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Free NCLEX-RN Cardiovascular Practice Questions

Cardiovascular content appears throughout the NCLEX-RN. These free questions cover heart failure, myocardial infarction, and cardiac assessment, each with a detailed rationale.

Q1

A client with left-sided heart failure is most likely to present with which finding?

AJugular venous distension
BPeripheral edema
Crackles in the lungs
DHepatomegaly

RATIONALE

Left-sided heart failure causes blood to back up into the lungs, producing pulmonary congestion — crackles, dyspnea, and orthopnea. JVD, peripheral edema, and hepatomegaly are signs of right-sided failure.

Q2

Which is the priority nursing action for a client reporting crushing substernal chest pain?

AObtain a 12-lead ECG
Administer oxygen and notify the provider
CDraw cardiac enzymes
DDocument the pain characteristics

RATIONALE

For suspected myocardial infarction, the priority is oxygenation and rapid provider notification (part of the MONA approach and time-sensitive perfusion). An ECG and enzymes follow, but immediate oxygen and escalation come first.

Q3

A client's cardiac monitor shows ventricular fibrillation. What is the nurse's first action?

AAdminister amiodarone
BBegin defibrillation
Start chest compressions and call for help
DCheck a blood pressure

RATIONALE

Ventricular fibrillation is a lethal rhythm with no effective cardiac output. Immediately begin CPR and call for help/defibrillator. Defibrillation is performed as soon as the device is available.

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