LPN exams cardiovascular practice questions set 20

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The correct answer is C: Five-year survival for patients over 75 years old is less than 2%. This is because older age is a significant risk factor for poorer outcomes in acute myeloid leukemia (AML) due to factors such as frailty, comorbidities, and reduced tolerance to aggressive treatments. Older adults are less likely to tolerate intensive chemotherapy and have lower overall survival rates compared to younger patients. Choice A is incorrect because early diagnosis alone does not guarantee good outcomes in AML, especially in older adults. Choice B is incorrect because the five-year survival rate for older adults with AML is much lower than 50%. Choice D is incorrect because while pre-illness health may influence survival rates, age is a more significant factor in predicting outcomes in older patients with AML.

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The correct answer is D: Ga 68-DOTATATE PET/CT. This imaging study is the most useful for determining the disease stage in a patient with paraganglioma. Paragangliomas are neuroendocrine tumors that express somatostatin receptors, which can be detected using Ga 68-DOTATATE PET/CT. This imaging modality helps to localize primary and metastatic lesions, as well as assess disease extent and stage. Now let's analyze the other options: A: Bone Scan - Not useful for determining disease stage in paraganglioma. B: Lumbar puncture for cerebrospinal fluid cytology - Not indicated for staging paraganglioma. C: Bone marrow aspirate and biopsy - Not specific for staging paraganglioma. In summary, Ga 68-DOTATATE PET/CT is the most appropriate study for determining disease stage in a patient with paraganglioma due to its

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The correct answer is A: Nodular sclerosis. This subtype of Hodgkin's lymphoma is more common in young women and has a good prognosis due to its characteristic fibrotic bands dividing the lymph node into nodules. These nodules contain a mixture of inflammatory cells and Reed-Sternberg cells. Choice B: Mixed cellularity is more common in older patients and has a less favorable prognosis due to its heterogeneous cell population with abundant Reed-Sternberg cells. Choice C: Lymphocyte predominance typically affects young adults and has an indolent course with a good prognosis, but it is not as common in young women as nodular sclerosis. Choice D: Lymphocyte depletion is a rare subtype seen in older individuals with a poor prognosis due to the paucity of lymphocytes and an abundance of Reed-Sternberg cells.

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The correct answer is A: neuroleptic malignant syndrome (NMS). NMS is a rare but serious side effect of antipsychotic medications like risperidone. The patient's symptoms of severe muscle stiffness, difficulty swallowing, altered mental status, diaphoresis, fever, tachycardia, and hypertension are classic signs of NMS. Step-by-step rationale: 1. Severe muscle stiffness: characteristic symptom of NMS due to muscle rigidity. 2. Difficulty swallowing and speaking: indicative of autonomic dysfunction commonly seen in NMS. 3. Altered mental status: stuporous state is a hallmark feature of NMS. 4. Diaphoresis, fever (38.8° C), tachycardia (110 beats/min), hypertension (150/90 mm Hg): all signs of autonomic dysregulation and hyperadrenergic state in NMS. Summary of other choices: B: Anticholinergic toxicity -

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Rationale for Correct Answer D: Aldosterone is a hormone that regulates salt and water balance by affecting sodium and potassium levels. Hydrochlorothiazide inhibits sodium reabsorption, while amiloride blocks potassium excretion. Since aldosterone promotes sodium reabsorption and potassium excretion, the presence of aldosterone would counteract the effects of both drugs. Therefore, the correct answer is D, as neither drug requires aldosterone for effectiveness. Choice A (Hydrochlorothiazide) is incorrect because it works independently of aldosterone by inhibiting sodium reabsorption in the kidneys. Choice B (Amiloride) is also incorrect as it directly blocks sodium channels in the kidneys, regardless of aldosterone levels. Choice C is incorrect because both drugs are effective regardless of aldosterone presence.

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Correct Answer: C - Calcium level of 7.0 mg/dL Rationale: 1. In a client with renal failure and myocardial infarction, monitoring calcium levels is crucial due to potential electrolyte imbalances. 2. A calcium level of 7.0 mg/dL is abnormally low (normal range is 8.5-10.5 mg/dL), indicating hypocalcemia which can lead to cardiac arrhythmias. 3. Low calcium levels can worsen heart function and increase the risk of complications in a client with a recent myocardial infarction. 4. Calling the doctor to report this critical result is essential for prompt intervention to prevent adverse cardiac events. Summary of Other Choices: A: Potassium level of 5.0 mEq/L - Within normal range, not urgent in this scenario. B: Sodium level of 145 mEq/L - Within normal range, not a priority in this context. D: Digoxin/d

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Rationale: A peripheral blood smear showing an increase in neutrophils, basophils, eosinophils, and platelets is indicative of Chronic Myelocytic Leukemia (CML). Neutrophils, basophils, and eosinophils are myeloid lineage cells typically elevated in CML. The presence of increased platelets is also common in CML due to the overproduction of cells in the bone marrow. Summary of other choices: A: Acute myeloid leukemia - Typically presents with a predominance of immature myeloid cells like blasts, rather than an increase in mature myeloid cells. B: Acute lymphoid leukemia - Primarily involves lymphoid lineage cells, not myeloid cells as seen in the blood smear. D: Chronic lymphocytic leukemia - Characterized by an increase in mature lymphocytes, not myeloid cells like neutrophils, basophils, and eosinophils.

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The correct answer is C: Monitor for hemorrhage. This is a priority nursing intervention because low molecular weight heparin can increase the risk of bleeding. Monitoring for signs of bleeding such as bruising, petechiae, or blood in stool is crucial to prevent serious complications. A: Monitoring heparin levels is not necessary for low molecular weight heparin as it does not require routine monitoring. B: Monitoring aPTT is not necessary for low molecular weight heparin as it primarily affects unfractionated heparin levels. D: Monitoring blood sugar is unrelated to low molecular weight heparin therapy and is not a priority intervention. In summary, monitoring for hemorrhage is essential to ensure patient safety when on low molecular weight heparin, making it the correct priority nursing intervention.

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Step 1: Extrapyramidal side effects are movement disorders caused by antipsychotic medications. Step 2: Akathisia and pseudo-Parkinson symptoms are classic examples of extrapyramidal side effects. Step 3: Anticholinergic medications primarily cause dry mouth, constipation, and blurred vision, not movement disorders. Step 4: Serotonergic medications affect serotonin levels, leading to mood and behavior changes, not movement disorders. Step 5: Adrenergic medications target the sympathetic nervous system, causing effects like increased heart rate and blood pressure, not movement disorders. Summary: The correct answer is A because extrapyramidal side effects specifically refer to abnormal movements caused by antipsychotic medications, while the other choices do not match the symptoms described in the question.

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The correct answer is A: Stage I. In the Ann Arbor staging system for Hodgkin lymphoma, Stage I indicates involvement of a single lymph node region (I) or a single extralymphatic site (IE) without systemic symptoms. In this case, the patient has a large mediastinal mass but no other sites of disease on metastatic workup. This corresponds to Stage I disease. Choice B: Stage II would indicate involvement of two or more lymph node regions on the same side of the diaphragm. Choice C: Stage III would indicate involvement of lymph node regions on both sides of the diaphragm. Choice D: Stage IV would indicate disseminated involvement of one or more extralymphatic organs or tissues. Therefore, based on the information provided, the correct stage for this patient is Stage I as per the Ann Arbor staging system.