🎯 High-Yield Points for This Topic
- Heart failure: priority is respiratory assessment — crackles, dyspnoea, SpO2
- MI: MONA acronym — Morphine, Oxygen, Nitroglycerin, Aspirin; inferior MI = leads II, III, aVF
- Digoxin toxicity: check K+ before administration; hold if HR <60 or K+ <3.5
- Hypertension: ACE inhibitors are first-line; monitor for dry cough side effect
- CAD: patient education includes low-fat diet, regular exercise, smoking cessation
[Infographic: Cardiovascular NCLEX Questions Key Concepts — Clinical Manifestations, Nursing Interventions, Priority Actions]
Practice Questions
Question 1
A nurse is caring for a client with acute heart failure. Which assessment finding should the nurse report IMMEDIATELY?
✓ Correct: Oxygen saturation of 87% on room air
SpO2 of 87% indicates significant hypoxaemia and is a critical finding requiring immediate intervention in a heart failure patient. Pulmonary oedema from heart failure impairs oxygen exchange. The nurse should apply oxygen, elevate HOB to 90 degrees, and notify the provider. Weight gain is concerning but not immediately life-threatening; the SpO2 is the priority.
SpO2 of 87% indicates significant hypoxaemia and is a critical finding requiring immediate intervention in a heart failure patient. Pulmonary oedema from heart failure impairs oxygen exchange. The nurse should apply oxygen, elevate HOB to 90 degrees, and notify the provider. Weight gain is concerning but not immediately life-threatening; the SpO2 is the priority.
Question 2
A client is receiving digoxin for atrial fibrillation. Which assessment is ESSENTIAL before administering the medication?
✓ Correct: Apical heart rate and serum potassium
Before administering digoxin, the nurse must assess the apical heart rate (hold if <60 bpm) and serum potassium level (hold if <3.5 mEq/L, as hypokalaemia potentiates digoxin toxicity). These two assessments are non-negotiable safety checks for every digoxin dose.
Before administering digoxin, the nurse must assess the apical heart rate (hold if <60 bpm) and serum potassium level (hold if <3.5 mEq/L, as hypokalaemia potentiates digoxin toxicity). These two assessments are non-negotiable safety checks for every digoxin dose.
Question 3
A client with myocardial infarction reports sudden severe chest pain radiating to the left arm. Which medication should the nurse prepare to administer FIRST?
✓ Correct: Aspirin 325 mg
Aspirin is the first-line treatment for suspected MI. It inhibits platelet aggregation and reduces thrombus extension. Aspirin should be chewed (not swallowed whole) for fastest absorption. While nitroglycerin and morphine are also used in ACS, aspirin comes first unless contraindicated.
Aspirin is the first-line treatment for suspected MI. It inhibits platelet aggregation and reduces thrombus extension. Aspirin should be chewed (not swallowed whole) for fastest absorption. While nitroglycerin and morphine are also used in ACS, aspirin comes first unless contraindicated.
Question 4
A client is diagnosed with hypertension and prescribed lisinopril. Which side effect should the nurse teach the client to report?
✓ Correct: Dry persistent cough
Lisinopril is an ACE inhibitor. The classic side effect is a dry, persistent, non-productive cough caused by accumulation of bradykinin. This occurs in approximately 10-15% of patients and requires switching to an ARB (e.g., losartan). The cough is not dangerous but is bothersome and often leads to non-compliance if not addressed.
Lisinopril is an ACE inhibitor. The classic side effect is a dry, persistent, non-productive cough caused by accumulation of bradykinin. This occurs in approximately 10-15% of patients and requires switching to an ARB (e.g., losartan). The cough is not dangerous but is bothersome and often leads to non-compliance if not addressed.
Question 5
A client with peripheral arterial disease asks what to do about leg pain when walking. Which instruction is CORRECT?
✓ Correct: Stop smoking immediately
Smoking cessation is the single most important intervention for peripheral arterial disease. Nicotine causes vasoconstriction and promotes atherosclerosis, directly worsening PAD. Exercise (walking programmes) is actually beneficial for PAD. Leg elevation is used for venous insufficiency, not arterial disease. Warm soaks risk burns due to impaired sensation.
Smoking cessation is the single most important intervention for peripheral arterial disease. Nicotine causes vasoconstriction and promotes atherosclerosis, directly worsening PAD. Exercise (walking programmes) is actually beneficial for PAD. Leg elevation is used for venous insufficiency, not arterial disease. Warm soaks risk burns due to impaired sensation.
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[Clinical Concept Map: Cardiovascular NCLEX Questions — Pathophysiology, Assessment Findings, Nursing Actions]