RN exams cardiovascular practice questions, set 20
RN exams · cardiovascular
RN exams cardiovascular practice questionsset 20
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 9-month-old boy has been referred to you for the evaluation of an enlarged abdomen. Imaging studies show a large liver mass (PRETEXT III). Alfa-fetoprotein is 98 ng/mL, and a CT scan of the lungs show bilateral lung metastases. A needle biopsy is performed, and you are planning to review the specimen with the pathologist. Which of the following diagnoses are you suspecting?
A. Pure fetal histology hepatoblastoma
B. Embryonal sarcoma of the liver
C. Fibrolamellar hepatocellular carcinoma
D. Small cell undifferentiated hepatoblastoma
Show answer and rationale
Correct answer: D — Small cell undifferentiated hepatoblastoma
The correct answer is D: Small cell undifferentiated hepatoblastoma. In this case, the key features to consider are the patient's age (9 months old), large liver mass with lung metastases, and elevated alpha-fetoprotein level. Small cell undifferentiated hepatoblastoma is commonly seen in infants, presents as a large liver mass, and frequently metastasizes to the lungs. The alpha-fetoprotein level in this case is also elevated, which is typical for hepatoblastoma. Pure fetal histology hepatoblastoma (A) is less common in older infants, and the presence of lung metastases is not typical. Embryonal sarcoma (B) typically presents as a solitary mass without metastases. Fibrolamellar hepatocellular carcinoma (C) is rare in infants and does not typically present with elevated alpha-fetoprotein levels. Thus, based on the clinical presentation and imaging findings, small cell undifferentiated hepatob
Question 2
The nurse educator is evaluating the performance of a new registered nurse (RN) who is providing care to a patient who is receiving mechanical ventilation with 15 cm H2O of peak end-expiratory pressure (PEEP). Which action indicates that the new RN is safe?
A. The RN plans to suction the patient every 1 to 2 hours.
B. The RN uses a closed-suction technique to suction the patient.
C. The RN tapes the connection between the ventilator tubing and the ET.
D. The RN changes the ventilator circuit tubing routinely every 48 hours.
Show answer and rationale
Correct answer: B — The RN uses a closed-suction technique to suction the patient.
The correct answer is B: The RN uses a closed-suction technique to suction the patient. This is the safe action because closed-suction technique minimizes the risk of ventilator-associated infections by maintaining a closed system during suctioning, reducing the exposure to pathogens. Closed-suction systems also help maintain lung compliance and oxygenation levels during the suctioning process.
Rationale: Option A is incorrect because suctioning every 1 to 2 hours may be too frequent and can lead to hypoxia and mucosal damage. Option C is incorrect as taping the connection between the ventilator tubing and ET can interfere with the proper functioning of the ventilator and increase the risk of disconnection. Option D is incorrect because changing ventilator circuit tubing routinely every 48 hours is not evidence-based practice and can increase the risk of contamination and unnecessary costs.
Question 3
A 9-month-old boy has been referred to you for the evaluation of an enlarged abdomen. Imaging studies show a large liver mass (PRETEXT III). Alfa-fetoprotein is 98 ng/mL, and a CT scan of the lungs show bilateral lung metastases. A needle biopsy is performed, and you are planning to review the specimen with the pathologist. Which of the following diagnoses are you suspecting?
A. Pure fetal histology hepatoblastoma
B. Embryonal sarcoma of the liver
C. Fibrolamellar hepatocellular carcinoma
D. Small cell undifferentiated hepatoblastoma
Show answer and rationale
Correct answer: D — Small cell undifferentiated hepatoblastoma
The correct answer is D: Small cell undifferentiated hepatoblastoma. In this case, the key features to consider are the patient's age (9 months old), large liver mass with lung metastases, and elevated alpha-fetoprotein level. Small cell undifferentiated hepatoblastoma is commonly seen in infants, presents as a large liver mass, and frequently metastasizes to the lungs. The alpha-fetoprotein level in this case is also elevated, which is typical for hepatoblastoma. Pure fetal histology hepatoblastoma (A) is less common in older infants, and the presence of lung metastases is not typical. Embryonal sarcoma (B) typically presents as a solitary mass without metastases. Fibrolamellar hepatocellular carcinoma (C) is rare in infants and does not typically present with elevated alpha-fetoprotein levels. Thus, based on the clinical presentation and imaging findings, small cell undifferentiated hepatob
Question 4
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 5
A 4-year-old child with acute lymphoblastic leukemia is receiving high-dose methotrexate during interim maintenance. He receives ondansetron and ðрrepitant during his stay, which control his nausea and vomiting well. These medications work by inhibiting signaling in which part of the brain?
A. Vestibular system
B. Cerebral cortex
C. Hypothalamus
D. Vomiting center
Show answer and rationale
Correct answer: E
The correct answer is D: Vomiting center. Ondansetron and aprepitant are antiemetic medications that work by inhibiting signaling in the vomiting center of the brain. The vomiting center is located in the medulla oblongata in the brainstem, which plays a crucial role in triggering the reflexes that lead to nausea and vomiting. By blocking signals in the vomiting center, these medications effectively prevent and control nausea and vomiting.
Incorrect choices:
A: The vestibular system is responsible for balance and spatial orientation, not for controlling nausea and vomiting.
B: The cerebral cortex is involved in higher brain functions such as thinking and decision-making, not in regulating nausea and vomiting.
C: The hypothalamus regulates various physiological processes like temperature regulation and hormone release, but it is not directly involved in controlling nausea and vomiting.
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Question 6
Which of the following actions best explains the potassium-sparing effect of triamterene in the 66-year-old woman with systolic cardiac failure?
A. Enhancement of K+ reabsorption in the proximal tubule
B. Blockade of Na+ channels in the collecting duct
C. Enhancement of K+ reabsorption in the loop of Henle
D. Blockade of aldosterone receptors in the collecting duct
Correct answer:
The correct answer is B: Blockade of Na+ channels in the collecting duct. Triamterene is a potassium-sparing diuretic that works by inhibiting the epithelial sodium channels (ENaC) in the collecting duct of the nephron. By blocking these channels, triamterene reduces sodium reabsorption, leading to decreased potassium excretion. This mechanism helps maintain potassium levels in the body, making it an effective treatment for conditions like systolic cardiac failure where potassium loss is a concern.
Summary:
A: Enhancement of K+ reabsorption in the proximal tubule - This is incorrect as triamterene does not act on the proximal tubule for potassium-sparing effects.
C: Enhancement of K+ reabsorption in the loop of Henle - This is incorrect as triamterene does not primarily affect potassium reabsorption in the loop of Henle.
D: Blockade of aldosterone receptors in the collecting duct - This is
A nurse is caring for a female diagnosed with a mental disorder who has been prescribed medication. Which fact will most impact the nurse’s assessment for possible side effects?
A. Women are at higher risk for tardive dyskinesia while taking conventional antipsychotic medications.
B. Women experience more severe side effects than men while taking atypical antidepressants.
C. Women are more susceptible to developing a dependence on most psychiatric medications than are men.
D. Women are less susceptible to developing the common side effects of antipsychotic medications than are men.
Correct answer:
The correct answer is A because women are at higher risk for tardive dyskinesia while taking conventional antipsychotic medications. This fact is crucial for the nurse's assessment because tardive dyskinesia is a serious side effect characterized by involuntary movements and can be irreversible. Understanding this risk allows the nurse to closely monitor the patient for symptoms and intervene promptly if needed.
Choice B is incorrect because there is no evidence to suggest that women experience more severe side effects than men while taking atypical antidepressants. Choice C is incorrect as there is no generalization that women are more susceptible to developing a dependence on most psychiatric medications compared to men. Choice D is incorrect because there is no established evidence that women are less susceptible to developing common side effects of antipsychotic medications than men.
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.
After receiving a diagnosis of acute lymphocytic leukemia, a patient is visibly distraught, stating, 'I have no idea where to go from here.' How should the nurse prepare to meet this patient's psychosocial needs?
A. Assess the patient's previous experience with the health care system.
B. Reassure the patient that treatment will be challenging but successful.
C. Assess the patient's specific needs for education and support.
D. Identify the patient's plan of medical care.
Correct answer:
Rationale: Choice C is correct because assessing the patient's specific needs for education and support is crucial in addressing psychosocial needs. By understanding the patient's knowledge gaps and support requirements, the nurse can provide tailored information and resources to help the patient cope effectively. This empowers the patient to make informed decisions and feel supported throughout the treatment process.
Incorrect Choices:
A: Assessing the patient's previous experience with the health care system may provide some insight but does not directly address the current psychosocial needs.
B: Reassuring the patient about treatment success is important but may not adequately address the patient's immediate distress and uncertainty.
D: Identifying the patient's plan of medical care is important but focuses more on the medical aspect rather than psychosocial support and education.
A nursing student is caring for a patient with acute myeloid leukemia who is preparing to undergo induction therapy. In preparing a plan of care for this patient, the student should assign the highest priority to which nursing diagnoses?
A. Activity Intolerance
B. Risk for Infection
C. Acute Confusion
D. Risk for Spiritual Distress
Correct answer:
The correct answer is B: Risk for Infection. During induction therapy for acute myeloid leukemia, the patient's immune system is compromised, making them highly susceptible to infections. Therefore, the highest priority nursing diagnosis should be addressing and preventing infections. This includes monitoring for signs of infection, implementing proper infection control measures, educating the patient and family on infection prevention, and administering prophylactic antibiotics as needed.
Choice A (Activity Intolerance) may be a concern due to the patient's underlying condition and treatment, but preventing infections takes precedence as it can lead to life-threatening complications. Choice C (Acute Confusion) and Choice D (Risk for Spiritual Distress) are important considerations but do not pose an immediate threat to the patient's health and safety compared to the risk of infection.
A nurse is caring for a female diagnosed with a mental disorder who has been prescribed medication. Which fact will most impact the nurse’s assessment for possible side effects?
A. Women are at higher risk for tardive dyskinesia while taking conventional antipsychotic medications.
B. Women experience more severe side effects than men while taking atypical antidepressants.
C. Women are more susceptible to developing a dependence on most psychiatric medications than are men.
D. Women are less susceptible to developing the common side effects of antipsychotic medications than are men.
Correct answer:
The correct answer is A because women are at higher risk for tardive dyskinesia while taking conventional antipsychotic medications. This fact is crucial for the nurse's assessment because tardive dyskinesia is a serious side effect characterized by involuntary movements and can be irreversible. Understanding this risk allows the nurse to closely monitor the patient for symptoms and intervene promptly if needed.
Choice B is incorrect because there is no evidence to suggest that women experience more severe side effects than men while taking atypical antidepressants. Choice C is incorrect as there is no generalization that women are more susceptible to developing a dependence on most psychiatric medications compared to men. Choice D is incorrect because there is no established evidence that women are less susceptible to developing common side effects of antipsychotic medications than men.
A patient has a low-density lipoprotein of 175 mg/dL and a high-density lipoprotein of 30 mg/dL. What teaching should the nurse implement for this patient?
A. Discuss medications ordered, dietary changes, and exercise.
B. No changes in lifestyle are needed; continue with the current plan.
C. Discuss how to have fat intake be 40% of caloric intake.
D. Begin keeping a food diary, and schedule laboratory work to be repeated in 6 months.
Correct answer:
The correct answer is A because the patient's lipid profile indicates high LDL and low HDL levels, which increase the risk of cardiovascular disease. By discussing medications, dietary changes, and exercise, the nurse can address these lipid abnormalities effectively. Medications may be needed to lower LDL and raise HDL levels. Dietary changes, such as reducing saturated fats and increasing fiber intake, can help improve the lipid profile. Implementing an exercise regimen can also positively impact lipid levels.
Choice B is incorrect because lifestyle changes are necessary to improve the patient's lipid profile. Choice C is incorrect as a high fat intake is not recommended for someone with elevated LDL levels. Choice D is incorrect as keeping a food diary and repeating laboratory work in 6 months may not address the immediate need for intervention to manage the patient's lipid levels.
A 3-month-old female presents to the emergency room with vomiting and abdominal distension. She has a left-side abdominal mass, and an abdominal ultrasound confirms an 8-cm mass arising from the left kidney. Liver lesions are also noted. Nephrectomy is performed and reveals a histologic diagnosis of malignant rhabdoid tumor of the kidney (MRTK). Which of the following is not a true statement about the management of this patient?
A. Most patients with rhabdoid tumor of the kidney present in infancy.
B. Most patients with rhabdoid tumor of the kidney present with metastatic (stage III or IV) disease.
C. She has an excellent prognosis with surgery, chemotherapy, and radiation.
D. Germline testing for SMARCB1/INI1 mutation on chromosome 22 is recommended, with brain MRI every 3 months until she is 5 years old, if testing is germline positive for SMARCB1/INI1.
Correct answer:
The correct answer is C: She has an excellent prognosis with surgery, chemotherapy, and radiation.
Rationale:
1. Malignant rhabdoid tumor of the kidney (MRTK) is an aggressive cancer with poor prognosis.
2. Even with aggressive treatment, including surgery, chemotherapy, and radiation, the prognosis is generally poor due to high rates of recurrence and metastasis.
3. Therefore, stating that the patient has an excellent prognosis with the mentioned treatments is not true.
Summary of other choices:
A: Most patients with rhabdoid tumor of the kidney present in infancy - True, MRTK commonly presents in infancy.
B: Most patients with rhabdoid tumor of the kidney present with metastatic (stage III or IV) disease - True, MRTK often presents with metastatic disease.
D: Germline testing for SMARCB1/INI1 mutation on chromosome 22 is recommended, with brain MRI every 3 months until she is
A client's cardiac monitor alarm sounds, indicating ventricular tachycardia. The nurse should:
A. perform immediate defibrillation.
B. Assess the client.
C. Call the physician.
D. Administer a precordial thump.
Correct answer:
Certainly! The correct answer is B: Assess the client. Ventricular tachycardia may or may not require immediate intervention like defibrillation. Assessing the client's condition first allows the nurse to gather vital information such as the client's level of consciousness, vital signs, and overall stability. This assessment will guide the nurse in determining the appropriate next steps, which may include interventions like defibrillation, calling the physician, or administering treatment. Performing immediate defibrillation (choice A) without assessing the client's condition can be harmful if the client does not actually require it. Calling the physician (choice C) can be done after assessing the client to provide a comprehensive report. Administering a precordial thump (choice D) is not recommended in current guidelines and should not be the initial response to ventricular tachycardia.
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
RN exams cardiovascular practice questions, set 20 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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