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NCLEX Practice Questions: Understanding High Yield Cardiovascular Causes and Symptoms

Get started here with cardiovascular questions, answers and rationals. Plus, check out this nursing review on cardiac rhythms and rhythm strips.

Normal sinus rhythm

Normal sinus rhythm (NSR) is a term used to describe a regular heartbeat that originates from the sinoatrial (SA) node, the heart’s natural pacemaker, and follows the normal conduction pathway through the heart. In NSR, the heart rate is between 60 and 100 beats per minute (bpm) at rest, and the rhythm is regular and coordinated.

Try NCLEX high yield cardiovascular questions, answers with rationales (below)

Normal Sinus Rhythm EKG

On an electrocardiogram (ECG), NSR is characterized by A P wave that precedes each QRS complex, indicating that the electrical impulse is originating from the SA node and is conducted normally through the heart’s atria and ventricles. A QRS complex that is narrow and consistent in shape and duration, indicating that the electrical impulse is being conducted normally through the heart’s ventricles. A T wave that follows each QRS complex, indicating that the ventricles are repolarizing normally.

Understanding Cardiac Arrhythmias: Causes and Symptoms

Cardiac arrhythmias are abnormal heart rhythms that can occur when the electrical impulses that regulate the heart’s beating become disrupted.

Cardiac Arrhythmias

These disruptions can cause the heart to beat too fast, too slow, or in an irregular pattern. Some arrhythmias are harmless, while others can be life-threatening.

Common Arrhythmias

Common types of arrhythmias include bradycardia (slow heart rate), tachycardia (fast heart rate), atrial fibrillation: This is a common arrhythmia in which the heart’s upper chambers (atria) beat irregularly and too fast, ventricular tachycardia: This is a fast, regular heartbeat that starts in the heart’s lower chambers (ventricles), ventricular fibrillation:

Understanding Cardiac Arrhythmias: NCLEX Priority Questions

This is a life-threatening arrhythmia in which the heart’s lower chambers quiver instead of contracting, which can lead to sudden cardiac arrest, and supraventricular tachycardia: This is a rapid heartbeat that originates above the heart’s lower chambers.

Causes of Cardiac Arrhythmias

There are many different causes of arrhythmias, including heart disease, electrolyte imbalances, medication side effects, and genetic factors. Some arrhythmias may require medical intervention, while others may not require treatment at all.

Bradycardia

Bradycardia is a condition characterized by an abnormally slow heart rate, usually defined as fewer than 60 beats per minute. Bradycardia may be asymptomatic, especially in people who are physically fit, but in some cases, it can cause symptoms such as fatigue or weakness, dizziness or lightheadedness, fainting or near-fainting, shortness of breath or difficulty breathing, chest pain or discomfort, confusion or difficulty concentrating, pale skin or cold extremities.Symptoms may occur when the heart rate becomes too slow to deliver enough oxygen and nutrients to the body’s tissues and organs.

Causative factors of bradycardia

Causes of bradycardia include aging, heart disease, certain medications, and certain medical conditions, such as hypothyroidism. Treatment may be necessary for people with symptomatic bradycardia, and may include medication, lifestyle changes, or surgery in some cases. People with underlying heart disease or other cardiac conditions may be at higher risk of complications associated with bradycardia, so it is important to seek medical attention if you experience symptoms.

Tachycardia

Tachycardia is a medical condition characterized by a heart rate that is faster than normal, typically defined as a heart rate of more than 100 beats per minute (bpm) at rest. Tachycardia can occur in the heart’s upper chambers (atria) or lower chambers (ventricles) and may be caused by a variety of factors, including exercise or physical activity, stress or anxiety, fever or infection, certain medications or drugs, dehydration, low blood sugar, heart disease or other cardiac conditions.

Symptoms of tachycardia

Tachycardia may result in symptoms such as palpitations (a sensation of fluttering, racing, or pounding in the chest), shortness of breath or difficulty breathing, dizziness or lightheadedness, chest pain or discomfort, fainting or near-fainting, fatigue or weakness. Tachycardia may be a temporary or chronic condition, and treatment may depend on the underlying cause and the severity of symptoms. Treatment options may include lifestyle changes, medications, or procedures such as catheter ablation.

Atrial fibrillation

Atrial fibrillation is a common arrhythmia in which the heart’s upper chambers (atria) beat irregularly and too fast. Atrial fibrillation “AFib” may be completely asymptomatic. Some people with AFib may not even be aware they have it until a routine medical exam or an ECG detects an irregular heartbeat. However, when symptoms do occur, they can include palpitations (a sensation of fluttering, racing, or pounding in the chest), shortness of breath or difficulty breathing, fatigue or weakness, dizziness or lightheadedness, chest discomfort or pain, fainting or nearly fainting, anxiety or confusion. Symptoms may be intermittent or persistent and may occur in episodes that last from minutes to days. Some people may experience persistent symptoms that can significantly impact their quality of life. In addition to these symptoms, people with AFib are at increased risk for stroke and other complications, so it is important to seek medical attention if you suspect you may have this condition.

Ventricular tachycardia

Ventricular tachycardia, “VTach”is a fast, regular heartbeat that starts in the heart’s lower chambers (ventricles) and causes a rapid, regular heart rate. The symptoms of VT can range from mild to severe, and can include palpitations (a sensation of fluttering, racing, or pounding in the chest), dizziness or lightheadedness, shortness of breath or difficulty breathing, chest pain or discomfort, fainting or near-fainting, weakness or fatigue, and sudden cardiac arrest (in severe cases). The severity of symptoms may depend on the duration and frequency of VT episodes, as well as the underlying cause of the arrhythmia. VT can be caused by a variety of factors, including heart disease, electrolyte imbalances, medication side effects, or genetic factors. People who experience symptoms of VT should seek immediate medical attention, as the condition can be life-threatening in some cases.

Ventricular fibrillation

Ventricular fibrillation (VF), also referred to as “VFib” is a life-threatening arrhythmia in which the heart’s lower chambers quiver instead of contracting, which can lead to sudden cardiac arrest. VF is a medical emergency and requires immediate treatment. Symptoms of VF can include sudden loss of consciousness, no pulse or breathing, seizures or convulsions, gasping for air; chest pain or discomfort, dizziness or lightheadedness may occur before ventricular fibrillation occurs. VF can occur in people with underlying heart disease or other cardiac conditions, but it can also occur in people without any known heart problems.

Risk factors for VF include a history of heart disease, previous heart attack, electrolyte imbalances, drug or alcohol abuse, and certain genetic conditions. VF is a life-threatening condition, and immediate medical attention is critical for survival. Treatment may include CPR, defibrillation, medications, and/or implantable devices such as an implantable cardioverter-defibrillator (ICD).

Supraventricular tachycardia

Supraventricular tachycardia (SVT) is a type of arrhythmia that originates above the heart’s lower chambers (ventricles) and causes a rapid heartbeat. Symptoms of SVT may include palpitations (a sensation of fluttering, racing, or pounding in the chest), shortness of breath or difficulty breathing, dizziness or lightheadedness, chest pain or discomfort, fainting or near-fainting, fatigue or weakness, anxiety or confusion. Symptoms may occur suddenly and may last from a few seconds to several hours, and may be intermittent or persistent. In some cases, SVT may be asymptomatic.

Causes of supraventricular tachycardia

SVT causative factors include heart disease, medications, stimulants (such as caffeine), and certain medical conditions. Treatment for SVT may depend on the underlying cause and the severity of symptoms, and may include medications, lifestyle changes, or procedures such as catheter ablation. People with SVT should seek medical attention if they experience symptoms or have concerns about their condition.

Premature ventricular contractions

Premature ventricular contractions (PVCs) are a type of arrhythmia that occur when the heart’s lower chambers (ventricles) contract earlier than usual. PVCs can be felt as a “skipped beat” or a palpitation (a sensation of fluttering or pounding in the chest). PVCs may be asymptomatic, but they can also cause symptoms such as palpitations (a sensation of fluttering, racing, or pounding in the chest), dizziness or lightheadedness, shortness of breath or difficulty breathing, chest pain or discomfort, or fatigue or weakness.

PVCs are common and may occur in healthy people without any underlying heart disease. However, they can also be associated with heart disease or other medical conditions. Risk factors for PVCs may include a history of heart disease, high blood pressure, smoking, caffeine or alcohol use, and certain medications. Treatment for PVCs may depend on the underlying cause and the severity of symptoms, and may include lifestyle changes (such as reducing caffeine intake), medications, or procedures such as catheter ablation. People with PVCs should seek medical attention if they experience symptoms or have concerns about their condition.

QUESTIONS NCLEX High Yield, Cardiovascular

It is essential for nclex exam test takers to do practice questions on nclex high-yield topics. Some high-yield topics in cardio include bradycardia, afib, vfib, PVC, SVT, complete heart block, tachycardia, hypertension, chest pain, hypotension, arterial and venous insufficiency and MI. Let’s get started with these free NCLEX exam high yield questions, answers and rationales.

Question 1: A 53 year old female was admitted to the hospital earlier that day, complaining of lightheadedness. She denied chest pain Her troponin is normal and her heart rate is 49 bpm. Which of the following is a common symptom of bradycardia?

a) Rapid heart rate 

b) Chest pain 

c) Shortness of breath 

d) Fatigue

e) Headache

f) Pain radiating to the left arm

Question 3: A 72-year-old patient with a history of hypertension and heart failure presents to the emergency department with complaints of palpitations and shortness of breath. An electrocardiogram reveals atrial fibrillation with a rapid ventricular response. The nurse should anticipate which medication to be administered?

a) Diltiazem 

b) Digoxin 

c) Amiodarone 

d) Warfarin

e) Nitroglycerin

NCLEX Questions: Focus on Medications for High Yield Cardiovascular

Question 5: A 55-year-old patient with a history of ischemic heart disease is admitted to the cardiac intensive care unit with an episode of ventricular tachycardia. The patient is hemodynamically stable and responsive. The nurse should anticipate which medication to be administered?

a) Adenosine 

b) Lidocaine 

c) Epinephrine 

d) Atropine

NCLEX Questions Critical Thinking: High Yield Cardiovascular Symptoms

Question 7: A 50-year-old patient with a history of coronary artery disease presents to the emergency department with chest pain and shortness of breath. An electrocardiogram reveals ventricular tachycardia. The nurse should anticipate which initial intervention for this patient?

a) Defibrillation 

b) Administration of epinephrine 

c) Administration of amiodarone 

d) Administration of atropine

NCLEX Review: High Yield Cardiovascular Treatments

Question 9: A patient with ventricular tachycardia is unresponsive to lidocaine. What is the next appropriate step in management? 

a. Administer amiodarone 

b. Cardiovert with synchronized shock 

c. Administer magnesium sulfate 

d. Administer atropine

ANSWERS

Question 1 Answer d) Fatigue

Rationale: Bradycardia is defined as a slow heart rate, typically less than 60 beats per minute. The most common symptom of bradycardia is fatigue or weakness. Other symptoms may include dizziness, lightheadedness, fainting, and confusion.

Question 2 Answer c) Monitor the patient closely

Rationale: Bradycardia is a slow heart rate, but not all cases of bradycardia require treatment. In this scenario, the patient’s heart rate is 50 beats per minute, which falls within the normal range for some individuals, such as athletes. The appropriate nursing intervention is to monitor the patient closely for any signs or symptoms of decreased cardiac output, such as fatigue or weakness. Atropine and digoxin are medications that can increase the heart rate and are only given when clinically indicated. Cardioversion, or the use of an electrical shock to reset the heart rhythm, is not appropriate for this patient with a heart rate in the normal range.

Question 3 Answer a) Diltiazem

Rationale: Diltiazem is a calcium channel blocker commonly used to treat atrial fibrillation with a rapid ventricular response. It works by slowing the heart rate and reducing the ventricular response. Digoxin and amiodarone are also used to treat atrial fibrillation, but they are not first-line treatments for a rapid ventricular response. Warfarin is an anticoagulant used to prevent blood clots in patients with atrial fibrillation, but it is not used to treat the rapid ventricular response associated with the condition.

Question 4 Answer: c) Thromboembolism

Rationale: Patients with atrial fibrillation are at an increased risk for thromboembolism, which is the formation of a blood clot that can travel to the brain and cause a stroke. Anticoagulant therapy, such as warfarin or direct oral anticoagulants, is typically prescribed to prevent thromboembolism in patients with atrial fibrillation. Hypertension and hyperglycemia are not direct complications of atrial fibrillation. Bradycardia may occur in some patients with atrial fibrillation, but it is not a common complication.

Question 5 Answer: b) Lidocaine

Rationale: Lidocaine is a class 1B antiarrhythmic drug commonly used to treat ventricular tachycardia. It works by blocking sodium channels in cardiac cells, which reduces the excitability of the ventricular myocardium and can terminate the arrhythmia. Adenosine is used to treat supraventricular tachycardia, not ventricular tachycardia. Epinephrine and atropine are not effective treatments for ventricular tachycardia.

Question 6 Answer: b) Initiating cardiopulmonary resuscitation (CPR)

Rationale: Sustained ventricular tachycardia is a life-threatening arrhythmia that can rapidly deteriorate into ventricular fibrillation, which requires immediate defibrillation.

Question 7 Answer: a) Defibrillation

Rationale: Ventricular tachycardia is a life-threatening arrhythmia that can quickly degenerate into ventricular fibrillation and cardiac arrest. The initial intervention for ventricular tachycardia is immediate defibrillation to restore a normal heart rhythm. Administration of epinephrine, amiodarone, and atropine may be indicated in certain situations, but they are not the initial interventions for ventricular tachycardia.

Question 8 Answer: d) Amiodarone

Rationale: Nonsustained ventricular tachycardia can occur in patients with structural heart disease, such as hypertension and heart failure. Treatment with antiarrhythmic medications, such as amiodarone, may be necessary to prevent the progression of ventricular tachycardia to sustained or malignant forms. Furosemide and lisinopril are medications commonly used to treat heart failure and hypertension, respectively, but they are not indicated for ventricular tachycardia. Metoprolol is a beta-blocker that may be used to treat ventricular tachycardia, but it is not the first-line therapy for this arrhythmia.

Question 9 Answer: B

Rationale: Cardiovert with synchronized shock Rationale: If a patient with ventricular tachycardia is unresponsive to lidocaine, the next appropriate step is to cardiovert with synchronized shock. This is a highly effective method of terminating ventricular tachycardia and restoring sinus rhythm. Amiodarone may also be considered as a second-line treatment. Magnesium sulfate is indicated for torsades de pointes, a type of polymorphic ventricular tachycardia. Atropine is not effective in treating ventricular tachycardia.

Question 10 Answer: A

Rationale: Wide QRS complexes with a regular rhythm Rationale: Ventricular tachycardia is characterized by wide QRS complexes with a regular rhythm. The QRS complex represents ventricular depolarization, and in ventricular tachycardia, the electrical activity of the ventricles becomes disorganized, resulting in an abnormal QRS complex. The QRS complex is wider than 0.12 seconds because the ventricles are depolarizing in an abnormal sequence. Narrow QRS complexes are typically seen in supraventricular tachycardia. An irregular rhythm may be seen in atrial fibrillation or other arrhythmias.