RN exams cardiovascular practice questions, set 21
RN exams · cardiovascular
RN exams cardiovascular practice questionsset 21
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 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.
Show answer and rationale
Correct answer: B — Assess the client.
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.
Question 2
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
Show answer and rationale
Correct answer: B — Risk for Infection
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.
Question 3
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
Show answer and rationale
Correct answer: A — Risk for falls related to decreased sensorium
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.
Question 4
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.
Show answer and rationale
Correct answer: A — Discuss medications ordered, dietary changes, and exercise.
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.
Question 5
A 4-year-old child with acute lymphoblastic leukemia is receiving high-dose methotrexate during interim maintenance. He receives ondansetron and арrepitant 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
A 5-year-old girl with a previously normal CBC now presents in your office with a hemoglobin of 8.5 g/dL, corrected reticulocyte count of 0.1%, and mean corpuscular volume of 80 fl. White cells and platelets are normal in number and morphology. Bilirubin, LDH, BUN, creatinine, and urinalysis are normal. Direct and indirect antiglobulin tests are negative. Workup for infection, including parvovirus, is negative. Occult blood in her stools is negative. Physical examination is unremarkable. She has had no restriction in her energy or activities and the family agrees she is 'fine.' What is the most appropriate next step in management?
A. Administer erythropoietin.
B. Initiate a red cell transfusion.
C. Observe serial hemoglobin values closely.
D. Prescribe oral iron supplement.
Correct answer:
The correct answer is C: Observe serial hemoglobin values closely. The 5-year-old girl has a low hemoglobin level with normal white cells and platelets, suggestive of a chronic process. Given the normal physical exam, lack of symptoms, and negative workup for infection or hemolysis, it is reasonable to observe serial hemoglobin values closely. This approach allows monitoring for any trends or significant drops in hemoglobin levels, which may prompt further investigation or intervention. Administering erythropoietin (choice A) is not indicated as there is no evidence of bone marrow failure. Initiating a red cell transfusion (choice B) is not necessary as the patient is asymptomatic with no signs of acute blood loss. Prescribing oral iron supplement (choice D) is not appropriate as the patient has normal iron studies and mean corpuscular volume, indicating a non-iron deficiency etiology.
A 5-year-old girl with a previously normal CBC now presents in your office with a hemoglobin of 8.5 g/dL, corrected reticulocyte count of 0.1%, and mean corpuscular volume of 80 fl. White cells and platelets are normal in number and morphology. Bilirubin, LDH, BUN, creatinine, and urinalysis are normal. Direct and indirect antiglobulin tests are negative. Workup for infection, including parvovirus, is negative. Occult blood in her stools is negative. Physical examination is unremarkable. She has had no restriction in her energy or activities and the family agrees she is 'fine.' What is the most appropriate next step in management?
A. Administer erythropoietin.
B. Initiate a red cell transfusion.
C. Observe serial hemoglobin values closely.
D. Prescribe oral iron supplement.
Correct answer:
The correct answer is C: Observe serial hemoglobin values closely. The 5-year-old girl has a low hemoglobin level with normal white cells and platelets, suggestive of a chronic process. Given the normal physical exam, lack of symptoms, and negative workup for infection or hemolysis, it is reasonable to observe serial hemoglobin values closely. This approach allows monitoring for any trends or significant drops in hemoglobin levels, which may prompt further investigation or intervention. Administering erythropoietin (choice A) is not indicated as there is no evidence of bone marrow failure. Initiating a red cell transfusion (choice B) is not necessary as the patient is asymptomatic with no signs of acute blood loss. Prescribing oral iron supplement (choice D) is not appropriate as the patient has normal iron studies and mean corpuscular volume, indicating a non-iron deficiency etiology.
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
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 10-year-old female patient in ICU receiving chemotherapy has requested that her dog be allowed to visit her. She is currently sharing a room with another patient. The nurse knows that the hospital does allow for pet visits with owners, but has strict guidelines. Which of the following scenarios is most likely to be permitted?
A. The girls father may bring the dog in on a leash for a 20-minute visit.
B. The girls sister may bring the dog in with a shirt on (to prevent shedding) for an overnight stay.
C. The girls mother may bring the dog in on a leash for a visit as long as he has had all his vaccinations.
D. The dog may be brought in for a brief visit once the girl is moved to a private room.
Correct answer:
The correct answer is A because it follows the hospital's guidelines for pet visits. It allows the dog to be brought in on a leash, which ensures control and safety during the visit. The 20-minute duration is appropriate to limit potential stress on the patient and other individuals in the room. Additionally, having the father bring the dog in maintains consistency with the hospital's policy of pet visits with owners.
Choices B, C, and D are incorrect because they do not adhere to the hospital's guidelines. Choice B allows for an overnight stay, which is typically not permitted due to potential disruptions and hygiene concerns. Choice C mentions vaccinations but overlooks other important factors like leash control and visit duration. Choice D suggests waiting until the girl is moved to a private room, which may not align with the hospital's policy of allowing pet visits with owners.
A 10-year-old patient with aplastic anemia, who is blood type B negative, is receiving a red blood cell transfusion. About 10 minutes after the transfusion starts, the patient develops anxiety and lower back pain. The transfusion continues for another 5 minutes until it is stopped when he develops a temperature of 40 °C with chills and rigors. A transfusion reaction work-up is most likely to reveal what findings?
A. Spherocytes on peripheral blood smear
B. Gram-negative Bacillus on gram stain of remaining RBC unit
C. Chest x-ray with bilateral pulmonary infiltrates that are new compared to an x-ray done last week
D. DAT positive for C3
Correct answer:
The correct answer is D because in this scenario, the patient is experiencing symptoms of a transfusion reaction, likely a hemolytic transfusion reaction due to ABO incompatibility. The presence of a positive Direct Antiglobulin Test (DAT) for C3 indicates complement activation, supporting the diagnosis.
Choice A (Spherocytes on peripheral blood smear) is incorrect as spherocytes are seen in autoimmune hemolytic anemia, not typically in transfusion reactions.
Choice B (Gram-negative Bacillus on gram stain of remaining RBC unit) is unlikely as the symptoms are more indicative of a hemolytic reaction rather than an infection.
Choice C (Chest x-ray with bilateral pulmonary infiltrates) is suggestive of transfusion-related acute lung injury (TRALI), but the symptoms described in the question (fever, chills, rigors) are more indicative of a hemolytic reaction rather than TRALI.
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. Monitoring the size and location of the aneurysm is crucial in determining the risk of rupture. Larger aneurysms in critical locations are more likely to rupture. This information guides healthcare providers in making informed decisions about interventions to prevent rupture.
Explanation of other choices:
A: Medication therapy the client is receiving - While medication therapy may be important in managing symptoms or risk factors associated with an aneurysm, it does not directly indicate impending rupture.
B: Client's usual blood pressure - Blood pressure management is important in preventing complications of an aneurysm, but it does not specifically signal impending rupture.
C: Age and gender of the client - While age and gender may influence the risk of developing an aneurysm, they do not indicate impending rupture.
The client has a resting heart rate of 80 and a regular rhythm. What is the likely source of electrical activity in this client?
A. The sino-atrial node
B. The atrio-ventricular node
C. The Purkinje fibers
D. The bundle of HIS
Correct answer:
The correct answer is A: The sino-atrial node. The SA node is the natural pacemaker of the heart, responsible for initiating the electrical impulses that regulate the heartbeat. A resting heart rate of 80 with a regular rhythm indicates normal sinus rhythm, which is typically driven by the SA node. The SA node is located in the right atrium and generates electrical impulses that spread through the atria, causing them to contract.
Choice B (The atrio-ventricular node) is incorrect because the AV node serves to delay the electrical impulse to allow the atria to contract before the ventricles. Choice C (The Purkinje fibers) is incorrect as they are responsible for rapid conduction of the electrical impulse to the ventricles. Choice D (The bundle of HIS) is incorrect as it is part of the electrical conduction system that transmits the impulse from the AV node to the bundle branches.
An acute, transient phase, of inflammation is characterized by:
A. Local vasodilatation and increased capillary permeability (phase of damage)
B. Infiltration of leucocytes and phagocytic cells (phase of exudation)
C. Tissue degeneration and fibrosis occurrence (phase of proliferation)
D. All of the above
Correct answer:
Rationale:
1. During acute inflammation, the initial response is vasodilation and increased capillary permeability.
2. This leads to increased blood flow, redness, heat, and swelling at the site of injury.
3. The purpose is to deliver immune cells and proteins to the affected area to fight off pathogens.
4. Infiltration of leukocytes and phagocytic cells occurs after vasodilation in the exudation phase.
5. Tissue degeneration and fibrosis occur in the later stages of chronic inflammation, not in the acute phase.
6. Choice A is correct as it specifically describes the characteristics of the acute, transient phase of inflammation.
Summary:
- Choice A is correct as it accurately describes the characteristics of acute inflammation.
- Choices B, C, and D are incorrect as they describe phases or processes that occur in chronic inflammation or are not specific to the acute phase.
While taking a client history, which factor(s) that place the client at risk for a hematologic health problem will the nurse document? (Select all that apply.)
A. Family history of military excellence
B. Diet low in iron and protein
C. Excessive alcohol consumption
D. Family history of allergies
Correct answer:
The correct answer is C: Excessive alcohol consumption. Excessive alcohol intake can lead to hematologic health problems such as anemia and abnormal blood clotting. Alcohol interferes with the production of red blood cells and impairs the function of platelets. Therefore, documenting excessive alcohol consumption is crucial in assessing a client's risk for hematologic issues.
Explanation for why other choices are incorrect:
A: Family history of military excellence - This choice is irrelevant to hematologic health problems and does not pose a risk factor.
B: Diet low in iron and protein - While a poor diet can contribute to hematologic issues, this specific choice does not directly indicate a risk factor for hematologic problems.
D: Family history of allergies - Allergies are not directly related to hematologic health problems, so this choice is not relevant in this context.
RN exams cardiovascular practice questions, set 21 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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