Coronary artery thrombosis

d. Renal failure

18. What supplemental medication is most frequently ordered in conjuction with furosemide (Lasix)?

a. Chloride

b. Digoxin

c. Potassium

d. Sodium

19. After myocardial infarction, serum glucose levels and free fatty acids are both increase. What type of physiologic changes are these?

a. Electrophysiologic

b. Hematologic

c. Mechanical

d. Metabolic

20. Which of the following complications is indicated by a third heart sound (S3)?

a. Ventricular dilation

b. Systemic hypertension

c. Aortic valve malfunction

d. Increased atrial contractions

21. After an anterior wall myocardial infarction, which of the following problems is indicated by auscultation of crackles in the lungs?

a. Left-sided heart failure

b. Pulmonic valve malfunction

c. Right-sided heart failure

d. Tricuspid valve malfunction

22. Which of the following diagnostic tools is most commonly used to determine the location of myocardial damage?

a. Cardiac catheterization

b. Cardiac enzymes

c. Echocardiogram

d. Electrocardiogram

23. What is the first intervention for a client experiencing myocardial infarction?

a. Administer morphine

b. Administer oxygen

c. Administer sublingual nitroglycerin

d. Obtain an electrocardiogram

24. What is the most appropriate nursing response to a myocardial infarction client who is fearful of dying?

a. “Tell me about your feeling right now.”

b. “When the doctor arrives, everything will be fine.”

c. “This is a bad situation, but you’ll feel better soon.”

d. “Please be assured we’re doing everything we can to make you feel better.”

25. Which of the following classes of medications protects the ischemic myocardium by blocking catecholamines and sympathetic nerve stimulation?

a. Beta-adrenergic blockers

b. Calcium channel blockers

c. Narcotics

d. Nitrates

26. What is the most common complication of a myocardial infarction?

a. Cardiogenic shock

b. Heart failure

c. Arrhythmias

d. Pericarditis

27. With which of the following disorders is jugular vein distention most prominent?

a. Abdominal aortic aneurysm

b. Heart failure

c. Myocardial infarction

d. Pneumothorax

28. What position should the nurse place the head of the bed in to obtain the most accurate reading of jugular vein distention?

a. High-fowler’s

b. Raised 10 degrees

c. Raised 30 degrees

d. Supine position

29. Which of the following parameters should be checked before administering digoxin?

a. Apical pulse

b. Blood pressure

c. Radial pulse

d. Respiratory rate

30. Toxicity from which of the following medications may cause a client to see a green halo around lights?

a. Digoxin

b. Furosemide

c. Metoprolol

d. Enalapril

31. Which ofthe following symptoms is most commonly associated with left-sided heart failure?

a. Crackles

b. Arrhythmias

c. Hepatic engorgement

d. Hypotension

32. In which of the following disorders would the nurse expect to assess sacral eddema in bedridden client?

a. DM

b. Pulmonary emboli

c. Renal failure

d. Right-sided heart failure

33. Which of the following symptoms might a client with right-sided heart failure exhibit?

a. Adequate urine output

b. Polyuria

c. Oliguria

d. Polydipsia

34. Which of the following classes of medications maximizes cardiac performance in clients with heat failure by increasing ventricular contractility?

a. Beta-adrenergic blockers

b. Calcium channel blockers

c. Diuretics

d. Inotropic agents

35. Stimulation of the sympathetic nervous system produces which of the following responses?

a. Bradycardia

b. Tachycardia

c. Hypotension

d. Decreased myocardial contractility

36. Which of the following conditions is most closely associated with weight gain, nausea, and a decrease in urine output?

a. Angina pectoris

b. Cardiomyopathy

c. Left-sided heart failure

d. Right-sided heart failure

37. What is the most common cause of abdominal aortic aneurysm?

a. Atherosclerosis

b. DM

c. HPN

d. Syphilis

38. In which of the following areas is an abdominal aortic aneurysm most commonly located?

a. Distal to the iliac arteries

b. Distal to the renal arteries

c. Adjacent to the aortic branch

d. Proximal to the renal arteries

39. A pulsating abdominal mass usually indicates which of the following conditions?

a. Abdominal aortic aneurysm

b. Enlarged spleen

c. Gastic distention

d. Gastritis

40. What is the most common symptom in a client with abdominal aortic aneurysm?

a. Abdominal pain

b. Diaphoresis

c. Headache

d. Upper back pain

41. Which of the following symptoms usually signifies rapid expansion and impending rupture of an abdominal aortic aneurysm?

a. Abdominal pain

b. Absent pedal pulses

c. Angina

d. Lower back pain

42. What is the definitive test used to diagnose an abdominal aortic aneurysm?

a. Abdominal X-ray

b. Arteriogram

c. CT scan

d. Ultrasound

43. Which of the following complications is of greatest concern when caring for a preoperative abdominal aneurysm client?

a. HPN

b. Aneurysm rupture

c. Cardiac arrythmias

d. Diminished pedal pulses

44. Which of the following blood vessel layers may be damaged in a client with an aneurysm?

a. Externa

b. Interna

c. Media

d. Interna and Media

45. When assessing a client for an abdominal aortic aneurysm, which area of the abdomen is most commonly palpated?

a. Right upper quadrant

b. Directly over the umbilicus

c. Middle lower abdomen to the left of the midline

d. Midline lower abdomen to the right of the midline

46. Which of the following conditions is linked to more than 50% of clients with abdominal aortic aneurysms?

a. DM

b. HPN

c. PVD

d. Syphilis

47. Which of the following sounds is distinctly heard on auscultation over the abdominal region of an abdominal aortic aneurysm client?

a. Bruit

b. Crackles

c. Dullness

d. Friction rubs

48. Which of the following groups of symptoms indicated a ruptured abdominal aneurysm?

a. Lower back pain, increased BP, decreased RBC, increased WBC

b. Severe lower back pain, decreased BP, decreased RBC, increased WBC

c. Severe lower back pain, decreased BP, decreased RBC, decreased WBC

d. Intermittent lower back pain, decreased BP, decreased RBC, increased WBC

49. Which of the following complications of an abdominal aortic repair is indicated by detection of a hematoma in the perineal area?

a. Hernia

b. Stage 1 pressure ulcer

c. Retroperitoneal rupture at the repair site

d. Rapid expansion of the aneurysm

50. Which hereditary disease is most closely linked to aneurysm?

a. Cystic fibrosis

b. Lupus erythematosus

c. Marfan’s syndrome

d. Myocardial infarction

51. Which of the following treatments is the definitive one for a ruptured aneurysm?

a. Antihypertensive medication administration

b. Aortogram

c. Beta-adrenergic blocker administration

d. Surgical intervention

52. Which of the following heart muscle diseases is unrelated to other cardiovascular disease?

a. Cardiomyopathy

b. Coronary artery disease

c. Myocardial infarction

d. Pericardial Effusion

53. Which of the following types of cardiomyopathy can be associated with childbirth?

a. Dilated

b. Hypertrophic

c. Myocarditis

d. Restrictive

54. Septal involvement occurs in which type of cardiomyopathy?

a. Congestive

b. Dilated

c. Hypertrophic

d. Restrictive

55. Which of the following recurring conditions most commonly occurs in clients with cardiomyopathy?

a. Heart failure

b. DM

c. MI

d. Pericardial effusion

56. What is the term used to describe an enlargement of the heart muscle?

a. Cardiomegaly

b. Cardiomyopathy

c. Myocarditis

d. Pericarditis

57. Dyspnea, cough, expectoration, weakness, and edema are classic signs and symptoms of which of the following conditions?

a. Pericarditis

b. Hypertension

c. Obliterative

d. Restricitve

59. Which of the following cardiac conditions does a fourth heart sound (S4) indicate?

a. Dilated aorta

b. Normally functioning heart

c. Decreased myocardial contractility

d. Failure of the ventricle to eject all the blood during systole

60. Which of the following classes of drugs is most widely used in the treatment of cardiomyopathy?

a. Antihypertensive

b. Beta-adrenergic blockers

c. Calcium channel blockers

d. Nitrates

Answers and Rationale

Latest Comments
  1. Dr.Bilawal

    Very good question here. keep it up. Good questions for exams preparation thanx

  2. JonieP

    I found the rationale…

    52. A. Cardiomyopathy isn’t usually related to an underlying heart disease such as atherosclerosis. The etiology in most cases is unknown. Coronary artery disease and myocardial infarction are directly related to atherosclerosis. Pericardial effusion is the escape of fluid into the pericardial sac, a condition associated with pericarditis and advanced heart failure.

    Thanks a lot!

  3. JonieP

    Please clarify this question’s choices by giving the rationale for each choice…

    52. Which of the following heart muscle diseases is unrelated to other cardiovascular disease?
    a. Cardiomyopathy
    b. Coronary artery disease
    c. Myocardial infarction
    d. Pericardial Effusion

    • Kabir

      Cardiomyopathy

  4. marion

    i cannot find the answers and rationale for these set of questions

  5. ryan daet

    thanks for sharing this sample questioners, i learned a lot.. i can use this for my future profession….

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