ATI RN
Med-Surg Cardiovascular Test Bank Questions
Question 1 of 5
During treatment with tissue plasminogen activator (tPA) for a patient with a ST segment elevation MI, the nurse is most concerned on finding
Correct Answer: B
Rationale: In this scenario, the correct answer is "
B) A decrease in responsiveness of the patient." This is the most concerning finding during treatment with tissue plasminogen activator (tP
A) for a patient with an ST segment elevation MI because it may indicate a potential adverse reaction to the medication or a worsening condition.
Option A, "Oozing of blood from the IV site," is not the most concerning finding in this situation because it is a common side effect of tPA therapy and can be managed by the healthcare team.
Option C, "BP of 102/60 with a HR of 78," is within normal parameters for blood pressure and heart rate and would not be the most concerning finding unless it drastically changed.
Option D, "The presence of intermittent accelerated idioventricular dysrhythmias," is also a serious finding but may be expected in the setting of an MI and tPA therapy. A decrease in patient responsiveness would be a more immediate concern as it could indicate a critical change in the patient's condition.
Educationally, this question highlights the importance of recognizing and prioritizing critical assessment findings in patients receiving specific treatments, such as tPA for ST segment elevation MI. Nurses must be vigilant in monitoring patients for changes in responsiveness, as this can indicate a need for urgent intervention. Understanding the significance of various assessment findings is crucial in providing safe and effective care to patients with cardiovascular emergencies.
Question 2 of 5
The nurse suspects the patient is in cardiogenic shock based upon which of the following findings?
Correct Answer: A
Rationale: In this scenario, option A, "Decreased or muffled heart sounds," is indicative of cardiogenic shock. Cardiogenic shock is characterized by the heart's inability to pump enough blood to meet the body's demands. This can lead to decreased cardiac output, resulting in diminished heart sounds due to weakened heart contractions or fluid accumulation around the heart.
Option B, "Cardiac index >2.2 L/min/m2," is incorrect because a high cardiac index would not typically be seen in cardiogenic shock, where the heart's pumping ability is compromised.
Option C, "Bounding pulses," is incorrect because bounding pulses are more commonly associated with conditions like hyperthyroidism or aortic regurgitation, not specifically cardiogenic shock.
Option D, "Cardiac output of 5 L/min," is incorrect because a cardiac output of 5 L/min is within the normal range and would not typically be a defining characteristic of cardiogenic shock.
Educationally, understanding the clinical manifestations of cardiogenic shock is crucial for nurses caring for patients with cardiac conditions. Recognizing subtle changes like decreased or muffled heart sounds can prompt timely intervention and prevent further deterioration in a patient's condition. This knowledge aids in providing appropriate care and improving patient outcomes in critical situations.
Question 3 of 5
You assess a patient who has just returned to the recovery area after having a coronary arteriogram. Which of these data is of most concern?
Correct Answer: C
Rationale: In this scenario, the most concerning data point is option
C) Left groin has a 3-cm ecchymotic area. This finding is concerning because it suggests a potential complication following a coronary arteriogram, such as bleeding or hematoma at the insertion site. This requires immediate attention to prevent further complications, such as hemorrhage or infection.
Option
A) Blood pressure is 144/78 is within normal range and not immediately concerning post-procedure. Option
B) Pedal pulses palpable at +1 indicate some perfusion to the lower extremities, which is a positive finding. Option
D) Apical pulse of 122 and regular is slightly elevated but not alarming in the immediate post-procedure period.
Educationally, it is essential for healthcare providers to prioritize and recognize signs of potential complications following invasive procedures like a coronary arteriogram. Understanding the significance of each data point helps in prompt identification and management of complications, ensuring patient safety and optimal outcomes.
Question 4 of 5
When assessing the mental status of a client with cardiac disorders, what does confusion indicate?
Correct Answer: D
Rationale: In assessing the mental status of a client with cardiac disorders, confusion indicates cerebral ischemia, making option D the correct answer. Cerebral ischemia occurs when there is a lack of blood flow to the brain, leading to cognitive impairment such as confusion. This is a critical finding in a client with cardiac disorders as it may indicate inadequate perfusion to the brain.
Option A, blood congestion in neck veins, is unlikely to cause confusion directly but may indicate right-sided heart failure. Option B, left-sided heart failure, typically presents with respiratory symptoms like dyspnea rather than confusion. Option C, absence of pulses, would not directly cause confusion but may suggest severe circulatory compromise.
Educationally, understanding the neurological manifestations of cardiac disorders is crucial for nurses to provide holistic care. Recognizing signs of cerebral ischemia early can prompt timely interventions to prevent further complications. Nurses must be able to differentiate between various cardiac-related symptoms to provide safe and effective care to patients with cardiovascular conditions.
Question 5 of 5
Which of the following cardiomyopathies is accompanied by dyspnea on exertion when lying down, fatigue, and edema in the lower extremities, as well as palpitations and chest pain?
Correct Answer: A
Rationale: The correct answer is
A) Dilated cardiomyopathy. In dilated cardiomyopathy, the heart muscle becomes weakened and enlarged, leading to poor pumping ability. This results in symptoms such as dyspnea on exertion when lying down due to fluid accumulation in the lungs, fatigue, edema in the lower extremities from fluid retention, palpitations, and chest pain due to inefficient blood circulation.
Option
B) Hypertrophic cardiomyopathy is characterized by thickening of the heart muscle, leading to symptoms such as chest pain, shortness of breath, and palpitations. However, it typically does not present with the specific symptom of dyspnea on exertion when lying down seen in dilated cardiomyopathy.
Option
C) Restrictive cardiomyopathy is characterized by stiffness of the heart muscle, leading to symptoms such as fatigue, fluid retention, and shortness of breath. However, it does not typically present with the specific symptom of dyspnea on exertion when lying down seen in dilated cardiomyopathy.
Option
D) Arrhythmogenic right ventricular cardiomyopathy is a condition where the muscle of the right ventricle is replaced by fatty or fibrous tissue, leading to abnormal heart rhythms. While it can present with symptoms such as palpitations, it is not typically associated with the specific symptom of dyspnea on exertion when lying down seen in dilated cardiomyopathy.
Understanding the distinguishing features of each type of cardiomyopathy is crucial for healthcare professionals in diagnosing and managing patients with these conditions. Recognizing the unique clinical presentations helps guide appropriate treatment strategies and improve patient outcomes.