Question 1

A heartbeat of less than 60 beats per minute is called?

Accepted Answer

Answer reason: A rate below 60 beats/min is termed bradycardia and reflects slowed sinus node activity or impaired conduction, though it can be physiologic in athletes. Tachycardia is the opposite pattern and typically refers to rates above 100 beats/min. Arrhythmia describes an irregular rhythm (rate may be fast, slow, or normal), and fibrillation is a specific chaotic rhythm, not simply a slow rate.

Question 2

During a cardiac catheterization blood samples from the right atrium, right ventricle, and pulmonary artery are analyzed for their oxygen content. Normally?

Accepted Answer

Answer reason: The right ventricle and pulmonary artery primarily contain the same mixed venous blood, and in normal physiology there is no substantial increase in O2 content between these sampling sites. Any notable “step-up” in oxygen saturation across RA→RV→PA would instead suggest a left-to-right shunt. Pulmonary venous blood is oxygenated in the lungs, so it has higher oxygen content than these right-sided samples, making the alternative statements inconsistent.

Question 3

What physiological change during pregnancy causes an increase in cardiac output?

Accepted Answer

Answer reason: Higher preload increases end-diastolic volume and supports a higher stroke volume via the Frank–Starling mechanism, raising overall cardiac output. Pregnancy also typically increases, not decreases, heart rate, which further contributes to higher output. Systemic vascular resistance generally falls due to progesterone-mediated vasodilation, so an increase in SVR would oppose forward flow. A reduced stroke volume would lower cardiac output rather than increase it.

Question 4

How often does the average human heart beat per minute?

Accepted Answer

Answer reason: This range reflects baseline sinoatrial node pacing influenced by autonomic tone at rest. Among the choices, this option best represents the typical average resting rate. The lower range can be seen in well-trained athletes, while the higher ranges more often suggest exertion, fever, pain, anxiety, or other causes of tachycardia.

Question 5

Normal blood pressure is?

Accepted Answer

Answer reason: This value serves as a reference point for interpreting deviations toward hypotension or hypertension in basic cardiovascular assessment. 140/90 mmHg meets traditional thresholds used to define hypertension, so it is not considered normal. While 100/60 or 110/70 can be normal for some individuals, they are lower than the standard reference used in most exam settings.

Question 6

Oxygenated blood circulated by..?

Accepted Answer

Answer reason: This makes them the primary vessels distributing oxygen-rich blood to body tissues. Veins and venules generally return deoxygenated blood to the heart in systemic circulation, making them less accurate as a general rule. Although pulmonary veins are an exception (they carry oxygenated blood), the best single general answer for oxygenated blood circulation is arteries.

Question 7

Primary vericose veins can be caused by?

Accepted Answer

Answer reason: Pregnancy promotes this through increased blood volume and progesterone-mediated venous smooth muscle relaxation, and by mechanical compression of pelvic veins by the gravid uterus, all of which increase lower-extremity venous pressure. This mechanism directly supports development/worsening of varicosities even without prior venous disease. Prolonged sitting is more associated with venous stasis symptoms and risk of thrombosis rather than being a classic primary cause of varicose veins, while coagulopathy and hemorrhage do not cause valvular reflux.

Question 8

Highest pressure chamber of heart is?

Accepted Answer

Answer reason: The chamber responsible for this work must develop the greatest systolic pressure and therefore has the thickest myocardium. In normal physiology, the right ventricle pumps to the low-resistance pulmonary circuit and operates at substantially lower pressures. The atria (auricles) function primarily as receiving chambers and generate only low filling pressures compared with ventricles.

Question 9

Which of the following chambers pumps blood toward the lungs?

Accepted Answer

Answer reason: The right ventricle is the chamber that generates the pressure needed to eject blood through the pulmonic valve into the pulmonary artery. In contrast, the atria mainly receive blood and contribute only a small “atrial kick,” not the primary pumping force to a great vessel. The left ventricle instead pumps oxygenated blood into the systemic circulation via the aorta.

Question 10

Which of the following condition most commonly causes cardiogenic shock?

Accepted Answer

Answer reason: Acute myocardial infarction is the most common cause because loss of functional myocardium abruptly reduces contractility, leading to low stroke volume, hypotension, pulmonary congestion, and end-organ hypoperfusion. Coronary artery disease is a common underlying risk factor, but it typically causes shock only when it results in an acute infarction or severe ischemia. Hypotension is a manifestation of shock rather than a cause, and decreased hemoglobin level causes tissue hypoxia via reduced oxygen-carrying capacity (more consistent with hypovolemic/anemic states), not primary pump failure.

Question 11

Which portion of the heart recieves oxygenated blood?

Accepted Answer

Answer reason: The atrium is the receiving chamber that fills before blood passes through the mitral valve into the left ventricle for systemic ejection. The right auricle/right heart structures receive deoxygenated venous blood from the systemic circulation. The left ventricle contains oxygenated blood but is primarily the pumping chamber rather than the chamber that first receives it from the lungs.

Question 12

The heart's natural pacemaker is termed the?

Accepted Answer

Answer reason: The sinoatrial (SA) node in the right atrium generates the electrical impulse that spreads through the atria and sets the baseline heart rate. The atrioventricular (AV) node primarily delays conduction to allow ventricular filling and serves as a secondary pacemaker if SA node function fails. The bundle of His and bundle branches are downstream conduction pathways that distribute impulses through the ventricles rather than setting the normal rhythm.

Question 13

When do coronary arteries primarily receive blood flow?

Accepted Answer

Answer reason: During systole, especially in the left ventricle, contraction markedly increases wall tension and squeezes coronary microvasculature, reducing forward flow despite high aortic pressure. In diastole, aortic pressure remains sufficient while ventricular pressure falls, creating a favorable pressure gradient into the coronary arteries. Respiratory phases (inspiration/expiration) can slightly affect venous return but are not the primary determinant of coronary blood flow timing.

Question 14

Failure of the foramen ovale to close will cause what congenital heart disease?

Accepted Answer

Answer reason: The foramen ovale is a fetal interatrial communication that normally functionally closes after birth when left atrial pressure exceeds right atrial pressure. If it fails to close, a persistent opening remains between the atria, which is essentially an atrial-level septal communication. This produces an atrial shunt (often left-to-right postnatally) and is categorized clinically as an atrial septal defect/patent foramen ovale spectrum. Total anomalous pulmonary venous return is due to abnormal pulmonary venous drainage, and pulmonary stenosis is an outflow tract obstruction—neither results from persistence of the foramen ovale.

Question 15

Normal systolic blood pressure in humans is about?

Accepted Answer

Answer reason: This value is a standard physiologic benchmark used in cardiovascular assessment and basic vital-sign interpretation. 80 mmHg corresponds to the usual diastolic pressure, not systolic. Values like 140 mmHg are more consistent with elevated systolic pressure/hypertension thresholds rather than normal.

Question 16

Which of these is considered a normal blood pressure reading?

Accepted Answer

Answer reason: Readings at or above 140/90 meet criteria for hypertension in many standard classifications and are not considered normal. A value like 180/120 represents hypertensive crisis and warrants urgent evaluation due to risk of end-organ damage. Therefore, among the listed choices, the only one that fits normal physiology is the 120/80 reading.

Question 17

Severe high BP is…?

Accepted Answer

Answer reason: g., stroke, aortic dissection, pulmonary edema). This threshold is used clinically to trigger urgent assessment for symptoms and end-organ injury. The other options represent hypotension rather than hypertension, with systolic values far below normal and therefore do not fit the concept of severe high blood pressure. When readings reach this range, confirmation with proper technique and prompt evaluation is indicated.

Question 18

What are veins that take deoxygenated blood from the head back to the heart?

Accepted Answer

Answer reason: The internal jugular vein is the primary deep venous drainage of the cranial cavity (via the dural venous sinuses), making it the key pathway from head to heart. Renal veins drain the kidneys and femoral vein drains the lower limb, so they do not represent head drainage. The aorta is an artery carrying oxygenated blood away from the heart, not a vein returning deoxygenated blood.

Question 19

The normal pulmonary capillary wedge pressure is?

Accepted Answer

Answer reason: The normal range is about 6–12 mm Hg, reflecting normal left atrial/left ventricular end-diastolic filling pressures. Values above this suggest left-sided volume overload or impaired left ventricular function and can correlate with cardiogenic pulmonary edema. The other ranges are either too low for typical normal preload estimates or include values more consistent with elevated filling pressures.

Question 20

A client hospitalized for an acute exacerbation of right sided heart failure would be least likely to have which symptom?

Accepted Answer

Answer reason: Orthopnea is classically associated with left-sided heart failure due to pulmonary venous congestion and increased pulmonary capillary pressures when lying flat. Although fatigue can occur in both right- and left-sided failure from reduced cardiac output and poor perfusion, it is not the distinguishing feature asked here. Therefore, the symptom least likely in an isolated acute right-sided exacerbation is the positional dyspnea of orthopnea.

Question 21

When assessing for myocardial damage, the nurse should anticipate which lab result?

Accepted Answer

Answer reason: They rise within hours after injury and remain elevated for days, supporting diagnosis even when presentation is delayed. Myoglobin can also rise early but is nonspecific because it increases with any skeletal muscle injury. Creatine kinase (including CK-MB) would be expected to increase rather than decrease with myocardial injury, making that option physiologically inconsistent.

Question 22

A 4-year-old is being treated with IV globulins for suspected Kawasaki disease. Which organ is most likely to be affected long-term and should be monitored closely?

Accepted Answer

Answer reason: Kawasaki disease is an acute medium-vessel vasculitis with a strong predilection for the coronary arteries. The major long-term complication is coronary artery aneurysm formation, which can lead to thrombosis, stenosis, myocardial ischemia, and infarction. IVIG reduces (but does not eliminate) the risk of coronary involvement, so ongoing cardiac surveillance (e.g., echocardiography) is essential. The other listed organs are not the classic site of the long-term, high-stakes sequelae tested for Kawasaki disease.

Question 23

Oxygen-rich blood is called...?

Accepted Answer

Answer reason: In standard physiology teaching, “arterial blood” refers to oxygen-rich blood (with exceptions such as pulmonary arteries, but the term still reflects oxygenation status in systemic circulation). Venous blood generally has lower oxygen saturation after tissue extraction. Serum and lymph are different body fluids and are not terms used to describe oxygen-rich whole blood.

Question 24

A patient with chest pain relieved by rest most likely has?

Accepted Answer

Answer reason: Rest lowers heart rate, blood pressure, and myocardial oxygen demand, allowing supply to meet demand and symptoms to resolve. Heart failure typically presents with dyspnea, orthopnea, edema, and fatigue rather than exertional chest pain consistently relieved by rest. Aortic aneurysm pain is often sudden and severe (tearing/back pain) and is not characteristically relieved by rest, while pneumonia causes pleuritic pain with fever and cough.

Question 25

Which is an example of a cardiac arrhythmia that can occur when there are issues with the electrical impulses that stimulate each heart beat?

Accepted Answer

Answer reason: In third-degree (complete) heart block, atrial impulses fail to conduct to the ventricles, producing AV dissociation and a slow escape rhythm—an electrical-impulse problem by definition. Angina pectoris, myocardial infarction, and coronary artery disease are ischemic conditions that can precipitate arrhythmias, but they are not themselves primary rhythm/conduction disturbances. Therefore the option that directly represents an arrhythmia from faulty electrical impulses is the conduction block.

Question 26

The nurse is caring for a newborn client with tetralogy of Fallot when the client becomes cyanotic during feeding. The nurse recognizes that cyanosis in tetralogy of Fallot occurs due to?

Accepted Answer

Answer reason: The key lesion producing this is right ventricular outflow tract obstruction (pulmonic stenosis), which limits pulmonary perfusion and promotes shunt reversal across the VSD. Feeding can increase oxygen demand and precipitate a hypercyanotic spell when pulmonary flow falls further relative to systemic flow. A left-to-right shunt would tend to increase pulmonary blood flow and is not the typical mechanism of cyanosis in TOF. An atrial septal opening is not required for TOF, and left ventricular outflow obstruction is not the primary hemodynamic problem.

Question 27

Blood pressure is lowest in;?

Accepted Answer

Answer reason: The highest pressures are found in the aorta and large arteries, with a major drop occurring across arterioles (the primary resistance vessels). Capillaries have lower pressure than arteries to allow exchange, but venous pressure is lowest because veins are capacitance vessels and are farthest downstream from the heart’s pumping force. Central venous pressure near the right atrium is only a few mmHg, reflecting the lowest pressure segment among the listed options.

Question 28

BP of 140/90 mmHg is...?

Accepted Answer

Answer reason: This value is not within normal or low ranges because both numbers are at the threshold associated with increased cardiovascular risk. “Borderline” is sometimes used for slightly lower ranges (e.g., prehypertension/Stage 1 depending on guideline), but 140/90 itself represents a diagnostic cutoff rather than a borderline value. Therefore the most accurate classification among the choices is the one indicating increased arterial pressure.

Question 29

Oxygenated blood in...?

Accepted Answer

Answer reason: This is why oxygenated blood is generally found in arteries throughout the body. A common confusion is that all veins carry deoxygenated blood, but pulmonary veins are an exception and carry oxygenated blood back to the heart. Hair and lymph do not function as primary conduits for oxygenated blood transport.

Question 30

Main reservoir of circulatory blood?

Accepted Answer

Answer reason: At rest, the majority of total blood volume resides in the systemic veins and venules, allowing the body to buffer acute changes in circulating volume. Sympathetic venoconstriction can rapidly mobilize this stored blood to increase venous return and cardiac output during stress or hemorrhage. In contrast, arteries are less compliant and function mainly as high-pressure conduits, and capillaries/ventricles do not hold the largest share of blood volume.

Question 31

The nurse is auscultating heart sounds on a patient and hears an abnormality over the left second intercostal space. Which area is the murmur heard?

Accepted Answer

Answer reason: The left 2nd intercostal space at the left sternal border corresponds to the pulmonic valve area, so abnormalities heard there localize to pulmonic flow. In contrast, the aortic area is at the right 2nd intercostal space, making it a common distractor when only “2nd intercostal space” is remembered. Tricuspid sounds are best at the left lower sternal border (4th–5th ICS), and mitral at the apex (5th ICS midclavicular line).

Question 32

Which cause of myocarditis is the most common?

Accepted Answer

Answer reason: Enteroviruses (e.g., coxsackievirus) and other viruses are classic and common causes, making this choice the best general answer on exams. Bacterial, fungal, and parasitic etiologies do occur but are much less common overall and are often tied to specific exposures or immunocompromised states. Clinically, viral myocarditis commonly follows a recent viral prodrome and can present with chest pain, arrhythmias, or new heart failure.

Question 33

Which term best describes the findings on cautious palpation of the vein in typical superficial thrombophlebitis?

Accepted Answer

Answer reason: A “knotty” feel best captures this cordlike, lumpy texture from clot and localized venous wall swelling. “Smooth” contradicts the typical palpable cord, and “dilated”/“tortuous” describe chronic venous insufficiency/varicosities rather than acute thrombophlebitis findings. The key bedside clue is a localized, tender, indurated, cordlike vein rather than generalized enlargement or twisting.

Question 34

Which condition may lead to sinus arrest or sinus pause in a child?

Accepted Answer

Answer reason: A Valsalva maneuver increases intrathoracic pressure and can trigger a reflex surge in vagal activity, slowing SA node firing enough to produce a sinus pause. In contrast, hypokalemia more typically predisposes to ectopy and tachyarrhythmias and can cause ST/T/U-wave changes rather than isolated vagally mediated sinus arrest. Hyperthermia generally increases heart rate, and decreased (not increased) intracranial pressure would not be expected to drive bradyarrhythmias from a Cushing-type response.

Question 35

A heart murmur is heard at the second left intercostal space along the left sternal border. Which heart valve is found in this area?

Accepted Answer

Answer reason: Cardiac auscultation landmarks correlate with where valve sounds are best transmitted to the chest wall, not the anatomic valve position itself. The pulmonic area is classically at the 2nd left intercostal space along the left sternal border, matching the location described. By contrast, the aortic area is at the 2nd right intercostal space, the tricuspid is lower left sternal border, and the mitral is at the cardiac apex (5th intercostal space, midclavicular line). A murmur best heard at this site most strongly implicates flow across the pulmonic valve.

Question 36

While assessing a client’s heart sounds, the nurse auscultates a murmur at the second left intercostal space along the left sternal border. Which valve is most likely involved?

Accepted Answer

Answer reason: The pulmonic valve is best heard at the 2nd left intercostal space at the left sternal border, so a murmur maximal there most strongly suggests pulmonic valve pathology. By contrast, the aortic area is at the 2nd right intercostal space, and mitral and tricuspid murmurs are typically lower (apex and left lower sternal border, respectively). Therefore, the location given most directly localizes the murmur to the pulmonic valve.

Question 37

Which condition is associated with a predictable level of pain that occurs as a result of physical or emotional stress?

Accepted Answer

Answer reason: Because the degree of obstruction is relatively constant, the ischemic chest pain threshold is reproducible and occurs in a predictable pattern with similar levels of activity or stress. Unstable angina is typically new, worsening, or occurring at rest and is not predictable because it involves plaque disruption and dynamic thrombus formation. Variant (Prinzmetal) angina is caused by coronary vasospasm and often occurs at rest, commonly in a cyclical pattern, rather than being triggered predictably by exertion.

Question 38

Which class of drugs is most widely used in the treatment of cardiomyopathy?

Accepted Answer

Answer reason: This drug class has broad use in cardiomyopathies—especially dilated cardiomyopathy with systolic dysfunction (improves survival) and hypertrophic cardiomyopathy (improves symptoms by slowing heart rate and decreasing contractility). Anticoagulants are used selectively when there is atrial fibrillation, intracardiac thrombus, or high embolic risk, not as a universal primary therapy. Calcium channel blockers and nitrates are more situation-dependent and are not as broadly foundational across cardiomyopathy types.

Question 39

Which condition is linked to more than 50% of clients with abdominal aortic aneurysms?

Accepted Answer

Answer reason: Chronic elevated pressure increases mechanical strain on the aortic wall and is present in a large proportion of patients with AAA, making it a key linked condition. Peripheral vascular disease is also associated via shared atherosclerotic risk factors, but the question asks for the condition linked to more than half of cases, for which elevated blood pressure is classically emphasized. Syphilitic aneurysms more typically involve the thoracic aorta, and diabetes is not a classic majority association for AAA.

Question 40

Which condition is caused by increased hydrostatic pressure and chronic venous stasis?

Accepted Answer

Answer reason: Chronic venous stasis is therefore most directly linked to venous outflow obstruction rather than arterial insufficiency. By contrast, cool extremities and reduced blood supply to the feet are classic findings of decreased arterial perfusion (e.g., peripheral arterial disease). Nocturnal calf cramps are more commonly associated with arterial insufficiency or electrolyte/neuromuscular causes than with venous hypertension.

Question 41

Which sound will be heard during the first phase of Korotkoff's sounds?

Accepted Answer

Answer reason: This produces the initial clear, repetitive tapping that marks the systolic blood pressure reading. Softer muffling occurs later as flow becomes less turbulent (phase IV), and disappearance of sounds corresponds to diastolic pressure (phase V). A murmur/swish is more consistent with later phases (II/III) rather than the first appearance of sound.

Question 42

The nurse auscultates the first heart sound, interpreting this sound as occurring?

Accepted Answer

Answer reason: S1 is produced by closure of the atrioventricular valves at the onset of ventricular systole, marking the end of ventricular filling. This sound is best understood as occurring at the beginning of systole rather than during diastole. In contrast, closure of the semilunar valves (aortic and pulmonic) produces S2, which occurs at the end of systole and start of diastole. Therefore the interpretation tied to S1 is AV valve closure.

Question 43

Which intervention or drug is recommended initially for preterm neonates to close a patent ductus arteriosus?

Accepted Answer

Answer reason: A cyclooxygenase inhibitor reduces prostaglandin levels and thereby encourages functional ductal constriction and closure, making it the preferred initial pharmacologic approach when not contraindicated. Prostaglandin E1 would have the opposite effect and is used to maintain ductal patency in certain congenital heart defects. Surgical ligation and catheter-based closure are generally reserved for cases where medical therapy fails or is contraindicated.

Question 44

Which cardiac anomaly produces a left-to-right shunt?

Accepted Answer

Answer reason: An atrial septal defect creates an opening between the atria, allowing blood to move from the left atrium to the right atrium under normal pressure conditions. This produces pulmonary overcirculation and can lead to right-sided volume overload over time. In contrast, tetralogy of Fallot is classically a right-to-left shunt due to RV outflow obstruction, and pulmonic stenosis is an obstructive lesion rather than a shunt.

Question 45

What surgical procedure is recommended for repair of transposition of the great arteries?

Accepted Answer

Answer reason: The Jatene procedure is the standard arterial switch operation used for this purpose, typically performed in the neonatal period. Balloon atrial septostomy is a temporizing catheter-based measure to improve mixing, not the definitive repair. Fontan and Blalock-Taussig procedures are palliative strategies for different congenital heart physiologies (single-ventricle pathways and decreased pulmonary blood flow, respectively).

Question 46

In which condition or group is sinus bradycardia a normal finding?

Accepted Answer

Answer reason: In a healthy athletic adolescent, sinus bradycardia is therefore a common normal physiologic variant, especially at rest or during sleep. In contrast, hypoxia is a pathologic stressor that typically causes tachycardia initially and bradycardia can signal deterioration. Hypothermia can also slow the sinus rate, but that represents a physiologic response to an abnormal condition and is treated/monitored rather than considered a normal baseline finding.

Question 47

In caring for a client with cardiac problems, the nurse must know that the condition most likely responsible for myocardial infarction (MI) is which of the following?

Accepted Answer

Answer reason: A thrombus forming on a disrupted atherosclerotic plaque is the most common immediate cause of coronary occlusion in MI. This option directly describes that mechanism, explaining the sudden loss of perfusion. Heart failure is typically a consequence of ischemic heart disease/MI rather than the initiating cause. Aneurysm and renal failure may increase cardiovascular risk but are not the usual direct event that precipitates an MI.

Question 48

The nurse auscultates a third heart sound (S3) while assessing her client. The nurse is aware that this results from?

Accepted Answer

Answer reason: An S3 is generated during early diastolic rapid ventricular filling when blood strikes a dilated, volume-overloaded, and poorly compliant ventricle, creating low-frequency vibrations. This is classically associated with conditions such as systolic heart failure and high-volume states where ventricular chamber size is increased. Increased atrial contraction is associated with an S4 gallop (late diastole) rather than S3. Aortic valve malfunctions more typically produce systolic or diastolic murmurs, not an isolated third heart sound.

Question 49

The nurse is counseling a client on types of cardiomyopathy associated with childbirth. The nurse should teach the client about which of the following?

Accepted Answer

Answer reason: The core principle is that this condition leads to ventricular dilation and reduced ejection fraction, producing heart failure symptoms (dyspnea, edema, fatigue). Hypertrophic obstructive cardiomyopathy is typically genetic and not specifically linked to childbirth. Restrictive cardiomyopathy is usually due to infiltrative or fibrotic processes and is not the classic cardiomyopathy associated with the peripartum period.

Question 50

Which term refers to the condition of blood coagulating faster than normal, causing thrombin and other clotting factors to multiply?

Accepted Answer

Answer reason: That state accelerates clot formation compared with normal physiology, aligning with the stem’s focus on coagulation factors multiplying. Venous stasis and venous wall injury are other components of Virchow’s triad but refer to slowed blood flow and endothelial damage rather than intrinsically faster coagulation. An embolus is a clot (or other material) that has traveled, which is a consequence of thrombosis rather than the underlying procoagulant condition.

Train with a large NCLEX question bank and jump into a full exam-style simulator

Cardiovascular System NCLEX Practice Test

Continue Learning