ATI RN
Cardiovascular System Test Bank Questions
Question 1 of 5
Which statement made by a patient with coronary artery disease after the nurse has completed teaching about the therapeutic lifestyle changes (TLC) diet indicates that further teaching is needed?
Correct Answer: D
Rationale: The correct answer is D. Switching to 1% milk (A) and incorporating salmon (B) are both heart-healthy choices. Moderate alcohol consumption like a glass of wine (C) is acceptable in TLC diet. However, peanut butter sandwiches can be high in saturated fat and should be limited in coronary artery disease diet, making choice D incorrect. Further teaching is needed to emphasize the importance of avoiding foods high in saturated fats.
Question 2 of 5
Which assessment finding by the nurse caring for a patient who has had coronary artery bypass grafting using a right radial artery graft is most important to communicate to the health care provider?
Correct Answer: B
Rationale: The correct answer is B: Pallor and weakness of the right hand. This finding suggests potential compromise of blood flow to the right radial artery graft, which is crucial for the patient's cardiac function. Pallor and weakness may indicate reduced perfusion, possibly due to graft occlusion or other complications. This warrants immediate attention from the healthcare provider to prevent further complications. Incorrect choices: A: Complaints of incisional chest pain - This is common post-surgery and may not indicate acute issues with the graft. C: Fine crackles heard at both lung bases - This could indicate a respiratory issue, but it is not directly related to the radial artery graft. D: Redness on both sides of the sternal incision - While redness could suggest infection, it is not as urgent as compromised blood flow to the graft, which requires immediate intervention.
Question 3 of 5
To improve the physical activity level for a mildly obese 71-yr-old patient, which action should the nurse plan to take?
Correct Answer: B
Rationale: The correct answer is B: Determine what kind of physical activities the patient usually enjoys. Rationale: 1. By determining the patient's preferred physical activities, the nurse can tailor an exercise plan that the patient is more likely to adhere to. 2. Enjoyable activities increase motivation and compliance, leading to sustained physical activity levels. 3. Personalized approach considers the patient's interests and abilities, promoting a successful and sustainable exercise routine. Summary of Incorrect Choices: A. Stressing weight loss may be discouraging and overshadow the importance of overall health benefits of exercise. C. Setting a strict time limit may not be suitable for all older adults and can hinder individualized exercise plans. D. While warming up is important, it is not the most crucial initial step in developing a personalized exercise plan.
Question 4 of 5
A nurse is evaluating a client with left- sided heart failure. Which finding should the nurse expect to assess?
Correct Answer: B
Rationale: The correct answer is B: Dyspnea. Left-sided heart failure typically results in the accumulation of fluid in the lungs, leading to difficulty breathing or dyspnea. This is due to the impaired ability of the left side of the heart to pump blood efficiently, causing fluid backup into the lungs. Ascites (choice A) is more commonly associated with right-sided heart failure. Hepatomegaly (choice C) and jugular vein distention (choice D) are also more indicative of right-sided heart failure. Therefore, based on the pathophysiology of left-sided heart failure, dyspnea is the expected finding.
Question 5 of 5
A nurse administers warfarin (Coumadin) to a client with deep vein thrombophlebitis. Which laboratory valve indicates that the client has a therapeutic level of warfarin?
Correct Answer: C
Rationale: The correct answer is C: International Normalized Ratio (INR) of 3 to 4. For patients on warfarin therapy, INR is used to monitor the anticoagulant effect. An INR of 3 to 4 indicates a therapeutic level, reducing the risk of clot formation while minimizing the risk of bleeding. Rationale: 1. A: PTT measures intrinsic clotting pathway, not specific for warfarin monitoring. 2. B: PT measures extrinsic clotting pathway, not specific for warfarin monitoring. 3. D: HCT measures the percentage of red blood cells in blood, not related to warfarin monitoring. INR is the standard test for monitoring warfarin therapy, ensuring the effectiveness and safety of anticoagulation.