ATI RN
ANCC Cardiovascular Certification Practice Questions Questions
Question 1 of 5
Which of the following is the best action by the nurse?
Correct Answer: A
Rationale: The correct answer is A: Administer the metoprolol (Lopressor) and the hydrochlorothiazide (HydroDiuril), hold the captopril (Copoten), and notify the physician. Rationale: 1. Metoprolol and hydrochlorothiazide are commonly prescribed medications for hypertension. 2. Captopril is an ACE inhibitor and should be held due to potential interactions with the other medications. 3. Notifying the physician is crucial to ensure proper management and prevent adverse effects. Summary of other choices: B: Incorrect because holding metoprolol is not recommended as it is a common antihypertensive drug. C: Incorrect because administering all medications without addressing the potential interaction with captopril is unsafe. D: Incorrect because withholding all medications without administering any could lead to uncontrolled hypertension, risking the patient's health.
Question 2 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 3 of 5
A patient is suspected of having a decreased cardiac output due to dysrhythmias. Which of the following assessments would be included in a decreased cardiac output? Select all that apply
Correct Answer: A
Rationale: The correct answer is A: Elevated jugular venous distention. This is a classic sign of decreased cardiac output as it indicates increased central venous pressure due to the heart's inability to effectively pump blood. This results in blood backing up into the jugular veins, causing them to appear distended. Explanation for why other choices are incorrect: B: Polyuria is not typically associated with decreased cardiac output. Polyuria is excessive urination and is more commonly seen in conditions such as diabetes insipidus or diabetes mellitus. C: Full and bounding pulses are not indicative of decreased cardiac output. In fact, decreased cardiac output often leads to weak and thready pulses due to reduced blood flow. D: Diaphoresis, or excessive sweating, can occur in various conditions but is not a specific sign of decreased cardiac output. It can be seen in response to pain, anxiety, or fever.
Question 4 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 5 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