Original DHA nursing questions on cardiovascular & respiratory, with explanations.
Short answer: 10 original multiple-choice practice questions on cardiovascular & respiratory for nurses preparing for the DHA licensing exam, each with the correct answer and a full explanation. This is a Meddex topic, not a DHA heading. They are original and are not real exam items.
About these questions
Every question here is original. Meddex wrote it for exam preparation. None is a real, recalled or leaked exam item, and none comes from DHA, Prometric, UAE University or the NIHS.
Meddex is independent and is not affiliated with DHA, Prometric, UAE University or the NIHS.
Clinical review of the question bank is not complete yet. Treat the explanations as study aids and check official guidance before you rely on a fact.
This is a sample, not the whole bank, and doing well on it does not predict an exam result.
What cardio-respiratory covers
Heart, vessels, airways and gas exchange.
For chest pain and breathlessness, airway, breathing and circulation come before tests. Learn the first action and the first drug for each common emergency.
Where it fits in the exam
DHA lists four coverage headings for Registered Nurse and publishes no weights. Cardiovascular & Respiratory is one of ten Meddex domains, so it is a Meddex grouping and not a DHA heading. Its questions can appear under more than one DHA heading.
DHA does not state how many answer options its questions have or whether each has one best answer. Meddex practice items use four options with one best answer, as a practice format.
How to use these questions
Decide your answer before you press Show answer. Then read the reason for every option, including the ones you rejected. Note the idea you missed and come back to it in a few days.
Practice questions
Question 1
Cardiovascular & RespiratoryMedium
A 74-year-old woman is dizzy and pale. Her monitor shows regular P waves at 80 per minute and a regular, wide QRS at 34 per minute, with no relationship between the P waves and the QRS complexes. Her blood pressure is 84/50 mmHg. What is the MOST appropriate nursing response?
AOption A: Recognise second-degree Mobitz type I, which needs observation only
BOption B: Recognise sinus bradycardia and recheck the rhythm in an hour
COption C: Recognise a junctional rhythm, which is a normal escape rhythm that needs no action while she remains awake and talking
DOption D: Complete heart block with adverse features: call for help and prepare atropine and transcutaneous pacing
Show answer for question 1
Correct answer: D. Complete heart block with adverse features: call for help and prepare atropine and transcutaneous pacing
Independent atrial and ventricular activity with a slow ventricular escape rhythm is third-degree (complete) atrioventricular block. Hypotension and dizziness are adverse features, so the resuscitation bradycardia algorithm applies: call for help, give atropine 500 micrograms intravenously, and use transcutaneous pacing if there is no response or for a high-risk rhythm. Mobitz type I keeps a relationship between P waves and QRS.
Why A is wrong. Mobitz type I shows progressively lengthening PR intervals with a relationship between P and QRS, which is not the case here.
Why B is wrong. There is no P wave to QRS relationship, so this is not sinus bradycardia.
Why C is wrong. A junctional rhythm would not show independent regular P waves at 80 and cannot be ignored with hypotension.
Topic: Complete heart block. Reference: Resuscitation Council UK Advanced Life Support: bradycardia algorithm; Brunner and Suddarth Textbook of Medical-Surgical Nursing (conduction disorders)
Question 2
Cardiovascular & RespiratoryMedium
A woman takes apixaban 5 mg twice a day for atrial fibrillation. At 14:00 she realises she forgot her morning dose. What should the nurse advise?
AOption A: Skip the missed dose and take two tablets this evening to catch up on what she has missed today
BOption B: Take the missed dose now, take the evening dose at the usual time, and never double a dose
COption C: Stop the drug until her INR has been checked
DOption D: Take a single 10 mg dose now and continue as normal tomorrow
Show answer for question 2
Correct answer: B. Take the missed dose now, take the evening dose at the usual time, and never double a dose
For apixaban, a missed dose should be taken as soon as remembered on the same day, then twice-daily dosing continues, and the dose is never doubled. Apixaban does not need INR monitoring, and doubling raises the bleeding risk while skipping leaves her unprotected from stroke.
Why A is wrong. Doubling a dose increases bleeding risk.
Why C is wrong. INR does not monitor apixaban, and stopping leaves her unprotected.
Why D is wrong. A 10 mg single dose is double the intended dose.
Topic: Missed dose of a direct oral anticoagulant. Reference: Summary of product characteristics for apixaban; ESC guidelines on atrial fibrillation
Question 3
Cardiovascular & RespiratoryMedium
A 78-year-old man with known severe aortic stenosis feels faint after climbing a flight of stairs on the ward. What is the MOST appropriate nursing action?
AOption A: Reassure him that fainting is expected and needs no review
BOption B: Give a glyceryl trinitrate spray without checking his blood pressure, as it relieves chest pain and breathlessness
COption C: Stop activity, sit or lay him down, check observations and report exertional syncope as high risk
DOption D: Encourage him to keep climbing stairs to build tolerance
Show answer for question 3
Correct answer: C. Stop activity, sit or lay him down, check observations and report exertional syncope as high risk
In fixed obstruction at the aortic valve the heart cannot raise cardiac output with exertion, so effort can cause syncope, angina or breathlessness. Exertional syncope signals severe disease with a poor prognosis unless the valve is replaced, so it needs urgent medical review. Vasodilators and hypovolaemia are dangerous because the output cannot compensate.
Why A is wrong. Fainting here is a warning sign that needs assessment.
Why B is wrong. Vasodilators can drop blood pressure sharply when output is fixed.
Why D is wrong. Continuing exertion risks collapse and arrhythmia.
Topic: Severe aortic stenosis symptoms. Reference: ESC/EACTS guidelines for the management of valvular heart disease; Brunner and Suddarth Textbook of Medical-Surgical Nursing (valvular disorders)
Question 4
Cardiovascular & RespiratoryEasy
A 30-year-old man has sharp central chest pain that is worse on deep inspiration and lying flat. A pericardial friction rub is heard. Which position is MOST likely to ease his pain?
AOption A: Sitting upright and leaning forward
BOption B: Lying on the left side with knees bent
COption C: Lying flat with legs raised
DOption D: Lying prone
Show answer for question 4
Correct answer: A. Sitting upright and leaning forward
Leaning forward reduces contact between the inflamed pericardium and the surrounding pleura and diaphragm, and relieves the pleuritic pain. Lying flat and deep breaths make it worse. Treatment is usually an anti-inflammatory drug, often with colchicine, and the nurse should still watch for signs of tamponade such as falling blood pressure and raised neck veins.
Why B is wrong. Lying on the left side does not relieve pericardial friction.
Why C is wrong. Lying flat increases pericardial stretch and pain.
Why D is wrong. Lying prone is not a position of comfort for this pain.
Topic: Acute pericarditis. Reference: ESC guidelines on pericardial diseases; Lewis Medical-Surgical Nursing (inflammatory heart disorders)
Question 5
Cardiovascular & RespiratoryMedium
A nurse sees water collecting in the inspiratory tubing of a ventilator circuit, close to the patient's tracheal tube. Which action is MOST appropriate to reduce the risk of ventilator-associated pneumonia?
AOption A: Tilt the tubing so that the water runs toward the patient and is cleared through the tube, which saves breaking the circuit
BOption B: Leave the water in place until the weekly circuit change
COption C: Wear gloves, perform hand hygiene, and drain the condensate away from the patient into a trap, breaking the circuit as little as possible
DOption D: Tip the water back into the humidifier reservoir and carry on
Show answer for question 5
Correct answer: C. Wear gloves, perform hand hygiene, and drain the condensate away from the patient into a trap, breaking the circuit as little as possible
Condensate in ventilator tubing becomes colonised with organisms and can be flushed into the lower airway by a change in position or a breath. Staff keep circuit breaks to a minimum, drain condensate away from the patient into a collection trap or the manufacturer's route, and perform hand hygiene and change gloves afterwards. Humidifier settings and water traps limit condensation, and circuits are changed when visibly soiled or faulty rather than on a fixed routine.
Why A is wrong. Tilting the tubing toward the patient delivers contaminated water into the airway.
Why B is wrong. Standing water is a reservoir of bacteria and does not become safe by waiting.
Why D is wrong. Returning contaminated water to the humidifier spreads organisms through the circuit.
Topic: Ventilator circuit condensate and pneumonia risk. Reference: SHEA/IDSA compendium on prevention of ventilator-associated pneumonia; Intensive Care Society guidance on care of the ventilated patient
Question 6
Cardiovascular & RespiratoryEasy
A 58-year-old man presents with crushing central chest pain, sweating and nausea. Which action should the nurse take FIRST?
AOption A: Ask him to walk to radiology for a chest X-ray before further assessment
BOption B: Obtain a 12-lead ECG within 10 minutes and alert the physician immediately
COption C: Give him a light meal to settle his nausea and reassess his pain afterwards
DOption D: Take a detailed social history, including smoking and family history, first
Show answer for question 6
Correct answer: B. Obtain a 12-lead ECG within 10 minutes and alert the physician immediately
Suspected ACS requires an ECG within about 10 minutes of arrival and immediate medical review. Exertion, food and non-urgent history delay time-critical diagnosis and treatment.
Why A is wrong. Walking increases cardiac workload and delays the ECG that is needed first.
Why C is wrong. A meal is not a priority and risks aspiration if he needs urgent procedures.
Why D is wrong. History can follow after urgent assessment and must not delay the ECG.
After morning handover on a general surgical ward, the nurse is told about four patients. Which one should she go to FIRST?
AOption A: A patient two hours after thyroidectomy with noisy breathing and increasing neck swelling
BOption B: A patient with serous wound drainage on day three after surgery and a normal temperature
COption C: A patient with BP 150/90 and a mild headache who has taken regular antihypertensives
DOption D: A patient asking for pain medication before a dressing change due in thirty minutes
Show answer for question 7
Correct answer: A. A patient two hours after thyroidectomy with noisy breathing and increasing neck swelling
Airway comes first. Neck swelling and noisy breathing after thyroidectomy may indicate haematoma compressing the airway, a surgical emergency. The other problems are less immediately life-threatening.
Why B is wrong. Expected serous wound drainage with a settled temperature is stable and non-urgent.
Why C is wrong. Mild hypertension with a headache in a patient already treated is a lower priority than airway compromise.
Why D is wrong. A pain request before a planned dressing change is important but not immediately life-threatening.
Topic: Airway priority. Reference: NCLEX-RN Test Plan: Management of care; British Association of Endocrine and Thyroid Surgeons guidance
Question 8
Cardiovascular & RespiratoryMedium
A patient with a tracheostomy becomes increasingly distressed with noisy breathing and falling SpO2. A suction catheter will not pass through the tube. What is the MOST appropriate first action?
AOption A: Instil a large volume of saline down the tube and continue suctioning to clear the plug
BOption B: Call for help, give oxygen and remove the inner cannula so it can be cleaned or replaced
COption C: Deflate the cuff and remove the whole tube immediately without waiting for skilled help
DOption D: Encourage the patient to cough and observe the oxygen saturation for the next ten minutes
Show answer for question 8
Correct answer: B. Call for help, give oxygen and remove the inner cannula so it can be cleaned or replaced
Failure to pass a suction catheter suggests a blocked tube, often from dried secretions in the inner cannula. The nurse calls for help, gives oxygen and removes the inner cannula to clear or replace it, which relieves most blockages. If the airway remains obstructed, the emergency tracheostomy algorithm is followed, including cuff deflation and tube change by trained staff.
Why A is wrong. Routine saline instillation is not recommended and can worsen hypoxia without clearing the plug.
Why C is wrong. Removing the whole tube without skilled help risks losing the airway and creating a false passage.
Why D is wrong. Coughing will not clear a blocked tube, and ten minutes of delay risks hypoxic arrest.
Topic: Tracheostomy emergency. Reference: National Tracheostomy Safety Project emergency algorithms; Royal College of Anaesthetists and Difficult Airway Society: 4th National Audit Project (NAP4)
Question 9
Cardiovascular & RespiratoryMedium
A woman has an underwater-seal chest drain for a pleural effusion and wants to walk to the bathroom. A colleague lifts the drainage bottle onto the bed beside her so that it is level with her chest. What should the nurse advise?
AOption A: Lay the bottle on its side on the bed so that it stays close to her chest
BOption B: Keep the bottle upright and below her chest level, and do not clamp the tube
COption C: Raise the bottle above the level of her chest so that fluid drains more quickly
DOption D: Clamp the tube for the whole walk so that nothing can move along it
Show answer for question 9
Correct answer: B. Keep the bottle upright and below her chest level, and do not clamp the tube
The drainage bottle must stay upright and below the level of the chest so that the tube end remains under water and fluid cannot flow back into the pleural space. The tubing should be free of kinks and the system must not be clamped without a clinical reason, as clamping a drain with an air leak risks tension pneumothorax. The patient can walk if someone carries the bottle at the correct height.
Why A is wrong. A bottle on its side can break the underwater seal, so air could be drawn into the chest.
Why C is wrong. A bottle above the chest lets fluid and air siphon back into the pleural space and risks infection.
Why D is wrong. Clamping a drain that may still be leaking air can cause a tension pneumothorax.
Topic: Chest drain: bottle position during mobilisation. Reference: BTS Pleural Disease Guideline
Question 10
Cardiovascular & RespiratoryEasy
A nurse sets up a non-rebreather mask with a reservoir bag for a patient with severe breathlessness and an SpO2 of 86%. Which finding shows the equipment is working as intended?
AOption A: The mask is held loosely away from the face so that room air can mix with the oxygen
BOption B: Flow is set at 10 to 15 L/min and the reservoir bag stays inflated throughout inspiration
COption C: Flow is set at 2 L/min, and the reservoir bag is collapsed at the end of each breath
DOption D: The valve flaps have been removed from the mask to make breathing easier for the patient
Show answer for question 10
Correct answer: B. Flow is set at 10 to 15 L/min and the reservoir bag stays inflated throughout inspiration
A non-rebreather mask needs enough flow, usually 10 to 15 L/min, to keep the reservoir bag filled so the patient does not run short on inspiration or rebreathe. Intact valves and a snug fit allow high concentrations of oxygen to be delivered.
Why A is wrong. A loose fit lets room air dilute the oxygen and lowers the concentration the patient receives.
Why C is wrong. A low flow cannot fill the bag, which would collapse and allow rebreathing of exhaled gas.
Why D is wrong. The one-way valves prevent rebreathing and room air entrainment, and removing them defeats the design.
Topic: Oxygen therapy: non-rebreather mask set-up. Reference: BTS guideline for oxygen use in adults in healthcare and emergency settings
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Frequently asked questions
DHA does not publish how many questions come from each topic. It lists four coverage headings for Registered Nurse with no weights. Meddex groups its questions into ten domains of its own.
No. They are original practice questions written by Meddex for exam preparation. DHA does not publish sample questions, and its Assessment Manual says sharing assessment questions is not allowed, so we do not use or claim real or recalled items.
The Meddex app has the full bank, which you can practise by topic with a free account. These pages are a short sample, and the questions on them do not change.
No. Each question has a Show answer button. The answer, the explanation and the reason each wrong option is wrong are part of the page text, so they are there when you press it.