ATI RN
Cardiovascular System Practice Exam Questions
Question 1 of 5
The client is on spironolactone (Aldactone). What is the most important dietary instruction?
Correct Answer: A
Rationale: The correct answer is A: Avoid foods high in potassium. Spironolactone is a potassium-sparing diuretic that can increase potassium levels in the body. Consuming foods high in potassium while on spironolactone can lead to hyperkalemia, which can be dangerous. By avoiding foods high in potassium, the client can help maintain a safe potassium level. Summary: - Choice B (Increase intake of foods high in potassium) is incorrect because it can lead to hyperkalemia when combined with spironolactone. - Choice C (Avoid foods high in sodium) is unrelated to spironolactone's mechanism of action. - Choice D (Increase intake of foods high in sodium) is incorrect as it is not relevant to the dietary instruction needed for a client on spironolactone.
Question 2 of 5
The client on warfarin has an INR of 3.8. What is the most appropriate action by the nurse?
Correct Answer: A
Rationale: The correct answer is A: Administer vitamin K. When a client on warfarin has an INR above the therapeutic range (usually 2-3), like in this case (3.8), administering vitamin K is appropriate to reverse the anticoagulant effects. This helps prevent bleeding complications. Holding the next dose of warfarin (B) may not be sufficient to lower the INR quickly. Increasing the dose of warfarin (C) would further elevate the INR, leading to higher bleeding risk. Notifying the healthcare provider (D) is important, but immediate action with vitamin K is necessary to address the high INR.
Question 3 of 5
The nurse is giving nitroglycerin sublingually for chest pain. What is the most important instruction to give to the client?
Correct Answer: A
Rationale: The correct answer is A: Place the tablet under the tongue and let it dissolve completely. Nitroglycerin is absorbed quickly through the oral mucosa, providing rapid relief for chest pain. Placing it under the tongue allows for direct absorption into the bloodstream. Swallowing the tablet whole (B) would delay absorption. Chewing the tablet (C) would cause rapid absorption and possibly lead to a drop in blood pressure. Taking one tablet every 5 minutes (D) is not recommended as it can lead to hypotension. Therefore, option A is the most appropriate instruction for the client.
Question 4 of 5
The client is receiving digoxin and complains of nausea. What is the nurse's priority action?
Correct Answer: A
Rationale: The correct answer is A: Check the client's digoxin level. The priority action is to assess the digoxin level to determine if it is within the therapeutic range, as nausea can be a sign of digoxin toxicity. Checking the level will guide further actions. Continuing the dose without assessment (B) may worsen toxicity. Administering an antiemetic (C) only addresses the symptom, not the underlying cause. Discontinuing digoxin immediately (D) without assessing the level can be harmful if the client actually needs the medication.
Question 5 of 5
The client on digoxin has a potassium level of 2.7 mEq/L. What is the nurse's priority action?
Correct Answer: A
Rationale: The correct answer is A: Hold the digoxin and notify the healthcare provider. A potassium level of 2.7 mEq/L is below the normal range (3.5-5.0 mEq/L), which can increase the risk of digoxin toxicity. Holding the digoxin and informing the healthcare provider is crucial to prevent potential harm. Administering the digoxin (choice B) can exacerbate toxicity symptoms. Increasing the dose of digoxin (choice C) is contraindicated due to the low potassium level. Administering potassium supplements (choice D) may be necessary, but the priority is to address the digoxin therapy first.