Cardiovascular System Practice Test 4
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 4th 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 4
The layer of pericardium which covers the surface of the heart is called?
- Visceral layer of serous pericardium
- Fibrous layer of Pericardium
- Parietal layer of serous Pericardium
- Visceral layer of pleura
Explanation: Answer reason: The heart’s surface is covered by the visceral layer of the serous pericardium (epicardium). The parietal layer lines the fibrous pericardium, and the fibrous pericardium is the tough outer sac; pleura pertains to lungs.
Apex of the heart is is formed by left ventricle & present at?
- 3 rdintercostals space
- 4 thinintercostals space
- 5 thinintercostals space
- 6 thinintercostals space
- 7 thinintercostals space
Explanation: Answer reason: The heart’s apex is formed by the left ventricle and is located in the left 5th intercostal space at the midclavicular line.
Which of the following factors that increase your risk of developing peripheral artery disease include ________?
- High blood pressure
- Smoking & Diabetes
- Increasing age
- All of these
Explanation: Answer reason: Hypertension, smoking, diabetes, and increasing age are all established risk factors for peripheral artery disease; therefore the correct choice is all of these.
A difference of greater than 10 to 15 mm Hg between the blood pressure in both arms can be due to?
- Orthostatic hypotension
- Anaphylactic shock
- Peripheral vasodilation
- Atherosclerotic obstruction
Explanation: Answer reason: A significant inter-arm BP difference suggests unilateral arterial disease such as subclavian artery stenosis from atherosclerosis. The other options cause generalized hypotension or vasodilation without side-to-side discrepancy.
Blood flows from the right ventricle of the heart into which of the following structures?
- Inferior vena cava
- Left ventricle
- Pulmonary arteries
- Pulmonary veins
- Right atrium
Explanation: Answer reason: The right ventricle pumps deoxygenated blood through the pulmonary valve into the pulmonary trunk and pulmonary arteries en route to the lungs.
Oxygenated blood is carried to the heart by which of the following structures?
- Aorta
- Carotid arteries
- Inferior vena cava
- Pulmonary veins
- Superior vena cava
Explanation: Answer reason: Pulmonary veins return oxygenated blood from the lungs to the left atrium of the heart; the aorta and carotids carry blood away from the heart, and the venae cavae return deoxygenated blood.
Which disease is known as the 'Silent Killer'?
- Cancer
- Hypertension
- Diabetes
- Typhoid
Explanation: Answer reason: Hypertension is often asymptomatic while causing progressive end-organ damage, hence termed the 'silent killer.
Which part of the heart regulates the heartbeat?
- Purkinje fibers
- Bundle of His
- Sinoatrial node
- Atrioventricular node
Explanation: Answer reason: The sinoatrial (SA) node is the heart’s natural pacemaker; it initiates and regulates the heart rate by generating impulses that spread through the atria.
Most common pathologic finding in individuals at risk for sudden cardiac death?
- Aortic valve disease
- Mitral valve disease
- Left ventricular dysfunction
- Atherosclerotic heart disease
Explanation: Answer reason: Most sudden cardiac deaths result from ventricular arrhythmias precipitated by myocardial ischemia; the most common underlying pathology on exam is coronary atherosclerosis (atherosclerotic heart disease).
Which heart muscle disease is unrelated to other cardiovascular diseases?
- Cardiomyopathy
- Coronary artery disease
- Myocardial infarction
- Pericardial effusion
Explanation: Answer reason: Cardiomyopathy is a primary disease of the myocardium and can occur independent of other cardiovascular diseases, unlike coronary artery disease, myocardial infarction, or pericardial effusion which involve vessels or pericardium.
Refers to the pressure when the ventricles are at rest?
- Diastole
- Systole
- Preload
- Pulse pressure
Explanation: Answer reason: Diastole is the phase when the ventricles relax and fill; diastolic pressure is the arterial pressure during this resting phase. Systole is contraction, preload is ventricular stretch at end-diastole, and pulse pressure is the difference between systolic and diastolic pressures.
Which of the following is TRUE about the blood pressure determinants?
- Hypervolemia lowers BP
- Hypervolemia increases GFR
- HCT of 70% might decrease or increase BP
- Epinephrine decreases BP
Explanation: Answer reason: Increased blood volume raises renal perfusion pressure, which typically increases renal blood flow and glomerular filtration rate. Hypervolemia does not lower BP; epinephrine generally raises BP; very high hematocrit usually increases viscosity and SVR.
What does the P wave indicate on an ECG?
- Atrial depolarization
- Ventricular depolarization
- Ventricular repolarization
- Atrial repolarization
Explanation: Answer reason: On ECG, the P wave represents atrial depolarization; QRS represents ventricular depolarization and the T wave ventricular repolarization, while atrial repolarization is buried in the QRS.
Jugular vein distention is most commonly seen in which condition?
- Cardiac tamponade
- Aortic dissection
- Myocardial infarction
- Myocardial infraction
Explanation: Answer reason: Jugular venous distention is part of Beck’s triad (JVD, hypotension, muffled heart sounds) for cardiac tamponade due to impaired venous return. It is not most commonly associated with aortic dissection or myocardial infarction.
How many chambers are there in the human heart?
- Four
- One
- Three
- Two
Explanation: Answer reason: The human heart has four chambers: two atria and two ventricles.
Which artery is an exception to the rule that all arteries carry oxygenated blood?
- Pulmonary artery
- Hepatic artery
- Renal artery
- Cardiac artery
Explanation: Answer reason: The pulmonary artery uniquely carries deoxygenated blood from the right ventricle to the lungs, whereas systemic arteries like hepatic, renal, and coronary carry oxygenated blood.
What is the normal pulse rate of a healthy adult?
- 40-60 beats/min
- 60-100 beats/min
- 190-120 beats/min
- 120-140 beats/min
Explanation: Answer reason: Normal resting adult heart rate is 60–100 beats per minute; other ranges are outside the typical normal range.
Where are vascular smooth muscles located in the human body?
- Intestine
- Blood vessels
- Gastric muscle
Explanation: Answer reason: Vascular refers to blood vessels; vascular smooth muscle is found in vessel walls, especially arteries and arterioles.
Which blood vessel has the highest blood pressure?
- Capillary
- Vein
- Artery
- Venule
Explanation: Answer reason: Arteries are closest to the heart’s pumping action and therefore carry blood under the highest pressure; pressure falls across arterioles and capillaries and is lowest in veins/venules.
How many chambers are there in the human heart?
- Two
- Three
- Four
- Five
Explanation: Answer reason: The human heart has four chambers: right atrium, right ventricle, left atrium, and left ventricle.
Blood is carried towards the heart by which type of blood vessel?
- Arteries
- Capillaries
- Veins
- None
Explanation: Answer reason: Veins return blood to the heart, whereas arteries carry blood away and capillaries are sites of exchange.
How many chambers are present in the human heart?
- 0 chambers
- 2 chambers
- 3 chambers
- 4 chambers
Explanation: Answer reason: The human heart has four chambers: right and left atria and right and left ventricles.
What is the connection between an artery and a vein called?
- Capillaries
- Arterioles
- Venules
- Lymph
Explanation: Answer reason: Capillaries form the microvascular network that links arterioles to venules, providing the connection between arteries and veins.
Which valve prevents backflow from the pulmonary artery to the right ventricle?
- Aortic valve
- Pulmonary valve
- Tricuspid valve
- Mitral valve
Explanation: Answer reason: The pulmonary semilunar valve sits between the right ventricle and the pulmonary artery and prevents regurgitation into the right ventricle during diastole.
Which blood vessel connects an artery and a vein?
- Venules
- Arteriole
- Capillary
- Sinus
Explanation: Answer reason: Capillaries form the microcirculation linking arterioles to venules, allowing exchange between blood and tissues.
Which organ is responsible for pumping blood throughout the body?
- Liver
- Lungs
- Heart
- Kidney
Explanation: Answer reason: The heart is the muscular pump that propels blood through the systemic and pulmonary circuits; liver, lungs, and kidneys have other functions.
Which structure prevents the mixing of oxygenated and deoxygenated blood in the heart?
- Tricuspid valve
- Mitral valve
- Interventricular septum
- Pulmonary valve
Explanation: Answer reason: The interventricular septum physically separates the right and left ventricles, keeping deoxygenated and oxygenated blood from mixing. Valves regulate one-way flow but do not separate the two circulations.
Which heart chamber pumps blood to the lungs?
- Right atrium
- Left atrium
- Right ventricle
- Left ventricle
Explanation: Answer reason: The right ventricle pumps deoxygenated blood through the pulmonary artery to the lungs for oxygenation.
The rule of halves is seen in which condition?
- CHD
- Blindness
- Burns
- Hypertension
Explanation: Answer reason: The epidemiologic 'rule of halves' describes that only about half of people with hypertension are diagnosed, half of those are treated, and half of those achieve control.
Blood pressure is measured in units of which of the following?
- °F
- N/m^2
- Beats per minute
- MmHg
Explanation: Answer reason: Clinically, blood pressure is expressed in millimeters of mercury (mmHg); the other options are units for temperature, SI pressure (pascal), or heart rate.
Which cholesterol is referred to as good cholesterol?
- HDL
- LDL
- ULDL
- NONE
Explanation: Answer reason: High-density lipoprotein (HDL) is considered good cholesterol because it participates in reverse cholesterol transport, carrying cholesterol from tissues to the liver for excretion and lowering atherosclerotic risk.
What is known as the silent killer disease?
- TB
- BP
- HIV
- Diarrhea
Explanation: Answer reason: Hypertension (high blood pressure) is termed the silent killer because it is often asymptomatic while causing progressive end-organ damage and increasing risk of stroke, MI, and renal disease.
What is the normal range for an adult's heart rate in beats per minute (bpm)?
- 30-60 bpm
- 60-100 bpm
- 20-150 bpm
- 90-140 bpm
Explanation: Answer reason: Normal resting adult heart rate is 60–100 bpm; the other ranges are either too low or too high.
Which chamber of the human heart is the thickest?
- Left atrium
- Right atrium
- Left ventricle
- Right ventricle
Explanation: Answer reason: The left ventricle has the thickest myocardium because it must generate the highest pressure to pump blood through the systemic circulation.
Which of the following is an abnormal heart rhythm?
- 1st degree AV block
- 2nd degree AV block
- Bundle branch block
- 3rd degree AV block
Explanation: Answer reason: Third-degree AV block (complete heart block) creates AV dissociation with an escape rhythm—an abnormal cardiac rhythm. First-degree AV block and bundle branch block are conduction delays, and second-degree AV block is primarily a conduction abnormality with a sinus atrial rhythm; only complete heart block produces a distinct abnormal rhythm.
What is the membranous covering of the heart called?
- Meninges
- Peritoneum
- Perisoteum
- Pericardium
Explanation: Answer reason: The pericardium is the fibrous serous sac that surrounds and protects the heart. Meninges cover the brain and spinal cord, peritoneum lines the abdominal cavity, and periosteum covers bone.
Which of the following is an abnormal heart rhythm?
- Atrial flutter
- Atrial fibrillation
- Normal sinus rhythm
- Ventricular tachycardia
Explanation: Answer reason: Ventricular tachycardia is a dangerous ventricular arrhythmia and thus clearly abnormal, whereas normal sinus rhythm is normal.
What is the term for a resting heart rate fewer than 60 beats per minute?
- Bradycardia
- Tachycardia
- Fibrillation
- Flutter
Explanation: Answer reason: Bradycardia is defined as a heart rate less than 60 bpm; tachycardia is fast rate, while fibrillation and flutter are rhythm abnormalities.
Which of the following is a common cause of junctional rhythm?
- Hyperkalemia
- Hypocalcemia
- Myocardial infarction
- Aortic stenosis
Explanation: Answer reason: Elevated potassium suppresses SA-node/atrial activity, allowing the AV junction to assume pacemaker control, producing a junctional rhythm. Hypocalcemia mainly prolongs QT; aortic stenosis is structural; MI can be associated but is less classically cited than hyperkalemia in electrolyte-related causes.
What are the sounds produced by the heart during the cardiac cycle?
- Tick-tock
- Lub-dub
- Pop-snap
- Beep-boop
Explanation: Answer reason: Normal heart sounds S1 and S2 are heard as "lub-dub," from closure of the AV valves (S1) and semilunar valves (S2).
Which of the following is a common sign of left-sided heart failure in infants?
- Ascites
- Hepatosplenomegaly
- Grunting
- Weight gain
Explanation: Answer reason: Left-sided heart failure causes pulmonary congestion and respiratory distress in infants, leading to signs such as tachypnea and grunting. Ascites, hepatosplenomegaly, and weight gain are more typical of right-sided failure.
What is the covering of the heart called?
- Renal capsule
- Pleura
- Pericardium
- Glisson's capsule
Explanation: Answer reason: The pericardium is the double-walled sac that encloses the heart. Renal capsule surrounds the kidney, pleura surrounds the lungs, and Glisson's capsule encloses the liver.
In a patient with third-degree AV block, which heart sound may be prominent due to the dissociation of atrial and ventricular activity?
- S1
- S2
- S3
- S4
Explanation: Answer reason: Complete AV block causes atrioventricular dissociation; a forceful atrial contraction (atrial kick) against a noncompliant ventricle can produce a prominent late-diastolic S4.
A client is diagnosed with emphysema and cor pulmonale. Which findings are characteristic of cor pulmonale?
- Hypoxia, shortness of breath, and exertional fatigue
- Weight loss, increased RBC, and fever
- Rales, edema, and enlarged spleen
- Edema of the lower extremities and distended neck veins
Explanation: Answer reason: Cor pulmonale causes right-sided heart failure with systemic venous congestion; classic signs are peripheral edema and jugular venous distention. Other options reflect pulmonary symptoms, polycythemia/fever, or left-sided failure findings.
Which organ continuously works 24 hours a day?
- Heart
- Nose
- Brain
- Eye
Explanation: Answer reason: The heart maintains continuous rhythmic contractions to circulate blood without rest, unlike organs such as the eyes which rest during sleep.
Which structure is called the pacemaker of the heart?
- SA node
- AV node
- Purkinje fiber
- Bundle of His
Explanation: Answer reason: The sinoatrial (SA) node has the highest intrinsic firing rate and initiates the cardiac impulse, setting the heart’s rhythm; thus it is the natural pacemaker.
What are the smallest veins in the human body known as?
- Venules
- Bronchioles
- Capillaries
- Villi
Explanation: Answer reason: Venules are the smallest veins that collect blood from capillary beds and merge into larger veins. Capillaries are smallest vessels but are not veins.
What is the largest artery in the human body?
- Pulmonary artery
- Aorta
- Femoral artery
- Coronary artery
Explanation: Answer reason: The aorta is the largest artery by diameter and length, carrying oxygenated blood from the left ventricle to systemic circulation.
What is the normal sound of the heart?
- LUB LUB
- LUB DUB
- DUB DUB
- RUB RUB
Explanation: Answer reason: Normal heart sounds are S1 and S2, described as "lub" (AV valve closure) followed by "dub" (semilunar valve closure).
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