ATI questions 231 PDF

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Cardiac, Respiratory, Blood Practice Questions

1. A nurse is caring for a client who has heart failure and a prescription for digoxin 125 mcg PO daily. Available is digoxin PO 0.25 mg/tablet. How many tablets should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.) _0.5_ tablet(s) 2. A nurse is assessing a client who has fluid overload. Which of the following findings should the nurse expect? (Select all that apply.) A. Increased heart rate B. Increased blood pressure C. Increased respiratory rate D. Increase hematocrit E. Increased temperature 3. A nurse is reviewing the EKG strip of a client who has prolonged vomiting. Which of the following abnormalities on the client's EKG should the nurse interpret as a sign of hypokalemia? A. Abnormally prominent U wave B. Elevated ST segment C. Wide QRS D. Inverted P wave 4. A client who has a history of myocardial infarction (MI) is prescribed aspirin 325 mg. The nurse recognizes that the aspirin is given due to which of the following actions of the medication? A. analgesic B. anti-inflammatory C. antiplatelet aggregate D. antipyretic 5. While performing an admission assessment for a client, the nurse notes that the client has varicose veins with ulcerations and lower extremity edema with a report of a feeling of heaviness. Which of the following nursing diagnoses should the nurse identify as being the priority in the client's care? A. Impaired tissue perfusion B. Alteration in body image C. Alteration in activity tolerance D. Impaired skin integrity 6. A nurse is assessing a client who is receiving one unit of packed RBCs to treat intraoperative blood loss. The client reports chills and back pain, and the client's blood pressure is 80/64 mm Hg. Which of the following actions should the nurse take first? A. Stop the infusion of blood.

B. Inform the provider. C. Obtain a urine specimen. D. Notify the laboratory. 7. A nurse is teaching the partner of a client who had an acute myocardial infarction (MI) about the reason blood was drawn from the client. Which of the following statements should the nurse make regarding cardiac enzymes studies? A. "These tests help determine the degree of damage to the heart tissues." B. "Cardiac enzymes will identify the location of the MI." C. "These tests will enable the provider to determine the heart structure and mobility of the heart valves." D. "Cardiac enzymes assist in diagnosing the presence of pulmonary congestion." 8. A nurse is caring for a client who was admitted with bleeding esophageal varices and has an esophagogastric balloon tamponade with a Sengstaken-Blakemore tube to control the bleeding. Which of the following actions should the nurse take? A. Ambulate the client four times per day. B. Encourage the client to consume clear liquids. C. Provide frequent oral and nares care. D. Keep the client in a supine position. 9. A nurse is teaching about risk factors of developing a stroke with a group of older adult clients. Which of the following nonmodifiable risk factors should the nurse include in the teaching? A. History of smoking B. Obesity C. History of hypertension D. Race 10.A nurse is caring for a client who is postoperative and is at risk for developing venous thromboembolism (VTE). The nurse should instruct the client to avoid which of the following unsafe actions? A. Elevating her feet B. Massaging her legs C. Flexing her ankles D. Ambulating soon after surgery 11. A nurse is auscultating a client's heart sounds and hears an extra heart sound before what should be considered the first heart sound S1. The nurse should document this finding as which of the following heart sounds? A. The fourth heart sound (S4) B. A friction rub C. The third heart sound (S3) D. A split second heart sound S2

12. A nurse on a medical-surgical unit is caring for four clients who are 24 to 36 hr postoperative. Which of the following surgical procedures places the client at risk for deep-vein thrombosis? A. Myringotomy B. Laparoscopic appendectomy C. Hip arthroplasty D. Cataract extraction 13.A nurse is caring for a client who is receiving a unit of packed red blood cells. Fifteen minutes following the start of the transfusion, the nurse notes that the client is febrile, with chills and red-tinged urine. Which of the following transfusion reactions should the nurse suspect? A. Febrile B. Allergic C. Acute pain D. Hemolytic 14. A nurse is assessing a client who had left femoral cardiac angiography. Identify where the nurse will palpate to assess the most distal pulse on the affected side. (Check areas, or "Hot Spots," as outlined in the artwork below. Select only the outlined area that corresponds to your answer.)

15. A nurse is caring for a client who has bleeding esophageal varices and is being treated with a Sengstaken-Blakemore tube. Which of the following actions should the nurse perform? A. Deflate the balloons for 5 min every 2 hr to prevent tissue necrosis. B. Maintain constant observation while the balloons are inflated. C. Suction the tube every 2 hr and as needed to maintain patency. D. Keep the head of the bed flat at all times to prevent the development of shock. 16. A nurse is caring for a client who has pericarditis and reports feeling a new onset of palpitations and shortness of breath. Which of the following assessments should indicate to the nurse that the client may have developed atrial fibrillation? A. Different blood pressures in the upper limbs. B. Different apical and radial pulses. C. Differences between oral and axillary temperatures. D. Differences in upper and lower lung sounds. 17. A nurse is caring for a client who has an elevated potassium level and is on a cardiac monitor. The nurse is aware that hyperkalemia may be associated with changes to the T-wave. On the graphic, point and click on the area of the electrocardiogram (ECG) that represents the Twave. (Check on the Hot Spot that corresponds to your answer.)

18.A nurse is teaching a client who has septic shock about the development of disseminated intravascular coagulation (DIC). Which of the following statements should the nurse make? A. "DIC is controllable with lifelong heparin usage." B. "DIC is characterized by an elevated platelet count." C. "DIC is caused by abnormal coagulation involving fibrinogen." D. "DIC is a genetic disorder involving a vitamin K deficiency." 19. A nurse is assessing a client who has disseminated intravascular coagulation (DIC). Which of the following findings should the nurse expect? A. Excessive thrombosis and bleeding B. Progressive increase in platelet production C. Immediate sodium and fluid retention D. Increased clotting factors 20. A nurse is reviewing the PT, aPTT, and INR laboratory values for a client who is experiencing an acute episode of disseminated intravascular coagulation (DIC). Which of the following laboratory results should the nurse expect? A. The laboratory values are within the expected reference range. B. The laboratory values are prolonged. C. The laboratory values are decreased. D. The laboratory values are the same as the previous test values. 21. A nurse is monitoring a client who is on telemetry. Which of the following findings on the ECG strip should the nurse recognize as normal sinus rhythm? A. The P wave falls before the QRS complex. B. The T wave is in the inverted position. C. The P-R interval measures 0.22 seconds. D. The QRS duration is 0.20 seconds. 22. A nurse is caring for a client who recently had surgery for insertion of a permanent pacemaker. Which of the following prescriptions should the nurse clarify? A. Serum cardiac enzyme levels B. MRI of the chest C. Physical therapy D. Low-sodium diet 23. A nurse in an emergency department is caring for a client who is bleeding profusely from a deep laceration on his left lower forearm. After observing standard precautions, which of the following actions should the nurse perform first? A. Apply a tourniquet just below the elbow. B. Apply direct pressure over the wound. C. Clean the wound. D. Elevate the limb and apply ice.

24. A nurse is selecting a qualified staff member to double check a blood label with a client ID bracelet prior to infusing a unit of blood. The nurse should identify that which of the following persons is qualified? A. Oncology nurse B. Assistive personnel C. Senior nursing student D. Phlebotomist 25. A nurse is assessing a client before administering a unit of packed RBCs. The nurse should identify which of the following data as most important to obtain prior to the infusion? A. Skin color B. Fluid intake C. Temperature D. Hemoglobin level 26. A nurse receives a unit of packed RBCs from a blood bank and notes that the time is 1130. The nurse should begin the infusion at which of the following times? A. When the client has finished eating lunch B. When the client states he is ready to start the infusion C. 2 hr after obtaining blood from the blood bank D. As soon as the nurse can prepare the client and the administration set 27.A nurse is planning care for a client who is to receive packed RBCs. The nurse should plan for the total infusion time to not exceed which of the following? A. 2 hr B. 6 hr C. 8 hr D. 4 hr 28. A nurse is caring for a client who has a prescription for one unit of packed RBCs. The nurse should plan to remain in the room with the client at which of the following times during the infusion to observe for a transfusion reaction? A. The first 2 min B. The final 2 min C. The first 15 min D. The final 15 min 29. A nurse is monitoring a client who reports having chills and back pain during a blood transfusion. Which of the following actions is nurse's priority? A. Stopping the transfusion B. Covering the client with a blanket C. Notifying the provider

D. Assessing the client's skin for a rash 30. A nurse is providing teaching to a client about interventions to reduce the risk of developing cardiovascular disease. Which of the following statements by the client should indicate to the nurse the need for further teaching? A. "A weight loss program can decrease my LDL cholesterol level." B. "Exercising regularly will increase HDL cholesterol levels." C. "Adding foods containing omega-3 fatty acids to my diet can lower my risk." D. "Increasing my intake of foods containing trans-fatty acids can lower my risk." 31. A nurse is giving a presentation to a community group about preventing atherosclerosis. Which of the following should the nurse include as a modifiable risk factor for this disorder? (Select all that apply.) A. Genetic predisposition B. Hypercholesterolemia C. Hypertension D. Obesity E. Smoking 32. A nurse is caring for a client who reports an area of redness, warmth, tenderness and pain in the right calf. The nurse anticipates which of the following orders when notifying the provider of this finding? A. Obtain a venous duplex ultrasound. B. Obtain impedance plethysmography. C. Monitor Homan’s sign. D. Apply cold therapy to the affected leg. 33. A nurse is caring for a client with a ventricular pacemaker who is on ECG monitoring. The nurse understands that the pacemaker is functioning properly when which of the following appears on the monitor strip? A. Pacemaker spikes after each QRS complex B. Pacemaker spikes before each P wave C. Pacemaker spikes before each QRS complex D. Pacemaker spikes with each T wave 34. A nurse is caring for a client who has a cardiopulmonary arrest. The nurse anticipates the emergency response team will administer which of the following medications if the client’s restored rhythm is symptomatic bradycardia? A. Epinephrine B. Magnesium C. Atropine D. Sodium bicarbonate

35. A nurse is preparing to administer a unit of red blood cells. The nurse’s responsibility is to compare and verify the information on the blood label with the client’s information. The nurse should use which of the following as the priority source of verification? A. chart B. order sheet C. medication administration record D. identification wristband 36. A nurse is admitting a client who has acute heart failure following myocardial infarction (MI). The nurse recognizes that which of the following prescriptions by the provider requires clarification? A. Morphine sulfate 2 mg IV bolus every 2 hr PRN pain B. Laboratory testing of serum potassium upon admission C. 0.9% normal saline IV at 50 mL/hr continuous D. Bumetanide 1 mg IV bolus every 12 hr 37. A nurse in a clinic is caring for a client who has a prescription for digoxin. Which of the following statements indicates the client is experiencing digoxin toxicity? A. "I am gaining weight." B. "I am constipated." C. "My vision seems yellow." D. "My tongue is red and beefy." 38. A nurse in a clinic is caring for a client who has recently begun taking warfarin. The nurse is reviewing potential drug and food interaction risks and should instruct the client to avoid which of the following? A. Cabbage B. Cantaloupe C. Green beans D. White beans 39. A nurse is caring for a male client who has peripheral vascular disease (PVD), is taking dietary supplements, and has a new prescription for warfarin. The nurse should instruct the client to stop which of the following supplements prior to starting the warfarin? (Select all that apply.) A. Saw palmetto B. Flaxseed oil C. Glucosamine D. Black cohosh E. Gingko biloba 40. A nurse is reviewing a client’s laboratory results and finds the hemoglobin is 10 g/dL and the hematocrit is 30%. The nurse recognizes that the client is at risk for which of the following? A. Prolonged bleeding

B. Cellular hypoxia C. Impaired immunity D. Fluid retention 41.A nurse is monitoring a client who is receiving a blood transfusion. Which of the following findings indicates an allergic transfusion reaction? A. Generalized urticaria. B. Blood pressure 184/92 mm Hg. C. Distended jugular veins. D. Bilateral flank pain. 42. A nurse is caring for a client who came to the emergency department reporting chest pain. The provider suspects a myocardial infarction. While waiting for the troponin levels report, the client asks what this blood test will show. Which of the following explanations should the nurse provide the client? A. Troponin is an enzyme that indicates damage to brain, heart, and skeletal muscle tissues. B. Troponin is a lipid whose levels reflect the risk for coronary artery disease. C. Troponin is a heart muscle protein that appears in the bloodstream when there is damage to the heart. D. Troponin is a protein that helps transport oxygen throughout the body. 43. A nurse is caring for a client who has a serum potassium level of 5.5 mEq/L. The provider prescribes polystyrene sulfonate. If this medication is effective, the nurse should expect which of the following changes on the client’s ECG? A. Reduction of T-wave amplitude B. Shortening of P-wave duration C. Widening of the QRS complex D. Restoration of QRS complex amplitude 44. The nurse is evaluating a client who had a cardiac catheterization with a left antecubital insertion site. Which of thefollowing pulses should the nurse palpate? A. Brachial pulse in the left arm B. Brachial pulse in the right arm C. Radial pulse in the left arm D. Radial pulse in the right arm 45. A nurse is caring for a client who is postoperative following vascular surgery. Which of the following signs should indicate to the nurse that the client has developed a thrombus? A. Positive Kernig’s sign B. Positive Homan’s sign C. Dull, aching calf pain D. Soft, pliable calf muscle

46. A nurse is preparing to administer 2 units of packed RBCs to an older adult client. Which of the following actions should the nurse take? A. Administer each unit over 3 hr. B. Use an 18-gauge needle to obtain venous access. C. Use blood that is less than a month old. D. Obtain the client's vital signs every 30 min throughout the transfusion. 47. A nurse is caring for a client who has valvular heart disease and is at risk for developing leftsided heart failure. Which of the following manifestations should alert the nurse the client is developing this condition? A. Anorexia B. Weight gain C. Breathlessness D. Distended abdomen 48.A nurse is caring for a client who has hypertension and has a potassium level of 6.8 mEq/L. Which of the following actions should the nurse take? A. Suggest that the client use a salt substitute. B. Obtain a 12-lead ECG. C. Advise the client to add citrus juices and bananas to her diet. D. Obtain a blood sample for a serum sodium level. 49. A nurse is caring for a client who the provider suspects might have pernicious anemia. The nurse should expect the provider to prescribe which of the following diagnostic tests? A. Sweat test B. Haptoglobin C. Antinuclear antibodies D. Schilling test 50. A nurse is assessing a client who is postoperative and has anemia due to excess blood loss following surgery. Which of the following findings should the nurse expect? A. Fatigue B. Hypertension C. Bradycardia D. Diarrhea 51. A nurse is caring for a client 4 hr following a cardiac catheterization. Which of the following actions should the nurse take? A. Have the client lie flat in bed. B. Keep the affected leg slightly flexed. C. Elevate the head of the bed 45°. D. Keep the client NPO for 4 hr.

52. A home health nurse is making a home visit to a client who takes a daily diuretic for heart failure. Which of the following manifestations should the nurse identify as indicating the client is hypokalemic? A. Pitting edema B. Fatigue C. Dyspnea D. Oliguria 53. A nurse is caring for a client who has infective endocarditis. Which of the following manifestations is the priority for the nurse to monitor for? A. Anorexia B. Dyspnea C. Fever D. Malaise 54. A nurse is preparing to administer atenolol 25 mg PO every 12 hr. The amount available is atenolol 50 mg/tab. How many tablets should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.) __0.5____ tablet(s) 55.A nurse is providing discharge instructions to a client who developed deep-vein thrombosis (DVT) postoperatively and is prescribed anticoagulant therapy. Which of the following instructions should the nurse include? A. Applying cool compresses to her legs B. Wearing loose, non-constricting stockings C. Flexing her knees and feet frequently D. Taking an NSAID tablet daily 56. A nurse in the emergency department is caring for a client who reports chest pressure and shortness of breath. Which of the following laboratory tests should the nurse anticipate the provider to prescribe? A. Troponin I B. Lipase C. B-type natriuretic peptide (BNP) D. Aspartate aminotransferase (AST) 57. A nurse is interpreting the ECG strip of a client who has bradycardia. Which of the following cardiac components should the nurse identify as the role of the P wave? A. Ventricular depolarization B. Slow repolarization of ventricular Purkinje fibers C. Atrial depolarization D. Early ventricular repolarization

58. A nurse is providing discharge teaching to a client who has an implantable cardioverter/defibrillator (ICD). Which of the following information should the nurse include? A. The client cannot travel by air due to security screening. B. The client should hold his cell phone on the side opposite the ICD. C. The client should avoid the use of small electric devices. D. The client can carry his ICD in a small pocket. 59. A nurse is caring for a client who is scheduled for an exercise stress test. Which of the following comments made by the client should indicate to the nurse that the client requires further teaching? A. "I will not smoke prior to my test." B. "I'll take my heart medications the morning of my test." C. "I'll get 8 hours of sleep the night before the test." D. "I'll skip my coffee the morning of my test." 60. A nurse is preparing a client who is scheduled for an echocardiogram the following day. Which of the following instructions should the nurse include about the test? A. "It might cause slight discomfort in the chest area." B. "It takes about 5 or 10 minutes." C. "It requires lying quietly on one side." D. "It is best to have no food or beverages the day of the test." 61. A nurse is interpreting a client's ECG strip. Which of the following com...