NCLEX-PN : Conditions and Treatments

Study concepts, example questions & explanations for NCLEX-PN

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Example Questions

Example Question #1 : Cardiovascular Conditions

A 50-year-old male client with a history of coronary artery disease begins to complain of chest pain. The physician has placed orders in the client's chart to allow for treatment prior to being notified of the chest pains. The nurse recognizes this client is experiencing angina.

All of the following interventions by the nurse should be performed except __________.

Possible Answers:

informing the patient that treatment may cause a bounding headache

checking blood pressure

giving oxygen via nasal canula at 

placing the client in a high Fowler's position

giving sublingual nitroglycerine

Correct answer:

placing the client in a high Fowler's position

Explanation:

There is no need to place patient in high Fowler's this would probably put them at risk for orthostatic hypotension which is a common side effect of nitroglycerine treatment, as is a bounding headache. Giving oxygen, assessing blood pressure and giving nitroglycerine are all proper nursing interventions for angina.

Example Question #1 : Causes And Treatments Of Cardiovascular Conditions

A 54-year-old male client is being discharged from the hospital after undergoing surgery to have an implantable cardioverter-defibrillator (ICD) placed. The nurse is teaching the patient on proper guidelines for aftercare. 

All of the following guidelines should be included in the teaching plan except __________.

Possible Answers:

"Report any signs or symptoms of infection, such as redness, drainage, swelling or fever at the operative site."

"You may travel without restrictions, the device should not interfere with airport security metal screening"

"A medic alert bracelet stating you have an ICD should be worn at all times."

"If your ICD fires more than once, contact the physician."

"Avoid lifting your arm on the affected side until physician allows for you do so."

Correct answer:

"You may travel without restrictions, the device should not interfere with airport security metal screening"

Explanation:

It is important to note that an (ICD) does have the potential to set of metal detector alarms at the airport. The staff should be notified to fact to make accommodations for the patient. A hand held may be used but should not be placed directly over the implanted device. 

Example Question #3 : Causes And Treatments Of Cardiovascular Conditions

A client with newly diagnosed heart failure after myocardial infarction calls the clinic to ask about his new medications. Which of the following statements made by the patient concerns the triage nurse?

Possible Answers:

“I take hydrochlorothiazide in the morning with breakfast.”

“I do not take metoprolol tartrate with food.”

“I do not like to take my digoxin because it makes me nauseous.”

“I keep nitroglycerin spray with me at all times.”

“I get out of bed very slowly in the morning.”

Correct answer:

“I do not like to take my digoxin because it makes me nauseous.”

Explanation:

Patients with heart failure after myocardial infarction often take many new medications. It is important to adequately educate these patients on each of the side effects and dosing schedules of each medication. Digoxin is a fundamental drug in the treatment of heart failure. The maintenance dose of digoxin is essential to maintain optimal cardiac functioning and should not be missed. Digoxin may induce nausea and vomiting, and this should be communicated to the primary care provider so it may be treated. Among other essential heart failure medications are vasodilators and inotropic agents, as well as antihypertensive medications such as diuretics, beta-blockers, and ACE inhibitors. Diuretics such as hydrochlorothiazide should be taken in the morning because they induce diuresis - this would disrupt sleeping if taken later in the day or at bedtime. Vasodilators such as nitroglycerin are essential to decrease afterload in the case of angina. Beta-blockers such as metoprolol are most effective when taken without food, such as before breakfast or at bedtime. Antihypertensive medications may also cause orthostatic hypotension, so it is essential for patients to change positions slowly.

Example Question #11 : Cardiovascular Conditions

The nurse observes a patient undergoing a blood transfusion. Which of the following is a priority intervention by the nurse if the patient exhibits signs of a transfusion reaction?

Possible Answers:

Assess patent airway

Administer supplemental oxygen

Stop the blood

Notify the physician

Give an antihistamine

Correct answer:

Assess patent airway

Explanation:

The priority consideration for a nurse when a patient exhibits signs of a transfusion reaction include focus on the airway. Anaphylactic and hemolytic reactions diminish the ability of circulating blood to be oxygenated. The priority is to maintain a patent airway so circulating blood may remain oxygenated. After assessing the patient’s airway, the nurse should administer supplemental oxygen, stop the blood, give Benadryl (if it is an allergic reaction), and then notify the physician.

Example Question #451 : Conditions And Treatments

The home health nurse cares for a 6-month-old infant with heart failure. The child is receiving diuretic therapy at home. Which of the following symptoms manifested in the child may indicate a need for further intervention?

Possible Answers:

Increased hunger

Sudden weight gain

Bradycardia

Shallow breathing

Lower blood pressure

Correct answer:

Sudden weight gain

Explanation:

Weight gain is an early symptom of worsened congestive heart failure due to an accumulation of fluid in the vascular system that has not been diuresed. With fluid overload, the nurse should expect to see an increase in blood pressure, as well as tachypnea and tachycardia. Fluid overload may indicate a need for increased diuresis. Infants and children with congestive heart failure commonly demonstrate decreased appetites, so increased hunger would not be a negative sign.

Example Question #1 : Causes And Treatments Of Cardiovascular Conditions

Which hypertension drug is known to cause side effects such as, bradycardia, first degree heart block, and gingival hyperplasia?

Possible Answers:

Furosemide

Amlodipine

Hydralazine

Enalapril

Clonidine

Correct answer:

Amlodipine

Explanation:

Calcium channel blockers, such as amlodipine cause side effects that affect the conduction of the heart. Other side effects include nausea, headache, rash, and gingival hyperplasia. 

Example Question #11 : Cardiovascular Conditions

The nurse cares for a patient in the stroke unit. The physician has ordered thrombolytic therapy for this patient. The nurse knows that the patient cannot receive thrombolytic medication if which of these is true?

Possible Answers:

The patient was pregnant three months ago.

The patient takes propranolol every day.

The patient has a history of cardiac dysrhythmias.

The patient had knee replacement surgery two weeks ago.

The patient takes ibuprofen every day.

Correct answer:

The patient had knee replacement surgery two weeks ago.

Explanation:

Thrombolytic therapy is commonly given to patients who have strokes to dissolve clots. This therapy is contraindicated in people who have recently had surgery due to the risk for hemorrhage. It is also contraindicated in currently pregnant women. Ibuprofen and beta blockers are not contraindications to thrombolytic therapy. Cardiac dysrhythmias are also not contraindicated with thrombolytic therapy.

Example Question #1261 : Nclex

An EKG monitor reveals a patient is in ventricular fibrillation. He is subsequently provided the appropriate management and is converted to normal sinus rhythm. What is the mechanism of this management?

Possible Answers:

Pharmacologic therapy to slow conduction at the atrioventricular node

Electrical shock to speed up heart rate

Pharmacologic therapy to block the release of angiotensin

Electrical shock to restart the electrical conductivity of the heart

Pharmacologic therapy to slow conduction at the sinoatrial node

Correct answer:

Electrical shock to restart the electrical conductivity of the heart

Explanation:

Ventricular fibrillation is a potentially lethal rhythm. It is treated via defibrillation. This is an electrical shock that temporarily stops the heart in an attempt to have the natural pacemaker rhythm of the heart take over. Electrical therapy via defibrillation is the appropriate management of ventricular fibrillation.

Example Question #1 : Symptoms And Tests For Cardiovascular Conditions

Which of the following is least likely to be a co-morbidity with congestive heart failure?

Possible Answers:

Type II diabetes

Atrial fibrillation

Hypertension

Vestibular irregularities

Correct answer:

Vestibular irregularities

Explanation:

Congestive heart failure tends to be precipitated by hypertension, type II diabetes, nutritional deficiencies such as thiamine, pulmonary disease, and chronic stress. Atrial fibrillation is not generally a causative factor in congestive heart failure, but these conditions are frequently seen together as they share an etiology. Vestibular irregularities are not generally observed in congestive heart failure.

Example Question #1 : Symptoms And Tests For Cardiovascular Conditions

A 50-year-old female presents to emergency room after complaining of chest pain that came on while at home watching television, she thought she was having a heart attack. The nurse proceeds to gather more history about this client. The client does not have a history of coronary artery or heart disease, but does report a history of migraine headaches and Raynaud's disease. There was a previous episode at this hospital where a transient ST segment elevation was identified on her EKG. 

Based on these findings, the nurse might suspect what condition?

Possible Answers:

Silent ischemia

Angina decubitus

Unstable angina

Chronic stable angina

Prinzmetal's angina

Correct answer:

Prinzmetal's angina

Explanation:

The client describes pain at rest without a history of heart disease. This type of chest pain often describes prinzmetal's angina which is a spasm of a major coronary artery and can occur while at rest. Many times the client may have a history of other vasospastic conditions such as Raynaud's. It may be treated with a calcium channel blocker or nitrates. 

 

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