Practice Perfusion NCLEX Questions And Answers
(Verified Solution)
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.
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
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
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."
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
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 drug
will affect insulin needs. The best response by the nurse would be that:
a. The drug will have no effect on insulin needs.
b. The drug might cause hypoglycemia.
c. The drug could cause hyperglycemia.
d. The client should ask the physician this question.
b. The drug might cause hypoglycemia.
There is increased incidence of hypoglycemia with type I diabetes mellitus, because
propranolol can inhibit glycogenolysis.
When planning care for a client receiving treatment for cardiac dysrhythmias, an
appropriate client outcome would be:
a. The client will avoid use of caffeine during therapy.
b. The client will maintain heart rate below 60 beats per minute.
c. The client will limit fluid intake to 1000 ml/day.
d. The client will limit cigarettes to 15/day.
a. The client will avoid use of caffeine during therapy.
Causes of dysrhythmias include electrolyte imbalance, hyperthyroidism, anxiety,
(Verified Solution)
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.
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
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
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."
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
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 drug
will affect insulin needs. The best response by the nurse would be that:
a. The drug will have no effect on insulin needs.
b. The drug might cause hypoglycemia.
c. The drug could cause hyperglycemia.
d. The client should ask the physician this question.
b. The drug might cause hypoglycemia.
There is increased incidence of hypoglycemia with type I diabetes mellitus, because
propranolol can inhibit glycogenolysis.
When planning care for a client receiving treatment for cardiac dysrhythmias, an
appropriate client outcome would be:
a. The client will avoid use of caffeine during therapy.
b. The client will maintain heart rate below 60 beats per minute.
c. The client will limit fluid intake to 1000 ml/day.
d. The client will limit cigarettes to 15/day.
a. The client will avoid use of caffeine during therapy.
Causes of dysrhythmias include electrolyte imbalance, hyperthyroidism, anxiety,
