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
Tranquilizers intoxication (5-10 tablets) features include:
A. Euphoria burst of energy increase in motor activity wave warmth all over the body
B. Visual hallucinations a distorted feelling of time and space
C. Physical bliss body lightness a wish to fly motionlessness
D. Synaesthesia (the sounds can be tensed the colors can be heard)
Show answer and rationale
Correct answer: A — Euphoria burst of energy increase in motor activity wave warmth all over the body
The correct answer is A because tranquilizers typically produce euphoria, burst of energy, increase in motor activity, and a warm sensation throughout the body. This is due to the sedative effects of tranquilizers, which can initially induce feelings of relaxation and well-being.
Choice B is incorrect because visual hallucinations and distorted perception of time and space are more commonly associated with hallucinogens rather than tranquilizers.
Choice C is incorrect because physical bliss, body lightness, a wish to fly, and motionlessness are not typical effects of tranquilizer intoxication.
Choice D is incorrect because synaesthesia, where senses mix and one sensory experience triggers another, is not a common effect of tranquilizers intoxication.
In summary, choice A is the correct answer as it aligns with the typical features of tranquilizers intoxication, while the other choices do not accurately describe the effects of tranquilizers.
Question 2
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 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.
Question 3
The drug of choice for partial seizures is:
A. Carbamazepin
B. Ethosuximide
C. Diazepam
D. Lamotrigine
Show answer and rationale
Correct answer: A — Carbamazepin
The correct answer is A: Carbamazepine. This drug is the drug of choice for partial seizures due to its efficacy in controlling focal seizures and its broad spectrum of activity. Carbamazepine works by blocking voltage-gated sodium channels, reducing neuronal excitability.
Rationale:
- Carbamazepine is a common first-line treatment for partial seizures.
- It is effective in controlling focal seizures.
- It has a broad spectrum of activity against various types of seizures.
- Carbamazepine's mechanism of action involves blocking sodium channels, reducing neuronal excitability.
Summary of other choices:
- B: Ethosuximide is primarily used for absence seizures, not partial seizures.
- C: Diazepam is a short-acting benzodiazepine used for acute seizure management, not as a primary treatment for partial seizures.
- D: Lamotrigine is more commonly used for generalized seizures and may not be as effective for controlling partial seizures.
Question 4
A 35-year-old male is admitted to the hospital complaining of severe headaches, vomiting, and testicular pain. His blood work shows reduced numbers of platelets, leukocytes, and erythrocytes, with a high proportion of immature cells. The nurse caring for this patient suspects a diagnosis of what?
A. AML
B. CML
C. MDS
D. ALL
Show answer and rationale
Correct answer: D — ALL
The correct answer is D: ALL (Acute Lymphoblastic Leukemia). In this scenario, the patient presents with symptoms of headaches, vomiting, testicular pain, and abnormal blood work showing reduced platelets, leukocytes, and erythrocytes with a high proportion of immature cells. These findings are characteristic of ALL, a type of leukemia that primarily affects lymphoid cells. The combination of symptoms and blood work results suggests a rapid and aggressive proliferation of immature lymphoid cells, leading to bone marrow failure and symptoms such as anemia, thrombocytopenia, and leukopenia. AML (choice A) primarily affects myeloid cells, not lymphoid cells. CML (choice B) typically presents with elevated leukocyte count and presence of the Philadelphia chromosome. MDS (choice C) is a group of disorders characterized by ineffective hematopoiesis leading to cytopenias, but does not typically present with the rapid onset of symptoms seen in this case
Question 5
A 35-year-old male is admitted to the hospital complaining of severe headaches, vomiting, and testicular pain. His blood work shows reduced numbers of platelets, leukocytes, and erythrocytes, with a high proportion of immature cells. The nurse caring for this patient suspects a diagnosis of what?
A. AML
B. CML
C. MDS
D. ALL
Show answer and rationale
Correct answer: D — ALL
The correct answer is D: ALL (Acute Lymphoblastic Leukemia). In this scenario, the patient presents with symptoms of headaches, vomiting, testicular pain, and abnormal blood work showing reduced platelets, leukocytes, and erythrocytes with a high proportion of immature cells. These findings are characteristic of ALL, a type of leukemia that primarily affects lymphoid cells. The combination of symptoms and blood work results suggests a rapid and aggressive proliferation of immature lymphoid cells, leading to bone marrow failure and symptoms such as anemia, thrombocytopenia, and leukopenia. AML (choice A) primarily affects myeloid cells, not lymphoid cells. CML (choice B) typically presents with elevated leukocyte count and presence of the Philadelphia chromosome. MDS (choice C) is a group of disorders characterized by ineffective hematopoiesis leading to cytopenias, but does not typically present with the rapid onset of symptoms seen in this case
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Question 6
The nurse is caring for a client with a dignosis of aortic stenosis. The client reports episodes of angina and passing out recently at home. The client has surgery scheduled in 2 weeks. Which of the following would be the nurse's best explanation about activity at this time?
A. "It is best to avoid strenuous exercise, stairs, and lifting before your surgery."
B. "Take short walks three times daily to prepare for postoperative rehabilitation."
C. "There are no activity restrictions unless the angina reoccurs; then please call the office."
D. "Gradually increase activity before surgery to build stamina for the postoperative period."
Correct answer:
The correct answer is A because in aortic stenosis, there is an obstruction of blood flow from the heart to the body. Strenuous activities can worsen the condition by increasing the workload on the heart, leading to angina and fainting. Preoperative preparation focuses on reducing the risk of complications during surgery. Therefore, advising the client to avoid strenuous exercise, stairs, and lifting helps minimize the risk of exacerbating symptoms and potential complications before surgery.
Explanation for other choices:
B: Taking short walks may be too strenuous for a client with aortic stenosis and can potentially worsen symptoms.
C: Allowing unrestricted activity can be dangerous for a client with aortic stenosis, as it may lead to worsening symptoms and increased risk of complications.
D: Gradually increasing activity can be risky for a client with aortic stenosis, as it can increase the workload on the heart and exacerbate symptoms.
A calcium channel blocker (CCB) is prescribed for a patient, and the nurse provides instructions to the patient about the medication. Which instruction is correct?
A. Chew the tablet for faster release of the medication.
B. To increase the effect of the drug, take it with grapefruit juice.
C. If the adverse effects of chest pain, fainting, or dyspnea occur, discontinue the medication immediately.
D. A high-fiber diet with plenty of fluids will help prevent the constipation that may occur.
Correct answer:
The correct answer is D: A high-fiber diet with plenty of fluids will help prevent the constipation that may occur.
Rationale:
1. CCBs can cause constipation as a side effect due to their action on smooth muscle.
2. A high-fiber diet and adequate fluids help prevent constipation by promoting bowel regularity.
3. Increasing fiber intake can soften stool and facilitate passage, reducing the risk of constipation.
4. Adequate fluid intake is essential to maintain hydration and support digestive function, aiding in the prevention of constipation.
Summary:
A: Chewing the tablet may alter the drug's release mechanism and is not recommended for CCBs.
B: Grapefruit juice can interact with CCBs, potentially increasing drug levels and side effects.
C: Adverse effects like chest pain, fainting, or dyspnea may indicate a serious reaction, but immediate discontinuation should be done under medical guidance, not solely based on patient judgment.
You examine a 10-year-old boy with severe aplastic anemia. He has no dysmorphic features and is at the 50th percentile for height and weight. Family history includes a sister with aplastic anemia unresponsive to anti-human thymocyte globulin (ATG) and cyclosporine who died early in the course of an unrelated donor hematopoietic stem cell transplant complicated by severe mucositis and transplant-related organ toxicities. There are no other siblings. A cousin died of acute myeloid leukemia at age 5 years. A peripheral blood sample test for Fanconi anemia is negative with no increased chromosomal breaks in response to diepoxybutane or mitomycin C. Which of the following is the most important next step in management?
A. Administer ATG and cyclosporine.
B. Search for a donor for matched unrelated transplant.
C. Send a bone marrow aspirate for Fanconi anemia testing.
D. Send a skin fibroblast culture for Fanconi anemia testing.
Correct answer:
The correct answer is D: Send a skin fibroblast culture for Fanconi anemia testing. This is the most important next step because the patient has a family history suggestive of Fanconi anemia, which is an inherited bone marrow failure syndrome. Aplastic anemia in a child with a family history of bone marrow failure syndromes raises suspicion for inherited causes like Fanconi anemia. Testing for Fanconi anemia involves assessing chromosomal breakage in response to DNA cross-linking agents like diepoxybutane or mitomycin C, which is best done using skin fibroblast culture. This specific test can confirm or rule out Fanconi anemia as the underlying cause of aplastic anemia in this patient. The other choices are incorrect because administering ATG and cyclosporine (Choice A) may not be effective if the underlying cause is Fanconi anemia. Searching for a donor for matched unrelated transplant (Choice B) is premature without confirming the diagnosis.
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
You examine a 10-year-old boy with severe aplastic anemia. He has no dysmorphic features and is at the 50th percentile for height and weight. Family history includes a sister with aplastic anemia unresponsive to anti-human thymocyte globulin (ATG) and cyclosporine who died early in the course of an unrelated donor hematopoietic stem cell transplant complicated by severe mucositis and transplant-related organ toxicities. There are no other siblings. A cousin died of acute myeloid leukemia at age 5 years. A peripheral blood sample test for Fanconi anemia is negative with no increased chromosomal breaks in response to diepoxybutane or mitomycin C. Which of the following is the most important next step in management?
A. Administer ATG and cyclosporine.
B. Search for a donor for matched unrelated transplant.
C. Send a bone marrow aspirate for Fanconi anemia testing.
D. Send a skin fibroblast culture for Fanconi anemia testing.
Correct answer:
The correct answer is D: Send a skin fibroblast culture for Fanconi anemia testing. This is the most important next step because the patient has a family history suggestive of Fanconi anemia, which is an inherited bone marrow failure syndrome. Aplastic anemia in a child with a family history of bone marrow failure syndromes raises suspicion for inherited causes like Fanconi anemia. Testing for Fanconi anemia involves assessing chromosomal breakage in response to DNA cross-linking agents like diepoxybutane or mitomycin C, which is best done using skin fibroblast culture. This specific test can confirm or rule out Fanconi anemia as the underlying cause of aplastic anemia in this patient. The other choices are incorrect because administering ATG and cyclosporine (Choice A) may not be effective if the underlying cause is Fanconi anemia. Searching for a donor for matched unrelated transplant (Choice B) is premature without confirming the diagnosis.
The nurse is preparing to discharge a client after CABG surgery. The client is taking several new medications, including digoxin (Lanoxin), metoprolol (Lopressor), and furosemide (Lasix). The client complains of nausea and anorexia. The nurse is preparing to report this finding to the physician before discharging the client. Which laboratory result will the nurse check before calling the physician?
A. Potassium level
B. Sodium level
C. PT / INR
D. Digoxin level
Correct answer:
The correct answer is A: Potassium level. After CABG surgery, the client is taking medications that can affect potassium levels, such as furosemide and digoxin. Nausea and anorexia can be symptoms of hypokalemia, a potential side effect of these medications. Therefore, checking the potassium level is crucial to monitor for any electrolyte imbalances that can lead to adverse effects like cardiac dysrhythmias.
Summary of incorrect choices:
B: Sodium level - Although important for electrolyte balance, sodium levels are less likely to be affected by the medications mentioned in the scenario and are not typically associated with nausea and anorexia.
C: PT/INR - These are coagulation studies and not directly related to the symptoms presented by the client.
D: Digoxin level - While monitoring digoxin levels is important for toxicity, the symptoms of nausea and anorexia are more indicative of potential electrolyte imbalances rather than digox
A healthy 17-year-old African American male presents with a thrombosis of the right upper extremity. His past medical history is remarkable only for sickle cell trait. The history is negative for recent risk factors for thrombosis (illness, surgery, immobility). He is the pitcher for his high school baseball team. Imaging confirms anatomical compression/narrowing of the right subclavian vein. Which of the following interventions is most likely to decrease this patient's long-term risk of recurrent thrombosis?
A. Systemic thrombolysis
B. Catheter-directed thrombolysis
C. Extended 12-month course of anticoagulation with low-molecular-weight heparin (LMWH)
D. Resection of right first rib
Correct answer:
The correct answer is D: Resection of right first rib. The patient's presentation with thrombosis of the right upper extremity, anatomical compression/narrowing of the right subclavian vein, and being a high school baseball pitcher suggests Paget-Schroetter syndrome (effort thrombosis). The first rib can compress the subclavian vein in people with certain anatomical variations, leading to thrombosis. Resection of the right first rib (first rib resection) is the definitive treatment for this condition, as it removes the mechanical compression, reducing the risk of recurrent thrombosis.
A: Systemic thrombolysis involves using medications to dissolve blood clots throughout the body and is not the first-line treatment for Paget-Schroetter syndrome.
B: Catheter-directed thrombolysis is not indicated for anatomical compression/narrowing as seen in this patient.
C: Extended anticoagulation with LMWH does not address the underlying mechanical
The nurse is caring for a client with a dignosis of aortic stenosis. The client reports episodes of angina and passing out recently at home. The client has surgery scheduled in 2 weeks. Which of the following would be the nurse's best explanation about activity at this time?
A. "It is best to avoid strenuous exercise, stairs, and lifting before your surgery."
B. "Take short walks three times daily to prepare for postoperative rehabilitation."
C. "There are no activity restrictions unless the angina reoccurs; then please call the office."
D. "Gradually increase activity before surgery to build stamina for the postoperative period."
Correct answer:
The correct answer is A because in aortic stenosis, there is an obstruction of blood flow from the heart to the body. Strenuous activities can worsen the condition by increasing the workload on the heart, leading to angina and fainting. Preoperative preparation focuses on reducing the risk of complications during surgery. Therefore, advising the client to avoid strenuous exercise, stairs, and lifting helps minimize the risk of exacerbating symptoms and potential complications before surgery.
Explanation for other choices:
B: Taking short walks may be too strenuous for a client with aortic stenosis and can potentially worsen symptoms.
C: Allowing unrestricted activity can be dangerous for a client with aortic stenosis, as it may lead to worsening symptoms and increased risk of complications.
D: Gradually increasing activity can be risky for a client with aortic stenosis, as it can increase the workload on the heart and exacerbate symptoms.
Which of the following is a chronic inflammatory disease of the airways that causes episodes of wheezing, breathlessness, chest tightness, and coughing?
A. Asthma
B. Bronchitis
C. Pneumonia
D. Emphysema
Correct answer:
A: Asthma is the correct answer because it is a chronic inflammatory disease of the airways characterized by symptoms like wheezing, breathlessness, chest tightness, and coughing. This condition is often triggered by various factors such as allergens, exercise, or respiratory infections. Asthma involves inflammation and narrowing of the airways, leading to the symptoms mentioned.
B: Bronchitis is incorrect as it refers to inflammation of the bronchial tubes, which can be acute or chronic, but it does not typically present with all the symptoms listed in the question.
C: Pneumonia is incorrect as it is an infection of the lungs caused by bacteria, viruses, or fungi, and does not typically cause chronic inflammation of the airways.
D: Emphysema is incorrect as it is a type of chronic obstructive pulmonary disease (COPD) characterized by damage to the air sacs in the lungs, leading to difficulty breathing, but it does not typically present
A 10-year-old girl has had transfusion-dependent anemia since age 6 months. She is found to have an unstable hemoglobin by sequence analysis (Hb Indianapolis). She has jaundice, obvious bony deformity from extramedullary hematopoiesis, and hepatosplenomegaly. Which of the following statements is correct?
A. Her diagnosis should have been picked up on newborn screen by electrophoresis, isoelectric focusing, or high-performance liquid chromatography similar to other beta-hemoglobinopathies.
B. Since her spleen is intact, her peripheral blood smear cannot have nucleated red cells or Howell Jolly bodies.
C. If she undergoes splenectomy, her anemia should be entirely ameliorated.
D. Since she is transfused, she will not be at risk for gallstones.
Correct answer:
Rationale for Correct Answer (E): The correct statement is likely about the fact that her hemoglobinopathy, Hb Indianapolis, is associated with ineffective erythropoiesis, leading to anemia, jaundice, and extramedullary hematopoiesis. This is a rare condition and not typically detected on newborn screens. Additionally, splenectomy may not entirely resolve her anemia due to the systemic nature of the disease. Since she has transfusion-dependent anemia, she is at risk for gallstones due to chronic hemolysis.
Summary of Incorrect Choices:
A: Incorrect because Hb Indianapolis is rare and not typically detected on newborn screens.
B: Incorrect because extramedullary hematopoiesis can lead to nucleated red cells in the peripheral blood smear.
C: Incorrect because the disease is systemic, and splenectomy may not fully resolve the anemia.
D: Incorrect because chronic hemolysis from the disease increases the risk of gallstones despite transf
RN exams cardiovascular practice questions, set 9 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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