LPN Cardio

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Sample questions from LPN Cardio

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.At change of shift on a telemetry unit, which client should the practical nurse report to the RN first?

   • A.A client taking a diuretic who reports urinating twice during the night
   • B.A client with atrial fibrillation whose apical pulse is irregular at 96/min and who denies discomfort
   • C.A client 6 hours after femoral cardiac catheterization whose affected foot is cool and pale with a diminished pedal pulse
   • D.A client with chronic heart failure who has gained 0.5 kg (1.1 lb) in 24 hours and denies dyspnea

   Rationale: A cool, pale foot and diminished pulse after femoral catheterization suggest impaired arterial perfusion and require prompt RN notification. The modest weight gain without dyspnea needs follow-up but is less urgent. An irregular rate of 96/min may be expected with atrial fibrillation if the client is stable, and nocturia can occur with diuretic therapy; neither takes priority over possible acute limb ischemia.

2. 2.During a home visit, a client with heart failure says, "I get mixed up about what to do when my weight changes." Which actions are appropriate for the practical nurse to take within the plan of care? Select all that apply.

   • A.Tell the client to take an extra dose of furosemide whenever weight increases by 1 kg.
   • B.Revise the client's fluid restriction based on today's weight.
   • C.Review the written daily-weight and symptom instructions already provided by the RN.
   • D.Ask the client to demonstrate how weight is recorded and report difficulty following the plan to the RN.
   • E.Reinforce taking prescribed medications as directed and using the established contact number for worsening symptoms.
   • F.Notify the RN if the client reports new breathlessness at rest or a rapid weight increase.

   Rationale: Reviewing existing written instructions and asking for a return demonstration reinforce, rather than independently initiate, teaching; difficulty should be shared with the RN. New breathlessness at rest or rapid weight gain is a meaningful change that warrants prompt reporting, and reinforcing the established medication and contact plan is appropriate. Directing an extra diuretic dose or changing fluid limits independently exceeds the practical nurse's role and the established plan.

3. 3.The provider prescribes digoxin 0.125 mg orally for a client with heart failure. Before administration, the practical nurse counts an apical pulse of 54/min; the client's usual rate is 68/min. What is the best action?

   • A.Hold the dose and report the pulse finding to the RN.
   • B.Give half the prescribed dose and document the change.
   • C.Recheck the pulse after the client walks in the hallway.
   • D.Administer the dose with food to reduce nausea.

   Rationale: A pulse of 54/min is below the commonly ordered hold parameter for digoxin, and the change from baseline should be reported before the medication is given. Giving the dose with food does not address the bradycardia. Walking could increase the pulse but would not make it appropriate to administer without clarification, and independently reducing the dose changes the prescription.

4. 4.In a community clinic, a 5-year-old with a congenital heart defect is scheduled for a dental extraction. The parent says, "I will stop the child's heart medicine tonight so there is no bleeding." Which response is best?

   • A."Withhold the medicine and restart it only after the dentist approves."
   • B."Give the prescribed medicine as usual unless the prescriber gives different instructions; I will alert the RN to your concern."
   • C."Stop every medication the night before any dental procedure."
   • D."Double the next dose after the extraction to make up for the missed dose."

   Answer and rationale are in the full material.

5. 5.A client's potassium is 6.1 mEq/L (reference range 3.5 to 5.0 mEq/L). The client takes lisinopril and reports new muscle weakness. Which action should the practical nurse take first?

   • A.Give the scheduled lisinopril and document the weakness.
   • B.Encourage a potassium-rich snack and recheck the level tomorrow.
   • C.Ask the client to walk to determine whether the weakness improves.
   • D.Promptly report the critical result and new weakness to the RN.

   Answer and rationale are in the full material.