ATI RN
Cardiovascular System Exam Questions
1. What is a surgical procedure to create an opening in the windpipe to assist with breathing?
- A. Tracheostomy
- B. Lobectomy
- C. Thoracotomy
- D. Pleurodesis
Correct answer: A
Rationale: Tracheostomy is the correct answer. It is a surgical procedure to create an opening in the windpipe (trachea) to assist with breathing. This procedure is commonly used for patients who require long-term ventilation support. Choice B, Lobectomy, involves the removal of a lobe of the lung and is not related to creating an opening in the windpipe. Choice C, Thoracotomy, is a surgical incision into the chest wall and is not specifically related to creating an opening in the windpipe. Choice D, Pleurodesis, is a procedure to treat recurrent pleural effusions by causing the pleural layers to stick together, and it is not related to creating an opening in the windpipe.
2. A patient with breast cancer is prescribed tamoxifen (Nolvadex). What should the nurse emphasize during patient education?
- A. Tamoxifen may increase the risk of venous thromboembolism, so patients should be aware of the signs and symptoms of blood clots.
- B. Tamoxifen may cause weight gain, so patients should monitor their diet.
- C. Tamoxifen may cause hot flashes and other menopausal symptoms.
- D. Tamoxifen may decrease the risk of osteoporosis, so patients should ensure adequate calcium intake.
Correct answer: A
Rationale: The correct answer is A. Tamoxifen increases the risk of venous thromboembolism, a serious side effect. Therefore, patients should be educated about the signs and symptoms of blood clots, such as swelling, pain, and redness in the legs, and advised to seek immediate medical attention if they occur. Choice B is incorrect because weight gain is not a significant side effect of tamoxifen. Choice C is incorrect because hot flashes and menopausal symptoms are common side effects of tamoxifen but are not as critical to address as venous thromboembolism. Choice D is incorrect because tamoxifen does not decrease the risk of osteoporosis; in fact, it may increase the risk of bone loss in premenopausal women.
3. When assessing a client diagnosed with post-traumatic stress disorder (PTSD), which finding should the nurse expect?
- A. Hypervigilance
- B. Insomnia
- C. Flashbacks
- D. Suicidal ideation
Correct answer: A
Rationale: Clients with PTSD commonly exhibit symptoms such as hypervigilance, insomnia, flashbacks, difficulty concentrating, and increased irritability. Hypervigilance refers to an enhanced state of awareness and alertness, often seen in individuals with PTSD as they are constantly on guard for potential threats. Insomnia is a common sleep disturbance associated with PTSD, where individuals may have trouble falling or staying asleep. Flashbacks involve re-experiencing the traumatic event as if it is occurring in the present moment. Suicidal ideation, while a serious concern in mental health, is not a hallmark symptom specifically associated with PTSD. Therefore, the correct finding that the nurse should expect when assessing a client diagnosed with PTSD is hypervigilance.
4. Which of the following lab values indicates a patient on warfarin is at a therapeutic level?
- A. INR of 1.1
- B. PT of 12 seconds
- C. INR of 2.5
- D. Platelet count of 150,000
Correct answer: C
Rationale: An INR of 2.5 indicates a therapeutic level for a patient on warfarin. The INR (International Normalized Ratio) is the most accurate way to monitor and adjust warfarin doses. An INR of 1.1 (Choice A) is below the therapeutic range, indicating a need for an increased dose. PT (Prothrombin Time) of 12 seconds (Choice B) is not specific for warfarin therapy monitoring. Platelet count (Choice D) is not directly related to monitoring warfarin therapy.
5. The nurse is caring for a patient post-coronary artery bypass graft procedure who is on a nitroglycerin intravenous drip. The nurse understands the importance of nitroglycerin with this procedure as:
- A. Decreasing myocardial oxygen supply.
- B. Increasing preload.
- C. Decreasing cardiac output.
- D. Decreasing afterload.
Correct answer: Decreasing afterload.
Rationale: Nitroglycerin is a vasodilator that works by decreasing afterload, which is the pressure the heart must work against to eject blood during systole. By reducing afterload, nitroglycerin helps the heart pump more effectively and decreases the workload on the heart. This results in improved cardiac output and decreased myocardial oxygen demand. Choices A, B, and C are incorrect because nitroglycerin does not decrease myocardial oxygen supply, increase preload, or decrease cardiac output.
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