LPN exams cardiovascular practice questions, set 14
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LPN exams cardiovascular practice questionsset 14
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
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 a patient with STEMI, the low blood pressure (86/40 mm Hg) and high heart rate (132 beats/min) indicate poor cardiac output. Cardiogenic shock is a life-threatening condition that occurs due to decreased cardiac output. Restlessness and anxiety can be signs of inadequate tissue perfusion in cardiogenic shock. Addressing decreased cardiac output is crucial to prevent further deterioration.
A: Acute pain is a common symptom in STEMI but not the priority when the patient is in cardiogenic shock.
B: Anxiety is a valid concern, but the primary focus should be on addressing the physiological instability caused by decreased cardiac output.
C: Stress overload can be a contributing factor, but the immediate priority is managing the cardiogenic shock to stabilize the patient's condition.
Question 2
Which of the following is the best action by the nurse?
A. Administer the metoprolol (Lopressor) and the hydrochlorothiazide (HydroDiuril), hold the captopril (Copoten), and notify the physician.
B. Administer the captopril (Capoten) and the hydrochlorothiazide (HydroDiuril), hold the metoprolol (Lepressor), and notify the physican.
C. Administer all the medications and notify the physician.
D. Withhold all the medications and notify the physician.
Show answer and rationale
Correct answer: A — Administer the metoprolol (Lopressor) and the hydrochlorothiazide (HydroDiuril), hold the captopril (Copoten), and notify the physician.
The correct answer is A: Administer the metoprolol (Lopressor) and the hydrochlorothiazide (HydroDiuril), hold the captopril (Copoten), and notify the physician.
Rationale:
1. Metoprolol and hydrochlorothiazide are commonly prescribed medications for hypertension.
2. Captopril is an ACE inhibitor and should be held due to potential interactions with the other medications.
3. Notifying the physician is crucial to ensure proper management and prevent adverse effects.
Summary of other choices:
B: Incorrect because holding metoprolol is not recommended as it is a common antihypertensive drug.
C: Incorrect because administering all medications without addressing the potential interaction with captopril is unsafe.
D: Incorrect because withholding all medications without administering any could lead to uncontrolled hypertension, risking the patient's health.
Question 3
A nurse is caring for a client who has an abdominal aortic aneurysm and is scheduled for surgery. The client's vital signs are blood pressure 160/98 mm Hg, heart rate 102/min, respirations 22/min, and SpO2 95%. Which of the following actions should the nurse take?
A. Administer antihypertensive medication for blood pressure.
B. Increase IV fluids
C. Monitor without intervention
D. Administer oxygen
Show answer and rationale
Correct answer: A — Administer antihypertensive medication for blood pressure.
The correct answer is A: Administer antihypertensive medication for blood pressure. Step-by-step rationale: 1. An abdominal aortic aneurysm is a serious condition that can lead to rupture if not managed properly. 2. The client's elevated blood pressure of 160/98 mm Hg can increase the risk of rupture. 3. Administering antihypertensive medication can help lower the blood pressure and reduce the risk of rupture. 4. By managing the blood pressure, the nurse is helping to stabilize the client before surgery. Summary of other choices: B: Increasing IV fluids may not directly address the elevated blood pressure and can potentially worsen the situation. C: Monitoring without intervention may lead to a missed opportunity to prevent a potential rupture. D: Administering oxygen is not the priority action in this scenario; addressing the elevated blood pressure is crucial.
Question 4
The nurse is evaluating an infant’s tolerance of feedings after a pyloromyotomy. Which finding indicates that the infant is not tolerating the feeding?
A. Need for frequent burping
B. Irritability during feeding
C. The passing of gas
D. Emesis after two feedings
Show answer and rationale
Correct answer: D — Emesis after two feedings
The correct answer is D. Emesis after two feedings indicates that the infant is not tolerating the feedings well, which could be a sign of complications post-pyloromyotomy such as gastric outlet obstruction or poor stomach emptying. This warrants immediate attention to prevent further issues.
A: Need for frequent burping is a common need for infants and does not necessarily indicate intolerance to feedings.
B: Irritability during feeding could be due to various reasons such as hunger, discomfort, or gas, but it does not specifically indicate feeding intolerance.
C: The passing of gas is a normal physiological process and does not directly indicate feeding intolerance.
In summary, emesis after feedings is concerning as it suggests possible complications, while the other options are more commonly seen in infants and do not directly indicate feeding intolerance.
Question 5
A patient who has chest pain is admitted to the emergency department (ED), and all of the following are ordered. Which one should the nurse arrange to be completed first?
A. Chest x-ray
B. Troponin level
C. Electrocardiogram (ECG)
D. . Insertion of a peripheral IV
Show answer and rationale
Correct answer: C — Electrocardiogram (ECG)
The correct answer is C: Electrocardiogram (ECG). This should be arranged first because it provides immediate information on the patient's cardiac status, helping to determine if the chest pain is due to a heart-related issue like a myocardial infarction. A quick ECG can identify any acute changes in the heart's electrical activity. This is crucial for prompt intervention and treatment.
Summary of other choices:
A: Chest x-ray - While important for assessing lung and chest abnormalities, it does not provide immediate information on the patient's cardiac status.
B: Troponin level - Useful for detecting myocardial damage, but results may take time to be available. Not as immediate as an ECG.
D: Insertion of a peripheral IV - Important for administering medications and fluids, but not a priority over assessing the cardiac status in a patient with chest pain.
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Question 6
A client diagnosed with schizophrenia takes an antipsychotic agent daily. Which assessment finding should a nurse immediately report to the client’s attending psychiatrist?
A. Respirations of 22 beats/minute
B. Weight gain of 8 pounds in 2 months
C. Temperature of 104 F (40 C)
D. Excessive salivation
Correct answer:
The correct answer is C: Temperature of 104 F (40 C). A high temperature may indicate a potential serious side effect such as neuroleptic malignant syndrome, which is a life-threatening condition associated with antipsychotic use. This requires immediate medical attention to prevent complications.
A: Respirations of 22 beats/minute - Normal respiratory rate is 12-20 breaths per minute, so 22 breaths per minute is slightly elevated but not an immediate concern.
B: Weight gain of 8 pounds in 2 months - Weight gain is a common side effect of antipsychotic medications and may require monitoring and potential intervention, but it is not an immediate cause for concern.
D: Excessive salivation - This is a common side effect of some antipsychotic medications but is not typically considered an urgent issue unless it is severe and causing distress to the client.
What procedure involves using a catheter to create a small scar in the heart tissue to block abnormal electrical signals and restore normal heart rhythm?
A. Catheter ablation
B. Angioplasty
C. Stent placement
D. Valve replacement
Correct answer:
The correct answer is A: Catheter ablation. This procedure involves using a catheter to create a small scar in the heart tissue to block abnormal electrical signals and restore normal heart rhythm. First, the catheter is guided to the heart through blood vessels. Then, using various techniques such as radiofrequency energy or freezing, the abnormal tissue causing the irregular heartbeat is destroyed to restore the heart's normal rhythm.
Choice B, Angioplasty, involves opening blocked or narrowed blood vessels to improve blood flow, not addressing abnormal heart rhythms. Choice C, Stent placement, involves inserting a mesh tube to keep arteries open, not related to treating abnormal electrical signals in the heart. Choice D, Valve replacement, is a procedure to replace damaged heart valves, not specifically targeting abnormal electrical signals in the heart.
A client diagnosed with schizophrenia, who has been taking antipsychotic medication for the last 5 months, presents in an emergency department (ED) with uncontrollable tongue movements, stiff neck, and difficulty swallowing. The nurse would expect the physician to recognize which condition and implement which treatment?
A. Neuroleptic malignant syndrome, treated by discontinuing antipsychotic medications
B. Agranulocytosis, treated by administration of clozapine (Clozaril)
C. Extrapyramidal symptoms, treated by administration of benztropine (Cogentin)
D. Tardive dyskinesia, treated by discontinuing antipsychotic medications
Correct answer:
The correct answer is D: Tardive dyskinesia, treated by discontinuing antipsychotic medications. Tardive dyskinesia is characterized by uncontrollable tongue movements, stiff neck, and difficulty swallowing, which are common side effects of long-term antipsychotic use. The treatment involves discontinuing the antipsychotic medication to prevent further worsening of symptoms. Neuroleptic malignant syndrome (choice A) presents with fever, muscle rigidity, altered mental status, and autonomic dysfunction, requiring immediate discontinuation of antipsychotic medication. Agranulocytosis (choice B) is a rare but serious side effect of clozapine, not associated with the symptoms described. Extrapyramidal symptoms (choice C) are movement disorders that can occur with antipsychotic use, but benztropine is typically used to treat parkinsonism, not the symptoms described.
The nurse is assessing the laboratory values for a patient with chronic heart failure before administering furosemide. Which of the following values would cause the nurse to withhold this drug and notify the primary care provider?
A. Potassium level of 3.5 mEq/L
B. Digoxin level of 0.7 ng/mL
C. Calcium level of 5 mg/dL
D. Magnesium level of 1 mg/dL
Correct answer:
The correct answer is A: Potassium level of 3.5 mEq/L. Furosemide is a loop diuretic that can lead to potassium depletion. A low potassium level (hypokalemia) can increase the risk of cardiac arrhythmias, especially in patients with chronic heart failure. Therefore, if the patient's potassium level is already low, administering furosemide can further decrease it and potentially lead to serious complications.
Choice B: Digoxin level of 0.7 ng/mL is not directly related to the administration of furosemide. While digoxin toxicity can occur with low potassium levels, the focus here is on the impact of furosemide on potassium levels.
Choice C: Calcium level of 5 mg/dL is not a direct contraindication for administering furosemide. Low calcium levels can affect cardiac function, but in this case, potassium level is more crucial.
Choice D: Magnesium level of
A patient takes lithium daily. The nurse should monitor the patient for:
A. pharyngitis, mydriasis, and dystonia.
B. alopecia, purpura, and drowsiness.
C. diaphoresis, weakness, and nausea.
D. ascites, dyspnea, and edema.
Correct answer:
Step-by-step rationale for the correct answer (C):
1. Lithium is known to cause side effects such as diaphoresis (excessive sweating), weakness, and nausea.
2. Monitoring for diaphoresis is important as it may indicate lithium toxicity.
3. Weakness and nausea are common side effects of lithium that should be closely monitored.
4. These symptoms can help the nurse assess the patient's response to lithium therapy and detect any potential adverse effects early.
5. Pharyngitis, mydriasis, dystonia (choice A) are not commonly associated with lithium therapy.
6. Alopecia, purpura, drowsiness (choice B) are not typical side effects of lithium.
7. Ascites, dyspnea, edema (choice D) are not commonly seen with lithium use.
In summary, monitoring for diaphoresis, weakness, and nausea is crucial in patients taking lithium to ensure patient safety and well-being.
A patient calls the clinic office saying that the cholestyramine (Questran) powder he started yesterday clumps and sticks to the glass when he tries to mix it. The nurse will suggest what method for mixing this medication for administration?
A. Mix the powder in a carbonated soda drink to dissolve it faster.
B. Add the powder to any liquid, and stir vigorously to dissolve it quickly.
C. Mix the powder with food or fruit, or at least 4 to 6 ounces of fluid.
D. Sprinkle the powder into a spoon and take it dry, followed by a glass of water.
Correct answer:
The correct answer is C: Mix the powder with food or fruit, or at least 4 to 6 ounces of fluid. This method is recommended for cholestyramine (Questran) powder as it helps prevent clumping and ensures proper mixing for administration. Mixing with food or fruit can help mask the texture and taste, making it easier for the patient to consume. Additionally, mixing with an adequate amount of fluid ensures the medication is properly dissolved and absorbed in the body.
Incorrect choices:
A: Mixing with a carbonated soda drink is not recommended as it may not effectively dissolve the powder and may lead to clumping.
B: Stirring vigorously may not be sufficient to dissolve the powder properly and could result in clumping.
D: Taking the powder dry followed by water is not ideal as it may lead to difficulty swallowing and inadequate absorption of the medication.
A 12-year-old patient has been referred to you following complete resection with clean margins of a high-grade malignant peripheral nerve sheath tumor of the shoulder region. The tumor measured approximately 4 cm in greatest dimension. A CT scan of the chest and a bone scan were within normal limits. The patient does not have evidence of neurofibromatosis type 1 (NF1). Which of the following treatment approaches would you recommend?
A. Chemotherapy with doxorubicin and ifosfamide
B. Radiotherapy
C. Chemotherapy with doxorubicin and ifosfamide plus radiotherapy
D. Observation
Correct answer:
The correct answer is D: Observation. In this case, the patient has undergone complete resection of the tumor with clean margins and there is no evidence of metastasis or neurofibromatosis type 1. Given these factors, observation is the most appropriate approach as there is no indication for adjuvant chemotherapy or radiotherapy. Chemotherapy with doxorubicin and ifosfamide (Choice A) is typically reserved for cases with high-risk features such as incomplete resection or metastasis. Radiotherapy (Choice B) may be considered in certain cases, but in this scenario where surgery was curative and there is no evidence of spread, it is not necessary. Chemotherapy plus radiotherapy (Choice C) may be overly aggressive and carry unnecessary risks for a patient who has already had successful surgery. Thus, observation is the most appropriate approach in this situation.
A patient has been taking a beta blocker for 4 weeks as part of his antianginal therapy. He also has type II diabetes and hyperthyroidism. When discussing possible adverse effects, the nurse will include which information?
A. Watch for unusual weight loss.
B. Monitor your pulse for increased heart rate.
C. Use the hot tub and sauna at the gym as long as time is limited to 15 minutes.
D. Monitor your blood glucose levels for possible hypoglycemia or hyperglycemia.
Correct answer:
The correct answer is D. Beta blockers can mask symptoms of hypoglycemia in diabetic patients and may also affect blood glucose levels. Monitoring blood glucose levels is crucial to detect any potential hypoglycemia or hyperglycemia.
A: Weight loss is not a common adverse effect of beta blockers, rather weight gain is more common.
B: Beta blockers typically slow down the heart rate, so monitoring for an increased heart rate is not necessary.
C: Hot tubs and saunas can potentially worsen the effects of beta blockers on blood pressure and heart rate, so it is not recommended to use them without medical advice.
In summary, monitoring blood glucose levels for possible hypoglycemia or hyperglycemia is essential for diabetic patients on beta blockers, while the other choices are not directly related to the adverse effects of beta blockers in this context.
In order to effectively provide appropriate patient teaching regarding the effects of psychotropic medications, an advanced practice nurse with prescriptive privileges is required to have a thorough understanding of which drug-related topic?
A. Clinical indicators
B. Pharmacology algorithms
C. Monotherapeutic symptoms
D. Doses of all “atypical†psychotropic drugs
Correct answer:
In 2003 the National Organization of Nurse Practitioner Faculties (NONPF) published a comprehensive set of competencies defining the scope and practice of psychiatric mental health nurse practitioners (PMHNPs). An example of a competency specific to medication prescribing for PMHNPs states that the PMHNP “prescribes psychotropic and related medications based on clinical indicators of a patient’s status, including results of diagnostic and lab tests as appropriate, to treat symptoms of psychiatric disorders and improve functional health status.†Knowledge of pharmacology algorithms or of monotherapeutic symptoms is not applicable since they are not required needs. A knowledge of the doses of all “atypical†psychotropic drugs is too specific to one class of psychotropic medications. Nurses need to know information about all psychotropic medications.
Diagnostic testing has resulted in a diagnosis of acute myeloid leukemia (AML) in an adult patient who is otherwise healthy. The patient and the care team have collaborated and the patient will soon begin induction therapy. The nurse should prepare the patient for which of the following?
A. Daily treatment with targeted treatment medications
B. Radiation therapy on a daily basis
C. Hematopoietic stem cell transplantation
D. An aggressive course of chemotherapy
Correct answer:
The correct answer is D: An aggressive course of chemotherapy. In the treatment of AML, induction therapy typically involves a combination of chemotherapy drugs to achieve remission. Chemotherapy targets rapidly dividing cancer cells in the bone marrow. This approach aims to eradicate leukemic cells and allow normal blood cell production to resume. Daily treatment with targeted medications (choice A) is not typically the first-line approach for AML. Radiation therapy (choice B) is not commonly used in the induction phase of AML treatment. Hematopoietic stem cell transplantation (choice C) is a treatment option for certain cases of AML but is usually considered after achieving remission with chemotherapy. Therefore, the most appropriate preparation for the patient in this scenario is to expect an aggressive course of chemotherapy to begin induction therapy.
LPN exams cardiovascular practice questions, set 14 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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