NCLEX Cardiac Questions: EKG, Dysrhythmias & Heart Failure

Cardiac questions are some of the most common and high‑priority items on the NCLEX. Whether it's interpreting EKG strips, identifying dangerous dysrhythmias, or managing heart failure symptoms, the exam expects nurses to make quick and safe clinical decisions. This guide breaks down everything you need to know to master **NCLEX cardiac** questions with confidence

Why Cardiac Questions Matter on the NCLEX

The heart is one of the highest‑risk systems in nursing care. Problems like arrhythmias, myocardial infarction, and acute heart failure can rapidly become life‑threatening. That’s why NCLEX places strong emphasis on:

• EKG interpretation
• Priority cardiac assessments
• Medication actions and side effects
• Identifying early vs. late symptoms
• Safety interventions

Mastering these topics not only boosts your NCLEX score but prepares you for real‑world practice.

EKG Interpretation Essentials for NCLEX

You don’t need to read full 12‑lead EKGs—just recognize critical patterns:

• Normal Sinus Rhythm (NSR)
  Rate 60–100 BPM, consistent P waves, and regular rhythm.
• Atrial Fibrillation (AFib)
  Irregular rhythm, no distinct P waves.
  Risks: clots, stroke.
  Treatment: anticoagulants, rate control.
• Ventricular Tachycardia (VTach)
  Wide QRS, fast rate.
  Stable → meds;
  Unstable → cardioversion;
  Pulseless → CPR & defibrillation.
• Ventricular Fibrillation (VFib)
  Chaotic rhythm, no pulse.
  IMMEDIATE defibrillation is priority.
• Heart Block Patterns
  Mobitz II & Third‑degree block require pacing.

High‑Yield Cardiac Dysrhythmias for NCLEX

• ✔ Bradycardia – treat symptomatic cases with atropine.
• ✔ SVT – treat with vagal maneuvers, adenosine, synchronized cardioversion.
• ✔ Asystole – CPR only (NO shock).
• ✔ PVCs – concerning when frequent or in MI patients.

Heart Failure NCLEX Must‑Know Concepts

**Left‑Sided HF Symptoms:**

• Crackles
• Dyspnea
• Orthopnea
• Pulmonary edema

**Right‑Sided HF Symptoms:**

• Edema
• Ascites
• JVD
• Weight gain

Priority interventions include:

• Administer oxygen
• Give diuretics (e.g., furosemide)
• Reduce fluid overload
• Daily weights
• Low sodium diet

Medications Seen on NCLEX

• ACE inhibitors: watch for cough & angioedema
• Beta blockers: avoid in severe HF or bradycardia
• Digoxin: check apical pulse; toxicity → nausea/vision changes
• Diuretics: monitor potassium levels

Practice NCLEX Cardiac Example

A patient in heart failure has frothy pink sputum, crackles, and severe dyspnea. What’s priority?

• ✔ Sit them upright & give high‑flow oxygen (pulmonary edema emergency).

Final Thoughts

Cardiac topics can feel intimidating, but with consistent practice, patterns become easier to recognize. Focus on EKG basics, high‑risk dysrhythmias, and heart failure priorities. With these concepts mastered, you'll approach **NCLEX cardiac** questions with confidence and accuracy.