Cardiovascular NCLEX Questions and Answers

Cardiovascular NCLEX Questions and Answers

Which of the following are most likely to be early signs of cardiac problems in older persons?(Select all that apply.)

Mental status changes Agitation Frequent falls Sudden changes in GI function - answerMental status changes Agitation Frequent falls Rationale: Many cardiovascular functions are complicated in that they involve many other systems. Mental status changes, agitation, and falls can be early signs of cardiac problems in the older person. Changes in function in the GI system are not typical signs of a cardiac problem.

A patient has been diagnosed with Right-Sided Congestive Heart Failure, and is confused about return of deoxygenated blood from the tissue. To clarify the confusion, which chamber of the heart receives blood from systemic circulation?

Left atrium Right atrium Right ventricle Left ventricle - answerRight atrium Rationale: The right atrium is a thin-walled structure that receives deoxygenated blood from all the peripheral tissues by way of the superior and inferior vena cava and from the heart muscle by way of the coronary sinus.

It is important that the nurse be knowledgeable about cardiac output in order to:

Evaluate blood flow to peripheral tissues.Determine the electrical activity of the myocardium.Provide information on the immediate need for oxygen.Implement nutritional changes. - answerEvaluate blood flow to peripheral tissues.

Rationale: Blood flow to the tissues is measured clinically as the cardiac output, and assists to predict tissue perfusion. Electrical activity is evaluated more effectively by EKG. While the cardiac output is important for perfusion and oxygenation of tissues, the oxygen saturation would provide more valuable information. Nutritional changes would be targeted to sodium and would depend on symptoms of disease.

Integrated Process: Nursing Process; Planning

Cognitive Level: Evaluation

NCLEX-RN Test Plan: Health Promotion and Maintenance

Nurses can best help older clients prevent hypertension by teaching:

Low-fat, low-cholesterol diets.The importance of exercise.How to handle stressful situations.How to maintain a normal blood pressure. - answerHow to maintain a normal blood pressure.

Rationale: Hypertension is a major risk factor for other cardiovascular conditions. In persons older than 50, systolic blood pressure greater than 140 mm Hg is a much more important cardiovascular disease risk factor than is diastolic blood pressure. The risk of cardiovascular disease, beginning at 115/75 mm Hg, doubles with each increment of 20/10 mm Hg. Answers 1, 2, and 3 are important elements to include in education of a patient with blood pressure elevation, and are included in the correct answer.

Modification of lifestyle behaviors to help manage hypertension does not include which of the following? (Select all that apply.)

Weight loss of even 10 pounds The DASH diet Fruits, vegetables, and whole grains Alcohol intake with meals - answerAlcohol intake with meals \ Rationale: Weight loss of even 10 pounds; fruits, vegetables, and whole grains; the DASH diet; and a daily exercise regimen will help reduce high blood pressure. Alcohol intake with meals should be reduced to help manage high blood pressure.

A patient receiving the drug simvastatin (Zocor) should be taught this medication helps to prevent

coronary heart disease by:

Increasing lower-density lipoprotein.Controlling lower-density lipoprotein.Increasing triglycerides.Increasing very low-density lipoprotein. - answerControlling lower-density lipoprotein.

Rationale: The Heart Protective Study has also shown that controlling low-density lipoprotein (LDL) with simvastatin (Zocor) assists in the prevention of coronary heart disease by raising HDL.Responses 1, 3, and 4 are incorrect.

Which of the following are direct causes of chronic ischemic pain? (Select all that apply.)

Aortic stenosis Acid reflux

Pulmonary embolus Herpes zoster (shingles) - answerAortic stenosis Acid reflux Pulmonary embolus Rationale: Herpes zoster (shingles) manifests as a vesicular rash along a dermatome, not chronic ischemic pain.

Integrated Process: Nursing Process; Evaluation

Cognitive Level: Evaluation

NCLEX-RN Test Plan: Physiological Integrity; Physiological Adaptation

Rationale: Herpes zoster (shingles) manifests as a vesicular rash along a dermatome, not chronic ischemic pain.

Older clients experiencing anginal pain with complaints of fatigue or weakness usually are medicated with which of the following types of medication?

Sublingual nitroglycerin Cardiac glycosides HMG-CoA reductase inhibitors Morphine sulfate - answerSublingual nitroglycerin

Rationale: Angina frequently is managed with sublingual nitroglycerin, which causes vasodilation and increases blood flow to the coronary arteries. Cardiac glycosides are used to treat heart failure, and morphine is used to treat myocardial infarction. The HMG-CoA reductase inhibitors are used for patients with type 2 diabetes mellitus.

Which of the following diagnostic studies most likely would confirm a myocardial infarction?

Serum myoglobin level