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
The client is being given a calcium channel blocker. Calcium channel blockers have what effect on the heart?
A. They increase the preload on the heart.
B. They decrease the velocity of electrical activity on the AV node.
C. They block the sodium channels in the heart muscle.
D. They cause vasoconstriction of coronary arteries.
Show answer and rationale
Correct answer: B — They decrease the velocity of electrical activity on the AV node.
The correct answer is B: They decrease the velocity of electrical activity on the AV node. Calcium channel blockers specifically target calcium channels in the heart muscle, which slows down the influx of calcium ions responsible for electrical conduction in the heart. By reducing the velocity of electrical activity on the AV node, calcium channel blockers help to decrease heart rate and improve myocardial oxygen supply.
Incorrect choices:
A: They increase the preload on the heart - This is incorrect because calcium channel blockers do not directly affect preload, which is the volume of blood in the heart at the end of diastole.
C: They block the sodium channels in the heart muscle - This is incorrect because calcium channel blockers do not target sodium channels; they specifically inhibit calcium channels.
D: They cause vasoconstriction of coronary arteries - This is incorrect because calcium channel blockers actually have a vasodilatory effect on coronary arteries, which can help improve blood flow to the heart muscle.
Question 2
A patient with ST-segment elevation in three contiguous electrocardiographic leads is admitted to the emergency department and diagnosed as having an ST-segment-elevation myocardial infarction. Which question should the nurse ask to determine whether the patient is a candidate for thrombolytic therapy?
A. “Do you have any allergies?â€
B. “Do you take aspirin on a daily basis?â€
C. “What time did your chest pain begin?â€
D. “Can you rate your chest pain using a 0 to 10 scale?â€
Show answer and rationale
Correct answer: C — “What time did your chest pain begin?â€
The correct answer is C: “What time did your chest pain begin?†This question is crucial for determining if the patient is a candidate for thrombolytic therapy as the time of symptom onset is a key factor in deciding the eligibility for this treatment. Thrombolytic therapy is most effective when administered within a specific timeframe from the onset of symptoms, typically within the first few hours of symptom onset. Therefore, knowing the exact time when the chest pain started will help healthcare providers assess if the patient falls within the window of opportunity for thrombolytic therapy.
Choices A, B, and D are incorrect because they do not directly address the time-sensitive nature of thrombolytic therapy eligibility. Allergies and daily aspirin intake are important considerations in healthcare, but they are not immediate factors in determining thrombolytic therapy candidacy. The pain rating on a scale of 0 to 10 is subjective and does not provide specific information regarding the urgency of thrombolytic therapy
Question 3
A 2-year-old girl has a diagnosis of overall stage IV favorable histology Wilms' tumor with pulmonary metastases and local stage III disease due to finding positive lymph nodes. After she completes 6 weeks of vincristine/dactinomycin/doxorubicin (DD4A) chemotherapy, restaging shows complete resolution of some but not all lung nodules. Tumor genetic testing reveals combined loss of heterozygosity for 1p and 16q. Which of the following would be the most appropriate treatment plan?
A. Continue chemotherapy with vincristine, doxorubicin, and dactinomycin to complete 25 weeks of therapy. Administer radiation to lungs and flank.
B. Continue chemotherapy with vincristine, doxorubicin and dactinomycin to complete 25 weeks of therapy. Radiation to flank only. No lung radiation.
C. Continue chemotherapy with vincristine, doxorubicin and dactinomycin, add cyclophosphamide and etoposide to complete 33 weeks of therapy. Radiation to flank only. No lung radiation.
D. Continue chemotherapy with vincristine, doxorubicin and dactinomycin, add cyclophosphamide and etoposide to complete 33 weeks of therapy. Radiation to lungs and flank.
Show answer and rationale
Correct answer: D — Continue chemotherapy with vincristine, doxorubicin and dactinomycin, add cyclophosphamide and etoposide to complete 33 weeks of therapy. Radiation to lungs and flank.
The correct answer is D because the addition of cyclophosphamide and etoposide to the chemotherapy regimen is indicated for patients with combined loss of heterozygosity for 1p and 16q in Wilms' tumor. This genetic abnormality is associated with a higher risk of relapse and poorer outcomes. The extended duration of chemotherapy (33 weeks) is necessary to target any remaining tumor cells and reduce the risk of recurrence. Additionally, the decision to administer radiation to both the lungs and flank is appropriate given the incomplete resolution of some lung nodules after initial chemotherapy. Lung radiation helps to target any remaining metastatic lesions, while flank radiation targets the primary tumor site and positive lymph nodes. This comprehensive treatment approach aims to maximize the chances of long-term disease control and survival for the patient.
Choice A is incorrect because it lacks the addition of cyclophosphamide and etoposide, which are needed for Wilms' tumor with the specific genetic abnormality mentioned.
Question 4
A 2-year-old girl has a diagnosis of overall stage IV favorable histology Wilms' tumor with pulmonary metastases and local stage III disease due to finding positive lymph nodes. After she completes 6 weeks of vincristine/dactinomycin/doxorubicin (DD4A) chemotherapy, restaging shows complete resolution of some but not all lung nodules. Tumor genetic testing reveals combined loss of heterozygosity for 1p and 16q. Which of the following would be the most appropriate treatment plan?
A. Continue chemotherapy with vincristine, doxorubicin, and dactinomycin to complete 25 weeks of therapy. Administer radiation to lungs and flank.
B. Continue chemotherapy with vincristine, doxorubicin and dactinomycin to complete 25 weeks of therapy. Radiation to flank only. No lung radiation.
C. Continue chemotherapy with vincristine, doxorubicin and dactinomycin, add cyclophosphamide and etoposide to complete 33 weeks of therapy. Radiation to flank only. No lung radiation.
D. Continue chemotherapy with vincristine, doxorubicin and dactinomycin, add cyclophosphamide and etoposide to complete 33 weeks of therapy. Radiation to lungs and flank.
Show answer and rationale
Correct answer: D — Continue chemotherapy with vincristine, doxorubicin and dactinomycin, add cyclophosphamide and etoposide to complete 33 weeks of therapy. Radiation to lungs and flank.
The correct answer is D because the addition of cyclophosphamide and etoposide to the chemotherapy regimen is indicated for patients with combined loss of heterozygosity for 1p and 16q in Wilms' tumor. This genetic abnormality is associated with a higher risk of relapse and poorer outcomes. The extended duration of chemotherapy (33 weeks) is necessary to target any remaining tumor cells and reduce the risk of recurrence. Additionally, the decision to administer radiation to both the lungs and flank is appropriate given the incomplete resolution of some lung nodules after initial chemotherapy. Lung radiation helps to target any remaining metastatic lesions, while flank radiation targets the primary tumor site and positive lymph nodes. This comprehensive treatment approach aims to maximize the chances of long-term disease control and survival for the patient.
Choice A is incorrect because it lacks the addition of cyclophosphamide and etoposide, which are needed for Wilms' tumor with the specific genetic abnormality mentioned.
Question 5
The client is being given a calcium channel blocker. Calcium channel blockers have what effect on the heart?
A. They increase the preload on the heart.
B. They decrease the velocity of electrical activity on the AV node.
C. They block the sodium channels in the heart muscle.
D. They cause vasoconstriction of coronary arteries.
Show answer and rationale
Correct answer: B — They decrease the velocity of electrical activity on the AV node.
The correct answer is B: They decrease the velocity of electrical activity on the AV node. Calcium channel blockers specifically target calcium channels in the heart muscle, which slows down the influx of calcium ions responsible for electrical conduction in the heart. By reducing the velocity of electrical activity on the AV node, calcium channel blockers help to decrease heart rate and improve myocardial oxygen supply.
Incorrect choices:
A: They increase the preload on the heart - This is incorrect because calcium channel blockers do not directly affect preload, which is the volume of blood in the heart at the end of diastole.
C: They block the sodium channels in the heart muscle - This is incorrect because calcium channel blockers do not target sodium channels; they specifically inhibit calcium channels.
D: They cause vasoconstriction of coronary arteries - This is incorrect because calcium channel blockers actually have a vasodilatory effect on coronary arteries, which can help improve blood flow to the heart muscle.
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Question 6
A patient with ST-segment elevation in three contiguous electrocardiographic leads is admitted to the emergency department and diagnosed as having an ST-segment-elevation myocardial infarction. Which question should the nurse ask to determine whether the patient is a candidate for thrombolytic therapy?
A. “Do you have any allergies?”
B. “Do you take aspirin on a daily basis?”
C. “What time did your chest pain begin?”
D. “Can you rate your chest pain using a 0 to 10 scale?”
Correct answer:
The correct answer is C: “What time did your chest pain begin?” This question is crucial for determining if the patient is a candidate for thrombolytic therapy as the time of symptom onset is a key factor in deciding the eligibility for this treatment. Thrombolytic therapy is most effective when administered within a specific timeframe from the onset of symptoms, typically within the first few hours of symptom onset. Therefore, knowing the exact time when the chest pain started will help healthcare providers assess if the patient falls within the window of opportunity for thrombolytic therapy.
Choices A, B, and D are incorrect because they do not directly address the time-sensitive nature of thrombolytic therapy eligibility. Allergies and daily aspirin intake are important considerations in healthcare, but they are not immediate factors in determining thrombolytic therapy candidacy. The pain rating on a scale of 0 to 10 is subjective and does not provide specific information regarding the urgency of thrombolytic therapy
A patient is brought to the emergency department for treatment of a suspected overdose. The patient was found with an empty prescription bottle of a barbiturate by his bedside. He is lethargic and barely breathing. The nurse would expect which immediate intervention?
A. Starting an intravenous infusion of diluted bicarbonate solution
B. Administering medications to increase blood pressure
C. Implementing measures to maintain the airway and support respirations
D. Administrating naloxone (Narcan) as an antagonist
Correct answer:
The correct answer is C: Implementing measures to maintain the airway and support respirations. In cases of a suspected barbiturate overdose, the priority is to ensure the patient has a patent airway and is able to breathe adequately. This intervention is crucial as barbiturates can depress the central nervous system, leading to respiratory depression or even respiratory arrest. By maintaining the airway and supporting respirations, the nurse can prevent further complications such as hypoxia and ensure the patient's vital functions are stable.
Other choices are incorrect:
A: Starting an intravenous infusion of diluted bicarbonate solution - While bicarbonate may be used in certain cases of drug toxicity to correct acidosis, it is not the immediate intervention needed for a patient with a suspected barbiturate overdose.
B: Administering medications to increase blood pressure - This is not the priority in a case of barbiturate overdose where respiratory depression is the main concern.
D: Administrating naloxone (Nar
During which process does coronary artery blood flow to the myocardium occur during diastole, when coronary vascular resistance is reduced?
A. Coronary perfusion pressure
B. Coronary vascular resistance
C. Diastolic filling
D. Ventricular ejection
Correct answer:
The correct answer is A: Coronary perfusion pressure. Coronary perfusion pressure is the pressure gradient that drives blood flow through the coronary arteries into the myocardium during diastole when the coronary vascular resistance is reduced. This pressure gradient is essential for delivering oxygen and nutrients to the heart muscle when it is relaxed and filling with blood. During diastole, the coronary arteries receive blood flow predominantly due to the pressure difference between the aortic diastolic pressure and the pressure in the coronary vasculature.
Summary of why the other choices are incorrect:
B: Coronary vascular resistance - This factor is reduced during diastole, allowing for increased blood flow, but it does not directly drive blood flow to the myocardium.
C: Diastolic filling - This refers to the filling of blood into the ventricles of the heart, not specifically the flow of blood through the coronary arteries.
D: Ventricular ejection - This occurs during systole when the ventricles contract
A patient is brought to the emergency department for treatment of a suspected overdose. The patient was found with an empty prescription bottle of a barbiturate by his bedside. He is lethargic and barely breathing. The nurse would expect which immediate intervention?
A. Starting an intravenous infusion of diluted bicarbonate solution
B. Administering medications to increase blood pressure
C. Implementing measures to maintain the airway and support respirations
D. Administrating naloxone (Narcan) as an antagonist
Correct answer:
The correct answer is C: Implementing measures to maintain the airway and support respirations. In cases of a suspected barbiturate overdose, the priority is to ensure the patient has a patent airway and is able to breathe adequately. This intervention is crucial as barbiturates can depress the central nervous system, leading to respiratory depression or even respiratory arrest. By maintaining the airway and supporting respirations, the nurse can prevent further complications such as hypoxia and ensure the patient's vital functions are stable.
Other choices are incorrect:
A: Starting an intravenous infusion of diluted bicarbonate solution - While bicarbonate may be used in certain cases of drug toxicity to correct acidosis, it is not the immediate intervention needed for a patient with a suspected barbiturate overdose.
B: Administering medications to increase blood pressure - This is not the priority in a case of barbiturate overdose where respiratory depression is the main concern.
D: Administrating naloxone (Nar
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 could indicate impaired circulation to the right hand due to a complication related to the radial artery graft. Impaired circulation could lead to ischemia or even graft failure, which are serious concerns post coronary artery bypass grafting. This information is crucial to communicate to the health care provider for immediate intervention to prevent further complications.
Incorrect choices:
A: Complaints of incisional chest pain - While chest pain is important to monitor post-surgery, it is a common occurrence and may not indicate a serious complication.
C: Fine crackles heard at both lung bases - This finding may suggest fluid overload or pulmonary issues, but it is not directly related to the radial artery graft or its complications.
D: Redness on both sides of the sternal incision - Redness at the incision site can be a sign of infection, but it is not as urgent as the potential circulation issue in the right hand, which could
During which process does coronary artery blood flow to the myocardium occur during diastole, when coronary vascular resistance is reduced?
A. Coronary perfusion pressure
B. Coronary vascular resistance
C. Diastolic filling
D. Ventricular ejection
Correct answer:
The correct answer is A: Coronary perfusion pressure. Coronary perfusion pressure is the pressure gradient that drives blood flow through the coronary arteries into the myocardium during diastole when the coronary vascular resistance is reduced. This pressure gradient is essential for delivering oxygen and nutrients to the heart muscle when it is relaxed and filling with blood. During diastole, the coronary arteries receive blood flow predominantly due to the pressure difference between the aortic diastolic pressure and the pressure in the coronary vasculature.
Summary of why the other choices are incorrect:
B: Coronary vascular resistance - This factor is reduced during diastole, allowing for increased blood flow, but it does not directly drive blood flow to the myocardium.
C: Diastolic filling - This refers to the filling of blood into the ventricles of the heart, not specifically the flow of blood through the coronary arteries.
D: Ventricular ejection - This occurs during systole when the ventricles contract
A 3-year-old nonsyndromic, well-appearing male with no significant past medical history presents with an abdominal mass palpated by his mother when giving him a bath. CT imaging reveals a 9-cm right renal mass without involvement of the inferior vena cava (IVC) and no evidence of tumor thrombus by ultrasound. The left kidney appears normal, and there is no imaging evidence of tumor rupture or adherence to surrounding organs. There are diffuse, bilateral pulmonary metastases from which he is asymptomatic with a normal respiratory rate and no supplemental oxygen requirement. Following the National Wilms Tumor Study Group (NWTS)/Children's Oncology Group (COG) approach to pediatric renal tumors, which of the following are appropriate next steps?
A. Core biopsy of the renal mass followed by three drug chemotherapyâ€â€vincristine, actinomycin, and doxorubicin
B. Nephrectomy with lymph node sampling followed by chemotherapy based on histology and stage
C. Fine-needle aspiration followed by three drug chemotherapyâ€â€vincristine, actinomycin, and doxorubicin
D. Neoadjuvant three drug chemotherapyâ€â€vincristine, actinomycin and doxorubicinâ€â€followed by nephrectomy at week 6
Correct answer:
The correct answer is B: Nephrectomy with lymph node sampling followed by chemotherapy based on histology and stage. This is the appropriate next step following NWTS/COG approach for pediatric renal tumors. Nephrectomy is crucial to remove the primary tumor and obtain tissue for definitive histologic diagnosis. Lymph node sampling helps determine if there is spread to regional nodes. Based on the histology and stage determined post-nephrectomy, appropriate chemotherapy can be initiated tailored to the specific characteristics of the tumor.
Explanation of other choices:
A: Core biopsy followed by chemotherapy is not recommended as it may not provide sufficient tissue for histologic diagnosis and staging.
C: Fine-needle aspiration is not adequate for a definitive diagnosis or staging and may not provide enough tissue for necessary testing.
D: Neoadjuvant chemotherapy before surgery is not appropriate in this scenario as the primary tumor needs to be resected for accurate staging and histologic evaluation.
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 could indicate impaired circulation to the right hand due to a complication related to the radial artery graft. Impaired circulation could lead to ischemia or even graft failure, which are serious concerns post coronary artery bypass grafting. This information is crucial to communicate to the health care provider for immediate intervention to prevent further complications.
Incorrect choices:
A: Complaints of incisional chest pain - While chest pain is important to monitor post-surgery, it is a common occurrence and may not indicate a serious complication.
C: Fine crackles heard at both lung bases - This finding may suggest fluid overload or pulmonary issues, but it is not directly related to the radial artery graft or its complications.
D: Redness on both sides of the sternal incision - Redness at the incision site can be a sign of infection, but it is not as urgent as the potential circulation issue in the right hand, which could
A patient who takes lithium phones the nurse at the clinic to say, “I’ve had diarrhea for 4 days. I feel weak and unsteady when I walk. My usual hand tremor has gotten worse. What should I do?†Which instruction by the nurse is appropriate?
A. “Have someone bring you to the clinic immediately.â€
B. “Restrict food and fluids for 24 hours and stay in bed.â€
C. “Drink a large glass of water with 1 teaspoon of salt added.â€
D. “Take antidiarrheal medication hourly until the diarrhea subsides.â€
Correct answer:
The correct answer is A: "Have someone bring you to the clinic immediately." This is the appropriate instruction because the patient is experiencing symptoms of lithium toxicity, such as diarrhea, weakness, unsteadiness, and worsening hand tremor. Lithium toxicity is a serious condition that can lead to life-threatening complications if not treated promptly. Bringing the patient to the clinic immediately allows for proper evaluation, monitoring, and treatment by healthcare professionals.
Summary:
- Choice B: "Restrict food and fluids for 24 hours and stay in bed" is incorrect as it does not address the urgency of the situation and may worsen dehydration.
- Choice C: "Drink a large glass of water with 1 teaspoon of salt added" is incorrect as it can exacerbate the electrolyte imbalance caused by lithium toxicity.
- Choice D: "Take antidiarrheal medication hourly until the diarrhea subsides" is incorrect as it does not address the root cause of the symptoms and may delay necessary medical intervention.
A 3-year-old nonsyndromic, well-appearing male with no significant past medical history presents with an abdominal mass palpated by his mother when giving him a bath. CT imaging reveals a 9-cm right renal mass without involvement of the inferior vena cava (IVC) and no evidence of tumor thrombus by ultrasound. The left kidney appears normal, and there is no imaging evidence of tumor rupture or adherence to surrounding organs. There are diffuse, bilateral pulmonary metastases from which he is asymptomatic with a normal respiratory rate and no supplemental oxygen requirement. Following the National Wilms Tumor Study Group (NWTS)/Children's Oncology Group (COG) approach to pediatric renal tumors, which of the following are appropriate next steps?
A. Core biopsy of the renal mass followed by three drug chemotherapy—vincristine, actinomycin, and doxorubicin
B. Nephrectomy with lymph node sampling followed by chemotherapy based on histology and stage
C. Fine-needle aspiration followed by three drug chemotherapy—vincristine, actinomycin, and doxorubicin
D. Neoadjuvant three drug chemotherapy—vincristine, actinomycin and doxorubicin—followed by nephrectomy at week 6
Correct answer:
The correct answer is B: Nephrectomy with lymph node sampling followed by chemotherapy based on histology and stage. This is the appropriate next step following NWTS/COG approach for pediatric renal tumors. Nephrectomy is crucial to remove the primary tumor and obtain tissue for definitive histologic diagnosis. Lymph node sampling helps determine if there is spread to regional nodes. Based on the histology and stage determined post-nephrectomy, appropriate chemotherapy can be initiated tailored to the specific characteristics of the tumor.
Explanation of other choices:
A: Core biopsy followed by chemotherapy is not recommended as it may not provide sufficient tissue for histologic diagnosis and staging.
C: Fine-needle aspiration is not adequate for a definitive diagnosis or staging and may not provide enough tissue for necessary testing.
D: Neoadjuvant chemotherapy before surgery is not appropriate in this scenario as the primary tumor needs to be resected for accurate staging and histologic evaluation.
RN exams cardiovascular practice questions, set 3 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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