ATI RN
ATI Med Surg Cardiovascular Test Bank Questions
Question 1 of 5
After receiving change-of-shift report about the following four patients on the cardiac care unit, which patient should the nurse assess first?
Correct Answer: D
Rationale: The correct answer is D because the patient with unstable angina who just returned after a PCI is at the highest risk for complications. Assessing this patient first allows the nurse to monitor for any signs of post-procedure complications such as bleeding, clot formation, or reperfusion injury. Immediate assessment and intervention can prevent adverse outcomes. Choice A is incorrect because although pericarditis can be painful, it is not an immediate priority compared to post-PCI complications. Choice B is incorrect as the patient scheduled to receive nifedipine can be assessed after addressing the more urgent situation. Choice C is incorrect because although anxiety is important, it is not a life-threatening concern compared to the post-PCI patient.
Question 2 of 5
A client with dilated cardiomyopathy, pulmonary edema, and severe dyspnea is placed on dobutamine. Which assessment finding indicates that the drug is effective?
Correct Answer: A
Rationale: The correct answer is A: Increased activity tolerance. Dobutamine is a positive inotrope that increases cardiac contractility, leading to improved cardiac output and oxygen delivery. As a result, the client will experience increased energy levels and improved exercise tolerance. Absence of arrhythmias (B) is important but does not directly indicate the drug's effectiveness. Negative Homans' sign (C) is unrelated to dobutamine therapy. Blood pressure of 160/90 mm Hg (D) does not specifically reflect the drug's effectiveness in this context.
Question 3 of 5
An infant age 2 months has a tentative diagnosis of congenital heart defect. During physical assessment, the nurse notes that the infant has a pulse rate of 168 beats/minute and a respiratory rate of 72 breaths/minute. In which position should the nurse place the infant?
Correct Answer: B
Rationale: The correct answer is B: Lying on the back. Placing the infant on the back helps improve respiratory effort and oxygenation by allowing for maximum expansion of the lungs. This position also helps in reducing the workload on the heart, especially crucial in congenital heart defects. It promotes better blood circulation and oxygen delivery. Choice A: Upright in an infant seat may increase the workload on the heart due to the position's effect on blood flow and lung expansion. Choice C: Lying on the abdomen can compromise respiratory effort and decrease oxygenation, which could be detrimental in a child with a congenital heart defect. Choice D: Sitting in high Fowler's position may also add stress to the heart and lungs, potentially worsening the infant's condition.
Question 4 of 5
The nurse is caring for a client who has just undergone cardiac angiography. The catheter insertion site is free from bleeding or signs of hematoma. The vital signs and distal pulses remain in the client's normal range. The intravenous fluids were discontinued. The client is not hungry or thirsty and refuses any food or fluids, asking to be left alone to rest. Which of the following is the nurse's best response?
Correct Answer: A
Rationale: The correct response is A: "You are recovering well from the procedure and resting is a good idea." This is the best response because the client's vital signs, distal pulses, and catheter insertion site are stable, indicating a good recovery. Encouraging rest aligns with the client's expressed preference, which promotes comfort and healing. Choice B is incorrect as walking may not be suitable immediately post-cardiac angiography. Choice C is incorrect as forcing fluids on a client who is not thirsty can lead to discomfort. Choice D is incorrect as focusing on leg exercises may not be the priority at this immediate post-procedure stage.
Question 5 of 5
The nurse is caring for a 2-month-old child with transposition of the great vessels. Which of these interventions has highest priority?
Correct Answer: B
Rationale: The correct answer is B: Maintaining proper caloric intake. In a case of transposition of the great vessels, ensuring adequate nutrition is crucial for the infant's growth and development. Without proper caloric intake, the child may experience complications. Providing comfort for parents (choice A) is important but not the highest priority. Reducing stressors for the infant (choice C) is also important but not as critical as ensuring proper nutrition. Documenting vital signs (choice D) is necessary but does not address the immediate need for nutrition in this case.