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 patient had a non–ST-segment-elevation myocardial infarction (NSTEMI) 3 days ago. Which nursing intervention included in the plan of care is appropriate for the registered nurse (RN) to delegate to an experienced licensed practical/vocational nurse (LPN/LVN)?
A. Evaluation of the patient’s response to walking in the hallway
B. Completion of the referral form for a home health nurse follow-up
C. Education of the patient about the pathophysiology of heart disease
D. Reinforcement of teaching about the purpose of prescribed medications
Show answer and rationale
Correct answer: D — Reinforcement of teaching about the purpose of prescribed medications
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.
Question 2
A patient with abdominal injuries from a motor vehicle crash is scheduled for surgery to remove the spleen. What bodily function will be affected by the removal of this organ?
A. Filtration of waste products
B. Removal of old red blood cells from circulation
C. Clearance of mucous in the tracheobronchial tree
D. Facilitation of glucose to be used by the cell for energy
Show answer and rationale
Correct answer: B — Removal of old red blood cells from circulation
The correct answer is B: Removal of old red blood cells from circulation. The spleen plays a crucial role in filtering and removing old or damaged red blood cells from circulation. When the spleen is removed, this function is compromised, leading to a decrease in the body's ability to clear out these cells efficiently. This can result in an increased risk of anemia and other complications related to the buildup of old red blood cells in the bloodstream.
A: Filtration of waste products - While the spleen does play a role in filtering blood, its primary function is related to red blood cells, not waste products.
C: Clearance of mucous in the tracheobronchial tree - This function is primarily carried out by the respiratory system, particularly the cilia and mucous membranes in the airways, not the spleen.
D: Facilitation of glucose to be used by the cell for energy - This function is primarily related to the pancreas and insulin production, not the
Question 3
A newborn infant develops jaundice on day of life 2. Labs are drawn, and she has a hemoglobin of 7.4 g/dL with a reticulocyte count of 8%. Upon peripheral blood smear review, she is found to have bizarre red cell forms with significant polkilocytosis. Although her parents have normal blood counts, on review of their peripheral blood smears, they both have a moderate number of ovalocytes. Which of the following is the most likely cause of the infant's red cell findings?
A. She has an autosomal dominant ankyrin mutation from one of her parents causing hereditary spherocytosis.
B. She has inherited band 3 variants from each parent and will likely need a splenectomy after she turns 5 years old.
C. She has inherited an alpha-spectrin mutation from both of her parents and may experience an improvement in her anemia over time.
D. She has inherited a PKLR variant from each parent, and enzyme testing will be consistent with her diagnosis of pyruvate kinase deficiency.
Show answer and rationale
Correct answer: C — She has inherited an alpha-spectrin mutation from both of her parents and may experience an improvement in her anemia over time.
The correct answer is C because the infant's red cell findings of ovalocytes and polikilocytosis are consistent with hereditary elliptocytosis, which is caused by mutations in genes encoding spectrin. In this scenario, the inheritance pattern aligns with the infant receiving an alpha-spectrin mutation from both parents, leading to the observed erythrocyte abnormalities. This condition may improve over time due to compensatory mechanisms.
Choice A (autosomal dominant ankyrin mutation causing hereditary spherocytosis) is incorrect because the clinical presentation and red cell morphology do not support a diagnosis of hereditary spherocytosis.
Choice B (inherited band 3 variants and need for splenectomy) is incorrect as the infant's condition does not match the characteristics of hereditary spherocytosis requiring splenectomy.
Choice D (PKLR variant and pyruvate kinase deficiency) is incorrect as the infant's red cell morphology is not indicative
Question 4
After receiving a diagnosis of acute lymphocytic leukemia, a patient is visibly distraught, stating, 'I have no idea where to go from here.' How should the nurse prepare to meet this patient's psychosocial needs?
A. Assess the patient's previous experience with the health care system.
B. Reassure the patient that treatment will be challenging but successful.
C. Assess the patient's specific needs for education and support.
D. Identify the patient's plan of medical care.
Show answer and rationale
Correct answer: C — Assess the patient's specific needs for education and support.
Rationale for Choice C (Correct Answer): Assessing the patient's specific needs for education and support is crucial in meeting the psychosocial needs of a patient diagnosed with acute lymphocytic leukemia. By understanding the patient's informational and emotional needs, the nurse can provide tailored support and resources, enhancing the patient's coping abilities and overall well-being. This approach fosters a therapeutic relationship and promotes patient-centered care.
Summary of Other Choices:
A: Assessing the patient's previous experience with the health care system is important but may not directly address the immediate psychosocial needs related to the new diagnosis.
B: Reassuring the patient about treatment success is premature and may invalidate the patient's feelings of distress and uncertainty.
D: Identifying the patient's plan of medical care is essential but focuses more on the medical aspect rather than the psychosocial aspect of care.
Question 5
After the nurse has finished teaching a patient about the use of sublingual nitroglycerin (Nitrostat), which patient statement indicates that the teaching has been effective?
A. “I can expect nausea as a side effect of nitroglycerin.”
B. “I should only take nitroglycerin when I have chest pain.”
C. “Nitroglycerin helps prevent a clot from forming and blocking blood flow to my heart.”
D. “I will call an ambulance if I still have pain after taking three nitroglycerin 5 minutes apart.”
Show answer and rationale
Correct answer: D — “I will call an ambulance if I still have pain after taking three nitroglycerin 5 minutes apart.”
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.
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Question 6
The nurse is giving the client digoxin for heart failure and recognizes that the drug has what type of effect on the heart?
A. Negative inotropic, negative chronotropic effect
B. Positive inotropic, negative chronotropic effect
C. Negative inotropic, positive chronotropic effect
D. Positive inotropic, positive chronotropic effect
Correct answer:
The correct answer is B: Positive inotropic, negative chronotropic effect. Digoxin is a positive inotrope, meaning it increases the force of myocardial contraction, which helps improve cardiac output in heart failure. It has a negative chronotropic effect, meaning it decreases the heart rate by slowing down the electrical conduction in the heart, which can be beneficial in certain heart conditions.
Choice A (Negative inotropic, negative chronotropic effect) is incorrect because digoxin is a positive inotrope, not a negative inotrope. Choice C (Negative inotropic, positive chronotropic effect) is incorrect because digoxin does not have a positive chronotropic effect. Choice D (Positive inotropic, positive chronotropic effect) is incorrect because digoxin has a negative chronotropic effect, not a positive one.
Therefore, the correct choice is B due to the combination of positive inotropic effect and negative chronotropic effect of digoxin on the heart
A delayed, subacute phase, of inflammation is characterized by:
A. Local vasodilatation and increased capillary permeability (phase of damage)
B. Infiltration of leucocytes and phagocytic cells (phase of exudation)
C. Tissue degeneration and fibrosis occurrence (phase of proliferation)
D. All of the above
Correct answer:
The correct answer is B: Infiltration of leucocytes and phagocytic cells (phase of exudation). During the delayed, subacute phase of inflammation, infiltrating leukocytes, such as neutrophils and macrophages, play a crucial role in removing debris and pathogens. This phase is characterized by the migration of these cells to the site of injury, where they engulf and digest foreign substances. This process helps to clear the area of infection and promote tissue repair.
Other choices are incorrect:
A: Local vasodilatation and increased capillary permeability (phase of damage) - This describes the initial phase of inflammation, not the delayed subacute phase.
C: Tissue degeneration and fibrosis occurrence (phase of proliferation) - This describes the later stages of inflammation involving tissue repair and remodeling, not the delayed subacute phase.
D: All of the above - This is incorrect as choices A and C do not accurately describe the delayed, subacute
A 68-year-old man was diagnosed with systolic heart failure with normal ejection fraction and normal sinus rhythm at rest. A treatment with captopril was started. Which of the following actions most likely mediated the therapeutic effect of captopril in this patient?
A. Increased cardiac contractility
B. Reduction of angiotensin-mediated vasoconstriction in the kidney
C. Reduction of preload and afterload
D. Stimulation of epinephrine release from adrenergic nerves
Correct answer:
The correct answer is C: Reduction of preload and afterload. Captopril, an ACE inhibitor, reduces preload (volume of blood returning to the heart) by inhibiting the conversion of angiotensin I to angiotensin II, which decreases aldosterone secretion and fluid retention. It also reduces afterload (resistance the heart has to pump against) by decreasing peripheral vascular resistance. This dual action helps improve cardiac output and decrease workload on the heart in systolic heart failure.
Explanation for why the other choices are incorrect:
A: Increased cardiac contractility - Captopril does not directly increase cardiac contractility, it mainly affects afterload and preload.
B: Reduction of angiotensin-mediated vasoconstriction in the kidney - While captopril does inhibit angiotensin production, its primary mechanism of action is not specific to the kidney.
D: Stimulation of epinephrine release from adrenergic nerves - Captopril does not stimulate ep
A patient had a non–ST-segment-elevation myocardial infarction (NSTEMI) 3 days ago. Which nursing intervention included in the plan of care is appropriate for the registered nurse (RN) to delegate to an experienced licensed practical/vocational nurse (LPN/LVN)?
A. Evaluation of the patient’s response to walking in the hallway
B. Completion of the referral form for a home health nurse follow-up
C. Education of the patient about the pathophysiology of heart disease
D. Reinforcement of teaching about the purpose of prescribed medications
Correct answer:
The correct answer is D: Reinforcement of teaching about the purpose of prescribed medications. This task can be safely delegated to an experienced LPN/LVN as it involves providing information that has already been taught by the RN. The LPN/LVN can reinforce the teaching without interpreting or altering the content. This task does not require critical thinking or assessment skills beyond the scope of practice for an LPN/LVN.
A, evaluation of the patient's response to walking in the hallway, involves physical assessment and monitoring for any adverse signs or symptoms, which requires the RN's expertise.
B, completion of the referral form for a home health nurse follow-up, involves coordination of care and decision-making, which falls under the RN's responsibility.
C, education of the patient about the pathophysiology of heart disease, involves complex medical information and understanding, which is beyond the scope of practice for an LPN/LVN.
The patient is admitted to the unit with the diagnosis of rhabdomyolysis. The patient is started on intravenous (IV) fluids and IV mannitol. What action by the nurse is best?
A. Assess the patient’s hearing.
B. Assess the patient’s lungs.
C. Decrease IV fluids once the diuretic has been administered.
D. Give extra doses before giving radiological contrast agents.
Correct answer:
The correct answer is B: Assess the patient’s lungs. Rhabdomyolysis can lead to acute kidney injury due to myoglobin release from damaged muscle cells. IV fluids and mannitol are given to prevent kidney damage by promoting myoglobin excretion. Assessing the patient’s lungs is crucial to monitor for potential complications such as acute respiratory distress syndrome (ARDS) which can occur as a result of rhabdomyolysis. This assessment helps to ensure early detection and prompt intervention if respiratory issues arise.
Summary of Incorrect Choices:
A: Assess the patient’s hearing - This is not directly related to rhabdomyolysis or its treatment.
C: Decrease IV fluids once the diuretic has been administered - Decreasing IV fluids can exacerbate kidney injury in rhabdomyolysis.
D: Give extra doses before giving radiological contrast agents - Mannitol is not routinely given before radiological contrast agents in the context of rhabdomyolysis management.
After receiving a diagnosis of acute lymphocytic leukemia, a patient is visibly distraught, stating, 'I have no idea where to go from here.' How should the nurse prepare to meet this patient's psychosocial needs?
A. Assess the patient's previous experience with the health care system.
B. Reassure the patient that treatment will be challenging but successful.
C. Assess the patient's specific needs for education and support.
D. Identify the patient's plan of medical care.
Correct answer:
Rationale for Choice C (Correct Answer): Assessing the patient's specific needs for education and support is crucial in meeting the psychosocial needs of a patient diagnosed with acute lymphocytic leukemia. By understanding the patient's informational and emotional needs, the nurse can provide tailored support and resources, enhancing the patient's coping abilities and overall well-being. This approach fosters a therapeutic relationship and promotes patient-centered care.
Summary of Other Choices:
A: Assessing the patient's previous experience with the health care system is important but may not directly address the immediate psychosocial needs related to the new diagnosis.
B: Reassuring the patient about treatment success is premature and may invalidate the patient's feelings of distress and uncertainty.
D: Identifying the patient's plan of medical care is essential but focuses more on the medical aspect rather than the psychosocial aspect of care.
The client has a heart rate of 70, a slightly irregular rhythm and P waves that come in multiples. What is this rhythm called?
A. Third degree AV block
B. Type 2 second degree AV block
C. Type 1 second degree AV block
D. Junctional escape rhythm
Correct answer:
The correct answer is C: Type 1 second degree AV block. This rhythm is characterized by a slightly irregular rhythm and P waves that come in multiples, known as "grouped beating." In Type 1 AV block, there is a progressive lengthening of the PR interval until a QRS complex is dropped. This is consistent with the description provided in the question.
A: Third degree AV block is characterized by complete dissociation between the atria and ventricles, resulting in an atrial rate that is typically faster than the ventricular rate. This is not the case in the scenario described.
B: Type 2 second degree AV block is characterized by intermittent failure of conduction of P waves to the ventricles, resulting in dropped QRS complexes. This is not consistent with the description provided.
D: Junctional escape rhythm is characterized by an escape rhythm originating from the AV junction, resulting in a heart rate of 40-60 bpm. This is not the rhythm described
A patient with abdominal injuries from a motor vehicle crash is scheduled for surgery to remove the spleen. What bodily function will be affected by the removal of this organ?
A. Filtration of waste products
B. Removal of old red blood cells from circulation
C. Clearance of mucous in the tracheobronchial tree
D. Facilitation of glucose to be used by the cell for energy
Correct answer:
The correct answer is B: Removal of old red blood cells from circulation. The spleen plays a crucial role in filtering and removing old or damaged red blood cells from circulation. When the spleen is removed, this function is compromised, leading to a decrease in the body's ability to clear out these cells efficiently. This can result in an increased risk of anemia and other complications related to the buildup of old red blood cells in the bloodstream.
A: Filtration of waste products - While the spleen does play a role in filtering blood, its primary function is related to red blood cells, not waste products.
C: Clearance of mucous in the tracheobronchial tree - This function is primarily carried out by the respiratory system, particularly the cilia and mucous membranes in the airways, not the spleen.
D: Facilitation of glucose to be used by the cell for energy - This function is primarily related to the pancreas and insulin production, not the
A newborn infant develops jaundice on day of life 2. Labs are drawn, and she has a hemoglobin of 7.4 g/dL with a reticulocyte count of 8%. Upon peripheral blood smear review, she is found to have bizarre red cell forms with significant polkilocytosis. Although her parents have normal blood counts, on review of their peripheral blood smears, they both have a moderate number of ovalocytes. Which of the following is the most likely cause of the infant's red cell findings?
A. She has an autosomal dominant ankyrin mutation from one of her parents causing hereditary spherocytosis.
B. She has inherited band 3 variants from each parent and will likely need a splenectomy after she turns 5 years old.
C. She has inherited an alpha-spectrin mutation from both of her parents and may experience an improvement in her anemia over time.
D. She has inherited a PKLR variant from each parent, and enzyme testing will be consistent with her diagnosis of pyruvate kinase deficiency.
Correct answer:
The correct answer is C because the infant's red cell findings of ovalocytes and polikilocytosis are consistent with hereditary elliptocytosis, which is caused by mutations in genes encoding spectrin. In this scenario, the inheritance pattern aligns with the infant receiving an alpha-spectrin mutation from both parents, leading to the observed erythrocyte abnormalities. This condition may improve over time due to compensatory mechanisms.
Choice A (autosomal dominant ankyrin mutation causing hereditary spherocytosis) is incorrect because the clinical presentation and red cell morphology do not support a diagnosis of hereditary spherocytosis.
Choice B (inherited band 3 variants and need for splenectomy) is incorrect as the infant's condition does not match the characteristics of hereditary spherocytosis requiring splenectomy.
Choice D (PKLR variant and pyruvate kinase deficiency) is incorrect as the infant's red cell morphology is not indicative
What is a condition where the heart is unable to pump blood effectively, leading to a buildup of fluid in the lungs and other parts of the body?
A. Heart failure
B. Cardiomyopathy
C. Myocardial infarction
D. Pulmonary edema
Correct answer:
Rationale for Correct Answer (A): Heart failure is the correct answer because it is a condition where the heart is unable to pump blood effectively, leading to fluid buildup in the lungs and other parts of the body. This occurs due to the heart's inability to adequately circulate blood, causing congestion and fluid retention. Symptoms include shortness of breath, fatigue, and swelling. Treatment aims to improve heart function and manage symptoms.
Summary of Incorrect Choices:
B (Cardiomyopathy): Cardiomyopathy is a disease of the heart muscle, which can lead to heart failure, but it is not the specific condition described in the question.
C (Myocardial infarction): Myocardial infarction, commonly known as a heart attack, results from a blockage in a coronary artery causing damage to the heart muscle, but it does not directly lead to fluid buildup in the lungs and body.
D (Pulmonary edema): Pulmonary edema is a condition characterized by fluid
RN exams cardiovascular practice questions, set 8 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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