ATI RN
Physical Exam Cardiovascular System
1. Which neurotransmitter released by the parasympathetic nervous system can decrease heart rate?
- A. Acetylcholine
- B. Norepinephrine
- C. Dopamine
- D. Serotonin
Correct answer: A
Rationale: Acetylcholine is the correct answer. It is a neurotransmitter released by the parasympathetic nervous system that can decrease heart rate. Norepinephrine, dopamine, and serotonin are neurotransmitters that usually have different effects on the body and are not specifically associated with decreasing heart rate. Norepinephrine, for example, is often related to the fight-or-flight response and can increase heart rate.
2. The client is on amiodarone. What is the most important side effect to monitor for?
- A. Pulmonary toxicity
- B. Thyroid dysfunction
- C. Liver toxicity
- D. Renal dysfunction
Correct answer: A
Rationale: The correct answer is A: Pulmonary toxicity. Amiodarone is known for causing serious pulmonary toxicity, which can be fatal. Monitoring for pulmonary toxicity is crucial due to its potential severity. Choice B, thyroid dysfunction, is a common side effect of amiodarone but is not as immediately life-threatening as pulmonary toxicity. Choices C and D, liver toxicity and renal dysfunction, are potential side effects of amiodarone but are not as critical or as common as pulmonary toxicity, making them less important to monitor initially.
3. What test uses high-frequency sound waves to create images of the heart, allowing doctors to assess its structure and function?
- A. Echocardiogram
- B. MRI
- C. CT scan
- D. X-ray
Correct answer: A
Rationale: The correct answer is an echocardiogram. An echocardiogram utilizes high-frequency sound waves (ultrasound) to create images of the heart, enabling doctors to evaluate its structure, function, and detect any abnormalities. MRI (Choice B) uses magnetic fields and radio waves to produce detailed images of the body's structures. CT scan (Choice C) combines X-rays and computer technology to create cross-sectional images of the body. X-ray (Choice D) uses electromagnetic radiation to produce images of the internal structures of the body, but it is not the most suitable for assessing the heart's structure and function.
4. What term refers to the degree of myocardial fiber stretch before contraction, related to the volume of blood distending the ventricles at the end of diastole, and determined by the amount of venous return?
- A. Preload
- B. Afterload
- C. Contractility
- D. Ejection fraction
Correct answer: A
Rationale: The correct answer is A: Preload. Preload is the degree of myocardial fiber stretch before contraction, influenced by the volume of blood returning to the heart. This parameter is related to the amount of blood in the ventricles at the end of diastole. Choice B, Afterload, refers to the pressure or resistance that the ventricles must overcome to eject blood. Choice C, Contractility, is the intrinsic ability of the heart muscle to contract. Choice D, Ejection fraction, is the percentage of blood pumped out of the ventricles with each contraction.
5. The nurse is giving digoxin to a client. What is the most important parameter to check before administration?
- A. Heart rate
- B. Blood pressure
- C. Respiratory rate
- D. Oxygen saturation
Correct answer: A
Rationale: The correct answer is A: Heart rate. Before administering digoxin, it is crucial to check the client's heart rate because digoxin can cause bradycardia, an abnormally slow heart rate. Monitoring the heart rate is essential to prevent potential complications associated with digoxin therapy. Choices B, C, and D are less critical parameters to assess before administering digoxin. While blood pressure is also important to monitor during digoxin therapy, the most crucial parameter to check due to the medication's potential effect on heart rate is the heart rate itself.
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