Published - Fri, 03 Mar 2023

NCLEX-RN Exam Questions - Part 12

1. When inspecting a cardiovascular client, the nurse notes that he needs to sit upright to breathe. This behavior is most indicative of:

A) Pericarditis
B) Anxiety
C) Congestive heart failure
D) Angina

2. When a client questions the nurse as to the purpose of exercise electrocardiography (ECG) in the diagnosis of cardiovascular disorders, the nurses response should be based on the fact that:

A) The test provides a baseline for further tests
B) The procedure simulates usual daily activity and myocardial performance
C) The client can be monitored while cardiac conditioning and heart toning are done
D) Ischemia can be diagnosed because exercise increasesO2 consumption and demand

3. In assessing cardiovascular clients with progression of aortic stenosis, the nurse should be aware that there is typically:

A) Decreased pulmonary blood flow and cyanosis
B) Increased pressure in the pulmonary veins and pulmonary edema
C) Systemic venous engorgement
D) Increased left ventricular systolic pressures and hypertrophy

4. The cardiac client who exhibits the symptoms of disorientation, lethargy, and seizures may be exhibiting a toxic reaction to:

A) Digoxin (Lanoxin)
B) Lidocaine (Xylocaine)
C) Quinidine gluconate or sulfate (Quinaglute,Quinidex)
D) Nitroglycerin IV (Tridil)

5. Which of the following ECG changes would be seen as a positive myocardial stress test response?

A) Hyperacute T wave
B) Prolongation of the PR interval
C) ST-segment depression
D) Pathological Q wave

1. Right Answer: C
Explanation: (A) Pericarditis can cause dyspnea but primarily causes chest pain. (B) Anxiety can cause dyspnea resulting in SOB, yet it is not typically influenced by degree of head elevation. (C) The inability to oxygenate well without being upright is most indicative of congestive heart failure, due to alveolar drowning. (D) Angina causes primarily chest pain; any SOB associated with angina is not influenced by body position.

2. Right Answer: D
Explanation: (A) The purpose of the study is not to provide a baseline for further tests. (B) The test causes an increase in O2 demand beyond that required to perform usual daily activities. (C) Monitoring does occur, but the test is not for the purpose of cardiac toning and conditioning. (D) Exercise ECG, or stress testing, is designed to elevate the peripheral and myocardial needs for O2 to evaluate the ability of the myocardium and coronary arteries to meet the additional demands.

3. Right Answer: D
Explanation: (A) These signs are seen in pulmonic stenosis or in response to pulmonary congestion and edema and mitral stenosis. (B) These signs are seen primarily in mitral stenosis or as a late sign in aortic stenosis after left ventricular failure. (C) These signs are seen primarily in right-sided heart valve dysfunction. (D) Left ventricular hypertrophy occurs to increase muscle mass and overcome the stenosis; left ventricular pressures increase as left ventricular volume increases owing to insufficient emptying.

4. Right Answer: B
Explanation: (A) Side effects of digoxin include headache, hypotension, AV block, blurred vision, and yellow-green halos. (B) Side effects of lidocaine include heart block, headache, dizziness, confusion, tremor, lethargy, and convulsions. (C) Side effects of quinidine include heart block, hepatotoxicity, thrombocytopenia, and respiratory depression. (D) Side effects of nitroglycerin include postural hypotension, headache, dizziness, and flushing.

5. Right Answer: C
Explanation: (A) Hyperacute T waves occur with hyperkalemia. (B) Prolongation of the P R interval occurs with first-degree AV block. (C) Horizontal ST-segment depression of>1 mm during exercise isdefinitely a positive criterion on the exercise ECG test. (D) Patho-logical Q waves occur with MI.

80% DISCOUNT: NCLEX-RN PRACTICE EXAMS