ATI RN
Cardiovascular System Practice Exam
1. The nurse is giving nitroglycerin sublingually for chest pain. What is the most important instruction to give to the client?
- A. Place the tablet under the tongue and let it dissolve completely.
- B. Swallow the tablet whole with a glass of water.
- C. Chew the tablet and then swallow it.
- D. Take one tablet every 5 minutes until pain is relieved.
Correct answer: A
Rationale: The correct answer is A. The tablet should be placed under the tongue and allowed to dissolve completely to ensure rapid absorption. This route of administration allows the medication to be quickly absorbed into the bloodstream. Choice B is incorrect because nitroglycerin is meant to be absorbed sublingually, not swallowed. Choice C is incorrect as chewing the tablet can cause the medication to be rapidly absorbed, leading to adverse effects like a drop in blood pressure. Choice D is incorrect because the client should take only one tablet every 5 minutes up to a maximum of three tablets for chest pain relief.
2. What is a condition where the heart muscle becomes abnormally enlarged, thickened, or stiffened, often leading to heart failure?
- A. Cardiomyopathy
- B. Pericarditis
- C. Aortic stenosis
- D. Mitral valve prolapse
Correct answer: A
Rationale: Cardiomyopathy is the correct answer. It is a condition characterized by the abnormal enlargement, thickening, or stiffening of the heart muscle, which can lead to heart failure. Pericarditis (choice B) is inflammation of the pericardium, the sac surrounding the heart, not directly related to heart muscle enlargement. Aortic stenosis (choice C) is the narrowing of the aortic valve opening, affecting blood flow from the heart, but not directly related to heart muscle enlargement. Mitral valve prolapse (choice D) is a condition where the valve between the left atrium and left ventricle doesn't close properly, causing blood to leak backward, and is not directly related to heart muscle enlargement.
3. What term describes the phenomenon wherein decreased BP causes a reflex SNS response with increased pulse, increased contractility, and vasoconstriction; and increased BP causes reflex vagal responses resulting in decreased heart rate and passive vasodilation in the systemic arterioles?
- A. Baroreflex
- B. Cheyne-Stokes breathing
- C. Frank-Starling Law
- D. Starling reflex
Correct answer: A
Rationale: The correct answer is A: Baroreflex. The Baroreflex is a mechanism by which the body maintains blood pressure homeostasis through reflexive adjustments in heart rate and vascular tone. Choice B, Cheyne-Stokes breathing, is a pattern of breathing characterized by progressively deeper and sometimes faster breathing, followed by a gradual decrease that results in a temporary stop in breathing. Choices C and D, Frank-Starling Law and Starling reflex, are related to the intrinsic ability of the heart to adjust its output based on venous return, not specifically regulating blood pressure through reflex adjustments in heart rate and vascular tone as seen in the described phenomenon.
4. What is the condition where the lungs become filled with fluid, often due to heart failure, making it difficult to breathe?
- A. Pulmonary edema
- B. Pleural effusion
- C. Pulmonary hypertension
- D. Pneumothorax
Correct answer: A
Rationale: Pulmonary edema is the correct answer. It occurs when fluid fills the lungs, usually due to heart failure, leading to breathing difficulties. Pleural effusion is the accumulation of fluid around the lungs, not inside. Pulmonary hypertension is high blood pressure in the arteries of the lungs, and pneumothorax is the presence of air between the lung and chest wall.
5. The client is receiving digoxin and complains of nausea. What is the nurse’s priority action?
- A. Check the client’s digoxin level.
- B. Continue the current dose of digoxin.
- C. Administer an antiemetic for nausea.
- D. Discontinue the digoxin immediately.
Correct answer: A
Rationale: The correct answer is to check the client’s digoxin level (Choice A). Nausea can be a sign of digoxin toxicity, so assessing the digoxin level is crucial to determine if the medication dosage needs adjustment. Continuing the current dose of digoxin (Choice B) may worsen the symptoms if toxicity is present. Administering an antiemetic (Choice C) may provide temporary relief but does not address the underlying issue of digoxin toxicity. Discontinuing digoxin immediately (Choice D) without assessing the digoxin level can be harmful if the medication is within the therapeutic range.
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