ATI RN
Cardiovascular System Exam
1. The client on amiodarone develops pulmonary fibrosis. What action should the nurse take?
- A. Notify the healthcare provider immediately.
- B. Continue the medication and monitor lung function.
- C. Discontinue the medication and start oxygen therapy.
- D. Reduce the dose and monitor respiratory status.
Correct answer: A
Rationale: When a client on amiodarone develops pulmonary fibrosis, a serious side effect, the immediate action the nurse should take is to notify the healthcare provider. This is crucial because pulmonary fibrosis can lead to severe respiratory compromise and requires prompt evaluation and management by the healthcare provider. Continuing the medication (choice B) can worsen the condition, and delaying action by reducing the dose and monitoring respiratory status (choice D) may not be appropriate given the seriousness of pulmonary fibrosis. Discontinuing the medication and starting oxygen therapy (choice C) may be necessary, but the priority is to notify the healthcare provider first for further assessment and guidance.
2. The client is on amiodarone. What is the most important side effect to monitor for?
- A. Pulmonary toxicity
- B. Thyroid dysfunction
- C. Liver toxicity
- D. Renal dysfunction
Correct answer: A
Rationale: The correct answer is A: Pulmonary toxicity. Amiodarone is known for causing serious pulmonary toxicity, which can be fatal. Monitoring for pulmonary toxicity is crucial due to its potential severity. Choice B, thyroid dysfunction, is a common side effect of amiodarone but is not as immediately life-threatening as pulmonary toxicity. Choices C and D, liver toxicity and renal dysfunction, are potential side effects of amiodarone but are not as critical or as common as pulmonary toxicity, making them less important to monitor initially.
3. The nurse is caring for a client on digoxin with a heart rate of 48 bpm. What is the nurse’s priority action?
- A. Hold the digoxin and notify the healthcare provider.
- B. Administer the digoxin as ordered.
- C. Administer atropine to increase the heart rate.
- D. Increase the dose of digoxin.
Correct answer: A
Rationale: In this scenario, the nurse's priority action should be to hold the digoxin and notify the healthcare provider. A heart rate of 48 bpm is low, and digoxin, being a medication that can further decrease the heart rate, should be withheld. Administering the digoxin as ordered (Choice B) would not be appropriate in this situation as it can exacerbate bradycardia. Atropine (Choice C) is not the initial treatment for this scenario; holding the digoxin is the first action. Increasing the dose of digoxin (Choice D) would be contraindicated due to the client's bradycardia. Therefore, the correct action is to hold the digoxin and inform the healthcare provider for further guidance.
4. Which structure serves as the normal pacemaker of the heart?
- A. SA node
- B. AV node
- C. Purkinje fibers
- D. Atria
Correct answer: A
Rationale: The correct answer is the SA node. The sinoatrial (SA) node is known as the natural pacemaker of the heart as it generates electrical impulses initiating each heartbeat. The SA node is located in the right atrium and sets the rhythm and rate of the heartbeat. The AV node (choice B) is responsible for delaying the electrical impulse to allow the atria to contract before the ventricles. Purkinje fibers (choice C) are specialized cardiac fibers responsible for the rapid conduction of impulses to the myocardial cells, and the atria (choice D) are the upper chambers of the heart involved in receiving blood from the veins.
5. What condition is characterized by narrowed or blocked arteries in the legs or arms, leading to pain and mobility issues?
- A. Peripheral artery disease
- B. Atherosclerosis
- C. Raynaud's disease
- D. Varicose veins
Correct answer: A
Rationale: The correct answer is A: Peripheral artery disease (PAD). PAD is a condition where the arteries in the legs or arms become narrowed or blocked, leading to pain and mobility issues. Choice B, Atherosclerosis, refers to the buildup of fats, cholesterol, and other substances in and on the artery walls, not specifically the narrowing or blockage in the extremities. Choice C, Raynaud's disease, is characterized by reduced blood flow to the extremities, leading to coldness, numbness, and color changes in the skin, but it is not primarily about narrowed or blocked arteries. Choice D, Varicose veins, involves enlarged, twisted veins usually in the legs, but it is not related to narrowed or blocked arteries causing pain and mobility issues.
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