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Cardiovascular NCLEX practice questions

Five NCLEX-style questions on heart failure, myocardial infarction, dysrhythmias, hypertension, anticoagulants and DVT. Pick your answer, then open it to see the right choice and why. New questions every week.

1. Question 1

   The nurse educators on a cardiovascular unit of a health care facility are creating a social media project that addresses improving outcomes for clients with heart failure. Which action should the nurses implement to protect client privacy?

   • A.May use information from the client's relatives instead.
   • B.Remove client identifying information of those who participate.
   • C.Respect all copyright laws when adding website content.
   • D.Implement full disclosure policy especially when giving example.
   Show answer and rationale ▾Answer and rationale ▴

   Answer: B. Remove client identifying information of those who participate.

   Even information from family members about a client violates privacy laws if shared without consent. De-identifying client information aligns with HIPAA regulations and ensures privacy. Copyright laws protect intellectual property but do not protect patient privacy. Even with full disclosure, sharing identifiable client information is not allowed. HIPAA requires strict confidentiality.

2. Question 2

   A nurse is reviewing the health history of a patient with angina pectoris who has a prescription for propranolol hydrochloride PO 40 mg twice daily.Which historical finding should the nurse report to the provider?

   • A.The patient has a history of migraine headaches.
   • B.The patient has a history of hypothyroidism.
   • C.The patient has a history of hypertension.
   • D.The patient has a history of bronchial asthma.
   Show answer and rationale ▾Answer and rationale ▴

   Answer: D. The patient has a history of bronchial asthma.

   Propranolol is sometimes used to prevent migraines, so a history of migraines would not typically be a contraindication. Hypothyroidism is not typically a contraindication for propranolol. However, propranolol can affect the metabolism of thyroid hormones and may mask signs of hyperthyroidism. Propranolol is often used to treat hypertension, so a history of hypertension would not typically be a contraindication. Propranolol is a non-selective beta-blocker, which means it blocks beta receptors in both the heart and the lungs. This can potentially cause bronchoconstriction and exacerbate asthma symptoms, so it should be used with caution in patients with a history of bronchial asthma.

3. Question 3

   A nurse is providing teaching to a patient who has stable angina and a new prescription for nitroglycerin oral, sustained-release capsules.Which of the following instructions should the nurse give?

   • A.“Take one capsule at the onset of anginal pain.”.
   • B.“Take the medication with meals.”.
   • C.“Stop taking the medication if side effects are troublesome.”.
   • D.“Swallow the capsules whole.”.
   Show answer and rationale ▾Answer and rationale ▴

   Answer: D. “Swallow the capsules whole.”.

   Nitroglycerin oral, sustained-release capsules are not typically taken at the onset of anginal pain. They are usually used to prevent angina attacks rather than to treat them. There is no specific requirement to take the medication with meals. While side effects can be troublesome, patients should not stop taking the medication without consulting their healthcare provider. Nitroglycerin oral, sustained-release capsules should be swallowed whole. They should not be crushed or chewed.

4. Question 4

   A nurse in the emergency department is attending to a patient exhibiting symptoms of a myocardial infarction. Which of the following actions should the nurse prioritize?

   • A.Initiate oxygen therapy.
   • B.Obtain a blood sample.
   • C.Attach the leads for a 12-lead ECG.
   • D.Insert an IV catheter.
   Show answer and rationale ▾Answer and rationale ▴

   Answer: C. Attach the leads for a 12-lead ECG.

   For a client experiencing symptoms of a myocardial infarction (MI), the priority action is to obtain a 12-lead electrocardiogram (ECG). Current evidence-based guidelines require that a 12-lead ECG be performed and interpreted within 10 minutes of arrival in the emergency department for any client with MI symptoms. This critical assessment identifies whether the client is experiencing an ST-segment elevation myocardial infarction (STEMI), which requires immediate reperfusion therapy (such as percutaneous coronary intervention) to minimize myocardial damage and save the client's life.

   While initiating oxygen therapy was previously considered a routine initial step, current guidelines recommend oxygen only if the client's oxygen saturation is less than 90% or if they are in respiratory distress. Routine oxygen administration can cause coronary vasoconstriction and worsen outcomes in clients with normal oxygen levels. Obtaining a blood sample for cardiac biomarkers (such as troponin) is necessary to confirm myocardial damage, but drawing blood should not delay the initial ECG. Inserting an IV catheter is also essential for administering emergency medications such as nitroglycerin, morphine, and antiplatelets, but establishing vascular access follows the immediate diagnostic priority of the 12-lead ECG.

5. Question 5

   A nurse is caring for an older adult patient with left-sided heart failure. What assessment findings should the nurse expect?

   • A.Frothy sputum.
   • B.Dependent edema.
   • C.Nocturnal polyuria.
   • D.Jugular distention.
   Show answer and rationale ▾Answer and rationale ▴

   Answer: A. Frothy sputum.

   Frothy sputum is a common finding in patients with left-sided heart failure. This is due to fluid accumulation in the lungs (pulmonary edema), which can cause the sputum to become frothy. Dependent edema is more commonly associated with right-sided heart failure. It occurs due to fluid accumulation in the systemic circulation, leading to swelling in the lower extremities. Nocturnal polyuria can occur in heart failure, but it is not a specific sign of left-sided heart failure. Jugular venous distention is a sign of right-sided heart failure, not left-sided heart failure. It occurs due to increased pressure in the right atrium, leading to visible distention of the jugular veins.