NCLEX - Cardiovascular (UWorld) with complete solutions 2024/2025

NCLEX - Cardiovascular (UWorld)Chronic Venous Insufficiency (CVI) - correct 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 - correct 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 - correct 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) - correct 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. 2. Check ingredients for over the counter medications or diet pills for stimulants such as caffeine or epinephrine as they can exacerbate symptoms. 3. Reduce stress and avoid alcohol use. 4. Exercise regularly. 5. Take Beta Blockers as prescribed for chest pain and palpitations.