RN exams cardiovascular practice questions, set 17
RN exams · cardiovascular
RN exams cardiovascular practice questionsset 17
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 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
Show answer and rationale
Correct answer: A — Generalized muscle aches and pains
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
Question 2
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.
Show answer and rationale
Correct answer: D — Check the infant's apical pulse for 1 minute.
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.
Question 3
A patient received maintenance doses of fluphenazine decanoate (Prolixin Decanoate) 25 mg IM every 2 weeks for 2 years. The clinic nurse notes the patient is grimacing and seems to be constantly smacking her lips. On the next clinic visit, the patient’s neck and shoulders twist in a slow, snakelike motion. The nurse should suspect the presence of ________ and should __________.
A. agranulocytosis…check the patient’s complete blood count for changes
B. tardive dyskinesia…administer the Abnormal Involuntary Movement Scale
C. Tourette’s syndrome…consult the patient’s physician about a neuro evaluation
D. anticholinergic effects…consult the physician about possible medication changes
Show answer and rationale
Correct answer: B — tardive dyskinesia…administer the Abnormal Involuntary Movement Scale
The correct answer is B: tardive dyskinesia...administer the Abnormal Involuntary Movement Scale. Tardive dyskinesia is a movement disorder characterized by repetitive, involuntary movements such as grimacing, lip smacking, and twisting motions. It is a known side effect of long-term antipsychotic use, like fluphenazine decanoate. Administering the Abnormal Involuntary Movement Scale can help assess the severity of the symptoms and guide further management.
Incorrect options:
A: Agranulocytosis is a serious side effect of some antipsychotic medications but does not present with the symptoms described.
C: Tourette's syndrome is a neurological disorder characterized by involuntary movements and vocalizations but is not typically associated with antipsychotic use.
D: Anticholinergic effects can cause dry mouth and constipation but do not typically present with the specific movement symptoms described.
Question 4
The effect of the drug on parasympathetic function declines rapidly in all organs EXCEPT:
A. Eye
B. Heart
C. Smooth muscle organs
D. Glands
Show answer and rationale
Correct answer: A — Eye
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
Question 5
A 4-year-old girl with a history of recurrent epistaxis and easy bruising is referred to you for evaluation. She is found to have a prolonged PTT and a factor VIII level that is less than 1%. Both parents have a history of excessive bleeding. She is admitted with a severe episode of epistaxis, and your colleague orders 40 IU/kg of recombinant factor VIII. Her epistaxis resolves initially but within an hour starts again at the same severity as before. What is the best next step?
A. Infuse a von Willebrand factor concentrate.
B. Give another dose of recombinant factor VIII concentrate.
C. Call otorhinolaryngology to pack her nose.
D. Check for a factor VIII inhibitor.
Show answer and rationale
Correct answer: A — Infuse a von Willebrand factor concentrate.
The correct answer is A: Infuse a von Willebrand factor concentrate. In this scenario, the 4-year-old girl has a history of recurrent epistaxis and easy bruising, indicative of a bleeding disorder. The prolonged PTT and factor VIII level less than 1% suggest a deficiency in von Willebrand factor (VWF) or factor VIII. When the initial dose of recombinant factor VIII did not completely resolve the epistaxis, it indicates a possible deficiency in VWF activity. Therefore, the best next step is to infuse a von Willebrand factor concentrate to address the VWF deficiency, which should help control the bleeding.
Summary:
- Option B (Give another dose of recombinant factor VIII concentrate) is not the best choice because the initial dose did not fully resolve the bleeding, indicating a different factor may be deficient.
- Option C (Call otorhinolaryngology to pack her nose) addresses the symptom but does not
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Question 6
A newly admitted client has taken thioridazine (Mellaril) for 2 years, with good symptom control. Symptoms exhibited on admission included paranoia and hallucinations. The nurse should recognize which potential cause for the return of these symptoms?
A. The client has developed tolerance to the antipsychotic medication.
B. The client has not taken the medication with food.
C. The client has not taken the medication as prescribed.
D. The client has combined alcohol with the medication.
Correct answer:
The correct answer is C: The client has not taken the medication as prescribed. Nonadherence to the prescribed medication regimen can lead to the return of symptoms. In this case, the client may not have been taking the medication consistently or at the correct dosage, resulting in the resurgence of paranoia and hallucinations.
Incorrect answers:
A: The client has developed tolerance to the antipsychotic medication - Tolerance does not typically develop to antipsychotic medications in the same way it does with some other types of medications.
B: The client has not taken the medication with food - Taking the medication with food may affect absorption but is unlikely to directly cause the return of symptoms.
D: The client has combined alcohol with the medication - While alcohol can interact with antipsychotic medications, it is not the most likely reason for the return of symptoms in this scenario.
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 59-year-old woman presented with an abrupt onset of palpitations accompanied by a vague complaint of feeling ill. Subsequent Holter monitoring revealed atrial fibrillation with a ventricular response up to 152 bpm. The patient's past history included primary hyperparathyroidism and intermittent claudication for 3 years, apparently due to peripheral occlusive arteriosclerosis. Which of the following drugs would be appropriate for the chronic control of the patient's arrhythmia?
A. Digoxin
B. Propranolol
C. Verapamil
D. Lidocaine
Correct answer:
The correct answer is B: Propranolol. Propranolol is a beta-blocker that can be used for rate control in atrial fibrillation. It works by blocking the effects of adrenaline on the heart, slowing the heart rate and reducing the force of contraction. In this case, the patient has atrial fibrillation with a rapid ventricular response, and propranolol can help slow the heart rate to a more appropriate level.
A: Digoxin is primarily used for rate control in patients with heart failure, not as the first-line agent for atrial fibrillation with a rapid ventricular response.
C: Verapamil is a calcium channel blocker that can also be used for rate control in atrial fibrillation, but beta-blockers are generally preferred in patients with concomitant peripheral artery disease.
D: Lidocaine is a local anesthetic and antiarrhythmic agent used for ventricular arrhythmias, not appropriate for atrial fibrillation.
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.
What is a condition where the heart muscle becomes thickened without an obvious cause, leading to a reduction in the heart's ability to pump blood?
A. Hypertrophic cardiomyopathy
B. Dilated cardiomyopathy
C. Restrictive cardiomyopathy
D. Myocarditis
Correct answer:
The correct answer is A: Hypertrophic cardiomyopathy. In this condition, the heart muscle becomes thickened, affecting the heart's ability to pump blood efficiently. This is due to genetic mutations causing the muscle cells to grow abnormally. This leads to poor relaxation and filling of the heart, impairing its pumping function.
B: Dilated cardiomyopathy involves the heart muscle becoming weak and stretched, leading to reduced pumping ability.
C: Restrictive cardiomyopathy involves the heart muscle becoming stiff and rigid, impairing its ability to fill with blood properly.
D: Myocarditis is inflammation of the heart muscle, typically caused by infections or autoimmune conditions, leading to temporary reduction in heart function.
Hence, the correct answer is A as it specifically describes the scenario of a thickened heart muscle without an obvious cause impacting the heart's pumping ability.
A patient with diabetes mellitus and chronic stable angina has a new order for captopril . The nurse should teach the patient that the primary purpose of captopril is to
A. decrease the heart rate.
B. control blood glucose levels.
C. prevent changes in heart muscle.
D. reduce the frequency of chest pain.
Correct answer:
Step 1: Captopril is an angiotensin-converting enzyme (ACE) inhibitor commonly used in patients with heart conditions.
Step 2: In a patient with chronic stable angina, captopril primarily works to prevent changes in heart muscle by reducing cardiac workload and improving blood flow.
Step 3: By preventing changes in heart muscle, captopril helps to reduce the risk of complications in patients with diabetes mellitus and chronic stable angina.
Step 4: The other choices (A: decrease heart rate, B: control blood glucose levels, D: reduce frequency of chest pain) are not the primary purposes of captopril in this patient population, making them incorrect.
Summary: The correct answer is C because captopril's primary purpose in this scenario is to prevent changes in heart muscle, while the other choices do not align with the mechanism of action and intended outcomes of captopril in this patient population.
A 4-year-old girl with a history of recurrent epistaxis and easy bruising is referred to you for evaluation. She is found to have a prolonged PTT and a factor VIII level that is less than 1%. Both parents have a history of excessive bleeding. She is admitted with a severe episode of epistaxis, and your colleague orders 40 IU/kg of recombinant factor VIII. Her epistaxis resolves initially but within an hour starts again at the same severity as before. What is the best next step?
A. Infuse a von Willebrand factor concentrate.
B. Give another dose of recombinant factor VIII concentrate.
C. Call otorhinolaryngology to pack her nose.
D. Check for a factor VIII inhibitor.
Correct answer:
The correct answer is A: Infuse a von Willebrand factor concentrate. In this scenario, the 4-year-old girl has a history of recurrent epistaxis and easy bruising, indicative of a bleeding disorder. The prolonged PTT and factor VIII level less than 1% suggest a deficiency in von Willebrand factor (VWF) or factor VIII. When the initial dose of recombinant factor VIII did not completely resolve the epistaxis, it indicates a possible deficiency in VWF activity. Therefore, the best next step is to infuse a von Willebrand factor concentrate to address the VWF deficiency, which should help control the bleeding.
Summary:
- Option B (Give another dose of recombinant factor VIII concentrate) is not the best choice because the initial dose did not fully resolve the bleeding, indicating a different factor may be deficient.
- Option C (Call otorhinolaryngology to pack her nose) addresses the symptom but does not
A patient is suspected of having a decreased cardiac output due to dysrhythmias. Which of the following assessments would be included in a decreased cardiac output? Select all that apply
A. Elevated jugular venous distention
B. Polyuria
C. Full and bounding pulses
D. Diaphoresis
Correct answer:
The correct answer is A: Elevated jugular venous distention. This is a classic sign of decreased cardiac output as it indicates increased central venous pressure due to the heart's inability to effectively pump blood. This results in blood backing up into the jugular veins, causing them to appear distended.
Explanation for why other choices are incorrect:
B: Polyuria is not typically associated with decreased cardiac output. Polyuria is excessive urination and is more commonly seen in conditions such as diabetes insipidus or diabetes mellitus.
C: Full and bounding pulses are not indicative of decreased cardiac output. In fact, decreased cardiac output often leads to weak and thready pulses due to reduced blood flow.
D: Diaphoresis, or excessive sweating, can occur in various conditions but is not a specific sign of decreased cardiac output. It can be seen in response to pain, anxiety, or fever.
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
RN exams cardiovascular practice questions, set 17 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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