ATI RN
ATI RN Custom Cardiovascular Med Surg Questions
Extract:
Nurses' Notes.
Hospital Day 1. 1738: Received 4-year-old child with an exacerbation of heart failure.
Family reports history of congenital mitral stenosis.
Breath sounds with wheezing noted in bilateral lower lobes.
Nonproductive cough noted.
Dyspnea with respiratory rate 30/min.
Oxygen at 2 L/min applied per nasal cannula.
Telemetry applied: Sinus rhythm at rate 116/min.
Abdomen soft, nontender.
Bowel sounds positive all 4 quadrants.
Lower extremities with 2+ edema noted.
Pedal pulses palpable bilaterally.
Peripheral saline lock intact to right forearm with no signs and symptoms of infection.
Weight 20 kg (44 lb). 2015: Increase in dyspnea noted with orthopnea.
Nasal flaring with respiratory rate of 36/min.
Lung sounds with wheezing noted throughout.
Lower extremity edema 3+ to bilateral lower extremities.
Extremities cool with decreased skin pigmentation noted.
Peripheral pulses weak bilateral.
Jugular vein distention noted.
Provider notified.
Received prescription for additional dose of IV furosemide.
Medication Administration Record.
Hospital Day 1: Furosemide 40 mg IV every 6 hr. Administered at 1755.
Give digoxin 250 mcg IV now.
Administered at 1800.
Hospital Day 2: Give digoxin 125 mcg 12 hr after initial dose.
Administered at 0608.
Give digoxin 125 mcg 12 hr after second dose.
Administered at 1804.
Furosemide 10 mg IV now.
Administered at 2020.
Vital Signs.
Hospital Day 1. 1738: Temperature: 36.7°C (98.0°F). Pulse rate: 114/min.
Respiratory rate: 30/min.
Blood pressure: 92/65 mm Hg. Oxygen saturation: 90%. 2015: Temperature: 36.9°C (98.4°F). Pulse rate: 120/min.
Respiratory rate: 36/min.
Blood pressure: 86/54 mmHg.
Oxygen saturation: 86% room air.
Question 1 of 5
The client is at risk for developing ...... and .....
Correct Answer: The child is at risk for digitalis toxicity due to digoxin administration and hypokalemia due to furosemide, a diuretic that can deplete potassium. Dependent rubor, carditis, hypercyanotic spells, fever, and hypertension are not indicated by the symptoms or medications.
Rationale:
Extract:
Question 2 of 5
A patient is admitted to the emergency department and diagnosed as having an ST-segment-elevation myocardial infarction (STEMI). Which question would the nurse ask to determine whether the patient is a candidate for thrombolytic therapy?
Correct Answer: The time of pain onset is crucial in determining eligibility for thrombolytic therapy. Thrombolytic therapy is most effective when given within a certain time frame from the onset of symptoms. Aspirin use, allergies, and pain severity are less relevant for eligibility.
Rationale:
Question 3 of 5
The nurse is providing teaching about the patient's laboratory values that increase the risk for coronary artery disease (CAD). Which of the following values should the nurse prioritize?
Correct Answer: A fasting triglyceride level of 167 mg/dL is above the desirable level of less than 150 mg/dL, indicating a higher risk for CAD. HDL is protective, LDL is near optimal, and total cholesterol is within normal range.
Rationale:
Extract:
Nurses' Notes
0700:
Adolescent alert and oriented, resting in bed in supine position with their legs straight.
Pressure dressing to right femoral area dry and intact.
Bilateral lower extremities warm to touch with equal posterior tibial and dorsalis pedis pulses palpated.
Reports pain as 0 on a scale of 0 to 10. 0730: Adolescent awake, resting in supine position with their legs straight.
Dressing to right femoral area saturated with bloody drainage.
Posterior tibial and dorsalis pedis pulses of right extremity 2+. Right lower extremity cool and pale in color.
Reports pain as 2 on a scale of 0 to 10.
Vital Signs
0700:
• Blood pressure 120/76 mm Hg. Apical pulse rate 90/min.
• Respiratory rate 16/min.
• Temperature 36.6° C (97.9° F). 0730: Blood pressure 100/52 mm Hg. Apical pulse rate 112/min.
• Respiratory rate 18/min.
• Temperature 36.7° C (98.1° F).
Medical History
• Adolescent has no significant past medical history.
• Adolescent was playing basketball last night when they suddenly "passed out" on the court.
• No significant maternal or paternal medical history.
Question 4 of 5
A nurse is caring for an adolescent following a cardiac catheterization. Which of the following assessment findings should the nurse report to the provider?
Correct Answer: Decreased pulses, saturated dressing, significant drop in blood pressure, and cool/pale extremity indicate potential bleeding or vascular complications post-catheterization, requiring immediate reporting. Pulse, position, pain, and respiratory rate changes are less critical.
Rationale:
Extract:
Question 5 of 5
After reviewing a patient's history, vital signs, physical assessment, and laboratory data, which information is most important for the nurse to communicate to the health care provider?
Correct Answer: Elevated troponin is a sign of heart damage, which could be caused by a heart attack or other stresses on the heart. This is a critical finding that needs immediate attention. Q waves may indicate a past event, crackles suggest fluid overload, and hyperglycemia is less urgent.
Rationale: