ATI RN
Cardiovascular System Exam Questions
Question 1 of 5
The nurse is caring for a client on digoxin with a heart rate of 48 bpm. 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 heart rate of 48 bpm is below the normal range, indicating bradycardia, a potential side effect of digoxin toxicity. Holding the medication and informing the healthcare provider is crucial to prevent further harm. Administering the digoxin (B) can worsen the bradycardia. Atropine (C) is not the first-line treatment for digoxin-induced bradycardia. Increasing the dose of digoxin (D) can exacerbate toxicity. Overall, prompt action to address the underlying cause is essential in this situation.
Question 2 of 5
The client is receiving digoxin and has a potassium level of 2.8 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. Digoxin toxicity is more likely to occur in patients with low potassium levels. With a potassium level of 2.8 mEq/L, the client is at risk for digoxin toxicity. Holding the digoxin and notifying the healthcare provider is the priority action to prevent potential harm to the client. B: Increasing the dose of digoxin would exacerbate the risk of digoxin toxicity in a client with low potassium levels. C: Continuing the current dose of digoxin without addressing the low potassium level could lead to digoxin toxicity. D: Administering potassium supplements alone may not be sufficient to address the potential digoxin toxicity. Holding the digoxin is the priority action.
Question 3 of 5
The client on spironolactone (Aldactone) has a potassium level of 5.8 mEq/L. What is the nurse's priority action?
Correct Answer: A
Rationale: The correct answer is A: Hold the spironolactone and notify the healthcare provider. The priority action is to stop the medication and inform the healthcare provider because a potassium level of 5.8 mEq/L is above the normal range (3.5-5.0 mEq/L), indicating hyperkalemia. Spironolactone is a potassium-sparing diuretic that can further increase potassium levels. Continuing the medication or administering a potassium supplement would exacerbate the issue. Increasing the dose of spironolactone would be unsafe and could lead to severe complications. Therefore, holding the medication and seeking guidance from the healthcare provider is crucial in managing the client's elevated potassium level.
Question 4 of 5
When administering enoxaparin (Lovenox) to a client, what is the most important lab value to monitor?
Correct Answer: A
Rationale: The correct answer is A: Platelet count. When administering enoxaparin, the most important lab value to monitor is the platelet count because enoxaparin can cause thrombocytopenia, a potentially serious adverse effect. Monitoring platelet count helps to detect and prevent this complication. Summary of other choices: B: aPTT - Enoxaparin does not directly affect aPTT, so monitoring this value is not as critical as platelet count. C: Hemoglobin - While monitoring hemoglobin may be important for some conditions, it is not the most crucial lab value to monitor when administering enoxaparin. D: INR - Enoxaparin does not affect the INR, so monitoring this value is not necessary when administering this medication.
Question 5 of 5
When administering enoxaparin (Lovenox) to a client for DVT prophylaxis, what is the most important lab value to monitor?
Correct Answer: A
Rationale: The correct answer is A: Platelet count. When administering enoxaparin for DVT prophylaxis, monitoring platelet count is crucial because enoxaparin can cause thrombocytopenia. Decreased platelet count can increase the risk of bleeding. Monitoring PT/INR and aPTT is more relevant for monitoring warfarin or heparin therapy, not enoxaparin. Hemoglobin monitoring is important for assessing anemia but not specifically related to enoxaparin administration for DVT prophylaxis.