RN exams cardiovascular practice questions set 6

Correct answer:

The correct answer is B: Hyperleukocytosis; leukapheresis or manual exchange transfusion and initiation of induction chemotherapy. In this scenario, the patient's symptoms and lab findings are consistent with acute myeloid leukemia (AML) with leukostasis, causing hypoxia and interstitial infiltrates. Leukapheresis or manual exchange transfusion is crucial to rapidly reduce the high white blood cell count, which can help alleviate symptoms and prevent complications like tissue hypoxia. Initiation of induction chemotherapy is also essential for long-term management of AML. Rationale for why other choices are incorrect: A: Hyperleukocytosis alone without leukostasis does not typically require immediate leukoreduction, as in this case. Induction chemotherapy should be initiated promptly to address the underlying AML. C: COVID-19 infection would not typically present with such profound leukocytosis and monocytic morphology. Convalescent plasma and prednisone are not

Correct answer:

The correct answer is D: Check the infant's apical pulse for 1 minute. Before administering digoxin, it is crucial to assess the apical pulse for a full minute to ensure the heart rate is within the appropriate range (usually above 100 bpm in infants). Digoxin can cause bradycardia, so monitoring the apical pulse is essential to prevent potential adverse effects. A: Taking the infant's blood pressure is not the most appropriate intervention before administering digoxin as the focus should be on assessing the heart rate specifically. B: Checking the infant's respiratory rate is not directly related to the administration of digoxin, and assessing the pulse rate is more relevant. C: Checking the infant's radial pulse is not as accurate as assessing the apical pulse when monitoring for potential digoxin-induced changes in heart rate. In summary, the most appropriate intervention before digoxin administration is to check the infant's apical pulse for 1 minute to

Correct answer:

The correct answer is B because autologous hematopoietic stem cell transplantation should be used when it can provide a survival benefit over chemotherapy. This approach is particularly beneficial for certain cancers such as neuroblastoma and relapsed lymphoma. - Choice A is incorrect because the indication for autologous transplantation is not solely based on the need for high-dose therapy, but rather on providing a meaningful survival benefit over chemotherapy. The listed cancers are not the most common ones treated with this approach. - Choice C is incorrect because the graft-versus-tumor effect is actually desired in some cases of autologous transplantation, and the listed cancers are not the most common ones treated with this approach. - Choice D is incorrect because the purpose of autologous transplantation is not to avoid extensive chemotherapy but to provide a survival benefit. The listed cancers are not the most common ones treated with this approach.

Correct answer:

The correct answer is A because in a client presenting with substernal chest pain, electrocardiographic changes, and elevated cardiac troponin level, the priority is to improve myocardial oxygenation and reduce cardiac workload. This is crucial to prevent further damage to the heart muscle and potential complications like myocardial infarction. By focusing on improving oxygen supply and reducing workload, the nurse can help stabilize the client's condition and prevent further cardiac events. Choice B is incorrect because while confirming the diagnosis and preventing complications are essential, the immediate focus should be on addressing the physiological needs of the heart. Choice C is incorrect as reducing anxiety and relieving pain are important but secondary to addressing the underlying cardiac issue. Choice D is incorrect as eliminating stressors and providing a nondemanding environment may be beneficial but not the immediate priority in this situation.

Correct answer:

The correct answer is A: Cure of the disease. The main goal of care for a patient with Hodgkin lymphoma is to achieve a cure whenever possible. This is because Hodgkin lymphoma is a potentially curable cancer with appropriate treatment. Achieving a cure means eradicating the cancer cells completely and preventing its recurrence in the future. This is the most desirable outcome for the patient's long-term health and well-being. Incorrect choices: B: Enhancing quality of life - While improving the patient's quality of life is important, the primary goal in treating Hodgkin lymphoma is to cure the disease. C: Controlling symptoms - Symptom management is important in providing comfort to the patient, but the main goal is to cure the disease. D: Palliation - Palliative care focuses on relieving symptoms and improving quality of life in patients with advanced or incurable diseases. For Hodgkin lymphoma, the main goal is to aim for a cure rather than palliation.

Correct answer:

The correct answer is D because it demonstrates the patient's understanding of the appropriate action to take if chest pain persists after taking nitroglycerin. This response shows that the patient comprehends the importance of seeking immediate medical attention if the chest pain is not relieved by the medication. Explanation for why other choices are incorrect: A: Choice A is incorrect because nausea is not a common side effect of nitroglycerin. B: Choice B is incorrect as nitroglycerin is used to relieve chest pain during an angina attack, not just when chest pain is present. C: Choice C is incorrect as nitroglycerin works by dilating blood vessels to improve blood flow, not by preventing clot formation. In summary, choice D is correct as it reflects the patient's understanding of the appropriate action to take in case of persistent chest pain after taking nitroglycerin, while the other choices demonstrate misunderstandings about nitroglycerin use.

Correct answer:

The correct answer is D: Ristoectin cofactor activity. This patient's history of significant menstrual bleeding, epistaxis, and low hemoglobin suggests a congenital bleeding disorder. Ristoectin cofactor activity is a test for von Willebrand disease (VWD), a common inherited bleeding disorder characterized by a deficiency or dysfunction of von Willebrand factor. VWD typically presents with mucocutaneous bleeding, such as epistaxis and menorrhagia. Choice A: Factor XI level is not the most likely diagnosis as Factor XI deficiency (Hemophilia C) typically presents with bleeding after surgery or trauma, not mucocutaneous bleeding. Choice B: Factor X level is not the most likely diagnosis as Factor X deficiency presents with bleeding that is more severe and can cause hemarthrosis, not typically seen in this patient. Choice C: Factor XIII level is not the most likely diagnosis as Factor XIII deficiency leads to delayed wound healing and poor clot formation,

Correct answer:

The correct answer is A: Hold 1 to 2 doses of warfarin and recheck INR. In this scenario, the high INR indicates an increased risk of bleeding due to excess anticoagulation. However, since the patient is asymptomatic and the high INR is likely due to transient factors (gastrointestinal illness), the most appropriate initial step is to temporarily hold warfarin to allow the INR to normalize. Rechecking the INR after holding the doses will guide further management. Choice B (Administer oral vitamin K therapy) is incorrect because the patient is not experiencing bleeding symptoms and oral vitamin K should be reserved for patients with active bleeding or high INR with bleeding symptoms. Choice C (Administer fresh frozen plasma) is inappropriate as the patient is not actively bleeding and FFP is typically reserved for acute bleeding situations. Choice D (Administer recombinant factor VIIa) is also incorrect as it is reserved for severe bleeding in patients on war

Correct answer:

The correct answer is D: Send a skin fibroblast culture for Fanconi anemia testing. This is the most important next step in management because the patient's family history, particularly the sister's unresponsiveness to ATG and cyclosporine and the cousin's history of leukemia, raises suspicion for Fanconi anemia. Testing for Fanconi anemia is crucial as it is an inherited bone marrow failure syndrome that predisposes individuals to aplastic anemia and leukemia. Skin fibroblast culture is the preferred test for diagnosing Fanconi anemia as it can detect chromosomal abnormalities indicative of the disease. Options A and B are not appropriate as the patient's sister did not respond to ATG and cyclosporine, and searching for a donor for transplant without confirming the underlying cause of aplastic anemia could lead to transplant failure. Option C is also not the best choice as the peripheral blood sample test for Fanconi anemia was already negative, and a skin fib

Correct answer:

The correct answer is D: Reinforcement of teaching about the purpose of prescribed medications. This task is appropriate for delegation to an LPN/LVN because it involves reinforcing previously taught information to the patient, which does not require advanced assessment or critical thinking skills. LPN/LVNs are typically trained to provide education and reinforcement of information to patients under the supervision of an RN. Choice A is incorrect because evaluating the patient's response to walking in the hallway requires ongoing assessment and monitoring, which should be done by an RN. Choice B is incorrect as completing a referral form involves making decisions about follow-up care, which is beyond the scope of an LPN/LVN. Choice C is incorrect because educating the patient about the pathophysiology of heart disease requires a comprehensive understanding of the disease process and is best done by an RN or healthcare provider with advanced knowledge.