NCLEX: Cardiovascular System
Have you seen my other NCLEX Prep / Nursing Books? NCLEX: Respiratory System : 105 Nursing Practice Questions and Rationales to Easily Crush the NCLEX! NCLEX: Endocrine System : 105 Nursing Practice Questions and Rationales to EASILY Crush the NCLEX! NCLEX: Integumentary System: 105 Nursing Practice Questions and Rationales to EASILY Crush the NCLEX! NCLEX: Emergency Nursing : 105 Practice Questions and Rationales to Easily Crush the NCLEX! EKG Interpretation: 24 Hours or Less to Easily Pass the ECG Portion of the NCLEX! Lab Values: 137 Values You Know to Easily Pass The NCLEX! Fluid and Electrolytes: 24 Hours or Less to Absolutely Crush the NCLEX Exam!
Table of Contents Chapter 1: NCLEX Questions, Answers & Rationales on the Cardiovascular System Chapter 2: NCLEX Questions Only on the Cardiovascular System
Chapter 1: NCLEX Questions, Answers & Rationales on the Cardiovascular System When studying for the NCLEX test, it is important to take as many practice questions as possible so that you can identify areas you know well and differentiate them from areas that need more review. The following are 105 questions on the Cardiovascular System that may be on the test. Take the test and compare your answers with the questions, answers, and rationales provided below. Good luck! 1. The function of the cardiovascular system involves any one or more of the following functions. Check all that apply. a.
Oxygen transportation
b.
Metabolic waste removal
c.
Hormone transportation
d.
Neural connectivity
e.
CO2 removal
Answer: a. b. c. e. The cardiovascular system is responsible for the transportation of oxygen and removal of CO2, the removal of metabolic waste products and the transportation of hormones. It is not responsible for neural connectivity.
2.
The heart is incased in what?
a.
The peritoneum
b.
The pericardial sac
c.
Lung tissue
d.
It has no encasement
Answer: b. The heart is encased in the pericardial sac—a connective tissue sac that separates it from other internal organs.
3.
What is the function of the pericardial sac?
a.
To keep foreign antigens from the heart
b.
To keep the heart from enlarging
c.
To provide nutrients to the heart
d.
To provide lubrication for the heart
Answer: d. The function of the pericardial sac is to provide lubrication to the heart when it beats.
4.
Which is not a layer of the heart?
a.
The pericardial layer
b.
The myocardium
c.
The endocardium
d.
The epicardium
Answer: a. The three layers of the heart are the epicardium, the myocardium and the endocardium.
5. List in order the pathway of blood through the heart from deoxygenated to oxygenated blood. a.
Left ventricle
b.
Right ventricle
c.
Left atrium
d.
Right atrium
Answer: d, b, c, a. Blood goes from the right atrium to the right ventricle, then to the lungs, the left atrium and out the left ventricle.
6. Which heart valves are closed to prevent backflow of blood into the atria during diastole? List all that apply. a.
Tricuspid valve
b.
Pulmonary valve
c.
Mitral valve
d.
Aortic valve
e.
Pneumonic valve
Answer: a. c. The tricuspid valve and the mitral valve are closed to prevent backflow of blood during diastole.
7. What artery supplies the back of the left ventricle, the inferior of the left ventricle, the right ventricle, and the right atrium? a.
Left main coronary artery
b.
Left anterior descending artery
c.
Circumflex artery
d.
Right coronary artery
Answer: d. the Right coronary artery supplies the inferior and posterior aspects of the left ventricle, the right ventricle and the right atrium.
8.
What is the cardiac output?
a.
The amount of blood ejected from the left ventricle in one beat.
b.
The amount of blood ejected from each ventricle in one minute.
c. beat.
The amount of blood ejected from both atria and ventricles per
d.
The amount of blood entering the lungs per minute.
Answer: b. The cardiac output is the amount of blood ejected from each ventricle in one minute. The normal value is 4-8 liters per minute.
9.
Which factors affect a person’s cardiac output?
a.
The oxygenation of blood
b.
The stroke volume
c.
The blood volume
d.
The preload
e.
The force of the contraction
Answer: b. d. e. The factors affecting the cardiac output are the stroke volume, the preload and the force of the contraction.
10.
The natural pacemaker of the heart is what?
a.
The AV node
b.
The purkinje fibers
c.
The SA node
d.
The bundle of His
Answer: c. The SA node is the natural pacemaker of the healthy heart.
11.
Distended neck veins mean what? Check all that apply.
a.
Decreased preload
b.
Increased preload
c.
Increased cardiac output
d.
Possible cardiac insufficiency
e.
Rapid heart rate
Answer: b. d. Distended neck veins mean that the preload of the heart is increased and/or that there is increased chance of cardiac insufficiency.
12.
Which vessels carry deoxygenated blood? Select all that apply.
a.
Arteries
b.
Capillaries
c.
Venules
d.
Arterioles
e.
Veins
Answer: b.c.d. The capillaries carry both oxygenated and deoxygenated blood to the venules and veins that carry deoxygenated blood.
13.
The sympathetic nervous system:
a.
Slows the heart rate
b.
Blocks beta-adrenergic receptors on the heart
c.
Increases the heart rate
d.
Determines the cardiac output
Answer: c. The sympathetic nervous system stimulates the beta-adrenergic receptors and increases heart rate.
14.
Which are true regarding heart sounds? Select all that are true.
a.
Diastole occurs between S1 and S2
b.
Systole occurs during S1 and S2
c.
Murmurs indicate vascular turbulence
d.
The time between S1 and S2 is variable
e.
S2 is occasionally absent
Answer: b. c. Systole occurs between S1 and S2 and murmurs represent areas of vascular turbulence.
15. You are briefly assessing a patient for his risk of stroke. What easy test can you do? a.
Check for a carotid bruit
b.
Assess speech function
c.
Do a carotid ultrasound
d.
Examine the patient for hemiparesis
Answer: a. A simple test for risk of stroke is to examine the patient’s carotid arteries with a stethoscope in order to listen for the presence of a carotid bruit.
16. The doctor tells you the patient has a grade IV heart murmur. What does that mean? a.
The patient has a very faint murmur
b.
The murmur can be heard without a stethoscope.
c. chest.
The murmur can be heard with a stethoscope just off the patient’s
d.
The murmur is laud and there is a palpable thrill.
Answer: d. A grade IV heart murmur is loud with a palpable thrill. Murmurs are graded from I-VI.
17. U wave?
On a standard EKG a U wave is seen. What can be said about the
a.
It represents early ventricular repolarization.
b.
It indicates a myocardial infarction.
c.
You should evaluate the patient for hypokalemia
d.
You should expect ventricular excitability.
Answer: c. A U wave is often present during situations involving hypokalemia.
18. Common causes of bradycardia include the following. Check all that apply. a.
Highly conditioned athlete
b.
Excess norepinephrine
c.
Inferior myocardial infarction
d.
Parasympathomimetic drugs
e.
Sympathetic drugs
Answer: a. c. d. Causes of bradycardia include being a highly conditioned athlete, having an inferior MI and parasympathomimetic drugs.
19. The treatment of symptomatic bradycardia with hypotension includes these choices. Check all that apply. a.
Give IV epinephrine.
b.
Give IV atropine.
c.
Hold all parasympathomimetic drugs
d.
Give Nitroprusside
e.
Defibrillate the patient.
Answer: b. c. In a patient with symptomatic bradycardia, the treatment of choice is to hold all parasympathomimetic drugs and give the patient IV atropine.
20. The patient is having ectopic beats occurring on the T wave of the previous beat while on telemetry. What should you look for? a.
The possibility of supraventricular tachycardia
b.
Third degree heart block
c.
Ventricular tachycardia
d.
The onset of bradycardia
Answer: c. The presence of ectopic beats occurring on the T wave of the previous beat indicates ventricular irritability with the possibility of impending ventricular tachycardia.
21. The patient’s rhythm on a cardiac monitor shows no P waves and a ventricular rate of 100. What are the possible causes of this condition? Check all that apply. a.
Excess epinephrine
b.
Alcoholism
c.
Infection
d.
Underlying cardiac disease
e.
Cocaine abuse
Answer: b. c. d. The patient is in atrial fibrillation which can be caused by alcoholism, infection, or underlying heart disease.
22. apply.
What is the significance of atrial fibrillation? Check all that
a.
The patient is at risk for low cardiac output.
b.
The patient is at risk for supraventricular tachycardia.
c.
The patient is at risk for embolic stroke.
d.
The patient is at risk for hypertension.
e.
The patient may develop angina.
Answer: a. c. e. A patient with atrial fibrillation may develop a decreased cardiac output and angina. There is also a risk for embolic stroke from clots developing in the fibrillating atria.
23. What are effective treatments for symptomatic atrial fibrillation? Check all that apply. a.
Asynchronized cardioversion
b.
Synchronized cardioversion
c.
IV ibutilide (Corvert)
d.
Radiofrequency catheter ablation
e.
Lanoxin IV
Answer: b. c. d. e. The patient may be treated with defibrillation synchronized to the ventricular beat, receive IV ibutilide, receive IV Lanoxin or have radiofrequency catheter ablation. Asynchronized cardioversion should not be attempted because the patient has a ventricular rhythm that may be disrupted with asynchronized cardioversion.
24. The patient has a saw-toothed p wave with an atrial rate of 350600 beats per minute and a ventricular rate of 100 beats per minute. What is this rhythm? a.
Atrial fibrillation
b.
Supraventricular tachycardia
c.
Frequent premature atrial contractions
d.
Atrial flutter
Answer: d. A saw-toothed pattern of p waves at a rate of 350-600 beats per minute represents atrial flutter, which is controlled because the ventricular rate is maintained at 100 beats per minute.
25. The patient has a cardiac rhythm with a progressively longer PR interval for three beats followed by a dropped QRS complex. What is this rhythm? a.
Third degree heart block
b.
Sinus bradycardia
c.
Second degree heart block, Wenckebach type
d.
Atrial flutter
Answer: c. The characteristics of a second degree heart block (Wenckebach) type I is a prolongation of the PR interval for a few beats followed by a single skipped QRS complex.
26. heart?
A junctional rhythm has a pacemaker originating where in the
a.
SA node
b.
AV node
c.
Bundle of His
d.
Ectopic sites in the atria
Answer: b. If the patient is exhibiting a junctional rhythm, the pacemaker of the heart is at the level of the AV node. QRS complexes are usually narrow.
27. If the patient is experiencing a junctional rhythm and is symptomatic, what treatment measures should be offered? Check all that apply. a.
IV atropine
b.
IV bretyllium
c.
IV nitroprusside
d.
Digoxin should be held
e.
IV procainamide
Answer: a. d. If a symptomatic junctional rhythm is noted, IV atropine can be given to stimulate the SA node. Since digoxin toxicity can cause this type of rhythm, a level should be drawn and the digoxin held until the results of the digoxin level returns.
28. apply.
Which drugs are known to increase the heart rate? Check all that
a.
Procainamide
b.
Epinephrine
c.
Propranolol
d.
Dopamine
e.
Atropine
Answer: b. d. e. Epinephrine, dopamine and atropine will all increase the heart rate. Propranolol will actually lower the heart rate and procainamide is an ant-arrhythmic medication.
29.
In third degree heart block, the ventricular rate is usually what?
a.
120-140 bpm
b.
80-100 bpm
c.
60-80 bpm
d.
20-40 bpm
Answer: d. In third degree heart block, there is no relationship between the P waves and the QRS complex and the ventricular rate is often between 20-40 beats per minute.