ATI RN
Physical Exam Cardiovascular System Questions
Question 1 of 5
The nurse is caring for a client on warfarin with an INR of 5.2. What is the most appropriate action?
Correct Answer: A
Rationale: The correct answer is A: Administer vitamin K as an antidote. A high INR level of 5.2 indicates the client is at risk of bleeding due to excess anticoagulation from warfarin. Vitamin K helps reverse the effects of warfarin by promoting clotting factor production. Administering vitamin K is crucial to prevent bleeding complications. Holding the next dose of warfarin (B) is not enough to rapidly lower the INR. Increasing the dose of warfarin (C) would worsen the situation. Monitoring the client's INR closely (D) is important, but immediate action with vitamin K is necessary in this case.
Question 2 of 5
The nurse is administering a beta blocker to a client with a heart rate of 50 bpm. What is the priority action?
Correct Answer: A
Rationale: The correct answer is A because a heart rate of 50 bpm is below the normal range, and beta blockers further decrease heart rate. Holding the medication and notifying the healthcare provider is crucial to prevent potential bradycardia and adverse effects. Administering the beta blocker (choice B) can further reduce the heart rate. Decreasing the dose (choice C) may not be enough to address the issue. Monitoring the heart rate (choice D) is important but not sufficient to address the potential harm caused by administering the beta blocker.
Question 3 of 5
The nurse is administering digoxin to a client with a heart rate of 45 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. Digoxin is a medication that can slow down the heart rate, and a heart rate of 45 bpm is below the normal range. Holding the medication and informing the healthcare provider is the priority to prevent potential harm from further slowing the heart rate. Administering the digoxin as ordered (B) would worsen the bradycardia. Increasing the dose of digoxin (C) would be dangerous. Monitoring the client's heart rate and reassessing in 30 minutes (D) may delay necessary intervention.
Question 4 of 5
The diagnostic test that is most useful in differentiating the dyspnea related to pulmonary effects of heart failure from the dyspnea of pulmonary disease is
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Question 5 of 5
You make a home visit to evaluate a hypertensive patient who has been taking enalapril (Vasotec) for 3 weeks. Which information indicates that you need to contact the physician about a change in the drug therapy?
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.