RN exams cardiovascular practice questions set 27

Correct answer:

Step-by-step rationale: 1. Subcutaneous injection of heparin is avoided due to the risk of hematoma formation at the injection site. 2. This statement is false because heparin is commonly administered subcutaneously for prophylaxis of thromboembolic events. 3. The preferred route for heparin administration is subcutaneous or intravenous. 4. Therefore, choice A is the false statement. Summary: - Choice A is incorrect as heparin is commonly given subcutaneously. - Choice B is incorrect as heparin is not stored in mast cells but in specialized granules in mast cells. - Choice C is correct as heparin binds to plasma antithrombin III to inhibit thrombin. - Choice D is correct as protamine sulfate can reverse heparin's anticoagulant effects in case of overdose.

Correct answer:

Rationale: 1. Type I familial hyperlipoproteinemia is characterized by increased chylomicrons and triglycerides in the serum, which decrease with a fat-free diet. 2. High- and low-density lipoproteins decrease with a fat-free diet, contrary to other types of hyperlipoproteinemia. 3. Tissue lipoprotein lipase activity is decreased in type I familial hyperlipoproteinemia. 4. Other choices are incorrect because they do not accurately describe the characteristics and pathophysiology of type I familial hyperlipoproteinemia. Summary: Choice A is correct as it aligns with the hallmark features of type I familial hyperlipoproteinemia. Choices B, C, and D contain inaccuracies regarding the lipid profile, genetic basis, and response to dietary changes in this condition.

Correct answer:

The correct answer is A: Infuse a von Willebrand factor concentrate. In this case, the 4-year-old girl with a factor VIII deficiency did not respond to recombinant factor VIII, suggesting a possible von Willebrand disease (vWD) as well. Infusing von Willebrand factor concentrate can help address the underlying vWD component, which is necessary for adequate hemostasis. Option B is incorrect because giving another dose of recombinant factor VIII won't address the potential vWD deficiency. Option C is not the best next step as packing the nose does not address the underlying bleeding disorder. Option D is not the immediate next step as checking for a factor VIII inhibitor is important but can be done after addressing the acute bleeding episode with appropriate therapy.

Correct answer:

The correct answer is A: Nodular sclerosis subtype of Hodgkin's lymphoma. It is common in young women due to its peak incidence in the 20s-30s. This subtype has a good prognosis as it is the most indolent with a high cure rate. It is characterized by fibrotic bands dividing the lymph node into nodules, containing lacunar (Reed-Sternberg) cells. The other choices (B: Mixed cellularity, C: Lymphocyte predominance, D: Lymphocyte depletion) are incorrect: B: Mixed cellularity is more common in older adults and has a less favorable prognosis. C: Lymphocyte predominance is rare and has a favorable prognosis, but it is more common in young males, not young women. D: Lymphocyte depletion is rare, aggressive, and associated with a poor prognosis, not common in young women.

Correct answer:

Step-by-step rationale: 1. Handling pacemaker leads and a toaster simultaneously can lead to interference with the device, so the patient understands the importance of avoiding this. 2. This answer demonstrates awareness of potential risks and shows the patient's commitment to safety. 3. Options B, C, and D do not directly address safe care of the pacemaker site or demonstrate understanding of potential risks. 4. Option B focuses on obtaining a medic alert tag but does not address specific care instructions for the pacemaker site. 5. Option C assumes that the OR environment guarantees no risk of infection, which is incorrect. 6. Option D's reference to avoiding a home microwave is not necessary for pacemaker care unless the microwave is very old and poorly shielded.

Correct answer:

The correct answer is A: Clarify the prescription with the provider. Desmopressin is a medication that can cause hyponatremia, especially in patients with low sodium levels like this client. Before administering desmopressin, the nurse should consult with the provider to ensure it is safe to administer the medication given the client's sodium level. Administering the drug without clarifying may worsen the hyponatremia. Choice B is incorrect because administering the drug with an analgesic is not necessary or relevant in this situation. Choice C is incorrect because desmopressin is typically administered via injection, not orally. Choice D is incorrect because assessing factor IX levels is not directly related to the administration of desmopressin in this scenario.

Correct answer:

The correct answer is B: Increased homocysteine level. Elevated homocysteine is a well-established risk factor for cardiovascular disease and stroke. High levels of homocysteine can damage the lining of blood vessels and promote blood clot formation. This increases the risk of atherosclerosis, leading to cardiovascular events. Incorrect choices: A: Decreased antidiuretic hormone - This hormone regulates water balance and does not directly contribute to cardiovascular disease or stroke. C: Decreased triglycerides - Low triglycerides are not a significant risk factor for cardiovascular disease and stroke. D: Increased high-density lipoprotein level - High levels of HDL cholesterol are actually beneficial and protective against cardiovascular disease and stroke.

Correct answer:

The correct answer is B because the patient's vital signs have changed post-procedure, indicating a potential complication. Checking the complete blood count report is the least important at this time as it does not immediately impact the patient's current condition. A: Observing the puncture site is important to assess for bleeding or infection. C: Asking about lightheadedness or dizziness is crucial to monitor for signs of hypovolemia or shock. D: Determining medications taken before the procedure is essential to identify any potential interactions or adverse effects. In summary, monitoring vital signs, assessing the puncture site, and checking for symptoms of hypovolemia or shock are more critical post-procedure than reviewing the complete blood count report.

Correct answer:

The correct answer is A: Infuse a von Willebrand factor concentrate. In this case, the 4-year-old girl with a factor VIII deficiency did not respond to recombinant factor VIII, suggesting a possible von Willebrand disease (vWD) as well. Infusing von Willebrand factor concentrate can help address the underlying vWD component, which is necessary for adequate hemostasis. Option B is incorrect because giving another dose of recombinant factor VIII won't address the potential vWD deficiency. Option C is not the best next step as packing the nose does not address the underlying bleeding disorder. Option D is not the immediate next step as checking for a factor VIII inhibitor is important but can be done after addressing the acute bleeding episode with appropriate therapy.

Correct answer:

The correct answer is C: “Weight gain is a common, but troubling, side effect.” This response acknowledges the client's concern, validates their experience, and provides accurate information. Weight gain is a known side effect of lithium carbonate, affecting a significant number of individuals. It is essential for the nurse to acknowledge this common side effect to educate and support the client effectively. Choice A is incorrect because weight gain, not weight loss, is typically associated with lithium carbonate. Choice B is incorrect as it implies the client is solely responsible for the weight gain, which may lead to feelings of guilt or shame. Choice D is incorrect because weight gain can occur beyond the first month of treatment with lithium carbonate.