ATI LPN
Cardiovascular NCLEX Questions with Rationale Questions
Question 1 of 5
57 y/o male is admitted with acute cholecystitis due to cholelithiasis and undergoes an uneventful laparoscopic cholecystectomy. He is discharged the next day but returns to the ER 2 days later due to abdominal pain, distension, and fever. Abdominal CT is only positive for moderate ascites. Paracentesis reveals 50 PMNs and bilious fluid. What is the most likely diagnosis?
Correct Answer: C
Rationale: Bile leak is a known complication of cholecystectomy, leading to bilious ascites and peritonitis symptoms like pain and fever.
Question 2 of 5
After diagnosing secondary syphilis(rash involving palms and soles of a traveling salesman), you should recommend all but the following:
Correct Answer: C
Rationale: Benzathine PCN 2.4 million units IM weekly x 3 is not recommended; a single dose is sufficient for treating secondary syphilis.
Question 3 of 5
Which of the following statements is true concerning a newly diagnosed Type 2 diabetic's risk for progression to ESRD?
Correct Answer: D
Rationale: All factors (retinopathy, proteinuria, creatinine elevation) are predictive of progression to ESRD in Type 2 diabetes, reflecting systemic microvascular damage.
Question 4 of 5
A 68-y old male with a longstanding history of cigarette smoking presents with a 3-month history of progressive shortness of breath and dyspnea on exertion. The symptoms have been ongoing and indolent. He reports chronic cough productive of his usual yellow sputum. Physical exam is notable for normal vital signs, prolonged expiratory phase and wheeze bilaterally, elevated jugular venous pressure, and moderate pedal edema. Hematocrit 49%. Which of the following is most likely to prolong his survival?
Correct Answer: D
Rationale: This patient likely has COPD with cor pulmonale (elevated JVP, edema). Long-term oxygen therapy is proven to prolong survival in hypoxemic COPD patients by reducing pulmonary hypertension and improving tissue oxygenation, as shown in trials like the NOTT and MRC studies.
Question 5 of 5
In which dysrhythmias should treatment be instituted immediately?
Correct Answer: D
Rationale: Atrial fibrillation is a completely disorganized and irregular atrial rhythm accompanied by an irregular ventricular rhythm of variable rate. Atrial fibrillation causes the atria to quiver rather than to contract forcefully. This allows blood to become stagnant in the atria and may lead to formation of thrombi. This condition requires resuscitation because of the reduction in cardiac output. The cause of the bradycardia should be investigated, but is not treated emergently when an individual is not exhibiting any symptoms. Fever-induced tachycardia will correct itself once the fever is lowered. Dysrhythmias are treated if they produce significant symptoms or are expected to progress to a more serious level.