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NCLEX-RN Med-Surg — Cardiac flashcards

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Angina versus MI, left versus right heart failure, digoxin and anticoagulant teaching, hypertension, what to do for each lethal and common dysrhythmia, pacemakers, pericarditis and tamponade, cardiac cath and CABG care, the types of shock, and arterial versus venous disease with DVT prevention.

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Learn deck · part of NCLEX-RN · written against: NCSBN 2026 NCLEX-RN Test Plan, in effect from 1 April 2026 (Next Generation NCLEX; client-needs categories and percentages unchanged from 2023, fact-checked 2026-10-11). Updated 2026-10-10.

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  1. How does stable angina differ from the chest pain of a myocardial infarction?
    Stable angina is predictable: brought on by exertion or stress, relieved within minutes by rest or nitroglycerin, and over in under about 15 minutes. MI pain starts at rest or with less exertion than usual, lasts longer, is not relieved by rest or nitroglycerin, and often comes with diaphoresis, nausea, and dyspnea.
    Angina & MI
  2. What are the signs of left-sided heart failure?
    The lungs back up: dyspnea, orthopnea, paroxysmal nocturnal dyspnea, crackles, a cough with frothy or pink-tinged sputum, and an S3 gallop, with fatigue and, when acute, pulmonary edema.

    Mnemonic: Left = Lungs.
    Heart Failure
  3. Which clients are at the highest risk of digoxin toxicity, and why?
    Older adults and those with kidney impairment (digoxin is cleared by the kidney), clients with hypokalemia or hypomagnesemia from diuretics, and those on interacting drugs such as amiodarone and verapamil. Toxicity shows as anorexia, nausea, bradycardia, confusion, and visual halos.
    Digoxin & Anticoagulation
  4. Why is hypertension called the 'silent killer', and what does that mean for teaching?
    Most clients have no symptoms until organ damage appears — stroke, MI, kidney failure, retinopathy — so they stop drugs that make them feel worse than the disease does. Teach that the medication is for the future, to take it even when feeling well, and never to stop it abruptly.
    Hypertension
  5. What is the nursing response to ventricular fibrillation?
    Defibrillate immediately — V-fib is a chaotic, pulseless rhythm and every minute without a shock lowers survival. Do CPR while the defibrillator charges, give epinephrine and amiodarone per ACLS, and check for a pulse only after the shock and 2 minutes of CPR.
    Dysrhythmias
  6. What does the nurse teach a client going home with a new permanent pacemaker?
    Check the pulse daily and report a rate below the set rate; keep the incision dry and watch for infection; avoid raising the arm on that side above the shoulder for the period the surgeon sets; carry the device ID card; and report dizziness, fainting, or persistent hiccups, which can mean a lead is stimulating the diaphragm.
    Pacemakers
  7. What distinguishes the chest pain of pericarditis from an MI?
    Pericarditis pain is sharp, worse with inspiration, coughing, and lying flat, and eased by sitting up and leaning forward, often with a pericardial friction rub; MI pain is pressure-like and unaffected by position or breathing. The ECG shows diffuse ST elevation rather than a regional pattern.
    Pericarditis · Endocarditis & Tamponade
  8. What does the nurse assess before a cardiac catheterization?
    Allergy to iodinated contrast (a shellfish allergy alone is not a contraindication), kidney function (contrast can injure kidneys that are already impaired, and metformin is often held per protocol, always when kidney function is poor), the baseline peripheral pulses of the limb to be used, anticoagulant use, NPO status, and informed consent.

    Mark the pedal pulses so post-procedure checks compare like with like.
    Cardiac Cath & CABG
  9. What is the common thread in every type of shock, and which early signs appear before the blood pressure drops?
    Inadequate tissue perfusion, whatever the cause. Compensation shows first: tachycardia, restlessness or anxiety, and falling urine output, with cool pale skin and a narrowing pulse pressure in hypovolemic and cardiogenic shock. A falling blood pressure is a late sign that compensation has failed.

    Watch out: early septic shock can be warm with a wide pulse pressure, and neurogenic shock brings bradycardia.
    Shock
  10. How does peripheral arterial disease differ from chronic venous insufficiency in the legs?
    • Arterial: pain with walking relieved by rest, cool pale or dusky hairless shiny skin, weak or absent pulses, pallor on elevation and redness when dangling, and painful round ulcers on the toes and feet
    • Venous: aching heavy swollen legs relieved by elevation, warm brown-stained skin, normal pulses, and irregular weeping ulcers around the ankles.
    Peripheral Vascular & DVT

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About these cards

Review status: Second-reader reviewed, with corrections applied.

Checked against:

  • Checked against Open RN Health Alterations and Open RN Nursing Fundamentals (Chippewa Valley Technical College, CC BY 4.0) and MedlinePlus (U.S. National Library of Medicine); reference only, no text copied.
  • Resuscitation and reperfusion principles cross-checked against the American Heart Association ACLS and ACC/AHA STEMI guidance; endocarditis prophylaxis against AHA recommendations; reference only.
  • CPR quality checked against the 2025 AHA Guidelines for CPR and ECC; the MAP target against the Surviving Sepsis Campaign 2026 international guidelines; nitroglycerin and post-MI activity teaching against AHA patient guidance; reference only, no text copied.
  • STEMI reperfusion times checked against the CMS emergency department STEMI measure (CMS996, 2026 specification); asystole care against the 2025 ILCOR Advanced Life Support CoSTR chapter; reference only, no text copied.

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