RN exams cardiovascular practice questions, set 30
RN exams · cardiovascular
RN exams cardiovascular practice questionsset 30
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
A client began taking lithium carbonate (Lithobid) for the treatment of bipolar disorder approximately 1 month ago. The client asks if it is normal to have gained 12 pounds in this time frame. Which is the appropriate nursing response?
A. “That’s strange. Weight loss is the typical pattern.”
B. “What have you been eating? Weight gain is not usually associated with lithium.”
C. “Weight gain is a common, but troubling, side effect.”
D. “Weight gain only occurs during the first month of treatment with this drug.”
Show answer and rationale
Correct answer: C — “Weight gain is a common, but troubling, side effect.”
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.
Question 2
A female patient's hematocrit level is 50% and oxygen saturation is 98% on room air. What should the nurse suspect as being the cause for this patient's hematocrit level?
A. Dehydration
B. Chronic renal failure
C. Bone marrow suppression
D. Bleeding esophageal varices
Show answer and rationale
Correct answer: A — Dehydration
The correct answer is A: Dehydration. When a patient is dehydrated, their blood volume decreases, leading to a relative increase in the concentration of red blood cells and hematocrit level. In this case, the patient's high hematocrit level of 50% indicates hemoconcentration due to dehydration. Oxygen saturation being normal suggests that the body is compensating for the decreased blood volume by maintaining adequate oxygen delivery.
Summary of incorrect choices:
B: Chronic renal failure would likely result in anemia due to decreased erythropoietin production.
C: Bone marrow suppression would lead to a decrease in red blood cell production, causing anemia.
D: Bleeding esophageal varices would result in acute blood loss and a decreased hematocrit level.
Question 3
The typical Reed-Sternberg cells are either infrequent or absent. Instead, lymphocytic and histiocytic cells or 'popcorn cells' are seen within a background of inflammatory cells, which are predominantly benign lymphocytes. Which type of Hodgkin's lymphoma best suit the description?
A. Nodular sclerosis
B. Mixed cellularity
C. Lymphocyte depleted
D. Lymphocyte predominance
Show answer and rationale
Correct answer: D — Lymphocyte predominance
The correct answer is D: Lymphocyte predominance. In this type of Hodgkin's lymphoma, the typical Reed-Sternberg cells are absent or rare. Instead, popcorn cells (lymphocytic and histiocytic cells) are seen among benign lymphocytes. This is characteristic of lymphocyte predominance subtype.
A: Nodular sclerosis - characterized by lacunar Reed-Sternberg cells in a background of collagen bands.
B: Mixed cellularity - characterized by numerous Reed-Sternberg cells, eosinophils, plasma cells, and histiocytes in a background of mixed inflammatory cells.
C: Lymphocyte depleted - characterized by few Reed-Sternberg cells in a background of fibrosis and few inflammatory cells.
Therefore, based on the description provided, choice D is the most appropriate answer.
Question 4
A 5-year-old boy presents with a 3-week history of his right eye “not moving to the right side.†The remainder of his neurologic exam is normal with the exception of a weak gag. MRI of the brain reveals a diffusely infiltrative mass in the pons. If this patient were to undergo a stereotactic biopsy, what would be the most likely molecular finding?
A. BRAFKIAA1549 fusion
B. Trisomy 21
C. H3 K27M mutation
D. RELA fusion
Show answer and rationale
Correct answer: C — H3 K27M mutation
The correct answer is C: H3 K27M mutation. This mutation is most commonly associated with diffuse intrinsic pontine gliomas (DIPG), which are high-grade brain tumors typically found in children. The presence of a diffusely infiltrative mass in the pons in a 5-year-old boy with neurological symptoms points towards a DIPG. Stereotactic biopsy of the mass would likely reveal the H3 K27M mutation, which is a key molecular finding in DIPG.
Choice A (BRAFKIAA1549 fusion) is incorrect as this fusion is typically associated with pilocytic astrocytomas, not DIPGs. Choice B (Trisomy 21) is incorrect as it is not a molecular finding commonly associated with DIPGs. Choice D (RELA fusion) is also incorrect as this fusion is more commonly seen in ependymomas, not DIPGs.
Question 5
Which type of heart disease involves the stiffening of the heart muscle, reducing its ability to relax and fill with blood?
A. Restrictive cardiomyopathy
B. Hypertrophic cardiomyopathy
C. Dilated cardiomyopathy
D. Ventricular hypertrophy
Show answer and rationale
Correct answer: A — Restrictive cardiomyopathy
The correct answer is A: Restrictive cardiomyopathy. This type of heart disease involves the stiffening of the heart muscle, leading to decreased ability to relax and fill with blood. Restrictive cardiomyopathy is characterized by abnormal stiffening of the heart muscle, impairing its ability to properly expand and contract during the cardiac cycle. This results in reduced filling of the heart chambers, leading to symptoms of heart failure.
Choice B: Hypertrophic cardiomyopathy involves thickening of the heart muscle, not stiffening.
Choice C: Dilated cardiomyopathy involves enlargement and weakening of the heart chambers, not stiffening.
Choice D: Ventricular hypertrophy is a general term for thickening of the heart muscle, not specific to stiffness.
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Question 6
What is a condition where the coronary arteries become narrowed or blocked, leading to reduced blood flow to the heart muscle?
A. Coronary artery disease (CAD)
B. Atherosclerosis
C. Stroke
D. Peripheral artery disease
Correct answer:
The correct answer is A: Coronary artery disease (CAD). CAD is the condition where the coronary arteries become narrowed or blocked, leading to reduced blood flow to the heart muscle. The narrowing or blockage is typically caused by atherosclerosis, which is the buildup of plaque in the arteries. Atherosclerosis is a contributing factor to CAD, but CAD specifically refers to the reduced blood flow in the coronary arteries. Stroke (C) is a condition involving the brain's blood vessels, not the heart. Peripheral artery disease (D) involves narrowing of arteries outside the heart, typically in the legs. Therefore, the most appropriate choice is A as it directly relates to the narrowed or blocked coronary arteries causing reduced blood flow to the heart muscle.
Which of the following is false regarding heparin?
A. Subcutaneous injection of heparin is avoided because of hematomas formation.
B. Heparin is usually stored in the mast cells.
C. Heparin binds to plasma anti thrombin III and inhibits activated thrombin.
D. Protamine sulfate can be used to counteract heparin overdose.
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.
The client has atrial fibrillation. What can the nurse say about the P wave?
A. It precedes a long PR interval
B. It falls on the previous T wave
C. The P wave is absent
D. It is peaked
Correct answer:
The correct answer is C: The P wave is absent. In atrial fibrillation, the atria are quivering and not contracting effectively, leading to the absence of distinct P waves on the ECG. This is due to the chaotic electrical activity in the atria.
Rationale:
A: The P wave does not precede a long PR interval in atrial fibrillation. Instead, the irregular electrical signals cause variable PR intervals.
B: The P wave falling on the previous T wave is not a characteristic of atrial fibrillation. The T wave represents ventricular repolarization, whereas the P wave reflects atrial depolarization.
D: The P wave being peaked is not relevant to atrial fibrillation. In this arrhythmia, the absence of distinct P waves is a key feature due to the erratic atrial activity.
What is a condition where the coronary arteries become narrowed or blocked, leading to reduced blood flow to the heart muscle?
A. Coronary artery disease (CAD)
B. Atherosclerosis
C. Stroke
D. Peripheral artery disease
Correct answer:
The correct answer is A: Coronary artery disease (CAD). CAD is the condition where the coronary arteries become narrowed or blocked, leading to reduced blood flow to the heart muscle. The narrowing or blockage is typically caused by atherosclerosis, which is the buildup of plaque in the arteries. Atherosclerosis is a contributing factor to CAD, but CAD specifically refers to the reduced blood flow in the coronary arteries. Stroke (C) is a condition involving the brain's blood vessels, not the heart. Peripheral artery disease (D) involves narrowing of arteries outside the heart, typically in the legs. Therefore, the most appropriate choice is A as it directly relates to the narrowed or blocked coronary arteries causing reduced blood flow to the heart muscle.
A patient who has started drug therapy for tuberculosis wants to know how long he will be on the medications. Which response by the nurse is correct?
A. “Drug therapy will last until the symptoms have stopped.â€
B. “Drug therapy will continue until the tuberculosis develops resistance.â€
C. “You should expect to take these drugs for as long as 24 months.â€
D. “You will be on this drug therapy for the rest of your life.â€
Correct answer:
The correct answer is C: “You should expect to take these drugs for as long as 24 months.†This is the correct response because drug therapy for tuberculosis typically lasts for 6 to 9 months for drug-sensitive TB and up to 24 months for drug-resistant TB. It is important to complete the full course of treatment to ensure complete eradication of the bacteria and prevent relapse.
Choice A is incorrect because relying solely on symptoms to determine the duration of treatment may lead to premature discontinuation of therapy. Choice B is incorrect as drug therapy is not based on waiting for resistance to develop. Choice D is incorrect because drug therapy for tuberculosis is not lifelong in most cases, except for certain scenarios of drug-resistant TB.
A 16-year-old patient with a left-side pelvic osteosarcoma is taking extended release oxycodone twice daily as well as immediate release oxycodone for breakthrough pain approximately 2 or 3 times per day. She describes her pain as burning, tingling, and shooting in her left leg. Her pain worsens with hot showers. Her most recent EKG has a QTc of 495. What would be the best strategy to manage her pain?
A. Switch from long-acting oxycodone to methadone.
B. Recommend more frequent use of her immediate release oxycodone.
C. Add amitriptyline daily. Start low and titrate upward on dosage.
D. Add gabapentin three times daily. Start low and titrate upward on dose.
Correct answer:
The correct answer is D: Add gabapentin three times daily. Gabapentin is a first-line option for neuropathic pain, which is likely the cause of the patient's burning, tingling, and shooting leg pain. The worsening of pain with hot showers is also characteristic of neuropathic pain. Gabapentin's mechanism of action in reducing neuropathic pain makes it a suitable choice for this patient. Switching to methadone (A) may not directly address the neuropathic pain component. Recommending more frequent use of immediate release oxycodone (B) may lead to increased risk of opioid-related adverse effects. While amitriptyline (C) is also used for neuropathic pain, starting with gabapentin is more appropriate given the patient's current opioid regimen and EKG findings.
The patient is experiencing phantom pain following the amputation of her foot. Which type of pain is most associated with phantom pain?
A. Neuropathic
B. Somatic
C. Visceral
D. Referred
Correct answer:
The correct answer is A: 'Neuropathic.' Phantom pain is a type of neuropathic pain that occurs after the amputation of a body part, such as a limb. Neuropathic pain is characterized by shooting or burning sensations that are caused by damage or dysfunction in the nervous system. In the case of phantom pain, the brain continues to receive pain signals from the nerves that used to supply the amputated limb, leading to the sensation of pain in the missing body part. Somatic pain (B) is associated with the skin, muscles, and bones; visceral pain (C) originates from internal organs; and referred pain (D) is felt in a different location than the actual source of pain. Therefore, neuropathic pain is the most closely associated type of pain with phantom pain.
A nurse is reviewing a client\'s medication for potential interactions. What should be a concern?
A. Taking multiple medications that affect liver function
B. Combining medications that cause drowsiness
C. Using herbal supplements with prescription drugs
D. Mixing medications that affect heart rate
Correct answer:
The correct answer is A: 'Taking multiple medications that affect liver function.' When a client is taking multiple medications that affect liver function, there is a higher risk for drug interactions and potential liver damage. The liver plays a crucial role in metabolizing medications, and if multiple drugs affect its function, it can lead to toxicity or reduce the effectiveness of certain medications. Monitoring liver function and adjusting the medication regimen is essential to prevent adverse effects. While the other options (B, C, and D) are also important considerations when reviewing medication interactions, the potential impact on liver function is a significant concern due to its role in drug metabolism and overall health.
A patient is suspected of having malaria. Which mode of transmission spreads malaria?
A. Droplet
B. Contact
C. Vector
D. Vehicle
Correct answer:
The correct answer is B: Contact. Malaria is transmitted through the bite of an infected mosquito, which is considered a form of contact transmission. Mosquitoes act as vectors, carrying the Plasmodium parasite from person to person through their bites. Droplet transmission involves respiratory droplets expelled when an infected person coughs or sneezes, which is not the mode of transmission for malaria. Vehicle transmission involves inanimate objects or substances carrying the infectious agent, which is also not applicable to malaria. Understanding the mode of transmission of malaria is crucial in implementing preventive measures such as using insect repellent, bed nets, and antimalarial medications in affected areas.
A nurse is educating a client on smoking cessation. What is an effective strategy?
A. Gradual reduction in smoking frequency
B. Nicotine replacement therapy
C. Acupuncture
D. Counseling and support groups
Correct answer:
Nicotine replacement therapy (NRT) is an effective strategy for smoking cessation because it helps reduce withdrawal symptoms by providing controlled amounts of nicotine without the harmful chemicals found in cigarettes. NRT can come in various forms such as patches, gum, lozenges, or inhalers, making it a flexible option for individuals trying to quit smoking. Gradual reduction in smoking frequency may not be as effective as NRT because it does not address the physical addiction to nicotine. Acupuncture is not supported by strong scientific evidence for smoking cessation, while counseling and support groups can be beneficial in conjunction with NRT to address the psychological aspects of quitting smoking.
RN exams cardiovascular practice questions, set 30 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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