RN exams cardiovascular practice questions set 25

Correct answer:

The correct answer is A: It inhibits thrombin. Rivaroxaban is a direct factor Xa inhibitor, which works by specifically inhibiting the activity of factor Xa, a key enzyme in the coagulation cascade. By inhibiting factor Xa, rivaroxaban prevents the formation of thrombin, a crucial enzyme in the blood clotting process. Thrombin is responsible for converting fibrinogen to fibrin, which forms the meshwork of a blood clot. Therefore, by inhibiting thrombin formation, rivaroxaban effectively prevents blood clots from forming. Choice B is incorrect because rivaroxaban does not directly inhibit fibrinogen; it acts upstream by inhibiting factor Xa. Choice C is incorrect because rivaroxaban does not actually "thin" the blood like warfarin or heparin; it specifically targets factor Xa. Choice D is incorrect because rivaroxaban does not work against vitamin K like warfarin

Correct answer:

The correct answer is B: Skin fibroblasts to evaluate the ETV6 gene. In individuals with familial thrombocytopenia and a history of malignancy, ETV6 gene mutations are often implicated. Sending skin fibroblasts for analysis allows for genetic testing to identify any ETV6 gene mutations that may be present. Skin fibroblasts are commonly used for genetic testing as they provide a stable and reliable source of DNA. Choice A (Skin fibroblasts to evaluate the RUNXI gene) is incorrect because RUNXI gene mutations are not typically associated with familial thrombocytopenia and cancer predisposition syndromes. Choice C (Buccal swab to evaluate the RUNXI gene) is also incorrect for the same reason. Choice D (Buccal swab to evaluate the ETV6 gene) is incorrect because buccal swabs may not provide enough genetic material for comprehensive testing of the ETV6 gene, which is

Correct answer:

The correct answer is D, Left ventricle. The left ventricle is responsible for ejecting oxygenated blood into the systemic arterial circulation via the aorta. It receives oxygen-rich blood from the left atrium and pumps it out through the aorta to the rest of the body. Rationale: 1. The left ventricle receives blood from the left atrium, which has already been oxygenated in the lungs. 2. It is the chamber that generates the highest pressure to propel blood into the systemic circulation. 3. The aorta is the main artery that carries oxygenated blood away from the heart to the body. 4. The right atrium and right ventricle are involved in pumping deoxygenated blood to the lungs for oxygenation, not into the systemic circulation. 5. The left atrium receives oxygenated blood from the lungs but does not directly eject blood into the systemic arterial circulation.

Correct answer:

The correct answer is D: Decreased cardiac output related to cardiogenic shock. In a patient with STEMI, the low blood pressure (86/40 mm Hg) and high heart rate (132 beats/min) indicate poor cardiac output. Cardiogenic shock is a life-threatening condition that occurs due to decreased cardiac output. Restlessness and anxiety can be signs of inadequate tissue perfusion in cardiogenic shock. Addressing decreased cardiac output is crucial to prevent further deterioration. A: Acute pain is a common symptom in STEMI but not the priority when the patient is in cardiogenic shock. B: Anxiety is a valid concern, but the primary focus should be on addressing the physiological instability caused by decreased cardiac output. C: Stress overload can be a contributing factor, but the immediate priority is managing the cardiogenic shock to stabilize the patient's condition.

Correct answer:

The correct answer is A: Administer the metoprolol (Lopressor) and the hydrochlorothiazide (HydroDiuril), hold the captopril (Copoten), and notify the physician. Rationale: 1. Metoprolol and hydrochlorothiazide are commonly prescribed medications for hypertension. 2. Captopril is an ACE inhibitor and should be held due to potential interactions with the other medications. 3. Notifying the physician is crucial to ensure proper management and prevent adverse effects. Summary of other choices: B: Incorrect because holding metoprolol is not recommended as it is a common antihypertensive drug. C: Incorrect because administering all medications without addressing the potential interaction with captopril is unsafe. D: Incorrect because withholding all medications without administering any could lead to uncontrolled hypertension, risking the patient's health.

Correct answer:

The correct answer is A: It inhibits thrombin. Rivaroxaban is a direct factor Xa inhibitor, which works by specifically inhibiting the activity of factor Xa, a key enzyme in the coagulation cascade. By inhibiting factor Xa, rivaroxaban prevents the formation of thrombin, a crucial enzyme in the blood clotting process. Thrombin is responsible for converting fibrinogen to fibrin, which forms the meshwork of a blood clot. Therefore, by inhibiting thrombin formation, rivaroxaban effectively prevents blood clots from forming. Choice B is incorrect because rivaroxaban does not directly inhibit fibrinogen; it acts upstream by inhibiting factor Xa. Choice C is incorrect because rivaroxaban does not actually "thin" the blood like warfarin or heparin; it specifically targets factor Xa. Choice D is incorrect because rivaroxaban does not work against vitamin K like warfarin

Correct answer:

The correct answer is B: Skin fibroblasts to evaluate the ETV6 gene. In individuals with familial thrombocytopenia and a history of malignancy, ETV6 gene mutations are often implicated. Sending skin fibroblasts for analysis allows for genetic testing to identify any ETV6 gene mutations that may be present. Skin fibroblasts are commonly used for genetic testing as they provide a stable and reliable source of DNA. Choice A (Skin fibroblasts to evaluate the RUNXI gene) is incorrect because RUNXI gene mutations are not typically associated with familial thrombocytopenia and cancer predisposition syndromes. Choice C (Buccal swab to evaluate the RUNXI gene) is also incorrect for the same reason. Choice D (Buccal swab to evaluate the ETV6 gene) is incorrect because buccal swabs may not provide enough genetic material for comprehensive testing of the ETV6 gene, which is

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.

Correct answer:

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.

Correct answer:

The correct answer is C: Temperature of 104 F (40 C). A high temperature may indicate a potential serious side effect such as neuroleptic malignant syndrome, which is a life-threatening condition associated with antipsychotic use. This requires immediate medical attention to prevent complications. A: Respirations of 22 beats/minute - Normal respiratory rate is 12-20 breaths per minute, so 22 breaths per minute is slightly elevated but not an immediate concern. B: Weight gain of 8 pounds in 2 months - Weight gain is a common side effect of antipsychotic medications and may require monitoring and potential intervention, but it is not an immediate cause for concern. D: Excessive salivation - This is a common side effect of some antipsychotic medications but is not typically considered an urgent issue unless it is severe and causing distress to the client.