the client on a beta blocker has a blood pressure of 8858 mm hg what is the nurses priority action
Logo

Nursing Elites

ATI RN

Cardiovascular System Exam

1. The client on a beta blocker has a blood pressure of 88/58 mm Hg. What is the nurse’s priority action?

Correct answer: A

Rationale: The correct action for the nurse to take when a client on a beta blocker presents with a blood pressure of 88/58 mm Hg is to hold the beta blocker and notify the healthcare provider. Beta blockers can further decrease blood pressure, which is already low in this case. Administering the beta blocker as ordered (Choice B) would exacerbate the hypotension. Increasing the dose of the beta blocker (Choice C) would be inappropriate and unsafe given the low blood pressure. Continuing to monitor the client and reassessing in 30 minutes (Choice D) could lead to a delay in necessary intervention. Therefore, the priority is to hold the medication and seek guidance from the healthcare provider.

2. Which condition is characterized by an inability to effectively pump blood, leading to fluid buildup and swelling in the body?

Correct answer: A

Rationale: Heart failure is the correct answer. It is a condition where the heart is unable to pump blood effectively, resulting in fluid accumulation and swelling in the body. Cardiomyopathy is a disease of the heart muscle that affects its ability to pump blood but is not the specific condition described in the question. Angina is chest pain or discomfort caused by reduced blood flow to the heart, not directly related to fluid buildup and swelling. Myocarditis is inflammation of the heart muscle and does not necessarily involve the inability to pump blood effectively.

3. Which of the following is a rare genetic disorder that affects the lungs, liver, and skin, causing the buildup of a specific protein that damages organs?

Correct answer: A

Rationale: The correct answer is Alpha-1 antitrypsin deficiency. This disorder leads to the accumulation of a specific protein that can harm the lungs, liver, and skin. Choice B, Cystic fibrosis, is incorrect because it primarily affects the lungs and digestive system due to a defective gene. Choice C, Wegener's granulomatosis, is an autoimmune disease that involves inflammation of blood vessels, not protein buildup. Choice D, Marfan syndrome, is a connective tissue disorder impacting the heart, blood vessels, bones, and eyes, but not involving protein accumulation that damages organs.

4. This is a test that measures the oxygen saturation level in the blood, often used to assess respiratory function.

Correct answer: A

Rationale: The correct answer is A, Pulse oximetry. Pulse oximetry is a non-invasive test that measures the oxygen saturation level in the blood, helping to assess respiratory and cardiovascular function. Choice B, Spirometry, measures lung function by assessing airflow and volume. Choice C, Arterial blood gas (ABG), evaluates the acidity, oxygen, and carbon dioxide levels in the blood. Choice D, Lung function test, is a broad term that may include various tests to assess lung health, but specifically measuring oxygen saturation is done through pulse oximetry.

5. The client on nitroglycerin complains of a headache. How does the nurse explain this?

Correct answer: A

Rationale: The correct answer is A: 'This is a normal side effect of nitroglycerin.' Headaches are a common side effect of nitroglycerin due to vasodilation. Choice B is incorrect because allergic reactions to nitroglycerin typically present with symptoms like rash, itching, or shortness of breath. Choice C is incorrect as an overdose of nitroglycerin would likely present with symptoms beyond just a headache. Choice D is incorrect because headaches related to nitroglycerin are not indicative of heart failure.

Similar Questions

The client is on amiodarone and reports blurred vision. What is the nurse’s best response?
Which order should the nurse question?
What is the condition where the blood flow through the coronary arteries is reduced or blocked, leading to chest pain or heart attack?
The client has a prescription for sublingual nitroglycerin. What is the nurse's instruction for how to take this medication during an episode of chest pain?
The nurse is teaching a client about the side effects of beta blockers. What is the most important side effect to monitor?

Access More Features

ATI RN Basic
$69.99/ 30 days

  • 5,000 Questions with answers
  • All ATI courses Coverage
  • 30 days access

ATI RN Premium
$149.99/ 90 days

  • 5,000 Questions with answers
  • All ATI courses Coverage
  • 30 days access

Other Courses