ATI RN
Physical Exam Cardiovascular System
1. The client is on digoxin and has severe digoxin toxicity. What is the nursing priority action?
- A. Check the potassium level.
- B. Give Digibind as an antidote.
- C. Change the dosing of digoxin to every other day.
- D. Administer a potassium supplement to decrease digoxin toxicity.
Correct answer: B
Rationale: The correct answer is to give Digibind as an antidote in cases of severe digoxin toxicity. Digibind works by binding to digoxin and preventing it from causing further harm. Checking the potassium level (choice A) is important but not the priority when the client has severe toxicity. Changing the dosing to every other day (choice C) is not appropriate in the setting of severe toxicity where immediate action is required. Giving a potassium supplement (choice D) may be needed eventually, but the priority is to administer Digibind to counteract the toxic effects of digoxin.
2. The nurse is giving the client digoxin for heart failure and recognizes that the drug has what type of effect on the heart?
- A. Negative inotropic, negative chronotropic effect
- B. Positive inotropic, negative chronotropic effect
- C. Negative inotropic, positive chronotropic effect
- D. Positive inotropic, positive chronotropic effect
Correct answer: B
Rationale: The correct answer is B: Positive inotropic, negative chronotropic effect. Digoxin strengthens the heart muscle, providing a positive inotropic effect, which increases the force of contraction. It also decreases the heart rate, having a negative chronotropic effect. Choice A is incorrect because digoxin has a positive inotropic effect, not a negative inotropic effect. Choice C is incorrect as digoxin does not have a positive chronotropic effect but a negative one. Choice D is incorrect because while digoxin has a positive inotropic effect, it does not have a positive chronotropic effect.
3. Which condition is characterized by the right ventricle of the heart failing due to increased pressure in the lungs, often caused by chronic lung disease?
- A. Cor pulmonale
- B. Pulmonary embolism
- C. Aortic stenosis
- D. Hypertrophic cardiomyopathy
Correct answer: A
Rationale: The correct answer is Cor pulmonale, a condition where the right ventricle of the heart fails due to increased pressure in the lungs, commonly caused by chronic lung diseases like COPD. Pulmonary embolism (choice B) is a blockage in one of the pulmonary arteries in the lungs, usually caused by a blood clot. Aortic stenosis (choice C) is a narrowing of the aortic valve opening that restricts blood flow from the left ventricle to the aorta. Hypertrophic cardiomyopathy (choice D) is a genetic condition where the heart muscle becomes abnormally thick, making it harder for the heart to pump blood.
4. Which of the following is a chronic condition characterized by difficulty breathing due to airflow obstruction, commonly associated with long-term smoking?
- A. Chronic obstructive pulmonary disease (COPD)
- B. Asthma
- C. Pulmonary hypertension
- D. Bronchitis
Correct answer: A
Rationale: The correct answer is A, Chronic obstructive pulmonary disease (COPD). COPD is a chronic lung condition characterized by persistent airflow obstruction, commonly linked to long-term smoking. Choice B, Asthma, is a chronic condition characterized by reversible airflow obstruction and airway inflammation triggered by various factors like allergens and irritants. Choice C, Pulmonary hypertension, is a condition characterized by high blood pressure in the arteries of the lungs. Choice D, Bronchitis, is an inflammation of the bronchial tubes that may be acute or chronic, but it is not typically associated with long-term smoking like COPD.
5. Which of the following is a genetic disorder that causes thick, sticky mucus to build up in the lungs and digestive system, leading to severe respiratory and digestive problems?
- A. Cystic fibrosis
- B. Pulmonary fibrosis
- C. Pulmonary edema
- D. Bronchiectasis
Correct answer: A
Rationale: The correct answer is A, cystic fibrosis. Cystic fibrosis is a genetic disorder characterized by the buildup of thick, sticky mucus in the lungs and digestive system, resulting in severe respiratory and digestive issues. Choice B, pulmonary fibrosis, involves scarring and thickening of lung tissue, not excessive mucus production. Choice C, pulmonary edema, refers to fluid accumulation in the lungs, not mucus buildup. Choice D, bronchiectasis, is a condition where the airways in the lungs are damaged and widened, leading to chronic cough and sputum production, but it does not specifically involve the thick, sticky mucus characteristic of cystic fibrosis.
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