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Quizzes > Health & Medicine > Diseases & Conditions

Myocardial Infarction & Heart Failure NCLEX Quiz - Ready to Test Your Skills?

Dive into our NCLEX cardiac quiz and master heart failure practice questions!

Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art illustration for NCLEX Myocardial Infarction and Heart Failure quiz on sky blue background

Are you ready to put your cardiac expertise to the test with our Myocardial Infarction and Heart Failure NCLEX Quiz? Specifically crafted for aspiring and practicing nurses, this free NCLEX cardiac quiz helps you assess EKG interpretation, MI treatment protocols, and heart failure practice questions. You'll dive into patient scenarios, from acute MI management to chronic failure care, and sharpen your NCLEX cardiovascular review. With instant feedback and detailed explanations, you'll identify gaps and reinforce critical interventions. Explore our comprehensive heart failure scenarios and tackle beat-the-clock myocardial challenges . Challenge yourself - take the quiz now to boost your exam prep and master lifesaving skills!

Which cardiac biomarker is most specific for diagnosing a myocardial infarction?
Troponin I
Myoglobin
Lactate dehydrogenase (LDH)
Creatine kinase-MB (CK-MB)
Troponin I is highly specific to myocardial tissue and remains elevated for up to 7 - 10 days after infarction, making it the preferred marker for diagnosing MI. CK-MB can also indicate myocardial damage but is less specific and returns to normal sooner. Myoglobin and LDH are even less specific for cardiac injury. More info.
What is the earliest ECG change indicating an acute ST-segment elevation myocardial infarction?
ST-segment elevation
T wave inversion
Pathological Q waves
ST-segment depression
ST-segment elevation is the hallmark ECG finding in acute transmural MI and appears within minutes of coronary artery occlusion. T-wave inversions and pathological Q waves develop later during the evolution of infarction. ST-segment depression generally suggests myocardial ischemia rather than acute infarction. More info.
Which initial medication should the nurse administer to a client with suspected acute myocardial infarction upon arrival to the emergency department?
Sublingual nitroglycerin
Oral metoprolol
Chewable aspirin 325 mg
Intravenous morphine
Early administration of aspirin inhibits platelet aggregation and reduces infarct size. Nitroglycerin, morphine, and beta blockers are all part of MI management but should follow aspirin in the acute setting. Aspirin is recommended within minutes of patient arrival. More info.
A client's chest pain persists after one nitroglycerin tablet with no relief. Which intervention should the nurse implement next?
Start a beta-blocker infusion
Offer a potassium supplement
Give a second dose of sublingual nitroglycerin
Administer IV morphine as prescribed
If chest pain is unrelieved by nitroglycerin, IV morphine is indicated to relieve pain and decrease cardiac workload. Repeated nitroglycerin doses must follow protocol and morphine is prioritized when pain persists. Potassium and beta-blockers are not first-line for ongoing ischemic pain. More info.
A client with left-sided heart failure is most likely to exhibit which clinical finding?
Hepatomegaly
Jugular venous distention
Crackles at lung bases
Peripheral pitting edema
Left-sided heart failure leads to pulmonary congestion, manifested by crackles on auscultation. Peripheral edema and JVD are more characteristic of right-sided failure. Hepatomegaly can occur with chronic right heart failure as well. More info.
Which class of medication is proven to reduce mortality when added to standard therapy in systolic heart failure?
Digoxin
Calcium channel blockers
ACE inhibitors
Loop diuretics
ACE inhibitors reduce afterload, prevent remodeling, and have been shown to lower mortality in systolic HF. Loop diuretics relieve symptoms but do not improve survival. Digoxin improves symptoms and decreases hospitalizations but has no mortality benefit. Calcium channel blockers are not indicated for systolic HF. More info.
Which laboratory test is most useful in diagnosing exacerbation of chronic heart failure?
B-type natriuretic peptide (BNP)
C-reactive protein
Creatinine kinase-MB
Troponin I
BNP is released in response to ventricular stretch and rises in heart failure exacerbations, aiding diagnosis and severity assessment. Troponin and CK-MB diagnose myocardial injury, not HF exacerbation. CRP is a nonspecific inflammatory marker. More info.
Which medication is contraindicated in acute decompensated heart failure due to its negative inotropic effect?
Dobutamine infusion
Furosemide IV
Nitroprusside infusion
Metoprolol infusion
Beta-blockers like IV metoprolol can worsen acute decompensated HF by decreasing contractility and should be held until the patient stabilizes. Furosemide, nitroprusside, and dobutamine support perfusion or reduce preload/afterload. More info.
A client 48 hours post-myocardial infarction reports sharp chest pain that worsens when lying flat and is relieved by leaning forward. What complication is most likely?
Unstable angina
Pulmonary embolism
Acute pericarditis
Reinfarction
Pericarditis typically occurs 1 - 4 days after MI and presents with sharp, positional chest pain and a friction rub. Reinfarction causes crushing pain similar to the original MI. Unstable angina and PE have different pain characteristics and timing. More info.
Loop diuretics relieve pulmonary congestion by inhibiting sodium and chloride reabsorption in which part of the nephron?
Distal convoluted tubule
Thick ascending loop of Henle
Collecting duct
Proximal convoluted tubule
Loop diuretics act on the Na?/K?/2Cl? cotransporter in the thick ascending limb of Henle, causing significant diuresis and relief of pulmonary edema. Other segments are targeted by different diuretic classes. More info.
Which clinical finding is most indicative of digoxin toxicity in a patient receiving therapy for heart failure?
Elevated blood pressure
Yellow-green halos around lights
Hypokalemia only
Shortened QT interval
Visual disturbances such as yellow-green halos are classic signs of digoxin toxicity. Patients may also experience gastrointestinal symptoms and arrhythmias. Blood pressure elevation and QT changes are not specific to digoxin toxicity. More info.
A client in cardiogenic shock exhibits which hemodynamic profile?
Cardiac index 4.0 L/min/m², pulmonary capillary wedge pressure 8 mm Hg, systemic vascular resistance 800 dyn·s/cm?
Cardiac index 1.8 L/min/m², pulmonary capillary wedge pressure 22 mm Hg, systemic vascular resistance 2500 dyn·s/cm?
Cardiac index 2.5 L/min/m², pulmonary capillary wedge pressure 12 mm Hg, systemic vascular resistance 900 dyn·s/cm?
Cardiac index 3.0 L/min/m², pulmonary capillary wedge pressure 6 mm Hg, systemic vascular resistance 1200 dyn·s/cm?
Cardiogenic shock is characterized by low cardiac output (CI <2.2 L/min/m²), elevated filling pressures (PCWP >18 mm Hg), and high systemic vascular resistance. These values reflect poor contractility with compensatory vasoconstriction. More info.
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Study Outcomes

  1. Recognize Clinical Manifestations of MI and HF -

    Identify and differentiate the key signs and symptoms of myocardial infarction and heart failure to support accurate cardiovascular assessment.

  2. Interpret Diagnostic Findings -

    Analyze EKG patterns, cardiac biomarkers, and imaging results commonly encountered in NCLEX cardiac quiz and heart failure practice questions.

  3. Apply Evidence-Based Treatment Protocols -

    Implement current pharmacologic and non-pharmacologic interventions for acute myocardial infarction and chronic heart failure management.

  4. Manage Hemodynamic Monitoring -

    Evaluate vital signs and hemodynamic parameters to guide patient care decisions during NCLEX cardiovascular review scenarios.

  5. Develop Clinical Judgment Skills -

    Use critical thinking to prioritize nursing interventions and anticipate complications in MI and HF practice question simulations.

  6. Enhance NCLEX Test-Taking Strategies -

    Engage with the Myocardial Infarction and Heart Failure NCLEX Quiz format and apply proven tips for mastering exam-style cardiovascular questions.

Cheat Sheet

  1. ECG Interpretation for Acute MI -

    Acute STEMI is diagnosed by ST-segment elevation ≥1 mm in two contiguous leads, while NSTEMI often shows ST depression or T-wave inversion, per American Heart Association guidelines. Remember the mnemonic "STEMI Means Emergency" for rapid recognition and activation of the cath lab.

  2. Cardiac Biomarkers Timeline -

    Troponin I rises within 3 - 4 hours post-infarct, peaks at 18 - 24 hours, and remains elevated for up to 10 days, making it highly specific per ACC guidelines. CK-MB rises in 3 - 6 hours, peaks at 24 hours, and normalizes by 72 hours, helping detect reinfarction.

  3. Initial MI Management: MONA -

    Morphine for pain relief and anxiety reduction, Oxygen to maintain SaO₂ > 94%, Nitroglycerin for preload reduction, and Aspirin 162 - 325 mg chewed immediately; always check blood pressure first. This time-tested "MONA" approach accelerates patient comfort and coronary perfusion, per University of Michigan cardiology protocols.

  4. Heart Failure Classification & Symptoms (HFrEF vs HFpEF) -

    Left ventricular ejection fraction <40% indicates HFrEF, while ≥50% suggests HFpEF, with 41 - 49% deemed borderline (ACC/AHA). Teach patients the "FACES" mnemonic - Fatigue, Activities limited, Chest congestion, Edema, Shortness of breath - to self-monitor worsening HF.

  5. Core HF Pharmacotherapy -

    First-line agents include loop diuretics (e.g., furosemide), ACE inhibitors (lisinopril), and beta-blockers (metoprolol); consider adding spironolactone and digoxin for symptomatic patients. A handy mnemonic is "DLAB": Diuretics, ACE/ARB, Beta-blocker, Aldosterone antagonist, aligning with ACC/AHA HF guidelines.

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