RN exams cardiovascular practice questions, set 24
RN exams · cardiovascular
RN exams cardiovascular practice questionsset 24
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
To improve the physical activity level for a mildly obese 71-yr-old patient, which action should the nurse plan to take?
A. Stress that weight loss is a major benefit of increased exercise.
B. Determine what kind of physical activities the patient usually enjoys.
C. Tell the patient that older adults should exercise for no more than 20 minutes at a time.
D. Teach the patient to include a short warm-up period at the beginning of physical activity.
Show answer and rationale
Correct answer: B — Determine what kind of physical activities the patient usually enjoys.
The correct answer is B: Determine what kind of physical activities the patient usually enjoys.
Rationale:
1. By determining the patient's preferred physical activities, the nurse can tailor an exercise plan that the patient is more likely to adhere to.
2. Enjoyable activities increase motivation and compliance, leading to sustained physical activity levels.
3. Personalized approach considers the patient's interests and abilities, promoting a successful and sustainable exercise routine.
Summary of Incorrect Choices:
A. Stressing weight loss may be discouraging and overshadow the importance of overall health benefits of exercise.
C. Setting a strict time limit may not be suitable for all older adults and can hinder individualized exercise plans.
D. While warming up is important, it is not the most crucial initial step in developing a personalized exercise plan.
Question 2
While obtaining patient histories, the nurse identifies that the patient with the highest risk for CAD is
A. An African American man, aged 65, with obesity and a BP of 160/85
B. A white man, aged 54, who is a smoker and has a stressful lifestyle
C. An Asian woman, aged 45, with a cholesterol level of 240 mg and a BP of 130/75
D. A white woman, aged 72, with a BP 172/100 and who is physically inactive
Show answer and rationale
Correct answer: D — A white woman, aged 72, with a BP 172/100 and who is physically inactive
The correct answer is D because the patient is a white woman aged 72 with a high blood pressure of 172/100 and physically inactive. Advanced age, high blood pressure, and physical inactivity are significant risk factors for coronary artery disease (CAD). Age is a non-modifiable risk factor, and hypertension and lack of physical activity are modifiable but critical factors contributing to CAD.
Choice A is incorrect because although the patient is African American, has obesity, and high blood pressure, the age is younger than the patient in choice D. Choice B is incorrect as smoking and stress are risk factors but not as significant as age, high blood pressure, and physical inactivity. Choice C is incorrect since although the patient has high cholesterol and elevated blood pressure, the age and other risk factors are less significant compared to the patient in choice D.
Question 3
A patient moving from chair to chair in the day room and pacing in the hallway repeatedly, rapidly, and for extended periods is likely demonstrating _________ , and the nurse should __________.
A. a dystonic reaction…administer PRN IM benztropine (Cogentin)
B. anxiety… teach and guide the patient to use relaxation exercises
C. akathisia…administer PRN diphenhydramine (Benadryl) PO
D. tardive dyskinesia…recommend a change in medication
Show answer and rationale
Correct answer: C — akathisia…administer PRN diphenhydramine (Benadryl) PO
The correct answer is C: akathisia...administer PRN diphenhydramine (Benadryl) PO. Akathisia is characterized by restlessness and the inability to sit still, leading to constant movement like pacing. Diphenhydramine is commonly used to manage akathisia due to its anticholinergic effects that can help reduce these symptoms.
Rationale:
1. Akathisia matches the patient's symptoms of constant movement and restlessness.
2. Diphenhydramine is a common treatment for akathisia due to its calming effects.
3. Administering diphenhydramine orally is appropriate for managing akathisia symptoms in a non-emergent situation.
Summary:
A: Dystonic reaction presents with muscle spasms, not constant movement like pacing.
B: Anxiety does not typically manifest as constant pacing and may require different interventions.
D: Tardive dyskinesia involves involuntary movements and is
Question 4
You are consulting on a 10-year-old male with severe persistent neutropenia, a history of recurrent infections, and warts. The rest of the peripheral blood count is normal. His mother also has neutropenia. Bone marrow examination shows a hypercellular marrow and retained myeloid cells with vacuolated cytoplasm. There are no abnormalities in the red cells or platelet precursors. Cytogenetics are 46XY. You start granulocyte colony stimulating factor therapy and the neutrophil count increases. A mutation in which of the following genes is most likely to have caused this familial inherited bone marrow failure syndrome?
A. CXCR4
B. ELANE
C. GATA 2
D. Mitochondrial DNA
Show answer and rationale
Correct answer: A — CXCR4
The correct answer is A: CXCR4. In this case, the patient presents with severe neutropenia, recurrent infections, and warts, suggestive of WHIM syndrome, where CXCR4 mutations are often involved. CXCR4 plays a crucial role in immune cell trafficking and retention in the bone marrow. The hypercellular marrow and vacuolated myeloid cells are consistent with WHIM syndrome. The absence of abnormalities in red cells or platelet precursors rules out other syndromes. Mutations in ELANE are commonly associated with congenital neutropenia, not familial inherited bone marrow failure syndromes. GATA2 mutations are linked to familial myelodysplastic syndromes, not typically presenting with neutropenia and warts. Mitochondrial DNA mutations are more related to mitochondrial disorders, which usually manifest with multi-system involvement, not specific to bone marrow failure syndromes.
Question 5
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
Show answer and rationale
Correct answer: A — Beta-blocker
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.
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Question 6
A patient admitted to the coronary care unit (CCU) with an ST-segment-elevation myocardial infarction (STEMI) is restless and anxious. The blood pressure is 86/40 mm Hg, and heart rate is 132 beats/min. Based on this information, which nursing diagnosis is a priority for the patient?
A. Acute pain related to myocardial infarction
B. Anxiety related to perceived threat of death
C. Stress overload related to acute change in health
D. Decreased cardiac output related to cardiogenic shock
Correct answer:
The correct answer is D: Decreased cardiac output related to cardiogenic shock. In this case, the patient's low blood pressure and high heart rate indicate poor cardiac output. Cardiogenic shock is a life-threatening condition where the heart cannot pump enough blood to meet the body's needs. This is a priority nursing diagnosis as it requires immediate intervention to stabilize the patient's hemodynamics and prevent further deterioration.
Choices A, B, and C are incorrect because while they are valid concerns for the patient, they are not as immediately life-threatening as cardiogenic shock. Acute pain, anxiety, and stress overload can all be addressed once the patient's hemodynamic stability is ensured. However, without addressing the decreased cardiac output and cardiogenic shock first, the patient's condition could rapidly worsen and lead to serious consequences.
You are consulting on a 10-year-old male with severe persistent neutropenia, a history of recurrent infections, and warts. The rest of the peripheral blood count is normal. His mother also has neutropenia. Bone marrow examination shows a hypercellular marrow and retained myeloid cells with vacuolated cytoplasm. There are no abnormalities in the red cells or platelet precursors. Cytogenetics are 46XY. You start granulocyte colony stimulating factor therapy and the neutrophil count increases. A mutation in which of the following genes is most likely to have caused this familial inherited bone marrow failure syndrome?
A. CXCR4
B. ELANE
C. GATA 2
D. Mitochondrial DNA
Correct answer:
The correct answer is A: CXCR4. In this case, the patient presents with severe neutropenia, recurrent infections, and warts, suggestive of WHIM syndrome, where CXCR4 mutations are often involved. CXCR4 plays a crucial role in immune cell trafficking and retention in the bone marrow. The hypercellular marrow and vacuolated myeloid cells are consistent with WHIM syndrome. The absence of abnormalities in red cells or platelet precursors rules out other syndromes. Mutations in ELANE are commonly associated with congenital neutropenia, not familial inherited bone marrow failure syndromes. GATA2 mutations are linked to familial myelodysplastic syndromes, not typically presenting with neutropenia and warts. Mitochondrial DNA mutations are more related to mitochondrial disorders, which usually manifest with multi-system involvement, not specific to bone marrow failure syndromes.
Following insertion of a central venous catheter, the nurse obtains a stat chest x-ray film to verify proper catheter placement. The radiologist reports to the nurse: “The tip of the catheter is located in the superior vena cava.” What is the best inter pretation of these results by the nurse?
A. The catheter is not positioned correctly and should be removed.
B. The catheter position increases the risk of ventricular daybisrbr.hcoymth/tmesti as.
C. The distal tip of the catheter is in the appropriate position.
D. The physician should be called to advance the catheter into the pulmonary artery.
Correct answer:
The correct answer is C: The distal tip of the catheter is in the appropriate position.
Rationale:
1. The superior vena cava is a desirable location for a central venous catheter tip placement as it is close to the heart for rapid medication delivery.
2. Catheter tip in the superior vena cava allows for proper venous return and minimizes the risk of complications.
3. The nurse does not need to remove or adjust the catheter if the tip is in the superior vena cava.
4. Advancing the catheter into the pulmonary artery (option D) would be incorrect as it can lead to serious complications.
Incorrect choices:
A: Incorrect because placement in the superior vena cava is acceptable.
B: Incorrect as placement in the superior vena cava does not increase the risk of ventricular dysrhythmias.
D: Incorrect as advancing the catheter into the pulmonary artery is unnecessary and risky.
In the laboratory diagnosis of leishmaniasis, the expected parasite stage in vitro is
A. Amastigote
B. Promastigote
C. Trypomastigote
D. Schizont
Correct answer:
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
While obtaining patient histories, the nurse identifies that the patient with the highest risk for CAD is
A. An African American man, aged 65, with obesity and a BP of 160/85
B. A white man, aged 54, who is a smoker and has a stressful lifestyle
C. An Asian woman, aged 45, with a cholesterol level of 240 mg and a BP of 130/75
D. A white woman, aged 72, with a BP 172/100 and who is physically inactive
Correct answer:
The correct answer is D because the patient is a white woman aged 72 with a high blood pressure of 172/100 and physically inactive. Advanced age, high blood pressure, and physical inactivity are significant risk factors for coronary artery disease (CAD). Age is a non-modifiable risk factor, and hypertension and lack of physical activity are modifiable but critical factors contributing to CAD.
Choice A is incorrect because although the patient is African American, has obesity, and high blood pressure, the age is younger than the patient in choice D. Choice B is incorrect as smoking and stress are risk factors but not as significant as age, high blood pressure, and physical inactivity. Choice C is incorrect since although the patient has high cholesterol and elevated blood pressure, the age and other risk factors are less significant compared to the patient in choice D.
A patient admitted to the coronary care unit (CCU) with an ST-segment-elevation myocardial infarction (STEMI) is restless and anxious. The blood pressure is 86/40 mm Hg, and heart rate is 132 beats/min. Based on this information, which nursing diagnosis is a priority for the patient?
A. Acute pain related to myocardial infarction
B. Anxiety related to perceived threat of death
C. Stress overload related to acute change in health
D. Decreased cardiac output related to cardiogenic shock
Correct answer:
The correct answer is D: Decreased cardiac output related to cardiogenic shock. In this case, the patient's low blood pressure and high heart rate indicate poor cardiac output. Cardiogenic shock is a life-threatening condition where the heart cannot pump enough blood to meet the body's needs. This is a priority nursing diagnosis as it requires immediate intervention to stabilize the patient's hemodynamics and prevent further deterioration.
Choices A, B, and C are incorrect because while they are valid concerns for the patient, they are not as immediately life-threatening as cardiogenic shock. Acute pain, anxiety, and stress overload can all be addressed once the patient's hemodynamic stability is ensured. However, without addressing the decreased cardiac output and cardiogenic shock first, the patient's condition could rapidly worsen and lead to serious consequences.
The nurse is giving intravenous nitroglycerin to a patient who has just been admitted because of an acute myocardial infarction. Which statement is true regarding the administration of the intravenous form of this medication?
A. The solution will be slightly colored green or blue.
B. The intravenous form is given by bolus injection.
C. It can be given in infusions with other medications.
D. Non-polyvinylchloride (non-PVC) plastic intravenous bags and tubing must be used.
Correct answer:
Step 1: Nitroglycerin is light-sensitive and can degrade when exposed to light. PVC plastic can release compounds that can interact with nitroglycerin. Therefore, non-PVC plastic must be used to prevent drug degradation.
Step 2: Using non-PVC bags and tubing ensures the drug's stability and efficacy during administration, reducing the risk of adverse effects.
Step 3: This requirement is specific to intravenous nitroglycerin administration and is crucial to ensure the patient receives the intended therapeutic benefits without compromising the drug's potency.
In summary, choice D is correct because using non-PVC plastic intravenous bags and tubing is essential to maintain the stability and effectiveness of intravenous nitroglycerin. Choices A, B, and C are incorrect as they do not address the specific requirement related to the administration of this medication.
The nurse is caring for a 100-kg patient being monitored with a pulmonary artery catheter. The nurse assesses a blood pressure of 90/60 mm Hg, hear t rate 110 beats/min, respirations 36/min, oxygen saturation of 89% on 3 L of oxygen via nasal cannula. Bilateral crackles are audible upon auscultation. Which hemodynamic value reqaubiirrbe.sco imm/temste diate action by the nurse?
A. Cardiac index (CI) of 1.2 L/min/m3
B. Cardiac output (CO) of 4 L/min
C. Pulmonary vascular resistance (PVR) of 80 dynes/sec/cm5
D. Systemic vascular resistance (SVR) of 1800 dynes/sec /cm5
Correct answer:
The correct answer is B: Cardiac output (CO) of 4 L/min. In this scenario, the patient is presenting with signs of pulmonary congestion and hypoxemia, indicating possible cardiogenic pulmonary edema. As the cardiac output is a key indicator of how well the heart is functioning and delivering blood to the body, a low cardiac output can lead to inadequate tissue perfusion and worsen the patient's condition. Therefore, immediate action is required to address the low cardiac output to improve tissue perfusion and oxygenation.
Choices A, C, and D are incorrect as they do not directly address the primary concern of inadequate cardiac output in this patient. Cardiac index, pulmonary vascular resistance, and systemic vascular resistance are important parameters to monitor, but in this case, the priority is to address the low cardiac output to improve the patient's condition.
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
To verify the correct placement of an oral endotracheal tube (ET) after insertion, the best initial action by the nurse is to:
A. Auscultate for the presence of bilateral breath sounds.
B. Obtain a portable chest x-ray to check tube placement.
C. Observe the chest for symmetric chest movement with ventilation.
D. Use an end-tidal CO2 monitor to check for placement in the trachea.
Correct answer:
The correct answer is D because using an end-tidal CO2 monitor is the most reliable method to confirm correct endotracheal tube placement in the trachea. This method detects exhaled CO2, indicating proper tube placement in the trachea. It is a quick and efficient way to confirm placement without delay, reducing the risk of complications.
A: Auscultating for bilateral breath sounds is not as reliable because breath sounds may be heard even if the tube is misplaced.
B: Obtaining a portable chest x-ray is not the best initial action as it takes time and delays confirming tube placement.
C: Observing chest movement may not provide conclusive evidence of proper tube placement and can lead to misinterpretation.
In summary, using an end-tidal CO2 monitor is the most accurate and efficient method to verify correct endotracheal tube placement compared to the other options.
RN exams cardiovascular practice questions, set 24 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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