RN exams cardiovascular practice questions, set 12
RN exams · cardiovascular
RN exams cardiovascular practice questionsset 12
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 RN exams exam guide or more RN 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 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
Show answer and rationale
Correct answer: A — Enucleation
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.
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
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
Show answer and rationale
Correct answer: A — anticholinergic toxicity…check vital signs and prepare to use a cooling blanket stat
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,
Question 4
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: 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.
Question 5
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
Show answer and rationale
Correct answer: A — "You are recovering well from the procedure and resting is a good idea."
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.
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Question 6
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 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 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,
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
The nurse cares for an adolescent patient who is dying. The patient’s parents are interested in organ donation and ask the nurse how the decision about brain death is made. Which response by the nurse is most appropriate?
A. Brain death occurs if a person is flaccid and unresponsive.
B. If CPR is ineffective in restoring a heartbeat, the brain cannot function.
C. Brain death has occurred if there is no breathing and certain reflexes are absent.
D. If respiratory efforts cease and no apical pulse is audible, brain death is present.
Correct answer:
The correct answer is C: Brain death has occurred if there is no breathing and certain reflexes are absent. Brain death is defined as the irreversible cessation of all functions of the entire brain, including the brainstem. The absence of breathing and certain reflexes, such as no response to painful stimuli or no pupillary response to light, are key indicators of brain death. This definition is crucial for determining eligibility for organ donation.
Incorrect choices:
A: Brain death occurs if a person is flaccid and unresponsive. Flaccidity and unresponsiveness are not specific criteria for diagnosing brain death.
B: If CPR is ineffective in restoring a heartbeat, the brain cannot function. The absence of a heartbeat alone does not indicate brain death.
D: If respiratory efforts cease and no apical pulse is audible, brain death is present. Respiratory cessation and the absence of pulse are not definitive signs of brain death.
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.
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.
Correct answer:
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.
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 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.
RN exams cardiovascular practice questions, set 12 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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