ATI RN
ANCC Cardiovascular Certification Practice Questions Questions
Question 1 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.
Question 2 of 5
The client is being given a cardio-selective beta blocker because of which possible reasons? Select all that apply.
Correct Answer: C
Rationale: The correct answer is C: Dysrhythmias. Cardio-selective beta blockers are commonly used to manage dysrhythmias by blocking the effects of adrenaline on the heart, helping to regulate the heart rate and rhythm. This is achieved by blocking beta-1 receptors in the heart, without affecting beta-2 receptors in the lungs. Incorrect choices: A: Hypotension - Beta blockers can actually worsen hypotension by reducing the heart rate and cardiac output. B: Hypertension - While beta blockers can be used to treat hypertension, cardio-selective beta blockers are not typically the first choice for this condition. D: Cardiac arrest - Beta blockers are used in some cases to prevent cardiac arrest, but they are not the primary treatment for this emergency situation.
Question 3 of 5
The client is taking Flecainide for arrhythmias. What type of anti- arrhythmic medication is this:
Correct Answer: D
Rationale: Flecainide is a Class IC antiarrhythmic medication. Class IC antiarrhythmics block sodium channels in the heart, slowing conduction velocity. This helps in treating tachyarrhythmias. Choices A and C are both listed as Class IB, which work by blocking sodium channels but have different effects on action potential duration compared to Flecainide. Choice B, Class II, works by blocking beta-adrenergic receptors and is not the correct class for Flecainide. Therefore, the correct answer is D as Flecainide belongs to Class IC due to its mechanism of action.
Question 4 of 5
The client is taking an ACE inhibitor. What is a contraindication to taking this drug?
Correct Answer: C
Rationale: The correct answer is C: Renal artery stenosis. ACE inhibitors can lead to decreased renal blood flow, which can worsen renal artery stenosis. This can result in decreased kidney function and potentially lead to renal failure. A: Hypertension is not a contraindication to taking ACE inhibitors, as they are commonly used to treat hypertension. B: Bronchospasm is not a contraindication to taking ACE inhibitors, as they are not known to worsen bronchospasm. D: Heart failure is not a contraindication to taking ACE inhibitors, as they are commonly used to treat heart failure by reducing strain on the heart.
Question 5 of 5
The client has had heparin-induced thrombocytopenia. How is this treated?
Correct Answer: D
Rationale: The correct answer is D: Give lepirudin. Heparin-induced thrombocytopenia is a serious condition caused by heparin use. Lepirudin is a direct thrombin inhibitor used to treat this condition by preventing further clot formation. Other choices are incorrect because: A: Clotting factors are not appropriate as they can worsen the condition. B: Vitamin K is used to reverse the effects of warfarin, not heparin-induced thrombocytopenia. C: Warfarin is not used in the acute treatment of heparin-induced thrombocytopenia, as it takes time to achieve therapeutic anticoagulation.