LPN exams cardiovascular practice questions, set 21
LPN exams · cardiovascular
LPN exams cardiovascular practice questionsset 21
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 5-year-old girl with a previously normal CBC now presents in your office with a hemoglobin of 8.5 g/dL, corrected reticulocyte count of 0.1%, and mean corpuscular volume of 80 fl. White cells and platelets are normal in number and morphology. Bilirubin, LDH, BUN, creatinine, and urinalysis are normal. Direct and indirect antiglobulin tests are negative. Workup for infection, including parvovirus, is negative. Occult blood in her stools is negative. Physical examination is unremarkable. She has had no restriction in her energy or activities and the family agrees she is 'fine.' What is the most appropriate next step in management?
A. Administer erythropoietin.
B. Initiate a red cell transfusion.
C. Observe serial hemoglobin values closely.
D. Prescribe oral iron supplement.
Show answer and rationale
Correct answer: C — Observe serial hemoglobin values closely.
The correct answer is C: Observe serial hemoglobin values closely. This is the most appropriate next step in management for a 5-year-old girl with a hemoglobin of 8.5 g/dL, normal white cells, and platelets. Given the absence of symptoms or signs of acute illness, a conservative approach of close observation is warranted. This allows monitoring for any trends in hemoglobin levels and the need for intervention. Administering erythropoietin (choice A) is not indicated as the patient is clinically stable and does not have evidence of erythropoietin deficiency. Initiating a red cell transfusion (choice B) is not necessary at this point since the patient is asymptomatic and stable. Prescribing oral iron supplement (choice D) is not appropriate as the MCV is normal, and there is no evidence of iron deficiency anemia.
Question 2
A client is having a bone marrow aspiration and biopsy and is extremely anxious. What action by the nurse is the most appropriate?
A. Assess the client's fears and coping mechanisms.
B. Reassure the client that this is a common test.
C. Sedate the client prior to the procedure.
D. Tell the client that he or she will be asleep.
Show answer and rationale
Correct answer: A — Assess the client's fears and coping mechanisms.
The correct answer is A because assessing the client's fears and coping mechanisms allows the nurse to provide individualized support and interventions to address the client's anxiety effectively. By understanding the client's specific concerns, the nurse can provide tailored information, emotional support, and coping strategies to help the client feel more comfortable during the procedure.
Option B is incorrect as simply reassuring the client may not address the underlying anxieties and fears. Option C is inappropriate as sedation should only be used if absolutely necessary and after other non-pharmacological interventions have been exhausted. Option D is incorrect because bone marrow aspiration and biopsy are typically performed with local anesthesia, so the client will not be asleep during the procedure.
Question 3
What causes the pain that occurs with myocardial ischemia?
A. Death of myocardial tissue
B. Dysrhythmias caused by cellular irritability
C. Lactic acid accumulation during anaerobic metabolism
D. Elevated pressure in the ventricles and pulmonary vessels
Show answer and rationale
Correct answer: C — Lactic acid accumulation during anaerobic metabolism
The correct answer is C: Lactic acid accumulation during anaerobic metabolism. During myocardial ischemia, there is a decrease in blood flow leading to insufficient oxygen supply to the heart muscle. This results in anaerobic metabolism, causing lactic acid accumulation. Lactic acid buildup leads to tissue acidosis, which is sensed as pain by nerve endings in the heart.
Incorrect choices:
A: Death of myocardial tissue - This is the result of prolonged ischemia leading to irreversible damage, not the direct cause of pain.
B: Dysrhythmias caused by cellular irritability - Dysrhythmias can occur with ischemia, but they are not the primary cause of pain.
D: Elevated pressure in the ventricles and pulmonary vessels - While elevated pressure can be a consequence of ischemia, it is not the direct cause of pain.
Question 4
A patient is admitted with and ST segment myocardial infarction. The patient's wife overhears the physician talking about this and asks you, the nurse, what the physician means by this type of heart attack. The nurse's BEST response would include
A. "Your husband has permanent changes that will stay on his ECG and the practitioner will always be able to tell that he has an MI."
B. "Your husband has had a smaller MI that goes through only part of the wall of the heart and therefore causes small areas to stay elevated."
C. "Your husband has had a rather large heart attack that has caused the death of the heart muscle through all of its three layers."
D. "Your husband is lucky; his cardiac markers are not elevated but he has had a severe heart attack that we can take care of with medication."
Show answer and rationale
Correct answer: C — "Your husband has had a rather large heart attack that has caused the death of the heart muscle through all of its three layers."
The correct answer is C because an ST segment myocardial infarction signifies a full-thickness heart attack causing death of heart muscle through all three layers. This type of MI is serious and can lead to significant complications.
Explanation for why other choices are incorrect:
A: This answer is incorrect because the permanency of changes on the ECG does not fully explain the severity or extent of the heart attack.
B: This answer is incorrect because describing a smaller MI that only affects part of the heart wall does not accurately represent an ST segment myocardial infarction.
D: This answer is incorrect because it confuses the absence of elevated cardiac markers with the severity of the heart attack, which is not a reliable indicator of the extent of damage in an ST segment myocardial infarction.
Question 5
In which of the following conditions is percent transferrin iron saturation highest?
A. Anemia of chronic disease
B. Iron deficiency
C. Pernicious anemia
D. Hemachromatosis
Show answer and rationale
Correct answer: D — Hemachromatosis
The correct answer is D: Hemachromatosis. In hemachromatosis, the body absorbs and stores too much iron, leading to high transferrin iron saturation.
Rationale:
1. In hemachromatosis, the body absorbs excess iron from the diet, causing high iron levels in the blood.
2. Transferrin is a protein that transports iron in the blood. In hemachromatosis, the high iron levels saturate the transferrin, leading to high percent transferrin iron saturation.
3. Anemia of chronic disease (A) is characterized by low iron levels and low transferrin iron saturation.
4. Iron deficiency (B) results in low iron levels and low transferrin iron saturation.
5. Pernicious anemia (C) is caused by vitamin B12 deficiency, not iron overload, leading to normal to low transferrin iron saturation.
Summary: Hemachromatosis leads to high
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Question 6
The nurse is explaining the role of red blood cells with oxygen transport in the body with a nursing student. Which term should the nurse use to describe hemoglobin that has given up its oxygen to the body's cells?
A. Reduced
B. Detached
C. Oxyhemoglobin
D. Hypoxyhemoglobin
Correct answer:
The correct term to describe hemoglobin that has given up its oxygen to the body's cells is "Reduced" (Choice A). This term refers to hemoglobin that has released its oxygen molecules and is now in a deoxygenated state.
Rationale:
1. Hemoglobin binds to oxygen in the lungs (forming oxyhemoglobin).
2. When hemoglobin reaches the body's cells, it releases oxygen for cellular use.
3. Once hemoglobin releases oxygen, it becomes deoxygenated or "Reduced".
Summary:
- Choice B (Detached) does not accurately describe the process of oxygen release by hemoglobin.
- Choice C (Oxyhemoglobin) refers to hemoglobin bound to oxygen, not hemoglobin that has released oxygen.
- Choice D (Hypoxyhemoglobin) would refer to hemoglobin that has a reduced oxygen level, not hemoglobin that has given up its oxygen to the cells.
Which of the following statements concerning nitrate mechanism of action is True?
A. Therapeutically active agents in this group are capable of releasing nitric oxide (NO) in to vascular smooth muscle target tissues
B. Nitric oxide (NO) is an effective activator of soluble guanylyl cyclase and probably acts mainly through this mechanism
C. Nitrates useful in angina decrease myocardial oxygen requirement (by decreasing the determinations of oxygen demand) and increase myocardial oxygen delivery (by reversing coronary arterial spasm)
D. All of the above
Correct answer:
The correct answer is D: All of the above.
Rationale:
A: Therapeutically active nitrates release NO, which activates guanylyl cyclase in vascular smooth muscle, leading to vasodilation.
B: Nitric oxide activates soluble guanylyl cyclase, promoting cGMP production, causing vasodilation and reducing blood pressure.
C: Nitrates decrease myocardial oxygen demand by reducing preload and afterload, while also increasing oxygen delivery by dilating coronary arteries.
Summary:
Option A highlights the release of NO, contributing to vasodilation. Option B explains NO's role in activating guanylyl cyclase. Option C describes the dual mechanism of nitrates in decreasing oxygen demand and increasing oxygen delivery. Therefore, the correct answer includes all valid statements regarding nitrate mechanism of action.
Tick the positive inotropic drug of glycoside structure:
A. Dopamine
B. Digoxin
C. Dobutamine
D. Adrenalin
Correct answer:
Step-by-step rationale:
1. Digoxin is a positive inotropic drug of glycoside structure.
2. Digoxin works by inhibiting the sodium-potassium pump, leading to increased intracellular calcium levels, enhancing myocardial contractility.
3. Dopamine is a catecholamine used for its positive inotropic effects but does not have a glycoside structure.
4. Dobutamine is a synthetic catecholamine with positive inotropic effects but lacks a glycoside structure.
5. Adrenaline is a catecholamine with positive inotropic effects, but it is not a glycoside structure.
Summary:
Digoxin is the correct answer because it has a glycoside structure and exerts positive inotropic effects by increasing intracellular calcium levels. Dopamine, dobutamine, and adrenaline are not glycoside drugs and work through different mechanisms.
You examine a 10-year-old boy with severe aplastic anemia. He has no dysmorphic features and is at the 50th percentile for height and weight. Family history includes a sister with aplastic anemia unresponsive to anti-human thymocyte globulin (ATG) and cyclosporine who died early in the course of an unrelated donor hematopoietic stem cell transplant complicated by severe mucositis and transplant-related organ toxicities. There are no other siblings. A cousin died of acute myeloid leukemia at age 5 years. A peripheral blood sample test for Fanconi anemia is negative with no increased chromosomal breaks in response to diepoxylbutane or mitomycin C. Which of the following is the most important next step in management?
A. Administer ATG and cyclosporine.
B. Search for a donor for matched unrelated transplant.
C. Send a bone marrow aspirate for Fanconi anemia testing.
D. Send a skin fibroblast culture for Fanconi anemia testing.
Correct answer:
The correct answer is D: Send a skin fibroblast culture for Fanconi anemia testing. This is the most important next step in management because the patient's history, including a family member with aplastic anemia and a cousin with leukemia, raises suspicion for a genetic disorder like Fanconi anemia. Testing skin fibroblasts for Fanconi anemia can help confirm or rule out this diagnosis. Administering ATG and cyclosporine (choice A) may not be effective if the underlying cause is a genetic disorder. Searching for a donor for matched unrelated transplant (choice B) is premature without confirming the diagnosis. Sending a bone marrow aspirate for Fanconi anemia testing (choice C) may not yield accurate results as the peripheral blood sample test was negative, making skin fibroblast culture the preferred choice.
A 30 year old patient had presented with fever and posterior cervical lymphadenopathy over the past two years. Which is the most probably causative organism?
A. Trypanosoma cruzi
B. Trypanosoma brucei rhodesiense
C. Trypanosoma brucei gambiense
D. Leishmania donovani
Correct answer:
The correct answer is C: Trypanosoma brucei gambiense. This is the most likely causative organism because the patient's presentation of fever and posterior cervical lymphadenopathy is consistent with African trypanosomiasis, also known as sleeping sickness, which is caused by T. brucei gambiense. This parasite is transmitted by the tsetse fly in sub-Saharan Africa. The other choices (A, B, D) are not the correct causative organism for African trypanosomiasis and do not match the clinical presentation described in the question. Trypanosoma cruzi causes Chagas disease, Trypanosoma brucei rhodesiense causes a more acute form of African trypanosomiasis, and Leishmania donovani causes visceral leishmaniasis, which typically presents with splenomegaly and hepatomegaly rather than posterior cervical lymphadenopathy.
Sedation,peripheral atropine-like toxicity (e.g. Cycloplegia tachycardia urinary retention and constipation) orthostatic hypotension arrhythmias weight gain and sexual disturbances are possible adverse effects of:
A. Sertaline
B. Amitriptyline
C. Phenelsine
D. Bupropion
Correct answer:
The correct answer is B: Amitriptyline. Amitriptyline is a tricyclic antidepressant known for its anticholinergic properties, leading to peripheral atropine-like toxicity such as cycloplegia, tachycardia, urinary retention, and constipation. It can also cause orthostatic hypotension, arrhythmias, weight gain, and sexual disturbances.
Explanation:
1. Amitriptyline is a tricyclic antidepressant that exerts anticholinergic effects, leading to peripheral atropine-like toxicity.
2. Anticholinergic effects can cause cycloplegia, tachycardia, urinary retention, and constipation.
3. Additionally, amitriptyline can lead to orthostatic hypotension, arrhythmias, weight gain, and sexual disturbances.
Summary of other choices:
A: Sertaline - Known for causing fewer anticholinergic side effects compared to tricy
A nurse is caring for a patient who has been diagnosed with leukemia. The nurse's most recent assessment reveals the presence of ecchymoses on the patient's sacral area and petechiae in her forearms. In addition to informing the patient's primary care provider, the nurse should perform what action?
A. Initiate measures to prevent venous thromboembolism (VTE).
B. Check the patient's most recent platelet level.
C. Place the patient on protective isolation.
D. Ambulate the patient to promote circulatory function.
Correct answer:
Step-by-step rationale for why answer B is correct:
1. Petechiae and ecchymoses indicate potential thrombocytopenia in a leukemia patient.
2. Checking the patient's platelet level will confirm thrombocytopenia and guide treatment.
3. Low platelet levels can lead to bleeding complications, hence the importance of monitoring.
4. Prompt intervention based on platelet level results can prevent worsening complications.
Summary of why other choices are incorrect:
A: Initiating measures to prevent VTE is not directly related to the patient's current presentation of ecchymoses and petechiae.
C: Placing the patient on protective isolation is not indicated for thrombocytopenia.
D: Ambulating the patient may be beneficial for circulation but does not address the underlying issue of potential thrombocytopenia.
A school-aged client admitted to the hospital because of decreased urine output and periorbital edema is diagnosed with glomerulonephritis. Which of the following interventions should receive the highest priority?
A. Assessing vital signs every four hours
B. Monitoring intake and output every 12 hours
C. Obtaining daily weight measurements
D. Obtaining serum electrolyte levels daily
Correct answer:
The correct answer is C: Obtaining daily weight measurements. Daily weight measurements are crucial in monitoring fluid status in clients with glomerulonephritis, as sudden weight gain can indicate fluid retention and worsening of the condition. This intervention allows for early detection of fluid imbalances, guiding appropriate fluid management and treatment adjustments.
Assessing vital signs every four hours (choice A) is important but not the highest priority in this scenario, as monitoring weight is more specific for fluid status changes. Monitoring intake and output every 12 hours (choice B) is also important, but not as immediate as obtaining daily weight measurements. Obtaining serum electrolyte levels daily (choice D) is essential, but weight measurements take precedence in assessing fluid status.
Which statement is correct regarding lymphocyte counts in infants versus adults?
A. NK-cell numbers are lowest at birth and increase with age.
B. B-cell numbers are highest at birth and decline with age.
C. T-cell numbers in infants are higher than in adults.
D. Infants have low lymphocyte counts that increase with age.
Correct answer:
The correct answer is C: T-cell numbers in infants are higher than in adults. This is because infants have a relatively higher proportion of T-cells compared to adults due to their underdeveloped immune system. T-cell numbers decrease with age as the immune system matures and adapts to the environment.
Rationale:
1. T-cells play a crucial role in the immune response, especially in infants who rely heavily on cellular immunity.
2. NK-cell numbers do not follow the pattern described in option A, as they are important in early immune responses.
3. B-cell numbers do not decline with age as stated in option B, as they are responsible for antibody production throughout life.
4. Option D is incorrect as infants actually have higher lymphocyte counts compared to adults due to their developing immune system.
A toddler with Kawasaki's disease is going home on salicylate (aspirin) therapy. Which is the priority teaching at the time of discharge?
A. Monitor the child for gastrointestinal bleeding.
B. Avoid contact with other children.
C. Report complaints of tingling extremities.
D. Maintain a low-calorie diet.
Correct answer:
The correct answer is A. Monitoring the child for gastrointestinal bleeding is the priority because aspirin therapy in Kawasaki's disease can increase the risk of bleeding due to its effects on platelet function. It is crucial to assess for signs of bleeding such as black/tarry stools, vomiting blood, or abdominal pain.
Explanation for why the other choices are incorrect:
B: Avoiding contact with other children is not directly related to the potential side effects of aspirin therapy in Kawasaki's disease.
C: Reporting complaints of tingling extremities is important but not as urgent as monitoring for gastrointestinal bleeding, which can be life-threatening.
D: Maintaining a low-calorie diet is not the priority teaching at the time of discharge for a toddler with Kawasaki's disease on aspirin therapy.
LPN exams cardiovascular practice questions, set 21 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
No. Nursier is independent practice. Register through the official path named on the LPN exams exam guide.
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