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 charge nurse is responsible for making the patient ass ignments on the critical care unit. She assigns the experienced, certified nurse to care for thea abicrbu.cteomly/t eisltl patient diagnosed with sepsis who also requires continuous renal replacement therapy and mechanical ventilation. She assigns the nurse with less than 1 year of experience to two patients who are more stable. This assignment reflects implementation of what guiding framework?
A. Crew resource management model
B. National Patient Safety Goals
C. Quality and Safety Education for Nurses (QSEN) mod el
D. Synergy model of practice
Show answer and rationale
Correct answer: D — Synergy model of practice
The correct answer is D: Synergy model of practice. The Synergy model emphasizes matching nurse competencies with patient needs for optimal outcomes. In this scenario, the charge nurse assigned the experienced, certified nurse to a complex patient requiring specialized care (sepsis, renal replacement therapy, ventilation), aligning with the model's principle of matching nurse expertise to patient acuity. Assigning the less experienced nurse to stable patients aligns with the model's focus on optimizing patient outcomes by matching nurse competencies appropriately.
A: Crew resource management model focuses on teamwork and communication to enhance safety, not specifically on nurse-patient assignments.
B: National Patient Safety Goals are broad guidelines for improving patient safety, not specific to nurse-patient assignments.
C: Quality and Safety Education for Nurses (QSEN) model focuses on integrating quality and safety competencies into nursing education, not specifically on nurse-patient assignments.
Question 2
Which of the following statements concerning potassium channel openers is true?
A. These agents decrease transmembrane calcium current associated in a smooth muscle with long-lasting relaxation and in a cardiac muscle with a reduction in contractility
B. These agents has a moderate reflex and vascular dilative action caused by the stimulation of sensitive nerve endings
C. Beneficial effects of these agents are related primarily to their hemodynamic effects – decreased heart rate, blood pressure, and contractility – which decrease myocardial oxygen requirements at rest and during exercise
D. These agents increase the permeability of K channels, probably ATP-dependent K channels, that results in stabilizing the membrane potential of excitable cells near the resting potential
Show answer and rationale
Correct answer: D — These agents increase the permeability of K channels, probably ATP-dependent K channels, that results in stabilizing the membrane potential of excitable cells near the resting potential
Correct Answer: D
Rationale:
1. Potassium channel openers increase the permeability of potassium channels, specifically ATP-dependent K channels.
2. This increased permeability results in stabilizing the membrane potential of excitable cells near the resting potential.
3. By stabilizing the membrane potential, these agents help regulate cell excitability and function.
4. This mechanism of action is crucial in conditions like cardiac arrhythmias and smooth muscle hyperactivity.
Summary of Incorrect Choices:
A. This statement incorrectly associates potassium channel openers with decreasing calcium current, which is not their primary mechanism of action.
B. This statement inaccurately attributes reflex and vascular dilative actions to potassium channel openers, which are not their primary effects.
C. This statement wrongly suggests that the beneficial effects of potassium channel openers are primarily hemodynamic, while their main mechanism is through potassium channel permeability modulation.
Question 3
A patient is undergoing abdominal surgery and has been anesthetized for 3 hours. Which nursing diagnosis would be appropriate for this patient?
A. Anxiety related to the use of an anesthetic
B. Risk for injury related to increased sensorium from general anesthesia
C. Decreased cardiac output related to systemic effects of local anesthesia
D. Impaired gas exchange related to central nervous system depression produced by general anesthesia
Show answer and rationale
Correct answer: D — Impaired gas exchange related to central nervous system depression produced by general anesthesia
The correct answer is D: Impaired gas exchange related to central nervous system depression produced by general anesthesia. During abdominal surgery under general anesthesia, the patient's central nervous system is depressed, leading to impaired gas exchange. This is due to decreased respiratory drive and potential airway obstruction. It is essential for the nurse to monitor the patient's respiratory rate, depth, and oxygen saturation to prevent respiratory complications.
Choice A (Anxiety related to the use of an anesthetic) is incorrect because anxiety is not a priority nursing diagnosis during surgery under anesthesia. Choice B (Risk for injury related to increased sensorium from general anesthesia) is incorrect as general anesthesia actually decreases sensorium, reducing the risk for injury. Choice C (Decreased cardiac output related to systemic effects of local anesthesia) is incorrect as local anesthesia does not typically affect cardiac output during abdominal surgery under general anesthesia.
Question 4
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.”
B. “Restrict food and fluids for 24 hours and stay in bed.”
C. “Drink a large glass of water with 1 teaspoon of salt added.”
D. “Take antidiarrheal medication hourly until the diarrhea subsides.”
Show answer and rationale
Correct answer: A — “Have someone bring you to the clinic immediately.”
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.
Question 5
A patient is undergoing abdominal surgery and has been anesthetized for 3 hours. Which nursing diagnosis would be appropriate for this patient?
A. Anxiety related to the use of an anesthetic
B. Risk for injury related to increased sensorium from general anesthesia
C. Decreased cardiac output related to systemic effects of local anesthesia
D. Impaired gas exchange related to central nervous system depression produced by general anesthesia
Show answer and rationale
Correct answer: D — Impaired gas exchange related to central nervous system depression produced by general anesthesia
The correct answer is D: Impaired gas exchange related to central nervous system depression produced by general anesthesia. During abdominal surgery under general anesthesia, the patient's central nervous system is depressed, leading to impaired gas exchange. This is due to decreased respiratory drive and potential airway obstruction. It is essential for the nurse to monitor the patient's respiratory rate, depth, and oxygen saturation to prevent respiratory complications.
Choice A (Anxiety related to the use of an anesthetic) is incorrect because anxiety is not a priority nursing diagnosis during surgery under anesthesia. Choice B (Risk for injury related to increased sensorium from general anesthesia) is incorrect as general anesthesia actually decreases sensorium, reducing the risk for injury. Choice C (Decreased cardiac output related to systemic effects of local anesthesia) is incorrect as local anesthesia does not typically affect cardiac output during abdominal surgery under general anesthesia.
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Question 6
A patient who is being admitted to the emergency department with intermittent chest pain gives the following list of daily medications to the nurse. Which medication has the most immediate implications for the patient’s care?
A. captopril
B. sildenafil (Viagra)
C. furosemide (Lasix)
D. warfarin (Coumadin)
Correct answer:
The correct answer is B: sildenafil (Viagra). Sildenafil is a phosphodiesterase-5 inhibitor used for erectile dysfunction and pulmonary arterial hypertension. It is contraindicated with nitrates due to the risk of severe hypotension. Given the patient's intermittent chest pain, which may suggest underlying cardiovascular issues, the use of sildenafil raises concerns about potential interactions with nitrate medications that may be needed for chest pain. This interaction can lead to a significant drop in blood pressure and exacerbate the patient's condition.
A: Captopril is an ACE inhibitor used for hypertension. While important to monitor, it does not have immediate implications based on the patient's current presentation.
C: Furosemide is a diuretic used for fluid overload. It is important in heart failure management but does not have immediate implications in this context.
D: Warfarin is an anticoagulant used for thromboembolic disorders. While important for long-term management, it does
Which of the following statements concerning potassium channel openers is true?
A. These agents decrease transmembrane calcium current associated in a smooth muscle with long-lasting relaxation and in a cardiac muscle with a reduction in contractility
B. These agents has a moderate reflex and vascular dilative action caused by the stimulation of sensitive nerve endings
C. Beneficial effects of these agents are related primarily to their hemodynamic effects – decreased heart rate, blood pressure, and contractility – which decrease myocardial oxygen requirements at rest and during exercise
D. These agents increase the permeability of K channels, probably ATP-dependent K channels, that results in stabilizing the membrane potential of excitable cells near the resting potential
Correct answer:
Correct Answer: D
Rationale:
1. Potassium channel openers increase the permeability of potassium channels, specifically ATP-dependent K channels.
2. This increased permeability results in stabilizing the membrane potential of excitable cells near the resting potential.
3. By stabilizing the membrane potential, these agents help regulate cell excitability and function.
4. This mechanism of action is crucial in conditions like cardiac arrhythmias and smooth muscle hyperactivity.
Summary of Incorrect Choices:
A. This statement incorrectly associates potassium channel openers with decreasing calcium current, which is not their primary mechanism of action.
B. This statement inaccurately attributes reflex and vascular dilative actions to potassium channel openers, which are not their primary effects.
C. This statement wrongly suggests that the beneficial effects of potassium channel openers are primarily hemodynamic, while their main mechanism is through potassium channel permeability modulation.
A patient with non-Hodgkin's lymphoma is receiving information from the oncology nurse. The patient asks the nurse why she should stop drinking and smoking and stay out of the sun. What would be the nurse's best response?
A. Everyone should do these things because they're health promotion activities that apply to everyone.
B. You don't want to develop a second cancer, do you?
C. You need to do this just to be on the safe side.
D. It's important to reduce other factors that increase the risk of second cancers.
Correct answer:
The correct answer is D because reducing factors that increase the risk of second cancers is crucial for a patient with non-Hodgkin's lymphoma due to the potential for developing secondary cancers. Alcohol, smoking, and sun exposure are known risk factors for various cancers, including secondary cancers. By avoiding these behaviors, the patient can decrease the likelihood of developing another cancer.
Choice A is incorrect because while health promotion activities are beneficial, the specific reason for a patient with non-Hodgkin's lymphoma to stop drinking, smoking, and avoiding sun exposure is to reduce the risk of second cancers, not just for general health.
Choice B is incorrect because it uses fear tactics and does not provide a clear rationale for why the patient should make these lifestyle changes.
Choice C is incorrect because it lacks a specific explanation for the importance of avoiding alcohol, smoking, and sun exposure in relation to reducing the risk of second cancers.
A patient who is being admitted to the emergency department with intermittent chest pain gives the following list of daily medications to the nurse. Which medication has the most immediate implications for the patient’s care?
A. captopril
B. sildenafil (Viagra)
C. furosemide (Lasix)
D. warfarin (Coumadin)
Correct answer:
The correct answer is B: sildenafil (Viagra). Sildenafil is a phosphodiesterase-5 inhibitor used for erectile dysfunction and pulmonary arterial hypertension. It is contraindicated with nitrates due to the risk of severe hypotension. Given the patient's intermittent chest pain, which may suggest underlying cardiovascular issues, the use of sildenafil raises concerns about potential interactions with nitrate medications that may be needed for chest pain. This interaction can lead to a significant drop in blood pressure and exacerbate the patient's condition.
A: Captopril is an ACE inhibitor used for hypertension. While important to monitor, it does not have immediate implications based on the patient's current presentation.
C: Furosemide is a diuretic used for fluid overload. It is important in heart failure management but does not have immediate implications in this context.
D: Warfarin is an anticoagulant used for thromboembolic disorders. While important for long-term management, it does
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€
Correct answer:
The correct answer is C, “What time did your chest pain begin?†This question is crucial in determining if the patient is within the time window for thrombolytic therapy, which is typically within the first 12 hours of symptom onset. This therapy is most effective when administered early after symptom onset to dissolve the blood clot causing the myocardial infarction. Asking about the time of chest pain onset helps assess if the patient falls within this critical treatment window.
Choice A, “Do you have any allergies?†is not directly relevant to the decision of thrombolytic therapy administration. Choice B, “Do you take aspirin on a daily basis?†is important for the patient’s medical history but does not directly impact the decision for thrombolytic therapy. Choice D, “Can you rate your chest pain using a 0 to 10 scale?†may provide information about the severity of pain but does not help in determining the eligibility for thrombolytic therapy based on the treatment
The nurse is caring for a patient following insertion of a left subclavian central venous catheter (CVC). Which action by the nurse best reduces th e risk of catheter-related bloodstream infection (CRBSI)?
A. Review daily the necessity of the central venous cathet er.
B. Cleanse the insertion site daily with isopropyl alcohol.
C. Change the pressurized tubing system and flush bag daily.
D. Maintain a pressure of 300 mm Hg on the flush bag.
Correct answer:
The correct answer is A: Review daily the necessity of the central venous catheter. This action reduces the risk of CRBSI by promoting early removal of unnecessary catheters, which is a key strategy in preventing infections. Unnecessary catheters increase the risk of infection due to prolonged exposure to the patient's skin flora and possible contamination during insertion. Reviewing daily ensures the catheter is only kept when necessary, minimizing the duration of catheter use and reducing the chances of infection.
Summary of other choices:
B: Cleansing the insertion site daily with isopropyl alcohol is important for maintaining skin integrity but does not directly reduce the risk of CRBSI.
C: Changing the pressurized tubing system and flush bag daily is important for maintaining catheter patency but does not directly reduce the risk of CRBSI.
D: Maintaining a pressure of 300 mm Hg on the flush bag is important for proper catheter function but does not directly reduce the risk of CR
A patient with non-Hodgkin's lymphoma is receiving information from the oncology nurse. The patient asks the nurse why she should stop drinking and smoking and stay out of the sun. What would be the nurse's best response?
A. Everyone should do these things because they're health promotion activities that apply to everyone.
B. You don't want to develop a second cancer, do you?
C. You need to do this just to be on the safe side.
D. It's important to reduce other factors that increase the risk of second cancers.
Correct answer:
The correct answer is D because reducing factors that increase the risk of second cancers is crucial for a patient with non-Hodgkin's lymphoma due to the potential for developing secondary cancers. Alcohol, smoking, and sun exposure are known risk factors for various cancers, including secondary cancers. By avoiding these behaviors, the patient can decrease the likelihood of developing another cancer.
Choice A is incorrect because while health promotion activities are beneficial, the specific reason for a patient with non-Hodgkin's lymphoma to stop drinking, smoking, and avoiding sun exposure is to reduce the risk of second cancers, not just for general health.
Choice B is incorrect because it uses fear tactics and does not provide a clear rationale for why the patient should make these lifestyle changes.
Choice C is incorrect because it lacks a specific explanation for the importance of avoiding alcohol, smoking, and sun exposure in relation to reducing the risk of second cancers.
A 13-year-old girl presents with acute myeloid leukemia (AML) and a WBC count of 120,000/mm3. Cytogenetics reveals a normal karyotype, and fluorescence in situ hybridization (FISH) tests for inv(16), t(8;21), t(15;17); 11q23 abnormalities; monosomy 7; and 5q deletion are negative. Molecular testing is negative for mutations in FLT3, NPM1, and CEBPA. She is treated with 10 days of daunorubicin, AraC, and gemtuzumab for induction therapy. On day 30, she recovers counts, and a bone marrow aspiration shows 2.2% leukemic blasts by flow cytometry. She receives a second course of treatment with daunorubicin and AraC, and her marrow is now in morphologic remission and is MRD-negative by flow cytometry. She has no HLA-matched siblings, but an unrelated donor search reveals a large number of potential matches. Which course of treatment is most likely to result in the best outcome?
A. Give two more courses of intensification chemotherapy.
B. Perform an autologous hematopoietic stem cell transplant (HSCT).
C. Give one more course of intensification chemotherapy and then perform a matched unrelated donor HSCT.
D. Give one more course of intensification chemotherapy and then 1 year of maintenance chemotherapy.
Correct answer:
The correct answer is C: Give one more course of intensification chemotherapy and then perform a matched unrelated donor HSCT.
Rationale:
1. The patient achieved morphologic remission and MRD-negative status after the second course of chemotherapy, indicating good response.
2. Given the high-risk AML with negative cytogenetics and molecular markers, HSCT from a matched unrelated donor offers the best chance for long-term remission.
3. HSCT provides a curative option by replacing the patient's diseased bone marrow with healthy donor cells, reducing the risk of relapse.
4. The presence of a large number of potential matched unrelated donors increases the likelihood of finding a suitable donor for the transplant.
Summary:
- Option A: Giving more courses of intensification chemotherapy may not address the high-risk nature of the disease and may not provide a curative outcome.
- Option B: Autologous HSCT uses the patient's own stem cells, which may carry the risk of relapse due
What test measures the electrical activity of the heart over a period of time, typically 24 to 48 hours?
A. Holter monitor
B. Echocardiogram
C. Stress test
D. Arterial blood gas (ABG)
Correct answer:
The correct answer is A: Holter monitor. A Holter monitor is a device that measures the electrical activity of the heart over an extended period, usually 24 to 48 hours. It is used to detect abnormal heart rhythms and assess how the heart responds to daily activities.
Explanation:
1. The Holter monitor records the heart's electrical activity continuously, providing a detailed analysis of any irregularities.
2. Unlike an echocardiogram, which uses sound waves to create images of the heart, the Holter monitor focuses on monitoring electrical signals.
3. A stress test evaluates the heart's performance under physical stress, not over an extended period like the Holter monitor.
4. Arterial blood gas (ABG) measures oxygen and carbon dioxide levels in the blood, not the heart's electrical activity.
In summary, the Holter monitor is the correct choice as it specifically measures the heart's electrical activity over an extended timeframe, distinguishing it from the other options.
The nurse is counseling a woman who will be starting rifampin (Rifadin) as part of antitubercular therapy. The patient is currently taking oral contraceptives. Which statement is true regarding rifampin therapy for this patient?
A. Women have a high risk for thrombophlebitis while on this drug.
B. A higher dose of rifampin will be necessary because of the contraceptive.
C. Oral contraceptives are less effective while the patient is taking rifampin.
D. The incidence of adverse effects is greater if the two drugs are taken together.
Correct answer:
The correct answer is C: Oral contraceptives are less effective while the patient is taking rifampin. Rifampin induces hepatic enzymes, which can accelerate the metabolism of oral contraceptives, leading to decreased contraceptive efficacy. This can result in breakthrough bleeding and potential contraceptive failure. It is important to advise the patient to use additional non-hormonal contraceptive methods while on rifampin therapy to prevent unintended pregnancy.
Incorrect answer explanations:
A: Women do not have a high risk for thrombophlebitis while on rifampin. Rifampin is not known to directly increase the risk of thrombophlebitis.
B: A higher dose of rifampin is not necessary because of the contraceptive. Rifampin does not interact with oral contraceptives in a way that requires a higher dose.
D: The incidence of adverse effects is not necessarily greater if the two drugs are taken together. Adverse effects are more related to individual drug reactions rather than a
RN exams cardiovascular practice questions, set 4 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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