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
Antiaggregants are used in disorders of brain circulation for:
A. Stimulation of the metabolic processes in neurons
B. Dilation of cerebral vessels
C. Improving the microcirculation in cerebral tissue
D. All the above
Show answer and rationale
Correct answer: C — Improving the microcirculation in cerebral tissue
The correct answer is C: Improving the microcirculation in cerebral tissue. Antiaggregants are used in disorders of brain circulation to prevent platelet aggregation and improve blood flow in the microcirculation of cerebral tissue. This helps to enhance oxygen and nutrient delivery to brain cells, ultimately improving brain function.
Rationale:
A: Stimulation of the metabolic processes in neurons is not the primary purpose of antiaggregants. While improved blood flow may indirectly support neuronal metabolism, the main goal of antiaggregants is to prevent clot formation and improve circulation.
B: Dilation of cerebral vessels is not the main mechanism of action for antiaggregants. Although vasodilation can enhance blood flow, antiaggregants primarily work by preventing platelet aggregation rather than directly causing vessel dilation.
D: All the above is incorrect because the primary purpose of antiaggregants in disorders of brain circulation is to improve microcirculation in cerebral tissue, not to stimulate metabolic processes in neurons or
Question 2
The client is being given a calcium channel blocker. Calcium channel blockers have what effect on the heart?
A. They increase the preload on the heart.
B. They decrease the velocity of electrical activity on the AV node.
C. They block the sodium channels in the heart muscle.
D. They cause vasoconstriction of coronary arteries.
Show answer and rationale
Correct answer: B — They decrease the velocity of electrical activity on the AV node.
The correct answer is B: Calcium channel blockers decrease the velocity of electrical activity on the AV node. This is because calcium channel blockers specifically target calcium channels in the heart, which are responsible for the influx of calcium ions during the cardiac action potential. By blocking these channels, calcium channel blockers slow down the rate of electrical conduction through the AV node, leading to a decrease in heart rate and potentially a decrease in blood pressure.
Explanation of why the other choices are incorrect:
A: Calcium channel blockers do not increase the preload on the heart. Preload is the amount of blood that fills the heart before it contracts, and calcium channel blockers do not directly affect this.
C: Calcium channel blockers do not block sodium channels in the heart muscle. They primarily target calcium channels.
D: Calcium channel blockers do not cause vasoconstriction of coronary arteries. They may actually cause vasodilation in coronary arteries, leading to increased blood flow to the heart muscle.
Question 3
A pediatric fellow is planning a project intended to decrease the incidence of acute chest syndrome among patients with sickle cell disease who are already admitted to the hospital for other reasons. The fellow discussed with her mentor whether the project proposal should be submitted for review by the Institutional Review Board (IRB). The mentor explains that, at their intuition, quality improvement activities do not require IRB review but research projects must be submitted to the IRB. Which of the following is NOT a relevant consideration in determining whether the project is research or quality improvement?
A. The aim to create new knowledge for the individual institution versus discovering new and generalizable knowledge
B. The chosen methodology which will include repeated Plan-Do-Study-Act cycles
C. The intent to publish the results in a peer reviewed hematology journal
D. The efforts to hold biases/confounders stable over time, rather than control for them with, for example, randomization
Show answer and rationale
Correct answer: C — The intent to publish the results in a peer reviewed hematology journal
The correct answer is C because the intent to publish results in a peer-reviewed journal is not a determining factor in distinguishing between quality improvement and research activities. Here's a step-by-step rationale:
1. Quality improvement focuses on improving processes within an institution to enhance patient care, while research aims to generate new knowledge that is generalizable beyond the institution.
2. The chosen methodology (B) such as using Plan-Do-Study-Act cycles is often associated with quality improvement projects to test and implement changes iteratively.
3. Efforts to hold biases stable over time (D) are more aligned with research, as quality improvement projects may not necessarily require controlling for biases like randomization.
4. The intent to publish in a peer-reviewed journal (C) can apply to both quality improvement and research projects, but the key factor in determining the need for IRB review is whether the project aims to generate generalizable knowledge (research) or improve local processes (quality improvement).
Question 4
The client is being given a calcium channel blocker. Calcium channel blockers have what effect on the heart?
A. They increase the preload on the heart.
B. They decrease the velocity of electrical activity on the AV node.
C. They block the sodium channels in the heart muscle.
D. They cause vasoconstriction of coronary arteries.
Show answer and rationale
Correct answer: B — They decrease the velocity of electrical activity on the AV node.
The correct answer is B: Calcium channel blockers decrease the velocity of electrical activity on the AV node. This is because calcium channel blockers specifically target calcium channels in the heart, which are responsible for the influx of calcium ions during the cardiac action potential. By blocking these channels, calcium channel blockers slow down the rate of electrical conduction through the AV node, leading to a decrease in heart rate and potentially a decrease in blood pressure.
Explanation of why the other choices are incorrect:
A: Calcium channel blockers do not increase the preload on the heart. Preload is the amount of blood that fills the heart before it contracts, and calcium channel blockers do not directly affect this.
C: Calcium channel blockers do not block sodium channels in the heart muscle. They primarily target calcium channels.
D: Calcium channel blockers do not cause vasoconstriction of coronary arteries. They may actually cause vasodilation in coronary arteries, leading to increased blood flow to the heart muscle.
Question 5
A 3-year-old nonsyndromic, well-appearing male with no significant past medical history presents with an abdominal mass palpated by his mother when giving him a bath. CT imaging reveals a 9-cm right renal mass without involvement of the inferior vena cava (IVC) and no evidence of tumor thrombus by ultrasound. The left kidney appears normal, and there is no imaging evidence of tumor rupture or adherence to surrounding organs. There are diffuse, bilateral pulmonary metastases from which he is asymptomatic with a normal respiratory rate and no supplemental oxygen requirement. Following the National Wilms Tumor Study Group (NWTS)/Children's Oncology Group (COG) approach to pediatric renal tumors, which of the following are appropriate next steps?
A. Core biopsy of the renal mass followed by three drug chemotherapyâ€â€vincristine, actinomycin, and doxorubicin
B. Nephrectomy with lymph node sampling followed by chemotherapy based on histology and stage
C. Fine-needle aspiration followed by three drug chemotherapyâ€â€vincristine, actinomycin, and doxorubicin
D. Neoadjuvant three drug chemotherapyâ€â€vincristine, actinomycin and doxorubicinâ€â€followed by nephrectomy at week 6
Show answer and rationale
Correct answer: B — Nephrectomy with lymph node sampling followed by chemotherapy based on histology and stage
The correct answer is B: Nephrectomy with lymph node sampling followed by chemotherapy based on histology and stage. This is the appropriate next step in managing this patient with a Wilms tumor. Nephrectomy is the primary treatment for Wilms tumor to remove the primary tumor and obtain tissue for histologic diagnosis. Lymph node sampling helps determine if there is any spread of the tumor. Chemotherapy based on histology and stage is tailored to the specific characteristics of the tumor and extent of disease.
Choice A (Core biopsy of the renal mass followed by three drug chemotherapy) is incorrect because core biopsy may not provide enough tissue for a definitive diagnosis, and treatment should be guided by surgical resection.
Choice C (Fine-needle aspiration followed by chemotherapy) is incorrect because fine-needle aspiration may not provide adequate tissue for diagnosis, and surgical resection is needed for definitive management.
Choice D (Neoadjuvant chemotherapy followed by nephrectomy) is incorrect because nephrectomy is
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Question 6
When should autologous hematopoietic stem cell transplantation be used, and what are the common cancers it is used for?
A. It should be used when high dose therapy is needed to maximize response. Most common cancers it is used for include lymphoma, late relapse of acute lymphoblastic leukemia, neuroblastoma, and Ewing sarcoma.
B. It should be used any time this approach can provide a meaningful survival benefit over chemotherapy. Most common cancers it is used for include neuroblastoma, responsive brain tumors in young children to avoid/minimize early radiation therapy, and relapsed lymphoma.
C. It should be used for tumors in which a graft-versus-tumor effect does not occur. Most common cancers include neuroblastoma, lymphoma, selected brain tumors, rhabdomyosarcoma, and Ewing sarcoma with lung metastases.
D. It should be used to avoid extensive treatment with chemotherapy and to shorten treatment. Most common cancers include neuroblastoma, relapsed Wilms' tumor, and selected brain tumors.
Correct answer:
Correct Answer: B
Rationale:
1. Autologous hematopoietic stem cell transplantation should be used when it can provide a meaningful survival benefit over chemotherapy.
2. The most common cancers it is used for include neuroblastoma, responsive brain tumors in young children to avoid/minimize early radiation therapy, and relapsed lymphoma.
3. This choice aligns with the current guidelines and evidence-based practice in utilizing autologous stem cell transplantation for specific cancer types to improve outcomes.
Summary of Other Choices:
A: Incorrect. It is not necessary to use autologous stem cell transplantation solely for high-dose therapy. The listed cancers are not the most common indications for this procedure.
C: Incorrect. The statement about the graft-versus-tumor effect is misleading, and the listed cancers are not the most common ones treated with autologous stem cell transplantation.
D: Incorrect. Autologous stem cell transplantation is not used to shorten treatment or avoid extensive chemotherapy. The listed cancers
A nurse is caring for a patient who is being treated for leukemia in the hospital. The patient was able to maintain her nutritional status for the first few weeks following her diagnosis but is now exhibiting early signs and symptoms of malnutrition. In collaboration with the dietitian, the nurse should implement what intervention?
A. Arrange for total parenteral nutrition (TPN).
B. Facilitate placement of a percutaneous endoscopic gastrostomy (PEG) tube.
C. Provide the patient with several small, soft-textured meals each day.
D. Assign responsibility for the patient's nutrition to the patient's friends and family.
Correct answer:
The correct answer is C: Provide the patient with several small, soft-textured meals each day. This intervention is appropriate because it focuses on improving the patient's nutritional intake through easily digestible meals, which can help address early signs of malnutrition. Small, soft-textured meals are easier for the patient to eat, especially if they are experiencing symptoms like mouth sores or difficulty swallowing. This approach also promotes regular intake of nutrients throughout the day, which can be more beneficial than relying solely on one large meal.
Incorrect answers:
A: Total parenteral nutrition (TPN) is typically reserved for patients who cannot tolerate oral or enteral nutrition. It is not the first-line intervention for early signs of malnutrition.
B: Percutaneous endoscopic gastrostomy (PEG) tube placement is usually considered for patients who are unable to eat orally in the long term. It is not indicated for early signs of malnutrition.
D: Assigning responsibility for the patient's nutrition to friends and
Which of the following actions most likely mediated the therapeutic effect of both drugs in the patient's disease?
A. Decreased intestinal reabsorption of bile acids
B. Decreased conversion of cholesterol to bile acids
C. Decreased synthesis of cholesterol by the liver
D. Upregulation of hepatic low-density lipoprotein (LDL) receptors
Correct answer:
The correct answer is D: Upregulation of hepatic low-density lipoprotein (LDL) receptors. This action is most likely to mediate the therapeutic effect of both drugs in the patient's disease because it would increase the clearance of LDL cholesterol from the bloodstream, leading to decreased cholesterol levels. By upregulating LDL receptors on hepatocytes, more LDL particles are taken up by the liver, reducing circulating LDL levels and lowering the risk of cardiovascular disease.
Choices A, B, and C are incorrect because they do not directly address the mechanism of action of the drugs in lowering cholesterol levels. Decreased intestinal reabsorption of bile acids (Choice A) may affect cholesterol absorption but is not the primary mechanism of action for most cholesterol-lowering drugs. Decreased conversion of cholesterol to bile acids (Choice B) and decreased synthesis of cholesterol by the liver (Choice C) do not target the clearance of LDL cholesterol from the bloodstream, which is the key therapeutic goal in managing hyperchole
A nurse is caring for a patient who is being treated for leukemia in the hospital. The patient was able to maintain her nutritional status for the first few weeks following her diagnosis but is now exhibiting early signs and symptoms of malnutrition. In collaboration with the dietitian, the nurse should implement what intervention?
A. Arrange for total parenteral nutrition (TPN).
B. Facilitate placement of a percutaneous endoscopic gastrostomy (PEG) tube.
C. Provide the patient with several small, soft-textured meals each day.
D. Assign responsibility for the patient's nutrition to the patient's friends and family.
Correct answer:
The correct answer is C: Provide the patient with several small, soft-textured meals each day. This intervention is appropriate for the patient showing early signs of malnutrition as it aims to increase the patient's nutrient intake in a manageable way. Small, soft-textured meals are easier for the patient to consume and digest, promoting better absorption of nutrients. This approach also aligns with the principle of promoting oral intake whenever possible before resorting to more invasive measures like TPN or PEG tube placement.
Incorrect choices:
A: Total parenteral nutrition (TPN) is typically reserved for patients who cannot tolerate oral feeding at all or have significant malabsorption issues.
B: Percutaneous endoscopic gastrostomy (PEG) tube placement is usually considered if the patient cannot meet their nutritional needs orally in the long term.
D: Assigning responsibility for the patient's nutrition to friends and family is not a sustainable or appropriate solution for addressing malnutrition in a hospitalized patient.
Which of the following actions most likely mediated the therapeutic effect of both drugs in the patient's disease?
A. Decreased intestinal reabsorption of bile acids
B. Decreased conversion of cholesterol to bile acids
C. Decreased synthesis of cholesterol by the liver
D. Upregulation of hepatic low-density lipoprotein (LDL) receptors
Correct answer:
The correct answer is D: Upregulation of hepatic low-density lipoprotein (LDL) receptors. This action is most likely to mediate the therapeutic effect of both drugs in the patient's disease because it would increase the clearance of LDL cholesterol from the bloodstream, leading to decreased cholesterol levels. By upregulating LDL receptors on hepatocytes, more LDL particles are taken up by the liver, reducing circulating LDL levels and lowering the risk of cardiovascular disease.
Choices A, B, and C are incorrect because they do not directly address the mechanism of action of the drugs in lowering cholesterol levels. Decreased intestinal reabsorption of bile acids (Choice A) may affect cholesterol absorption but is not the primary mechanism of action for most cholesterol-lowering drugs. Decreased conversion of cholesterol to bile acids (Choice B) and decreased synthesis of cholesterol by the liver (Choice C) do not target the clearance of LDL cholesterol from the bloodstream, which is the key therapeutic goal in managing hyperchole
A 3-year-old nonsyndromic, well-appearing male with no significant past medical history presents with an abdominal mass palpated by his mother when giving him a bath. CT imaging reveals a 9-cm right renal mass without involvement of the inferior vena cava (IVC) and no evidence of tumor thrombus by ultrasound. The left kidney appears normal, and there is no imaging evidence of tumor rupture or adherence to surrounding organs. There are diffuse, bilateral pulmonary metastases from which he is asymptomatic with a normal respiratory rate and no supplemental oxygen requirement. Following the National Wilms Tumor Study Group (NWTS)/Children's Oncology Group (COG) approach to pediatric renal tumors, which of the following are appropriate next steps?
A. Core biopsy of the renal mass followed by three drug chemotherapy—vincristine, actinomycin, and doxorubicin
B. Nephrectomy with lymph node sampling followed by chemotherapy based on histology and stage
C. Fine-needle aspiration followed by three drug chemotherapy—vincristine, actinomycin, and doxorubicin
D. Neoadjuvant three drug chemotherapy—vincristine, actinomycin and doxorubicin—followed by nephrectomy at week 6
Correct answer:
The correct answer is B: Nephrectomy with lymph node sampling followed by chemotherapy based on histology and stage. This is the appropriate next step in managing this patient with a Wilms tumor. Nephrectomy is the primary treatment for Wilms tumor to remove the primary tumor and obtain tissue for histologic diagnosis. Lymph node sampling helps determine if there is any spread of the tumor. Chemotherapy based on histology and stage is tailored to the specific characteristics of the tumor and extent of disease.
Choice A (Core biopsy of the renal mass followed by three drug chemotherapy) is incorrect because core biopsy may not provide enough tissue for a definitive diagnosis, and treatment should be guided by surgical resection.
Choice C (Fine-needle aspiration followed by chemotherapy) is incorrect because fine-needle aspiration may not provide adequate tissue for diagnosis, and surgical resection is needed for definitive management.
Choice D (Neoadjuvant chemotherapy followed by nephrectomy) is incorrect because nephrectomy is
A nurse is caring for a patient who is being treated for leukemia in the hospital. The patient was able to maintain her nutritional status for the first few weeks following her diagnosis but is now exhibiting early signs and symptoms of malnutrition. In collaboration with the dietitian, the nurse should implement what intervention?
A. Arrange for total parenteral nutrition (TPN).
B. Facilitate placement of a percutaneous endoscopic gastrostomy (PEG) tube.
C. Provide the patient with several small, soft-textured meals each day.
D. Assign responsibility for the patient's nutrition to the patient's friends and family.
Correct answer:
The correct answer is C: Provide the patient with several small, soft-textured meals each day. This intervention is appropriate because it focuses on improving the patient's nutritional intake through easily digestible meals, which can help address early signs of malnutrition. Small, soft-textured meals are easier for the patient to eat, especially if they are experiencing symptoms like mouth sores or difficulty swallowing. This approach also promotes regular intake of nutrients throughout the day, which can be more beneficial than relying solely on one large meal.
Incorrect answers:
A: Total parenteral nutrition (TPN) is typically reserved for patients who cannot tolerate oral or enteral nutrition. It is not the first-line intervention for early signs of malnutrition.
B: Percutaneous endoscopic gastrostomy (PEG) tube placement is usually considered for patients who are unable to eat orally in the long term. It is not indicated for early signs of malnutrition.
D: Assigning responsibility for the patient's nutrition to friends and
A nurse is caring for an elderly man recently admitted to the ICU following a stroke. She assesses his cognitive function using a new cognitive assessment test she learned about in a recent article in a nursing journal. She then brings a cup of water and a straw to the patient because she observes that his lips are dry. Later, she has the patient sit in a wheelchair and takes him to have some blood tests performed. He objects at first, saying that he can walk on his own, but the nurse explains that it is hospital policy to use the wheelchair. That evening, she recognizes signs of an imminent stroke in the patient and immediately pages the physician. Which action taken by the nurse is the best example of evidence-based practice?
A. Giving the patient a cup of water
B. Transferring the patient in a wheelchair
C. Recognizing signs of imminent stroke and paging the physician
D. Using the cognitive assessment test
Correct answer:
The correct answer is C: Recognizing signs of an imminent stroke and paging the physician. This action exemplifies evidence-based practice as it involves timely identification of a critical medical condition based on clinical assessment and prompt communication with the physician for further intervention. This aligns with the principles of evidence-based practice, which emphasize the integration of best available evidence with clinical expertise and patient values.
The other choices are incorrect:
A: Giving the patient a cup of water - While providing hydration is important for patient care, it does not demonstrate evidence-based practice in this scenario.
B: Transferring the patient in a wheelchair - Although using a wheelchair may be hospital policy, it does not directly relate to evidence-based practice in this context.
D: Using the cognitive assessment test - While assessing cognitive function is essential, it does not directly address the immediate medical needs of the patient as recognizing signs of an imminent stroke does.
A nurse is caring for a patient who is being treated for leukemia in the hospital. The patient was able to maintain her nutritional status for the first few weeks following her diagnosis but is now exhibiting early signs and symptoms of malnutrition. In collaboration with the dietitian, the nurse should implement what intervention?
A. Arrange for total parenteral nutrition (TPN).
B. Facilitate placement of a percutaneous endoscopic gastrostomy (PEG) tube.
C. Provide the patient with several small, soft-textured meals each day.
D. Assign responsibility for the patient's nutrition to the patient's friends and family.
Correct answer:
The correct answer is C: Provide the patient with several small, soft-textured meals each day. This intervention is appropriate for the patient showing early signs of malnutrition as it aims to increase the patient's nutrient intake in a manageable way. Small, soft-textured meals are easier for the patient to consume and digest, promoting better absorption of nutrients. This approach also aligns with the principle of promoting oral intake whenever possible before resorting to more invasive measures like TPN or PEG tube placement.
Incorrect choices:
A: Total parenteral nutrition (TPN) is typically reserved for patients who cannot tolerate oral feeding at all or have significant malabsorption issues.
B: Percutaneous endoscopic gastrostomy (PEG) tube placement is usually considered if the patient cannot meet their nutritional needs orally in the long term.
D: Assigning responsibility for the patient's nutrition to friends and family is not a sustainable or appropriate solution for addressing malnutrition in a hospitalized patient.
When should autologous hematopoietic stem cell transplantation be used, and what are the common cancers it is used for?
A. It should be used when high dose therapy is needed to maximize response. Most common cancers it is used for include lymphoma, late relapse of acute lymphoblastic leukemia, neuroblastoma, and Ewing sarcoma.
B. It should be used any time this approach can provide a meaningful survival benefit over chemotherapy. Most common cancers it is used for include neuroblastoma, responsive brain tumors in young children to avoid/minimize early radiation therapy, and relapsed lymphoma.
C. It should be used for tumors in which a graft-versus-tumor effect does not occur. Most common cancers include neuroblastoma, lymphoma, selected brain tumors, rhabdomyosarcoma, and Ewing sarcoma with lung metastases.
D. It should be used to avoid extensive treatment with chemotherapy and to shorten treatment. Most common cancers include neuroblastoma, relapsed Wilms' tumor, and selected brain tumors.
Correct answer:
Correct Answer: B
Rationale:
1. Autologous hematopoietic stem cell transplantation should be used when it can provide a meaningful survival benefit over chemotherapy.
2. The most common cancers it is used for include neuroblastoma, responsive brain tumors in young children to avoid/minimize early radiation therapy, and relapsed lymphoma.
3. This choice aligns with the current guidelines and evidence-based practice in utilizing autologous stem cell transplantation for specific cancer types to improve outcomes.
Summary of Other Choices:
A: Incorrect. It is not necessary to use autologous stem cell transplantation solely for high-dose therapy. The listed cancers are not the most common indications for this procedure.
C: Incorrect. The statement about the graft-versus-tumor effect is misleading, and the listed cancers are not the most common ones treated with autologous stem cell transplantation.
D: Incorrect. Autologous stem cell transplantation is not used to shorten treatment or avoid extensive chemotherapy. The listed cancers
RN exams cardiovascular practice questions, set 2 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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