ATI RN
Physical Exam Cardiovascular System
1. The client is on digoxin and has severe digoxin toxicity. What is the nursing priority action?
- A. Check the potassium level.
- B. Give Digibind as an antidote.
- C. Change the dosing of digoxin to every other day.
- D. Administer a potassium supplement to decrease digoxin toxicity.
Correct answer: B
Rationale: The correct answer is to give Digibind as an antidote in cases of severe digoxin toxicity. Digibind works by binding to digoxin and preventing it from causing further harm. Checking the potassium level (choice A) is important but not the priority when the client has severe toxicity. Changing the dosing to every other day (choice C) is not appropriate in the setting of severe toxicity where immediate action is required. Giving a potassium supplement (choice D) may be needed eventually, but the priority is to administer Digibind to counteract the toxic effects of digoxin.
2. Which medication is used to lower high blood pressure and reduce the risk of heart attacks and strokes?
- A. ACE inhibitor
- B. Beta-blocker
- C. Diuretic
- D. Calcium channel blocker
Correct answer: A
Rationale: The correct answer is an ACE inhibitor. ACE inhibitors are medications specifically designed to lower high blood pressure and reduce the risk of heart attacks, strokes, and other cardiovascular events. Beta-blockers, diuretics, and calcium channel blockers are also used to treat high blood pressure, but ACE inhibitors are particularly effective in reducing the risk of heart attacks and strokes.
3. What procedure is used to visualize the airways and diagnose lung disease?
- A. Bronchoscopy
- B. Thoracentesis
- C. Pulmonary function test
- D. Chest X-ray
Correct answer: A
Rationale: Bronchoscopy is the correct answer because it is a procedure specifically designed to visualize the airways and diagnose lung diseases by allowing doctors to examine the inside of the airways. Thoracentesis involves the removal of fluid from the pleural space around the lungs, not the airways. Pulmonary function tests assess how well the lungs work but do not visualize the airways directly. A chest X-ray provides an image of the lungs and surrounding structures but does not involve direct visualization of the airways.
4. The client on furosemide (Lasix) has a potassium level of 3.1 mEq/L. What is the nurse’s priority action?
- A. Administer a potassium supplement.
- B. Hold the furosemide and notify the healthcare provider.
- C. Continue the current dose of furosemide.
- D. Administer Digibind.
Correct answer: A
Rationale: The correct answer is to administer a potassium supplement. A potassium level of 3.1 mEq/L indicates hypokalemia, which can lead to serious complications like cardiac dysrhythmias. Therefore, the priority action is to address the low potassium level by administering a potassium supplement. Holding the furosemide (Choice B) may be necessary in the long term to prevent further potassium loss, but the immediate need is to correct the low potassium level. Continuing the current dose of furosemide (Choice C) without addressing the low potassium level can worsen hypokalemia. Administering Digibind (Choice D) is not indicated for low potassium levels; Digibind is used to treat digoxin toxicity.
5. The client is on dobutamine. Adverse effects of Dobutrex (dobutamine) include the following: Select all that apply.
- A. Heart failure
- B. Bradycardia
- C. Tachycardia
- D. Respiratory distress
Correct answer: C
Rationale: The correct answer is C: Tachycardia. Dobutamine is a medication that primarily increases heart rate (tachycardia) and blood pressure. Therefore, the adverse effects of dobutamine include tachycardia. Choices A, B, and D are incorrect. Heart failure is not an adverse effect of dobutamine; in fact, it is used to treat heart failure by increasing heart contractility. Bradycardia (slow heart rate) is not an expected adverse effect of dobutamine, as it usually increases heart rate. Respiratory distress is not a common adverse effect of dobutamine.
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