COTAC Test 2: ATI Questions
A nurse is teaching a client who has heart failure about the need to limit sodium in the diet to 2,000 mg daily. Which of the following foods should the nurse recommend for the client?
- 1 slice cheddar cheese - 3 oz Atlantic salmon - 3 oz roasted chicken breast
A nurse at a provider's office is reviewing the laboratory test results for a group of clients. The nurse should identify that which of the following results indicates the client is at risk for heart disease?
- Total Cholesterol 245 mg/dL - LDL 140 mg/dL
A nurse on a cardiac unit is caring for a group of clients. The nurse should recognize which of the following clients as being at risk for the development of a dysrhythmia?
- a client who has metabolic alkalosis - a client who has COPD - a client who underwent a stent placement in a coronary artery
A nurse is planning postoperative care for a client following a surgical placement of a synthetic graft to repair an aneurysm. Which of the following interventions should the nurse include in the plan of care?
- assess pedal pulses - monitor for an increase in pain below the graft site - administer prescribed antiplatelet agents
A nurse is teaching a client who has a new prescription for Clopidogrel. Which of the following instructions should the nurse include in the teaching?
- avoid the consuming grapefruit while taking this medication - monitor for the presence of black, tarry stools
A nurse is assessing a client who is undergoing hemodynamic monitoring. The client has a CVP of 7 mm Hg and a PAWP of 17 mm Hg. Which of the following findings should the nurse expect?
- bilateral crackles in the lungs - jugular vein distention (JVD) - hepatomegaly
A nurse is caring for a client following peripheral bypass graft surgery of the left lower extremity. Which of the following findings pose an immediate concern?
- capillary refill of the affected limb of 6 seconds - mottled appearance of the limb
A nurse is caring for a client following the insertion of a temporary venous pacemaker via the femoral artery that is set as a VVI pacemaker rate of 70/min. Which of the following findings should the nurse report to the provider?
- cool and clammy foot with capillary refill of 5 seconds - persistent hiccups
A nurse is reviewing manifestations of a thoracic aortic aneurysm with a newly hired nurse. Which of the following findings should the nurse include in the discussion?
- cough - SOB - altered swallowing
A nurse educator is reviewing expected findings in a client who has right-sided valvular heart disease with a group of nurses. Which of the following findings should the nurse include in the discussion?
- dyspnea - client report of fatigue - peripheral edema
A nurse is screening a male client for hypertension. The nurse should identify that which of the following actions by the client increase his risk for hypertension?
- eating popcorn at the movie theatre - consuming 36 oz beer daily
A nurse is caring for a client who experienced defibrillation. Which of the following should be included in the documentation of the procedure?
- follow up EKG - energy settings used - skin condition under electrodes
A nurse in the emergency department is completing an assessment on a client who is in shock. Which of the following findings should the nurse expect?
- seizure activity - respiratory rate 42min - weak, thready pulse - decreased urine output - tachycardia
A nurse is reviewing the health record of a client who is being evaluated for possible valvular heart disease. The nurse should recognize which of the following data as risk factors for the condition?
- surgical repair of an atrial septal defect at age 2 - hypertension of 5 years - diastolic murmur present
A nurse is completing the admission assessment of a client who has suspected pulmonary edema. Which of the following manifestation are expected findings?
- tachypnea - a persistent cough - orthopnea
A nurse educator is reviewing the use of cardiopulmonary bypass during surgery for coronary artery bypass grafting with a group of nurses. Which of the following statements should the nurse include in the discussion?
- the client's demand for oxygen is lowered - motion of the heart ceases - rewarming of the client takes place
A student nurse is observing a cardioversion procedure and hears the team leader call out, "Stand Clear". The student should recognize the purpose of this action is to alert personnel that
- they cannot be in contact with equipment connected to the client
A nurse planning care for a client who has a PICC line in the right arm. Which of the following interventions should the nurse include in the plan of care?
- use a 10 mL syringe to flush the PICC line - cleanse ports with alcohol for 15 seconds prior to use - maintain a transparent dressing over the insertion site
A nurse is admitting a client to the coronary care unit following placement of a temporary pacemaker. Which of the following nursing actions should the nurse use to promote safety?
- wear gloves when handling pacemaker leads - minimize the client's shoulder movements
A nurse is completing discharge teaching with a client who has heart failure and is encouraged to increase potassium in his diet. Which of the following food selections should the nurse include as having the highest source of potassium?
1 medium baked potato
A nurse is orienting a newly licensed nurse on the care of a client who is to have a line placed for hemodynamic monitoring. Which of the following statements by the newly licensed nurse indicates effectiveness of the teaching?
A chest x-ray is needed to verify placement after the procedure
A nurse is assessing a client who has splinter hemorrhages in her nail beds and reports a fever. The nurse should identify these findings as manifestations of which of the following disorders?
Infective Endocarditis
A nurse is planning care for a client who has septic shock. Which of the following actions is the priority for the nurse to take?
Administer antibiotic therapy
A nurse is caring for a client who has chronic venous insufficiency and a prescription for thigh-high compression stockings. Which of the following actions should the nurse take?
Apply the stockings in the morning upon awakening and before getting out of bed
A nurse is caring for a client who has a prescription for an afterload-reducing medication. The nurse should identify that this medication is administered for which of the following types of shock?
Cardiogenic
A nurse is teaching a client who has angina about a new prescription for metroprolol. Which of the following statements by the client indicates understanding of the teaching?
I will call my doctor if my pulse rate is less than 60
A nurse is completing discharge teaching with a client who had a surgical placement of a mechanical heart valve. Which of the following statements by the client indicates an understanding of the teaching?
I will have my aPTT checked on a regular basis
A nurse is completing discharge teaching with a client who has a permanent pacemaker. Which of the following statements by the client indicates understanding of the teaching?
I will notify the airport screeners about my pacemaker
A nurse is providing teaching for a client who has a new diagnosis of hypertension and a new prescription of Spironolactone 25 mg/day. Which of the following statements by the client indicates an understanding of the teaching?
I will report any changes in heart rate to my provider
A nurse is teaching a client who has a new diagnosis of an aneurysm. The client asks the nurse to explain what causes an aneurysm to rupture. Which of the following statements should the nurse give?
It is due to hypertension
A nurse is caring for a client who has a deep-vein thrombosis (DVT) and has been taking unfractionated heparin for 1 week. Two days ago, the provider also prescribed Warfarin. The client asks the nurse about receiving both Heparin and Warfarin at the same time. Which of the following statements should the nurse give?
It takes 3-4 days before the therapeutic effects of Warfarin are achieved and then the Heparin will be discontinued.
A nurse is providing discharge teaching for a client who has a prescription of furosemide 40 mg PO daily. The nurse should instruct the client to take this medication at which of the following times of day?
Morning
A nurse is caring for a client who is admitted to the emergency department with a blood pressure of 266/147 mmHg. The client reports a headache and double vision. The client states that she ran out of her diltiazem 3 days ago, and is unable to purchase more. Which of the following actions should the nurse take first?
Obtain IV access and prepare to administer an IV antihypertensive
A nurse in a clinic is caring for a client who has been on long-term NSAID therapy to treat myocarditis. Which of the following laboratory findings should the nurse report to the provider?
Platelets 100,000/mm3
A nurse is caring for a 72-year old client who is to undergo a percutaneous balloon valvuloplasty. The client's daughter asks the nurse to explain the expected outcome of the procedure. Which of the following responses should the nurse give?
This will permit your mother to resume her activities of daily living
A nurse on a cardiac unit is reviewing the laboratory findings of a client who has a diagnosis of MI and reports that his dyspnea began 2 weeks ago. Which of the following cardiac enzymes would confirm the MI occurred 14 days ago?
Troponin-T
A nurse is teaching a client who is scheduled for an angiography. Which of the following statements should the nurse include in the teaching?
You will need to keep your affected leg straight following the procedure
A nurse is caring for a client who is 4 hr postoperative following CABG surgery. He is able to inspire 200 mL with the incentive spirometer, then refuses to cough because he is tired and it hurts too much. Which of the following actions should the nurse take?
administer IV Bolus Analgesic and return in 15 minutes
A nurse in the emergency department is admitting a client who has a possible dissecting abdominal aortic aneurysm. Which of the following actions is the priority for the nurse to take?
administer IV fluids as prescribed
A nurse is admitting a client who has a suspected MI and history of angina. Which of the following findings will help the nurse distinguish angina from an MI?
angina can be relived with rest and nitroglycerin
A nurse is admitting a client who has complete heart block as demonstrated by EKG. The client HR is 34/min and BP is 83/48 mmHg. The client is lethargic and unable to complete sentences. Which of the following actions should the nurse perform first?
apply transcutaneous pacemaker pads
A nurse is caring for a client who asks why her provider prescribed a daily aspirin. Which of the following is an appropriate response by the nurse?
aspirin reduces the formation of blood clots that could cause a heart attack
A nurse who is caring for a client who has heart failure and reports increased SOB. The nurse increases the client's oxygen per protocol. Which of the following actions should the nurse take first?
assist the client into high-Fowler's position
A nurse in a cardiac unit is assisting with the admission of a client who is to undergo hemodynamic monitoring. Which of the following actions should the nurse anticipate performing?
assist with insertion of pulmonary artery catheter
A nurse is caring for a client following an angioplasty that was inserted through the femoral artery. While turning the client the nurse discovers blood underneath the client's lower back. Which of the following findings should the nurse suspect?
bleeding from the incisional site
A nurse is caring for four clients. Which of the following should the nurse identify as being at risk for acquiring Rheumatic Endocarditis?
child who has streptococcal pharyngitis
A nurse is completing the admission physical assessment of the client who has a history of mitral valve insufficiency. Which of the following findings should the nurse expect?
crackles in lung bases
A nurse in the emergency department is caring for a client who had an allergic reaction related to a bee sting. The client is experiencing wheezing and swelling of the tongue. Which of the following medications should the nurse anticipate administering first?
epinephrine IV
A nurse is caring for a client who has pericarditis. Which of the following findings should the nurse expect?
friction rub
A nurse is admitting a client who has a suspected occlusion of a graft of the abdominal aorta. Which of the following manifestations should the nurse expect?
increase in abdominal girth
A nurse on a cardiac unit is caring for a client who is on telemetry. The nurse recognizes the client's HR is 45/min and notifies the provider. The nurse should anticipate which of the following management strategies will be used for this client?
pacemaker insertion
A nurse is assessing a client who has chronic Peripheral Arterial Disease (PAD). Which of the following findings should the nurse expect?
pallor elevation of the limbs, and rubor when the limbs are dependent
A nurse is teaching a client who has been a new diagnosis of severe Peripheral Arterial Disease (PAD). Which of the following instructions should the nurse include?
place both legs in dependent position while sleeping
A nurse is providing discharge teaching for a client who has heart failure and is on a fluid restriction of 2,000 mL/day. The client asks the nurse how to determine the appropriate amount of fluids he is allowed. Which of the following statements is an appropriate response by the nurse?
pour the amount of fluid you drink into an empty 2-liter bottle to keep track of how much you drink
A nurse is completing the admission assessment of a client who will undergo peripheral bypass graft surgery on the left leg. Which of the following findings should the nurse expect?
report of intermittent claudication in the affected leg
A nurse is presenting a community education program on recommended lifestyle changes to prevent angina and MI. Which of the following changes should the nurse recommend be made first?
smoking cessation
A nurse in an urgent care clinic is obtaining a history from a client who has Type 2 Diabetes Mellitus and a recent diagnosis of Hypertension. This is the second time in 2 weeks that the client experienced hypoglycemia. Which of the following client data should the nurse report to the provider?
takes metoprolol daily after meals
What should be used before/after administration of medication through a PICC?
the nurse should flush the PICC line with 10 mL 0.9% sodium chloride before, between, and after medications
A cardiac nurse educator is reviewing the use of the fixed rate mode pacemaker with a group of newly hired nurses. Which of the following statements by a newly hired nurse indicates understanding of the review?
this means the pacemaker fires in an asynchronous pattern
A nurse is admitting a client who has suspected Rheumatic Endocarditis. The nurse should anticipate a prescription from the provider for which of the following laboratory tests to assist in confirmation of this diagnosis?
throat culture
When is a flush of 5 mL heparin recommended with a PICC?
when the PICC is not in use
