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 to the left hand can lead to ischemia, causing severe pain due to inadequate blood flow. This pain is typically described as sudden and severe. Pale skin (B) is a sign of inadequate blood supply but may not be specific to arterial embolism. Bounding radial pulse (C) is unlikely in arterial embolism as it obstructs blood flow. Parasthesias (D) may occur due to nerve compression, but pain is a more prominent symptom in arterial embolism.
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: Step 1: Enalapril is an ACE inhibitor that helps lower blood pressure by blocking the production of angiotensin II, a potent vasoconstrictor. Step 2: Adding enalapril would be the appropriate next step as it provides an additional mechanism of action to control hypertension. Step 3: Changing to a beta blocker (B) or adding another diuretic (C) may not address the underlying cause of the uncontrolled hypertension. Step 4: Increasing the drug dosage above recommended levels (D) can lead to adverse effects without necessarily improving blood pressure control.
Question 3 of 5
A second 12 lead ECG performed on a patient 4 hours after the onset of chest pain reveals ST segment elevation. The nurse recognizes that this finding indicates
Correct Answer: C
Rationale: The correct answer is C) Myocardial infarction associated with prolonged and complete coronary thrombosis. Explanation: ST segment elevation on an ECG is a classic indicator of myocardial infarction (MI), commonly known as a heart attack. This finding suggests that there is significant myocardial damage occurring due to prolonged and complete coronary thrombosis, where a coronary artery is completely blocked, leading to inadequate blood supply to the heart muscle. This lack of blood flow can cause irreversible damage to the myocardial cells, resulting in an MI. Why the other options are wrong: A) Transient ischemia typical of unstable angina: ST elevation is not typically seen in unstable angina, which is characterized by transient episodes of chest pain due to temporary reductions in blood flow to the heart. B) Lack of permanent damage to myocardial cells: ST elevation indicates ongoing myocardial damage, suggesting permanent damage to myocardial cells. D) Myocardial infarction associated with transient or incomplete coronary artery occlusion: ST elevation is more indicative of a complete blockage leading to myocardial infarction rather than a transient or incomplete occlusion. Educational context: Understanding ECG findings in the context of cardiovascular events is crucial for nurses caring for patients with chest pain. Recognizing ST segment elevation and its implications can guide timely interventions and improve patient outcomes. Nurses must be able to differentiate between various ECG patterns to provide appropriate care and collaborate effectively with the healthcare team in managing acute cardiovascular events.
Question 4 of 5
To prevent arterial trauma during the use of the IABP, the nurse should
Correct Answer: C
Rationale: In the context of using an Intra-Aortic Balloon Pump (IABP) to provide circulatory support for a patient, preventing arterial trauma is crucial for the patient's safety and well-being. The correct answer, option C, "Prevent hip flexion of the cannulated leg," is essential to avoid kinking or compression of the arterial line connected to the IABP. By preventing hip flexion of the cannulated leg, the nurse ensures that the arterial line remains patent and free of obstructions, reducing the risk of arterial trauma. Hip flexion can lead to mechanical stress on the arterial line, potentially causing damage that may compromise circulation and lead to complications. Option A, repositioning the patient every 2 hours, is not directly related to preventing arterial trauma during IABP use. While repositioning is important for preventing complications like pressure ulcers, it does not address the specific risk of arterial trauma associated with hip flexion. Checking the site for bleeding every hour, as suggested in option B, is important for monitoring for complications post-IABP insertion, but it does not directly address the mechanical issue of hip flexion causing arterial trauma. Covering the insertion site with an occlusive dressing, as mentioned in option D, is important for maintaining a sterile environment and preventing infections at the insertion site. However, it does not address the mechanical issue of hip flexion impacting arterial flow. In an educational context, understanding the importance of proper positioning and care during IABP use is crucial for nurses caring for patients requiring circulatory support. By grasping the rationale behind preventing hip flexion of the cannulated leg, nurses can provide safe and effective care to patients undergoing IABP therapy, ultimately improving patient outcomes and reducing the risk of complications.
Question 5 of 5
A patient with atrial fibrillation is ambulating in the hallway on the coronary step-down unit and suddenly tells you, 'I feel really dizzy.' Which action should you take first?
Correct Answer: A
Rationale: In this scenario, the most appropriate action to take first when a patient with atrial fibrillation reports feeling dizzy while ambulating is to help the patient sit down (Option A). This is crucial for ensuring the patient's safety and preventing potential falls or injuries. By assisting the patient to sit down, you are addressing the immediate risk of the patient falling and causing harm. This action also allows you to quickly assess the patient's condition in a safe and controlled manner. Checking the patient's apical pulse (Option B) may provide some information about the patient's heart rate, but it is not the most urgent action in this situation. Similarly, while taking the patient's blood pressure (Option C) is important in assessing their cardiovascular status, it is not the primary concern when a patient reports feeling dizzy while ambulating. Having the patient breathe deeply (Option D) is not the most appropriate action to take first in this situation. While focusing on breathing techniques may be beneficial in certain situations, addressing the immediate risk of falling and assessing the patient's condition take precedence here. In an educational context, understanding the prioritization of actions in response to a patient's symptoms is vital for providing safe and effective care in a clinical setting. Nurses and healthcare providers must be able to quickly assess and respond to changes in a patient's condition to prevent adverse outcomes. Prioritizing interventions based on the patient's immediate needs is a fundamental aspect of nursing practice.