Practice Perfusion NCLEX Questions
The nurse has completed an assessment on a client with a decreased cardiac
output. Which findings should receive highest priority?
a. BP 110/62, atrial fibrillation with HR 82, bibasilar crackles
b. Confusion, urine output 15mL over the last 2 hours, orthopnea.
c. SpO2 92 on 2 liters nasal cannula, respirations 20, 1+ edema of lower
extremities.
d. Weight gain of 1kg in 3 days, BP 130/80, mild dyspnea with exercise. -
correct answer-b. A low urine output and confusion are signs of decreased
tissue perfusion. Orthopnea is a sign of left-sided heart failure. Crackles,
edema and weight gain should be monitored closely, but the levels are not as
high a priority. With atrial fibrillation there is a loss of atrial kick, but the blood
pressure and heart rate are stable
Which of the following is an expected outcome when a client is receiving an IV
administration of furosemide?
a. Increased blood pressure
b. Increased urine output
c. Decreased pain
d. Decreased premature ventricular contractions - correct answer-b.
Furosemide is a loop diuretic that acts to increase urine output. Furosemide
does not increase blood pressure, decrease pain, or decrease arrhythmias
The nurse is assessing clients at a health fair. Which client is at greatest risk
for coronary artery disease?
a. a 32-year-old female with mitral valve prolapse who quit smoking 10 years
ago.
b. a 43-year-old male with a family history of CAD and cholesterol level of 158
c. A 56-year-old male with an HDL of 60 who takes atorvastatin (Lipitor)
d. A 65-year-old female who is obese with an LDL of 188 - correct answer-d.
The woman who is 65-years-old, over weight and has an elevated LDL is at
greatest risk. Total cholesterol >200, LDL >100, HDL <40 in men, HDL <50 in
women, men 45-years and older, women 55-years and older, smoking and
obesity increase the risk of CAD. Atorvastatin is a medication to reduce LDL
and decrease risk of CAD. The combination of postmenopausal, obesity and
high LDL cholesterol places this client at greatest risk.
, A 58-year-old female with a family history of CAD is being seen for her annual
physical exam. Fasting lab test results include: Total cholesterol 198; LDL
cholesterol 120; HDL cholesterol 58; Triglycerides 148; Blood sugar 102; and
C-reactive protein (CRP) 4.2. The health care provider informs the client that
she will be started on a statin medication and aspirin. The client asks the
nurse why she needs to take these medications. Which is the best response
by the nurse?
a. "The labs indicate severe hyperlipidemia and the medications will lower
your LDL, along with a low-fat diet."
b. "The triglycerides are elevated and will not return to normal without these
medications."
c. "The CRP is elevated indicating inflammation seen in cardiovascular
disease, which can be lowered by the medications ordered."
d. "The medications are not indicated since your lab values are all normal." -
correct answer-c. CRP is a marker of inflammation and is elevated in the
presence of cardiovascular disease. The high sensitivity CRP (hs-CRP) is the
blood test for greater accuracy in measuring the CRP to evaluate
cardiovascular risk. The family history, post-menopausal age, LDL above
optimum levels and elevated CRP place the client at risk of CAD. Statin
medications can decrease LDL, whereas statins and aspirin can reduce CRP
and decrease the risk of MI and stroke.
An older, sedentary adult may not respond to emotional or physical stress as
well as a younger individual because of:
a. Left ventricular atrophy
b. Irregular heartbeats
c. Peripheral vascular occlusion
d. Pacemaker placement - correct answer-a. In older adults who are less
active and do not exercise the heart muscle, atrophy can result. Disuse or
deconditioning can lead to abnormal changes in the myocardium of the older
adult. As a result, under sudden emotional or physical stress, the left ventricle
is less able to respond to the increased demands on the myocardial muscle.
Decreased cardiac output, cardiac hypertrophy, and heart failure are examples
of the chronic conditions that may develop in response to inactivity, rather than
in response to the aging process. Irregular heartbeats are generally not
associated with an older sedentary adult's lifestyle. Peripheral vascular
occlusion or pacemaker placement should not affect response to stress.
A client with a diagnosis of cardiac dysrhythmias and a history of type I
diabetes mellitus is placed on propranolol therapy. The client asks the nurse if
The nurse has completed an assessment on a client with a decreased cardiac
output. Which findings should receive highest priority?
a. BP 110/62, atrial fibrillation with HR 82, bibasilar crackles
b. Confusion, urine output 15mL over the last 2 hours, orthopnea.
c. SpO2 92 on 2 liters nasal cannula, respirations 20, 1+ edema of lower
extremities.
d. Weight gain of 1kg in 3 days, BP 130/80, mild dyspnea with exercise. -
correct answer-b. A low urine output and confusion are signs of decreased
tissue perfusion. Orthopnea is a sign of left-sided heart failure. Crackles,
edema and weight gain should be monitored closely, but the levels are not as
high a priority. With atrial fibrillation there is a loss of atrial kick, but the blood
pressure and heart rate are stable
Which of the following is an expected outcome when a client is receiving an IV
administration of furosemide?
a. Increased blood pressure
b. Increased urine output
c. Decreased pain
d. Decreased premature ventricular contractions - correct answer-b.
Furosemide is a loop diuretic that acts to increase urine output. Furosemide
does not increase blood pressure, decrease pain, or decrease arrhythmias
The nurse is assessing clients at a health fair. Which client is at greatest risk
for coronary artery disease?
a. a 32-year-old female with mitral valve prolapse who quit smoking 10 years
ago.
b. a 43-year-old male with a family history of CAD and cholesterol level of 158
c. A 56-year-old male with an HDL of 60 who takes atorvastatin (Lipitor)
d. A 65-year-old female who is obese with an LDL of 188 - correct answer-d.
The woman who is 65-years-old, over weight and has an elevated LDL is at
greatest risk. Total cholesterol >200, LDL >100, HDL <40 in men, HDL <50 in
women, men 45-years and older, women 55-years and older, smoking and
obesity increase the risk of CAD. Atorvastatin is a medication to reduce LDL
and decrease risk of CAD. The combination of postmenopausal, obesity and
high LDL cholesterol places this client at greatest risk.
, A 58-year-old female with a family history of CAD is being seen for her annual
physical exam. Fasting lab test results include: Total cholesterol 198; LDL
cholesterol 120; HDL cholesterol 58; Triglycerides 148; Blood sugar 102; and
C-reactive protein (CRP) 4.2. The health care provider informs the client that
she will be started on a statin medication and aspirin. The client asks the
nurse why she needs to take these medications. Which is the best response
by the nurse?
a. "The labs indicate severe hyperlipidemia and the medications will lower
your LDL, along with a low-fat diet."
b. "The triglycerides are elevated and will not return to normal without these
medications."
c. "The CRP is elevated indicating inflammation seen in cardiovascular
disease, which can be lowered by the medications ordered."
d. "The medications are not indicated since your lab values are all normal." -
correct answer-c. CRP is a marker of inflammation and is elevated in the
presence of cardiovascular disease. The high sensitivity CRP (hs-CRP) is the
blood test for greater accuracy in measuring the CRP to evaluate
cardiovascular risk. The family history, post-menopausal age, LDL above
optimum levels and elevated CRP place the client at risk of CAD. Statin
medications can decrease LDL, whereas statins and aspirin can reduce CRP
and decrease the risk of MI and stroke.
An older, sedentary adult may not respond to emotional or physical stress as
well as a younger individual because of:
a. Left ventricular atrophy
b. Irregular heartbeats
c. Peripheral vascular occlusion
d. Pacemaker placement - correct answer-a. In older adults who are less
active and do not exercise the heart muscle, atrophy can result. Disuse or
deconditioning can lead to abnormal changes in the myocardium of the older
adult. As a result, under sudden emotional or physical stress, the left ventricle
is less able to respond to the increased demands on the myocardial muscle.
Decreased cardiac output, cardiac hypertrophy, and heart failure are examples
of the chronic conditions that may develop in response to inactivity, rather than
in response to the aging process. Irregular heartbeats are generally not
associated with an older sedentary adult's lifestyle. Peripheral vascular
occlusion or pacemaker placement should not affect response to stress.
A client with a diagnosis of cardiac dysrhythmias and a history of type I
diabetes mellitus is placed on propranolol therapy. The client asks the nurse if
