Cardiac ATI

Question 1

A nurse is preparing an AED for a pt receiving CPR after cardiac arrest. Which of the following actions should the nurse perform first?
a. Press the analyze button on the machine
b. Stop CPR and move away from the client
c. Push the charge button to prepare to shock
d. Apply the defibrillator pads to the pt’s chest

Answer 1

d
Nurse should first apply 2 large adhesive pads on the pt’s anterior chest wall
a. Third step
b. Second step
c. Last ste

Question 2

A nurse is caring for a pt who is receiving IV ampicillin and developing urticaria and dyspnea. Which of the following actions should the nurse take first?
a. Elevate the pt’s feet and legs
b. Administer epinephrine
c. Infuse 0.9% sodium chloride
d. Stop the medication infusion

Answer 2

d
The nurse should use the ABC priority. The greatest risk to the pt is an allergic reaction that can progress to anaphylaxis.
Urticaria=hives dyspenea=difficult breathing
a. for adequate BP
c. can help hydrate the [t and maintain BP

Question 3

A nurse is planning for a pt who has pernicious anemia. Which of the following interventions should the nurse include in the plan?
a. Administer ferrous sulfate supplementation.
b. Increase dietary intake of folic acid
c. Initiate weekly injections of vitamin B12
d.Initiate a blood transfusion

Answer 3

A-c
Perinicious anemia is caused by a lack of intrinsic fractor needed to absorb vitamin B12 from gastrointestinal tract.

Question 4

What is aortic aneurysm?

Answer 4

An enlargement of the aorta.
An abdominal aortic aneurysm (AAA) can be life-threatening if it bursts.

Question 5

A nurse is caring for a pt who has an aortic aneurysm and is scheduled for surgery. The pt’s vital signs are Bp 160/98, HR 102, RR 22, and O2 95%/Which of the following actions should the nurse take?
a. Administer antihypertensive medication for BP
b. Monitor to ensure the pt’s urinary output is 20mL/hr
c. Withhold pain medication to prepare the pt for surgery
d. Take the pt’s vital every 2hr

Answer 5

A-a
HTN can cause a sudden rupture of the aneurysm d/t pressure on the arterial wall
b-A urinal out put atleaset 30mL/hr. Oliguria can indicate a rupture of the aneurysm.
c-The nurse should administre pain med, cause pain increase BP
d-should take atlease every 15 minutes

Question 6

A nurse is caring for an adult pt who is undergoing screening tests for atherosclerosis. Which following laboratory findings should the nurse identify as an increased risk for this disorder?
a. Cholesterol level 195mg/d
b. Elevated HDL levels
c. Elevated LDL levels
d. Triglyceride level 135mg

Answer 6

A-c
Pt’s desirable LDL level is <100mg
a-total cholesterol levels should <200mg
b-decrease HDL levels is the risk
d-A triglyceride level should <150mg

Question 7

A nurse is providing teaching for a pt who has a prescription for a low-sodium diet to manage HTN. Which of the following statements by the pt an understanding of the teaching?
a. I can snack on fresh fruit.
b. I can continue to eat lunchmeat sandwiches.
c. I can have cottage cheese with my meals.
d. Canned soup is a good lunch option.

Answer 7

A-a
fresh fruits contain little to no sodium which is a good snack for HTN.
b,c,d-contains high sodium

Question 8

A nurse is caring for a pt who has PVD and ulcers on the toes. Which of the following findings of PVD is a risk factor for ulceration of the extremities?
a. Insufficient skin care
b. Dehydration
c. Immobility
d. Impaired circulation

Answer 8

A-d
a-cause skin infection not ulceraton
b-cause delay wound healing
c-cause oressure ulcers if the pt is not turned frequently

Question 9

A nurse is providing teaching about lifestyle changes to pt who experiences MI and has a new prescription for a beta-blocker. Which of the following pt statements indicates an understanding of teaching?
a. I should eat foods that are high in saturated fat.
b. Before taking my medication, I will count my radial pulse rate.
c. I will exercise once a week for an hour at the health club.
d. I will stop taking my medication when my BP is within the normal range.

Answer 9

b
A beta-blocker will induce bradycardia.
a-shuold consume low in saturated fat to decrease further atherosclertic plaque
c-Should exercise at least 3-5 times per week for a minimum of 30 mitus.

Question 10

A nurse is caring for a pt who is undergoing treatment for HTN. WHich of the following statemts indicates that the pt is adhering to the tratment plan?
a. I would never have believed I could get used to enjying my food without salt.
b. My BP device at home usually shows about 156 over 98 or so.
c. I make sure I take my BP medicine when I have headache.
d. My BP pills are very expensive. Can I take a different pill?

Answer 10

a

Question 11

A nurse is caring for a pt with HF whose telemetry reading displays a flattening of the T wave. WHich of the following laboratory results should the nurse anticipate as the cause of these ECG changes?
a. Potassium 2.8mEq/L
b. Digoxin level 0.7ng/mL
c. Hemoglobin 9.8/dL
d. Calcium 88.0mg

Answer 11

a
a flattened T wave or the development of U aves is indicative of low potassium
b-therapeutic range of digoxin is 0.5-0.8ng/mL.
c-low hemoglobin will manifeest tachycardia on the ECG rhythum
dhypocalcemia can have a prolong S-T interval and a prolonged Q-Y internal,not flatted

Question 12

A nurse is planing care of a pt who is having a percutaneous transluminal cornary angioplasty(PCTA) with stent placement. Which of the following actions should the nurse anticipate in the post-procedure of care?
a. Instruct the pt about a long-term cardiac conditioning program
b. Administer schedule doses of acetaminophe
c. Check for peak laboratory marlers of myocardial damage
d. Montir for bleeding

Answer 12

d
Bleeding is a post-procedure complication of PXTA because of the administration of haparin during the procedure.

Question 13

A nurse is teaching about a low-cholesterol diet to a pt who had a MI. Which of the following meal selections by the pt indicates an understanding of teaching?
a. Chicken breast and corn on the cob
b. Shrimp and rice
c. Cheese omelet and turkey beacon
d. Liver and onions

Answer 13

a
chicken breast is low cholesterol and all veges including corn are cholesterol free.
b- shrimp is high cholesterol
d- liver and other orfan meats are high cholesterol

Question 14

A nurse is teaching a 70 years pt about risk factors for HF. THe pt has mild asthma, diabetes, and CAD. Which of the following statemts by the pt indicates an understanding of the teaching?
a. My diabetes will not increase my risk of HF.
b. My asthma makes it more likely for me to have HF.
c. My age does not increase my risk of HF.
d. My CAD is a risk factor for HF.

Answer 14

d
CAD is a primary risk factor for the development of HF.
a-diabete is a risk
b-asthma is not a risk
c-age is a risk.increase age increase risk

Question 15

A nurse is caring for a pt who reports calf pain. What is the first action the nurse should take?
a. Notify the provider
b. Elevate the affected extermity
c. Check the affected extermity for warmth and redness
d. Prepare to administer unfractionated heparin

Answer 15

c
Assesee the pt’s calf for swelling, redness and warmth. These findings can indicate a DVT.
b-the nruse should elevate the pt’s extermity to decrease swelling and relieve pain. but this isnot the first action

Question 16

A nurse is providing discharge teaching to an adult female who has infective endocarditis about how to prevent a recurrence. Which of the following statements by the pt indicates an understanding of the teaching?
a. I will ask my provider to change my contraception to an intrauterine device.
b. I will notify my doctor before I have dental procedures.
c. I will avoid using antiseptic mouthwash for oral care.
d. I will wear a mask when I go out in public.

Answer 16

b
The pt should notify prior to invasive or dental procedures d/t the need for prophylactic antibiotic therapy.
a-intrauterine devices increase the risk of infection.
c-good oral hygiene reduces the risk.
d-do not need to wear a mask, however, avoid contact with individuals who have a streptococcal infection.

Question 17

A nurse is teaching a pt about a dietary modification to control BP. Which of the following food choices should the nurse identify as an indication that the pt understands the instructions?
a. Onion soup and salad
b. Vege warp with potato chips
c. Grilled chicken salad with fresh tomatoes
d. Chicken bouillon and crackers

Answer 17

c
Grilled chicken salad and fresh tomatoes are free of preservatives, therefore, are likely to be low in sodium.
d-crackers that are not labeled low-sodium are also a poor choice for a sodium-restricted diet.

Question 18

A nurse is teaching a pt with heart disease about a low-cholesterol diet. Which of the following pt statements indicates the teaching was effective?
a. I should remove the skin from poultry(chicken) before eating it.
b. I will eat seafood once per week.
c. I should use margarine when preparing meals.
d. I can use whole milk in my oatmeal.

Answer 18

a
b-they should eat seafood 2/week
c-they should use liquid oils such as cannola oil
d-they should use nonfat or low-fat milk

Question 19

A nurse is showing a pt who has right-sided HF an illustration of the heart. Which of the following blood vessels carry deoxygenated blood to the right atrium?
a. Right coronary artery
b. Left carotid artery
c. Aorta
d. Superior vena cava

Answer 19

d
a-supplies oxygenated blood to the heart
b-supplies oxygenated blood to the head and neck
c-carried oxygenated blood away from the left side of the heart

Question 20

Appical pulse?

Answer 20

A pulse point on your chest that gives the most accurate reading of the heart rate

Question 21

A nurse is assessing a pt who has HF and is taking daily furosemide. The pt’s apical pulse is weak and irregular. The nurse should identify these findings as manifestations of which of the following electrolyte imbalance?
a. Hypokalemia
b. Hypophosphatemia
c. Hypercalcemia
d. Hypermagnesemia

Answer 21

a
Furosemide can cause the loss of K, sodium, CA, and MG. Manifestation of hypokalemia can include shallow respirations, muscle weakness, lethargy, and ectopic heartbeats.
b-manifestation can be muscle weakness and bradycardia.
c-manifestations can be tachycardia, HTN, and muscle weakness.

Question 22

A nurse completing an assessment of a pt. WhIch of the following findings should the nruse identify as a risk factor for CAD? SATA
a. Hypothyroidism
b. HTN
c. Diabetes mellitus
d. Hyperlipidemia
e. Tabacco smoking

Answer 22

b,c,d,e

Question 23

A nurse is reviewing the progress of a pt who has HF. The provider noted some improvement in the pt’s CO. The nurse should understand that cardiac output reflects which of the following physiological parameters?
a. The percentage of blood the ventricles pump during each beat
b. The amount of blood the left ventricle pumps during each beat
c. The amount of blood in the left ventricle at the end of diastole
d. The HR times the stroke volume

Answer 23

d
a-ejection fraction
b-stroke volume
c-end-diastolic volume

Question 24

A nurse is examining the ECG of a pt who has hyperkalemia. Which of the follwoing ECG changes should the nurse expect?
a. Elevated ST segments
b. Absent P waves
c. Depressed ST segments
d. Varying PP intervals

Answer 24

a
b-atrial fibrillation
c-hypokalemia
d-irregular atrial rate

Question 25

A nurse is assessing a pt who is 85 years old. Which of the following findings should the nurse identify as a manifestation of MI?
a. Sudden hemoptysis
b. Acute diarrhea
c. Frontal headache
d. Acute confusion

Answer 25

d
Manifestation for age 65 and older.Other manidestation include nausea,vomiting, dyspnea,diaphoresis, anxiety,dizziness,palpitations and fatige.
a-gastrointestinal bleeding
b-gastroenteritis
c-fluid overload

Question 26

A nurse is caring for a pt who had a MI 5 days ago. The pt has a sudden onset of SOB and begins coughing frothy, pink sputum. The nurse auscultates loud, bubbly sounds on inspiration. Which of the following adventitious breath sounds should the nurse document?
a. Coarse crackles
b. Wheezes
c. Rhonchi
d. Friction rub

Answer 26

a

Question 26

A nurse is caring for a pt who had a MI 5 days ago. The pt has a sudden onset of SOB and begins coughing frothy, pink sputum. The nurse auscultates loud, bubbly sounds on inspiration. Which of the following adventitious breath sounds should the nurse document?
a. Coarse crackles
b. Wheezes
c. Rhonchi
d. Friction rub

Answer 26

A pt who had a recent MI is at risk for left-side HF. Crackles are breath sounds caused by the movement of air through airways partially or intermittently occluded with fluid and are associated with HF and frothy sputum. Cracking sounds are heard at the end of inspiration and are not cleared by coughing.
b-manifest a high-pitched musical squeak on inspiration or expiration through or obstructed airway.
c-manifest coarse loud, low-pitched sounds during inspiration or expiration. Coughing often clears the airway and stops the sounds.
d-manifest loud, dry, rubbing, or grating sounds over the lower lateral anterior chest surface during inspiration or expiration.

Question 27

A nurse is assessing a pt who has overload from a cardiovascular. Which of the following manifestations should the nurse expect? SATA
a. Jugular vein distension
b. Moist crackles
c. Postural hypotension
d. Increased HR
e. Fever

Answer 27

a,b,d
Moist crackles are an indicator of pulmonary edema.
b-hypervolemia results in hypertension and tachycardia.
e-common in dehydration.

Question 28

A nurse is monitoring a pt who has HF-related mitral stenosis. The pt reports SOB on exertion. Which of the following conditions should the nurse expect?
a. Increased cardiac output
b. Increased pulmonary congestion
c. Decreased left atrial pressure
d. Decreased pulmonary artery pressure

Answer 28

b
d/t defect in the mitral valve, the left atrial pressure rises and the left atrium dilates. The increased pressure results in a backflow of blood from the left atrium through the pulmonary vein and into the lungs resulting in pulmonary congestion.
b-CP is decreased in a pt who has HF r/t mitral stenosis because the left ventricle is receiving insufficient blood volume to pump into the systemic circulation
a-Pulmonary edema is much the same as congestion except that the substance in the alveoli is the watery plasma of blood, rather than whole blood.
c-As the mitral valve opening narrows, blood flow from the atria to the ventricle falls causing a backup and increased pressure in the left atria.
d-should increase as a result of backup pressure from the narrowing(stenosis) of the mitral valve that affects the flow of blood from the left atrium to the left ventricl

Question 29

A nurse is assessing the lower extremities and ankles of a pt who has a history of peripheral arterial disease. Which of the following findings should the nurse expect?
a. Pitting edema
b. Areas of reddish-brown pigmentation
c. Dry, pale skin with minimal body hair
d. Sunburned appearance with desquamation

Answer 29

c
d/t narrowing of the arteries in the legs and feet. This cause a decrease in blood flow to the distal extremities, which can lead to tissue damage.
a,b-pt who have venous insufficiency.
d-desquamation, which is the loss of bits of outer skin by peeling or shedding, is associated with sunburn, Kawasaki disease, and various other skin lesions.

Question 30

A nurse is caring for an older adult pt who had acute MI. When assessing the pt, the nurse should identify that older adults are prone to complications of MI from poor tissue perfusion because of which of the following age-related factors?
a. Peripheral vascular resistance increases.
b. The sensitivity of BP adjusting baroreceptors increases.
c. Blood is hypercoagulable and clots more quickly.
d. Cardiac medications are less effective.

Answer 30

a
This results from calcification and loss of elasticity of the blood vessels
b-causing postural and postprandial hypertension, which can affect perfusion
c-older adults are more prone to bleeding complications, particularly hemorrhage. Anticoagulation therapy requires constant and careful monitoring of clotting times.
d-Older adults are more likely to develop toxicity from cardiac medication.

Question 31

A nurse is monitoring a pt who had a MI. For which of the following complications should the nruse monitor in the first 24hr?
a. Infective endocarditis
b. Pericarditis
c. Ventricular dysrhythmias
d. Pulmonary emboli

Answer 31

a
b-can occur from 10 days to 2 months following a MI.
d-can occur if the pt develops HF following MI.

Question 32

A nurse is assessing a pt who has late-stage HF and is experiencing fluid volume overload. Which of the following findings should the nurse expect?
a. Weight gain of 1kg(2.2lb) in 1 day
b. pitting edema +1
c. Pt report of a nocturnal cough
d. B-type natriuretic peptide (BNP) level of 100pg/mL

Answer 32

a

Question 33

A nurse is reaching a pt who is schedule for coronary angiography. WHich of the following statements should the nruse include?
a) you should have nothing to eat or drink for 4 hours prioi to the procedure.
b) you will be given general anesthesia during the procedure.
c) You shoulc not thave this procedure dine if you are allergic to eggs.
d) You will need to keep your affected leg straigt follwojg the procedure.

Answer 33

d

Question 34

A nurse is reviewing the lab test result for a group of pt The nurse should identify that which of the follwoing results indicates the pt is at risk for heart disease?
a) Cholesterol(total) 245mg/dL
b) HDL 90mg/dL
c) LDL 140mg/dL
d) Triglyceides 125mg/dL
e) Tropin 1 0.02mg/mL

Answer 34

a,c
a-grater than 200 mg/dL is abnormal
c-grater than 130mg/dL is abnormal
b-HDL should grater than 55mg/dL
d-femal 35-135 and male 40-160 is normal
e-less than 0.03ng/mL is normal

Question 35

A nurse is caring for a pt who is 4 hr postoperative follwong CABG surgery. The pt able to inspore 200ml with th incentive spirometer then declines to try to cught because of fatigue and pain. Which of the follwoing actions should teh nurse take?
a) Allow the pt to rest. and retuin in 1 hr.
b) Admiimsger IV bouls analfsci, and retrun in 15 mints.
c) Documenta the 200ml as an aooropritate indpired volume.
d) Tell the pt coughing after incentive spirometery is required.

Answer 35

b
Providing adequate pin med and returning 15 miin will reduce pain and improve coughing effectiveness.
a-Turning, coughing, and deep breathing should be performed every 2hrs
c-200 is not an adequate inspired air volume
d-this intervention is non-therapeutic comminication

Question 36

A nurse is caring for a pt following peripheral bypass graft surgery of the left lower extremity. Which of the following findings poses an immediate concern? SATA
a) Trace bloody drainage on the dressing
b) Capillary refill of affected lim of 6 secs
c) Mottled appearance of the limb
d) Throbbing pain of affected limp that is decreased following IV bolus analgesia
e) Pulse of 2+ in the affected limb

Answer 36

b,c
b-grater then 3 secs not normal
c-Mottled is a bluish-red, lace-like pattern under the skin

Question 37

A nurse is completing the admission assessment of a pt who will undergo peripheral bypass graft surgery on the left leg. Which of the following findings should the nurse expect?
a) Rubor of the affected leg when elevated
b) 3+ dorsal pulse in the left foot
c) Thin, peeling toenails if left foot
d) Report of intermittent claudication in the affected leg

Answer 37

d
b-pulses are decreased or absent in the feet cases of PAD
0 indicating no palpable pulse; 1 + indicating a faint, but detectable pulse; 2 + suggesting a slightly more diminished pulse than normal; 3 + is a normal pulse; and 4 + indicating a bounding pulse.