ATI RN
ATI RN Custom Cardiovascular Med Surg Questions
Extract:
Question 1 of 5
The nurse is caring for a patient with mitral regurgitation. Where would the nurse listen to best hear a murmur typical of mitral regurgitation?
Correct Answer: The apex of the heart is the best place to hear a murmur typical of mitral regurgitation. This is where the sound will be most audible. Other locations are less optimal for detecting this specific murmur.
Rationale:
Question 2 of 5
A patient who has chronic heart failure is admitted to the emergency department with severe dyspnea and a dry, hacking cough. Which action would the nurse take first?
Correct Answer: In a patient with severe dyspnea and a dry, hacking cough, auscultating the breath sounds would be the first action to assess for any abnormalities. Capillary refill, abdominal auscultation, and allergies are less immediate priorities.
Rationale:
Extract:
A nurse is caring for an adolescent in an emergency department.
Vital Signs.
2300: Medical History.
Blood pressure 120/78 mm Hg. Apical pulse rate 100/min.
Respiratory rate 20/min.
2400: Temperature 37.9° C (100.2° F). Oxygen saturation 98% on room air.
Nurses' Notes.
Blood pressure 112/64 mm Hg. Apical pulse rate 108/min.
Respiratory rate 28/min.
Temperature 38.9° C (102° F). Oxygen saturation 95% on room air.
Medical History.
History of rheumatic fever with resulting cardiac valve damage.
Nurses' Notes.
2300: Adolescent brought to emergency department by their parent.
Adolescent reports intermittent low-grade fever and anorexia.
Manifestations presented a few days after having dental work performed.
Now they are worse.
Adolescent noticed shortness of breath with exertion today.
Adolescent in semi-reclining position.
Respirations easy and unlabored while at rest.
Mild dyspnea observed when adolescent ambulated to the room.
Lung sounds clear bilaterally.
Oral mucous membranes pink with petechiae noted.
Adolescent reports diffuse joint pain as 2 on a scale of 0 to 10. 2400: Adolescent restless and sweating, sitting in high-Fowler's position.
Dyspnea noted at rest.
Adolescent reports pain in mid-chest as dull, aching, and as 2 on a scale of 0 to 10. Few coarse rales auscultated bilaterally
Question 3 of 5
A nurse is caring for an adolescent in an emergency department. Which of the following should the nurse anticipate the provider will prescribe?
Correct Answer: Obtaining blood cultures, administering antibiotics, and obtaining an echocardiogram are anticipated due to suspected endocarditis from recent dental work and symptoms like fever and dyspnea. Restricting dental hygiene and strenuous exercise are contraindicated as they could worsen the condition or are unnecessary.
Rationale:
Extract:
Question 4 of 5
Which data indicates to the nurse that the patient with stable angina is experiencing a side effect of metoprolol?
Correct Answer: Metoprolol is a beta-blocker that can lower blood pressure, so a blood pressure of 90/54 mm Hg could indicate a side effect of this medication. Feeling anxious, normal sinus rhythm, and restlessness/agitation are not typical side effects of metoprolol.
Rationale:
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 5 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: