ATI RN
Cardiovascular System Exam
1. A client on spironolactone (Aldactone) has a potassium level of 6.0 mEq/L. What is the nurse’s priority action?
- A. Hold the spironolactone and notify the healthcare provider.
- B. Administer a potassium supplement.
- C. Continue the spironolactone as ordered.
- D. Increase the dose of spironolactone.
Correct answer: A
Rationale: The correct action for a client on spironolactone with a potassium level of 6.0 mEq/L is to hold the medication and notify the healthcare provider. Spironolactone is a potassium-sparing diuretic that can further elevate potassium levels, which are already high. Administering a potassium supplement (Choice B) would exacerbate the hyperkalemia. Continuing the spironolactone as ordered (Choice C) could lead to worsening hyperkalemia. Increasing the dose of spironolactone (Choice D) would be contraindicated in the presence of elevated potassium levels.
2. 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.
3. What is a surgical procedure where a blood vessel is grafted to bypass a blocked coronary artery, improving blood flow to the heart muscle?
- A. Coronary artery bypass graft (CABG)
- B. Valve replacement
- C. Angioplasty
- D. Endarterectomy
Correct answer: A
Rationale: The correct answer is A: Coronary artery bypass graft (CABG). CABG involves grafting a blood vessel to bypass a blocked coronary artery, enhancing blood flow to the heart muscle. This procedure helps reduce the risk of heart attack by restoring proper blood circulation to the heart. Choice B, valve replacement, is a different surgical procedure that involves replacing damaged or dysfunctional heart valves. Choice C, angioplasty, is a minimally invasive procedure that uses a balloon to open narrowed or blocked blood vessels. Choice D, endarterectomy, is the surgical removal of plaque from the lining of an artery to improve blood flow.
4. Where is the impulse from the SA node delayed, enabling atrial contraction to complete before the ventricles are stimulated and contract?
- A. AV node
- B. Bundle of His
- C. SA node
- D. Aorta
Correct answer: A
Rationale: The correct answer is AV node. The AV node is responsible for delaying the impulse from the SA node, allowing the atria to contract before the ventricles. This delay ensures the effective pumping of blood in a coordinated manner. Choices B, C, and D are incorrect because the Bundle of His is responsible for transmitting the impulse to the Purkinje fibers, the SA node is the pacemaker of the heart responsible for initiating the heartbeat, and the aorta is the main artery carrying oxygenated blood from the heart to the body, respectively, none of which are involved in delaying the impulse to allow atrial contraction before ventricular contraction.
5. For what reason might the nurse be given an order to administer milrinone (Primacor)?
- A. For congestive heart failure
- B. For hypertension
- C. For cardiac arrhythmias
- D. For bradycardia
Correct answer: A
Rationale: Milrinone is commonly prescribed for congestive heart failure to help improve cardiac function and alleviate symptoms. Choices B, C, and D are incorrect as milrinone is not typically used for hypertension, cardiac arrhythmias, or bradycardia. It is specifically indicated for congestive heart failure for short-term management.
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