RN exams cardiovascular practice questions, set 23
RN exams · cardiovascular
RN exams cardiovascular practice questionsset 23
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
In the laboratory diagnosis of leishmaniasis, the expected parasite stage in vitro is
A. Amastigote
B. Promastigote
C. Trypomastigote
D. Schizont
Show answer and rationale
Correct answer: B — Promastigote
The correct answer is B: Promastigote. In the laboratory diagnosis of leishmaniasis, the expected parasite stage in vitro is the promastigote form. This is because the promastigote form is the stage of the parasite that lives in the sandfly vector and is transmitted to humans, causing infection. In vitro, the promastigote form can be cultured and studied for diagnostic purposes.
Incorrect choices:
A: Amastigote - This is the intracellular form of the parasite found in mammalian hosts and not typically used for laboratory diagnosis.
C: Trypomastigote - This form is typically associated with Trypanosoma species, not Leishmania.
D: Schizont - This term is used for malaria parasites, not Leishmania parasites.
In summary, the promastigote form is the most relevant stage for laboratory diagnosis of leishmaniasis due to its presence in the sandfly vector and its ability to
Question 2
An infant is born with a firm mass over the chest with a central area of purpura and a 'halo' around it. An ultrasound reveals a high-flow lesion. What is the most likely diagnosis?
A. Fibrosarcoma
B. Infantile hemangioma
C. Congenital hemangioma
D. Capillary malformation
Show answer and rationale
Correct answer: C — Congenital hemangioma
The most likely diagnosis in this case is congenital hemangioma (Choice C). This is because the description of a firm mass over the chest with central purpura and a 'halo' suggests a rapidly involuting congenital hemangioma. The high-flow lesion seen on ultrasound is characteristic of this type of hemangioma.
Choice A (Fibrosarcoma) is incorrect as fibrosarcoma typically presents differently and does not typically have a central area of purpura. Choice B (Infantile hemangioma) is incorrect as infantile hemangiomas are not usually present at birth and do not typically have a 'halo' appearance. Choice D (Capillary malformation) is incorrect as capillary malformations do not usually present as a firm mass with central purpura and a 'halo'.
In summary, the key features described in the question point towards a diagnosis of congenital hemangioma, making Choice C the most likely
Question 3
A 13-year-old Hispanic girl is found to have a WBC count of 6,500/mm3 with 40% Auer rod–containing granular blasts that, by flow cytometry, express very bright CD33 but are negative for human leukocyte antigen–DR isotype (HLA-DR). She is oozing blood around her peripheral IV site. Coagulation studies reveal an international normalized ratio (INR) of 3.4, a fibrinogen of 170, and a markedly elevated D-dimer. Marrow aspirate shows nearly 90% blasts with a similar morphology. You send the marrow to the fluorescence in situ hybridization (FISH) lab and request STAT testing for the most likely recurrent genetic abnormality based on the clinical presentation. How do you plan to initiate therapy?
A. Perform a lumbar puncture to determine leukemic involvement, then proceed with induction chemotherapy.
B. Begin therapy with all-trans retinoic acid (ATRA) immediately while aggressively managing coagulopathy with blood product support.
C. Start dexamethasone and hydroxyurea immediately while aggressively managing coagulopathy with blood product support.
D. Start induction chemotherapy, obtain HLA typing, and start a donor search because of the poor prognosis associated with this leukemic phenotype.
Show answer and rationale
Correct answer: B — Begin therapy with all-trans retinoic acid (ATRA) immediately while aggressively managing coagulopathy with blood product support.
The correct answer is B: Begin therapy with all-trans retinoic acid (ATRA) immediately while aggressively managing coagulopathy with blood product support.
Rationale:
1. The clinical presentation describes acute promyelocytic leukemia (APL), characterized by Auer rod-containing blasts, coagulopathy (elevated INR, D-dimer), and CD33 positivity. ATRA is the standard treatment for APL.
2. ATRA induces differentiation of leukemic promyelocytes, reducing the risk of disseminated intravascular coagulation (DIC) and bleeding.
3. Aggressively managing the coagulopathy with blood product support is crucial to prevent hemorrhagic complications.
Summary:
A: Not needed as the clinical presentation already suggests APL. Lumbar puncture is not indicated for APL diagnosis.
C: Dexamethasone and hydroxyurea are not standard treatments for APL. Immediate ATRA therapy is preferred.
D
Question 4
When caring for a patient with acute coronary syndrome who has returned to the coronary care unit after having angioplasty with stent placement, the nurse obtains the following assessment data. Which data indicate the need for immediate action by the nurse?
A. Heart rate 102 beats/min
B. Pedal pulses 1+ bilaterally
C. Report of severe chest pain
D. Blood pressure 103/54 mm Hg
Show answer and rationale
Correct answer: C — Report of severe chest pain
The correct answer is C: Report of severe chest pain. Severe chest pain in a patient with acute coronary syndrome after angioplasty with stent placement can indicate a potential complication like stent thrombosis or myocardial infarction. Immediate action is required to assess the patient's condition, administer appropriate interventions, and prevent further complications.
A: Heart rate 102 beats/min - Although an elevated heart rate can indicate cardiac stress, it is not as urgent as severe chest pain in this context.
B: Pedal pulses 1+ bilaterally - While decreased pedal pulses may indicate peripheral vascular issues, it is not as critical as addressing severe chest pain in a patient with acute coronary syndrome.
D: Blood pressure 103/54 mm Hg - Although low blood pressure can be concerning, it is not as immediately life-threatening as severe chest pain in this scenario.
Question 5
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
Show answer and rationale
Correct answer: C — Excessive alcohol consumption
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.
Keep going past these 15 questions
Missed-question review, longer banks, and the rest of 20,000+ nursing practice questions open when you start studying.
Stems and choices stay public so you can still reason. Correct answers and full rationales unlock with the rest of the bank.
Question 6
Which type of medication helps to reduce the workload on the heart by slowing down the heart rate?
A. Beta-blocker
B. Calcium channel blocker
C. Diuretic
D. ACE inhibitor
Correct answer:
The correct answer is A: Beta-blocker. Beta-blockers work by blocking the effects of adrenaline on the heart, which helps to reduce the heart rate. This reduction in heart rate helps to decrease the workload on the heart muscle, making it an effective treatment for conditions such as high blood pressure and heart failure.
Incorrect choices:
B: Calcium channel blocker - Calcium channel blockers work by dilating blood vessels and reducing the heart's workload by relaxing the muscles in the blood vessels, not by slowing down the heart rate.
C: Diuretic - Diuretics help the body get rid of excess salt and water, reducing blood volume and lowering blood pressure, but they do not directly affect heart rate.
D: ACE inhibitor - ACE inhibitors work by relaxing blood vessels to lower blood pressure and improve blood flow, but they do not specifically target heart rate reduction.
A 16-year-old female patient with severe factor XI deficiency presents with acute appendicitis and requires urgent surgery. You are called by the surgeon, who wants to know what, if any, blood products or treatments are required to reduce the risk of perioperative bleeding. The patient weighs 62 kg. What should you tell him to administer?
A. Cryoprecipitate (five units), which will likely raise her factor XI level to 20%
B. Factor XI concentrate (20 units/kg), which will raise her factor XI level to 20%
C. Fresh frozen plasma (20 mL/kg), which will raise her factor XI level to 20%
D. Prothrombin complex concentrate (40 units/kg), which will raise her factor XI level to 20%
Correct answer:
The correct answer is C: Fresh frozen plasma (20 mL/kg), which will raise her factor XI level to 20%. Fresh frozen plasma contains various clotting factors, including factor XI. In patients with severe factor XI deficiency, like this 16-year-old female, fresh frozen plasma can provide factor XI replacement and improve hemostasis. The dose of 20 mL/kg is appropriate to achieve a factor XI level of around 20%, which is sufficient for hemostasis during surgery.
Now, let's analyze the other choices:
A: Cryoprecipitate (five units), which will likely raise her factor XI level to 20% - Cryoprecipitate contains factor VIII and fibrinogen, but the amount of factor XI in cryoprecipitate is minimal and may not significantly raise factor XI levels to the required 20%.
B: Factor XI concentrate (20 units/kg), which will raise her factor XI level to 20% - While factor XI concentrate is
Assuming that adherence has been excellent, which of the following should have returned to normal 6 weeks following appropriate oral iron treatment for a child with severe dietary iron deficiency (hemoglobin [Hgb] 5.0 g/dL and mean corpuscular volume [MCV] 48 fL at the beginning of therapy)?
A. Hgb concentration
B. MCV
C. Red cell distribution width
D. Peripheral blood smear
Correct answer:
Rationale for Correct Answer (A): Hgb concentration reflects the amount of hemoglobin in the blood, which is directly affected by iron levels. After 6 weeks of appropriate oral iron treatment, the child's severe iron deficiency should have improved, leading to an increase in Hgb concentration back to normal levels.
Explanation of Incorrect Choices:
B: MCV measures the size of red blood cells, which is affected by iron deficiency anemia. However, it may take longer than 6 weeks for MCV to return to normal.
C: Red cell distribution width indicates the variation in red blood cell sizes and is not directly related to iron levels. It may not necessarily return to normal within 6 weeks.
D: Peripheral blood smear provides information on the morphology of red blood cells but does not directly reflect iron levels. It may not show significant changes within 6 weeks of iron treatment.
You are asked to evaluate a 2-day-old boy in the newborn nursery with petechiae who has a platelet count of 8,000/mcL. On further questioning, you learn that he had a maternal uncle who died of intracerebral hemorrhage as a toddler. There is no eczema on physical examination. Review of the smear shows anisocytosis; poikilocytosis; normal white blood cell morphology; and small, infrequent platelets. The neonatologists have sent human platelet antigen (HPA)-1a testing from both parents, which is pending. Which of the following is the most likely diagnosis?
A. Congenital infection
B. Neonatal alloimmune thrombocytopenia
C. Wiskott-Aldrich syndrome
D. May-Hegglin anomaly
Correct answer:
The most likely diagnosis is Wiskott-Aldrich syndrome (C). This is supported by the presence of petechiae, low platelet count, family history of bleeding, anisocytosis, poikilocytosis, small platelets, and normal white blood cell morphology. Wiskott-Aldrich syndrome is an X-linked disorder characterized by thrombocytopenia, eczema, and recurrent infections. The absence of eczema in this case could be due to the young age of the patient. The other choices can be ruled out based on the clinical presentation and laboratory findings. Congenital infection (A) typically presents with other systemic symptoms. Neonatal alloimmune thrombocytopenia (B) usually presents with maternal history of previous pregnancies with affected infants. May-Hegglin anomaly (D) would typically present with giant platelets and Döhle-like inclusion bodies in neutrophils, which are not seen in this case.
A new nurse has recently joined the ICU from a different hospital, which had a much stricter policy regarding visiting hours. She expresses concern about the impact of open visiting hours on patient well-being. Which of the following would be the best explanation for the purpose of open visiting hours? Select all that apply.
A. To better provide rest and quiet
B. To strengthen the relationship between the family and health care provider
C. To control the number of visitors for a patient
D. To provide an undisturbed environment
Correct answer:
The correct answer is B: To strengthen the relationship between the family and health care provider.
Rationale:
1. Open visiting hours encourage family involvement in care, fostering a partnership between healthcare providers and families.
2. Family support can positively impact patient outcomes and satisfaction.
3. It allows families to be updated on the patient's condition and involved in decision-making.
4. Strengthening the relationship can lead to better communication and trust between all parties.
Summary of Incorrect Choices:
A: Open visiting hours may disrupt rest and quiet, but the primary purpose is not to provide rest.
C: Open visiting hours do not aim to control the number of visitors but rather encourage family involvement.
D: While open visiting hours may not provide an entirely undisturbed environment, the focus is on improving family-provider relationships.
You are asked to evaluate a 2-day-old boy in the newborn nursery with petechiae who has a platelet count of 8,000/mcL. On further questioning, you learn that he had a maternal uncle who died of intracerebral hemorrhage as a toddler. There is no eczema on physical examination. Review of the smear shows anisocytosis; poikilocytosis; normal white blood cell morphology; and small, infrequent platelets. The neonatologists have sent human platelet antigen (HPA)-1a testing from both parents, which is pending. Which of the following is the most likely diagnosis?
A. Congenital infection
B. Neonatal alloimmune thrombocytopenia
C. Wiskott-Aldrich syndrome
D. May-Hegglin anomaly
Correct answer:
The most likely diagnosis is Wiskott-Aldrich syndrome (C). This is supported by the presence of petechiae, low platelet count, family history of bleeding, anisocytosis, poikilocytosis, small platelets, and normal white blood cell morphology. Wiskott-Aldrich syndrome is an X-linked disorder characterized by thrombocytopenia, eczema, and recurrent infections. The absence of eczema in this case could be due to the young age of the patient. The other choices can be ruled out based on the clinical presentation and laboratory findings. Congenital infection (A) typically presents with other systemic symptoms. Neonatal alloimmune thrombocytopenia (B) usually presents with maternal history of previous pregnancies with affected infants. May-Hegglin anomaly (D) would typically present with giant platelets and Döhle-like inclusion bodies in neutrophils, which are not seen in this case.
The client is to be given warfarin. What is a contraindication to giving this drug?
A. Thrombocytosis
B. Mild thrombocytopenia
C. Lumbar puncture
D. History of eye surgery in the distant past
Correct answer:
The correct answer is A: Thrombocytosis. Warfarin is an anticoagulant that works by inhibiting blood clotting. Thrombocytosis is a condition where there is an excessive number of platelets in the blood, increasing the risk of blood clots. Giving warfarin to a patient with thrombocytosis can further increase the risk of bleeding complications.
Summary of incorrect choices:
B: Mild thrombocytopenia - This condition involves a low platelet count, which would actually make the patient more susceptible to blood clots, not a contraindication for warfarin.
C: Lumbar puncture - This procedure involves obtaining cerebrospinal fluid and is not directly related to the use of warfarin.
D: History of eye surgery in the distant past - This is not a contraindication for warfarin unless there were specific complications related to the surgery that would increase the risk of bleeding
The nurse is assessing a child's weight and height during a clinic visit prior to starting school. The nurse plots the child's weight on the growth chart and notes that the child's weight is in the 95th percentile for the child's height. What action should the nurse take?
A. Question the type and quantity of foods eaten in a typical day.
B. Encourage giving two additional snacks each day to the child.
C. Recommend a daily intake of at least four glasses of whole milk.
D. Assess for signs of poor nutrition, such as a pale appearance.
Correct answer:
The correct answer is A: Question the type and quantity of foods eaten in a typical day. When a child's weight is in the 95th percentile for their height, it indicates possible overweight or obesity. To address this, the nurse should assess the child's dietary habits to identify any unhealthy eating patterns contributing to excess weight. By questioning the type and quantity of foods eaten, the nurse can provide appropriate guidance on nutrition and healthy eating habits.
Summary:
B: Encouraging additional snacks may further contribute to weight gain and is not recommended without knowing the current eating habits.
C: Recommending a high intake of whole milk may increase calorie intake and potentially worsen the weight concern.
D: Assessing for signs of poor nutrition, such as a pale appearance, is important but not directly addressing the weight concern in this scenario.
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.
Which assessment finding by the nurse caring for a patient who has had coronary artery bypass grafting using a right radial artery graft is most important to communicate to the health care provider?
A. Complaints of incisional chest pain
B. Pallor and weakness of the right hand
C. Fine crackles heard at both lung bases
D. Redness on both sides of the sternal incision
Correct answer:
The correct answer is B: Pallor and weakness of the right hand. This finding suggests potential compromise of blood flow to the right radial artery graft, which is crucial for the patient's cardiac function. Pallor and weakness may indicate reduced perfusion, possibly due to graft occlusion or other complications. This warrants immediate attention from the healthcare provider to prevent further complications.
Incorrect choices:
A: Complaints of incisional chest pain - This is common post-surgery and may not indicate acute issues with the graft.
C: Fine crackles heard at both lung bases - This could indicate a respiratory issue, but it is not directly related to the radial artery graft.
D: Redness on both sides of the sternal incision - While redness could suggest infection, it is not as urgent as compromised blood flow to the graft, which requires immediate intervention.
RN exams cardiovascular practice questions, set 23 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
No. Nursier is independent practice. Register through the official path named on the RN exams exam guide.
The first five questions already include the rationale. Start full practice to unlock the remaining keys, missed-question review, and the rest of the bank.
Keep going past these 15 questions
Missed-question review, longer banks, and the rest of 20,000+ nursing practice questions open when you start studying.
