RN exams cardiovascular practice questions, set 19
RN exams · cardiovascular
RN exams cardiovascular practice questionsset 19
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
The nurse observes a PAWP waveform on the monitor when the balloon of the catheter is deflated. The nurse recognizes that
A. The patient is at risk for embolism because of occlusion of th catheter with a thrombus
B. The patient is developing pulmonary edema that has increased the pulmonary artery pressure
C. The patient is at risk for an air embolism because the injected air cannot be withdrawn into the syringe
D. The catheter must be immediately repositioned to prevent pulmonary infarction or pulmonary artery rupture
Show answer and rationale
Correct answer: D — The catheter must be immediately repositioned to prevent pulmonary infarction or pulmonary artery rupture
The correct answer is D because observing a PAWP waveform when the balloon of the catheter is deflated indicates improper positioning of the catheter. If the catheter is not properly positioned, it can lead to inaccurate pressure readings and pose a risk for complications such as pulmonary infarction or pulmonary artery rupture. Repositioning the catheter immediately is crucial to ensure accurate monitoring and prevent potential harm to the patient.
A: This choice is incorrect because the presence of a PAWP waveform does not necessarily indicate occlusion of the catheter with a thrombus.
B: This choice is incorrect because the development of pulmonary edema would typically result in a different waveform pattern, not specifically a PAWP waveform.
C: This choice is incorrect because the risk of an air embolism is not directly related to observing a PAWP waveform when the catheter is deflated.
Question 2
The family members of a patient who has just been admitted to the intensive care unit (ICU) with multiple traumatic injuries have just arrived in the ICU waiting room. Which action should the nurse take next?
A. Explain ICU visitation policies and encourage family visits.
B. Immediately take the family members to the patient’s bedside.
C. Describe the patient’s injuries and the care that is being provided.
D. Invite the family to participate in a multidisciplinary care conference.
Show answer and rationale
Correct answer: A — Explain ICU visitation policies and encourage family visits.
The correct answer is A: Explain ICU visitation policies and encourage family visits. This is the best course of action because it prioritizes the needs of the family members by providing them with information on visitation policies and encouraging them to visit the patient. This helps establish communication, support, and involvement in the patient's care. It also respects the family's emotional needs during a challenging time.
Choices B, C, and D are incorrect:
B: Immediately taking the family members to the patient's bedside may overwhelm them and disrupt the patient's care.
C: Describing the patient's injuries and care being provided should be done in a more controlled environment to ensure the family's understanding and emotional readiness.
D: Inviting the family to a multidisciplinary care conference may be premature without first addressing their immediate concerns and providing support.
Question 3
When caring for a patient who has just arrived on the telemetry unit after having cardiac catheterization, which nursing intervention should the nurse delegate to a licensed practical/vocational nurse (LPN/LVN)?
A. Give the scheduled aspirin and lipid-lowering medication.
B. Perform the initial assessment of the catheter insertion site.
C. Teach the patient about the usual postprocedure plan of care.
D. Titrate the heparin infusion according to the agency protocol.
Show answer and rationale
Correct answer: A — Give the scheduled aspirin and lipid-lowering medication.
The correct answer is A: Give the scheduled aspirin and lipid-lowering medication. This task is within the scope of practice for an LPN/LVN as it involves administering medications. LPN/LVNs are trained in medication administration and can safely give prescribed medications to patients. This intervention is crucial for the patient's post-cardiac catheterization care to prevent complications and promote recovery.
Choice B is incorrect because assessing the catheter insertion site requires more specialized knowledge and skill, typically performed by a registered nurse or higher-level provider. Choice C involves patient education, which is usually the responsibility of the RN due to the complexity and importance of the information provided. Choice D involves titrating medications, which requires a higher level of assessment and decision-making that is typically within the RN's scope of practice.
Question 4
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.
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.
Question 5
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
Show answer and rationale
Correct answer: A — Hypertrophic cardiomyopathy
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.
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Question 6
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.
When palpating the patient's popliteal pulse, the nurse feels a vibration at the site. How should the nurse record this finding?
A. Thready, weak pulse
B. Bruit at the artery site
C. Bounding pulse volume
D. Thrill of the popliteal artery
Correct answer:
The correct answer is D: Thrill of the popliteal artery. A thrill is a vibration felt over a turbulent blood flow, indicating an abnormality like a narrowing or blockage in the artery. When palpating the popliteal pulse, feeling a vibration suggests the presence of a thrill, indicating a potential vascular issue.
A: Thready, weak pulse - This choice does not describe the sensation of vibration felt with a thrill.
B: Bruit at the artery site - A bruit is a whooshing sound heard over an artery due to turbulent blood flow, not a vibration felt during palpation.
C: Bounding pulse volume - This choice describes a strong, forceful pulse, not a vibration felt with a thrill.
In summary, the correct choice, D, is supported by the presence of a vibration indicating a thrill, while the other choices do not align with the specific finding of a vibration felt during palpation of the popliteal pulse.
When teaching a client with an aneurysm what signs and symptoms may indicate impending rupture, the nurse considers which of the following?
A. Medication therapy the client is receiving
B. Client's usual blood pressure
C. Age and gender of the client
D. Size and location of the aneurysm
Correct answer:
The correct answer is D: Size and location of the aneurysm. This is crucial because an aneurysm's risk of rupture is directly related to its size and location. Larger aneurysms and those located in critical areas are more likely to rupture.
Explanation:
1. Size: Larger aneurysms have a higher risk of rupture due to increased pressure on the arterial wall.
2. Location: Aneurysms in certain areas, such as the brain or aorta, are more prone to rupture.
3. Medication therapy (choice A) is important but does not directly indicate impending rupture.
4. The client's usual blood pressure (choice B) is relevant but not a definitive sign of impending rupture.
5. Age and gender (choice C) are important factors but do not directly indicate impending rupture.
In summary, monitoring the size and location of the aneurysm is crucial for identifying signs of impending rupture in a client with an aneur
A patient is recovering from a minor automobile accident that occurred 1 week ago. He is taking cyclobenzaprine (Flexeril) for muscular pain and goes to physical therapy three times a week. Which nursing diagnosis would be appropriate for him?
A. Risk for falls related to decreased sensorium
B. Risk for addiction related to psychological dependency
C. Decreased fluid volume related to potential adverse effects
D. Disturbed sleep pattern related to the drug’s interference with REM sleep
Correct answer:
The correct answer is A: Risk for falls related to decreased sensorium. The rationale is as follows:
1. Cyclobenzaprine can cause drowsiness, dizziness, and blurred vision, leading to decreased sensorium.
2. The patient is undergoing physical therapy, which may further increase the risk of falls due to potential muscle weakness or fatigue.
3. The combination of medication, therapy, and recent accident increases the risk of falls.
4. Nursing diagnosis should focus on preventing harm, making "Risk for falls related to decreased sensorium" the most appropriate choice.
Summary:
B: Risk for addiction is not relevant as the patient is using the medication as prescribed for acute pain.
C: Decreased fluid volume is not a common side effect of cyclobenzaprine.
D: Disturbed sleep pattern is a potential side effect, but the risk of falls due to decreased sensorium is a higher priority in this case.
A patient in the ICU has recently been diagnosed with diabetes mellitus. Before being discharged, this patient will require detailed instructions on how to manage her diet, how to self-inject insulin, and how to handle future diabetic emergencies. Which nurse competency is most needed in this situation?
A. Clinical judgment
B. Advocacy and moral agency
C. Caring practices
D. Facilitation of learning
Correct answer:
The correct answer is D: Facilitation of learning. In this scenario, the nurse needs to effectively educate the patient on managing her diet, insulin injections, and handling emergencies. Facilitation of learning involves assessing the patient's learning needs, providing relevant information, demonstrating skills, and evaluating understanding. This competency is crucial for promoting patient education and empowerment in managing their condition.
A: Clinical judgment involves making decisions based on assessment data, which is important but not the primary focus in this situation.
B: Advocacy and moral agency involve standing up for patients' rights and values, which is important but not as directly relevant to the patient's education needs.
C: Caring practices involve showing empathy and compassion, which are essential but not the main competency required for educational purposes in this case.
Nadolol (Corgard) is prescribed for a patient with chronic stable angina and left ventricular dysfunction. To determine whether the drug is effective, the nurse will monitor for
A. decreased blood pressure and heart rate.
B. fewer complaints of having cold hands and feet.
C. improvement in the strength of the distal pulses.
D. participation in daily activities without chest pain.
Correct answer:
The correct answer is D: participation in daily activities without chest pain. This is because the effectiveness of Nadolol in treating chronic stable angina and left ventricular dysfunction is indicated by the patient's ability to engage in daily activities without experiencing chest pain, which reflects improved myocardial oxygen supply.
A: decreased blood pressure and heart rate is incorrect because Nadolol is a beta-blocker, which can lower blood pressure and heart rate as a side effect, but the primary goal is to reduce angina symptoms.
B: fewer complaints of having cold hands and feet is incorrect as it is not a direct indicator of Nadolol's effectiveness in treating angina and left ventricular dysfunction.
C: improvement in the strength of the distal pulses is incorrect as it may not directly correlate with the drug's effectiveness in managing angina and left ventricular dysfunction.
When caring for a patient who has just arrived on the telemetry unit after having cardiac catheterization, which nursing intervention should the nurse delegate to a licensed practical/vocational nurse (LPN/LVN)?
A. Give the scheduled aspirin and lipid-lowering medication.
B. Perform the initial assessment of the catheter insertion site.
C. Teach the patient about the usual postprocedure plan of care.
D. Titrate the heparin infusion according to the agency protocol.
Correct answer:
The correct answer is A: Give the scheduled aspirin and lipid-lowering medication. This task is within the scope of practice for an LPN/LVN as it involves administering medications. LPN/LVNs are trained in medication administration and can safely give prescribed medications to patients. This intervention is crucial for the patient's post-cardiac catheterization care to prevent complications and promote recovery.
Choice B is incorrect because assessing the catheter insertion site requires more specialized knowledge and skill, typically performed by a registered nurse or higher-level provider. Choice C involves patient education, which is usually the responsibility of the RN due to the complexity and importance of the information provided. Choice D involves titrating medications, which requires a higher level of assessment and decision-making that is typically within the RN's scope of practice.
A nurse is preparing to administer a prescribed dose of desmopressin to a client who has hemophilia A. The client's laboratory results indicate that the client has a sodium level of 130 mEq/L. Which of the following actions should the nurse take?
A. Clarify the prescription with the provider.
B. Administer the drug with an analgesic.
C. Administer the required dose orally.
D. Assess factor IX levels.
Correct answer:
The correct answer is A: Clarify the prescription with the provider. Desmopressin is contraindicated in clients with low sodium levels due to the risk of hyponatremia. By having a sodium level of 130 mEq/L, the client is at risk for further lowering of sodium levels if desmopressin is administered. Therefore, the nurse should clarify the prescription with the provider to ensure the safety of the client.
B: Administer the drug with an analgesic - Irrelevant and not related to the administration of desmopressin in a client with hemophilia A and low sodium levels.
C: Administer the required dose orally - The route of administration does not address the concern of potential hyponatremia with desmopressin.
D: Assess factor IX levels - While important in managing hemophilia A, assessing factor IX levels does not address the immediate concern of potential harm from desmopressin administration in a
A 4-year-old boy is pale with intermittent jaundice and splenomegaly. Laboratory results are as follows: RBC 4.85 M/mcL (N); Hgb 8.6 g/dL (L); Hct 25.8% (L); MCV 81.6 (N); MCHC 38% (H); RDW 20% (H); Retic 7% (H). What are the two best tests to distinguish autoimmune hemolytic anemia from hereditary spherocytosis?
A. Free erythrocyte protoporphyrin and IgG levels
B. Hemoglobin electrophoresis and direct antiglobulin test (DAT)
C. Lactate dehydrogenase (LDH) and modified Russell viper venom test
D. Red cell distribution width (RDW) and mean corpuscular hemoglobin concentration (MCHC)
Correct answer:
As the correct answer is not provided, I'll provide a step-by-step rationale for each choice:
A: Free erythrocyte protoporphyrin and IgG levels are not specific tests for distinguishing between autoimmune hemolytic anemia and hereditary spherocytosis.
B: Hemoglobin electrophoresis and direct antiglobulin test (DAT) can help differentiate between these two conditions as autoimmune hemolytic anemia is associated with a positive DAT, while hereditary spherocytosis typically has a negative DAT.
C: Lactate dehydrogenase (LDH) and modified Russell viper venom test are not specific tests for distinguishing between autoimmune hemolytic anemia and hereditary spherocytosis.
D: Red cell distribution width (RDW) and mean corpuscular hemoglobin concentration (MCHC) are not typically used to distinguish between autoimmune hemolytic anemia and hereditary spherocytosis.
Therefore, the best tests
Tick the drug that can induce peripheral neuropathy and oral ulceration:
A. Acyclovire
B. Zalcitabine
C. Zidovudine
D. Saquinavir
Correct answer:
The correct answer is B: Zalcitabine. Zalcitabine is a nucleoside reverse transcriptase inhibitor commonly associated with peripheral neuropathy and oral ulceration as side effects. These adverse effects are well-documented in clinical studies and are known to be dose-dependent. Zalcitabine can cause damage to peripheral nerves leading to neuropathy and can also irritate the mucous membranes in the mouth causing oral ulceration.
Incorrect Choices:
A: Acyclovir - Acyclovir is an antiviral medication used to treat herpes infections and does not typically cause peripheral neuropathy or oral ulceration.
C: Zidovudine - Zidovudine is also a nucleoside reverse transcriptase inhibitor used in the treatment of HIV, but it is not associated with peripheral neuropathy or oral ulceration.
D: Saquinavir - Saquinavir is a protease inhibitor used to treat HIV and does not commonly induce peripheral neurop
RN exams cardiovascular practice questions, set 19 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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