NCLEX-RN DRILL: MEDICAL SURGICAL CARDIOVASCULAR C

Medical Surgical Nursing is a very broad area in the field of Nursing for it tackles the management of different client condition. Books in Medical Surgical Nursing are usually divided according to the Organ System of the Human Body. The Cardiovascular System is one of the most difficult areas to study and to master since any deviation in this system will affect every organ system. Mastery is needed to be able to answer board type questions pertaining to Cardiovascualr System.



1. A client with no history of cardiovascular disease comes to the ambulatory clinic with flu-like symptoms. The client suddenly complains of chest pain. Which of the following questions would best help a nurse discriminate pain caused by a noncardiac problem?
1. “Can you describe the pain to me?”
2. “Have you ever had this pain before?”
3. “Does the pain get worse when you breathe in?”
4. “Can you rate the pain on a scale of 1 to 10, with 10 being the worst?”

2. A client is admitted to an emergency room with chest pain that is being ruled out for myocardial infarction. Vital signs are as follows: at 11 am, pulse (P), 92 beats/min, respiratory rate (RR), 24 breaths/min, blood pressure (BP), 140/88 mm Hg; 11:15 am, P, 96 beats/min, RR, 26 breaths/min, BP, 128/82 mm Hg; 11:30 am, P, 104 beats/min, RR, 28 breaths/min, BP, 104/68 mm Hg; 11:45 am, P, 118 beats/min, RR, 32 breaths/min, BP, 88/58 mm Hg. The nurse should alert the physician because these changes are most consistent with which of the following complications?
1. Cardiogenic shock
2. Cardiac tamponade
3. Pulmonary embolism
4. Dissecting thoracic aortic aneurysm

3. A client with myocardial infarction has been transferred from a coronary care unit to a general medical unit with cardiac monitoring via telemetry. A nurse plans to allow for which of the following client activities?
1. Strict bed rest for 24 hours after transfer
2. Bathroom privileges and self-care activities
3. Ad lib activities because the client is monitored
4. Unsupervised hallway ambulation with distances under 200 feet

4. A client admitted to the hospital with chest pain and history of type II diabetes mellitus is scheduled for cardiac catheterization. Which of the following medications would need to be held for 48 hours before and after the procedure?
1. Regular insulin
2. Glipizide (Glucotrol)
3. Repaglinide (Prandin)
4. Metformin (Glucophage)

5. A client is in sinus bradycardia with a heart rate of 45 beats/min, complains of dizziness, and has a blood pressure of 82/60 mmHg. Which of the following should the nurse anticipate will be prescribed?
1. Defibrillate the client.
2. Administer digoxin (Lanoxin).
3. Continue to monitor the client.
4. Prepare for transcutaneous pacing.

6. A nurse notes bilateral 12 edema in the lower extremities of a client with myocardial infarction who was admitted 2 days ago. The nurse would plan to do which of the following next?
1. Order daily weights starting on the following morning.
2. Review the intake and output records for the last 2 days.
3. Request a sodium restriction of 1 g/day from the physician
4. Change the time of diuretic administration from morning to evening.

7. A nurse is conducting a health history of a client with a primary diagnosis of heart failure. Which of the following disorders reported by the client is unlikely to play a role in exacerbating the heart failure?
1. Atrial fibrillation
2. Nutritional anemia
3. Peptic ulcer disease
4. Recent upper respiratory infection

8. A client with myocardial infarction suddenly becomes tachycardic, shows signs of air hunger, and begins coughing frothy, pink-tinged sputum. Which of the following would the nurse anticipate when auscultating the client's breath sounds?
1. Stridor
2. Crackles
3. Scattered rhonchi
4. Diminished breath sounds

9. A client who has developed severe pulmonary edema would most likely exhibit which of the following?
1. Mild anxiety
2. Slight anxiety
3. Extreme anxiety
4. Moderate anxiety

10. A client with pulmonary edema has been on diuretic therapy. The client has an order for additional furosemide (Lasix) in the amount of 40 mg intravenous push. Knowing that the client will also be started on digoxin (Lanoxin), the nurse should review which laboratory result?
1. Sodium level
2. Digoxin level
3. Creatinine level
4. Potassium level