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WorksheetsCardiovascular Assessment/MEDS — NCLEX-
Total questions: 40
Worksheet time: 20mins
During a cardiovascular assessment, the nurse notes hair loss on the lower legs. This finding most likely indicates:
Normal aging changes
Increased venous return
Decreased peripheral perfusion
Excess sympathetic stimulation
Which heart sound represents closure of the mitral and tricuspid valves?
S2
S3
S4
S1
The nurse palpates a weak dorsalis pedis pulse bilaterally. What is the priority follow-up assessment?
Measure apical heart rate
Inspect for jugular venous distention
Assess skin temperature and capillary refill
Auscultate lung sounds
When assessing jugular venous distention (JVD), the nurse positions the patient in which position?
Supine
Prone
High Fowler’s (90°)
Semi-Fowler’s (30–45°)
Which assessment finding is most consistent with impaired venous return?
Bounding peripheral pulses
Cool, pale extremities
Dependent lower-extremity edema
Delayed capillary refill in fingers
The nurse hears a “lub-dub” while auscultating the heart. What physiologic event produces the “dub”?
Opening of the mitral valve
Closure of the mitral and tricuspid valves
Closure of the aortic and pulmonic valves
Ventricular filling
Which assessment finding would the nurse associate with decreased cardiac output?
Bounding pulses
Warm, flushed skin
Fatigue and activity intolerance
Elevated systolic blood pressure
Capillary refill greater than 3 seconds in an adult most strongly suggests:
Normal aging
Increased preload
Impaired peripheral tissue perfusion
Fluid volume excess
Which pulse site is best used to assess overall cardiac output during a cardiovascular assessment?
Radial
Popliteal
Posterior tibial
Carotid
When inspecting the skin during a cardiovascular assessment, which finding is most concerning for chronic hypoxia?
Pallor
Cool temperature
Clubbing of the fingers
Dry skin
The nurse assesses a patient's capillary refill and notes refill time of 5 seconds. How should this finding be interpreted?
Normal finding in older adults
Indicator of fluid volume excess
Sign of impaired tissue perfusion
Expected with elevated blood pressure
Which assessment finding is most consistent with arterial insufficiency?
Warm skin with edema
Brown discoloration of lower legs
Cool skin with diminished pulses
Bounding pulses with dependent edema
While palpating peripheral pulses, the nurse documents a pulse as 1+. What does this indicate?
Normal pulse strength
Bounding pulse
Weak, diminished pulse
Absent pulse
The nurse is assessing heart sounds and hears S2. Which event is occurring in the cardiac cycle?
Ventricular contraction
Atrial contraction
Beginning of diastole
Ventricular filling
Which peripheral pulse site is most appropriate to assess circulation to the foot?
Radial
Popliteal
Femoral
Dorsalis pedis
When inspecting the lower extremities, which finding suggests chronic venous insufficiency?
Pale, cool skin
Edema with skin discoloration
Delayed capillary refill
Absent peripheral pulses
The nurse notes irregular rhythm while palpating the radial pulse. What is the next priority action?
Document the finding
Assess blood pressure
Auscultate apical pulse for one full minute
Apply oxygen
Which assessment finding most strongly suggests right-sided heart involvement?
Crackles in lung bases
Pink, frothy sputum
Jugular venous distention
Decreased oxygen saturation
The nurse observes cyanosis of the lips during assessment. This finding is best explained by:
Excess carbon dioxide retention
Increased preload
Inadequate oxygenation of the blood
Venous blood pooling
A patient with heart failure is prescribed digoxin. Which assessment finding requires the nurse to hold the medication and notify the provider?
Blood pressure 138/82 mm Hg
Heart rate 56 beats/min
Potassium level 4.2 mEq/L
BNP level 420 pg/mL
The primary therapeutic effect of digoxin in heart failure is:
Reduction of preload through diuresis
Decreased afterload via vasodilation
Increased myocardial contractility
Suppression of ventricular dysrhythmias
Which electrolyte imbalance is the nurse most concerned about when administering hydrochlorothiazide?
Hyperkalemia
Hypernatremia
Hypokalemia
Hypercalcemia
A patient with hypertension and early renal insufficiency is prescribed lisinopril. What is the primary benefit of this medication for this patient?
Increased renal sodium excretion
Reduced intraglomerular pressure
Increased cardiac output
Prevention of platelet aggregation
Which adverse effect should the nurse specifically monitor for in a patient taking lisinopril?
Bradycardia
Dry, persistent cough
Hypokalemia
Reflex tachycardia
A patient with heart failure is prescribed metoprolol. Which assessment finding would require the nurse to question administration?
Blood pressure 148/90 mm Hg
Heart rate 54 beats/min
Mild bilateral ankle edema
History of myocardial infarction
Metoprolol improves outcomes in heart failure primarily by:
Increasing preload
Increasing myocardial oxygen demand
Decreasing sympathetic stimulation of the heart
Causing direct vasodilation
A patient receiving furosemide for acute decompensated heart failure should be monitored most closely for:
Hypernatremia
Bradycardia
Hypokalemia
Hypercalcemia
The primary reason furosemide improves symptoms in heart failure is that it:
Improves ventricular contractility
Reduces preload by decreasing circulating volume
Decreases afterload
Suppresses dysrhythmias
A patient with CAD is prescribed atorvastatin. What is the primary goal of this therapy?
Acute relief of chest pain
Reduction of blood pressure
Stabilization of atherosclerotic plaque
Prevention of coronary vasospasm
A patient experiencing chest pain takes sublingual nitroglycerin. Which outcome indicates the medication is working as intended?
Decreased platelet aggregation
Increased coronary artery occlusion
Reduced myocardial oxygen demand
Increased cardiac contractility
A patient taking digoxin reports nausea and seeing yellow halos around lights. What is the nurse’s priority action?
Administer ondansetron
Check the patient’s serum digoxin level
Encourage increased oral fluids
Document the finding as expected
Which laboratory value places a patient taking digoxin at highest risk for toxicity?
Sodium 138 mEq/L
Potassium 3.1 mEq/L
Calcium 9.2 mg/dL
Magnesium 2.0 mEq/L
A patient prescribed hydrochlorothiazide should receive teaching to:
Limit potassium-rich foods
Take the medication at bedtime
Change positions slowly
Expect weight gain
Which assessment finding indicates hydrochlorothiazide therapy is effective?
Increased heart rate
Decreased urine output
Reduced blood pressure
Elevated potassium level
A patient develops facial swelling and difficulty breathing after starting lisinopril. How should the nurse interpret this finding?
Expected adverse effect
Worsening heart failure
Angioedema
Medication nonadherence
A patient who cannot tolerate an ACE inhibitor due to cough is prescribed losartan. The nurse understands this medication works by:
Blocking calcium channels in vascular smooth muscle
Preventing angiotensin II from binding to receptors
Increasing sodium excretion in the kidneys
Reducing sympathetic stimulation
When administering metoprolol, the nurse recognizes which effect is most beneficial in patients with CAD?
Increased myocardial oxygen demand
Decreased heart rate and contractility
Coronary artery dilation
Increased preload
A patient taking furosemide for heart failure should be taught to report which finding immediately?
Increased appetite
Muscle weakness and cramps
Mild thirst
Urinary frequency
Which nursing intervention is most important when administering nitroglycerin for acute chest pain?
Monitor urine output
Place the patient supine
Check blood pressure before administration
Administer with food
A patient with CAD is prescribed atorvastatin. Which statement by the patient indicates correct understanding?
“I should take this medication when I have chest pain.”
“This medication will dissolve existing clots.”
“This medication helps reduce plaque progression.”
“I can stop this medication once my cholesterol improves.”
