ATI RN Adult Medical-Surgical ATI RN Adult Medical-Surgical

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, ATI RN Adult Medical-Surgical ATI RN Adult
Medical-Surgical
1. A client on a cardiac monitor suddenly develops a rapid, irregular rhythm with no
identifiable P waves. The client's blood pressure is 90/60 mmHg, and they report
lightheadedness. What is the nurse's priority action?

• A) Prepare for synchronized cardioversion

• B) Administer IV amiodarone

• C) Check the client's carotid pulse

• D) Obtain a 12-lead EKG
Answer: A) Prepare for synchronized cardioversion
Rationale: This rhythm is atrial fibrillation with a rapid ventricular response causing
hemodynamic instability (hypotension and lightheadedness). Synchronized cardioversion
is the priority treatment for unstable tachyarrhythmias.

2. A client with heart failure is prescribed carvedilol. Which finding indicates the
medication is having the desired therapeutic effect?

• A) Heart rate increases from 72 to 88 bpm
• B) Blood pressure increases from 110/70 to 130/80 mmHg

• C) Ejection fraction improves from 30% to 45%

• D) Patient reports increased ankle swelling
Answer: C) Ejection fraction improves from 30% to 45%
Rationale: Carvedilol is a beta-blocker that reduces myocardial workload and improves
left ventricular ejection fraction (LVEF) in heart failure patients. An improved EF
indicates positive remodeling.

3. A client is 2 hours post-cardiac catheterization via the femoral artery. The nurse notes
bright red bleeding at the insertion site. What should the nurse do first?

• A) Apply firm manual pressure 1 inch above the site

• B) Reapply the pressure dressing more tightly

• C) Notify the provider

• D) Place the client in Trendelenburg position
Answer: A) Apply firm manual pressure 1 inch above the site
Rationale: Immediate manual pressure above the arterial puncture site is the first line of