ATI RN
Cardiovascular System Exam Questions
1. The nurse is caring for a client on enalapril (Vasotec). What is the most important side effect to monitor?
- A. Cough
- B. Hyperkalemia
- C. Hypotension
- D. Dizziness
Correct answer: A
Rationale: The correct answer is A: Cough. Enalapril is an ACE inhibitor, and cough is a common side effect associated with this class of medication. Monitoring for cough is crucial as it can indicate the development of a potentially serious condition known as angioedema. Hyperkalemia (choice B) is a possible side effect of ACE inhibitors but is not the most important side effect to monitor. Hypotension (choice C) and dizziness (choice D) are also potential side effects of enalapril; however, cough takes precedence due to its association with angioedema, a severe adverse reaction.
2. When monitoring a client on dobutamine, what is the most important parameter to assess?
- A. Blood pressure
- B. Heart rate
- C. Oxygen saturation
- D. Respiratory rate
Correct answer: A
Rationale: The correct answer is A: Blood pressure. When a client is on dobutamine, it is crucial to closely monitor their blood pressure as dobutamine can cause significant changes in blood pressure. While heart rate is also important to monitor during this time, blood pressure is the most critical parameter to assess. Oxygen saturation and respiratory rate are also important parameters to monitor in a patient receiving dobutamine, but they are not as crucial as blood pressure in this scenario.
3. The client on warfarin has an INR of 5.5. What is the priority nursing action?
- A. Administer vitamin K as an antidote.
- B. Hold the next dose of warfarin.
- C. Increase the dose of warfarin.
- D. Administer fresh frozen plasma.
Correct answer: A
Rationale: An INR of 5.5 is significantly elevated, indicating an increased risk of bleeding. The priority nursing action in this situation is to administer vitamin K as an antidote to reverse the effects of warfarin and lower the INR. Holding the next dose of warfarin (choice B) is important but not as immediate as administering vitamin K. Increasing the dose of warfarin (choice C) would further elevate the INR, worsening the bleeding risk. Administering fresh frozen plasma (choice D) is not the first-line treatment for high INR due to warfarin.
4. Which type of heart disease involves the stiffening of the heart muscle, reducing its ability to relax and fill with blood?
- A. Restrictive cardiomyopathy
- B. Hypertrophic cardiomyopathy
- C. Dilated cardiomyopathy
- D. Ventricular hypertrophy
Correct answer: A
Rationale: The correct answer is A, restrictive cardiomyopathy. This condition specifically involves the stiffening of the heart muscle, leading to a reduced ability to relax and fill with blood between beats. Choice B, hypertrophic cardiomyopathy, is characterized by abnormal thickening of the heart muscle, not stiffening. Choice C, dilated cardiomyopathy, involves the enlargement and weakening of the heart chambers, not stiffening. Choice D, ventricular hypertrophy, refers to the thickening of the walls of the heart's pumping chambers but does not specifically involve the stiffening that is characteristic of restrictive cardiomyopathy.
5. The client on amiodarone reports shortness of breath. What is the nurse’s best response?
- A. Notify the healthcare provider immediately.
- B. Reassure the client that this is a common side effect.
- C. Instruct the client to monitor their symptoms at home.
- D. Suggest the client reduce physical activity.
Correct answer: A
Rationale: When a client on amiodarone reports shortness of breath, it can be indicative of pulmonary toxicity, a severe side effect associated with this medication. The nurse's priority is to notify the healthcare provider immediately to assess the situation and determine the appropriate course of action. Choice B is incorrect because shortness of breath with amiodarone should not be dismissed as a common side effect. Instructing the client to monitor symptoms at home (Choice C) may delay necessary intervention. Suggesting the client reduce physical activity (Choice D) does not address the potential serious nature of the symptom and the need for prompt evaluation.
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