Ready to elevate your cardiovascular care skills? Take our medical surgical nursing quiz and challenge yourself with engaging, evidence-based scenarios designed for today's RN professionals. This cardiovascular nursing quiz will test your mastery of heart failure nursing questions, sharpen your critical thinking in a myocardial infarction nursing test, and guide you through essential DKA nursing quiz cases with instant feedback. Whether you're reviewing for exams or refreshing clinical expertise, friendly insights and detailed explanations help you fill knowledge gaps and boost confidence before hands-on shifts. Enhance your learning journey with our rn learning system medical-surgical: cardiovascular and hematology practice quiz , then tackle focused cardiac nursing questions . Ready to start? Dive in now!
What is the most common underlying cause of myocardial infarction?
Coronary vasospasm
Embolic occlusion
Drug-induced vasoconstriction
Coronary atherosclerosis
Myocardial infarction most frequently results from rupture of an atherosclerotic plaque leading to thrombus formation and coronary artery occlusion. Atherosclerosis underlies over 90% of MIs. Other causes like vasospasm or emboli are far less common in comparison. American Heart Association.
Which characteristic of chest pain is most suggestive of myocardial ischemia?
Localized stabbing pain reproducible by palpation
Sharp pleuritic pain worsened by inspiration
Substernal pressure radiating to the left arm
Epigastric burning relieved by antacids
Anginal pain is classically described as substernal pressure or heaviness that may radiate to the jaw, neck, or left arm. It is typically not sharp, pleuritic, or reproducible by palpation. Epigastric burning that responds to antacids suggests a gastrointestinal source. National Heart, Lung, and Blood Institute.
Which laboratory value is most helpful in diagnosing acute decompensated heart failure?
Creatine kinase-MB
C-reactive protein
B-type natriuretic peptide
Cardiac troponin I
B-type natriuretic peptide (BNP) is released by ventricular myocytes in response to increased wall stretch and is elevated in heart failure exacerbations. Troponin and CK-MB are markers of myocardial injury, not volume overload. C-reactive protein indicates inflammation but is not specific to heart failure. Circulation Journal.
Which serum electrolyte finding is most characteristic in early diabetic ketoacidosis?
Hypernatremia
Hypokalemia
Hyponatremia
Hyperkalemia
In DKA, insulin deficiency and acidosis cause a shift of potassium from the intracellular to extracellular space, resulting in elevated serum potassium despite total body potassium depletion. Hypokalemia may occur later once treatment begins. Sodium can be normal or low due to osmotic diuresis. Diabetes Care.
On an ECG, ST-segment elevation is most indicative of which process?
Acute pericarditis
Transmural myocardial infarction
Left ventricular hypertrophy
Subendocardial ischemia
ST-segment elevation typically indicates a full-thickness (transmural) myocardial infarction. Subendocardial ischemia usually causes ST depression. Pericarditis can cause diffuse ST elevation but with PR depression. Hypertrophy produces repolarization abnormalities but not classic ST elevation. Cedars-Sinai.
In the acute management of suspected myocardial infarction, which intervention should be initiated first?
Start a heparin infusion
Administer chewable aspirin
Begin beta-blocker therapy
Give sublingual nitroglycerin
Immediate administration of 325 mg of chewable aspirin reduces platelet aggregation and mortality in suspected MI. Oxygen is given if hypoxic, and other therapies follow, but aspirin is highest priority. Beta-blockers, heparin, and nitrates are important but are secondary to aspirin in most protocols. ACC.
Which clinical finding is most associated with left-sided heart failure?
Peripheral pitting edema
Jugular venous distention
Hepatomegaly
Pulmonary crackles
Left-sided heart failure leads to increased pulmonary venous pressure and fluid transudation into the alveoli, causing crackles on auscultation. Jugular venous distention and peripheral edema are more prominent in right-sided failure. Hepatomegaly is also a sign of right-sided congestion. NCBI Bookshelf.
Which laboratory finding indicates an elevated anion gap in diabetic ketoacidosis?
Negative anion gap
Serum anion gap <8 mEq/L
Normal anion gap 8 - 12 mEq/L
Serum anion gap >12 mEq/L
Diabetic ketoacidosis is characterized by an increased anion gap metabolic acidosis, typically greater than 12 mEq/L. A gap below 8 mEq/L is low, and 8 - 12 mEq/L is considered normal. A negative anion gap is not clinically relevant. NCBI Bookshelf.
What is the immediate priority nursing intervention for a patient presenting with diabetic ketoacidosis?
Administer subcutaneous insulin
Begin isotonic intravenous fluids
Check thyroid function tests
Obtain hemoglobin A1c level
Fluid resuscitation with isotonic saline is the initial priority in DKA to restore circulating volume, improve perfusion, and reduce blood glucose concentration. Insulin therapy follows fluid replacement. Hemoglobin A1c and thyroid tests are not urgent. NCBI Bookshelf.
Which finding most specifically differentiates systolic from diastolic heart failure?
Increased left ventricular hypertrophy
Presence of S4 gallop
Reduced ejection fraction
Elevated systemic vascular resistance
Systolic heart failure is defined by a reduced ejection fraction (EF < 40%), whereas diastolic failure has a preserved EF with impaired relaxation. Elevated vascular resistance and hypertrophy may occur in both types, and an S4 gallop is more common in diastolic dysfunction. Circulation.
Nitroglycerin relieves anginal pain primarily by which mechanism?
Beta-1 adrenergic blockade
Calcium channel blockade
Venodilation reducing preload
Arterial dilation lowering afterload
Nitroglycerin predominantly causes venodilation, which reduces venous return (preload) and decreases myocardial oxygen demand. At higher doses it can dilate arterial vessels, but its primary effect in angina is preload reduction. Beta-blockade and calcium channel blockade are different drug classes. FDA Label.
A patient on digoxin presents with nausea, blurred vision, and cardiac arrhythmias. These signs are most indicative of:
New myocardial infarction
Acute hypokalemia
Digoxin toxicity
Beta-blocker overdose
Digoxin toxicity often presents with gastrointestinal symptoms (nausea), visual disturbances (yellow halos), and arrhythmias. Hypokalemia can predispose to toxicity but does not itself cause visual changes. Beta-blocker overdose presents with bradycardia and hypotension, and MI causes chest pain and troponin elevation. NCBI Bookshelf.
Non - ST-elevation myocardial infarction (NSTEMI) differs from ST-elevation MI (STEMI) by:
No coronary artery occlusion
Absence of persistent ST-segment elevation
Lack of chest pain
Negative cardiac troponin levels
NSTEMI is characterized by myocardial necrosis (elevated troponins) without persistent ST-segment elevation on ECG. Chest pain and coronary occlusion can be present in both NSTEMI and STEMI. Troponin is typically positive in both. ACC/AHA Guidelines.
In the treatment of DKA, which insulin regimen is preferred for continuous intravenous infusion?
Lispro insulin
NPH insulin
Regular insulin
Glargine insulin
Regular insulin is used in continuous IV infusion for DKA because of its rapid onset and predictable pharmacokinetics. Rapid?acting analogs are not recommended IV due to lack of data, and long?acting insulins are unsuitable for acute correction. Diabetes Care.
Beta-blockers are contraindicated in which scenario?
Acute decompensated heart failure with hypotension
Hypertension with tachycardia
Unstable angina after initial stabilization
Chronic heart failure with reduced ejection fraction
Beta-blockers should be avoided in acute decompensated heart failure when the patient is hypotensive or in cardiogenic shock, as they can further depress myocardial contractility. They are indicated in stable chronic HFrEF, hypertension, and post-MI once hemodynamics permit. ESC Guidelines.
The term 'cardiorenal syndrome' most accurately describes which phenomenon?
Cardiorenal syndrome refers to dysfunction in one organ (heart or kidneys) leading to acute or chronic dysfunction in the other. The classic Type 1 syndrome is acute cardiac failure causing acute kidney injury. Other types include renal-to-cardiac interactions, but liver failure and stroke are not part of this classification. Circulation Research.
After percutaneous coronary intervention for STEMI, close monitoring is essential for which immediate complication?
Acute renal failure
Reperfusion arrhythmias
Gastrointestinal bleeding
Ischemic stroke
Reperfusion of ischemic myocardium can trigger ventricular ectopy, accelerated idioventricular rhythm, or ventricular tachycardia/fibrillation. While renal function, stroke, and bleeding require vigilance, electrical complications are the most immediate post-PCI risk. ACC.
An S3 gallop on cardiac auscultation most likely indicates:
Increased left ventricular filling pressures
Aortic regurgitation
Ventricular septal defect
Mitral stenosis
An S3 gallop arises during rapid ventricular filling and indicates elevated left ventricular end-diastolic pressures, commonly seen in heart failure. Mitral stenosis produces an opening snap and diastolic rumble. VSD and aortic regurgitation have distinct murmurs. Circulation.
What is the primary hemodynamic effect of an intra-aortic balloon pump (IABP)?
Increases preload and cardiac output
Increases coronary perfusion and decreases afterload
Directly augments myocardial contractility
Reduces right atrial pressure
An IABP inflates in diastole to augment aortic diastolic pressure, improving coronary perfusion, and deflates just before systole to reduce afterload and myocardial oxygen demand. It does not directly increase preload or contractility. NCBI Bookshelf.
Diabetic patients often present atypically with myocardial infarction. Which symptom is less frequently reported in this population?
Nausea
Diaphoresis
Dyspnea
Typical chest pain
Diabetic neuropathy can blunt the classic chest pain of MI, leading to atypical presentations such as dyspnea, nausea, or diaphoresis. These subtler symptoms often delay diagnosis in diabetics. Journal of the American College of Cardiology.
Sacubitril/valsartan benefits patients with heart failure by which combined mechanism?
Aldosterone blockade and vasodilation
Neprilysin inhibition and angiotensin II receptor blockade
ACE inhibition and beta-1 blockade
Direct renin inhibition and diuresis
Sacubitril/valsartan combines neprilysin inhibition, which increases natriuretic peptides, and angiotensin II receptor blockade, reducing vasoconstriction and aldosterone release. This dual action improves morbidity and mortality in HFrEF. NEJM.
For a patient on warfarin who requires percutaneous coronary intervention (PCI), the most appropriate anticoagulation adjustment is to:
Discontinue all anticoagulants 48 hours prior
Switch to unfractionated heparin before PCI
Administer thrombolytic therapy instead
Continue warfarin throughout the procedure
Guidelines recommend stopping warfarin and bridging with unfractionated heparin for PCI to allow rapid reversal if bleeding occurs and to achieve precise anticoagulation control. Continuing warfarin raises bleeding risk. Thrombolytics are not indicated for elective PCI. ACC.
Reciprocal ST-segment depression in leads II, III, and aVF on ECG suggests an infarction in which area of the heart?
Lateral wall
Right ventricular free wall
Anterior wall
Inferior wall
ST-segment depression in the inferior leads (II, III, aVF) is often reciprocal to ST elevation seen in anterior wall infarctions (leads V1 - V4). Lateral or inferior infarctions would show primary changes in corresponding leads. Circulation.
In diabetic ketoacidosis fluid resuscitation, which intravenous fluid is recommended initially?
0.45% sodium chloride
0.9% sodium chloride
5% dextrose in water
Lactated Ringer's solution
0.9% sodium chloride is used initially to restore intravascular volume and correct hyperglycemia slowly. After plasma glucose drops below 200 mg/dL, fluids are switched to dextrose-containing solutions. Hypotonic or Ringer's solutions are not used for initial resuscitation. NCBI Bookshelf.
When evaluating an anion gap metabolic acidosis in DKA, calculating the delta gap helps to assess:
Presence of a mixed acid-base disturbance
Degree of total body fluid deficit
Adequacy of insulin dose
Serum potassium depletion
The delta gap (change in anion gap versus change in bicarbonate) identifies whether a pure high-anion-gap metabolic acidosis is present or if an additional metabolic alkalosis or non - anion-gap acidosis exists. It does not directly assess insulin dosing, fluid deficit, or potassium stores. NCBI Bookshelf.
Pulmonary artery wedge pressure (PAWP) primarily reflects which cardiac parameter?
Cardiac output
Right atrial pressure
Left atrial pressure
Systemic vascular resistance
PAWP, measured via a pulmonary artery catheter, estimates left atrial pressure and left ventricular end-diastolic pressure. It is not a direct measure of right atrial pressure, cardiac output, or systemic vascular resistance. NCBI Bookshelf.
A patient develops sustained ventricular tachycardia after myocardial infarction and is hemodynamically unstable. Immediate management should be:
Unfractionated heparin infusion
IV amiodarone only
CPR without defibrillation
Synchronized cardioversion
In unstable sustained ventricular tachycardia (hypotension, altered mental status), synchronized cardioversion is indicated immediately. Amiodarone may be used if the patient is stable. Heparin and CPR without defibrillation do not address the arrhythmia. AHA.
Despite elevated serum potassium in DKA, total body potassium is depleted. What is the most appropriate nursing action?
No potassium replacement is necessary during DKA treatment
Administer immediate potassium supplementation regardless of level
Begin potassium replacement when serum K+ falls below 5.5 mEq/L and urine output is adequate
Withhold potassium until serum K+ is below 3.0 mEq/L
Although serum potassium is initially elevated in DKA, total body potassium is depleted due to osmotic diuresis. Guidelines recommend beginning potassium replacement once serum K+ falls below 5.5 mEq/L and urine output is confirmed. Immediate supplementation in the face of hyperkalemia can worsen outcomes, and withholding until very low levels risks arrhythmias. Diabetes Care.
Which characteristic of CK-MB makes it useful for detecting reinfarction a few days after an initial MI?
Remains elevated for up to two weeks
Is more specific than troponin for myocardial injury
Is unaffected by skeletal muscle injury
Rises within 4 - 6 hours and normalizes by 48 - 72 hours
CK-MB levels rise 4 - 6 hours after myocardial injury and return to baseline within 48 - 72 hours, making it useful to detect reinfarction if levels rise again. Troponin remains elevated for up to 10 days, making it less helpful for early reinfarction. CK-MB is less specific than troponin and can be elevated in skeletal muscle injury. Circulation.
Which SGLT2 inhibitor has demonstrated a significant reduction in cardiovascular death and heart failure hospitalization in HFrEF patients?
Canagliflozin
Ertugliflozin
Dapagliflozin
Sotagliflozin
The DAPA-HF trial showed that dapagliflozin significantly reduced cardiovascular death and heart failure hospitalizations in patients with HFrEF, irrespective of diabetes status. Canagliflozin and ertugliflozin are approved for diabetes but lack similar robust HFrEF outcome data, and sotagliflozin is not yet standard in this population. NEJM.
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Study Outcomes
Understand cardiovascular pathophysiology -
Describe the underlying mechanisms of heart failure, myocardial infarction, and diabetic ketoacidosis and how they impact patient status.
Analyze clinical assessment data -
Interpret vital signs, lab results, and diagnostic findings to identify early warning signs in cardiovascular and metabolic emergencies.
Apply targeted nursing interventions -
Implement evidence-based care plans for patients with heart failure, MI, and DKA to optimize outcomes and prevent complications.
Prioritize patient care tasks -
Organize and sequence nursing actions according to patient acuity, ensuring timely response in life-threatening cardiovascular scenarios.
Evaluate treatment effectiveness -
Monitor and assess patient responses to therapies, adjust interventions as needed, and document outcomes in cardiovascular nursing practice.
Reinforce exam readiness -
Test and solidify your knowledge of cardiovascular nursing principles through targeted quiz questions and instant feedback.
Cheat Sheet
Accurate Assessment of Heart Failure Symptoms -
When tackling heart failure nursing questions in a medical-surgical nursing quiz, use the "FLUIDS" mnemonic (Fatigue, Limitation of activities, Unintended weight gain, Intractable cough, Dyspnea, Swelling) from ACCF/AHA guidelines to recall key signs. Regularly review daily weights and jugular venous pressure to detect early decompensation. Precise documentation boosts both patient safety and quiz confidence.
In a cardiovascular nursing quiz, focus on identifying ST-segment elevation or depression, T-wave inversions, and Q-wave formation within 90 minutes of chest pain onset per ACC/AHA standards. Practice reading sample ECG strips to distinguish anterior, inferior, or lateral MI patterns. Quick recognition guides urgent reperfusion therapy and earns points in a myocardial infarction nursing test.
Managing DKA Fluid and Electrolyte Balance -
For a DKA nursing quiz, remember to correct fluid deficits at 1 - 1.5 L/hour initially and monitor the anion gap as per ADA guidelines. Keep a close eye on serum potassium - insulin therapy shifts K+ intracellularly, risking hypokalemia. Mastering this balance reduces complications and boosts your exam performance.
Pharmacologic Strategies in Heart Failure -
Review first-line medications (ACE inhibitors, beta-blockers, and aldosterone antagonists) from ESC and AHA protocols, starting low and titrating slowly to avoid hypotension. Recall the "ABC" approach: ACEi/ARB, Beta-blocker, and Check renal function before each dose increase. Understanding drug mechanisms enhances answers on therapy-focused quiz items.
Nursing Priorities During Acute MI -
Apply the MONA-B mnemonic (Morphine, Oxygen, Nitrates, Aspirin, Beta-blockers) within the first hour of suspected MI, referencing UA/NSTEMI and STEMI pathways. Prioritize continuous telemetry, pain reassessment, and IV access for emergent interventions. Solid grasp of these steps will set you apart on a cardiovascular nursing quiz.
