NCLEX Cardiac Practice Questions

15 free NCLEX-RN cardiac questions with answers and rationales — perfect for cardiac nclex questions practice. Want them as an interactive timed quiz?

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1. A 76-year-old patient with a history of heart failure presents to the clinic with increased shortness of breath and peripheral edema. Which of the following assessments is the BEST indicator of worsening heart failure?
- A. Increased blood pressure
- B. Weight gain of 3 pounds in 2 days ✓
- C. Increased heart rate
- D. Decreased urine output
Answer: B. Weight gain of 3 pounds in 2 days — Rapid weight gain is a key indicator of fluid retention and worsening heart failure.
2. A patient is admitted to the emergency department with chest pain and an ECG showing ST-segment elevation. What is the priority nursing action?
- A. Administer aspirin as ordered ✓
- B. Obtain a blood glucose level
- C. Start an IV line
- D. Prepare the patient for a chest x-ray
Answer: A. Administer aspirin as ordered — Aspirin is given to reduce platelet aggregation and limit the size of a myocardial infarction.
3. A patient on digoxin therapy presents with nausea, vomiting, and visual disturbances. Which laboratory value should the nurse check first?
- A. Potassium level ✓
- B. Calcium level
- C. Magnesium level
- D. Sodium level
Answer: A. Potassium level — Hypokalemia can increase the risk of digoxin toxicity, which can cause nausea, vomiting, and visual disturbances.
4. A patient with atrial fibrillation is started on warfarin. Which of the following statements by the patient indicates a need for further teaching?
- A. I will avoid green leafy vegetables. ✓
- B. I will use an electric razor for shaving.
- C. I will report any unusual bleeding to my doctor.
- D. I will have my INR checked regularly.
Answer: A. I will avoid green leafy vegetables. — Patients on warfarin should maintain a consistent intake of Vitamin K, not avoid it entirely.
5. A patient is prescribed nitroglycerin for angina. What is the primary action of this medication?
- A. Decrease myocardial oxygen demand ✓
- B. Increase heart rate
- C. Decrease blood volume
- D. Increase cardiac output
Answer: A. Decrease myocardial oxygen demand — Nitroglycerin primarily acts by dilating blood vessels, which decreases myocardial oxygen demand and relieves angina.
6. A patient with a history of myocardial infarction is prescribed a beta blocker. What should the nurse include in the patient education?
- A. Take the medication on an empty stomach.
- B. Monitor for signs of hyperglycemia.
- C. Do not stop the medication abruptly. ✓
- D. Avoid exposure to sunlight.
Answer: C. Do not stop the medication abruptly. — Abruptly stopping beta blockers can lead to rebound hypertension or angina.
7. A patient has a new prescription for lisinopril. Which side effect should the nurse instruct the patient to report immediately?
- A. Dry cough
- B. Dizziness
- C. Facial swelling ✓
- D. Fatigue
Answer: C. Facial swelling — Facial swelling may indicate angioedema, a serious and potentially life-threatening reaction to ACE inhibitors like lisinopril.
8. A patient with heart failure is prescribed furosemide. Which laboratory value requires the nurse's immediate attention?
- A. Sodium 140 mEq/L
- B. Potassium 3.0 mEq/L ✓
- C. Calcium 9.5 mg/dL
- D. Magnesium 2.0 mg/dL
Answer: B. Potassium 3.0 mEq/L — Hypokalemia (low potassium) is a common side effect of furosemide and can lead to serious cardiac complications.
9. A patient with a suspected myocardial infarction is receiving thrombolytic therapy. Which assessment finding is the BEST indicator that the therapy is effective?
- A. Resolution of chest pain ✓
- B. Decreased blood pressure
- C. Improved urine output
- D. Increased heart rate
Answer: A. Resolution of chest pain — The resolution of chest pain indicates that the blood flow has been restored to the affected area of the heart.
10. A nurse is monitoring a patient with a potassium level of 6.8 mEq/L. Which ECG change is most indicative of hyperkalemia?
- A. Flattened T waves
- B. Prominent U waves
- C. Peaked T waves ✓
- D. ST-segment depression
Answer: C. Peaked T waves — Peaked T waves are a classic ECG finding associated with hyperkalemia.
11. A patient recovering from a myocardial infarction is on a cardiac rehabilitation program. What is the primary goal of this program?
- A. To increase the patient's knowledge of medications
- B. To prevent further cardiac events ✓
- C. To provide emotional support
- D. To improve the patient's diet
Answer: B. To prevent further cardiac events — Cardiac rehabilitation aims to improve the patient's overall cardiovascular health and prevent future cardiac events.
12. A nurse is assessing a patient with left-sided heart failure. Which of the following symptoms should the nurse expect to find?
- A. Peripheral edema
- B. Jugular venous distention
- C. Orthopnea ✓
- D. Hepatomegaly
Answer: C. Orthopnea — Orthopnea is a symptom of left-sided heart failure due to pulmonary congestion.
13. A patient is admitted with hypertensive crisis. Which of the following is the PRIORITY nursing intervention?
- A. Administer IV antihypertensives as ordered ✓
- B. Monitor urine output frequently
- C. Provide a low-sodium diet
- D. Encourage ambulation
Answer: A. Administer IV antihypertensives as ordered — Rapid control of blood pressure is crucial in preventing target organ damage during a hypertensive crisis.
14. A patient with chronic heart failure is prescribed spironolactone. What dietary advice should the nurse provide?
- A. Increase intake of potassium-rich foods
- B. Avoid excessive salt substitutes ✓
- C. Limit fluid intake to 1 liter per day
- D. Increase calcium-rich foods
Answer: B. Avoid excessive salt substitutes — Spironolactone is a potassium-sparing diuretic, and excessive use of salt substitutes can lead to hyperkalemia.
15. A patient with suspected pericarditis is experiencing sharp chest pain that worsens with deep inspiration. What position should the nurse encourage to help relieve the pain?
- A. Supine position
- B. Prone position
- C. Sitting up and leaning forward ✓
- D. Left lateral position
Answer: C. Sitting up and leaning forward — Sitting up and leaning forward reduces pressure on the pericardium and helps alleviate pain associated with pericarditis.

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NCLEX Cardiac Practice Questions

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