ATI RN
ATI RN Custom Cardiovascular Med Surg Questions
Extract:
Question 1 of 5
Which action by the nurse will determine if therapies ordered for a patient with chronic constrictive pericarditis are effective?
Correct Answer: Jugular venous distention (JVD) is a common sign of chronic constrictive pericarditis. If JVD is not present, it may indicate that the therapies are effective. ST segment changes, sedimentation rate, and paradoxical pulse are not specific to this condition.
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 2 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.
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Question 3 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.
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Question 4 of 5
A patient with a history of hypertension arrives in the emergency department with a blood pressure (BP) reading of 213/126 mm Hg. The patient has a history of drug abuse. Which of the following initial questions posed by the nurse is MOST appropriate?
Correct Answer: Cocaine or crack use can cause a significant and dangerous increase in blood pressure. Given the patient's history of drug abuse and the current high blood pressure reading, this is a critical question to ask. Tylenol, stress, and salty foods are less likely to cause such an acute spike.
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Question 5 of 5
After receiving a change-of-shift report on four patients, which patient would the nurse assess first?
Correct Answer: Acute aortic regurgitation can lead to a rapid and severe drop in blood pressure, which is a medical emergency. Therefore, this patient should be assessed first. Crackles, endocarditis symptoms, and chest pain are less immediately life-threatening.
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