NCLEX Nursing Questions On Cardiovascular System

1. One hour later, administering IV furosemide (Lasix) to a client who had heart failure. A short burst of ventricular tachycardia appears on the cardiac monitor. Which electrolyte imbalance should the nurse suspect?

Hypocalcemia

Hypermagnesemia

Hypokalemia

Hypernatremia

The correct answer is hypokalemia. Hypokalemia refers to low levels of potassium in the blood. Furosemide is a loop diuretic that can cause potassium loss through increased urine output. Potassium plays a crucial role in maintaining normal cardiac function, and low levels can lead to arrhythmias such as ventricular tachycardia. Therefore, the nurse should suspect hypokalemia as the electrolyte imbalance responsible for the appearance of ventricular tachycardia on the cardiac monitor.

Explanation

The correct answer is hypokalemia. Hypokalemia refers to low levels of potassium in the blood. Furosemide is a loop diuretic that can cause potassium loss through increased urine output. Potassium plays a crucial role in maintaining normal cardiac function, and low levels can lead to arrhythmias such as ventricular tachycardia. Therefore, the nurse should suspect hypokalemia as the electrolyte imbalance responsible for the appearance of ventricular tachycardia on the cardiac monitor.

2. What can cause blood pressure to drop to normal levels?

Kidneys’ excretion of sodium only.

Kidneys’ retention of sodium and water

Kidneys’ excretion of sodium and water

Kidneys’ retention of sodium and excretion of water

The kidneys play a crucial role in regulating blood pressure. When the kidneys excrete sodium and water, it helps to decrease the volume of blood in the body, which in turn lowers blood pressure. This is because sodium attracts water, so when the kidneys excrete sodium, water is also excreted, reducing the overall fluid volume and thus reducing blood pressure. Therefore, the kidneys' excretion of sodium and water can cause blood pressure to drop to normal levels.

Explanation

The kidneys play a crucial role in regulating blood pressure. When the kidneys excrete sodium and water, it helps to decrease the volume of blood in the body, which in turn lowers blood pressure. This is because sodium attracts water, so when the kidneys excrete sodium, water is also excreted, reducing the overall fluid volume and thus reducing blood pressure. Therefore, the kidneys' excretion of sodium and water can cause blood pressure to drop to normal levels.

3. What describes the amount of stretch on the myocardium at the end of diastole?

Afterload

Cardiac index

Cardiac output

Preload

Preload refers to the amount of stretch on the myocardium at the end of diastole. It represents the volume of blood in the ventricles just before contraction. When the ventricles are filled with a greater volume of blood during diastole, it results in a higher preload and leads to a more forceful contraction during systole. Therefore, preload is an important determinant of cardiac output and is directly related to the stroke volume.

Explanation

Preload refers to the amount of stretch on the myocardium at the end of diastole. It represents the volume of blood in the ventricles just before contraction. When the ventricles are filled with a greater volume of blood during diastole, it results in a higher preload and leads to a more forceful contraction during systole. Therefore, preload is an important determinant of cardiac output and is directly related to the stroke volume.

4. A client receives spironolactone to treat hypertension. Which instruction should the nurse provide?

“Eat foods high in potassium.”

“Take daily potassium supplements.”

“Discontinue sodium restrictions.”

“Avoid salt substitutes.”

The nurse should instruct the client to "Avoid salt substitutes" when receiving spironolactone to treat hypertension. Spironolactone is a potassium-sparing diuretic, which means it helps the body retain potassium and excrete sodium. Salt substitutes often contain high amounts of potassium, so consuming them can lead to excessive potassium levels in the body, which can be dangerous. Therefore, it is important for the client to avoid salt substitutes to maintain a balanced potassium level while taking spironolactone.

Explanation

The nurse should instruct the client to "Avoid salt substitutes" when receiving spironolactone to treat hypertension. Spironolactone is a potassium-sparing diuretic, which means it helps the body retain potassium and excrete sodium. Salt substitutes often contain high amounts of potassium, so consuming them can lead to excessive potassium levels in the body, which can be dangerous. Therefore, it is important for the client to avoid salt substitutes to maintain a balanced potassium level while taking spironolactone.

5. Aorta and Baroreceptors in the carotid artery walls respond to

Changes in blood pressure

Changes in arterial oxygen tension

Changes in arterial carbon dioxide tension

Changes in heart rate

The aorta and baroreceptors in the carotid artery walls respond to changes in blood pressure. When blood pressure increases, the baroreceptors detect the change and send signals to the brain, which then triggers a response to lower the blood pressure. Similarly, when blood pressure decreases, the baroreceptors detect the change and send signals to increase the blood pressure. Therefore, the aorta and baroreceptors play a crucial role in maintaining blood pressure homeostasis by responding to changes in blood pressure.

Explanation

The aorta and baroreceptors in the carotid artery walls respond to changes in blood pressure. When blood pressure increases, the baroreceptors detect the change and send signals to the brain, which then triggers a response to lower the blood pressure. Similarly, when blood pressure decreases, the baroreceptors detect the change and send signals to increase the blood pressure. Therefore, the aorta and baroreceptors play a crucial role in maintaining blood pressure homeostasis by responding to changes in blood pressure.

6. What describes the force against which the ventricle must expel blood?

Afterload

Cardiac output

Overload

Preload

Afterload refers to the force that the ventricle must overcome in order to eject blood from the heart into the systemic circulation. It represents the resistance that the ventricle encounters when pumping blood out of the heart. This resistance is mainly determined by the peripheral vascular resistance and the compliance of the arterial system. Therefore, afterload can be seen as the force against which the ventricle must expel blood. Cardiac output, overload, and preload are not accurate descriptions of this force.

Explanation

Afterload refers to the force that the ventricle must overcome in order to eject blood from the heart into the systemic circulation. It represents the resistance that the ventricle encounters when pumping blood out of the heart. This resistance is mainly determined by the peripheral vascular resistance and the compliance of the arterial system. Therefore, afterload can be seen as the force against which the ventricle must expel blood. Cardiac output, overload, and preload are not accurate descriptions of this force.

7. After a treadmill test and cardiac catheterization, the client seems to have coronary artery disease, which is inoperative. He is taken to the cardiac rehabilitation unit. During the first visit to the unit, he says that he doesn’t know why he should be there because nothing can make him better. The best nursing response should be:

“Cardiac rehabilitation is not a cure but can help restore you to many of your former activities.”

“Here, we teach you to gradually change your lifestyle to accommodate your heart disease.”

“You are probably right, but we can gradually increase your activities so that you can live a more active life.”

“Do you feel that you will have to make some changes in your life now?”

The correct answer is "Cardiac rehabilitation is not a cure but can help restore you to many of your former activities." This response acknowledges the client's belief that nothing can make him better, while also providing information about the purpose of cardiac rehabilitation. It emphasizes that although it is not a cure, it can still help the client regain some of their previous abilities and improve their quality of life. This response offers hope and encourages the client to participate in the rehabilitation program.

Explanation

The correct answer is "Cardiac rehabilitation is not a cure but can help restore you to many of your former activities." This response acknowledges the client's belief that nothing can make him better, while also providing information about the purpose of cardiac rehabilitation. It emphasizes that although it is not a cure, it can still help the client regain some of their previous abilities and improve their quality of life. This response offers hope and encourages the client to participate in the rehabilitation program.

8. Which is the major determinant of diastolic blood pressure?

Baroreceptors

Cardiac output

Renal function

Vascular resistance

Vascular resistance is the major determinant of diastolic blood pressure. Diastolic blood pressure is the pressure in the arteries when the heart is at rest between contractions. Vascular resistance refers to the resistance to blood flow in the blood vessels. When the blood vessels constrict, the resistance increases, leading to an increase in diastolic blood pressure. On the other hand, when the blood vessels dilate, the resistance decreases, resulting in a decrease in diastolic blood pressure. Therefore, changes in vascular resistance have a significant impact on diastolic blood pressure.

Explanation

Vascular resistance is the major determinant of diastolic blood pressure. Diastolic blood pressure is the pressure in the arteries when the heart is at rest between contractions. Vascular resistance refers to the resistance to blood flow in the blood vessels. When the blood vessels constrict, the resistance increases, leading to an increase in diastolic blood pressure. On the other hand, when the blood vessels dilate, the resistance decreases, resulting in a decrease in diastolic blood pressure. Therefore, changes in vascular resistance have a significant impact on diastolic blood pressure.

9. A 57-year-old client who has a history of asthma is prescribed propranolol (Inderal) for the purpose of controlling hypertension. Before administered propranolol. Which action should the nurse take first?

Monitor the apical pulse rate

Instruct the client to take the medication with food

Question the physician about the order

Caution the client to rise slowly when standing.

The nurse should question the physician about the order because propranolol is a non-selective beta blocker, which can cause bronchospasm in clients with a history of asthma. It is contraindicated in clients with asthma because it can worsen their respiratory symptoms. Therefore, it is important for the nurse to clarify the order with the physician before administering the medication to ensure the client's safety.

Explanation

The nurse should question the physician about the order because propranolol is a non-selective beta blocker, which can cause bronchospasm in clients with a history of asthma. It is contraindicated in clients with asthma because it can worsen their respiratory symptoms. Therefore, it is important for the nurse to clarify the order with the physician before administering the medication to ensure the client's safety.

10. When assessing an ECG, The nurse is aware that the P-R interval represents the time taken for the:

Impulse to begin atrial contraction

Impulse to transverse the atria to the AV node

SA node to discharge the impulse to begin atrial depolarization

Impulse to travel to the ventricles

The P-R interval represents the time taken for the impulse to travel to the ventricles. This interval measures the time between the beginning of atrial depolarization (represented by the P wave) and the beginning of ventricular depolarization (represented by the QRS complex). It reflects the time it takes for the electrical signal to travel from the atria, through the AV node, and into the ventricles.

Explanation

The P-R interval represents the time taken for the impulse to travel to the ventricles. This interval measures the time between the beginning of atrial depolarization (represented by the P wave) and the beginning of ventricular depolarization (represented by the QRS complex). It reflects the time it takes for the electrical signal to travel from the atria, through the AV node, and into the ventricles.