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NCLEX-RN Exam Questions - Part 13
1. Assessment of the client with pericarditis may reveal which of the following?
A) Ventricular gallop and substernal chest pain
B) Narrowed pulse pressure and shortness of breath
C) Pericardial friction rub and pain on deep inspiration
D) Pericardial tamponade and widened pulse pressure
2. Clinical manifestations seen in left-sided rather than in right-sided heart failure are:
A) Elevated central venous pressure and peripheral edema
B) Dyspnea and jaundice
C) Hypotension and hepatomegaly
D) Decreased peripheral perfusion and rales
3. Which classification of drugs is contraindicated for the client with hypertrophic cardiomyopathy?
A) Positive inotropes
B) Vasodilators
C) Diuretics
D) Antidysrhythmics
4. To ensure proper client education, the nurse should teach the client taking SL nitroglycerin to expect which of the following responses with administration?
A) Stinging, burning when placed under the tongue
B) Temporary blurring of vision
C) Generalized urticaria with prolonged use
D) Urinary frequency
5. When a client is receiving vasoactive therapy IV, such as dopamine (Intropin), and extravasation occurs, the nurse should be prepared to administer which of the following medications directly into the site?
A) Phentolamine (Regitine)
B) Epinephrine
C) Phenylephrine (Neo-Synephrine)
D) Sodium bicarbonate
A) Ventricular gallop and substernal chest pain
B) Narrowed pulse pressure and shortness of breath
C) Pericardial friction rub and pain on deep inspiration
D) Pericardial tamponade and widened pulse pressure
2. Clinical manifestations seen in left-sided rather than in right-sided heart failure are:
A) Elevated central venous pressure and peripheral edema
B) Dyspnea and jaundice
C) Hypotension and hepatomegaly
D) Decreased peripheral perfusion and rales
3. Which classification of drugs is contraindicated for the client with hypertrophic cardiomyopathy?
A) Positive inotropes
B) Vasodilators
C) Diuretics
D) Antidysrhythmics
4. To ensure proper client education, the nurse should teach the client taking SL nitroglycerin to expect which of the following responses with administration?
A) Stinging, burning when placed under the tongue
B) Temporary blurring of vision
C) Generalized urticaria with prolonged use
D) Urinary frequency
5. When a client is receiving vasoactive therapy IV, such as dopamine (Intropin), and extravasation occurs, the nurse should be prepared to administer which of the following medications directly into the site?
A) Phentolamine (Regitine)
B) Epinephrine
C) Phenylephrine (Neo-Synephrine)
D) Sodium bicarbonate
1. Right Answer: C
Explanation: (A) No S3 or S4 are noted with pericarditis. (B) No change in pulse pressure occurs. (C) The symptoms of pericarditis vary with the cause, but they usually include chest pain, dyspnea, tachycardia, rise in temperature, and friction rub caused by fibrin or other deposits. The pain seen with pericarditis typically worsens with deep inspiration. (D) Tamponade is not typically seen early on, and no change in pulse pressure occurs.
2. Right Answer: D
Explanation: (A, B, C) Clinical manifestations of right-sided heart failure are weakness, peripheral edema, jugular venous distention, hepatomegaly, jaundice, and elevated central venous pressure. (D) Clinical manifestations of left-sided heart failure are left ventricular dysfunction, decreased cardiac output, hypotension, and the backward failure as a result of increased left atrium and pulmonary artery pressures, pulmonary edema, and rales.
3. Right Answer: A
Explanation: (A) Positive inotropic agents should not be administered owing to their action of increasing myocardial contractility. Increased ventricular contractility would increase outflow tract obstruction in the client with hypertrophic cardiomyopathy. (B) Vasodilators are not typically prescribed but are not contraindicated. (C)Diuretics are used with caution to avoid causing hypovolemia. (D) Antidysrhythmics are typically needed to treat both atrial and ventricular dysrhythmias.
4. Right Answer: A
Explanation: (A) Stinging or burning when nitroglycerin is placed under the tongue is to be expected. This effect indicates that the medication is potent and effective for use.Failure to have this response means that the client needs to get a new bottle of nitroglycerin. (B, C, D) The other responses are not expected in this situation and are not even side effects.
5. Right Answer: A
Explanation: (A) Phentolamine is given to counteract the-adrenergic effects that cause ischemia and necrosis of local tissue. (B) Epinephrine is an endogenous catecholamine that produces vasoconstriction and increases heart rate and contractility. (C) Phenylephrine causes constriction of arterioles of skin, mucous membranes, and viscera, which in turn can cause ischemia and necrosis. (D) Sodium bicarbonate is an alkalinizing agent that is incompatible with dopamine.
Explanation: (A) No S3 or S4 are noted with pericarditis. (B) No change in pulse pressure occurs. (C) The symptoms of pericarditis vary with the cause, but they usually include chest pain, dyspnea, tachycardia, rise in temperature, and friction rub caused by fibrin or other deposits. The pain seen with pericarditis typically worsens with deep inspiration. (D) Tamponade is not typically seen early on, and no change in pulse pressure occurs.
2. Right Answer: D
Explanation: (A, B, C) Clinical manifestations of right-sided heart failure are weakness, peripheral edema, jugular venous distention, hepatomegaly, jaundice, and elevated central venous pressure. (D) Clinical manifestations of left-sided heart failure are left ventricular dysfunction, decreased cardiac output, hypotension, and the backward failure as a result of increased left atrium and pulmonary artery pressures, pulmonary edema, and rales.
3. Right Answer: A
Explanation: (A) Positive inotropic agents should not be administered owing to their action of increasing myocardial contractility. Increased ventricular contractility would increase outflow tract obstruction in the client with hypertrophic cardiomyopathy. (B) Vasodilators are not typically prescribed but are not contraindicated. (C)Diuretics are used with caution to avoid causing hypovolemia. (D) Antidysrhythmics are typically needed to treat both atrial and ventricular dysrhythmias.
4. Right Answer: A
Explanation: (A) Stinging or burning when nitroglycerin is placed under the tongue is to be expected. This effect indicates that the medication is potent and effective for use.Failure to have this response means that the client needs to get a new bottle of nitroglycerin. (B, C, D) The other responses are not expected in this situation and are not even side effects.
5. Right Answer: A
Explanation: (A) Phentolamine is given to counteract the-adrenergic effects that cause ischemia and necrosis of local tissue. (B) Epinephrine is an endogenous catecholamine that produces vasoconstriction and increases heart rate and contractility. (C) Phenylephrine causes constriction of arterioles of skin, mucous membranes, and viscera, which in turn can cause ischemia and necrosis. (D) Sodium bicarbonate is an alkalinizing agent that is incompatible with dopamine.
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