Cardiovascular NCLEX Flashcards Guide
Cardiovascular NCLEX Flashcards Guide
a. Aorta
b. Left ventricle
c. Pulmonary veins
d. Right ventricle
A nurse is teaching about the heart. Which information should the nurse c. Left ventricle
include? The chamber of the heart that generates the highest pressure is
the:
a. Right atrium
b. Left atrium
c. Left ventricle
d. Right ventricle
A nurse recalls the chamber that receives blood from the systemic a. Right atrium
circulation is the:
a. Right atrium
b. Right ventricle
c. Left atrium
d. Left ventricle
Which statement indicates the nurse understands blood flow? b. Pulmonary veins
Oxygenated blood flows through the:
b. Pulmonary veins
c. Pulmonary artery
d. Cardiac veins
The nurse is planning care for a patient with heart problems. Which c. Left anterior descending
information should the nurse remember? The _____ artery travels down
the interventricular septum and delivers blood to portions of the left
and right ventricle.
a. Right coronary
b. Circumflex
When a staff member asks where venous blood from the coronary c. Right atrium
circulation drains into, what is the best response by the nurse? The:
c. Right atrium
d. Reft atrium
While viewing the electrocardiogram, the nurse recalls the _____ conducts b. Bundle of His
action potentials down the atrioventricular septum.
a. Bachmann bundle
b. Bundle of His
c. Sinoatrial node
d. Atrioventricular node
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cardiovascular
A 13-year-old NCLEX
female took a weight loss questions
drug that activated the c. Increased cardiac conduction Study
sympathetic nervous system. Which of the following assessment findings
would the nurse expect?
A 50-year-old female received trauma to the chest that caused severe b. Sinoatrial (SA) node
impairment of the primary pacemaker cells of the heart. Which of the
following areas received the greatest damage?
c. Bundle of His
d. Ventricles
A nurse assesses the heart after acetylcholine because the effect of d. Decrease the heart rate
acetylcholine on the heart is to
a. Preload
b. Afterload
Which principle should the nurse remember when planning nursing care b. Volume, force
for a patient with heart problems? As stated by the Frank-Starling law,
there is a direct relationship between the _____ of the blood in the heart
at the end of diastole and the _____ of contraction during the next systole.
a. Pressure, duration
b. Volume, force
c. Viscosity, force
d. Viscosity, duration
Within a normal physiologic range, an increase in left ventricular end- a. An increased force of contraction
diastolic volume would lead the nurse to monitor for:
d. Heart failure
While planning care for a heart patient, which principle should the nurse d. Pulmonary vascular resistance
recall? Right ventricular afterload is affected by:
Which principle should the nurse remember while planning care for a b. Aorta
cardiac patient? Pressure in the left ventricle must exceed pressure in
the _____ before the left ventricle can eject blood.
a. Coronary arteries
b. Aorta
d. Pulmonary veins
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cardiovascular
A 50-year-old NCLEX
female presents with a low heart questions
rate and low blood d. Increased heart rate Study
pressure. She is given an intravenous (IV) infusion of fluids. The increase
in atrial distension results in:
c. Release of acetylcholine
A nurse observes a cardiologist multiplying the heart rate by stroke c. Cardiac output
volume. What is the cardiologist measuring?
a. Vascular resistance
b. Preload
c. Cardiac output
d. Ejection fraction
a. Renal artery
c. Carotid sinus
d. Circle of Willis
A nurse is evaluating the direct end effect of the renin-angiotensin- a. Angiotensin II causes systemic vasoconstriction.
aldosterone system. Which principle should the nurse remember?
a. Lungs
b. Liver
c. Kidneys
d. Heart
a. Autonomic regulation
b. Somatic regulation
c. Autoregulation
d. Metabolic regulation
a. Vagus
b. Phrenic
c. Brachial
d. Pectoral
If an individual with respiratory difficulty were retaining too much a. Increase in respiratory rate
carbon dioxide, which of the following compensatory responses would
the nurse expect to be initiated?
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cardiovascular
A nurse remembers NCLEX
the majority of total airway questions
resistance occurs in the:
b. Nose Study
a. Bronchi
b. Nose
c. Oral pharynx
d. Diaphragm
An aide asks a nurse how surfactant works. How should the nurse c. Decreasing surface tension in alveoli
respond? Surfactant facilitates alveolar distention and ventilation by:
A patient asks how oxygen is transported in the body. What is the nurse's b. Bound to hemoglobin
best response? Most of the oxygen (O2) is transported
b. Bound to hemoglobin
d. As a free-floating molecule
a. Reactive vasodilation
b. Local bronchoconstriction
a. hypernatremia.
b. hypertension.
c. hyperkalemia.
d. hypokalemia.
A nurse is discussing heart failure with a group of nursing students. c. When the heart rate increases to increase cardiac output, it can prevent adequate filling of the ventricles."
Which statement by a student reflects an understanding of how
compensatory mechanisms can compound existing problems in patients
with heart failure?
A patient with chronic hypertension is admitted to the hospital. During c. Furosemide (Lasix)
the admission assessment, the nurse notes a heart rate of 96 beats per
minute, a blood pressure of 150/90 mm Hg, bibasilar crackles, 2+ pitting
edema of the ankles, and distension of the jugular veins. The nurse will
contact the provider to request an order for which medication?
a. ACE inhibitor
b. Digoxin (Lanoxin)
c. Furosemide (Lasix)
d. Spironolactone (Aldactone)
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cardiovascular
A diabetic patient is recovering fromNCLEX questions
a myocardial infarction but does a. ACE inhibitors and beta blockers Study
not have symptoms of heart failure. The nurse will expect to teach this
patient about:
b. biventricular pacemakers.
A patient with heart failure who has been taking an ACE inhibitor, a d. serum electrolyte levels.
thiazide diuretic, and a beta blocker for several months comes to the
clinic for evaluation. As part of the ongoing assessment of this patient,
the nurse will expect the provider to evaluate:
b. ejection fraction.
b. Increasing diuresis
d. Reducing afterload
A nurse prepares to administer a scheduled dose of digoxin. The nurse d. Check the patient's apical pulse, and if it is within a safe range, administer the digoxin.
finds a new laboratory report showing a plasma digoxin level of 0.7
ng/mL. What action should the nurse take?
A man asks a nurse why he cannot use digoxin (Lanoxin) for his heart b. It does not correct the underlying pathology of heart failure.
failure, because both of his parents used it for HF. The nurse will explain
A nurse is preparing to administer digoxin (Lanoxin) to a patient. The b. Give the dose of digoxin and notify the provider of the potassium level.
patient's heart rate is 62 beats per minute, and the blood pressure is
120/60 mm Hg. The last serum electrolyte value showed a potassium The patient's serum potassium level is above normal limits, but only slightly. An elevated potassium level can
level of 5.2 mEq/L. What will the nurse do?
reduce the effects of digoxin, so there is no risk of toxicity. There is no indication that an increased dose of
digoxin is needed. There is no indication for a diuretic. The heart rate is acceptable; doses should be withheld if
a. Contact the provider to request an increased dose of digoxin.
the heart rate is less than 60 beats per minute.
b. Give the dose of digoxin and notify the provider of the potassium
level.
d. Withhold the dose and notify the provider of the heart rate.
A patient with heart failure who has been given digoxin (Lanoxin) daily a. Assess the heart rate (HR) and give the dose if the HR is greater than 60 beats per minute.
for a week complains of nausea. Before giving the next dose, the nurse
will:
Anorexia, nausea, and vomiting are the most common adverse effects of digoxin and should cause nurses to
evaluate for more serious signs of toxicity. If the HR is greater than 60 beats per minute, the dose may be given.
a. Assess the heart rate (HR) and give the dose if the HR is greater than Nausea by itself is not a sign of toxicity. A decreased dose is not indicated. A serum potassium level less than 3.5
60 beats per minute.
mEq/L is an indication for withholding the dose
b. Contact the provider to report digoxin toxicity.
d. Review the serum electrolyte values and withhold the dose if the
potassium level is greater than 3.5 mEq/L
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a. Blood viscosity
Important mechanisms for maintaining venous return to the right atrium a. Cardiac output
a. Cardiac output
d. Blood volume
e. Contractility
a. Preload
c. Afterload
d. Ejection fraction
e. Contractility
The nurse is monitoring a client who is taking digoxin (Lanoxin) for b. Nausea and Vomiting
adverse effects. Which findings are characteristics of digoxin toxicity? c. Blurred Vision
a. Irritability
c. Blurred Vision
d. Diarrhea
e. Tremors
The nurse in a medical unit is caring for a client with heart failure. The a. Inserting a Foley catheter
client suddenly develops extreme dyspnea, tachycardia, and lung d. Administering oxygen
crackles and the nurse suspects pulmonary edema. The nurse e. Administering furosemide (Lasix)
immediately asks another nurse to contact the HCP and prepares to f. Administering morphine sulfate intravenously
Rationale: Pulmonary edema is a life-threatening event that can result from severe heart failure. In pulmonary
edema, the left ventricle fails to eject sufficient blood, and pressure increases in the lungs because of the
a. Inserting a Foley catheter
accumulated blood. Oxygen is always prescribed and the client is placed in high fowler's to ease the work of
b. Transporting the client to the coronary care unit
breathing. Furosemide, a rapidly acting diuretic, will eliminate accumulated fluid. A Foley catheter is inserted to
c. Placing the client in a low Fowler's side-lying position
measure output accurately. IV administration of morphine sulfate reduces venous return (preload), decreases
d. Administering oxygen
anxiety, and also reduces the work of breathing. Transporting the client to the coronary care unit is not a priority
e. Administering furosemide (Lasix)
intervention. In fact, this may not be necessary at all if the client's response to treatment is successful.
f. Administering morphine sulfate intravenously
Which client teaching should the nurse implement for the client a. Refer to counselor for stress reduction techniques
The client with coronary artery disease asks the nurse, "Why do I get a. "Chest pain is caused by decreased oxygen to the heart muscle."
chest pain?" Which statement would be the most appropriate response
by the nurse?"
b. "Chest pain occurs when the lungs cannot adequately oxygenate the
blood"
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cardiovascular
The client diagnosed NCLEX questions
with essential hypertension asks the nurse, "Why c. "There is no specific cause for hypertension, but there are many known risk factors." Study
do I have high blood pressure?" Which response by the nurse would be
the most appropriate?
a. "More than likely you have had a diet high in salt, fat, and cholesterol."
b. "You probably have some type of kidney disease that causes the high
BP."
d. "You are concerned that you have high blood pressure. Let's sit down
and talk."
The client diagnosed with hypertension asks the nurse, "I don't know b. "Damage can be occurring to your heart and kidneys even if you feel great."
why the doctor is worried about my blood pressure. I feel just great."
Which statement by the nurse would be the most appropriate
response?
a. "When is the last time you saw your doctor? Does he know you are
feeling great?"
b. "Damage can be occurring to your heart and kidneys even if you feel
great."
The client is admitted to the telemetry unit diagnosed with acute a. Apical pulse rate of 110 and 4+ pitting edema of feet
exacerbation of congestive heart failure. Which signs/symptoms would
the nurse expect to find when assessing this client?
The nurse is assessing the client diagnosed with congestive heart failure. a. The client is able to perform activities of daily living without dyspnea
Which signs/symptoms would indicate that the medical treatment has
been effective?
The nurse provides home care instructions to the parents of a child with b. "If my child vomits after medication administration, I will repeat the dose."
heart failure regarding the procedure for administration of digoxin
(Lanoxin). Which statement by the parent indicates the need for further
instruction?
a. "If more than one dose is missed, I will call the HCP."
The nurse is preparing to administer a beta blocker to the client d. The client had an apical pulse of 56
diagnosed with CAD. Which assessment data would cause the nurse to
question administering the medication?
Which intervention should the nurse implement when administering a b. Assess the client's serum potassium level
loop diuretic to a client diagnosed with CAD?
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cardiovascular
The HCP prescribes an ACE inhibitorNCLEX questions
for the client diagnosed with c. ACE inhibitors prevent vasoconstriction and sodium and water retention Study
essential hypertension. Which statement is the most appropriate
rationale for administering this medication?
The client diagnosed with essential hypertension is taking a loop d. The client has a weight gain of 2 kg within 1-2 days
diuretic daily. Which assessment data would require immediate
intervention by the nurse?
The nurse is monitoring a client who is taking propranolol (Inderal LA). b. The development of audible expiratory wheezes
Which assessment data indicates a potential serious complication
associated with this medication?
The nurse is planning to administer hydrochlorothiazide to a client. The a. Hypokalemia, hyperglycemia, sulfa allergy
nurse understands that which is a concern related to the administration
of this medication?
d. Hypouricemia, hyperkalemia
Prior to administering a client's daily dose of digoxin, the nurse reviews a. Serum magnesium level
the client's laboratory data and notes the following results: serum
calcium, 9.8 mg/dL; serum magnesium , 1.2 mg/dL; serum potassium, 4.1
mEq/L; serum creatinine, 0.9 mg/dL. Which result should alert the nurse
that the client is at risk for digoxin toxicity?
The nurse is monitoring an infant with congenital heart disease closely d. Tachycardia
for signs of heart failure. The nurse should assess the infant for which
EARLY signs of heart failure?
b. Cough
c. Pallor
d. Tachycardia
The elderly client has coronary artery disease. Which question should c. "Are you sexually active?"
Rationale: Sexual activity is a risk factor for angina resulting from CAD. The client's being elderly should not affect
a. "Do you get a yearly x-ray?"
the nurse's assessment of the client's concerns about sexual activity.
b. "Do you have a daily bowel movement?"
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cardiovascular
The 66-year-old NCLEX
male client has his BP checked questions
at a health fair. His BP is d. Instruct the client to see his HCP as soon as possible Study
168/98. Which action should the nurse implement first?
b. Explain that this BP is within the normal range for an elderly person
c. Discuss the importance of eating a low salt, low fat, low cholesterol
diet
The nurse is teaching the client recently diagnosed with essential d. Walk at least 30 minutes a day on flat surfaces.
hypertension. Which instruction should the nurse provide when
discussing exercise?
The nurse is administering a beta-blocker to the client diagnosed with d. Question administering the medication if the BP is <90/60 mmHg
essential hypertension. Which intervention should the nurse implement?
The male client diagnosed with essential hypertension has been d. Change position slowly when going from lying to sitting position
prescribed an alpha-adrenergic blocker. Which intervention should the
nurse discuss with the client?
b. Eat at least one banana a day to help increase the potassium level
The nurse just received the AM shift report. Which client should the a. Client diagnosed with DVT who is complaining of chest pain.
nurse assess first?
The nurse is teaching the Dietary Approaches to Stop Hypertension a. "I should eat at least 4-5 servings of vegetables a day."
(DASH) diet to a client diagnosed with hypertension. Which statement
indicates that the client understands the client teaching concerning the
DASH diet?
b. "I should drink no more than two glasses of whole milk a day"
d. "I should eat meat that has a lot of white streaks in it."
The nurse is teaching a class on arterial essential hypertension. Which d. Discuss sedentary lifestyle and smoking cessation
modifiable risk factors would the nurse include when preparing this
presentation?
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After noting a pulse deficit when assessing a patient who has just a. electrocardiographic (ECG) monitoring.
arrived in the emergency department, the nurse will anticipate that the
patient may require
b. 2-D echocardiogram.
c. cardiac catheterization.
When reviewing the 12-lead electrocardiograph (ECG) for a healthy 86- d. The heart rate (HR) is 43 beats/minute.
year-old patient who is having an annual physical examination, which of
the following will be of most concern to the nurse?
During a physical examination of a patient, the nurse palpates the point c. assess the patient for symptoms of left ventricular hypertrophy.
of maximal impulse (PMI) in the sixth intercostal space lateral to the left
midclavicular line. The most appropriate action for the nurse to take next
will be to
d. ask the patient about risk factors for coronary artery disease.
To auscultate for S3 or S4 gallops in the mitral area, the nurse listens d. bell of the stethoscope with the patient in the left lateral position.
with the
The bell of the stethoscope is more sensitive to low-pitched sounds (e.g. heart murmurs, abnormal heart sounds
a. bell of the stethoscope with the patient sitting and leaning forward.
such as S3 and S4). The diaphragm of the stethoscope is more sensitive to high-pitched sounds (e.g. S1 and S2
b. diaphragm of the stethoscope with the patient in a reclining position.
and bowel sounds)
c. diaphragm of the stethoscope with the patient lying flat on the left
side.
d. bell of the stethoscope with the patient in the left lateral position.
To determine the effects of therapy for a patient who is being treated b. B-type natriuretic peptide (BNP)
for heart failure, which laboratory result will the nurse plan to review?
a. Homocysteine (Hcy)
c. Myoglobin
While doing the admission assessment for a thin 72-year-old patient, the d. Document the finding in the patient chart.
nurse observes pulsation of the abdominal aorta in the epigastric area.
Which action should the nurse take?
A patient is scheduled for a cardiac catheterization with coronary a. a warm feeling may be noted when the contrast dye is injected.
angiography. Before the test, the nurse informs the patient that
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cardiovascular
While assessing NCLEX
a patient who was admitted withquestions
heart failure, the nurse a. Observe for JVD with the head at 30 degrees. Study
notes that the patient has jugular venous distention (JVD) when lying flat
in bed. Which action should the nurse take next?
The nurse teaches the patient being evaluated for rhythm disturbances b. keep a diary of daily activities while the monitor is worn.
with a Holter monitor to
When auscultating over the patient's abdominal aorta, the nurse hears a b. bruit.
humming sound. The nurse documents this finding as a
a. heave.
b. bruit.
c. thrill.
d. murmur.
The nurse has received the laboratory results for a patient who a. troponins T and I.
developed chest pain 4 hours ago and may be having a myocardial
infarction. The most important laboratory result to review will be
a. troponins T and I.
b. LDL cholesterol.
c. C-reactive protein.
When assessing a newly admitted patient, the nurse notes a thrill along d. Auscultate for any cardiac murmurs.
the left sternal border. To obtain more information about the cause of
the thrill, which action will the nurse take next?
The nurse hears a murmur between the S1 and S2 heart sounds at the d. "Systolic murmur heard at mitral area."
patient's left 5th intercostal space and midclavicular line. How will the
nurse record this information?
The RN is observing a student nurse who is doing a physical assessment c. palpates both carotid arteries simultaneously to compare pulse quality.
on a patient. The RN will need to intervene immediately if the student
nurse
a. places the patient in the left lateral position to check for the point of
maximal impulse (PMI).
b. presses on the skin over the tibia for 10 seconds to check for edema.
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cardiovascular
Which information NCLEX
obtained by the nurse who isquestions
admitting the patient a. The patient has a permanent ventricular pacemaker in place. Study
for magnetic resonance imaging (MRI) will be most important to report
to the health care provider before the MRI?
When the nurse is monitoring a patient who is undergoing exercise c. Electrocardiographic (ECG) changes indicating coronary ischemia.
(stress) testing on a treadmill, which assessment finding requires the
most rapid action by the nurse?
The standard policy on the cardiac unit states, "Notify the health care d. the postoperative patient with a BP of 116/42.
provider for mean arterial pressure (MAP) less than 70 mm Hg." The
nurse will need to call the health care provider about
When admitting a patient for a coronary arteriogram and angiogram, a. The patient is allergic to shellfish.
which information about the patient is most important for the nurse to
communicate to the health care provider?
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