Cardiovascular Nursing for the NCLEX-RN Exam

Common failure modes

These are the patterns that cause most candidates to lose marks on this topic. Recognising them in advance is half the work.

• !Confusing STEMI vs. NSTEMI presentation — STEMI requires emergent reperfusion (PCI within 90 min)
• !Misidentifying lethal rhythms — V-fib requires defibrillation, not synchronized cardioversion
• !Forgetting that patients post-cardiac-cath must lie flat 4–6 hours with the affected leg straight
• !Mixing up beta-blocker contraindications (severe bradycardia, decompensated HF) with indications (post-MI, stable HF)

Study tips

• 1Memorize ACLS algorithms for V-fib, V-tach (pulseless and with pulse), bradycardia, and tachycardia.
• 2Drill 12-lead ECG STEMI localization: anterior (V1–V4) = LAD, inferior (II/III/aVF) = RCA, lateral (I/aVL/V5–V6) = LCx.
• 3Practice post-cath nursing priorities: assess site, distal pulses, urine output every 15–30 min for the first 2 hours.
• 4Learn HF triggers: dietary sodium, missed diuretic dose, NSAID use, atrial-fibrillation onset.

Sample NCLEX-RN Cardiovascular Nursing questions

These sample items mirror the format and difficulty of real NCLEX-RN questions. Practice with thousands more on the free Koydo question bank.

1. 1

   A client with chest pain has a 12-lead ECG showing ST elevation in leads II, III, and aVF. Which artery is most likely occluded?

   • ALeft anterior descending
   • BRight coronary arteryCorrect
   • CLeft circumflex
   • DPosterior descending
   Why this answer?

   ST elevation in the inferior leads (II, III, aVF) indicates an inferior wall MI, most commonly caused by occlusion of the right coronary artery (RCA). Inferior MIs may also affect the right ventricle and AV node, requiring monitoring for bradycardia and heart block.