ATI cardiac

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C) antiplatelet aggregate

A client who has a history of myocardial infarction (MI) is prescribed aspirin 325 mg. The nurse recognizes that the aspirin is given to which of the following actions of the medication? A) analgesic B) anti-inflammatory C) antiplatelet aggregate D) antipyretic

B) Massaging her legs

A nurse is caring for a client who is postoperative and is at risk for developing venous thromboembolism (VTE). The nurse should instruct the client to avoid which of the following unsafe actions? A) Elevating her feet B) Massaging her legs C) Flexing her ankles D) Ambulating soon after surgery

A) Impaired tissue perfusion

While performing an admission assessment for a client, the nurse notes that the client has varicose veins with ulcerations and lower extremity edema with a report of a feeling of heaviness. Which of the following nursing diagnoses should the nurse identify as being the priority in the client's care? A) Impaired tissue perfusion B) Alteration in body image C) Alteration in activity tolerance D) Impaired Skin integrity

A) Abnormally prominent U wave

A nurse is reviewing the EKG strip of a client who has prolonged vomiting. Which of the following abnormalities on the client's EKG should the nurse interpret as a sign of hypokalemia? A) Abnormally prominent U wave B) Elevated ST segment C) Wide QRS D) Inverted P wave

A) "I have started taking ginger root to treat my joint stiffness."

A nurse is teaching a client who takes warfarin daily. Which of the following statements by the client indicates a need for further teaching? A) "I have started taking ginger root to treat my joint stiffness." B) "I take this medication at the same time each day." C) "I eat a green salad every night with dinner." D) "I had my INR checked three weeks ago."

D) Race

A nurse is teaching about risk factors of developing a stroke with a group of older adult clients. Which of the following nonmodifiable risk factors should the nurse include in the teaching? A) History of smoking B) Obesity C) History of hypertension D) Race

C) Hip arthroplasty

A nurse on a medical-surgical unit is caring for four clients who are 24 to 36 hr postoperative. Which of the following surgical procedures places the client at risk for deep-vein thrombosis? A) Myringotomy B) Laparoscopic appendectomy C) Hip arthroplasty D) Cataract extraction

A) Increased heart rate B) Increased blood pressure C) Increased respiratory rate

A nurse is assessing a client who has fluid overload. Which of the following findings should the nurse expect? Select all that apply. A) Increased heart rate B) Increased blood pressure C) Increased respiratory rate D) Increase hematocrit E) Increased temperature

A) Stop the infusion of blood

A nurse is assessing a client who is receiving one unit of packed RBCs to treat intraoperative blood loss. The client reports chills and back pain, and the client's blood pressure is 80/64 mm Hg. Which of the following actions should the nurse take first? A) Stop the infusion of blood B) Inform the provider C) Obtain a urine specimen D) Notify the laboratory

B) The client's bladder becomes distended.

A nurse is caring for a client who has a T-4 spinal cord injury. Which of the following client findings should the nurse identify as an indication the client is at risk for experiencing autonomic dysreflexia? A) The client states having a severe headache. B) The client's bladder becomes distended. C) The client's blood pressure becomes elevated. D) The client states having nasal congestion.

A) Check the client's vital signs.

A nurse is caring for a client who has congestive heart failure and is taking digoxin daily. The client refused breakfast and is complaining of nausea and weakness. Which of the following actions should the nurse take first? A) Check the client's vital signs. B) Request a dietitian consilt. C) Suggest that the client rests before eating the meal. D) Request an order for an antiemetic.

A) "Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level."

A nurse is caring for a client who has deep vein thrombosis and has been on heparin continuous infusion for 5 days. The provider prescribes warfarin PO without discontinuing the heparin. The client asks the nurse why both anticoagulants are necessary. Which of the following statements should the nurse make? A) "Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level." B) "I will call the provider to get a prescription for discontinuing the IV heparin today." C) "Both heparin and warfarin work together to dissolve the clots." D) "The IV heparin increases the effects of the warfarin and decreases the length of your hospital stay."

D) "I feel nauseated and have no appetite."

A nurse is caring for a client who has heart failure and a prescription for digoxin. Which of the following statements by the client indicates an adverse effect of the medication? A) "I can walk a mile a day." B) "I've had a backache for several days." C) "I am urinating more frequently." D) "I feel nauseated and have no appetite."

A) Obtain a pair of slipper-socks for the client.

A nurse is caring for a client who has peripheral vascular disease and reports difficulty sleeping because of cold feet. Which of the following nursing actions should the nurse take to promote the client's comfort? A) Obtain a pair of slipper-socks for the client. B) Rub the client's feet briskly for several minutes. C) Increase the client's oral fluid intake. D) Place a moist heating pad under the client's feet.

C) "Heparin does not dissolve clots. It stops new clots from forming."

A nurse is caring for a client who has thrombophlebitis and is receiving heparin by continuous IV infusion. The client asks the nurse how long it will take for the heparin to dissolve the clot. Which of the following responses should the nurse give? A) "It usually takes heparin at least 2 to 3 days to reach a therapeutic blood level." B) "A pharmacist is the person to answer that question." C) "Heparin does not dissolve clots. It stops new clots from forming." D) "The oral medication you will take after this IV will dissolve the clot."

C) Perform neurovascular checks of the extremities.

A nurse is caring for a client who is postoperative following an open reduction and internal fixation of a fracture femur. Which of the following actions is the most important for the nurse to complete in the postoperative period? A) Medicate the client for pain. B) Instruct the client on the use of crutches. C) Perform neurovascular checks of the extremities. D) Direct the client to perform exercises of the ankle and toes.

B) Prothrombin (PT)

A nurse is caring for a client who is prescribed warfarin therapy for an artificial heart valve. Which of the following laboratory values should the nurse monitor for a therapeutic effect of warfarin? A) Hemoglobin (Hgb) B) Prothrombin (PT) C) Bleeding time D) Activated partial thromboplastin time (aPTT)

A) Measure the circumference of both upper arms.

A nurse is caring for a client who is receiving total parenteral nutrition via a peripherally inserted central catheter (PICC). When assessing the client, the nurse notes swelling of the client's arm above the PICC insertion site. Which of the following actions should the nurse take first? A) Measure the circumference of both upper arms. B) Notify the provider who inserted the PICC line. C) Remove the PICC line. D) Apply a cold pack to the client's upper arm.

A) Decreased blood pressure

A nurse is caring for a client who is taking lisinopril. Which of the following outcomes indicates a therapeutic effect of the medication? A) Decreased blood pressure B) Increase of HDL cholesterol C) Prevention of bipolar manic episodes D) Improved sexual function

D) Increase the heart rate from 88 to 110/min

A nurse is caring for a client who returns to the nursing unit from the recovery room after a sigmoid colon resection for adenocarcinoma. The client had an episode of intraoperative bleeding. Which finding indicates to the nurse that the client may be developing hypovolemic shock? A) Decrease in the respiratory rate from 20 to 16/min. B) Decrease in the urinary output from 50mL to 30mL per hour. C) Increase in the temperature from 37.5C (99.5F) to 38.6C (101.5F). D) Increase the heart rate from 88 to 110/min.

A) Recombinant

A nurse is caring for an adolescent who has hemophilia A and is scheduled for wisdom teeth extractions. Prior to the procedure, the nurse should anticipate that the client will receive which of the following products? A) Recombinant B) Packed RBCs C) Prophylactic antibodies D) Fresh frozen plasma

D) "I will take my medications at the first time of an attack."

A nurse is instructing a client who has a new diagnosis of Raynaud's disease about preventing the onset of manifestations. Which of the following client statements should indicate to the nurse the need for additional teaching? A) "I will wear gloves when removing food from the freezer." B) "I will try to anticipate and avoid stressful situations when possible." C) "I will complete the smoking cessation program I started." D) "I will take my medications at the first time of an attack."

A) The P wave falls before the QRS complex.

A nurse is monitoring a client who is on telemetry. Which of the following findings on the ECG strip should the nurse recognize as normal sinus rhythm? A) The P wave falls before the QRS complex. B) The T wave is the inverted position. C) The P-R interval measures 0.22 seconds. D) The QRS duration is 0.20 seconds.

31 gtts/min 120/250 x15=31.25

A nurse is preparing to infuse a 250-mL unit of packed RBCs over 2 hr. The drop factor of the manual IV tubing is 15 gtts/mL. The nurse should adjust the flow rate to deliver how many drops per minute? (Round to the nearest whole answer)


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