LPN exams cardiovascular practice questions, set 9
LPN exams · cardiovascular
LPN exams cardiovascular practice questionsset 9
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 infant is born with a 7 cm × 6 cm lesion over the upper extremity from the elbow to the shoulder. The lesion is indurated and purpuric, with some petechiae around the edges. No other areas of petechiae are noted on the skin. The infant is doing well without other systemic problems. i were 9 and 9. You are called by the pediatric nurse practitioner to the NICU. What is the most appropriate next step?
A. Do nothing because the infant is doing well and had good Apgars.
B. Obtain an ultrasound for more information about the lesion.
C. Obtain an MRI to assess the extent of the lesion.
D. Obtain labs, including a CBC with platelet count and fibrinogen.
Show answer and rationale
Correct answer: D — Obtain labs, including a CBC with platelet count and fibrinogen.
The correct answer is D: Obtain labs, including a CBC with platelet count and fibrinogen. This is the most appropriate next step because the infant's presentation with an indurated and purpuric lesion raises concern for a possible bleeding disorder or coagulopathy. By obtaining labs, including a CBC with platelet count and fibrinogen, we can assess the infant's hemostatic profile and rule out any underlying hematologic abnormalities. This step is crucial in ensuring the infant's well-being and guiding further management if any abnormalities are detected.
Why the other choices are incorrect:
A: Doing nothing is not appropriate as the presentation warrants further investigation.
B: An ultrasound may not provide useful information in this scenario as the lesion is concerning for a systemic issue.
C: An MRI is not the initial diagnostic test of choice for evaluating a possible bleeding disorder or coagulopathy.
Question 2
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 diepoxybutane 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.
Show answer and rationale
Correct answer: D — Send a skin fibroblast culture for Fanconi anemia testing.
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 negative peripheral blood test for Fanconi anemia does not rule out the possibility of having this condition. Skin fibroblast culture testing is more sensitive for detecting Fanconi anemia compared to peripheral blood testing. Given the family history of aplastic anemia and leukemia, along with the sister's poor response to treatment, it is crucial to definitively confirm or rule out Fanconi anemia as the underlying cause. Administering ATG and cyclosporine (choice A) without confirming the diagnosis may not be effective. 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 be as sensitive as skin fibroblast culture testing.
Question 3
A 13-year-old Hispanic girl is found to have a WBC count of 6,500/mm3 with 40% Auer rod–containing granular blasts that, by flow cytometry, express very bright CD33 but are negative for human leukocyte antigen–DR isotype (HLA-DR). She is oozing blood around her peripheral IV site. Coagulation studies reveal an international normalized ratio (INR) of 3.4, a fibrinogen of 170, and a markedly elevated D-dimer. Marrow aspirate shows nearly 90% blasts with a similar morphology. You send the marrow to the fluorescence in situ hybridization (FISH) lab and request STAT testing for the most likely recurrent genetic abnormality based on the clinical presentation. How do you plan to initiate therapy?
A. Perform a lumbar puncture to determine leukemic involvement, then proceed with induction chemotherapy.
B. Begin therapy with all-trans retinoic acid (ATRA) immediately while aggressively managing coagulopathy with blood product support.
C. Start dexamethasone and hydroxyurea immediately while aggressively managing coagulopathy with blood product support.
D. Start induction chemotherapy, obtain HLA typing, and start a donor search because of the poor prognosis associated with this leukemic phenotype.
Show answer and rationale
Correct answer: B — Begin therapy with all-trans retinoic acid (ATRA) immediately while aggressively managing coagulopathy with blood product support.
The correct answer is B: Begin therapy with all-trans retinoic acid (ATRA) immediately while aggressively managing coagulopathy with blood product support. The patient's presentation is consistent with acute promyelocytic leukemia (APL), indicated by the presence of Auer rod-containing blasts, very bright CD33 expression, and coagulopathy (elevated INR, low fibrinogen, elevated D-dimer). APL is associated with a specific genetic abnormality involving the PML-RARA fusion gene. ATRA is the mainstay of induction therapy for APL as it induces differentiation of leukemic promyelocytes. Aggressive management of coagulopathy is crucial to prevent life-threatening bleeding complications.
Incorrect answers:
A: Performing a lumbar puncture is not necessary at this stage as the patient's symptoms and laboratory findings point towards APL, not central nervous system involvement.
C: Dexamethasone and hydroxyurea are not
Question 4
What is a chronic inflammatory disease that affects the small airways in the lungs, leading to episodes of wheezing, breathlessness, and coughing?
A. Asthma
B. COPD
C. Bronchitis
D. Lung cancer
Show answer and rationale
Correct answer: A — Asthma
The correct answer is A: Asthma. Asthma is a chronic inflammatory disease that affects the small airways in the lungs, causing symptoms like wheezing, breathlessness, and coughing. The inflammation in the airways leads to narrowing and constriction, resulting in the characteristic symptoms of asthma. Asthma is typically triggered by various factors such as allergens, pollutants, exercise, or infections.
Summary of other choices:
B: COPD (Chronic Obstructive Pulmonary Disease) is a different condition characterized by irreversible airflow limitation due to chronic bronchitis and emphysema.
C: Bronchitis is an inflammation of the bronchial tubes, often caused by viral infections or smoking, but it does not specifically target the small airways like asthma.
D: Lung cancer is a malignancy that arises in the lungs and is not primarily associated with chronic inflammation of the small airways as seen in asthma.
Question 5
The client is diabetic and is given a non-cardio-selective beta blocker. What might happen to the blood sugars?
A. The blood sugars will increase because of breakdown of glycogen.
B. The blood sugar drops due to impaired production of glucose from glycogen.
C. It does not affect the blood sugar.
D. The blood sugar drops due to increased cellular uptake of glucose.
Show answer and rationale
Correct answer: B — The blood sugar drops due to impaired production of glucose from glycogen.
Correct Answer: B - The blood sugar drops due to impaired production of glucose from glycogen.
Rationale:
1. Non-cardio-selective beta blockers inhibit beta-2 receptors in the liver.
2. Beta-2 receptors stimulate glycogenolysis, converting glycogen to glucose.
3. Inhibition of glycogenolysis leads to impaired production of glucose from glycogen.
4. Consequently, blood sugar levels decrease due to reduced availability of glucose.
Summary of Other Choices:
A: Incorrect. Non-cardio-selective beta blockers inhibit glycogenolysis, leading to decreased breakdown of glycogen and reduced glucose production, resulting in lower blood sugar levels.
C: Incorrect. Non-cardio-selective beta blockers do affect blood sugar by impairing glucose production from glycogen.
D: Incorrect. Non-cardio-selective beta blockers do not increase cellular uptake of glucose, but rather decrease glucose production from glycogen.
Keep going past these 15 questions
Missed-question review, longer banks, and the rest of 20,000+ nursing practice questions open when you start studying.
Stems and choices stay public so you can still reason. Correct answers and full rationales unlock with the rest of the bank.
Question 6
An infant with a ventricular septal defect is receiving digoxin (Lanoxin). Which intervention by the nurse is most appropriate before digoxin administration?
A. Take the infant's blood pressure.
B. Check the infant's respiratory rate for 1 minute.
C. Check the infant's radial pulse for 1 minute.
D. Check the infant's apical pulse for 1 minute.
Correct answer:
The correct answer is D: Check the infant's apical pulse for 1 minute. Before administering digoxin, it is crucial to assess the infant's apical pulse because digoxin is a medication that affects the heart rate. By checking the apical pulse, the nurse can determine the baseline heart rate and assess for any irregularities or changes that may indicate digoxin toxicity. This step is essential to ensure the medication is safe for the infant.
Incorrect choices:
A: Taking the infant's blood pressure is not necessary before administering digoxin, as the focus should be on assessing the heart rate specifically.
B: Checking the respiratory rate is not directly related to digoxin administration and does not provide crucial information about the medication's effects.
C: Checking the radial pulse is not as accurate as checking the apical pulse when assessing the heart rate, which is critical before giving digoxin.
Which of the following would be an appropriate therapeutic adjustment for this patient?
A. Discontinue digoxin and start milrinone
B. Add physostigmine and decrease the digoxin dose
C. Add atropine and decrease the digoxin dose
D. Discontinue digoxin and start metoprolol
Correct answer:
The correct answer is A because milrinone is a positive inotrope that can be used as an alternative to digoxin for heart failure. Discontinuing digoxin is appropriate if the patient is experiencing toxicity symptoms. Starting milrinone provides the necessary positive inotropic support without the risk of digoxin toxicity.
Option B is incorrect because physostigmine is used for anticholinergic toxicity, not digoxin toxicity. Decreasing the digoxin dose alone may not be sufficient to address toxicity symptoms.
Option C is incorrect because atropine is used for bradycardia and not for digoxin toxicity. Decreasing the digoxin dose alone may not be sufficient to address toxicity symptoms.
Option D is incorrect because metoprolol is a beta-blocker and can worsen symptoms of digoxin toxicity by further slowing the heart rate. Discontinuing digoxin is appropriate, but starting metoprolol is not recommended.
A patient who has recently started taking pravastatin (Pravachol) and niacin reports several symptoms to the nurse. Which information is most important to communicate to the health care provider?
A. Generalized muscle aches and pains
B. Dizziness with rapid position changes
C. Nausea when taking the drugs before meals
D. Flushing and pruritus after taking the drugs
Correct answer:
The correct answer is A: Generalized muscle aches and pains. This is the most important information to communicate because it could indicate a serious side effect known as rhabdomyolysis, a rare but severe condition that can be caused by statins (like pravastatin) and niacin. Rhabdomyolysis is characterized by muscle breakdown that can lead to kidney damage. It is crucial to monitor and address this symptom promptly.
Choice B (Dizziness with rapid position changes) may be related to orthostatic hypotension, a common side effect of some medications but is not as urgent as potential rhabdomyolysis. Choice C (Nausea when taking the drugs before meals) is a common side effect of niacin and may be managed by adjusting the timing of medication administration. Choice D (Flushing and pruritus after taking the drugs) is a common side effect of niacin known as flushing and is generally not considered as serious as
Which category of histamine H1 antagonists is noted for the highest local anesthetic effect?
A. Alkylamines (propylamines); i.e. Brompheniramine
B. Piperidines; i.e. Loratadine, Fexofenadine
C. Ethylenediamines; i.e. Suprastine
D. Phenothiazines; i.e. Promethazine
Correct answer:
The correct answer is D, Phenothiazines such as Promethazine, because they have the highest local anesthetic effect among histamine H1 antagonists. This is due to their structural properties that allow them to interact with sodium channels and block nerve impulses effectively. Phenothiazines have a bulky side chain that enhances their local anesthetic properties.
A, Alkylamines like Brompheniramine, are known for their sedative effects rather than local anesthetic properties.
B, Piperidines including Loratadine and Fexofenadine, are mainly used for their antihistaminic effects and do not exhibit strong local anesthetic properties.
C, Ethylenediamines like Suprastine, are not recognized for their local anesthetic effects but rather for their antihistaminic actions.
In summary, Phenothiazines stand out as having the highest local anesthetic effect compared to the other categories of histamine H
Which condition would most likely result in a human body being unable to defend itself against pathogens and cancerous cells?
A. a genetic tendency toward a disorder such as diabetes
B. a parasitic infestation of ringworm on the body
C. the production of antibodies in response to an infection in the body
D. the presence in the body of the virus that causes AIDS
Correct answer:
The correct answer is D because the human immunodeficiency virus (HIV) attacks and weakens the immune system, making the body unable to defend itself against pathogens and cancerous cells. HIV specifically targets CD4 T cells, crucial for coordinating immune responses. This leads to a compromised immune system, leaving the body vulnerable to infections and unable to combat cancerous cells effectively.
Choice A is incorrect as a genetic tendency toward diabetes does not directly impact the body's ability to defend against pathogens and cancerous cells. Choice B is incorrect as ringworm is a fungal infection that can be treated and does not typically affect the immune system in a way that compromises defense mechanisms. Choice C is incorrect as the production of antibodies in response to an infection is a normal immune response that helps the body fight off pathogens, rather than weakening the immune system.
A nurse is caring for a client who is about to begin alteplase therapy to treat pulmonary embolism. Which of the following drugs should the nurse have available in the event of a severe adverse reaction?
A. Vitamin K
B. Aminocaproic acid
C. Protamine
D. Deferoxamine
Correct answer:
The correct answer is B: Aminocaproic acid. This drug is a fibrinolytic inhibitor that can be used to manage bleeding complications associated with alteplase therapy. It helps to prevent excessive bleeding by inhibiting the breakdown of blood clots. Having aminocaproic acid available is crucial in case the client experiences severe bleeding as a result of alteplase therapy.
A: Vitamin K is used to reverse the effects of warfarin, a blood thinner, and is not indicated for managing bleeding due to alteplase therapy.
C: Protamine is used to reverse the effects of heparin, not alteplase, and is not indicated for managing bleeding due to alteplase therapy.
D: Deferoxamine is an antidote for iron poisoning and is not indicated for managing bleeding due to alteplase therapy.
In summary, aminocaproic acid is the correct choice as it helps manage bleeding complications associated with alteplase therapy
What is a procedure to remove fluid or air from the pleural space to help a patient breathe easier?
A. Thoracentesis
B. Bronchoscopy
C. Chest X-ray
D. CT scan
Correct answer:
Thoracentesis is the correct answer because it is a procedure used to remove fluid or air from the pleural space, which can help a patient breathe easier. The steps involved in thoracentesis include identifying the location for insertion, numbing the area with local anesthesia, inserting a needle or catheter into the pleural space, draining the fluid or air, and monitoring the patient for any complications.
Summary:
- B: Bronchoscopy is a procedure used to visualize the airways and diagnose lung conditions, not to remove fluid or air from the pleural space.
- C: Chest X-ray is an imaging test used to visualize the chest area and diagnose various conditions, but it does not involve removing fluid or air from the pleural space.
- D: CT scan is an imaging test that provides detailed images of the internal structures of the body, but it is not a procedure for removing fluid or air from the pleural space.
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.
Correct answer:
The correct answer is B. Platelet transfusions are rarely successful in patients with autoimmune thrombocytopenia.
Rationale:
1. Patients with autoimmune thrombocytopenia have low platelet levels due to immune destruction.
2. Platelet transfusions may not be effective as the underlying autoimmune process continues to destroy transfused platelets.
3. Reviewing transfusion records of these patients would likely show low success rates of platelet transfusions.
Summary of Incorrect Choices:
A: Frozen storage of platelets increasing units available is not directly related to the success of platelet transfusions in autoimmune thrombocytopenia.
C: Platelet units do carry a risk of transmitting hepatitis C infection, so this conclusion is incorrect.
D: Preference for pooled donor platelets over single-donor platelets does not address the success of platelet transfusions in autoimmune thrombocytopenia.
The client has a ventricular rate of 40 and P waves that are normal and unconnected to the QRS complex on a standard EKG. What is this called?
A. Normal sinus rhythm
B. Type 1 second degree AV block
C. Type 2 second degree AV block
D. Third degree AV block
Correct answer:
The correct answer is C: Type 2 second degree AV block. In this type of AV block, there is a consistent pattern of dropped QRS complexes due to intermittent failure of AV conduction. The ventricular rate of 40 indicates a slow conduction of impulses from the atria to the ventricles. The presence of normal and unconnected P waves suggests that some P waves are conducted to the ventricles (resulting in QRS complexes) while others are blocked. This pattern is characteristic of Type 2 second degree AV block.
Summary:
A: Normal sinus rhythm - Incorrect, as the EKG findings do not show a normal sinus rhythm.
B: Type 1 second degree AV block - Incorrect, as this type is characterized by a progressively prolonged PR interval leading to a dropped QRS complex, which is not seen in this case.
D: Third degree AV block - Incorrect, as in third degree AV block, there is complete dissociation between the atria and
The effect of the drug on parasympathetic function declines rapidly in all organs EXCEPT:
A. Eye
B. Heart
C. Smooth muscle organs
D. Glands
Correct answer:
The correct answer is A: Eye. The parasympathetic nervous system controls functions like pupil constriction in the eye. This effect is mediated by the neurotransmitter acetylcholine. The eye has a unique structure called the iris sphincter muscle, which responds to parasympathetic stimulation by constricting the pupil. Unlike other organs, the effect on the eye is not subject to rapid decline, as the iris sphincter muscle has a high sensitivity to acetylcholine. Therefore, the parasympathetic function in the eye does not decline rapidly compared to other organs.
Summary of other choices:
B: Heart - Parasympathetic control of heart rate can decline rapidly due to factors like decreased acetylcholine release.
C: Smooth muscle organs - Parasympathetic control of smooth muscle organs can also decline rapidly due to factors like receptor desensitization.
D: Glands - Parasympathetic control of glands can
LPN exams cardiovascular practice questions, set 9 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.
The first five questions already include the rationale. Start full practice to unlock the remaining keys, missed-question review, and the rest of the bank.
Keep going past these 15 questions
Missed-question review, longer banks, and the rest of 20,000+ nursing practice questions open when you start studying.
