Canadian Cardiac Vascular Nursing Practice Test

Canadian Cardiac Vascular Nursing Practice Test

The Canadian Cardiac Vascular Nursing Practice Test is a comprehensive resource designed to aid nursing professionals in their preparation for exams and clinical practice. Focused on cardiovascular and vascular health, the test covers a wide range of topics essential for effective patient care in these areas. It includes multiple-choice questions that address key concepts such as myocardial infarction, heart failure, arrhythmias, coronary artery disease, and vascular disorders like aortic aneurysms.

Each question is paired with a detailed explanation, helping to reinforce essential knowledge and improve critical thinking skills. The test evaluates understanding of the pathophysiology of heart and vascular conditions, diagnostic procedures, pharmacological interventions, and post-operative care. It ensures nurses are well-equipped to handle real-world clinical situations and make informed decisions in patient management.

This practice test is valuable for nurses preparing for certification exams, continuing education, or those looking to enhance their expertise in cardiac and vascular nursing. The questions reflect the practical aspects of patient care and are structured to deepen the nurse’s understanding of complex cardiovascular issues. Whether for novice or experienced practitioners, this exam provides a solid foundation in cardiovascular nursing, supporting the delivery of high-quality, safe care for patients with heart and vascular conditions.

Sample Questions and answer

1. Which of the following is the most reliable indicator of left ventricular failure?
A. Hepatomegaly
B. Peripheral edema
C. Pulmonary crackles
D. Jugular venous distension
Answer: C. Pulmonary crackles
Explanation: Pulmonary crackles are the most reliable sign of left-sided heart failure as fluid backs up into the lungs, leading to pulmonary congestion.
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2. What ECG change is most commonly associated with myocardial ischemia?
A. Tall, peaked T waves
B. ST segment depression
C. U waves
D. Prolonged PR interval
Answer: B. ST segment depression
Explanation: ST segment depression often indicates myocardial ischemia, reflecting subendocardial injury.
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3. A patient with chronic stable angina is prescribed nitroglycerin. What instruction is most important to provide?
A. Take it after meals
B. Swallow the tablet whole
C. Take it at bedtime
D. Sit down before taking the medication
Answer: D. Sit down before taking the medication
Explanation: Nitroglycerin can cause sudden hypotension and dizziness. The patient should sit or lie down to avoid injury.
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4. Which lab test best reflects long-term anticoagulation with warfarin?
A. INR
B. aPTT
C. Platelet count
D. D-dimer
Answer: A. INR
Explanation: INR (International Normalized Ratio) monitors the therapeutic effect of warfarin therapy.
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5. Which of the following is the priority nursing action after femoral cardiac catheterization?
A. Encourage ambulation
B. Administer pain medication
C. Monitor peripheral pulses
D. Increase fluid intake
Answer: C. Monitor peripheral pulses
Explanation: Assessing pulses ensures circulation is intact post-procedure and detects vascular complications.
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6. Which medication is a first-line treatment for atrial fibrillation with rapid ventricular response?
A. Atropine
B. Amiodarone
C. Digoxin
D. Adenosine
Answer: B. Amiodarone
Explanation: Amiodarone is effective for rate and rhythm control in atrial fibrillation.
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7. Which cardiac marker rises earliest after myocardial infarction?
A. Troponin I
B. CK-MB
C. Myoglobin
D. LDH
Answer: C. Myoglobin
Explanation: Myoglobin is the earliest marker, rising within 1–3 hours, but is less specific than troponin.
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8. What is a major side effect of ACE inhibitors in cardiac patients?
A. Hypoglycemia
B. Bradycardia
C. Persistent cough
D. Hypercalcemia
Answer: C. Persistent cough
Explanation: ACE inhibitors often cause a dry cough due to bradykinin accumulation.
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9. Which of the following is a risk factor unique to women for coronary artery disease?
A. Smoking
B. Diabetes
C. Early menopause
D. Family history
Answer: C. Early menopause
Explanation: Loss of estrogen protection after early menopause increases cardiovascular risk in women.
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10. What is the purpose of a cardiac stress test?
A. Determine heart valve function
B. Assess conduction abnormalities
C. Detect ischemia during exertion
D. Evaluate fluid status
Answer: C. Detect ischemia during exertion
Explanation: A stress test identifies areas of reduced blood flow when the heart is under stress.
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11. Which lifestyle change is most effective in reducing hypertension?
A. Avoiding coffee
B. Reducing alcohol intake
C. Weight loss
D. Taking aspirin
Answer: C. Weight loss
Explanation: Even moderate weight loss significantly lowers blood pressure.
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12. Which nursing action takes priority for a patient with acute pericarditis?
A. Monitor for ST elevation
B. Administer corticosteroids
C. Auscultate for friction rub
D. Assess for cardiac tamponade
Answer: D. Assess for cardiac tamponade
Explanation: Cardiac tamponade is life-threatening and must be identified early in pericarditis.
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13. In vascular nursing, intermittent claudication is best described as:
A. Constant leg pain at rest
B. Pain during exercise relieved by rest
C. Sudden sharp pain in the chest
D. Tingling in the fingers
Answer: B. Pain during exercise relieved by rest
Explanation: This is a classic symptom of peripheral artery disease.
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14. What is the primary goal in treating heart failure?
A. Reduce blood glucose
B. Improve cardiac output
C. Prevent infection
D. Lower cholesterol
Answer: B. Improve cardiac output
Explanation: The central aim is to enhance the heart’s pumping ability and reduce symptoms.
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15. Which of the following indicates venous insufficiency?
A. Pale, cool extremities
B. Dependent edema
C. Hair loss on legs
D. Absent pedal pulses
Answer: B. Dependent edema
Explanation: Edema and stasis dermatitis are classic signs of venous insufficiency.
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16. What is the function of beta-blockers in cardiac patients?
A. Increase heart rate
B. Reduce myocardial oxygen demand
C. Enhance preload
D. Promote vasoconstriction
Answer: B. Reduce myocardial oxygen demand
Explanation: Beta-blockers slow the heart rate and reduce the workload on the heart.
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17. Which finding would you expect in a patient with mitral valve stenosis?
A. Systolic murmur
B. Pulmonary congestion
C. Bradycardia
D. Bounding pulses
Answer: B. Pulmonary congestion
Explanation: Blood backs up into the lungs due to poor forward flow, causing congestion.
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18. The primary symptom of thoracic aortic aneurysm is:
A. Back pain
B. Headache
C. Chest pain
D. Leg cramps
Answer: C. Chest pain
Explanation: Thoracic aneurysms often present with chest pain due to pressure on surrounding structures.
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19. A nurse is teaching about DASH diet. Which food is appropriate?
A. Bacon
B. Canned soup
C. Low-fat yogurt
D. Processed cheese
Answer: C. Low-fat yogurt
Explanation: DASH diet emphasizes low-fat dairy and reduced sodium intake.
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20. Which drug is used to prevent clot formation after a coronary stent?
A. Warfarin
B. Heparin
C. Clopidogrel
D. Alteplase
Answer: C. Clopidogrel
Explanation: Clopidogrel is an antiplatelet used post-stent to prevent thrombosis.
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21. What is a common sign of endocarditis?
A. Pericardial friction rub
B. Petechiae
C. Jaundice
D. Polyuria
Answer: B. Petechiae
Explanation: Small red or purple spots due to microemboli are classic in infective endocarditis.
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22. Which factor increases preload in heart failure?
A. Diuresis
B. Vasodilation
C. Fluid retention
D. Dehydration
Answer: C. Fluid retention
Explanation: Preload increases when there is more circulating volume due to sodium and water retention.
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23. When assessing for a bruit, the nurse should:
A. Palpate the area
B. Use the bell of the stethoscope
C. Ask the patient to swallow
D. Listen over the trachea
Answer: B. Use the bell of the stethoscope
Explanation: Bruits are low-pitched sounds best heard with the bell over the artery.
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24. A DVT is most commonly associated with:
A. Smoking
B. Surgery
C. Heart failure
D. Varicose veins
Answer: B. Surgery
Explanation: Surgery, especially orthopedic or abdominal, increases DVT risk due to immobility and endothelial injury.
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25. Which assessment finding suggests peripheral arterial disease?
A. Warm, swollen legs
B. Brown discoloration
C. Absent pedal pulses
D. Pruritus
Answer: C. Absent pedal pulses
Explanation: Diminished or absent pulses suggest arterial insufficiency.
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26. The ankle-brachial index (ABI) is used to assess:
A. Cardiac output
B. Valvular function
C. Peripheral perfusion
D. Coronary artery disease
Answer: C. Peripheral perfusion
Explanation: ABI is a non-invasive test to detect peripheral artery disease.
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27. Which medication is used to manage pulmonary edema in heart failure?
A. Morphine
B. Aspirin
C. Epinephrine
D. Acetaminophen
Answer: A. Morphine
Explanation: Morphine reduces preload and anxiety, easing pulmonary congestion.
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28. What is a classic early sign of digoxin toxicity?
A. Tinnitus
B. Confusion
C. Visual disturbances
D. Chest pain
Answer: C. Visual disturbances
Explanation: Yellow-green halos or blurred vision are early signs of digoxin toxicity.
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29. What symptom is most concerning in a patient with an abdominal aortic aneurysm?
A. Nausea
B. Back pain
C. Bruising
D. Leg swelling
Answer: B. Back pain
Explanation: Sudden or severe back pain can indicate rupture of the aneurysm.
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30. A nurse notes bilateral 3+ pitting edema in a cardiac patient. The best interpretation is:
A. Fluid overload
B. Dehydration
C. Arterial insufficiency
D. Infection
Answer: A. Fluid overload
Explanation: Bilateral pitting edema commonly indicates right-sided heart failure or fluid retention.
31. Which diagnostic test is most definitive for detecting coronary artery blockages?
A. ECG
B. Chest X-ray
C. Echocardiogram
D. Coronary angiography
Answer: D. Coronary angiography
Explanation: This is the gold standard for visualizing blockages in coronary arteries.
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32. In heart failure, what compensatory mechanism leads to ventricular hypertrophy?
A. Diuresis
B. RAAS activation
C. Baroreceptor suppression
D. Natriuretic peptide release
Answer: B. RAAS activation
Explanation: RAAS causes vasoconstriction and fluid retention, increasing workload and leading to hypertrophy.
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33. Which of the following findings is expected in a patient with severe aortic stenosis?
A. Bounding pulses
B. Wide pulse pressure
C. Syncope
D. Tachypnea at rest
Answer: C. Syncope
Explanation: Aortic stenosis limits cardiac output, especially during exertion, causing syncope.
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34. Which medication reduces afterload in patients with heart failure?
A. Furosemide
B. Digoxin
C. Lisinopril
D. Nitroglycerin
Answer: C. Lisinopril
Explanation: ACE inhibitors reduce afterload by vasodilation, easing the heart’s workload.
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35. A patient with atrial fibrillation is at risk for:
A. DVT
B. Pulmonary embolism
C. Stroke
D. Cardiac tamponade
Answer: C. Stroke
Explanation: Irregular atrial contraction can lead to thrombus formation and embolic stroke.
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36. What is the most important pre-procedure assessment before cardiac catheterization?
A. Blood sugar
B. Allergy to iodine or shellfish
C. Family history
D. BMI
Answer: B. Allergy to iodine or shellfish
Explanation: Contrast dye contains iodine; allergic reactions can be life-threatening.
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37. Which valve disorder causes a systolic murmur at the apex?
A. Aortic stenosis
B. Pulmonary regurgitation
C. Mitral regurgitation
D. Tricuspid stenosis
Answer: C. Mitral regurgitation
Explanation: Blood backflows during systole from the left ventricle to the left atrium.
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38. An S3 heart sound is most commonly associated with:
A. Aging
B. Mitral stenosis
C. Heart failure
D. Aortic regurgitation
Answer: C. Heart failure
Explanation: S3 is heard due to rapid ventricular filling in volume overload states like heart failure.
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39. Which teaching point is important for a patient starting warfarin therapy?
A. Increase green leafy vegetables
B. Monitor blood pressure daily
C. Avoid aspirin and NSAIDs
D. Take antacids before warfarin
Answer: C. Avoid aspirin and NSAIDs
Explanation: These increase bleeding risk and should be avoided with warfarin.
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40. A patient on a statin should be monitored for:
A. Kidney failure
B. Muscle pain or weakness
C. Bradycardia
D. Insomnia
Answer: B. Muscle pain or weakness
Explanation: Statins can cause myopathy or rhabdomyolysis; report muscle symptoms promptly.
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41. What is a key nursing intervention for post-operative care after carotid endarterectomy?
A. Keep patient flat for 12 hours
B. Monitor for stridor or hoarseness
C. Apply heat to the incision
D. Encourage vigorous coughing
Answer: B. Monitor for stridor or hoarseness
Explanation: These signs indicate possible airway obstruction or nerve injury.
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42. What is the purpose of using compression stockings in vascular patients?
A. Reduce blood pressure
B. Treat arterial ulcers
C. Promote venous return
D. Prevent hypotension
Answer: C. Promote venous return
Explanation: Compression improves blood flow and helps prevent venous stasis and DVT.
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43. The first action when a patient reports chest pain is to:
A. Perform ECG
B. Give nitroglycerin
C. Assess vital signs
D. Stop activity and sit the patient down
Answer: D. Stop activity and sit the patient down
Explanation: Reducing myocardial oxygen demand is the first step while further assessments follow.
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44. Which is the best marker of cardiac tissue damage after MI?
A. Troponin
B. CK
C. ALT
D. BNP
Answer: A. Troponin
Explanation: Troponin is highly specific to cardiac muscle and remains elevated for days.
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45. What symptom distinguishes arterial from venous ulcers?
A. Irregular borders
B. Shiny, hairless skin
C. Brown discoloration
D. Moist wound bed
Answer: B. Shiny, hairless skin
Explanation: Arterial ulcers are dry and occur with poor circulation, leading to hair loss and shiny skin.
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46. What is the priority in managing hypertensive crisis?
A. Reduce blood pressure to normal rapidly
B. Administer IV beta-blockers
C. Lower BP gradually to prevent ischemia
D. Restrict fluids immediately
Answer: C. Lower BP gradually to prevent ischemia
Explanation: Rapid reduction may impair perfusion to vital organs; gradual lowering is safer.
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47. A client with PAD should be encouraged to:
A. Avoid walking
B. Sit with legs elevated above the heart
C. Keep legs dependent when resting
D. Use heating pads to improve circulation
Answer: C. Keep legs dependent when resting
Explanation: Gravity aids arterial flow when the legs are positioned lower than the heart.
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48. BNP is used primarily to:
A. Diagnose DVT
B. Evaluate response to diuretics
C. Monitor fluid status in sepsis
D. Distinguish heart failure from respiratory causes
Answer: D. Distinguish heart failure from respiratory causes
Explanation: BNP is elevated in heart failure and helps confirm its presence over pulmonary causes.
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49. Which patient teaching is essential for someone with a new pacemaker?
A. Avoid cell phone use
B. Report hiccups or dizziness
C. Sleep on the same side as the device
D. Check radial pulse daily
Answer: B. Report hiccups or dizziness
Explanation: These could indicate pacemaker malfunction or lead displacement.
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50. Which ECG finding suggests pericarditis?
A. ST elevation in all leads
B. T wave inversion in V1–V3
C. Peaked T waves
D. QT prolongation
Answer: A. ST elevation in all leads
Explanation: Diffuse ST elevation without reciprocal changes is a hallmark of pericarditis.
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51. What assessment finding is most concerning after CABG surgery?
A. Drainage of 50 mL/hour
B. Temperature of 38°C
C. BP of 98/60 mmHg
D. Chest tube output of 300 mL in 1 hour
Answer: D. Chest tube output of 300 mL in 1 hour
Explanation: This suggests postoperative hemorrhage and requires immediate attention.
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52. Which is a modifiable risk factor for cardiovascular disease?
A. Age
B. Family history
C. Smoking
D. Gender
Answer: C. Smoking
Explanation: Unlike age or genetics, smoking can be controlled through behavioral change.
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53. In patients with chronic venous insufficiency, ulcers are typically:
A. Dry with well-defined edges
B. Located on the lateral foot
C. Painful with black eschar
D. Moist with irregular borders near the ankles
Answer: D. Moist with irregular borders near the ankles
Explanation: Venous ulcers occur in dependent areas and are often weepy, with irregular margins.
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54. What does a widened QRS complex indicate?
A. Atrial conduction delay
B. Premature atrial contraction
C. Bundle branch block or ventricular origin
D. Normal conduction
Answer: C. Bundle branch block or ventricular origin
Explanation: A wide QRS reflects delayed ventricular depolarization from a ventricular ectopic or conduction block.
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55. Which lab value is most critical to monitor for a patient on heparin therapy?
A. INR
B. PT
C. aPTT
D. Troponin
Answer: C. aPTT
Explanation: Heparin is monitored using aPTT to adjust dosage and prevent bleeding.
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56. Which sound is typical of a patient with a pericardial friction rub?
A. Low-pitched rumble during diastole
B. Harsh systolic murmur
C. High-pitched, scratchy sound
D. Soft, blowing sound
Answer: C. High-pitched, scratchy sound
Explanation: Friction rubs occur due to inflamed pericardial surfaces rubbing together.
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57. What is the primary cause of angina pectoris?
A. Arrhythmias
B. Inflammation of the myocardium
C. Decreased myocardial oxygen supply
D. Increased blood volume
Answer: C. Decreased myocardial oxygen supply
Explanation: Angina is due to imbalance between oxygen demand and coronary supply.
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58. A bruit over the carotid artery is best assessed with:
A. The diaphragm of the stethoscope
B. The bell of the stethoscope
C. Two fingers
D. Doppler probe
Answer: B. The bell of the stethoscope
Explanation: Bruits are low-frequency and best heard with the bell.
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59. The nurse is caring for a patient with an implantable cardioverter-defibrillator (ICD). What statement indicates proper understanding?
A. “I can use a TENS unit for my back pain.”
B. “I’ll avoid leaning over running engines.”
C. “I should avoid metal detectors forever.”
D. “I’ll need to keep my heart rate below 60.”
Answer: B. “I’ll avoid leaning over running engines.”
Explanation: Electromagnetic interference can affect ICDs, especially from strong motors.
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60. Which finding in a patient with hypertension warrants immediate follow-up?
A. Headache in the morning
B. BP 168/96 mmHg
C. Blurred vision and epistaxis
D. Fatigue and palpitations
Answer: C. Blurred vision and epistaxis
Explanation: These are warning signs of hypertensive urgency or emergency.