Cardiovascular System Practice Test 25
Cardiovascular System NCLEX Practice Test
Cardiovascular System is a key topic within the NCLEX test plan, located under Nursing Science → Clinical Foundations → Cardiovascular System. This section explores cardiac physiology and nursing care for common cardiovascular disorders. Each test contains 50 questions designed to mirror the difficulty and variety of the real exam.
This is the 25th part of the Cardiovascular System series. To explore all practice tests under this topic, use the “Back to Main Topic” button at the end of the page.
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In the Cardiovascular System Study Cards section, shared by real NCLEX candidates, you’ll find concise summaries and high-yield insights related to the most tested concepts. It’s a perfect space to reinforce challenging topics and sharpen your recall through quick, focused repetitions. Short, powerful, and repeatable!
Cardiovascular System Practice Test 25
Which symptoms indicate left-sided heart failure?
- Crackles in lungs
- Peripheral edema
- Orthopnea
- Frothy sputum
- Jugular vein distension
Explanation: Answer reason: Left-sided heart failure primarily causes pulmonary congestion, leading to crackles, orthopnea, and possibly frothy sputum. Among the options, crackles are the most classic and directly indicative finding. Peripheral edema and jugular vein distension are more associated with right-sided heart failure.
Normal blood pressure in adults is —?
- 90/60 mm Hg
- 120/80 mm Hg
- 140/100 mm Hg
- 160/110 mm Hg
Explanation: Answer reason: This value best represents a normotensive baseline used for screening and comparison in clinical assessment. A systolic/diastolic of 90/60 mm Hg is low and may indicate hypotension depending on symptoms and perfusion. Readings like 140/100 and 160/110 mm Hg fall into hypertensive ranges and are not considered normal.
Heart attack is medically known as —?
- Myocardial infarction
- Angina pectoris
- Hypertension
- Tachycardia
Explanation: Answer reason: The medical term for this necrotic event is myocardial infarction. Angina pectoris is ischemic chest pain without myocardial cell death and is often transient or exertional. Hypertension and tachycardia are cardiovascular findings/risk factors but do not define the ischemic necrosis event itself.
Normal Systolic Blood Pressure is ...?
- 120 mmHg
- 100 mmHg
- 140 mmHg
- 80 mmHg
Explanation: Answer reason: Among the choices, 120 mmHg best matches the standard teaching value for normal systolic pressure in a healthy resting adult. A systolic of 140 mmHg is more consistent with hypertension thresholds rather than normal. Values like 100 mmHg can be low-normal in some individuals but are not the conventional “normal” reference used in exams.
Tachycardia means heart rate above —?
- 60 bpm
- 80 bpm
- 100 bpm
- 50 bpm
Explanation: Answer reason: This threshold distinguishes normal sinus rhythm range (typically 60–100 bpm at rest) from an abnormally fast rate that may reflect increased sympathetic tone, fever, hypovolemia, anemia, pain, or arrhythmias. Values like 80 bpm fall within normal resting range for many adults, while 50–60 bpm align more with bradycardia or low-normal depending on conditioning. Therefore, the cutoff “above 100 bpm” best matches the clinical definition used in exams.
“Cheyne–Stokes breathing” is seen in –?
- Heart failure
- Asthma
- Pneumonia
- Tuberculosis
Explanation: Answer reason: Cheyne–Stokes respiration is a periodic breathing pattern driven by delayed feedback in the respiratory control system, classically occurring when circulation time is prolonged. In systolic heart failure, reduced cardiac output delays delivery of blood gases to central chemoreceptors, producing cycles of hyperventilation followed by apnea. This pattern is especially associated with central sleep apnea in heart failure and can signal advanced disease severity. Asthma typically causes wheeze with prolonged expiration, while pneumonia and tuberculosis more often cause tachypnea or irregular respirations rather than true periodic crescendo–decrescendo breathing with apneic pauses.
Which blood vessel carries oxygenated blood?
- Pulmonary vein
- Pulmonary artery
- Superior vena cava
- Inferior vena cava
Explanation: Answer reason: The pulmonary veins uniquely return this oxygen-rich blood from the lungs to the left atrium for systemic distribution. In contrast, the pulmonary artery is an exception among arteries because it carries deoxygenated blood from the right ventricle to the lungs. The superior and inferior vena cava both return deoxygenated systemic venous blood to the right atrium.
The covering of the heart is —?
- Pleura
- Pericardium
- Peritoneum
- Meninges
Explanation: Answer reason: This sac is the pericardium (fibrous pericardium plus serous pericardium with a lubricating pericardial cavity). Pleura covers the lungs, peritoneum lines the abdominal cavity, and meninges surround the brain and spinal cord. Therefore the only anatomically correct covering of the heart among the choices is the pericardium.
Hypertension is defined as BP above ?
- 120/80
- 140/90
- 100/70
- 90/60
Explanation: Answer reason: This threshold corresponds to elevated long-term cardiovascular risk and is historically used for diagnosis when readings are confirmed on repeated measurements. The other options represent normal blood pressure (120/80), low-normal (100/70), or hypotension (90/60), so they do not meet the definition of hypertension. While some newer guidelines stage hypertension beginning at lower cutoffs, the single best answer among the provided choices for the traditional definition is the 140/90 threshold.
A child with hypoplastic left heart syndrome will undergo three surgical procedures. Which of the following is not indicated for this child?
- Fontan procedure
- Glenn shunt
- Norwood procedure
- Transmyocardial revascularization
Explanation: Answer reason: The classic three-stage pathway is the Norwood procedure (neonatal), followed by the bidirectional Glenn shunt (at a few months), and then the Fontan procedure (later infancy/early childhood). Transmyocardial revascularization is a procedure aimed at ischemic coronary artery disease (creating channels in myocardium to improve perfusion) and is not part of HLHS palliation. Therefore, it does not fit the disease’s pathophysiology or the established staged surgical management.
A nurse is providing teaching to a patient regarding coronary artery disease (CAD). Which of the following terms refers to the build-up of plaque on the arterial walls, which leads to narrowing of the arteries?
- Atherosclerosis
- Hyperlipidemia
- Hypertension
- Vasculitis
Explanation: Answer reason: This pathologic process is specifically termed atherosclerosis and directly describes plaque build-up on arterial walls. Hyperlipidemia is a risk factor (elevated blood lipids) that promotes plaque formation but is not the plaque itself. Hypertension increases endothelial injury and accelerates plaque development, while vasculitis refers to inflammatory vessel wall disease rather than cholesterol plaque accumulation.
Baroreceptors in the carotid artery walls and aorta respond to which of the following conditions?
- Changes in blood pressure.
- Changes in arterial oxygen tension.
- Changes in arterial carbon dioxide tension.
- Changes in heart rate.
Explanation: Answer reason: Baroreceptors are stretch receptors located primarily in the carotid sinus and aortic arch that sense changes in arterial wall stretch produced by changes in arterial pressure. Increased pressure increases stretch and baroreceptor firing to the medulla, promoting parasympathetic activity and inhibiting sympathetic outflow to lower blood pressure. Decreased pressure reduces firing, leading to sympathetic activation to raise heart rate, contractility, and peripheral vasoconstriction. Oxygen and carbon dioxide tensions are mainly detected by peripheral and central chemoreceptors, while heart rate is an effector response rather than the primary stimulus these receptors detect.
A patient who has been diagnosed with the vasospastic disorder (Raynaud’s disease) complains of cold and stiffness in the fingers. Which of the following descriptions is most likely to fit the patient?
- An adolescent male
- An elderly woman
- A young woman
- An elderly man
Explanation: Answer reason: It occurs most commonly in women, typically beginning in adolescence to early adulthood, making the demographic profile a key clue. The patient’s cold, stiff fingers are consistent with transient ischemia from vasospasm rather than fixed arterial obstruction. Older age or male sex raises suspicion for secondary Raynaud’s (e.g., connective tissue disease, occupational vibration, atherosclerotic disease) rather than the classic presentation tested here.
If medical treatments fail, which of the following invasive procedures is necessary for treating cardiomyopathy?
- Cardiac catheterization
- Coronary artery bypass graft (CABG)
- Heart transplantation
- Intra-aortic balloon pump (IABP)
Explanation: Answer reason: This procedure is the established life-prolonging option for eligible patients with advanced, irreversible systolic dysfunction when other therapies no longer maintain adequate perfusion and functional status. Diagnostic procedures like catheterization may assess hemodynamics or coronary disease but do not treat the primary pump failure. CABG targets ischemic coronary obstruction rather than primary myocardial dysfunction, and mechanical support like an IABP is typically a temporary bridge to recovery or definitive therapy rather than a long-term cure.
Which of the following cardiac conditions does a fourth heart sound (S4) indicate?
- Dilated aorta.
- Normally functioning heart.
- Decreased myocardial contractility.
- Failure of the ventricle to eject all of the blood during systole.
Explanation: Answer reason: S4 is produced during late diastole when atrial contraction forces blood into a stiff, noncompliant ventricle, a finding associated with decreased ventricular compliance from chronic pressure/volume loading states (e.g., long-standing hypertension, aortic stenosis, ischemic cardiomyopathy). A ventricle that cannot relax/fill normally commonly also has impaired overall pump performance and increased end-systolic volume, reflecting incomplete effective forward emptying. In contrast, decreased myocardial contractility is more classically linked to S3 from rapid passive filling into a dilated ventricle (systolic dysfunction). A normal, healthy adult heart does not produce an audible S4, and a dilated aorta is not the mechanism for this heart sound.
Which of the following ECG findings is a morphologic characteristic of a third-degree atrioventricular (AV) block?
- P waves are present but have no consistent relationship with QRS complexes.
- PR intervals progressively lengthen until a QRS is dropped.
- P waves are absent and replaced by fibrillatory waves.
- Wide QRS complexes occur prematurely with a compensatory pause.
Explanation: Answer reason: Third-degree (complete) AV block is defined by AV dissociation, where atrial depolarizations continue independently of ventricular depolarizations due to complete conduction failure through the AV node/His-Purkinje system. This produces regular P waves and a separate, slower escape rhythm generating QRS complexes, so there is no fixed PR interval or consistent P-to-QRS relationship. By contrast, progressively lengthening PR with a dropped QRS describes Mobitz I (Wenckebach), absent P waves with fibrillatory waves indicates atrial fibrillation, and premature wide QRS with a compensatory pause reflects premature ventricular complexes. The key morphological hallmark is the independent atrial and ventricular rhythms rather than a predictable conduction pattern.
Nurse Jobs is conducting a thorough assessment of Kobe, a child diagnosed with coarctation of the aorta. She knows the specific clinical features associated with this condition and is vigilant in her examination. Which of the following findings would Nurse Jobs anticipate when assessing Kobe?
- Preference for a squatting posture.
- Episodes of cyanosis ("tet" spells).
- Weak or absent femoral pulses.
- Intense cyanosis immediately after birth.
Explanation: Answer reason: Coarctation of the aorta causes a fixed narrowing of the aorta, creating higher pressures proximal to the obstruction and reduced perfusion distal to it. This leads to diminished lower-extremity blood flow, so femoral pulses are classically weak/delayed compared with upper-extremity pulses (and leg blood pressure is lower). Squatting and "tet" spells are hallmark findings of Tetralogy of Fallot, not coarctation. Profound cyanosis immediately after birth is more typical of ductal-dependent cyanotic lesions (e.g., transposition of the great arteries) rather than isolated aortic coarctation.
Which statement best describes the difference between the pain of angina and the pain of myocardial infarction?
- Pain associated with myocardial infarction is referred to the left arm
- Pain associated with angina is confined to the chest area
- Pain associated with myocardial infarction can last for 5-7 minutes
- Pain associated with angina is relieved by nitroglycerin
Explanation: Answer reason: Nitroglycerin venodilates and decreases preload (and may dilate coronary vessels), which commonly resolves anginal chest discomfort within minutes. In contrast, myocardial infarction pain is usually more severe, lasts longer (>20 minutes), and is often not fully relieved by rest or nitrates because there is ongoing myocardial necrosis. Options about referral pattern or confinement to the chest are unreliable differentiators because both angina and MI can radiate to the arm, jaw, neck, or back. The short 5–7 minute duration is more consistent with angina than infarction, making that distractor incorrect.
A strategy for preventing thromboembolism in patients at risk who cannot take an anticoagulants is?
- Administration of two aspirin tablets every 4 hours.
- Infusion of thrombolytics.
- Insertion of a vena cava filter.
- Subcutaneous heparin administration every 12 hours.
Explanation: Answer reason: When anticoagulation is contraindicated, mechanical prevention of pulmonary embolism becomes the preferred approach. An inferior vena cava filter is designed to trap emboli from lower-extremity venous thrombi before they reach the pulmonary circulation. Thrombolytics treat existing clots and carry high bleeding risk, so they are not used for routine prophylaxis. Heparin is an anticoagulant and therefore conflicts with the stated inability to take anticoagulants, and aspirin alone is inadequate for venous thromboembolism prophylaxis in high-risk patients.
Which of the following signs and symptoms usually signifies rapid expansion and impending rupture of an abdominal aortic aneurysm?
- Abdominal pain
- Absent pedal pulses
- Chest pain
- Lower back pain
Explanation: Answer reason: Rapid expansion or impending rupture of an abdominal aortic aneurysm classically causes sudden, severe pain that may radiate to the back or flank due to retroperitoneal irritation and pressure on adjacent structures. This presentation is a warning sign because it often precedes hypotension and shock if rupture occurs. Lower back pain is therefore more specific for expansion/impending rupture than chronic findings related to reduced distal perfusion. Absent pedal pulses can occur with peripheral arterial disease or thromboembolism but does not usually indicate acute aneurysm expansion, and chest pain is not a typical symptom of an abdominal aneurysm.
The nurse is caring for a patient with a diagnosis of pulmonary embolism. The nurse understands that the most common cause of a pulmonary embolus is?
- Amniotic fluid embolus.
- Deep vein thrombosis from lower extremities.
- Fat embolus from a long bone fracture.
- Vegetation that dislodges from an infected central venous catheter.
Explanation: Answer reason: Most pulmonary emboli originate from thrombi that form in the deep veins of the legs or pelvis and then embolize to the pulmonary arterial circulation. This mechanism is by far the most prevalent cause in typical adult patients, especially in the setting of immobility, surgery, malignancy, or hypercoagulable states. Fat embolism and amniotic fluid embolism are important but comparatively uncommon and occur in specific contexts (long-bone trauma; peripartum). Septic emboli from infected intravascular devices can occur but are not the usual overall source of pulmonary embolism.
Which assessment data would indicate to the nurse that the client would be at risk for a hemorrhagic stroke?
- A blood glucose level of 480 mg/dl.
- A right-sided carotid bruit.
- A blood pressure of 220/120 mmHg.
- The presence of bronchogenic carcinoma.
Explanation: Answer reason: Hemorrhagic stroke risk rises sharply with severe uncontrolled hypertension because high intravascular pressure can rupture small intracerebral arteries and cause bleeding. A reading in the hypertensive crisis range (≥180 systolic and/or ≥120 diastolic) indicates markedly increased risk for intracranial hemorrhage and other acute end-organ damage. A carotid bruit more directly suggests atherosclerotic stenosis and embolic/ischemic stroke risk rather than hemorrhage. Hyperglycemia is associated with worse neurologic outcomes but is not a primary direct precipitant of vessel rupture, and bronchogenic carcinoma is not a typical direct risk factor for hemorrhagic stroke in basic risk assessment.
The nurse caring for a newborn diagnosed with a heart defect knows that which of the following is the most common cyanotic lesion?
- Tricuspid atresia
- Hypoplastic left heart
- Tetralogy of fallot
- Truncus arteriosus
Explanation: Answer reason: The classic and most common cyanotic congenital heart defect is this tetrad (VSD, RV outflow obstruction, overriding aorta, RV hypertrophy), which produces early cyanosis and potential “tet spells.” The other listed lesions are also cyanotic but are less common overall compared with this diagnosis in standard epidemiology and exam framing. A frequent distractor is to confuse this with common acyanotic defects (e.g., VSD/ASD/PDA), but those are not among the options here.
Which chamber forms the apex of the heart?
- Left atrium
- Right atrium
- Left ventricle
- Left atrium
Explanation: Answer reason: The left ventricle generates systemic arterial pressure, so it has the greatest muscle bulk and extends to create the apical impulse (PMI) typically palpated at the left 5th intercostal space along the midclavicular line. Atria primarily form the base/posterior aspect of the heart rather than the pointed tip. This anatomic relationship is clinically relevant when correlating PMI displacement with left ventricular enlargement.
Blood Pressure Highest in?
- Arteries
- Veins
- Capillaries
- Aorta
Explanation: Answer reason: The aorta receives blood directly from the left ventricle, so it has the highest systolic and pulse pressures in the systemic circulation. As blood flows away from the heart through progressively smaller arteries/arterioles, mean pressure falls due to resistance and compliance effects. Capillaries have much lower pressure to permit exchange without fluid flooding, and veins have the lowest pressures as they return blood to the heart.
Which part of the heart is usually damaged due to scarlet fever?
- Pericardium
- Endocardium
- Epicardium
- Myocardium
Explanation: Answer reason: The clinically most important and classically emphasized lesion is valvulitis with verrucae along the lines of closure, which involves the valve leaflets and thus the inner lining of the heart. This places the primary damage at the endocardial surface, especially the mitral (and sometimes aortic) valve, leading to chronic regurgitation/stenosis. Pericardial involvement can occur but is typically less responsible for long-term morbidity than endocardial/valvular injury.
When teaching about causes of deep vein thrombosis, the nurse would include?
- Arterial stasis, hypercoagulability, and arterial wall injury
- Myocardial infarction, stroke, and prolonged sitting
- Venous stasis, hypercoagulability, and venous wall injury
- Motor vehicle accident and prolonged bed rest
Explanation: Answer reason: This option states all three core mechanisms directly and in the correct vascular context (venous, not arterial). The arterial-stasis option is incorrect because DVT is primarily a venous process rather than an arterial thrombosis framework. The remaining choices list risk factors or clinical events but do not capture the full underlying pathophysiologic triad that defines the causes.
Normal blood pressure?
- 80/120
- 120/80
- 100/60
- 140/90
Explanation: Answer reason: This value is used as a standard reference point for assessing hypertension and hypotension in basic cardiovascular physiology. A reading like 140/90 meets common thresholds for hypertension rather than normal. Values such as 100/60 may be normal for some individuals but are not the conventional “normal BP” cited in exam settings.
The nurse is educating a patient with myocarditis. The nurse explains to the patient that myocarditis affects the?
- Inner layer of the heart
- Outermost layer of the heart
- Heart muscle
- Heart valves
Explanation: Answer reason: When inflamed, myocardial fibers can weaken and irritate the electrical conduction system, leading to reduced cardiac output and dysrhythmias. The inner layer (endocardium) involvement would be termed endocarditis, and the outermost layer (pericardium) involvement is pericarditis. Valve involvement is characteristic of valvular disease or infective endocarditis rather than myocarditis.
Pulse is feel in?
- Arteries
- Veins
- Vessels
- Both A & B
Explanation: Answer reason: Arteries have higher pressure and elastic recoil, which transmits this wave to the periphery where it can be felt over superficial arteries (e.g., radial). Veins are low-pressure capacitance vessels and do not normally transmit a palpable pulsation except in special situations (e.g., jugular venous pulsation is observed, not palpated). Therefore, the vessel type where pulse is felt is arterial, not venous.
What does the heart pump?
- Proteins
- Hormones
- Blood
- Nutrients
Explanation: Answer reason: Its primary output is blood, which carries oxygen, carbon dioxide, nutrients, hormones, and waste products between organs. Proteins, hormones, and nutrients are transported within the blood, but they are not pumped as separate circulating systems. Therefore the best single answer is the substance the heart directly propels through the arteries and veins.
Average weight of human heart?
- 100 g
- 200–300 g
- 500 g
- 700 g
Explanation: Answer reason: This makes the 200–300 g range the best single estimate for an “average” heart. Values like 100 g are too low for a normal adult heart, while 500 g and 700 g would suggest marked cardiomegaly from pathology such as long-standing hypertension or valvular disease. Therefore the only option consistent with standard anatomic norms is the 200–300 g range.
A 33-year-old female has just given birth. The doctor orders Hydralazine due to this client’s diagnosis of cardiomyopathy. The nurse is aware that the most common form of pregnancy-related cardiomyopathy is which of the following?
- Restrictive
- Arrhythmogenic
- Dilated
- Hypertrophic
Explanation: Answer reason: Pregnancy-associated hemodynamic stress and myocardial injury lead to ventricular dilation and reduced ejection fraction, which drives symptoms of heart failure postpartum. This makes a dilated pattern the expected “most common” form in pregnancy-related cardiomyopathy questions. Hypertrophic and restrictive patterns are typically linked to genetic/infiltrative causes rather than the classic peripartum presentation.
A nurse is caring for a patient with a diagnosed bundle branch block. Which specific electrocardiogram (EKG) lead location will determine whether the patient has a right- or left-bundle branch block?
- V1
- V2
- V4
- V6
Explanation: Answer reason: In right bundle branch block, V1 typically shows an rSR′/“rabbit ears” pattern due to delayed right ventricular activation, whereas in left bundle branch block V1 tends to show a predominantly negative QRS (deep, broad S/QS). This makes V1 the key lead for deciding right vs left BBB on a standard 12-lead ECG. Lateral leads like V6 are supportive (e.g., broad terminal S in RBBB or broad notched R in LBBB) but V1 is most direct for the initial distinction.
Which one provides hemodynamic stability & prolongs survival in CHF?
- Lisinopril
- Furosemide
- Digoxin
- Milrinone
Explanation: Answer reason: This leads to improved hemodynamic status over time and a proven reduction in mortality. Loop diuretics primarily relieve congestion and symptoms but do not meaningfully prolong survival. Digoxin can reduce symptoms and hospitalizations, and milrinone is an IV inotrope used short-term in decompensation and may increase arrhythmia risk without survival benefit in chronic use.
Which of the following is a symptom of a heart attack?
- Chest pain
- Runny nose
- Sore throat
- Diarrhea
Explanation: Answer reason: This symptom reflects inadequate coronary perfusion leading to pain signaling from the heart and surrounding structures. The other options are more consistent with upper respiratory infection (runny nose, sore throat) or gastrointestinal infection/irritation (diarrhea) rather than acute coronary syndrome. While atypical presentations exist (especially in women, older adults, and people with diabetes), chest pain remains the classic and most test-relevant symptom.
A patient is admitted with uncontrolled atrial fibrillation. The patient’s medication history includes vitamin D supplements and calcium. What type of stroke is this patient at MOST risk for?
- Ischemic thrombosis
- Ischemic embolism
- Hemorrhagic
- Ischemic stenosis
Explanation: Answer reason: These atrial clots can dislodge and travel to cerebral arteries, producing an embolic ischemic stroke pattern. This mechanism is distinct from in-situ thrombotic stroke, which more commonly arises from local atherosclerotic plaque rupture and platelet aggregation within cerebral vessels. The vitamin D and calcium history does not override the dominant, high-yield AF-related risk of cardioembolic stroke.
Which blood vessel supplies blood to the brain?
- Coronary artery
- Carotid artery
- Pulmonary artery
- Aorta
Explanation: Answer reason: The internal carotid arteries are major direct suppliers of oxygenated blood to the anterior brain and contribute to the Circle of Willis. In contrast, coronary arteries supply the myocardium, and the pulmonary artery carries deoxygenated blood from the right ventricle to the lungs. The aorta is the main outflow trunk but is not the specific named vessel that directly supplies the brain in the way asked by the item.
While assessing a patient with an abdominal aortic aneurysm (AAA), the nurse should auscultate for bruits. Which location is the most common site for AAA formation?
- Proximal to the renal arteries
- Slightly distal to the aortic arch
- Slightly distal to the iliac arteries
- Slightly distal to the renal arteries
Explanation: Answer reason: This region is just below the renal arteries and above the aortic bifurcation, making it the classic location to assess/monitor for aneurysmal dilation and turbulent flow. A thoracic location near the aortic arch would describe a thoracic aortic aneurysm rather than an abdominal one. A location distal to the iliac arteries is beyond the typical abdominal aortic segment and is not the most common site for AAA formation.
Which type of blood vessel has the thinnest walls?
- Arteries
- Veins
- Capillaries
- Arterioles
Explanation: Answer reason: Their walls consist of a single layer of endothelial cells with a thin basement membrane, making them the thinnest vessels. In contrast, arteries and arterioles need thicker smooth muscle layers to withstand and regulate higher-pressure flow. Veins operate at lower pressure than arteries but still have more than a one-cell-thick wall and structural layers to support venous return and valves.
Classic symptom of heart failure?
- Weight loss
- Orthopnea
- Dry skin
- Constipation
Explanation: Answer reason: This leads to shortness of breath in the supine position that improves with sitting up or using pillows, making it a classic, high-yield symptom. The other options are nonspecific and do not reflect the typical cardiopulmonary congestion pattern of heart failure. Clinically, orthopnea often accompanies paroxysmal nocturnal dyspnea, crackles, and peripheral edema due to volume overload.
A patient is admitted to the hospital with complaints of a severe headache and tinnitus. The patient's blood pressure is 202/118 mm Hg. The patient is diagnosed with malignant hypertension, which is most commonly caused by?
- Hyperthyroidism
- Illicit drug use
- Pheochromocytoma
- Untreated hypertension
Explanation: Answer reason: In most patients, there is no single secondary endocrine cause; instead, chronic vascular remodeling and renal microvascular injury lead to abrupt worsening with end-organ symptoms (e.g., headache). Secondary causes like pheochromocytoma can produce very high pressures but are comparatively rare and not the most common etiology. Illicit sympathomimetic drugs can trigger hypertensive crises, yet they account for a smaller proportion than uncontrolled essential hypertension overall.
A patient is admitted to the hospital for an acute exacerbation of heart failure. The nurse questions the patient about his medical and social history. Which of the following would not contribute to this patient's exacerbation?
- Anemia
- Hyperthyroidism
- Irritable bowel syndrome
- Nonsteroidal anti-inflammatory drug (NSAID) use
Explanation: Answer reason: Anemia can precipitate high-output demand and worsen dyspnea and fatigue in heart failure. Hyperthyroidism raises heart rate and metabolic demand and can provoke tachyarrhythmias, increasing myocardial workload and decompensation risk. NSAID use promotes renal sodium and water retention and can blunt diuretic effect, leading to volume overload; IBS does not typically cause volume overload or increased cardiac workload in a way that precipitates acute heart failure exacerbation.
Right-sided heart failure causes?
- Pulmonary edema
- Dyspnea
- Pedal edema
- Hemoptysis
Explanation: Answer reason: This increases venous hydrostatic pressure in the peripheral circulation, driving fluid into interstitial tissues and producing dependent (lower-extremity) swelling. In contrast, pulmonary edema and prominent dyspnea are more characteristic of left-sided failure due to pulmonary venous congestion. Hemoptysis is not a typical primary manifestation of uncomplicated heart failure and suggests an alternative pulmonary process.
What is the term for inflammation of the sac surrounding the heart?
- Pancarditis
- Pericarditis
- Myocarditis
- Cholesterol
Explanation: Answer reason: The key is matching the anatomic structure in the stem—“sac surrounding the heart”—to the pericardium. Myocarditis refers to inflammation of the myocardium (heart muscle), and pancarditis involves inflammation of multiple heart layers. Cholesterol is a lipid, not an inflammatory condition.
For a patient who is in the late stages of chronic bronchitis, which of the following would indicate the patient has developed cor pulmonale?
- Hepatomegaly
- Night sweats
- Hypocapnia
- Venous stasis ulcers
Explanation: Answer reason: Right ventricular failure causes systemic venous congestion, leading to an enlarged, congested liver and possible ascites and peripheral edema. Hepatomegaly therefore signals chronic right-sided volume/pressure overload rather than a primary pulmonary symptom. Hypocapnia is not typical of late chronic bronchitis (hypercapnia is more expected), and night sweats are nonspecific and more suggestive of infection or malignancy. Venous stasis ulcers can occur with chronic venous insufficiency but are not a hallmark indicator of cor pulmonale compared with signs of systemic congestion.
The nurse auscultates the abdomen of a client with suspected abdominal aortic aneurysm (AAA). Which location is the most common site to auscultate bruits due to AAA?
- Distal to the iliac arteries
- Proximal to the renal arteries
- Slightly distal to the renal arteries
- Slightly proximal to the aortic arch
Explanation: Answer reason: Turbulent flow across an aneurysmal dilation can generate an abdominal bruit that is best heard over the periumbilical area corresponding to the infrarenal segment. Suprarenal aneurysms are less common, making an area proximal to the renal arteries a less likely site for an audible bruit. Iliac involvement may occur but is not the most typical primary location compared with the infrarenal aorta.
You are teaching a health education class on prevention of heart disease. You are discussing cholesterol. In terms of cholesterol levels, which of the following patients has the highest risk for heart disease based on cholesterol levels?
- Total cholesterol 310, LDL 185, HDL 35
- Total cholesterol 265, LDL 130, HDL 55
- Total cholesterol 235, LDL 159, HDL 60
- Total cholesterol 175, LDL 110, HDL 65
Explanation: Answer reason: This profile combines a very high total cholesterol (>240) with a very high LDL (near the ≥190 mg/dL “severe hypercholesterolemia” threshold), both strongly associated with plaque formation. The HDL is low (<40), removing a protective factor for reverse cholesterol transport, further increasing risk. Other choices have lower LDL and/or higher HDL, making their overall risk from cholesterol levels less concerning by comparison.
Which muscles are found in Tunica Media?
- Cardiac muscle
- Smooth muscle
- Skeleton muscle
- Non of abouve
Explanation: Answer reason: This function is mediated by concentric layers of involuntary muscle cells, which are smooth muscle. Cardiac muscle is confined to the myocardium of the heart, and skeletal muscle is attached to bones for voluntary movement, so neither belongs in vessel tunica media. Therefore the option naming smooth muscle best matches the histologic structure and function of the tunica media.
What is the normal range for blood pressure in adults?
- 90/60 mmHg to 120/80 mmHg
- 120/80 mmHg to 140/90 mmHg
- 140/90 mmHg to 160/100 mmHg
- 160/100 mmHg to 180/110 mmHg
Explanation: Answer reason: This range reflects typical physiologic arterial pressure needed for adequate organ perfusion without meeting hypertension criteria. The higher ranges listed align with elevated blood pressure or hypertension thresholds rather than normal. Therefore the option spanning 90/60 through 120/80 best represents normal adult BP.
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