Cardiac NCLEX Practice Questions For Nursing Excellence In 2023

As aspiring or practicing nurses, you understand that cardiac care is an indispensable aspect of modern healthcare, demanding both knowledge and skill to provide optimal patient outcomes. Whether you are preparing for the NCLEX exam or seeking to sharpen your expertise, mastering cardiac concepts is essential for your professional growth and patient well-being.

In this blog, we have compiled a series of thoughtfully crafted NCLEX practice questions that will challenge and expand your understanding of cardiac nursing. These cardiac NCLEX questions are from Smart’n cardiac test bank. By tackling these nursing cardiac questions, you will gain valuable insights and reinforce your grasp of crucial cardiac concepts.

Smart'n is an innovative NCLEX study tool created to assist nursing students in their academic journey, granting them access to an extensive array of practice questions, explanations, and evaluations.

Boasting over 2,500 practice questions and 60+ hours of NGN NCLEX-style nursing case studies, Smart'n presents students with concise NextGen questions and case studies organized by subject.

This streamlined categorization enables students to concentrate on particular nursing practice areas like respiratory, cardiac, mental health, neurological, and beyond with utmost convenience.

What is cardiac nursing?

Cardiac nursing is a specialized area of nursing that focuses on caring for patients with cardiovascular conditions. Cardiac nurses assess, monitor, and provide comprehensive care to individuals of all ages who are experiencing heart-related issues. They play a vital role in administering medications, conducting tests, and implementing interventions to support patients' cardiac health and recovery. With their expertise in cardiovascular anatomy, physiology, and the latest treatments, cardiac nurses make a significant impact on improving patients' well-being and quality of life.

Cardiac NXLEX questions

NCLEX cardiac questions hold immense importance for nursing students and aspiring nurses for several key reasons:

1- Exam preparation

The NCLEX exam is a critical step toward becoming a licensed nurse. Cardiovascular NCLEX questions help students prepare for this challenging exam, which often includes a significant number of cardiac-focused inquiries.

2- Specialized knowledge

NCLEX questions related to cardiology help reinforce essential concepts, ensuring that nurses possess the necessary expertise to provide quality care to patients with heart conditions.

3- Patient safety

By practicing cardiac NCLEX questions, nurses can improve their ability to recognize cardiac symptoms, intervene promptly, and administer appropriate treatments, thus minimizing potential risks.

Now you know the importance of cardiac NCLEX questions. Let's see some cardiac nursing questions from Smart’n.

Question (1)

A client is recovering from a heart transplant surgery and is at risk of blood clots because of immobility status. Which of the following interventions is a priority for the nurse in this scenario?

1. Have the client ambulate at least 5 times per day

2. Apply below-the-knee sequential compression devices

3. Administer intravenous potassium supplements as ordered

4. Massage the lower legs to promote circulation

Answer 1: Incorrect

Have the client ambulate at least 5 times per day

Rationale: This client is currently immobile due to the type of procedure that was performed, so ambulating is contraindicated at this time.

Answer 2: Correct

Apply below-the-knee sequential compression devices

Rationale: An immobile client is at risk of deep vein thrombosis (DVT), which is a blood clot in a major vein of the pelvis or the lower extremities.  The nursing priority for this client is to implement DVT prophylaxis. 

Answer 3: Incorrect

Administer intravenous potassium supplements as ordered

Rationale: IV potassium is not related to preventing blood clots.

Answer 4: Incorrect

Massage the lower legs to promote circulation

Rationale: Sequential compression devices are appropriate, but massaging the lower legs manually is not effective or efficient.

Question (2)

A nurse is caring for a client who has just returned from a cardiac catheterization procedure. The nurse notes that the client has developed a hematoma at the catheter site because the post-op nurse did not provide appropriate pressure. The nurse feels the need to report this occurrence. Which activity listed would best support the nurse’s sense of moral courage in this situation?

1. Taking deep breaths to control anger regarding the situation

2. Exploring other alternatives for treatment of the hematoma

3. Determining that the incident is important enough to mention

4. Fearing that the other nurse would be disciplined for not doing a good job

Answer 1: Incorrect

Taking deep breaths to control anger regarding the situation

Rationale: This is not an activity that supports the nurse's sense of moral courage.

Answer 2: Incorrect

Exploring other alternatives for the treatment of the hematoma

Rationale: This is not an activity that supports the nurse's sense of moral courage.

Answer 3: Correct

Determining that the incident is important enough to mention

Rationale: Moral courage describes the willingness to speak up about a situation, even if circumstances dictate otherwise. In this situation, the nurse who wants to speak up about inappropriate client care should first determine whether the situation warrants reporting. If it does, then the nurse would take further steps of action.

Answer 4: Incorrect

Fearing that the other nurse would be disciplined for not doing a good job

Rationale: This is not an activity that supports the nurse's sense of moral courage.

Question (3)

A nurse in the ICU is caring for a client who is experiencing cardiogenic shock secondary to endocarditis. The provider has just left new orders for the care of this client. Which of the following orders would the nurse most likely see in this client’s chart?

1. Administer dopamine 10 mcg/kg/min IV to keep systolic BP > 100 mmHg

2. Administer metoprolol 100 mg po

3. Ambulate client t.i.d.

4. Titrate O2 to keep saturations between 85 and 90%

Answer 1: Correct

Administer dopamine 10 mcg/kg/min IV to keep systolic BP > 100 mmHg

Rationale: Cardiogenic shock is a critical condition in which a client is in a life-threatening situation. The primary care of the nurse is to prevent the condition from occurring and to manage symptoms to prevent it from worsening if it does develop. A client in cardiogenic shock would most likely need medications to maintain an increase in blood pressure to within normal limits and oxygen to keep saturations greater than 95%.

Answer 2: Incorrect

Administer metoprolol 100 mg po

Rationale: Beta-blocker medications, such as metoprolol, may actually cause hypotension and can worsen the client's condition.

Answer 3: Incorrect

Ambulate client t.i.d.

Rationale: A client in cardiogenic shock is not able to ambulate.

Answer 4: Incorrect

Titrate O2 to keep saturations between 85 and 90%

Rationale: When it is not properly perfused with oxygenated blood, the client's O2 saturation should be higher so that as much oxygen as possible is delivered to vital organs.

Question (4)

The student nurse is reviewing the electrical activity of the heart. The student nurse is aware that the electrical impulse begins with which of the following?

1. Purkinje Fibers

2. Bundle of His

3. AV Node

4. SA Node

Answer 1: Incorrect

Purkinje Fibers

Rationale: The Purkinje fibers are the last to receive the electrical stimulus, which begins at the SA node.

Answer 2: Incorrect

Bundle of His

Rationale: The bundle of his receives the signal from the AV node.

Answer3: Incorrect

AV Node

Rationale: The AV node receives the signal from the SA node where electrical conduction begins.

Answer 4: Correct

SA Node

Rationale: This is where the electrical conduction begins.

Question (5)

A student nurse is studying an electrocardiogram graph paper and understands the small boxes measure how many seconds?

1. 0.6

2. 0.04

3. 0.004

4. 0.2

Answer 1: Incorrect

0.6

Rationale: The small boxes measure 0.04 seconds. 

Answer 2: Correct

0.04

Rationale: The small boxes measure 0.04 seconds.

Answer 3: Incorrect

0.004

Rationale: The small boxes measure 0.04 seconds. 

Answer 4: Incorrect

0.2

Rationale: The small boxes measure 0.04 seconds. 

Question (6)

A nurse assigned to four clients is receiving the report. The nurse knows that the client with which of the following is the most at risk for developing coronary artery disease?

1. Anemia and multiple blood infusions

2. History of drinking a glass of wine per day and hypotension

3. Smoking cessation 10 years ago and history of gastritis

4. History of hypertension and hyperlipidemia

Answer 1: Incorrect

Anemia and multiple blood infusions

Rationale: Anemia and blood infusions are not risk factors for coronary artery disease. 

Answer 2: Incorrect

History of drinking a glass of wine per day and hypotension

Rationale: Drinking one glass of wine per day will not put the patient at a higher risk of developing coronary artery disease. Hypertension is a cause of coronary artery disease, not hypotension.  

Answer 3: Incorrect

Smoking cessation 10 years ago and history of gastritis

Rationale: This client quit smoking, lowering her risk. Gastritis is not a cause of coronary artery disease.  

Answer 4: Correct

History of hypertension and hyperlipidemia

Rationale: This client has a history of hypertension and hyperlipidemia which are both causes of coronary artery disease.

Question (7)

A client has undergone percutaneous coronary intervention (PCI) for the management of acute coronary syndrome. Following the procedure, the client develops a retroperitoneal hemorrhage. Which of the following nursing interventions is necessary if this occurs?

1. Prepare for intubation and mechanical ventilation

2. Assist the client to get out of bed to ambulate

3. Apply pressure to the lower back

4. Notify the provider and prepare for a CT scan or blood administration

Answer 1: Incorrect

Prepare for intubation and mechanical ventilation

Rationale: A hemorrhage situation does not warrant intubation or a ventilator. Rather, interventions that center on protecting or restoring blood volume are needed.

Answer 2: Incorrect

Assist the client to get out of bed to ambulate

Rationale: The client would need to maintain bedrest in this situation.

Answer 3: Incorrect

Apply pressure to the lower back

Rationale: Pressure to the lower back would do nothing to stop a retroperitoneal bleed.

Answer 4: Correct

Notify the provider and prepare for a CT scan or blood administration

Rationale: Retroperitoneal hemorrhage is a complication of PCI when there is bleeding into the retroperitoneal cavity. The client may have a drop in blood pressure and the situation could become severe if bleeding is not controlled. The nurse should have the client rest and increase fluid administration. If the client is not stable, the provider must be notified. A CT scan will likely be ordered in addition to a blood product transfusion and/or surgery.

Question (8)

The nurse is caring for a client who was admitted with shortness of breath and has a new diagnosis of heart failure. Which of the following labs indicate that the client is suffering from severe heart failure?

1. LDL 192 mg/dL

2. LDL 19.2 mmHg

3. BNP 85 pg/mL

4. BNP 850 pg/mL

Answer 1: Incorrect

LDL 192 mg/dL

Rationale: LDL is a measurement of low-density lipoproteins. This does not provide any further information about heart failure, but it does give an indication of cholesterol level and overal cardiovascular risk. The normal level for LDL is <100.

Answer 2: Incorrect

LDL 19.2 mmHg

Rationale: LDL does not measure heart failure severity.

Answer 3: Incorrect

BNP 85 pg/mL

Rationale: This is a normal value for BNP.

Answer 4: Correct

BNP 850 pg/mL

Rationale: BNP helps quantify the severity of heart failure. A BNP from 600-900 pg/mL indicates severe heart failure.

Question (9)

A nurse is working on a team responding to cardiac arrest in the hospital. Because the client’s heart stopped, his body has gone into a state of acidosis. Which of the following medications would most likely correct metabolic acidosis that occurs during cardiac arrest?

1. Lidocaine

2. Procainamide

3. Sodium bicarbonate

4. Dobutamine

Answer 1: Incorrect

Lidocaine

Rationale: As this is an antiarrhythmic drug used for ventricular arrhythmias. It is a second-choice drug used if amiodarone is contraindicated, but is not used to correct metabolic acidosis.

Answer 2: Incorrect

Procainamide

Rationale: This is an antiarrhythmic drug used to cardiovert a client out of various arrhythmias. It is not used to correct metabolic acidosis.

Answer 3: Correct

Sodium bicarbonate

Rationale: When a client's heart stops during cardiac arrest, his body goes into a state of acidosis in which the pH of the bloodstream is too low and acidic wastes have accumulated. Sodium bicarbonate can be given to correct acidosis and help restore a normal pH level.

Answer 4: Incorrect

Dobutamine

Rationale: This is an inotropic agent used to treat heart failure. It does not improve metabolic acidosis.

Question (10)

The nurse is caring for a child with Kawasaki disease who is receiving IV immunoglobulins.  The child's parent wants to know why this treatment is required.  The nurse explains that this therapy is given to:

1. Fight the infection

2. Minimize rash

3. Prevent heart disease

4. Reduce spleen size

Answer 1: Incorrect

Fight the infection

Rationale: KD is a vasculitis of unknown etiology, but it is not an infectious process.  Because the child will often have a similar clinical presentation to that of an infection (eg, persistent fever, inflammatory immune response), KD may be mistaken for a bacterial or viral illness.

Answer 2: Incorrect

Minimize rash

Rationale: Polymorphous rash of the trunk and extremities is an expected finding in a child with KD.  Cool compresses, unscented lotions, and loose-fitting clothing can minimize discomfort.  IVIG is not given to control the rash.

Answer 3: Correct

Prevent heart disease

Rationale: Kawasaki disease (KD), also known as mucocutaneous lymph node syndrome, is characterized by ≥5 days of fever, bilateral nonexudative conjunctivitis, mucositis, cervical lymphadenopathy, rash, and extremity swelling.  Coronary artery aneurysms are the most serious potential sequelae in untreated clients, leading to complications such as myocardial infarction and death.  Echocardiography is used to monitor these cardiovascular complications.

Intravenous immunoglobulin (IVIG) along with aspirin is used to prevent coronary aneurysms and subsequent occlusion.  KD is one of the few pediatric illnesses in which aspirin therapy is warranted due to its antiplatelet and anti-inflammatory properties.  However, parents should be cautioned about the risk of Reye syndrome.  Cardiopulmonary resuscitation should also be taught to parents of children with coronary artery aneurysms.

Answer 4: Incorrect

Reduce spleen size

Rationale: Lymphadenopathy (usually a single palpable anterior cervical node >1.5 cm) and splenomegaly are included in the clinical presentation of KD.  IVIG therapy is not indicated to reduce the incidence of these findings.

Educational objective:
IVIG along with aspirin is the recommended initial treatment for Kawasaki disease, with the primary goal of coronary disease prevention.

FAQs
1- What score is passing on NCLEX?

Due to the format of the NCLEX exam, your result will be determined solely by the number of questions you answer correctly, with no consideration given to letter grades or percentages. The main objective of the NCLEX is to assess your readiness for nursing, rather than assigning traditional grades or scores.

2- What are Nclex questions?

The NCLEX-RN consists predominantly of text-based multiple-choice questions, each offering four options. These questions are crafted at the application/analysis level of difficulty and may incorporate charts, tables, or graphic images.