NCLEX - Cardiovascular (UWorld) Exam with Questions and Answers

NCLEX - Cardiovascular (UWorld) Exam with Questions and Answers Chronic Venous Insufficiency (CVI) ANSWER Occurs when the valves in the veins of the lower extremities consistently fail to keep venous blood moving forward, which causes chronic increased venous pressure. The increased pressure pushes fluid out of the vascular space and into the surrounding tissues, where tissue enzymes break down red blood cells. The destruction of red blood cells releases hemosiderin (a reddish brown protein that sores iron) which causes a brownish skin discoloration; chronic edema and inflammation cause the tissue to harden and appear leathery. Affected skin is highly prone to breakdown and ulcerations (venous leg ulcers) commonly on the inside of the ankle. Peripheral Arterial Disease ANSWER Diminished pulses, non healing ulcers on a toe, and shiny, hairless extremities are usually associated with peripheral arterial disease due to hardening of the arterial walls, which constricts blood flow and impairs transportation of nutrients to tissues. Heart Failure ANSWER In heart failure, the weakened cardiac pump function does not allow for adequate blood flow to the kidneys. The tissue in this diagnosis is excess fluid. It is considered as dilutional hyponatremia (more free water than sodium) and is treated with fluid restriction and diuretics. Diuresis using furosemide will decrease fluid volume overload, decrease the workload of the heart, and increase cardiac pump function and renal blood flow. Mitral Valve Prolapse (MVP) ANSWER Clients with MVP may have palpitations, dizziness, and pigheadedness. Chest pain can occur but its etiology is unknown in this client population. It may be a result of abnormal tension on the papillary muscles. Chest pain that occurs in MVP does not typically respond to antianginal treatment (nitrates). Beta Blockers may be prescribed to treat chest pain and palpitations. Client teaching for MVP management includes: 1. Adopt healthy eating habits and avoid caffeine.