ATI RN
ATI RN Custom Cardiovascular Med Surg Questions
Extract:
Question 1 of 5
The nurse obtains a health history from an older adult with a prosthetic mitral valve who has symptoms of infective endocarditis (IE). Which question by the nurse helps identify a risk factor for IE?
Correct Answer: Dental work can introduce bacteria into the bloodstream, which can lead to infective endocarditis, especially in individuals with prosthetic heart valves. Heart attack, immunizations, and family history are not specific risk factors for IE.
Rationale:
Question 2 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 3 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 4 of 5
Which patient statement would help the nurse confirm the previous diagnosis of chronic stable angina?
Correct Answer: Chronic stable angina is characterized by chest pain that is relieved by rest or nitroglycerin. Therefore, if the patient's pain goes away with a nitroglycerin tablet, it would help confirm a diagnosis of chronic stable angina. Pain level, worsening pain, or nighttime pain are less specific.
Rationale:
Question 5 of 5
A patient who has had chest pain for several hours is admitted with a diagnosis of rule out acute myocardial infarction (AMI). Which laboratory test is most specific for the nurse to monitor in determining whether the patient has had an AMI?
Correct Answer: Cardiac-specific troponin is a protein that is released into the bloodstream when there is damage to the heart muscle, such as during an acute myocardial infarction (AMI). It is considered the most specific marker for AMI because it is found only in heart muscle.
Rationale: