ATI RN
Physical Exam Cardiovascular System
1. The client on digoxin has a potassium level of 3.0 mEq/L. What is the nurse’s priority action?
- A. Administer a potassium supplement
- B. Hold the digoxin and notify the healthcare provider
- C. Continue the current digoxin dose
- D. Administer Digibind
Correct answer: B
Rationale: The correct answer is to hold the digoxin and notify the healthcare provider. A potassium level of 3.0 mEq/L indicates hypokalemia, which can increase the risk of digoxin toxicity. Digoxin and low potassium levels can lead to serious cardiac arrhythmias. Administering a potassium supplement (choice A) without healthcare provider guidance can worsen the situation. Continuing the current digoxin dose (choice C) can further increase the risk of toxicity. Administering Digibind (choice D) is used in severe cases of digoxin toxicity, not for addressing low potassium levels.
2. The nurse is caring for a client on warfarin with an INR of 5.2. What is the most appropriate action?
- A. Administer vitamin K as an antidote.
- B. Hold the next dose of warfarin.
- C. Increase the dose of warfarin.
- D. Monitor the client’s INR closely.
Correct answer: A
Rationale: An INR of 5.2 is elevated, indicating an increased risk of bleeding. Administering vitamin K can help reverse the effects of warfarin, which is the most appropriate action in this situation. Holding the next dose of warfarin is not enough to address the high INR, and increasing the dose would further elevate the INR level. Monitoring the INR closely is important, but in this case, immediate action is needed to counteract the anticoagulant effects of warfarin.
3. What is a condition where the lung's alveoli are permanently enlarged and damaged, leading to shortness of breath?
- A. Emphysema
- B. Bronchitis
- C. Atelectasis
- D. Pulmonary fibrosis
Correct answer: A
Rationale: Emphysema is the correct answer. It is a chronic lung condition characterized by the permanent enlargement and damage of the alveoli, leading to shortness of breath and impaired oxygen exchange. Bronchitis is the inflammation of the bronchial tubes, not specifically related to alveolar damage. Atelectasis is the collapse of lung tissue, not enlargement. Pulmonary fibrosis involves scarring and thickening of lung tissue, different from the alveolar damage seen in emphysema.
4. The nurse is administering digoxin to a client with a heart rate of 45 bpm. What is the nurse’s priority action?
- A. Hold the digoxin and notify the healthcare provider.
- B. Administer the digoxin as ordered.
- C. Increase the dose of digoxin.
- D. Monitor the client’s heart rate and reassess in 30 minutes.
Correct answer: A
Rationale: The correct answer is to hold the digoxin and notify the healthcare provider. A heart rate of 45 bpm is already low, and digoxin can further decrease the heart rate, leading to serious complications like bradycardia or heart block. Administering the medication can exacerbate the bradycardia, hence it should be withheld. Increasing the dose of digoxin is contraindicated due to the client's low heart rate. Monitoring the heart rate alone without taking immediate action to withhold the medication is not the priority when faced with the risk of further lowering the heart rate.
5. Which medication is used to prevent blood clots by thinning the blood, reducing the risk of stroke and heart attack?
- A. Anticoagulant
- B. ACE inhibitor
- C. Beta-blocker
- D. Calcium channel blocker
Correct answer: A
Rationale: The correct answer is 'Anticoagulant.' Anticoagulants are medications specifically designed to prevent blood clots by thinning the blood, which effectively reduces the risk of stroke, heart attack, and other cardiovascular events. Choices B, C, and D, which are ACE inhibitors, beta-blockers, and calcium channel blockers, respectively, do not have the primary mechanism of action to prevent blood clot formation. ACE inhibitors, beta-blockers, and calcium channel blockers are commonly used for managing hypertension and other cardiovascular conditions by different mechanisms of action.
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