Exam for RN Cardiovascular NCLEX Exam

Exam for RN Cardiovascular NCLEX Exam Related

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The following scenario applies to the next 1 items
The nurse cares for a client admitted for a myocardial infarction
Item 1 of 1
Nurses' Note
0800 - Client was found in bed pale and diaphoretic, stating, I do not feel well. Approximately two minutes later, the cardiac monitor showed ventricular tachycardia. Upon assessment, the client became unresponsive and did not have a pulse.

For each potential intervention, click to specify if it is essential or contraindicated: A. Call a code blue, B. Cardiovert the client, C. Defibrillate the client, D. Anticipate a prescription for intravenous digoxin, E. Perform chest compressions

  • A. Call a code blue
  • B. Cardiovert the client
  • C. Defibrillate the client
  • D. Anticipate a prescription for intravenous digoxin
  • E. Perform chest compressions
Correct Answer: A,C,E

Rationale: A: Essential - Calling a code blue activates the emergency response team for immediate intervention. B: Contraindicated - Cardioversion is used for synchronized shocks in stable rhythms like atrial fibrillation, not for pulseless ventricular tachycardia. C: Essential - Defibrillation is the treatment for pulseless ventricular tachycardia to restore a viable rhythm. D: Contraindicated - Digoxin is not used in acute cardiac arrest; it is for heart failure or rate control in arrhythmias. E: Essential - Chest compressions are required in pulseless clients as part of CPR.

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The nurse is preparing a client for a scheduled percutaneous coronary intervention (PCI). Which statement made by the client should be reported to the primary healthcare provider (PHCP)

  • A. I took my metformin this morning.
  • B. I get anxious when I am in closed spaces.
  • C. I am allergic to shellfish.
  • D. I may feel a warm sensation during the procedure.
Correct Answer: C

Rationale: Shellfish allergy may indicate iodine sensitivity, relevant for contrast dye used in PCI, requiring PHCP notification.

The nurse has taught a client newly prescribed sublingual nitroglycerin for acute angina. Which of the following statements by the client would require follow-up?

  • A. I will get a refill of my prescription every six months.
  • B. I will take one tablet every 2 minutes if chest pain occurs.
  • C. I will place my medication in a dark amber bottle.
  • D. I must not chew on the tablet when taking it.
Correct Answer: B

Rationale: Nitroglycerin should be taken every 5 minutes (up to 3 doses) for chest pain, not every 2 minutes, to avoid overdose.

The following scenario applies to the next 1 items
The nurse in the intensive care unit (ICU) is caring for a 41-year-old male client.
Item 1 of 1
Progress Notes
1544: Received client to ICU immediately following percutaneous transluminal coronary angioplasty followed by stenting via right femoral artery. Notified primary health care provider about client status. Awaiting orders.
The nurse contacts the primary healthcare provider for admission orders

For each potential order, click to specify whether the potential order is indicated or not indicated for the client post-percutaneous transluminal coronary angioplasty.

  • A. Head of the bed elevated up to 30 degrees
  • B. Elevate the right leg on a pillow
  • C. Continuous cardiac monitoring
  • D. Serial troponin levels
  • E. Keep the client NPO
  • F. Obtain serum glucose levels every two hours
Correct Answer: A,C,D,F

Rationale: A: Indicated - Elevating the head of the bed promotes comfort and reduces cardiac workload. B: Not indicated - Elevating the leg is not standard post-angioplasty unless specified for complications. C: Indicated - Continuous monitoring detects arrhythmias post-procedure. D: Indicated - Serial troponin levels monitor for myocardial injury. E: Not indicated - NPO status is typically temporary and not required post-procedure unless specified. F: Indicated - Glucose monitoring is crucial for diabetic patients or those at risk post-procedure.

Which of the following statements by the client with atrial fibrillation would require a follow-up? Select all that apply.

  • A. I have an increased risk for a stroke.
  • B. I should weigh myself daily at the same time.
  • C. I may be prescribed medications such as amiodarone.
  • D. I should wear a mask when I am in public.
  • E. I should seek medical care if I develop shortness of breath.
Correct Answer: B,D

Rationale: Atrial fibrillation increases stroke risk due to clot formation; no follow-up needed. B: Incorrect - Daily weighing is more relevant for heart failure, not atrial fibrillation; requires clarification. C: Correct - Amiodarone is a common medication for atrial fibrillation; no follow-up needed. D: Incorrect - Wearing a mask in public is not related to atrial fibrillation management; requires clarification. E: Correct - Shortness of breath could indicate complications; no follow-up needed.

The nurse cares for a client with the below tracing on the electrocardiogram. The client is unresponsive and without a pulse. The nurse should implement which priority treatment based on the tracing

  • A. Start cardiopulmonary resuscitation (CPR)
  • B. Perform immediate defibrillation
  • C. Initiate intravenous (IV) access
  • D. Review the client's most recent electrolyte levels
Correct Answer: B

Rationale: Pulseless ventricular fibrillation or tachycardia requires immediate defibrillation to restore rhythm.

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