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. What is a condition where the heart muscle becomes thickened without an obvious cause, leading to a reduction in the heart's ability to pump blood?
- A. Hypertrophic cardiomyopathy
- B. Dilated cardiomyopathy
- C. Restrictive cardiomyopathy
- D. Myocarditis
Correct answer: A
Rationale: Hypertrophic cardiomyopathy is the correct answer. It is a condition characterized by the abnormal thickening of the heart muscle without an obvious cause, which impairs the heart's ability to effectively pump blood. Dilated cardiomyopathy (choice B) involves the enlargement and weakening of the heart chambers, not thickening. Restrictive cardiomyopathy (choice C) refers to the stiffening of the heart muscle, limiting its ability to fill properly. Myocarditis (choice D) is inflammation of the heart muscle usually caused by a viral infection, not thickening.
3. The client is being taught about the use of warfarin. What is the most important dietary instruction?
- A. Avoid foods high in vitamin K.
- B. Increase the intake of vitamin K-rich foods.
- C. Avoid foods high in protein.
- D. Increase the intake of foods high in calcium.
Correct answer: A
Rationale: The correct answer is A: Avoid foods high in vitamin K. Warfarin is a medication that works by decreasing the activity of vitamin K in the body to prevent blood clotting. Therefore, consuming foods high in vitamin K like green leafy vegetables can interfere with the medication's effectiveness. Choices B, C, and D are incorrect. Increasing the intake of vitamin K-rich foods would counteract the effects of warfarin. Avoiding foods high in protein or increasing the intake of foods high in calcium are not specifically related to the use of warfarin.
4. Which condition refers to the heart being unable to pump sufficient blood to meet the body's needs?
- A. Heart failure
- B. Myocardial infarction
- C. Cardiomyopathy
- D. Pericarditis
Correct answer: A
Rationale: The correct answer is A, heart failure. This condition occurs when the heart can't pump enough blood to fulfill the body's requirements. Myocardial infarction (choice B) is the medical term for a heart attack, which is caused by a blockage in the coronary arteries. Cardiomyopathy (choice C) is a disease of the heart muscle that makes it harder for the heart to pump blood. Pericarditis (choice D) is the inflammation of the pericardium, the thin sac-like membrane surrounding the heart, and does not specifically involve the heart's inability to pump sufficient blood.
5. When administering an ACE inhibitor to a client with heart failure, what is the expected outcome of this medication?
- A. Decreased blood pressure
- B. Increased heart rate
- C. Increased cardiac output
- D. Decreased heart rate
Correct answer: C
Rationale: The correct answer is C: Increased cardiac output. ACE inhibitors are commonly used in heart failure to reduce the workload on the heart by decreasing blood pressure and increasing cardiac output. This ultimately helps improve the heart's efficiency and function. Choice A is incorrect because ACE inhibitors generally lead to a reduction in blood pressure. Choice B is incorrect as ACE inhibitors do not increase heart rate. Choice D is incorrect as ACE inhibitors do not typically decrease heart rate in the context of heart failure.
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