ATI RN
ANCC Cardiovascular Certification Practice Questions Questions
Question 1 of 5
An infant with a ventricular septal defect is receiving digoxin (Lanoxin). Which intervention by the nurse is most appropriate before digoxin administration?
Correct Answer: D
Rationale: The correct answer is D: Check the infant's apical pulse for 1 minute. Before administering digoxin, it is crucial to assess the apical pulse for a full minute to ensure the heart rate is within the appropriate range (usually above 100 bpm in infants). Digoxin can cause bradycardia, so monitoring the apical pulse is essential to prevent potential adverse effects. A: Taking the infant's blood pressure is not the most appropriate intervention before administering digoxin as the focus should be on assessing the heart rate specifically. B: Checking the infant's respiratory rate is not directly related to the administration of digoxin, and assessing the pulse rate is more relevant. C: Checking the infant's radial pulse is not as accurate as assessing the apical pulse when monitoring for potential digoxin-induced changes in heart rate. In summary, the most appropriate intervention before digoxin administration is to check the infant's apical pulse for 1 minute to
Question 2 of 5
When teaching a client with an aneurysm what signs and symptoms may indicate impending rupture, the nurse considers which of the following?
Correct Answer: D
Rationale: The correct answer is D: Size and location of the aneurysm. Monitoring the size and location of the aneurysm is crucial in determining the risk of rupture. Larger aneurysms in critical locations are more likely to rupture. This information guides healthcare providers in making informed decisions about interventions to prevent rupture. Explanation of other choices: A: Medication therapy the client is receiving - While medication therapy may be important in managing symptoms or risk factors associated with an aneurysm, it does not directly indicate impending rupture. B: Client's usual blood pressure - Blood pressure management is important in preventing complications of an aneurysm, but it does not specifically signal impending rupture. C: Age and gender of the client - While age and gender may influence the risk of developing an aneurysm, they do not indicate impending rupture.
Question 3 of 5
The nurse would assess for which of the following manifestations in a client with suspected arterial embolism to the left hand? Select all that apply.
Correct Answer: A
Rationale: The correct answer is A: Pain. Arterial embolism results in decreased blood flow to the affected area, leading to tissue ischemia and pain. Pale skin (B) is a sign of decreased blood flow but may not always be present initially. A bounding radial pulse (C) is unlikely in the presence of an arterial embolism as it indicates increased blood flow. Parasthesias (D) may occur due to nerve compression but are not as specific to arterial embolism as pain. Pain is a key manifestation due to tissue ischemia and should be assessed promptly to prevent further complications.
Question 4 of 5
A patient is suspected of having a decreased cardiac output due to dysrhythmias. Which of the following assessments would be included in a decreased cardiac output? Select all that apply
Correct Answer: A
Rationale: The correct answer is A: Elevated jugular venous distention. This is a classic sign of decreased cardiac output as it indicates increased central venous pressure due to the heart's inability to effectively pump blood. This results in blood backing up into the jugular veins, causing them to appear distended. Explanation for why other choices are incorrect: B: Polyuria is not typically associated with decreased cardiac output. Polyuria is excessive urination and is more commonly seen in conditions such as diabetes insipidus or diabetes mellitus. C: Full and bounding pulses are not indicative of decreased cardiac output. In fact, decreased cardiac output often leads to weak and thready pulses due to reduced blood flow. D: Diaphoresis, or excessive sweating, can occur in various conditions but is not a specific sign of decreased cardiac output. It can be seen in response to pain, anxiety, or fever.
Question 5 of 5
If a hypertensive client with asthma takes the maximal dose of his diuretic and his blood pressure still isn't controlled, the nurse understands the next step in controlling his hypertension would be to:
Correct Answer: A
Rationale: Rationale: 1. ACE inhibitors like enalapril are recommended as second-line therapy for hypertension. 2. ACE inhibitors are effective in managing hypertension in patients with asthma. 3. Adding another diuretic may lead to electrolyte imbalances. 4. Beta blockers like Metoprolol may worsen asthma symptoms. 5. Increasing drug dosage above recommended levels can be harmful and ineffective. Summary: Adding enalapril is the best choice as it is effective, safe in asthma, and avoids potential adverse effects of other options like beta blockers or excessive diuretics.