ATI RN
Med Surg Cardiovascular Test Bank Questions
Question 1 of 5
Three days after experiencing a myocardial infarction (MI), a patient who is scheduled for discharge asks for assistance with hygiene activities, saying, “I am too nervous about my heart to be alone while I get washed up.” Based on this information, which nursing diagnosis is appropriate?
Correct Answer: B
Rationale: The correct answer is B: Anxiety related to change in health status. The patient's statement indicates fear and nervousness about their heart health, which aligns with anxiety. Activity intolerance (A) is not supported as the patient is seeking assistance for hygiene, not physical activity. Denial (C) is not appropriate as the patient acknowledges their nervousness about the heart. Altered body image (D) is not relevant based on the information provided.
Question 2 of 5
A patient with diabetes mellitus and chronic stable angina has a new order for captopril . The nurse should teach the patient that the primary purpose of captopril is to
Correct Answer: C
Rationale: The correct answer is C: prevent changes in heart muscle. Captopril is an ACE inhibitor that helps prevent remodeling of the heart muscle in patients with conditions like chronic stable angina and diabetes mellitus. This drug does not directly affect heart rate (A), blood glucose levels (B), or the frequency of chest pain (D). By inhibiting the renin-angiotensin-aldosterone system, captopril can reduce the strain on the heart and prevent adverse changes in heart structure and function over time. This is crucial in managing conditions like chronic stable angina and diabetes mellitus to prevent complications such as heart failure.
Question 3 of 5
A nurse is performing discharge teaching for a client with PVD. The nurse should teach the client to:
Correct Answer: A
Rationale: The correct answer is A: inspect his feet weekly. This is important for clients with peripheral vascular disease (PVD) to detect any signs of infection or injury early. Choice B is beneficial for improving circulation but not specific to PVD. Choice C, wearing constrictive clothing, can further restrict blood flow and worsen PVD symptoms. Choice D, standing rather than sitting, can increase pressure on the legs and worsen symptoms of PVD. Therefore, regular foot inspections are the most appropriate teaching for a client with PVD.
Question 4 of 5
A child returns to his room after a cardiac catheterization. Which nursing intervention is most appropriate?
Correct Answer: B
Rationale: The correct answer is B: Maintain the child on bed rest with the affected extremity immobilized. After a cardiac catheterization, it is crucial to keep the affected extremity immobilized to prevent bleeding or complications at the catheter site. Bed rest helps reduce the risk of bleeding and ensures the child's safety. Choices A, C, and D involve allowing the child to move or sit up, which can increase the risk of bleeding. Choice A does not specify immobilizing the extremity, which is essential post-catheterization. Choice C involves unnecessary movement, and choice D allows sitting, which may also increase the risk of bleeding.
Question 5 of 5
The nurse is preparing to discharge a client after CABG surgery. The client is taking several new medications, including digoxin (Lanoxin), metoprolol (Lopressor), and furosemide (Lasix). The client complains of nausea and anorexia. The nurse is preparing to report this finding to the physician before discharging the client. Which laboratory result will the nurse check before calling the physician?
Correct Answer: A
Rationale: Step 1: The client is taking digoxin, which can cause toxicity if the potassium level is low. Step 2: Low potassium levels can increase the risk of digoxin toxicity. Step 3: Nausea and anorexia are symptoms of digoxin toxicity. Step 4: Therefore, the nurse should check the potassium level to assess the risk of digoxin toxicity. Step 5: Checking the sodium level (choice B) is not directly related to digoxin toxicity. Step 6: PT/INR (choice C) is used to monitor anticoagulant therapy, not related to digoxin toxicity. Step 7: Checking the digoxin level (choice D) would confirm toxicity, but checking potassium level helps prevent toxicity. Summary: The nurse should check the potassium level as it directly correlates with the risk of digoxin toxicity, whereas the other choices are not directly related to the client's symptoms and medication regimen.