Cardiovascular NCLEX questions 2023 GRADED A+ (Provides Rationales For Each Question)

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 - ANSWER Mental 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 - ANSWER Right 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. - ANSWER Evaluate 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. - ANSWER How 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 - ANSWER Alcohol 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. - ANSWER Controlling 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) - ANSWER Aortic 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 - ANSWER Sublingual 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 Creatinine kinase (CK) White blood cell count (WBC) Troponin T levels - ANSWER Troponin T levels Rationale: CK-MB elevates 4-6 hours after tissue necrosis. Troponin levels rise 6-8 hours after the infarct (tissue necrosis) but also can occur with other types of tissue damage. Myoglobin also elevates, but to a lesser degree. WBC levels elevate with an inflammatory response. Troponin levels are more elevated than are the other cardiac enzymes, are more specific to cardiac tissue, and rise 6-8 hours after the infarct (tissue necrosis). A client with post-myocardial infarction develops acute bacterial pericarditis. Which of the following medications would the physician most likely prescribe as the primary drug? Ticarcillin disodium (Ticar) Acetaminophen (Tylenol) Ibuprofen (Motrin) Trioxsalen (Trisoralen) - ANSWER Ticarcillin disodium (Ticar) Rationale: Acute bacterial pericarditis is a complication that can occur post-myocardial infarction. Acute bacterial pericarditis usually requires antibiotics. NSAIDs usually are prescribed to relieve pain from the inflammatory process. If the NSAIDs do not relieve pain within 48 to