ATI RN
Cardiovascular System Exam
1. The client on a beta blocker has a blood pressure of 88/58 mm Hg. What is the nurse’s priority action?
- A. Hold the beta blocker and notify the healthcare provider.
- B. Administer the beta blocker as ordered.
- C. Increase the dose of the beta blocker.
- D. Continue to monitor the client and reassess in 30 minutes.
Correct answer: A
Rationale: The correct action for the nurse to take when a client on a beta blocker presents with a blood pressure of 88/58 mm Hg is to hold the beta blocker and notify the healthcare provider. Beta blockers can further decrease blood pressure, which is already low in this case. Administering the beta blocker as ordered (Choice B) would exacerbate the hypotension. Increasing the dose of the beta blocker (Choice C) would be inappropriate and unsafe given the low blood pressure. Continuing to monitor the client and reassessing in 30 minutes (Choice D) could lead to a delay in necessary intervention. Therefore, the priority is to hold the medication and seek guidance from the healthcare provider.
2. What is a chronic inflammatory disease that affects the small airways in the lungs, leading to episodes of wheezing, breathlessness, and coughing?
- A. Asthma
- B. COPD
- C. Bronchitis
- D. Lung cancer
Correct answer: A
Rationale: Asthma is the correct answer. It is a chronic inflammatory disease that affects the small airways in the lungs, leading to symptoms like wheezing, breathlessness, and coughing. Asthma is commonly triggered by allergens, exercise, respiratory infections, and other factors. Choice B, COPD (Chronic Obstructive Pulmonary Disease), is characterized by airflow limitation and is often caused by smoking. Choice C, Bronchitis, is an inflammation of the bronchial tubes and can be acute or chronic. Choice D, Lung cancer, is a disease characterized by uncontrolled cell growth in lung tissues and is commonly associated with smoking or environmental factors.
3. The nurse is monitoring a client on dobutamine. What adverse effect should the nurse watch for?
- A. Tachycardia
- B. Bradycardia
- C. Hypertension
- D. Respiratory distress
Correct answer: A
Rationale: The correct answer is A: Tachycardia. Dobutamine is a medication that stimulates beta-1 adrenergic receptors in the heart, leading to increased heart rate. Therefore, tachycardia is a common adverse effect that the nurse should monitor for. Choices B, C, and D are incorrect because dobutamine typically does not cause bradycardia, hypertension, or respiratory distress as its primary adverse effects.
4. The client is on furosemide (Lasix) and has a potassium level of 2.9 mEq/L. What is the nurse’s priority action?
- A. Administer potassium supplements.
- B. Hold the furosemide and notify the healthcare provider.
- C. Continue the current dose of furosemide.
- D. Decrease the dose of furosemide.
Correct answer: A
Rationale: The correct answer is A: Administer potassium supplements. A potassium level of 2.9 mEq/L indicates hypokalemia (low potassium levels). Furosemide (Lasix) is a loop diuretic that can cause potassium loss. Therefore, the priority action is to administer potassium supplements to correct the imbalance. Option B is incorrect because holding the furosemide without addressing the low potassium level could further worsen the imbalance. Option C is incorrect as continuing the current dose of furosemide without addressing the low potassium level could lead to complications. Option D is incorrect because decreasing the dose of furosemide does not directly address the low potassium level that needs immediate correction.
5. The client is on nitroglycerin and reports chest pain. What is the nurse’s priority action?
- A. Administer nitroglycerin as ordered.
- B. Administer morphine as ordered.
- C. Administer aspirin as ordered.
- D. Notify the healthcare provider immediately.
Correct answer: D
Rationale: The correct answer is D: Notify the healthcare provider immediately. If a client on nitroglycerin reports chest pain, the priority action is to notify the healthcare provider immediately. This is crucial to ensure prompt reassessment of the client's condition and treatment plan. Administering nitroglycerin, morphine, or aspirin without consulting the healthcare provider first can be risky as the chest pain may indicate a need for a change in treatment or further evaluation. Administering medications without proper assessment and guidance can lead to complications and is not recommended in this scenario.
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