LPN exams cardiovascular practice questions, set 6
LPN exams · cardiovascular
LPN exams cardiovascular practice questionsset 6
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 10-year-old girl has had transfusion-dependent anemia since age 6 months. She is found to have an unstable hemoglobin by sequence analysis (Hb Indianapolis). She has jaundice, obvious bony deformity from extramedullary hematopoiesis, and hepatosplenomegaly. Which of the following statements is correct?
A. Her diagnosis should have been picked up on newborn screen by electrophoresis, isoelectric focusing, or high-performance liquid chromatography similar to other beta-hemoglobinopathies.
B. Since her spleen is intact, her peripheral blood smear cannot have nucleated red cells or Howell Jolly bodies.
C. If she undergoes splenectomy, her anemia should be entirely ameliorated.
D. Since she is transfused, she will not be at risk for gallstones.
Show answer and rationale
Correct answer: E
Rationale for Correct Answer (E): The correct statement is likely about the fact that her hemoglobinopathy, Hb Indianapolis, is associated with ineffective erythropoiesis, leading to anemia, jaundice, and extramedullary hematopoiesis. This is a rare condition and not typically detected on newborn screens. Additionally, splenectomy may not entirely resolve her anemia due to the systemic nature of the disease. Since she has transfusion-dependent anemia, she is at risk for gallstones due to chronic hemolysis.
Summary of Incorrect Choices:
A: Incorrect because Hb Indianapolis is rare and not typically detected on newborn screens.
B: Incorrect because extramedullary hematopoiesis can lead to nucleated red cells in the peripheral blood smear.
C: Incorrect because the disease is systemic, and splenectomy may not fully resolve the anemia.
D: Incorrect because chronic hemolysis from the disease increases the risk of gallstones despite transf
Question 2
A laboratory study is conducted to determine the optimal usage of platelets for transfusion. The blood bank inventory along with the transfusion records and medical records of subjects who were recipients of platelet transfusion are reviewed. Which of the following conclusions is most likely to be made from this study?
A. Frozen storage of platelets helps increase the units available.
B. Platelet transfusions are rarely successful in patients with autoimmune thrombocytopenia.
C. Platelet units carry no risk for transmission of hepatitis C infection.
D. Pooled donor platelets are preferred over single-donor platelets.
Show answer and rationale
Correct answer: B — Platelet transfusions are rarely successful in patients with autoimmune thrombocytopenia.
Step-by-step rationale for why answer B is correct:
1. Autoimmune thrombocytopenia is a condition where the body's immune system attacks and destroys its own platelets.
2. Platelet transfusions in patients with autoimmune thrombocytopenia are less likely to be successful due to the underlying immune response.
3. Reviewing transfusion records of subjects with this condition would likely show a pattern of unsuccessful platelet transfusions.
4. This conclusion is supported by medical knowledge and understanding of autoimmune thrombocytopenia.
Summary:
- Choice A is incorrect because frozen storage of platelets does not necessarily increase units available in the context of the study.
- Choice C is incorrect as platelet units can carry a risk of transmission for hepatitis C infection.
- Choice D is incorrect as the preference for pooled donor platelets over single-donor platelets is not a conclusion that can be drawn from the study.
Question 3
Which of the following is a chronic inflammatory disease of the airways that causes episodes of wheezing, breathlessness, chest tightness, and coughing?
A. Asthma
B. Bronchitis
C. Pneumonia
D. Emphysema
Show answer and rationale
Correct answer: A — Asthma
A: Asthma is the correct answer because it is a chronic inflammatory disease of the airways characterized by symptoms like wheezing, breathlessness, chest tightness, and coughing. This condition is often triggered by various factors such as allergens, exercise, or respiratory infections. Asthma involves inflammation and narrowing of the airways, leading to the symptoms mentioned.
B: Bronchitis is incorrect as it refers to inflammation of the bronchial tubes, which can be acute or chronic, but it does not typically present with all the symptoms listed in the question.
C: Pneumonia is incorrect as it is an infection of the lungs caused by bacteria, viruses, or fungi, and does not typically cause chronic inflammation of the airways.
D: Emphysema is incorrect as it is a type of chronic obstructive pulmonary disease (COPD) characterized by damage to the air sacs in the lungs, leading to difficulty breathing, but it does not typically present
Question 4
A healthy 17-year-old African American male presents with a thrombosis of the right upper extremity. His past medical history is remarkable only for sickle cell trait. The history is negative for recent risk factors for thrombosis (illness, surgery, immobility). He is the pitcher for his high school baseball team. Imaging confirms anatomical compression/narrowing of the right subclavian vein. Which of the following interventions is most likely to decrease this patient's long-term risk of recurrent thrombosis?
A. Systemic thrombolysis
B. Catheter-directed thrombolysis
C. Extended 12-month course of anticoagulation with low-molecular-weight heparin (LMWH)
D. Resection of right first rib
Show answer and rationale
Correct answer: D — Resection of right first rib
The correct answer is D: Resection of right first rib. The patient's presentation with thrombosis of the right upper extremity, anatomical compression/narrowing of the right subclavian vein, and being a high school baseball pitcher suggests Paget-Schroetter syndrome (effort thrombosis). The first rib can compress the subclavian vein in people with certain anatomical variations, leading to thrombosis. Resection of the right first rib (first rib resection) is the definitive treatment for this condition, as it removes the mechanical compression, reducing the risk of recurrent thrombosis.
A: Systemic thrombolysis involves using medications to dissolve blood clots throughout the body and is not the first-line treatment for Paget-Schroetter syndrome.
B: Catheter-directed thrombolysis is not indicated for anatomical compression/narrowing as seen in this patient.
C: Extended anticoagulation with LMWH does not address the underlying mechanical
Question 5
This is a more accurate indicator of tissue perfusion. It represents the cardiac output in terms of liters per minute per square meter of body surface area. Its normal range is 2.4-4 L/min.
A. Cardiac Index
B. Stroke volume
C. Ejection fraction
D. Cardiac output
Show answer and rationale
Correct answer: A — Cardiac Index
The correct answer is A: Cardiac Index. Cardiac Index is a more accurate indicator of tissue perfusion as it takes into account the individual's body surface area, providing a more standardized measure. It is calculated by dividing the cardiac output by body surface area. This normalization allows for a more precise assessment of tissue perfusion compared to just cardiac output alone. The normal range of Cardiac Index is 2.4-4 L/min/m^2.
Summary:
- Choice B (Stroke volume) is incorrect because it is the volume of blood pumped out by the heart with each heartbeat, not accounting for body surface area.
- Choice C (Ejection fraction) is incorrect because it is the percentage of blood ejected from the heart's left ventricle with each heartbeat, not adjusted for body surface area.
- Choice D (Cardiac output) is incorrect because it doesn't consider the individual's body surface area, making it less accurate in assessing tissue perfusion.
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Question 6
An oncology nurse is providing health education for a patient who has recently been diagnosed with leukemia. What should the nurse explain about commonalities between all of the different subtypes of leukemia?
A. The different leukemias all involve unregulated proliferation of WBC
B. The different leukemias all have unregulated proliferation of red blood cells and decreased bone marrow function.
C. The different leukemias all result in a decrease in the production of white blood cells.
D. The different leukemias all involve the development of cancer in the lymphatic system.
Correct answer:
The correct answer is A: The different leukemias all involve unregulated proliferation of WBC. Leukemia is a type of cancer that affects the blood and bone marrow, leading to the uncontrolled growth of white blood cells. This abnormal proliferation of white blood cells is a common feature across all subtypes of leukemia.
Explanation:
1. Leukemia is a cancer of the blood and bone marrow.
2. In leukemia, there is uncontrolled proliferation of white blood cells.
3. Different subtypes of leukemia may have specific characteristics, but they all involve the abnormal growth of white blood cells.
Summary:
Choice B is incorrect because leukemias do not involve unregulated proliferation of red blood cells. Choice C is incorrect because leukemias do not always result in a decrease in white blood cell production. Choice D is incorrect because leukemia is not specifically related to the lymphatic system; it affects the blood and bone marrow.
A patient is admitted to your acute coronary care unit with the diagnosis of ACS. The nurse has seen ECG changes that are indicative of an anterior wall infarction and is observing the patient for signs/symptoms of complications. The nurse has noted the following vital sign trends: 1100-HR 92, RR 24, BP 140/88, Cardiac rhythm NSR 1115-HR 96, RR 26, BP 128/82, Cardiac rhythm NSR 1130-HR 104, RR 28, BP 102/68, Cardiac rhythm ST 1145-HR 120, RR 32, BP 80/52, Cardiac rhythm ST with frequent PVC's The nurse should be alert for which of the following complications? Choose all that apply.
A. Syncope
B. Pericarditis
C. Cardiogenic shock
D. Cardiac tamponade
Correct answer:
The correct answer is C - Cardiogenic shock. In this scenario, the vital sign trends indicate a progressive decline in blood pressure (BP) along with an increasing heart rate (HR) and respiratory rate (RR), which are signs of hemodynamic instability. Cardiogenic shock is a serious complication of acute coronary syndrome (ACS) and occurs when the heart is unable to pump enough blood to meet the body's demands. The decreasing BP and increasing HR in this patient suggest a failing cardiac output, leading to inadequate tissue perfusion and subsequent shock. Syncope (choice A) is possible but less likely given the progressive decline in vital signs. Pericarditis (choice B) typically presents with chest pain and ECG changes different from those seen in this case. Cardiac tamponade (choice D) is characterized by Beck's triad (muffled heart sounds, hypotension, and jugular venous distention), which is not evident in the vital sign trends provided.
Which of the oral calcium preparations is often the preparation of choice:
A. Calcium carbonate (40% calcium)
B. Calcium lactate (13% calcium)
C. Calcium phosphate (25% calcium)
D. Calcium citrate (17% calcium)
Correct answer:
The correct answer is A: Calcium carbonate. It is often the preparation of choice due to its high calcium content (40%). This means that a smaller dose can provide the required amount of elemental calcium compared to other options. Additionally, calcium carbonate is well-absorbed in an acidic environment, making it suitable for individuals with normal gastric acid production.
Incorrect choices:
B: Calcium lactate has a lower calcium content (13%) compared to calcium carbonate, requiring a higher dose to achieve the same calcium intake.
C: Calcium phosphate has a lower calcium content (25%) compared to calcium carbonate, making it less efficient in providing elemental calcium.
D: Calcium citrate has a lower calcium content (17%) compared to calcium carbonate and is better absorbed in individuals with low gastric acid production. However, in general, calcium carbonate is preferred for its higher calcium content and cost-effectiveness.
The client on nitroglycerin patches reports dizziness when standing up. What is the nurse's best response?
A. Advise the client to rise slowly to prevent dizziness.
B. Instruct the client to discontinue the nitroglycerin patches.
C. Encourage the client to rest and avoid physical activity.
D. Suggest the client take an over-the-counter antiemetic.
Correct answer:
The correct response is A: Advise the client to rise slowly to prevent dizziness. Nitroglycerin patches can cause orthostatic hypotension, leading to dizziness when standing up quickly. By advising the client to rise slowly, the nurse can help prevent a sudden drop in blood pressure and reduce the risk of dizziness and falls. This response promotes client safety and addresses the underlying cause of the symptom.
Choices B, C, and D are incorrect:
B: Instructing the client to discontinue nitroglycerin patches is not appropriate without consulting the healthcare provider. Abruptly stopping nitroglycerin can lead to serious complications.
C: Encouraging the client to rest and avoid physical activity does not address the issue of orthostatic hypotension caused by nitroglycerin patches.
D: Suggesting an over-the-counter antiemetic is not indicated for dizziness related to orthostatic hypotension. It does not address the underlying cause
The client is on an ADP receptor blocker for the prevention of recurrent myocardial infarction. What does the nurse expect when the client develops hemorrhaging and a low platelet count?
A. The low platelet count is the anticipated reaction to taking an ADP receptor blocker.
B. The client is taking the ADP receptor blocker with aspirin.
C. The client has developed thrombotic thrombocytopenia.
D. The client is taking too much of the ADP receptor blocker.
Correct answer:
Rationale for Correct Answer (C): The client developing hemorrhaging and a low platelet count while on an ADP receptor blocker suggests thrombotic thrombocytopenia. Thrombotic thrombocytopenia is a rare but serious adverse effect characterized by the formation of blood clots and a decrease in platelet count. This condition can lead to both bleeding and clotting issues, explaining the hemorrhaging and low platelet count in the client.
Summary of Incorrect Choices:
A: The low platelet count is not an anticipated reaction to taking an ADP receptor blocker. While some antiplatelet medications can cause decreased platelet count, thrombotic thrombocytopenia is a more specific and severe condition.
B: The combination of ADP receptor blockers with aspirin is a common therapy for preventing cardiovascular events but does not directly explain the development of thrombotic thrombocytopenia.
D: Simply taking too much of the ADP receptor blocker
Which treatment should a nurse identify as most appropriate for clients diagnosed with generalized anxiety disorder (GAD)?
A. Long-term treatment with diazepam (Valium).
B. Acute symptom control with citalopram (Celexa).
C. Long-term treatment with buspirone (BuSpar).
D. Acute symptom control with ziprasidone (Geodon).
Correct answer:
The correct answer is C: Long-term treatment with buspirone (BuSpar) is most appropriate for clients diagnosed with generalized anxiety disorder (GAD). Buspirone is a non-addictive anxiolytic medication that is effective for long-term management of GAD. It works by affecting serotonin and dopamine receptors in the brain, helping to reduce anxiety symptoms over time.
Choice A (Long-term treatment with diazepam) is incorrect because diazepam is a benzodiazepine with a high potential for dependence and tolerance, making it unsuitable for long-term treatment of GAD.
Choice B (Acute symptom control with citalopram) is incorrect because citalopram is an antidepressant commonly used for treating depression, not specifically indicated for GAD.
Choice D (Acute symptom control with ziprasidone) is incorrect because ziprasidone is an antipsychotic medication primarily used to treat schizophrenia and bipolar disorder, not recommended for
A nurse explains to a patient undergoing diagnostic testing that which brain imaging technique measures brain structure?
A. Computed tomography (CT)
B. Positron emission tomography (PET)
C. Brain electrical activity mapping (BEAM)
D. Single-photon emission computed tomography (SPECT)
Correct answer:
The correct answer is A: Computed tomography (CT). CT scans use X-ray technology to create detailed images of brain structures. This technique is ideal for measuring brain structure due to its ability to provide clear and precise images of the brain's anatomy.
Explanation:
- CT scans are commonly used to assess brain structures such as the size, shape, and density of tissues.
- The high-resolution images produced by CT scans allow healthcare professionals to identify abnormalities, tumors, hemorrhages, and other structural issues in the brain.
- Unlike functional brain imaging techniques like PET, SPECT, and BEAM, which focus on brain activity, CT is specifically designed for visualizing brain structure.
Summary of other choices:
B: PET measures brain activity by detecting radioactive tracers.
C: BEAM records brain electrical activity using electrodes.
D: SPECT images brain blood flow and activity using radioactive tracers.
A newborn male has severe bleeding after circumcision, resulting in the need for a blood transfusion. You are called to consult on this child, and you diagnose him with severe hemophilia A. Upon taking a family history, you note that no other family members have hemophilia, other bleeding disorders, or a bleeding diathesis. Which of the following is the most likely outcome of genotyping the Factor VIII gene?
A. No mutation will be found because there is no family history.
B. A missense mutation in the F8 gene will be identified.
C. An inversion mutation in the F8 gene will be identified.
D. A nonsense mutation in the F8 gene will be found.
Correct answer:
The correct answer is C: An inversion mutation in the F8 gene will be identified. In hemophilia A, about 50% of cases result from inversion mutations in the F8 gene. In this case, since there is no family history of hemophilia or other bleeding disorders, the most likely scenario is a de novo genetic mutation, such as an inversion mutation. This type of mutation can occur spontaneously and is not inherited from parents. Therefore, genotyping the Factor VIII gene in this newborn male with severe hemophilia A is likely to reveal an inversion mutation as the underlying genetic cause.
Choice A is incorrect because the absence of a family history does not rule out the presence of a de novo mutation. Choice B (missense mutation) and Choice D (nonsense mutation) are less likely in hemophilia A compared to inversion mutations. Missense and nonsense mutations are more commonly associated with other genetic conditions or types of hemophilia.
The nurse is providing instruction to the parents of an infant with a colostomy. Which statement by the parents’ indicates appropriate understanding of the teaching session?
A. We will change the colostomy bag with each wet diaper.'
B. We will use adhesive enhancers when we change the bag.'
C. We will watch for skin irritation around the stoma.'
D. We will expect a moderate amount of bleeding after cleansing the area around the stoma.'
Correct answer:
The correct answer is C: "We will watch for skin irritation around the stoma." This statement indicates appropriate understanding because monitoring for skin irritation is essential in colostomy care to prevent complications. Skin irritation can occur due to leakage, improper fitting of the colostomy bag, or irritation from stool or urine. By closely observing the skin around the stoma, parents can detect early signs of irritation and take necessary actions to prevent skin breakdown.
Incorrect Choices:
A: Changing the colostomy bag with each wet diaper is unnecessary and may lead to increased skin irritation.
B: Using adhesive enhancers without proper guidance can cause skin damage and is not a routine practice in colostomy care.
D: Expecting a moderate amount of bleeding after cleansing the stoma area is incorrect as bleeding should be minimal. Monitoring for bleeding is important but expecting a moderate amount is not appropriate.
The pathophysiology of venous thrombosis is often explained by Virchow's triad, which includes hypercoagulability, endothelial injury, and venous stasis. Based on Virchow's triad and your knowledge of risk factors for thrombosis, which of the following pediatric patients has the greatest risk of hospital-acquired venous thromboembolism?
A. 3-day-old full-term infant admitted to hospital pediatrics for hyperbilirubinemia
B. 6-month-old male admitted to the infectious disease unit for respiratory syncytial virus
C. Ex-28 week premature infant, requiring NICU-level care for necrotizing enterocolitis
D. 7-year-old male with acute lymphoblastic leukemia receiving maintenance chemotherapy admitted to hematology/oncology unit for fever and neutropenia
Correct answer:
The correct answer is C because the ex-28 week premature infant requiring NICU-level care for necrotizing enterocolitis has the greatest risk of hospital-acquired venous thromboembolism. Premature infants have inherent hypercoagulability due to immature coagulation factors and increased risk of endothelial injury from central lines or catheters. Necrotizing enterocolitis further increases the risk of venous stasis due to decreased gut perfusion.
Choice A: The 3-day-old full-term infant admitted for hyperbilirubinemia is less likely to have significant risk factors for thrombosis compared to a premature infant with necrotizing enterocolitis.
Choice B: The 6-month-old male admitted for respiratory syncytial virus is less likely to have prolonged immobilization or other significant risk factors compared to a premature infant in the NICU.
Choice D: The 7-year-old male with acute lymphoblastic leukemia has a higher risk of thromb
LPN exams cardiovascular practice questions, set 6 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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