LPN exams cardiovascular practice questions, set 7
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LPN exams cardiovascular practice questionsset 7
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
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.
Show answer and rationale
Correct answer: A — The different leukemias all involve unregulated proliferation of WBC
The correct answer is A because all subtypes of leukemia involve unregulated proliferation of white blood cells (WBC). Leukemia is a type of cancer that starts in the blood-forming tissues, leading to the production of abnormal WBCs in the bone marrow. This uncontrolled growth of WBCs interferes with the production of normal blood cells.
Choice B is incorrect because leukemia does not involve unregulated proliferation of red blood cells, but rather white blood cells. It also does not necessarily result in decreased bone marrow function as stated in the choice.
Choice C is incorrect because while some subtypes of leukemia may result in a decrease in the production of normal white blood cells, the primary issue is the unregulated proliferation of abnormal WBCs.
Choice D is incorrect because leukemia is not specifically related to cancer development in the lymphatic system. Leukemia primarily affects the bone marrow and blood.
Question 2
You have a new 7-year-old female patient with a WBC count of 6,000/mm3, hemoglobin of 7.2 g/dL, and platelet count of 30,000/mm3. A bone marrow aspirate reveals 14% blasts with a monocytic morphologic appearance that are surface marker positive for CD33. You receive a call from the fluorescence in situ hybridization (FISH) lab that the bone marrow is positive for KMT2A rearrangement in 68% of cells. Your staff asks whether this represents a diagnosis of acute leukemia in the current classification scheme for this type of hematologic malignancy. What would you say?
A. No, because for a diagnosis of acute leukemia you must have 30% or more blasts in the marrow.
B. No, because for a diagnosis of acute leukemia you must have 20% or more blasts in the marrow.
C. No, because the cytogenetics do not include +21, monosomy 7, or trisomy 8.
D. Yes, because the FISH is positive for KMT2A rearrangement.
Show answer and rationale
Correct answer: D — Yes, because the FISH is positive for KMT2A rearrangement.
The correct answer is D: Yes, because the FISH is positive for KMT2A rearrangement. The presence of KMT2A rearrangement in 68% of cells indicates a specific genetic abnormality associated with acute leukemia. This abnormality is a known marker for acute myeloid leukemia (AML) with recurrent genetic abnormalities. The percentage of blasts in the bone marrow (14%) may not meet the traditional criteria for a diagnosis of acute leukemia based on blast percentage alone, but the presence of KMT2A rearrangement overrides this requirement in this case. Choices A and B are incorrect because blast percentage alone is not the sole determinant of a diagnosis of acute leukemia when specific genetic abnormalities are present. Choice C is incorrect because while the absence of specific cytogenetic abnormalities may be relevant for some cases, the presence of KMT2A rearrangement is sufficient to support a diagnosis of acute leukemia in this context.
Question 3
The laboratory report for a patient taking clozapine (Clozaril) shows a white blood cell count of 3000 mm3. Select the nurse’s best action.
A. Report these results to the health care provider immediately.
B. Give the next dose as prescribed.
C. Give aspirin and force fluids.
D. Repeat the laboratory test.
Show answer and rationale
Correct answer: A — Report these results to the health care provider immediately.
The correct answer is A: Report these results to the health care provider immediately. A low white blood cell count (3000 mm3) in a patient taking clozapine (Clozaril) could indicate a potentially serious condition called agranulocytosis, which is a severe decrease in white blood cells. This condition can increase the risk of infection and is a known side effect of clozapine. Reporting these results to the health care provider immediately is crucial for prompt evaluation and appropriate management, such as discontinuing the medication or adjusting the dosage.
Summary of incorrect choices:
B: Giving the next dose as prescribed is risky without addressing the low white blood cell count first.
C: Giving aspirin and forcing fluids is unrelated to the low white blood cell count and could worsen the situation.
D: Repeating the laboratory test may delay necessary intervention for the potentially serious condition of agranulocytosis.
Question 4
An otherwise healthy 18-year-old female is diagnosed with high-risk neuroblastoma after presenting with fatigue and bony pain. Imaging findings demonstrate a left adrenal mass with multiple osseous metastases. She successfully completes standard therapy for high-risk neuroblastoma, but experiences several episodes of disease recurrence and ultimately dies of her disease 10 years after her initial diagnosis. During her treatment, her tumor was sent for molecular analysis. Of the following, what molecular aberration was most likely to have been detected?
A. ETV6-NTRK3 gene fusion
B. PTPN11 mutation
C. ATRX mutation
D. WT1 mutation
Show answer and rationale
Correct answer: C — ATRX mutation
The correct answer is C: ATRX mutation. In neuroblastoma, ATRX mutations are associated with poor prognosis and high-risk disease. ATRX gene mutations are commonly found in cases with aggressive behavior and poor outcomes, such as in this case where the patient experienced disease recurrence and ultimately died. ATRX mutations are linked to chromosomal instability and telomere dysfunction, which can contribute to tumor progression and resistance to therapy.
A: ETV6-NTRK3 gene fusion is more commonly associated with infantile fibrosarcoma and secretory breast carcinoma, not neuroblastoma.
B: PTPN11 mutations are typically seen in juvenile myelomonocytic leukemia and Noonan syndrome, not neuroblastoma.
D: WT1 mutations are more commonly found in Wilms tumor and acute myeloid leukemia, not neuroblastoma.
In summary, the ATRX mutation is the most likely molecular aberration detected in this patient with high-risk neuroblast
Question 5
The client has atrial fibrillation. What can the nurse say about the P wave?
A. It precedes a long PR interval
B. It falls on the previous T wave
C. The P wave is absent
D. It is peaked
Show answer and rationale
Correct answer: C — The P wave is absent
The correct answer is C because in atrial fibrillation, the chaotic and irregular electrical activity in the atria results in the absence of distinct P waves on the ECG. This is due to the disorganized depolarization of the atria, leading to the absence of a clear, identifiable P wave. Therefore, the nurse can accurately state that the P wave is absent in the ECG of a client with atrial fibrillation.
Choices A, B, and D are incorrect:
A: It precedes a long PR interval - This statement is not accurate for atrial fibrillation as the irregular electrical activity disrupts the normal conduction pathway, leading to variable PR intervals.
B: It falls on the previous T wave - This scenario would indicate an abnormality in the ECG, but it does not specifically relate to atrial fibrillation.
D: It is peaked - While peaked P waves can indicate certain conditions like right atrial enlargement, this is not a characteristic finding in atr
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Question 6
The nurse is caring for a client who has just undergone cardiac angiography. The catheter insertion site is free from bleeding or signs of hematoma. The vital signs and distal pulses remain in the client's normal range. The intravenous fluids were discontinued. The client is not hungry or thirsty and refuses any food or fluids, asking to be left alone to rest. Which of the following is the nurse's best response?
A. "You are recovering well from the procedure and resting is a good idea."
B. "It is important for you to walk, so I will be back in 1 hour to walk with you."
C. "It is important to drink fluids after this procedure, to protect your kidney function. I will bring you a pitcher of water, and I encourage you to drink."
D. "You will need to do the leg exercises that you practiced before the procedure to keep good circulation to your legs. After your exercises, you can rest." Med-Surg: Cardiovascular Review Questions https://quizlet.com/275960218/med- surg-cardiovascular-review-questions-flash-cards/ 11/154 10/21/24, 11:15 AM Med-Surg: Cardiovascular Review Questions Flashcards | Quizlet
Correct answer:
The correct answer is A: "You are recovering well from the procedure and resting is a good idea." This response acknowledges the client's autonomy and respects their desire for rest after the procedure. It also recognizes the client's normal vital signs and absence of complications. Encouraging rest promotes healing and reduces the risk of complications.
Choice B is incorrect because forcing the client to walk may not be appropriate immediately after the procedure, especially if the client is fatigued or not feeling well.
Choice C is incorrect because the client is not thirsty and forcing fluids may lead to discomfort. It's important to respect the client's preferences and monitor for signs of dehydration.
Choice D is incorrect because while leg exercises are important for circulation, the client's immediate need for rest should be prioritized. It is essential to balance activity with rest based on the client's condition.
A 3-year-old boy is referred to you for evaluation of right leukocoria. Funduscopic examination under anesthesia reveals a large amelanotic mass occupying more than two-thirds of the vitreous space in his right eye, with massive retinal detachment, consistent with group E retinoblastoma. The left eye is normal. An MRI confirms the funduscopic findings and shows no extraocular disease. What is the most appropriate next step in the management of this child's disease?
A. Enucleation
B. Systemic chemotherapy
C. Brachytherapy
D. Needle biopsy
Correct answer:
The most appropriate next step in the management of the child's retinoblastoma is enucleation (choice A). Enucleation, the surgical removal of the affected eye, is indicated when there is a large intraocular tumor with extensive retinal detachment, as in this case. Enucleation can provide local control of the disease and prevent systemic spread. It is considered the standard treatment for advanced retinoblastoma to prevent metastasis.
Systemic chemotherapy (choice B) is not the first-line treatment for advanced retinoblastoma with massive intraocular involvement. Brachytherapy (choice C) involves the placement of a radioactive source near the tumor, which may not be effective in this case of extensive intraocular disease. Needle biopsy (choice D) is not recommended as the primary management strategy due to the risk of seeding tumor cells outside the eye. Therefore, enucleation is the most appropriate next step in this scenario.
A patient has not come out of her room for breakfast. The nurse finds the patient moving restlessly about her room in a disorganized manner. The patient is talking to herself, and her verbal responses to the nurse are nonsensical and suggest disorientation. The nurse notices that the patient’s skin is hot and dry, and her pupils are somewhat dilated. All these symptoms are significant departures from the patient’s recent presentation. The patient is likely experiencing ________ , and the nurse should ___________.
A. anticholinergic toxicity…check vital signs and prepare to use a cooling blanket stat
B. relapse of her psychosis…administer PRN antipsychotic drugs and notify her physician
C. neuroleptic malignant syndrome…contact her physician for a transfer to intensive care
D. agranulocytosis…hold her antipsychotic and draw blood for a complete blood count
Correct answer:
The correct answer is A: anticholinergic toxicity. The patient's symptoms (restlessness, disorganized movement, nonsensical speech, disorientation, hot and dry skin, dilated pupils) are indicative of anticholinergic toxicity. Anticholinergic medications can cause these symptoms by blocking the action of acetylcholine in the brain and body. The nurse should check vital signs and prepare to use a cooling blanket to lower the patient's body temperature, as anticholinergic toxicity can lead to hyperthermia.
Choice B (relapse of psychosis) is incorrect because the symptoms are not typical of a simple relapse of psychosis. Choice C (neuroleptic malignant syndrome) is incorrect because the symptoms do not match the classic presentation of neuroleptic malignant syndrome, which includes fever, muscle rigidity, and altered mental status. Choice D (agranulocytosis) is incorrect because the symptoms are not consistent with agranulocytosis,
A client diagnosed with schizophrenia is slow to respond and appears to be listening to unseen others. Which medication should a nurse expect a physician to order to address this type of symptom?
A. Haloperidol (Haldol) to address the negative symptom
B. Clonazepam (Klonopin) to address the positive symptom
C. Risperidone (Risperdal) to address the positive symptom
D. Clozapine (Clozaril) to address the negative symptom
Correct answer:
The correct answer is C: Risperidone (Risperdal) to address the positive symptom of hallucinations. Risperidone is an atypical antipsychotic commonly used to treat schizophrenia symptoms such as hallucinations and delusions. It works by blocking dopamine and serotonin receptors in the brain, helping to reduce hallucinations.
A: Haloperidol (Haldol) is an older typical antipsychotic that is more commonly used for treating positive symptoms like hallucinations and delusions, not negative symptoms like social withdrawal or lack of motivation.
B: Clonazepam (Klonopin) is a benzodiazepine used to treat anxiety and seizures, not typically used for treating the positive symptoms of schizophrenia.
D: Clozapine (Clozaril) is typically reserved for treatment-resistant schizophrenia and is more effective in addressing negative symptoms like social withdrawal and lack of motivation, rather than positive symptoms like hallucinations.
A patient with advanced leukemia is responding poorly to treatment. The nurse finds the patient tearful and trying to express his feelings, but he is clearly having difficulty. What is the nurse's most appropriate action?
A. Tell him that you will give him privacy and leave the room.
B. Offer to call pastoral care.
C. Ask if he would like you to sit with him while he collects his thoughts.
D. Tell him that you can understand how he's feeling.
Correct answer:
The correct answer is C: Ask if he would like you to sit with him while he collects his thoughts. This is the most appropriate action because it shows empathy and support for the patient's emotional distress. By offering to sit with the patient, the nurse acknowledges the patient's feelings and provides a comforting presence. This can help the patient feel understood and supported during a difficult time.
Choices A and D are incorrect because they do not actively offer emotional support or show empathy towards the patient. Choice A may make the patient feel abandoned, and choice D may come across as insincere or dismissive of the patient's emotions.
Choice B, offering to call pastoral care, is also not the most appropriate action in this scenario because the patient may need immediate emotional support from the nurse. Pastoral care can be considered later if the patient expresses a desire for spiritual or religious support.
A 19-year old male patient with a history of acute lymphoblastic leukemia, currently 13 years from completion of therapy, presents for a fertility consultation. He is interested in his risk for infertility. Which of the following statements is true?
A. A semen analysis at this point would provide accurate information about future fertility.
B. Males can maintain gonadal function at higher cumulative alkylator dosages compared with females.
C. He should have been offered sperm cryopreservation at diagnosis.
D. His risk for testosterone deficiency is greater than his risk for infertility.
Correct answer:
The correct answer is A. A semen analysis at this point would provide accurate information about future fertility because it assesses sperm count, motility, and morphology, which are crucial indicators of fertility potential. This is important for the patient to understand his current fertility status and make informed decisions about future fertility preservation options.
Choice B is incorrect because males are also susceptible to gonadal toxicity from alkylating agents, and there is no evidence to suggest that they can maintain gonadal function at higher dosages compared to females.
Choice C is incorrect because sperm cryopreservation should ideally have been offered at the time of leukemia diagnosis, but it is not too late to assess current fertility status with a semen analysis.
Choice D is incorrect as the patient's primary concern is infertility, not testosterone deficiency, which is a different issue altogether.
A patient with a history of depression reports not feeling well rested in recent weeks. Before making the assumption that the complaint is related to depression, a nurse should investigate whether the patient has had any recent changes in:
A. work schedule that affect the hours of sleep.
B. vacations taken within the same time zone.
C. fluid intake with reduced overall intake of water.
D. food intake with decreased intake of heavy foods before bedtime.
Correct answer:
The correct answer is A: work schedule that affect the hours of sleep. This is because changes in work schedule can directly impact the amount and quality of sleep a person gets, leading to feelings of not being well-rested. Investigating this factor is important before assuming the complaint is solely related to depression.
Choice B: vacations taken within the same time zone, is incorrect as vacations within the same time zone should not significantly affect sleep patterns unless there are other factors involved.
Choice C: fluid intake with reduced overall intake of water, is incorrect because while hydration is important for overall health, it is less likely to be the primary cause of not feeling well-rested.
Choice D: food intake with decreased intake of heavy foods before bedtime, is incorrect as while diet can impact sleep quality, it is less likely to be the primary cause of feeling not well-rested in this case.
When a patient diagnosed with paranoid schizophrenia was discharged from the unit 6 months ago, the plan was for him to take chlorpromazine (Thorazine), a conventional (first generation) antipsychotic medication, 300 mg po daily. He tells the nurse he stopped taking his pills after a few months because they made him feel like a “zombie.†What other common side effects should the nurse determine if the patient experienced?
A. Sweating, nausea, and weight gain
B. Sedation, tremor, and muscle stiffness
C. Headache, watery eyes, and runny nose
D. Mild fever, sore throat, and skin rash
Correct answer:
The correct answer is B: Sedation, tremor, and muscle stiffness. This is because chlorpromazine, a first-generation antipsychotic like Thorazine, commonly causes sedation, tremors, and muscle stiffness as side effects. Sedation is a common side effect of antipsychotic medications, leading to feelings of drowsiness or fatigue. Tremors can manifest as involuntary shaking or trembling of the hands or other body parts. Muscle stiffness, also known as extrapyramidal symptoms, can cause rigidity and difficulty moving smoothly. These side effects are typical with first-generation antipsychotics due to their mechanism of action on the central nervous system.
The other choices are incorrect:
A: Sweating, nausea, and weight gain are not typically associated with chlorpromazine or first-generation antipsychotics.
C: Headache, watery eyes, and runny nose are not common side effects of chlorpromazine.
D: Mild fever, sore throat, and
A 13-year-old boy presents to the emergency department with complaints of headache and visual changes. History reveals progressive dyspnea on exertion, generalized fatigue, and increased bruising. His labs are significant for a WBC of 350,000/mcL, of which 80% are reported to be blasts and appear to be myeloblasts without the presence of Auer rods. His hemoglobin is 7.2 g/dL, and his platelets are 18,000/mcL. A CT scan of the head shows a small intracerebral hemorrhage. His coags are normal. Which of the following is the most appropriate therapy?
A. Start induction chemotherapy.
B. Perform emergent leukapheresis followed the next day by induction chemotherapy.
C. Perform emergent leukapheresis plus hydroxyurea.
D. Provide emergent cranial radiation plus hydroxyurea followed the next day by induction chemotherapy.
Correct answer:
The correct answer is C: Perform emergent leukapheresis plus hydroxyurea. In this scenario, the patient presents with symptoms suggestive of acute myeloid leukemia with hyperleukocytosis and intracerebral hemorrhage. The goal of emergent therapy is to rapidly reduce the high blast count to prevent further complications such as leukostasis and hemorrhage. Leukapheresis can provide immediate reduction in the blast count, while hydroxyurea can further decrease the WBC count. Starting induction chemotherapy immediately can lead to tumor lysis syndrome due to rapid cell destruction. Emergent cranial radiation is not the primary intervention for hyperleukocytosis. Performing leukapheresis alone without adjunctive therapy like hydroxyurea may not adequately control the blast count. Thus, the most appropriate initial therapy is emergent leukapheresis plus hydroxyurea to stabilize the patient before initiating induction chemotherapy.
NADPH is a product of the hexose monophosphate pathway (HMP) in the red blood cell. The NADPH is used for the
A. Synthesis of fatty acids
B. Reduction of glutathione
C. Formation of ATP
D. Removal of oxygen radicals
Correct answer:
The correct answer is B: Reduction of glutathione. In the hexose monophosphate pathway (HMP), NADPH is generated, which serves as a reducing agent. This NADPH is crucial for reducing oxidized glutathione back to its reduced form, maintaining cellular antioxidant defense. This process helps to protect cells from oxidative damage and maintain redox balance.
Now, let's summarize why the other choices are incorrect:
A: Synthesis of fatty acids - NADPH is indeed involved in fatty acid synthesis, but in the context of red blood cells, the primary role of NADPH is in reducing glutathione.
C: Formation of ATP - NADPH is not directly involved in ATP synthesis. ATP is primarily produced through processes like glycolysis and oxidative phosphorylation.
D: Removal of oxygen radicals - While NADPH indirectly contributes to the removal of oxygen radicals through its role in reducing glutathione, it is not the primary function of NAD
LPN exams cardiovascular practice questions, set 7 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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