RN exams cardiovascular practice questions set 10

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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.

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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

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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

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The correct answer is A: Potassium level. After CABG surgery, the client is taking medications that can affect potassium levels, such as furosemide and digoxin. Nausea and anorexia can be symptoms of hypokalemia, a potential side effect of these medications. Therefore, checking the potassium level is crucial to monitor for any electrolyte imbalances that can lead to adverse effects like cardiac dysrhythmias. Summary of incorrect choices: B: Sodium level - Although important for electrolyte balance, sodium levels are less likely to be affected by the medications mentioned in the scenario and are not typically associated with nausea and anorexia. C: PT/INR - These are coagulation studies and not directly related to the symptoms presented by the client. D: Digoxin level - While monitoring digoxin levels is important for toxicity, the symptoms of nausea and anorexia are more indicative of potential electrolyte imbalances rather than digox

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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

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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

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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

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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.

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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.

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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.