ATI RN
Physical Exam Cardiovascular System
1. What structures hold up the AV valves and are anchored to the ventricular wall by the papillary muscles?
- A. Chordae tendineae
- B. Papillary muscles
- C. Semilunar valves
- D. Aortic valve
Correct answer: A
Rationale: The correct answer is A: Chordae tendineae. Chordae tendineae are fibrous cords that connect the AV valves to the papillary muscles, preventing the valves from inverting during ventricular contraction. Papillary muscles (choice B) anchor the chordae tendineae to the ventricular wall but do not hold up the AV valves directly. Semilunar valves (choice C) are located between the ventricles and the major arteries and are not involved in holding up the AV valves. The aortic valve (choice D) is one of the semilunar valves and is not responsible for holding up the AV valves.
2. What is the condition where the lungs become filled with fluid, often due to heart failure, making it difficult to breathe?
- A. Pulmonary edema
- B. Pleural effusion
- C. Pulmonary hypertension
- D. Pneumothorax
Correct answer: A
Rationale: Pulmonary edema is the correct answer. It occurs when fluid fills the lungs, usually due to heart failure, leading to breathing difficulties. Pleural effusion is the accumulation of fluid around the lungs, not inside. Pulmonary hypertension is high blood pressure in the arteries of the lungs, and pneumothorax is the presence of air between the lung and chest wall.
3. After the AV node, the electrical impulse is then transmitted into the _________, and into the _________.
- A. Purkinje fibers, ventricles
- B. Atria, ventricles
- C. Bundle of His, Purkinje fibers
- D. Ventricles, Purkinje fibers
Correct answer: C
Rationale: The correct answer is C. After the AV node, the electrical impulse is transmitted to the Bundle of His and then to the Purkinje fibers. This sequence is crucial for the coordinated contraction of the ventricles. Choice A (Purkinje fibers, ventricles) is incorrect because the Purkinje fibers come after the Bundle of His in the sequence of electrical conduction. Choice B (Atria, ventricles) is incorrect because the impulse does not go back to the atria after passing through the AV node. Choice D (Ventricles, Purkinje fibers) is incorrect because the impulse first reaches the Bundle of His before spreading to the Purkinje fibers.
4. Which medication relaxes the muscles around the airways, making it easier to breathe?
- A. Bronchodilator
- B. Corticosteroid
- C. Antihistamine
- D. Mucolytic
Correct answer: A
Rationale: The correct answer is A, Bronchodilator. Bronchodilators are medications that relax the muscles surrounding the airways, which helps to open them and makes breathing easier. Corticosteroids (choice B) work by reducing inflammation, antihistamines (choice C) are used to manage allergies, and mucolytics (choice D) help to break down and thin mucus in the airways.
5. A client on a beta blocker has a blood pressure of 90/60 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. Administer a diuretic to reduce blood pressure.
- D. Continue to monitor the client and reassess in 30 minutes.
Correct answer: A
Rationale: The correct answer is to hold the beta blocker and notify the healthcare provider. A blood pressure of 90/60 mm Hg is already low, and beta blockers can further decrease blood pressure. Administering the beta blocker can potentially worsen the situation, leading to complications. Administering a diuretic or continuing to monitor the client without taking immediate action could delay necessary intervention. Therefore, holding the beta blocker and involving the healthcare provider promptly is crucial in this scenario.
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