ATI RN
Physical Exam Cardiovascular System
1. Which type of lung cancer begins in the cells lining the bronchi and bronchioles?
- A. Adenocarcinoma
- B. Small cell lung cancer
- C. Squamous cell carcinoma
- D. Mesothelioma
Correct answer: A
Rationale: Adenocarcinoma is the correct answer because it is a type of lung cancer that originates in the cells lining the bronchi and bronchioles. Adenocarcinoma is one of the most common types of lung cancer, often found in non-smokers and more frequently in women. Small cell lung cancer (Choice B) typically starts in the bronchi, but it is characterized by its rapid growth and tendency to spread quickly. Squamous cell carcinoma (Choice C) usually begins in the squamous cells lining the bronchi and is strongly associated with smoking. Mesothelioma (Choice D) is a cancer that affects the lining of certain organs like the lungs, often caused by asbestos exposure, but it does not specifically start in the cells lining the bronchi and bronchioles.
2. The client on amiodarone reports shortness of breath. What is the nurse’s best response?
- A. Notify the healthcare provider immediately.
- B. Reassure the client that this is a common side effect.
- C. Instruct the client to monitor their symptoms at home.
- D. Suggest the client reduce physical activity.
Correct answer: A
Rationale: When a client on amiodarone reports shortness of breath, it can be indicative of pulmonary toxicity, a severe side effect associated with this medication. The nurse's priority is to notify the healthcare provider immediately to assess the situation and determine the appropriate course of action. Choice B is incorrect because shortness of breath with amiodarone should not be dismissed as a common side effect. Instructing the client to monitor symptoms at home (Choice C) may delay necessary intervention. Suggesting the client reduce physical activity (Choice D) does not address the potential serious nature of the symptom and the need for prompt evaluation.
3. The client is on warfarin and has an INR of 1.5. What is the nurse’s priority action?
- A. Increase the dose of warfarin.
- B. Hold the next dose of warfarin.
- C. Continue the current dose of warfarin.
- D. Monitor the client’s INR closely.
Correct answer: B
Rationale: An INR of 1.5 is below the therapeutic range for a client on warfarin, indicating that the client may be at risk of clot formation. The nurse's priority action should be to hold the next dose of warfarin to prevent further reduction of the INR. Increasing the dose could potentially lead to an increased risk of bleeding, and continuing the current dose may not be sufficient to bring the INR within the therapeutic range. Monitoring the client's INR closely is important but not the priority action in this scenario.
4. What is a condition characterized by the presence of air or gas in the pleural space, leading to the collapse of the lung?
- A. Pneumothorax
- B. Pulmonary embolism
- C. Pleural effusion
- D. Atelectasis
Correct answer: A
Rationale: The correct answer is Pneumothorax. Pneumothorax occurs when air or gas accumulates in the pleural space, causing the lung to collapse. This condition can result in symptoms such as chest pain and difficulty breathing. Pulmonary embolism (choice B) is a blockage in one of the pulmonary arteries in the lungs, usually caused by a blood clot. Pleural effusion (choice C) is the accumulation of excess fluid in the pleural space, not air or gas. Atelectasis (choice D) refers to the collapse or closure of a lung resulting in reduced or absent gas exchange.
5. The client on amiodarone develops pulmonary fibrosis. What action should the nurse take?
- A. Notify the healthcare provider immediately.
- B. Continue the medication and monitor lung function.
- C. Discontinue the medication and start oxygen therapy.
- D. Reduce the dose and monitor respiratory status.
Correct answer: A
Rationale: When a client on amiodarone develops pulmonary fibrosis, a serious side effect, the immediate action the nurse should take is to notify the healthcare provider. This is crucial because pulmonary fibrosis can lead to severe respiratory compromise and requires prompt evaluation and management by the healthcare provider. Continuing the medication (choice B) can worsen the condition, and delaying action by reducing the dose and monitoring respiratory status (choice D) may not be appropriate given the seriousness of pulmonary fibrosis. Discontinuing the medication and starting oxygen therapy (choice C) may be necessary, but the priority is to notify the healthcare provider first for further assessment and guidance.
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