LPN exams cardiovascular practice questions, set 13
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LPN exams cardiovascular practice questionsset 13
You read heart failure, perfusion, and blood-pressure stems and decide what to do before the patient declines. Five of the 15 questions include the correct answer and rationale. The other ten keep answers in the study hub. Continue with the LPN exams exam guide or more LPN exams practice questions.
Five cardiovascular questions with answers
Cover the key. Write the first action. Then open the rationale and name why the other choices fail.
Question 1
To improve the physical activity level for a mildly obese 71-yr-old patient, which action should the nurse plan to take?
A. Stress that weight loss is a major benefit of increased exercise.
B. Determine what kind of physical activities the patient usually enjoys.
C. Tell the patient that older adults should exercise for no more than 20 minutes at a time.
D. Teach the patient to include a short warm-up period at the beginning of physical activity.
Show answer and rationale
Correct answer: B — Determine what kind of physical activities the patient usually enjoys.
The correct answer is B: Determine what kind of physical activities the patient usually enjoys.
Rationale:
1. By determining the patient's preferred physical activities, the nurse can tailor an exercise plan that the patient is more likely to adhere to.
2. Enjoyable activities increase motivation and compliance, leading to sustained physical activity levels.
3. Personalized approach considers the patient's interests and abilities, promoting a successful and sustainable exercise routine.
Summary of Incorrect Choices:
A. Stressing weight loss may be discouraging and overshadow the importance of overall health benefits of exercise.
C. Setting a strict time limit may not be suitable for all older adults and can hinder individualized exercise plans.
D. While warming up is important, it is not the most crucial initial step in developing a personalized exercise plan.
Question 2
While obtaining patient histories, the nurse identifies that the patient with the highest risk for CAD is
A. An African American man, aged 65, with obesity and a BP of 160/85
B. A white man, aged 54, who is a smoker and has a stressful lifestyle
C. An Asian woman, aged 45, with a cholesterol level of 240 mg and a BP of 130/75
D. A white woman, aged 72, with a BP 172/100 and who is physically inactive
Show answer and rationale
Correct answer: D — A white woman, aged 72, with a BP 172/100 and who is physically inactive
The correct answer is D because the patient is a white woman aged 72 with a high blood pressure of 172/100 and physically inactive. Advanced age, high blood pressure, and physical inactivity are significant risk factors for coronary artery disease (CAD). Age is a non-modifiable risk factor, and hypertension and lack of physical activity are modifiable but critical factors contributing to CAD.
Choice A is incorrect because although the patient is African American, has obesity, and high blood pressure, the age is younger than the patient in choice D. Choice B is incorrect as smoking and stress are risk factors but not as significant as age, high blood pressure, and physical inactivity. Choice C is incorrect since although the patient has high cholesterol and elevated blood pressure, the age and other risk factors are less significant compared to the patient in choice D.
Question 3
Graft-versus-host disease prevention in transfusion?
A. Packed cells
B. Irradiating blood components
C. Fresh whole blood
D. Crystalloid replacement
Show answer and rationale
Correct answer: B — Irradiating blood components
The correct answer is B: Irradiating blood components. This is because irradiation of blood components helps prevent graft-versus-host disease by inactivating T lymphocytes present in the transfused blood. This decreases the risk of these donor T cells attacking the recipient's tissues, which is the underlying mechanism of graft-versus-host disease.
Explanation of other choices:
A: Packed cells - While packed red blood cells are less likely to cause a reaction compared to whole blood, they do not prevent graft-versus-host disease.
C: Fresh whole blood - Fresh whole blood does not address the specific mechanism of graft-versus-host disease prevention like irradiation does.
D: Crystalloid replacement - Crystalloid replacement does not have any impact on preventing graft-versus-host disease as it does not affect the T lymphocytes present in the transfused blood components.
Question 4
Kaposi's sarcoma- findings should expect with this condition?
A. Onset of progressive dementia- describes as AIDS-dementia complex that can occur, as the HIV infection affects the nervous system
B. Reddish-purple skin lesions- associated with AIDS and manifests as hyperpigmentation multicentric lesions that can be firm, flat, raised, and nodular; treated with radiation and/or chemotherapy
C. Yellowing of the skin
D. Persistent cough
Show answer and rationale
Correct answer: B — Reddish-purple skin lesions- associated with AIDS and manifests as hyperpigmentation multicentric lesions that can be firm, flat, raised, and nodular; treated with radiation and/or chemotherapy
The correct answer is B: Reddish-purple skin lesions. Kaposi's sarcoma is a type of cancer that is commonly seen in individuals with HIV/AIDS. The skin lesions associated with Kaposi's sarcoma are typically reddish-purple in color and can present as flat, raised, or nodular lesions. These lesions are caused by abnormal growth of blood vessels and can be found on the skin, mouth, or internal organs. Treatment options include radiation therapy, chemotherapy, or antiretroviral therapy.
Choice A is incorrect because the onset of progressive dementia is more characteristic of the AIDS-dementia complex, which can occur as HIV affects the nervous system. Choice C, yellowing of the skin, is not a typical finding of Kaposi's sarcoma. Choice D, persistent cough, is not a direct symptom of Kaposi's sarcoma and is more commonly associated with respiratory conditions or infections.
Question 5
A patient admitted to the coronary care unit (CCU) with an ST-segment-elevation myocardial infarction (STEMI) is restless and anxious. The blood pressure is 86/40 mm Hg, and heart rate is 132 beats/min. Based on this information, which nursing diagnosis is a priority for the patient?
A. Acute pain related to myocardial infarction
B. Anxiety related to perceived threat of death
C. Stress overload related to acute change in health
D. Decreased cardiac output related to cardiogenic shock
Show answer and rationale
Correct answer: D — Decreased cardiac output related to cardiogenic shock
The correct answer is D: Decreased cardiac output related to cardiogenic shock. In this case, the patient's low blood pressure and high heart rate indicate poor cardiac output. Cardiogenic shock is a life-threatening condition where the heart cannot pump enough blood to meet the body's needs. This is a priority nursing diagnosis as it requires immediate intervention to stabilize the patient's hemodynamics and prevent further deterioration.
Choices A, B, and C are incorrect because while they are valid concerns for the patient, they are not as immediately life-threatening as cardiogenic shock. Acute pain, anxiety, and stress overload can all be addressed once the patient's hemodynamic stability is ensured. However, without addressing the decreased cardiac output and cardiogenic shock first, the patient's condition could rapidly worsen and lead to serious consequences.
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Question 6
You are consulting on a 10-year-old male with severe persistent neutropenia, a history of recurrent infections, and warts. The rest of the peripheral blood count is normal. His mother also has neutropenia. Bone marrow examination shows a hypercellular marrow and retained myeloid cells with vacuolated cytoplasm. There are no abnormalities in the red cells or platelet precursors. Cytogenetics are 46XY. You start granulocyte colony stimulating factor therapy and the neutrophil count increases. A mutation in which of the following genes is most likely to have caused this familial inherited bone marrow failure syndrome?
A. CXCR4
B. ELANE
C. GATA 2
D. Mitochondrial DNA
Correct answer:
The correct answer is A: CXCR4. In this case, the patient presents with severe neutropenia, recurrent infections, and warts, suggestive of WHIM syndrome, where CXCR4 mutations are often involved. CXCR4 plays a crucial role in immune cell trafficking and retention in the bone marrow. The hypercellular marrow and vacuolated myeloid cells are consistent with WHIM syndrome. The absence of abnormalities in red cells or platelet precursors rules out other syndromes. Mutations in ELANE are commonly associated with congenital neutropenia, not familial inherited bone marrow failure syndromes. GATA2 mutations are linked to familial myelodysplastic syndromes, not typically presenting with neutropenia and warts. Mitochondrial DNA mutations are more related to mitochondrial disorders, which usually manifest with multi-system involvement, not specific to bone marrow failure syndromes.
A patient moving from chair to chair in the day room and pacing in the hallway repeatedly, rapidly, and for extended periods is likely demonstrating _________ , and the nurse should __________.
A. a dystonic reaction…administer PRN IM benztropine (Cogentin)
B. anxiety… teach and guide the patient to use relaxation exercises
C. akathisia…administer PRN diphenhydramine (Benadryl) PO
D. tardive dyskinesia…recommend a change in medication
Correct answer:
The correct answer is C: akathisia...administer PRN diphenhydramine (Benadryl) PO. Akathisia is characterized by restlessness and the inability to sit still, leading to constant movement like pacing. Diphenhydramine is commonly used to manage akathisia due to its anticholinergic effects that can help reduce these symptoms.
Rationale:
1. Akathisia matches the patient's symptoms of constant movement and restlessness.
2. Diphenhydramine is a common treatment for akathisia due to its calming effects.
3. Administering diphenhydramine orally is appropriate for managing akathisia symptoms in a non-emergent situation.
Summary:
A: Dystonic reaction presents with muscle spasms, not constant movement like pacing.
B: Anxiety does not typically manifest as constant pacing and may require different interventions.
D: Tardive dyskinesia involves involuntary movements and is
The nurse is giving intravenous nitroglycerin to a patient who has just been admitted because of an acute myocardial infarction. Which statement is true regarding the administration of the intravenous form of this medication?
A. The solution will be slightly colored green or blue.
B. The intravenous form is given by bolus injection.
C. It can be given in infusions with other medications.
D. Non-polyvinylchloride (non-PVC) plastic intravenous bags and tubing must be used.
Correct answer:
Step 1: Nitroglycerin is light-sensitive and can degrade when exposed to light. PVC plastic can release compounds that can interact with nitroglycerin. Therefore, non-PVC plastic must be used to prevent drug degradation.
Step 2: Using non-PVC bags and tubing ensures the drug's stability and efficacy during administration, reducing the risk of adverse effects.
Step 3: This requirement is specific to intravenous nitroglycerin administration and is crucial to ensure the patient receives the intended therapeutic benefits without compromising the drug's potency.
In summary, choice D is correct because using non-PVC plastic intravenous bags and tubing is essential to maintain the stability and effectiveness of intravenous nitroglycerin. Choices A, B, and C are incorrect as they do not address the specific requirement related to the administration of this medication.
What is the term used to describe a condition where the blood flow to the brain is temporarily interrupted, often referred to as a 'mini-stroke'?
A. Transient ischemic attack (TIA)
B. Stroke
C. Myocardial infarction
D. Pulmonary embolism
Correct answer:
The correct answer is A: Transient ischemic attack (TIA). A TIA is a temporary interruption of blood flow to the brain, causing stroke-like symptoms that usually resolve within 24 hours. It is often referred to as a 'mini-stroke' because the symptoms are similar to a stroke but last for a shorter duration.
Explanation:
1. TIA specifically describes a temporary interruption of blood flow to the brain, aligning with the scenario described in the question.
2. Stroke (Choice B) refers to a more severe and lasting interruption of blood flow to the brain, not a temporary one as seen in a TIA.
3. Myocardial infarction (Choice C) refers to a heart attack, which involves blockage of blood flow to the heart muscle, not the brain.
4. Pulmonary embolism (Choice D) is a blockage of an artery in the lungs, not related to blood flow interruption to the brain.
In summary,
A client diagnosed with bipolar I disorder is exhibiting severe manic behaviors. A physician prescribes lithium carbonate (Eskalith) and olanzapine (Zyprexa). The client’s spouse asks the nurse how Zyprexa works. Which is the appropriate nursing response?
A. “Zyprexa in combination with Eskalith cures manic symptoms.â€
B. “Zyprexa prevents extrapyramidal side effects.â€
C. “Zyprexa increases the effectiveness of the immune system.â€
D. “Zyprexa calms hyperactivity until the Eskalith takes effect.â€
Correct answer:
The correct answer is D: “Zyprexa calms hyperactivity until the Eskalith takes effect.â€
Rationale:
1. Zyprexa (olanzapine) is an atypical antipsychotic used to treat manic symptoms in bipolar disorder by stabilizing mood.
2. Lithium carbonate (Eskalith) is a mood stabilizer that takes time to reach therapeutic levels and effectiveness.
3. Zyprexa acts quickly to calm hyperactivity and aggression associated with mania while Eskalith gradually takes effect to stabilize mood long-term.
4. Therefore, the appropriate nursing response is to explain that Zyprexa helps manage acute symptoms until Eskalith fully kicks in.
Other Choices:
A: Incorrect. Zyprexa does not cure manic symptoms but helps manage them alongside Eskalith.
B: Incorrect. Zyprexa does not prevent extrapyramidal side effects, which are more commonly associated with typical antipsychotics.
C
A 12-year-old patient with localized osteosarcoma is being treated with cisplatin, doxorubicin, and high-dose methotrexate. The pain at his primary site rapidly resolves after initiation of chemotherapy. After tumor resection, pathology reveals the tumor was greater than 95% necrotic. You want to continue cisplatin, doxorubicin, and high-dose methotrexate. Which of the following is the best answer regarding the evaluations that should be performed to monitor for toxicity in patients receiving cisplatin, doxorubicin, and high-dose methotrexate?
A. Complete blood count, creatinine, liver function tests
B. Complete blood count, serum electrolytes (sodium, potassium, BUN, chloride), and EKG to monitor for prolonged QTc
C. Complete blood count, creatinine, serum magnesium, audiogram, and echocardiogram
D. Complete blood count, creatinine, serum magnesium, chest x-ray
Correct answer:
The correct answer is C because it includes essential evaluations to monitor for toxicity associated with cisplatin, doxorubicin, and high-dose methotrexate.
1. Complete blood count: To monitor for potential bone marrow suppression caused by chemotherapy drugs.
2. Creatinine: To assess renal function, as cisplatin can cause nephrotoxicity.
3. Serum magnesium: Monitoring for hypomagnesemia, a common side effect of cisplatin.
4. Audiogram: To screen for hearing loss, a known side effect of cisplatin.
5. Echocardiogram: To evaluate for cardiotoxicity, especially with doxorubicin known to cause cardiomyopathy.
Other choices are incorrect:
A: Does not include serum magnesium, audiogram, and echocardiogram, which are important for monitoring toxicity.
B: While electrolytes and EKG are relevant, it lacks creatinine, serum magnesium, and other crucial tests.
D:
A client's angiogram demonstrates the final stage of atherosclerosis. The nurse concludes that this client's pathophysiology includes which of the following elements?
A. The presence of atheromas.
B. Fatty deposits in the intima
C. Lipoprotein accumulation in the intima
D. Inflammation of the arterial wall
Correct answer:
The correct answer is A: The presence of atheromas. Atheromas are plaques that form in the arterial wall due to the accumulation of cholesterol and other substances. In the final stage of atherosclerosis, these atheromas can lead to complete blockages or rupture, causing serious health issues.
Choice B (Fatty deposits in the intima) is incorrect because while fatty deposits are a part of atherosclerosis, the final stage involves the formation of atheromas, not just fatty deposits.
Choice C (Lipoprotein accumulation in the intima) is incorrect because lipoprotein accumulation is an early stage of atherosclerosis, not the final stage involving atheromas.
Choice D (Inflammation of the arterial wall) is incorrect because although inflammation plays a role in atherosclerosis, the final stage is characterized by the presence of atheromas, not just inflammation.
You are consulted on a 4-year-old girl who is newly diagnosed with standard-risk pre-B acute lymphoblastic leukemia. After reviewing her previous complete blood examinations, you note she has had a platelet count ranging from 80,000 to 100,000 cells/mcL over the past 2 years. Her father mentions that he has also been told he has mild thrombocytopenia. You suspect the child may have a cancer predisposition syndrome. Which sample should you send for analysis, and which gene is most likely implicated?
A. Skin fibroblasts to evaluate the RUNXI gene
B. Skin fibroblasts to evaluate the ETV6 gene
C. Buccal swab to evaluate the RUNXI gene
D. Buccal swab to evaluate the ETV6 gene
Correct answer:
The correct answer is B: Skin fibroblasts to evaluate the ETV6 gene. In individuals with familial thrombocytopenia and a history of malignancy, ETV6 gene mutations are often implicated. Sending skin fibroblasts for analysis allows for genetic testing to identify any ETV6 gene mutations that may be present. Skin fibroblasts are commonly used for genetic testing as they provide a stable and reliable source of DNA.
Choice A (Skin fibroblasts to evaluate the RUNXI gene) is incorrect because RUNXI gene mutations are not typically associated with familial thrombocytopenia and cancer predisposition syndromes. Choice C (Buccal swab to evaluate the RUNXI gene) is also incorrect for the same reason. Choice D (Buccal swab to evaluate the ETV6 gene) is incorrect because buccal swabs may not provide enough genetic material for comprehensive testing of the ETV6 gene, which is
A client is receiving rivaroxaban (Xarelto) and asks the nurse to explain how it works. What response by the nurse is best?
A. It inhibits thrombin.
B. It inhibits fibrinogen.
C. It thins your blood.
D. It works against vitamin K.
Correct answer:
The correct answer is A: It inhibits thrombin. Rivaroxaban is a direct factor Xa inhibitor, which works by specifically inhibiting the activity of factor Xa, a key enzyme in the coagulation cascade. By inhibiting factor Xa, rivaroxaban prevents the formation of thrombin, a crucial enzyme in the blood clotting process. Thrombin is responsible for converting fibrinogen to fibrin, which forms the meshwork of a blood clot. Therefore, by inhibiting thrombin formation, rivaroxaban effectively prevents blood clots from forming.
Choice B is incorrect because rivaroxaban does not directly inhibit fibrinogen; it acts upstream by inhibiting factor Xa. Choice C is incorrect because rivaroxaban does not actually "thin" the blood like warfarin or heparin; it specifically targets factor Xa. Choice D is incorrect because rivaroxaban does not work against vitamin K like warfarin
Which heart chamber ejects blood into the systemic arterial circulation via the aorta?
A. Right atrium
B. Left atrium
C. Right ventricle
D. Left ventricle
Correct answer:
The correct answer is D, Left ventricle. The left ventricle is responsible for ejecting oxygenated blood into the systemic arterial circulation via the aorta. It receives oxygen-rich blood from the left atrium and pumps it out through the aorta to the rest of the body.
Rationale:
1. The left ventricle receives blood from the left atrium, which has already been oxygenated in the lungs.
2. It is the chamber that generates the highest pressure to propel blood into the systemic circulation.
3. The aorta is the main artery that carries oxygenated blood away from the heart to the body.
4. The right atrium and right ventricle are involved in pumping deoxygenated blood to the lungs for oxygenation, not into the systemic circulation.
5. The left atrium receives oxygenated blood from the lungs but does not directly eject blood into the systemic arterial circulation.
LPN exams cardiovascular practice questions, set 13 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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