LPN exams cardiovascular practice questions, set 2
LPN exams · cardiovascular
LPN exams cardiovascular practice questionsset 2
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 nurse is caring for a patient who is being treated for leukemia in the hospital. The patient was able to maintain her nutritional status for the first few weeks following her diagnosis but is now exhibiting early signs and symptoms of malnutrition. In collaboration with the dietitian, the nurse should implement what intervention?
A. Arrange for total parenteral nutrition (TPN).
B. Facilitate placement of a percutaneous endoscopic gastrostomy (PEG) tube.
C. Provide the patient with several small, soft-textured meals each day.
D. Assign responsibility for the patient's nutrition to the patient's friends and family.
Show answer and rationale
Correct answer: C — Provide the patient with several small, soft-textured meals each day.
The correct answer is C: Provide the patient with several small, soft-textured meals each day. This intervention is appropriate for the patient showing early signs of malnutrition as it aims to increase the patient's nutrient intake in a manageable way. Small, soft-textured meals are easier for the patient to consume and digest, promoting better absorption of nutrients. This approach also aligns with the principle of promoting oral intake whenever possible before resorting to more invasive measures like TPN or PEG tube placement.
Incorrect choices:
A: Total parenteral nutrition (TPN) is typically reserved for patients who cannot tolerate oral feeding at all or have significant malabsorption issues.
B: Percutaneous endoscopic gastrostomy (PEG) tube placement is usually considered if the patient cannot meet their nutritional needs orally in the long term.
D: Assigning responsibility for the patient's nutrition to friends and family is not a sustainable or appropriate solution for addressing malnutrition in a hospitalized patient.
Question 2
A nurse is planning care for a client who is having a percutaneous transluminal coronary angioplasty (PTCA) with stent placement. Which of the following actions should the nurse anticipate in the post-procedure plan of care?
A. Monitor for bleeding
B. Administer beta blockers
C. Increase fluid intake
D. Restrict all movement
Show answer and rationale
Correct answer: A — Monitor for bleeding
The correct answer is A: Monitor for bleeding. After PTCA with stent placement, the nurse should anticipate monitoring the client for signs of bleeding at the catheter insertion site. This is crucial as bleeding is a common complication post-procedure. The nurse should assess the insertion site regularly for any signs of bleeding, such as swelling, hematoma, or active bleeding. Prompt identification and management of bleeding can prevent further complications.
Summary of why other choices are incorrect:
B: Administer beta blockers - Beta blockers are not typically administered immediately post-PTCA with stent placement. They may be part of the long-term management for cardiac conditions but are not a priority post-procedure.
C: Increase fluid intake - While maintaining adequate hydration is important for overall health, increasing fluid intake is not a specific post-procedure intervention for PTCA with stent placement.
D: Restrict all movement - Restricting all movement post-PTCA with stent placement is not necessary. Encouraging
Question 3
A mother states that she brought her child to the clinic because the 3-year-old girl was not keeping up with her siblings. During physical assessment, the nurse notes that the child has pale skin and conjunctiva and has muscle weakness. The hemoglobin on admission is 6.4 g/dl. After notifying the practitioner of the results, the nurse’s priority intervention is to:
A. Reduce environmental stimulation to prevent seizures.
B. Have the laboratory repeat the analysis with a new specimen.
C. Minimize energy expenditure to decrease cardiac workload.
D. Administer intravenous fluids to correct the dehydration.
Show answer and rationale
Correct answer: C — Minimize energy expenditure to decrease cardiac workload.
The correct answer is C: Minimize energy expenditure to decrease cardiac workload. The child's low hemoglobin level of 6.4 g/dl indicates severe anemia, leading to reduced oxygen-carrying capacity. With pale skin, conjunctiva, and muscle weakness, the child likely has symptoms of anemia, causing fatigue and decreased exercise tolerance. By minimizing energy expenditure, the nurse can prevent further strain on the child's already compromised cardiovascular system, reducing the risk of cardiac complications. This intervention prioritizes the child's safety and well-being by addressing the immediate physiological concern of decreased oxygen supply to tissues.
Summary of why the other choices are incorrect:
A: Reducing environmental stimulation is not the priority as the child's main issue is related to severe anemia, not seizures.
B: Repeating the analysis with a new specimen may be necessary to confirm the hemoglobin level but is not the immediate priority when dealing with a critically low hemoglobin level.
D: Administering intr
Question 4
The client is being given a calcium channel blocker. Calcium channel blockers have what effect on the heart?
A. They increase the preload on the heart.
B. They decrease the velocity of electrical activity on the AV node.
C. They block the sodium channels in the heart muscle.
D. They cause vasoconstriction of coronary arteries.
Show answer and rationale
Correct answer: B — They decrease the velocity of electrical activity on the AV node.
The correct answer is B: They decrease the velocity of electrical activity on the AV node. Calcium channel blockers specifically target calcium channels in the heart muscle, which slows down the influx of calcium ions responsible for electrical conduction in the heart. By reducing the velocity of electrical activity on the AV node, calcium channel blockers help to decrease heart rate and improve myocardial oxygen supply.
Incorrect choices:
A: They increase the preload on the heart - This is incorrect because calcium channel blockers do not directly affect preload, which is the volume of blood in the heart at the end of diastole.
C: They block the sodium channels in the heart muscle - This is incorrect because calcium channel blockers do not target sodium channels; they specifically inhibit calcium channels.
D: They cause vasoconstriction of coronary arteries - This is incorrect because calcium channel blockers actually have a vasodilatory effect on coronary arteries, which can help improve blood flow to the heart muscle.
Question 5
A patient with ST-segment elevation in three contiguous electrocardiographic leads is admitted to the emergency department and diagnosed as having an ST-segment-elevation myocardial infarction. Which question should the nurse ask to determine whether the patient is a candidate for thrombolytic therapy?
A. “Do you have any allergies?â€
B. “Do you take aspirin on a daily basis?â€
C. “What time did your chest pain begin?â€
D. “Can you rate your chest pain using a 0 to 10 scale?â€
Show answer and rationale
Correct answer: C — “What time did your chest pain begin?â€
The correct answer is C: “What time did your chest pain begin?†This question is crucial for determining if the patient is a candidate for thrombolytic therapy as the time of symptom onset is a key factor in deciding the eligibility for this treatment. Thrombolytic therapy is most effective when administered within a specific timeframe from the onset of symptoms, typically within the first few hours of symptom onset. Therefore, knowing the exact time when the chest pain started will help healthcare providers assess if the patient falls within the window of opportunity for thrombolytic therapy.
Choices A, B, and D are incorrect because they do not directly address the time-sensitive nature of thrombolytic therapy eligibility. Allergies and daily aspirin intake are important considerations in healthcare, but they are not immediate factors in determining thrombolytic therapy candidacy. The pain rating on a scale of 0 to 10 is subjective and does not provide specific information regarding the urgency of thrombolytic therapy
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Question 6
A 2-year-old girl has a diagnosis of overall stage IV favorable histology Wilms' tumor with pulmonary metastases and local stage III disease due to finding positive lymph nodes. After she completes 6 weeks of vincristine/dactinomycin/doxorubicin (DD4A) chemotherapy, restaging shows complete resolution of some but not all lung nodules. Tumor genetic testing reveals combined loss of heterozygosity for 1p and 16q. Which of the following would be the most appropriate treatment plan?
A. Continue chemotherapy with vincristine, doxorubicin, and dactinomycin to complete 25 weeks of therapy. Administer radiation to lungs and flank.
B. Continue chemotherapy with vincristine, doxorubicin and dactinomycin to complete 25 weeks of therapy. Radiation to flank only. No lung radiation.
C. Continue chemotherapy with vincristine, doxorubicin and dactinomycin, add cyclophosphamide and etoposide to complete 33 weeks of therapy. Radiation to flank only. No lung radiation.
D. Continue chemotherapy with vincristine, doxorubicin and dactinomycin, add cyclophosphamide and etoposide to complete 33 weeks of therapy. Radiation to lungs and flank.
Correct answer:
The correct answer is D because the addition of cyclophosphamide and etoposide to the chemotherapy regimen is indicated for patients with combined loss of heterozygosity for 1p and 16q in Wilms' tumor. This genetic abnormality is associated with a higher risk of relapse and poorer outcomes. The extended duration of chemotherapy (33 weeks) is necessary to target any remaining tumor cells and reduce the risk of recurrence. Additionally, the decision to administer radiation to both the lungs and flank is appropriate given the incomplete resolution of some lung nodules after initial chemotherapy. Lung radiation helps to target any remaining metastatic lesions, while flank radiation targets the primary tumor site and positive lymph nodes. This comprehensive treatment approach aims to maximize the chances of long-term disease control and survival for the patient.
Choice A is incorrect because it lacks the addition of cyclophosphamide and etoposide, which are needed for Wilms' tumor with the specific genetic abnormality mentioned.
A client underwent an antibody test for human immunodeficiency virus (HIV) as part of a screening process and has just been told that the results were positive. Which anticipatory guidance regarding the next step should the nurse provide to the client?
A. The client will be started on fluoxetine in 1 month
B. Antiretroviral therapy will begin within 3 months
C. Follow-up testing will be promptly performed to confirm the result
D. The client will be monitored for signs and symptoms of HIV to determine the need for treatment
Correct answer:
The correct answer is C: Follow-up testing will be promptly performed to confirm the result. This is the most appropriate next step as a positive result on an antibody test does not confirm HIV infection. Follow-up testing, such as a confirmatory test like Western blot or PCR, is needed to confirm the diagnosis. This step is crucial to avoid unnecessary anxiety or premature treatment initiation.
Explanation for incorrect choices:
A: The client will be started on fluoxetine in 1 month - This choice is incorrect because fluoxetine is an antidepressant and not a treatment for HIV.
B: Antiretroviral therapy will begin within 3 months - This choice is incorrect because starting antiretroviral therapy should be based on confirmed diagnosis, not just a positive antibody test result.
D: The client will be monitored for signs and symptoms of HIV to determine the need for treatment - This choice is incorrect because monitoring signs and symptoms alone is not sufficient to confirm HIV infection or determine the need for treatment.
Which interventions apply in the care of a client at high risk for an allergic response to a latex allergy?
A. Use nonlatex gloves.
B. Place the client in a private room only.
C. Use a blood pressure cuff from an electronic device only to measure the blood pressure.
D. Avoid the use of medication vials that have rubber stoppers.
Correct answer:
The correct answer is A: Use nonlatex gloves. This intervention is crucial in preventing an allergic response in a client with a latex allergy. Latex gloves are a common source of exposure to latex allergens, so using nonlatex gloves reduces the risk of triggering an allergic reaction.
Explanation:
1. Latex gloves contain latex proteins that can cause allergic reactions in sensitive individuals.
2. By using nonlatex gloves, the risk of direct contact with latex allergens is minimized.
3. This intervention is a practical and effective measure to protect the client from exposure to latex.
4. It is a proactive approach to prevent potential allergic responses and promote client safety.
Summary of other choices:
B: Placing the client in a private room only does not directly address the risk of latex exposure.
C: Using a blood pressure cuff from an electronic device only is not specific to preventing latex exposure.
D: Avoiding medication vials with rubber stoppers is important but does not directly address the use of latex
A patient is brought to the emergency department for treatment of a suspected overdose. The patient was found with an empty prescription bottle of a barbiturate by his bedside. He is lethargic and barely breathing. The nurse would expect which immediate intervention?
A. Starting an intravenous infusion of diluted bicarbonate solution
B. Administering medications to increase blood pressure
C. Implementing measures to maintain the airway and support respirations
D. Administrating naloxone (Narcan) as an antagonist
Correct answer:
The correct answer is C: Implementing measures to maintain the airway and support respirations. In cases of a suspected barbiturate overdose, the priority is to ensure the patient has a patent airway and is able to breathe adequately. This intervention is crucial as barbiturates can depress the central nervous system, leading to respiratory depression or even respiratory arrest. By maintaining the airway and supporting respirations, the nurse can prevent further complications such as hypoxia and ensure the patient's vital functions are stable.
Other choices are incorrect:
A: Starting an intravenous infusion of diluted bicarbonate solution - While bicarbonate may be used in certain cases of drug toxicity to correct acidosis, it is not the immediate intervention needed for a patient with a suspected barbiturate overdose.
B: Administering medications to increase blood pressure - This is not the priority in a case of barbiturate overdose where respiratory depression is the main concern.
D: Administrating naloxone (Nar
During which process does coronary artery blood flow to the myocardium occur during diastole, when coronary vascular resistance is reduced?
A. Coronary perfusion pressure
B. Coronary vascular resistance
C. Diastolic filling
D. Ventricular ejection
Correct answer:
The correct answer is A: Coronary perfusion pressure. Coronary perfusion pressure is the pressure gradient that drives blood flow through the coronary arteries into the myocardium during diastole when the coronary vascular resistance is reduced. This pressure gradient is essential for delivering oxygen and nutrients to the heart muscle when it is relaxed and filling with blood. During diastole, the coronary arteries receive blood flow predominantly due to the pressure difference between the aortic diastolic pressure and the pressure in the coronary vasculature.
Summary of why the other choices are incorrect:
B: Coronary vascular resistance - This factor is reduced during diastole, allowing for increased blood flow, but it does not directly drive blood flow to the myocardium.
C: Diastolic filling - This refers to the filling of blood into the ventricles of the heart, not specifically the flow of blood through the coronary arteries.
D: Ventricular ejection - This occurs during systole when the ventricles contract
Which assessment finding by the nurse caring for a patient who has had coronary artery bypass grafting using a right radial artery graft is most important to communicate to the health care provider?
A. Complaints of incisional chest pain
B. Pallor and weakness of the right hand
C. Fine crackles heard at both lung bases
D. Redness on both sides of the sternal incision
Correct answer:
The correct answer is B: Pallor and weakness of the right hand. This finding could indicate impaired circulation to the right hand due to a complication related to the radial artery graft. Impaired circulation could lead to ischemia or even graft failure, which are serious concerns post coronary artery bypass grafting. This information is crucial to communicate to the health care provider for immediate intervention to prevent further complications.
Incorrect choices:
A: Complaints of incisional chest pain - While chest pain is important to monitor post-surgery, it is a common occurrence and may not indicate a serious complication.
C: Fine crackles heard at both lung bases - This finding may suggest fluid overload or pulmonary issues, but it is not directly related to the radial artery graft or its complications.
D: Redness on both sides of the sternal incision - Redness at the incision site can be a sign of infection, but it is not as urgent as the potential circulation issue in the right hand, which could
A 3-year-old nonsyndromic, well-appearing male with no significant past medical history presents with an abdominal mass palpated by his mother when giving him a bath. CT imaging reveals a 9-cm right renal mass without involvement of the inferior vena cava (IVC) and no evidence of tumor thrombus by ultrasound. The left kidney appears normal, and there is no imaging evidence of tumor rupture or adherence to surrounding organs. There are diffuse, bilateral pulmonary metastases from which he is asymptomatic with a normal respiratory rate and no supplemental oxygen requirement. Following the National Wilms Tumor Study Group (NWTS)/Children's Oncology Group (COG) approach to pediatric renal tumors, which of the following are appropriate next steps?
A. Core biopsy of the renal mass followed by three drug chemotherapyâ€â€vincristine, actinomycin, and doxorubicin
B. Nephrectomy with lymph node sampling followed by chemotherapy based on histology and stage
C. Fine-needle aspiration followed by three drug chemotherapyâ€â€vincristine, actinomycin, and doxorubicin
D. Neoadjuvant three drug chemotherapyâ€â€vincristine, actinomycin and doxorubicinâ€â€followed by nephrectomy at week 6
Correct answer:
The correct answer is B: Nephrectomy with lymph node sampling followed by chemotherapy based on histology and stage. This is the appropriate next step following NWTS/COG approach for pediatric renal tumors. Nephrectomy is crucial to remove the primary tumor and obtain tissue for definitive histologic diagnosis. Lymph node sampling helps determine if there is spread to regional nodes. Based on the histology and stage determined post-nephrectomy, appropriate chemotherapy can be initiated tailored to the specific characteristics of the tumor.
Explanation of other choices:
A: Core biopsy followed by chemotherapy is not recommended as it may not provide sufficient tissue for histologic diagnosis and staging.
C: Fine-needle aspiration is not adequate for a definitive diagnosis or staging and may not provide enough tissue for necessary testing.
D: Neoadjuvant chemotherapy before surgery is not appropriate in this scenario as the primary tumor needs to be resected for accurate staging and histologic evaluation.
A patient who takes lithium phones the nurse at the clinic to say, “I’ve had diarrhea for 4 days. I feel weak and unsteady when I walk. My usual hand tremor has gotten worse. What should I do?†Which instruction by the nurse is appropriate?
A. “Have someone bring you to the clinic immediately.â€
B. “Restrict food and fluids for 24 hours and stay in bed.â€
C. “Drink a large glass of water with 1 teaspoon of salt added.â€
D. “Take antidiarrheal medication hourly until the diarrhea subsides.â€
Correct answer:
The correct answer is A: "Have someone bring you to the clinic immediately." This is the appropriate instruction because the patient is experiencing symptoms of lithium toxicity, such as diarrhea, weakness, unsteadiness, and worsening hand tremor. Lithium toxicity is a serious condition that can lead to life-threatening complications if not treated promptly. Bringing the patient to the clinic immediately allows for proper evaluation, monitoring, and treatment by healthcare professionals.
Summary:
- Choice B: "Restrict food and fluids for 24 hours and stay in bed" is incorrect as it does not address the urgency of the situation and may worsen dehydration.
- Choice C: "Drink a large glass of water with 1 teaspoon of salt added" is incorrect as it can exacerbate the electrolyte imbalance caused by lithium toxicity.
- Choice D: "Take antidiarrheal medication hourly until the diarrhea subsides" is incorrect as it does not address the root cause of the symptoms and may delay necessary medical intervention.
Which of the following statements concerning potassium channel openers is true?
A. These agents decrease transmembrane calcium current associated in a smooth muscle with long-lasting relaxation and in a cardiac muscle with a reduction in contractility
B. These agents has a moderate reflex and vascular dilative action caused by the stimulation of sensitive nerve endings
C. Beneficial effects of these agents are related primarily to their hemodynamic effects – decreased heart rate, blood pressure, and contractility – which decrease myocardial oxygen requirements at rest and during exercise
D. These agents increase the permeability of K channels, probably ATP-dependent K channels, that results in stabilizing the membrane potential of excitable cells near the resting potential
Correct answer:
Correct Answer: D
Rationale:
1. Potassium channel openers increase the permeability of potassium channels, specifically ATP-dependent K channels.
2. This increased permeability results in stabilizing the membrane potential of excitable cells near the resting potential.
3. By stabilizing the membrane potential, these agents help regulate cell excitability and function.
4. This mechanism of action is crucial in conditions like cardiac arrhythmias and smooth muscle hyperactivity.
Summary of Incorrect Choices:
A. This statement incorrectly associates potassium channel openers with decreasing calcium current, which is not their primary mechanism of action.
B. This statement inaccurately attributes reflex and vascular dilative actions to potassium channel openers, which are not their primary effects.
C. This statement wrongly suggests that the beneficial effects of potassium channel openers are primarily hemodynamic, while their main mechanism is through potassium channel permeability modulation.
A patient is undergoing abdominal surgery and has been anesthetized for 3 hours. Which nursing diagnosis would be appropriate for this patient?
A. Anxiety related to the use of an anesthetic
B. Risk for injury related to increased sensorium from general anesthesia
C. Decreased cardiac output related to systemic effects of local anesthesia
D. Impaired gas exchange related to central nervous system depression produced by general anesthesia
Correct answer:
The correct answer is D: Impaired gas exchange related to central nervous system depression produced by general anesthesia. During abdominal surgery under general anesthesia, the patient's central nervous system is depressed, leading to impaired gas exchange. This is due to decreased respiratory drive and potential airway obstruction. It is essential for the nurse to monitor the patient's respiratory rate, depth, and oxygen saturation to prevent respiratory complications.
Choice A (Anxiety related to the use of an anesthetic) is incorrect because anxiety is not a priority nursing diagnosis during surgery under anesthesia. Choice B (Risk for injury related to increased sensorium from general anesthesia) is incorrect as general anesthesia actually decreases sensorium, reducing the risk for injury. Choice C (Decreased cardiac output related to systemic effects of local anesthesia) is incorrect as local anesthesia does not typically affect cardiac output during abdominal surgery under general anesthesia.
LPN exams cardiovascular practice questions, set 2 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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