Nursing Expo

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NCLEX-RN Exercises “Cardiovascular System”, level 1

1. to avoid an error of parallax when taking a client?s blood pressure, the nurse should:

1. use a narrow cuff

2. read it at eye level

3. stand close to the manometer

4. elevate the client?s arm on a pillow

2. the nurse institutes safety precautions for a client receiving oxygen, because oxygen:

1. is flammable

2. supports combustion

3. has unstable properties

4. increases apprehension

3. when instituting oxygen therapy, the nurse recognizes that the method of oxygen administration least likely to increase apprehension in the client is:

1. tent

2. mask

3. cannula

4. catheter

4. the nurse identifies a commonality between the strain on client?s heart with prolonged anemia or polycythemia to be:

1. pressure

2. temperature

3. cardiac output

4. surface tension

5. a client with pyrexia will most likely demonstrate:

1. dyspnea

2. percordial pain

3. increased pulse rate

4. elevated blood pressure

6. the nurse asseses that a client?s pulse pressure is decreasing. This would be evaluated by calculating the:

1. force exerted against an arterial wall

2. difference between the apical and radial rates

3. difference between systolic and diastolic readings

4. degree of ventricular contraction in relation to output

7. following open heart surgery a client develops a temperature of 102 ? F (38.8 ? C). the nurse notifies the physician because elevated temperatures:

1. increase the cardiac output

2. may indicate cerebral edema

3. may be a forerunner or hemorrhage

4. cause diaphoresis and possible chilling

8. the nurse should teach clients with peripheral vascular disease to stop smoking because nicotine:

1. constricts the superficial vessels, dilating the deep vessels

2. constricts the peripheral vessels and increases the force of flow

3. dilates the superficial vessels but constricts the collateral circulation

4. dilates the peripheral vessels vessels, causing a reflex constriction of visceral vessels

9. when obtaining data from a client with thromboangitis obliterans (Buerger?s disease), the nurse would expect the client to demonstrate or report:

1. easy fatigue of extremities, continuous claudication

2. general blanching of skin and intermitten claudication

3. intermittent claudication, burning pain after exposure to cold

4. burning pain precipitated by cold exposure, fatigue, blanching of skin

10. following a vein ligation and stripping, the client should be positioned:

1. flat with the knee gatch engaged

2. supine with the legs elevated at 30?

3. in semi-Fowler?s position with the knees flexed

4. with the head elevated and the feet against a footboard

11. the nurse understand that a pulmonary embolism is a most unlikely complication in the postoperative period following:

1. hysterectomy

2. prostatectomy

3. appendectomy

4. saphenous vein ligation

12. to prevent a pulmonary embolus in a client on bed rest, the nurse should:

1. limit the client?s fluid intake

2. encourage deep breathing and coughing

3. use the knee gatch when the client is in bed

4. teach the client to move the legs when in bed

13. after abdominal surgery a client suddenly complains of numbness in the rigt leg and a funny feeling in the toes. The nurse should first:

1. elevate the legs and tell the client to stay in bed

2. tell the client to remain in bed and notify the physician

3. rub the client?s leg to start circulation and cover the client with a warm blanket

4. tell the client about the dangers of staying in bed too much and encourage ambulation.

14. While convalescing from abdominal surgery a clients develop thrombophlebitis. The sign that would indicate this complication to the nurse would be:

1. Intermitten claudication

2. Pitting edema of lower extremities

3. Severe pain on extension of an extremity

4. Localized warmth and tenderness of the leg.

15. A client is being instructed on the use of elastic stocking should be:

1. Alternately kept on 2 hours and off 2 hours

2. Worm only at night when activity is lessened

3. Put on before getting out of bed in the morning

4. Left in place until the physician advises otherwise

1.????? 2. An improper reading of the level of mercury will be obtained if the reader is not perpendicular to the column. An error of parallax results when an object is displaced by an observer?s altered position

1. Too narrow a cuff can result in erroneously high readings; not an error of parallax

3. Standing close to the manometer is not explicit; there may or may not be a resultant error of parallax depending on whether the examiner is perpendicular to the column of mercury

4. Elevating the arm above the level of the heart will result in erroneously low readings; not an error of parallax

2.????? 2. An open flame or spark from static electricity (e.g., leather-soled shoes, wool, silk, nylon, and Dacron blankets, ungrounded electric appliances) can initiate an explosion and fire in the presence of higher than normal oxygen levels

1. Oxygen is not flammable; however, it increases the rate of combustion

3. Oxygen is not unstable

4. oxygen doesn?t increases apprehension; by reducing dyspnea and shortness of breath, it usually reduces apprehension

3.????? 3. Oxygen via nasal cannula is the most comfortable and least instrusive, because the cannula extends minimally into the nose

1. This method is oppressive, and clients complain of feeling ?suffocated? when it is used.

2. Same as answer 1

4. Same as answer 1

4.????? 3. With anemia there is a greater return of blood to the heart from the peripheral vessels; the greater volume of blood returning to the heart stretches it and results in greater cardiac output. With polycythemia the heart must work harder to propel the more viscous blood through the circulatory system

1. Pressure is not involved; the terms anemia and polycythemia both refer to the number of cells present in a given volume (viscosity)

2. Temperature is not involved; the terms anemia and polycythemia both refer to the number of cells present in a given volume (viscosity)

4. Surface tension is not involved; the terms anemia and polycythemia both refer to the number of cells present in a given volume (viscosity)

5.????? 3. The pulse increases to meet increased tissue demands for oxygen in the febrile state.

1. Fever may not cause difficulty in breathing

2. Pain is not related to fever

4. Blood pressure is not necessarily elevated in fever

6.????? 3. Pulse pressure is obtained by subtracting the diastolic from the systolic readings after the blood pressure has been recorded.

1. this is only a partial factor in determining pulse pressure; it is not the pulse pressure itself

2. this is not pulse pressure; it is pulse deficit

4. This is not pulse pressure

7.????? 1. Temperatures of 102?F (38?C) or greater lead to an increased metabolism and cardiac workload

2. An elevated temperature is not an early sign of developing cerebral edema, although the temperature may rise eventually because of medullary compression

3. Fever is unrelated to hemorrhage; in hemorrhage with shock, the temperature decreases

4. Although these symptoms are caused by an elevated temperature, it is not the reason for notifying the physician

8.????? 2. Constriction of the peripheral blood vessels and the resulting increase in blood pressure impair circulation and limit the amount of oxygen being delivered to body cell, particularly in the extremities

1. Nicotine constricts all peripheral vessels, not just superficial ones; its primary action is vasoconstriction; it will not dilate deep vessels

3. Nicotine constricts rather than dilates peripheral vessels

4. Same as answer 3.

9.????? 3. Buerger?s disease (thromboangiitis obliterans) is characterized by vascular inflammation usually in the lower extremities, leading to thrombus formation. As a result of impaired circulation, there is burning pain and intermittent claudication.

1. these symptoms are not related to thromboangiitis obliterans

2. blanching is not related to thromboangiitis obliterans

4. fatigue and blanching of the skin are not related to thromboangiitis obliterans

10.? 2. The legs should be elevated to promote venous return by gravity

1. this position increases pressure on the popliteal space, which may interfere with venous return from the legs

3. flexion of the knees and hips with the legs lower than the heart interferes with venous return

4. dorsiflexion of the feet places tension on the suture line and should be avoided; placing the legs lower than the level of the heart will not promote venous return

11.? 3. An appendectomy is a relatively simple operation; the clients generally out of bed the same day. With an ambulatory client there is less risk of venous stasis, a condition that predisposes the individual to thrombus formation and emboli

1. although generally ambulated the first day postoperatively, the client often is hampered by pain; pelvic surgery increases risk

2. the client may or may not be out of bed the same day depending on the surgical approach; mobility may be hampered by a Foley Catheter

4. vein ligation is performed for varicose veins; the diseased vein is removed, placing and additional burden on the deep venous system and possibly increasing the risk of thrombi

12.? 4. The client who is on bed rest must do exercises such as dorsiflexon of the feet to prevent venous stasis and thrombus formation.

1. limiting fluid intake may lead to hemoconcentration and subsequent thrombus formation

2. this improves pulmonary function rather than prevents venous stasis

3. this actually promotes venous stasis by compressing the popliteal space

13.? 2. Localized sensory changes may indicate nerve damage, impaired circulation, or thrombhophlebitis. Activity should be limited, and physician notified

1. symptoms may indicate a serious problem, and the physician must be notified

3. rubbing or massaging the legs is contraindicated because of possible dislodging of a thrombus if present

4. bed rest is indicated to prevent the possibility of further damage or creation of an embolus

14.? 4. Thrombophlebitis is inflammation of a vein that occurs with the formation of a clot. Signs include pain (especially on dorsiflexion of the foot), redness, warmth, tenderness, and edema

1. intermittent claudication (pain when walking resulting from tissue ischemia) may occur with peripheral vascular disease

2. pitting edema does not occur in thrombophlebitis

3. pain occur on flexion of the foot (Homan?s sign)

15.? 3. Support hose apply external pressure on the veins, preventing the retrograde pressure or flow that may occur in the standing or sitting position; application before arising prevents the vein from having the opportunity to become engorged

1.if the feet are permitted to be dependent before the srocking are put on, venous pooling and edema may occur; application of elastic stockings at this time can cause tissue trauma.

2. because they promote venous return they do not need to be worn when the legs are elevated when sleeping

4. stockings must be removed so the legs can be washed and dried at least daily. They usually need not be worn while in bed with the feet elevated because gravity prevents venous pooling

Sumber:

Comprehensive Review of Nursing for NCLEX-RN, terbitan Mosby tahun 1999.

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