Cardiovascular NCLEX Questions

Cardiovascular NCLEX Questions Related

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A 34-y old lifelong nonsmoking male presents for evaluation of dyspnea, fatigue, and nonproductive cough which is worse in the evening. His symptoms have been ongoing for the last 6 months. He is an auto mechanic working in an autobody shop for the last 4 years. He believes his symptoms are work related. Medical history is otherwise negative and he is on no medications. Physical exam and vital signs are normal. CXR and spirometry are normal. What is the most appropriate next step?

  • A. CT chest
  • B. Repeat spirometry after workplace exposure
  • C. Allergy testing
  • D. Inhaled glucocorticoid
Correct Answer: B

Rationale: Symptoms worsening in the evening suggest occupational asthma related to autobody shop exposures (e.g., isocyanates). Repeat spirometry post-exposure can confirm reversible airway obstruction, a key diagnostic step per occupational lung disease guidelines.

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An abnormally wide (more than 0.10 second) QRS complex is characteristic of

  • A. paroxysmal atrial tachycardia.
  • B. supraventricular tachycardia.
  • C. junctional escape rhythm.
  • D. premature ventricular complexes.
Correct Answer: D

Rationale: The QRS of the premature complex is prolonged (greater than 0.10 second) and bizarre in appearance. Paroxysmal atrial tachycardia does not display a QRS complex that is greater than 0.10 seconds. Supraventricular tachycardia does not display a wide QRS complex. Escape rhythms may have a P wave that is inverted and located before, during, or after the QRS.

A 60-year-old man has experienced angina on exertion for the past 6 years. A coronary angiogram performed 2 years ago showed 75% stenosis of the left anterior descending coronary artery and 50% stenosis of the right coronary artery. For the past 3 weeks, the frequency and severity of the anginal attacks have increased, and pain sometimes occurs even when he is lying in bed. Which of the following is most likely to explain these findings?

  • A. Hypertrophy of ischemic myocardium with increased oxygen demands
  • B. Increasing stenosis of right coronary artery
  • C. Fissuring plaque in left coronary artery with superimposed mural thrombosis
  • D. Sudden complete thrombotic occlusion of right and left coronary artery
Correct Answer: C

Rationale: Fissuring of a plaque with mural thrombosis causes unstable angina by partially obstructing flow.

Regarding ECG changes, which is CORRECT?

  • A. Hypernatraemia is associated with low voltage complexes
  • B. The first change in hyperkalaemia is prolongation of QRS
  • C. With hypokalaemia, the resting membrane potential decreases
  • D. In hypercalcaemia, myocardial contractility is enhanced
Correct Answer: D

Rationale: In hypercalcaemia, the increased calcium levels enhance myocardial contractility by increasing the availability of calcium during contraction.

Cuspid valves open into:

  • A. the aorta.
  • B. the pulmonary artery.
  • C. the ventricles of the heart.
  • D. both A and B.
Correct Answer: C

Rationale: Cuspid valves (tricuspid and mitral) open into the ventricles of the heart.

21 y/o presents to the ER with abdominal pain, fatigue, and loss of appetite. He admits to IV heroin use and drinks 2-3 beers/day. He has mild scleral icterus, tender hepatomegaly, & antecubital needle tracks. Labs: T. Bili 5.6 mg/dL, AST & ALT 950 & 1280, Alk Phos 115, Albumin 3.4 HBsAg-, HAV IgM-, HBsAb+, HCV Ab-, HBcIgM-. Which labs is most likely to make a diagnosis?

  • A. AMA & Anti-Smooth muscle Ab
  • B. HCV RNA
  • C. HBc IgG
  • D. HAV total
Correct Answer: B

Rationale: Given the history of IV drug use and acute hepatitis symptoms with negative serologies, HCV RNA testing is key to diagnose acute hepatitis C infection.