Cardiovascular
NCLEX® practice.

Free practice set · 3 questions

3 more free cardiovascular NCLEX-RN® practice questions

Real questions from the same bank the app serves. Pick an answer in your head, then open the rationale to see why the correct option holds and why each other option falls short. No account needed for these.

1. Question 1 of 3 · Heart Failure & Cardiac Output

   A 62-year-old client is found unresponsive on the unit. The monitor shows a rhythm consistent with ventricular fibrillation. The client has no palpable pulse, no spontaneous breathing, and skin is pale and cool. The chart shows no valid DNR order on file. The AED is located in a room down the hallway. What is the nurse's priority action?

   1. ADefibrillate the client immediately, then begin chest compressions if the rhythm remains unchanged.
   2. BCall for help and immediately begin chest compressions at 100–120/min with a depth of 2–2.4 inches.
   3. CLeave the bedside to retrieve the AED from the hallway before starting any compressions.
   4. DWait for the code team to arrive before beginning any resuscitation, because the AED is not immediately available.
   Show the answer and rationale

   Correct answer: B. Call for help and immediately begin chest compressions at 100–120/min with a depth of 2–2.4 inches.

   For an unresponsive, pulseless adult client in ventricular fibrillation, the AHA BLS adult chain of survival prioritizes immediate, high-quality chest compressions over retrieval of equipment. The nurse activates the code, begins compressions immediately at 100–120 compressions per minute with a depth of 2–2.4 inches (5–6 cm), ensures full chest recoil between compressions, and directs another team member to retrieve the AED. Starting compressions without delay is critical because perfusion to the brain and heart must be restored as quickly as possible; delaying compressions to obtain the defibrillator significantly reduces the chance of successful resuscitation. Once the AED arrives, defibrillation is applied for the shockable rhythm (ventricular fibrillation), followed immediately by resumption of compressions. The absence of a valid DNR order confirms that full resuscitation is indicated. Option C and D both delay compressions, violating the principle that high-quality CPR must begin within seconds. Option A suggests defibrillating without first beginning compressions, which reverses the correct priority sequence in this scenario.

   A. Defibrillate the client immediately, then begin chest compressions if the rhythm remains unchanged.

   Incorrect, violates the "compress at 80/min or 1 inch depth" error pattern pattern. Attempting to defibrillate without having first established compressions does not follow the correct priority. Although ventricular fibrillation is shockable, compressions must be initiated immediately; the AED/defibrillator is applied once it arrives, not before compressions begin.

   B. Call for help and immediately begin chest compressions at 100–120/min with a depth of 2–2.4 inches.

   Correct. Per the AHA BLS adult chain of survival, the nurse immediately initiates high-quality chest compressions at 100–120/min and 2–2.4 inches depth for an unresponsive, pulseless client. Compressions begin before the AED is retrieved; another responder is summoned to get the defibrillator. This maximizes perfusion and survival probability.

   C. Leave the bedside to retrieve the AED from the hallway before starting any compressions.

   Incorrect, violates the "delay compressions to retrieve the AED" error pattern. Leaving the bedside to retrieve the AED delays the start of compressions, which reduces coronary and cerebral perfusion. The AED is a secondary priority; compressions and calling for help are the immediate actions. Another team member retrieves the AED while compressions continue.

   D. Wait for the code team to arrive before beginning any resuscitation, because the AED is not immediately available.

   Incorrect, violates the "delay compressions to retrieve the AED" error pattern. Withholding compressions until the code team arrives or the AED is present causes preventable deterioration. High-quality CPR is the standard of care and must begin immediately, regardless of equipment location. Waiting causes unacceptable delays in perfusion.

2. Question 2 of 3 · Heart Failure & Cardiac Output

   A 3-day-postoperative client with a new sigmoid colostomy reports feeling ready to learn self-care. The nurse assesses the stoma, which is beefy red, moist, and protruding 1 cm above the skin. The surrounding skin is intact. The client has not yet viewed the stoma directly. Which action best supports the client's adjustment and skin integrity during this phase?

   1. AInvite the client to view the stoma in a mirror during pouch change, and size the wafer opening 1/8 inch (2–3 mm) larger than the stoma.
   2. BTape over small areas of leaking around the current pouch and reinforce the seal until the next scheduled change.
   3. CCut the pouch opening to match the stoma size exactly to ensure a secure seal and prevent leakage.
   4. DKeep the stoma covered with gauze throughout hospitalization to minimize the client's emotional distress.
   Show the answer and rationale

   Correct answer: A. Invite the client to view the stoma in a mirror during pouch change, and size the wafer opening 1/8 inch (2–3 mm) larger than the stoma.

   A healthy sigmoid colostomy stoma is beefy red and moist, signaling good perfusion and viability. The nurse must protect the peristomal skin by fitting the pouch opening 1/8 inch (2–3 mm) larger than the stoma; this spacing prevents pressure injury to the stoma tissue and reduces the risk of skin contact with stool effluent. In the early postoperative period, gradual visualization of the stoma supports psychological adjustment and enables the client to participate in self-care. Inviting the client to view the stoma during a pouch change, using a mirror, respects readiness while building confidence and acceptance, which are essential foundations for long-term self-management. The correct answer combines stoma perfusion recognition, appliance-sizing rule, and progressive education matched to the client's readiness.

   A. Invite the client to view the stoma in a mirror during pouch change, and size the wafer opening 1/8 inch (2–3 mm) larger than the stoma.

   This option correctly applies the key rules: stoma color assessment (beefy red indicates healthy perfusion), the 1/8-inch sizing rule to protect peristomal skin from pressure and effluent contact, and progressive education that honors the client's readiness and supports acceptance.

   B. Tape over small areas of leaking around the current pouch and reinforce the seal until the next scheduled change.

   This option violates the appliance-change principle. Taping over a leaking pouch (the "tape over a leaking pouch instead of changing it" error pattern) delays removal of the leaking barrier, allowing effluent to damage the peristomal skin beneath the wafer. A leaking pouch must be removed and replaced immediately, not reinforced.

   C. Cut the pouch opening to match the stoma size exactly to ensure a secure seal and prevent leakage.

   This option violates the appliance-sizing rule (the "protect peristomal skin with a well-fitted appliance and barrier care" rule). Cutting the wafer opening flush to the stoma causes direct contact between skin barrier and stoma tissue, resulting in pressure injury and necrosis. The correct margin is 2–3 mm larger than the stoma at the base.

   D. Keep the stoma covered with gauze throughout hospitalization to minimize the client's emotional distress.

   This option violates the education principle (the "cover the stoma to spare the client emotional distress" error pattern). Covering the stoma and avoiding client exposure delays acceptance and prevents the client from gradually becoming comfortable with the altered anatomy. Self-care requires progressive, readiness-matched viewing and participation; the nurse explores boundaries while gently supporting visualization.

3. Question 3 of 3 · Heart Failure & Cardiac Output

   A 45-year-old client is 2 days post-op following creation of a sigmoid colostomy for colorectal cancer. The stoma is beefy red, moist, and 2 cm in diameter. The peristomal skin is intact. During morning care, the nurse notes a small amount of stool leaking from under the wafer, and the client expresses reluctance to look at or touch the stoma, stating, "I'm not ready to deal with this yet." The nurse has available the current two-piece pouch system with a pre-cut wafer. Which nursing action is most appropriate?

   1. AChange the pouch immediately and size the new wafer opening 2–3 mm larger than the stoma base to prevent skin contact with effluent.
   2. BReinforce the current pouch with additional waterproof tape and defer the change until the scheduled time tomorrow.
   3. CCut the wafer opening to fit flush against the stoma circumference to create a secure seal.
   4. DProceed with patient education and encourage viewing the stoma in the mirror now to establish self-care independence quickly.
   Show the answer and rationale

   Correct answer: A. Change the pouch immediately and size the new wafer opening 2–3 mm larger than the stoma base to prevent skin contact with effluent.

   Prompt pouch change is needed when leakage occurs, and the wafer opening must be sized correctly. When stool leaks under the wafer, it rapidly damages the peristomal skin through enzymatic and chemical irritation; leaving the pouch in place and reinforcing it with tape allows continued skin contact with effluent, accelerating breakdown and infection. The wafer opening must be 2–3 mm (1/8 inch) larger than the stoma base. This margin prevents pressure on the stoma, which compromises perfusion and risks necrosis, while protecting the peristomal skin by ensuring the barrier, not the skin, bears the contact with stool. In a sigmoid colostomy, stool is formed or pasty and predictable, making proper appliance fit and timely changes key to skin integrity and client confidence. Addressing the leak immediately, rather than reinforcing the pouch, demonstrates to the client that ostomy care is manageable and responsive. The nurse should explore the client's readiness to view the stoma gradually, using photos, mirrors, and hands-on guidance only when the client consents, rather than forcing participation during acute distress. This honors autonomy and supports long-term acceptance.

   A. Change the pouch immediately and size the new wafer opening 2–3 mm larger than the stoma base to prevent skin contact with effluent.

   Correct. Changing the pouch immediately when leakage occurs removes the source of skin damage. Sizing the wafer 2–3 mm larger than the stoma base protects peristomal skin by preventing both pressure injury to the stoma and direct effluent contact with skin. This action follows the key rules for healthy stoma perfusion and peristomal-skin protection.

   B. Reinforce the current pouch with additional waterproof tape and defer the change until the scheduled time tomorrow.

   Incorrect (the "tape over a leaking pouch instead of changing it" error pattern). Reinforcing a leaking pouch delays necessary care and violates the key rule: effluent leaking under the wafer rapidly causes chemical and enzymatic skin breakdown. The pouch must be removed and replaced immediately, not reinforced with tape and deferred.

   C. Cut the wafer opening to fit flush against the stoma circumference to create a secure seal.

   Incorrect (the "cut the pouch opening flush to the stoma" error pattern). Cutting the wafer opening flush to the stoma circumference creates pressure injury and places the stoma edge in direct contact with the wafer, risking necrosis and compromising perfusion. The opening must be 1/8 inch (2–3 mm) larger than the stoma base to prevent pressure and protect the peristomal skin.

   D. Proceed with patient education and encourage viewing the stoma in the mirror now to establish self-care independence quickly.

   Incorrect (the "cover the stoma to spare the client emotional distress" error pattern). Forcing the client to view the stoma during acute distress disrespects autonomy and risks emotional harm, impeding long-term acceptance. The nurse must assess the client's readiness and offer graduated exposure (photos, mirrors, gentle touch) only when the client is prepared, supporting gradual acceptance and self-care independence.