ATI Cardiovascular Targeted Exam STUDYYY

A nurse is caring for a client who is scheduled for a coronary artery bypass graft (CABG) in 2 hr. Which of the following client statements indicates a need for further clarification by the nurse? -"My arthritis is really bothering me because I haven't taken my aspirin in a week." -"My blood pressure shouldn't be high because I took my blood pressure medication this morning." -"I took my warfarin last night according to my usual schedule." -"I will check my blood sugar because I took a reduced dose of insulin this morning."

"I took my warfarin last night according to my usual schedule." Clients who are scheduled for a CABG should not take anticoagulants, such as warfarin, for several days prior to the surgery to prevent excessive bleeding.

A nurse is providing teaching for a client who is 2 days postoperative following a heart transplant. Which of the following statements should the nurse include in the teaching? -"You might no longer be able to feel chest pain." -"Your level of activity intolerance will not change." -"After 6 months, you will no longer need to restrict your sodium intake." -"You will be able to stop taking immunosuppressants after 12 months."

"You might no longer be able to feel chest pain." Heart transplant clients usually are no longer able to feel chest pain due to the denervation of the heart.

A nurse in an emergency department is caring for a client who had an anterior myocardial infarction. The client's history reveals she is 1 week postoperative following an open cholecystectomy. The nurse should recognize that which of the following interventions is contraindicated? -Administering IV morphine sulfate -Administering oxygen at 2 L/min via nasal cannula -Helping the client to the bedside commode -Assisting with thrombolytic therapy

Assisting with thrombolytic therapy The nurse should recognize that major surgery within the previous 3 weeks is a contraindication for thrombolytic therapy.

A nurse is caring for a client who is 8 hr postoperative following a coronary artery bypass graft (CABG). Which of the following client findings should the nurse report? -Mediastinal drainage 100 mL/hr -Blood pressure 160/80 mm Hg -Temperature 37.1 C (98.8 F) -Potassium 4.0 mEq/L

Blood pressure 160/80 mm Hg The nurse should report an elevated blood pressure following a CABG because increased vascular pressure can cause bleeding at the incision sites.

A nurse is caring for a client who had an onset of chest pain 24 hr ago. The nurse should recognize that an increase in which of the following is diagnostic of a myocardial infarction (MI)? -Myoglobin -C-reactive protein -Creatine kinase- MB -Homocysteine

Creatine kinase-MB MY ANSWER Creatine kinase-MB is the isoenzyme specific to the myocardium. Elevated creatine kinase-MB indicates myocardial muscle injury.

A nurse is assessing a client who has dilated cardiomyopathy. Which of the following findings should the nurse expect? -Dyspnea on exertion -Tracheal deviation -Pericardial rub -Weight loss

Dyspnea on exertion The nurse should identify dyspnea on exertion as an expected manifestation of dilated cardiomyopathy. Dyspnea on exertion is due to ventricular compromise and reduced cardiac output.

A nurse is caring for a postoperative client 1 hr following an aortic aneurysm repair. Which of the following findings can indicate shock and should be reported to the provider? -Serosanguineous drainage on dressing -Severe pain with coughing -Urine output of 20 mL/hr -Increase in temperature from 36.8 C (98.2 F) to 37.5C (99.5 F)

Urine output of 20 mL/hr Urine output less than 30 mL/hr is a manifestation of shock. Urine output is decreased due to a compensatory decreased blood flow to the kidneys, hypovolemia, or graft thrombosis or rupture.

A nurse is teaching a client who is starting to take an ACE inhibitor to treat hypertension. The nurse should instruct the client to notify his provider if he experiences which of the following adverse effects of this medication? -Tendon pain -Persistent cough -Frequent urination -Constipation

Persistent cough A persistent cough is an adverse effect of ACE inhibitors. The client should report this finding to the provider and discontinue the medication.

A nurse is providing discharge teaching for a client who has a prescription for the transdermal nitroglycerin patch. Which of the following instructions should the nurse include in the teaching? -Apply the new patch to the same site as the previous patch -Place the patch on an area of skin away from skin folds and joints -Keep the patch on 24 hr per day -Replace the patch at the onset of angina

Place the patch on an area of skin away from skin folds and joints

A nurse is caring for a client who has endocarditis. Which of the following findings should the nurse recognize as a potential complication? -Ventricular depolarization -Guillain-Barre syndrome -Myelodysplastic syndrome -Valvular disease

Valvular disease Valvular disease or damage often occurs as a result of inflammation or infection of the endocardium.

A nurse is assessing a client who has left-sided heart failure. Which of the following manifestations should the nurse expect to find? -Increased abdominal girth -Weak peripheral pulses -Jugular venous neck distention -Dependent edema

Weak peripheral pulses. Weak peripheral pulses are related to decreased cardiac output resulting from left-sided heart failure.

A nurse is caring for a client who has a history of angina and is scheduled for exercise electrocardiography at 1100. Which of the following statements by the client requires the nurse to contact the provider for possible rescheduling? -"I'm still hungry after the bowl of cereal I ate at 7 a.m." -"I didn't take my heart pills this morning because the doctor told me not to." -"I have had chest pain a couple times since I saw my doctor in the office last week." -"I smoked a cigarette this morning to calm my nerves about having this procedure."

"I smoked a cigarette this morning to calm my nerves about having this procedure." Smoking prior to this test can change the outcome and places the client at additional risk. The procedure should be rescheduled if the client has smoked before the test.

A nurse is preparing a client for coronary angiography. The nurse should report which of the following findings to the provider prior to the procedure? -Hemoglobin 14.4 g/dL -History of peripheral arterial disease -Urine output 200 mL/4 hr -Previous allergic reaction to shellfish

Previous allergic reaction to shellfish

A nurse is caring for a client who was admitted for treatment of left-sided heart failure with intravenous loop diuretics and digitalis therapy. The client is experiencing weakness and an irregular heart rate. Which of the following actions should the nurse take first? -Obtain client's current weight -Review serum electrolyte values -Determine the time of the last digoxin dose -Check the client's urine output

Review serum electrolyte values. Weakness and irregular heart rate indicate that the client is at the greatest risk for electrolyte imbalance, an adverse effect of loop diuretics. The first action the nurse should take is to review the client's electrolyte values, particularly the potassium level, because the client is at risk for dysrhythmias from hypokalemia.

A nurse is caring for a client who is receiving heparin therapy and develops hematuria. Which of the following actions should the nurse take if the client's aPTT is 96 seconds? -Increase the heparin infusion flow rate by 2 mL/hr -Continue to monitor the heparin infusion as prescribed -Request a prothrombin time (PT) -Stop the heparin infusion

Stop the heparin infusion. The nurse should identify that the client's aPTT is above the critical value and the client is displaying manifestations of bleeding. Therefore, the nurse should discontinue the heparin infusion immediately and notify the provider to reduce the risk of client injury.