ATI RN
ANCC Cardiovascular Certification Practice Questions Questions
Question 1 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 2 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 3 of 5
Which order should the nurse question?
Correct Answer: A
Rationale: The correct order for the nurse to question is A: The addition of a loop diuretic with digoxin. This is because loop diuretics can increase the risk of digoxin toxicity by causing hypokalemia. Digoxin toxicity is more likely to occur when potassium levels are low. Therefore, the nurse should question this order to prevent potential harm to the patient. Summary: - B: The addition of a beta blocker with digoxin: Beta blockers can also increase the risk of digoxin toxicity but it is not as directly related to potassium levels as loop diuretics. - C: A digoxin dose of 0.125 mg per day: This is within the recommended therapeutic range for digoxin and does not directly impact the risk of toxicity with loop diuretics. - D: The addition of an ACE inhibitor with digoxin: ACE inhibitors can also increase the risk of digoxin toxicity, but the priority in this case is
Question 4 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 5 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.