RN exams cardiovascular practice questions, set 13
RN exams · cardiovascular
RN exams cardiovascular practice questionsset 13
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 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.
Show answer and rationale
Correct answer: A — work schedule that affect the hours of sleep.
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.
Question 2
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
Question 3
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
Show answer and rationale
Correct answer: B — Sedation, tremor, and muscle stiffness
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
Question 4
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)
Show answer and rationale
Correct answer: A — Computed tomography (CT)
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.
Question 5
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.
Show answer and rationale
Correct answer: C — Ask if he would like you to sit with him while he collects his thoughts.
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.
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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.
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
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
Correct answer:
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
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 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.
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.
When caring for a patient who is recovering from a sudden cardiac death (SCD) event and has no evidence of an acute myocardial infarction (AMI), the nurse will anticipate teaching the patient that
A. sudden cardiac death events rarely reoccur.
B. additional diagnostic testing will be required.
C. long-term anticoagulation therapy will be needed.
D. limiting physical activity will prevent future SCD events.
Correct answer:
The correct answer is B because after a sudden cardiac death (SCD) event without evidence of an acute myocardial infarction (AMI), additional diagnostic testing is needed to determine the underlying cause and assess the risk of recurrence. This testing may include cardiac imaging, electrophysiological studies, and genetic testing. By identifying the specific cause, healthcare providers can tailor treatment plans to prevent future SCD events.
A: This is incorrect because the risk of SCD recurrence can vary based on the underlying cause and individual patient factors.
C: Long-term anticoagulation therapy is not typically indicated for SCD without evidence of AMI unless there is a specific indication such as atrial fibrillation or a clotting disorder.
D: Limiting physical activity alone is not a comprehensive strategy for preventing future SCD events; individualized recommendations should be based on diagnostic findings.
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.
Myelodysplastic syndromes are a group of clonal stem cell disorders. Which of the following type has the poorest prognosis according to the FAB system of classifications?
A. Refractory anemia (RA)
B. RA with ring sideroblasts
C. RA with excess blasts
D. RA with excess blasts in transformation
Correct answer:
The correct answer is D: RA with excess blasts in transformation. This choice has the poorest prognosis because it represents a progression of RA with excess blasts, indicating a higher percentage of blast cells in the bone marrow. This progression signifies a more aggressive form of the disease with a worse outcome.
A: Refractory anemia (RA) is a milder form with a better prognosis compared to the other choices.
B: RA with ring sideroblasts is a subtype of RA, and while it may have some adverse features, it generally has a better prognosis than RA with excess blasts.
C: RA with excess blasts represents a higher risk group, but it is not as severe as RA with excess blasts in transformation, which indicates a further deterioration of the disease.
In summary, D is the correct answer because it signifies the most advanced stage of the disease with the highest risk and poorest prognosis compared to the other choices.
You receive a phone call from a community pediatrician who is caring for a 2-year-old toddler with a cancer predisposition syndrome. The pediatrician describes a child at the 95th percentile for height and weight with a history of corrective oral surgery to reduce a large tongue and a history of an omphalocele in infancy. The pediatrician is currently performing ultrasound of the abdomen and laboratory evaluation for this patient every 3 months. Which tumor is this patient most at risk of developing?
A. Pleuropulmonary blastoma
B. Hepatocellular carcinoma
C. Cystic nephroma
D. Nephroblastoma
Correct answer:
The correct answer is D: Nephroblastoma (Wilms tumor). This patient likely has Beckwith-Wiedemann syndrome given the features of overgrowth, macroglossia, and omphalocele. Beckwith-Wiedemann syndrome is associated with an increased risk of Wilms tumor. Wilms tumor is the most common renal malignancy in childhood. Monitoring for Wilms tumor with ultrasound and laboratory evaluations is appropriate due to the increased risk in this patient population.
Choice A: Pleuropulmonary blastoma is a rare lung tumor more commonly seen in children under 2 years old. It is not typically associated with Beckwith-Wiedemann syndrome.
Choice B: Hepatocellular carcinoma is a primary liver cancer more commonly seen in adults, not children with Beckwith-Wiedemann syndrome.
Choice C: Cystic nephroma is a benign kidney tumor typically seen in young children, but it is not associated with Beckwith-Wiedemann syndrome nor is it malignant
RN exams cardiovascular practice questions, set 13 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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