ATI RN
Physical Exam Cardiovascular System
1. The client is on a calcium channel blocker. What is the expected effect on the heart?
- A. Increased heart rate
- B. Decreased heart rate
- C. Increased blood pressure
- D. Decreased blood pressure
Correct answer: D
Rationale: When a client is on a calcium channel blocker, the expected effect on the heart is a decreased heart rate and decreased blood pressure. Calcium channel blockers work by dilating blood vessels and reducing the heart's workload, resulting in decreased blood pressure. Choice A, increased heart rate, is incorrect as calcium channel blockers actually have a negative chronotropic effect, reducing the heart rate. Choice C, increased blood pressure, is also incorrect because these medications are used to lower blood pressure.
2. The physician orders the administration of high-humidity oxygen by face mask and placement of the patient in a high Fowler’s position. After assessing Mrs. Paul, the nurse writes the following nursing diagnosis: Impaired gas exchange related to increased secretions. Which of the following nursing interventions has the greatest potential for improving this situation?
- A. Encourage the patient to increase her fluid intake to 200 ml every 2 hours
- B. Place a humidifier in the patient’s room
- C. Continue administering oxygen by high humidity face mask
- D. Perform chest physiotherapy on a regular schedule
Correct answer: D
Rationale: Chest physiotherapy is the most effective intervention in cases of impaired gas exchange related to increased secretions. This technique helps mobilize and clear secretions from the airways, thereby improving gas exchange in the lungs. Placing a humidifier or administering oxygen by high humidity face mask may provide moisture but may not directly address the clearance of secretions. Encouraging increased fluid intake can help with hydration but may not address the underlying issue of impaired gas exchange due to secretions.
3. A healthcare professional is caring for a client who is receiving treatment with carboplatin. Which of the following findings should the healthcare professional monitor?
- A. Hyperglycemia
- B. Ototoxicity
- C. Hypertension
- D. Bradycardia
Correct answer: B
Rationale: The healthcare professional should monitor the client for ototoxicity when receiving carboplatin. Ototoxicity is a known serious adverse effect associated with this medication, characterized by damage to the inner ear structures leading to hearing loss or balance issues. Monitoring for hearing changes and balance problems is crucial to detect ototoxicity early and prevent further complications. Hyperglycemia, hypertension, and bradycardia are not typically associated with carboplatin therapy.
4. A healthcare provider is on a med-surg unit caring for a client who follows the dietary laws of Orthodox Judaism. Which of the following menu selections should the healthcare provider recommend for this client?
- A. Fried catfish
- B. Broiled shrimp
- C. Pork sausage
- D. Grilled vegetables
Correct answer: D
Rationale: The correct answer is D: Grilled vegetables. Orthodox Judaism restricts the consumption of certain animals, including catfish, shrimp, and pork, making choices A, B, and C inappropriate for a client following these dietary laws. Grilled vegetables are a safe and suitable option that complies with Orthodox Jewish dietary guidelines.
5. When interviewing a distressed client who was fired after 15 years of loyal employment, which of the following questions would best assist the nurse in determining the client's appraisal of the situation? Select the one that does not apply.
- A. What coping resources have you used previously in stressful situations?
- B. Have you ever faced a similar stressful situation before?
- C. Who do you think is to blame for this situation?
- D. What do you believe led to your termination from your job?
Correct answer: C
Rationale: In this scenario, it is crucial for the nurse to help the client assess their coping mechanisms and perspective on the situation. Questions A and B focus on exploring the client's coping resources and past experiences to guide them towards effective stress management. Asking who is to blame (choice C) is not conducive to evaluating coping abilities; instead, it might elicit a blame-focused response, which can impede progress. Choice D, inquiring about the reason for being fired, is a nontherapeutic approach that does not promote a constructive appraisal of the situation.
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