ATI RN
Physical Exam Cardiovascular System
1. What is a condition where the lung's alveoli are permanently enlarged and damaged, leading to shortness of breath?
- A. Emphysema
- B. Bronchitis
- C. Atelectasis
- D. Pulmonary fibrosis
Correct answer: A
Rationale: Emphysema is the correct answer. It is a chronic lung condition characterized by the permanent enlargement and damage of the alveoli, leading to shortness of breath and impaired oxygen exchange. Bronchitis is the inflammation of the bronchial tubes, not specifically related to alveolar damage. Atelectasis is the collapse of lung tissue, not enlargement. Pulmonary fibrosis involves scarring and thickening of lung tissue, different from the alveolar damage seen in emphysema.
2. The client is on a beta blocker for hypertension. What should the nurse monitor for?
- A. Bradycardia
- B. Tachycardia
- C. Hypertension
- D. Respiratory distress
Correct answer: A
Rationale: Corrected Rationale: When a client is on a beta blocker for hypertension, the nurse should monitor for bradycardia. Beta blockers are known to decrease heart rate, which can lead to bradycardia. Tachycardia (choice B) is unlikely as beta blockers have the opposite effect. Hypertension (choice C) is the condition being treated, not a side effect of beta blockers. Respiratory distress (choice D) is not a common effect of beta blockers and is not typically monitored in clients taking beta blockers.
3. 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.
4. The nurse is caring for a client on warfarin with an INR of 1.8. What is the most appropriate action?
- A. Increase the dose of warfarin.
- B. Administer vitamin K.
- C. Hold the warfarin and notify the healthcare provider.
- D. Monitor the client’s INR closely.
Correct answer: D
Rationale: An INR of 1.8 is below the therapeutic range for a client on warfarin, indicating the need for monitoring closely to ensure that the INR levels reach the desired therapeutic range. Increasing the dose of warfarin (Choice A) without proper monitoring may lead to an increased risk of bleeding. Administering vitamin K (Choice B) is not typically recommended unless the client is experiencing major bleeding or requires rapid reversal of warfarin's effects. Holding the warfarin and notifying the healthcare provider (Choice C) may be necessary in certain situations, but the immediate action in this case should be to monitor the client's INR closely to guide further management.
5. What is the condition where the heart's mitral valve does not close properly, allowing blood to leak backward into the left atrium?
- A. Mitral regurgitation
- B. Aortic stenosis
- C. Tricuspid regurgitation
- D. Pulmonary hypertension
Correct answer: A
Rationale: Mitral regurgitation is the condition where the heart's mitral valve does not close properly, allowing blood to leak backward into the left atrium. This can result in symptoms like shortness of breath and fatigue. Choices B, C, and D are incorrect because aortic stenosis, tricuspid regurgitation, and pulmonary hypertension involve different heart valves or conditions, not the mitral valve specifically.
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