ATI RN
Physical Exam Cardiovascular System
1. The client on clopidogrel (Plavix) should be monitored for which adverse effect?
- A. Bleeding
- B. Hypertension
- C. Tachycardia
- D. Bradycardia
Correct answer: A
Rationale: Correct! Clopidogrel (Plavix) is an antiplatelet medication that helps prevent blood clots. As a side effect, it can increase the risk of bleeding. Monitoring for signs of bleeding, such as easy bruising, blood in urine or stools, or prolonged bleeding from cuts, is crucial. Choices B, C, and D are incorrect as hypertension, tachycardia, and bradycardia are not typically associated with clopidogrel use.
2. The client on warfarin has an INR of 3.8. What is the most appropriate action by the nurse?
- A. Administer vitamin K.
- B. Hold the next dose of warfarin.
- C. Increase the dose of warfarin.
- D. Notify the healthcare provider immediately.
Correct answer: A
Rationale: An INR of 3.8 is elevated, indicating an increased risk of bleeding. Administering vitamin K can help reverse the effects of warfarin. Holding the next dose of warfarin would be appropriate if the INR was too high, but not as the first-line action. Increasing the dose of warfarin would worsen the situation by further increasing the INR. Notifying the healthcare provider is important, but immediate action to address the elevated INR is necessary.
3. The client has a prescription for sublingual nitroglycerin. What is the nurse's instruction for how to take this medication during an episode of chest pain?
- A. Take one tablet every 5 minutes, up to three tablets.
- B. Take one tablet every hour until the pain subsides.
- C. Take two tablets immediately if chest pain occurs.
- D. Take one tablet with a full glass of water.
Correct answer: A
Rationale: The correct answer is A. The standard instruction for sublingual nitroglycerin during an episode of chest pain is to take one tablet every 5 minutes, up to three tablets. If the pain persists after taking three tablets, the client should seek emergency help. Choice B is incorrect because taking one tablet every hour is not the appropriate dosing for acute chest pain. Choice C is incorrect as taking two tablets immediately is not in line with the recommended dosing instructions. Choice D is incorrect because sublingual nitroglycerin should be placed under the tongue, not swallowed with water.
4. The client on furosemide is at risk for which electrolyte imbalance?
- A. Hypokalemia
- B. Hypernatremia
- C. Hyperkalemia
- D. Hyponatremia
Correct answer: A
Rationale: The correct answer is A: Hypokalemia. Furosemide is a loop diuretic that can lead to potassium loss, resulting in hypokalemia. This electrolyte imbalance is a significant risk associated with the use of diuretics. Choice B, Hypernatremia, is incorrect as furosemide is not known to cause high sodium levels. Choice C, Hyperkalemia, is also incorrect as furosemide tends to cause potassium depletion rather than excess. Choice D, Hyponatremia, is not directly related to furosemide use.
5. What type of medication is used to reduce high blood pressure by relaxing the blood vessels?
- A. Calcium channel blocker
- B. Beta-blocker
- C. ACE inhibitor
- D. Diuretic
Correct answer: A
Rationale: Calcium channel blockers are medications that reduce high blood pressure by relaxing the blood vessels, facilitating easier blood flow through the vessels. Beta-blockers work by reducing the heart rate and the heart's workload. ACE inhibitors help relax blood vessels by blocking the production of a chemical that narrows blood vessels. Diuretics help the body get rid of excess sodium and water to lower blood pressure, but they do not directly relax blood vessels like calcium channel blockers do.
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