ATI RN
ATI RN Custom Cardiovascular Med Surg Questions
Extract:
Question 1 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 2 of 5
Which statement by a patient with restrictive cardiomyopathy indicates that the nurse's discharge teaching about self-management has been effective?
Correct Answer: Limiting salt and fluid intake is crucial for patients with restrictive cardiomyopathy to manage their condition. Avoiding aspirin, taking antibiotics, and restarting exercise are not specific to this condition's self-management.
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:
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 4 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:
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 5 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: