ATI LPN
Cardiovascular Disease Questions Questions
Question 1 of 5
A 70-year-old woman hospitalized one week ago for acute on chronic kidney injury. Since her hospitalization, she has been receiving hemodialysis through a temporary femoral catheter. Last night she developed a fever 101.7°F. On examination, she is confused; blood pressure 76/40 mmHg the heart rate of 108 b/min. Weight is 60 kg(132 pounds). She is adequate peripheral venous access and is given a 1-liter bolus of normal intravenous saline over 30 minutes. After receiving fluids, her blood pressure is 78/44 mmHg. Oxygen saturation 96% breathing ambient air. Cardiac examination is a regular tachycardia rhythm. There is no jugular venous distention. There is erythema without purulent drainage noted at the femoral catheter site. The extremities are warm with bounding pulses without edema. Data: Hemoglobin 9 g/dL; leukocytosis 16,000; Creatinine 2.6; Potassium 5.6 mEq/L. Blood cultures are growing gram-positive cocci. A chest radiograph is normal. EKG shows sinus tachycardia without ischemia. In addition to replacing the hemodialysis catheter which of the following is the most appropriate next step in treatment?
Correct Answer: A
Rationale: The patient is in septic shock likely due to catheter-related bloodstream infection. Additional fluid resuscitation is necessary to stabilize hemodynamics before considering vasopressors or other interventions.
Question 2 of 5
Right-sided heart failure is usually a consequence of
Correct Answer: A
Rationale: Because the right and left ventricles function in tandem, left-ventricular failure eventually increases the workload on the right ventricle. Consequently, the right ventricle may fail causing infarction. Pulmonary disorders create a high afterload on the right ventricle and may cause a progression to right ventricular failure. Tricuspid valve defects are not the cause of right-sided heart failure. Congenital anomalies are not generally associated with right-sided failure.
Question 3 of 5
During your morning assessment of a patient with heart failure, the patient complains of sudden vision changes that include seeing yellowish-green halos around the lights. Which of the following medications do you suspect is causing this issue?
Correct Answer: D
Rationale: Yellow-green halos are a classic sign of Digoxin toxicity (D).
Question 4 of 5
Which action should the nurse take first to assist a patient with newly diagnosed stage 1 hypertension in making needed dietary changes?
Correct Answer: A
Rationale: The initial nursing action should be assessment of the patient's baseline dietary intake through a thorough diet history. The other actions may be appropriate, but assessment of the patient's baseline should occur first.
Question 5 of 5
Which action will be included in the plan of care when the nurse is caring for a patient who is receiving nicardipine(Cardene) to treat a hypertensive emergency?
Correct Answer: D
Rationale: Frequent monitoring of BP is needed when the patient is receiving rapid-acting IV antihypertensive medications. This can be most easily accomplished with an automated BP machine or arterial line. The patient will require frequent assessments, so allowing 6 to 8 hours of undisturbed sleep is not appropriate. When patients are receiving IV vasodilators, bed rest is maintained to prevent decreased cerebral perfusion and fainting. There is no indication that this patient is nauseated or at risk for aspiration, so an NPO status is unnecessary.