ATI MED-SURGE CARDIAC EXAM – 2025 – COMPLETE
SET OF QUESTIONS WITH CORRECT DETAILED ANSWERS
AND EXPLANATION – A+ RATED
A patient is prescribed digitalis preparations. Which of the following conditions
should the nurse closely monitor when caring for the patient?
a) Enlargement of joints
b) Vasculitis
c) Potassium levels
d) Flexion contractures c) Potassium levels
Explanation:
A key concern associated with digoxin therapy is digitalis toxicity. Clinical
manifestations of toxicity include anorexia, nausea, visual disturbances,
confusion, and bradycardia. The serum potassium level is monitored because
the effect of digoxin is enhanced in the presence of hypokalemia and digoxin
toxicity may occur.
When the nurse observes that the patient has increased difficulty breathing when
lying flat, the nurse records that the patient is demonstrating which of the
following?
a) Hyperpnea
b) Dyspnea on exertion
,c) Paroxysmal nocturnal dyspnea
d) Orthopnea d) Orthopnea
Explanation:
Patients with orthopnea prefer not to lie flat and will need to maintain their
beds in a semi- to high Fowler's position. Dyspnea on exertion refers to difficulty
breathing with activity. Hyperpnea refers to increased rate and depth of
respiration. Paroxysmal nocturnal dyspnea refers to orthopnea that occurs only
at night.
The patient with cardiac failure is taught to report which of the following
symptoms to the physician or clinic immediately?
a) Persistent cough
b) Weight loss
c) Ability to sleep through the night
d) Increased appetite a) Persistent cough
Explanation:
Persistent cough may indicate an onset of left-sided heart failure. Loss of
appetite should be reported immediately. Weight gain should be reported
immediately. Frequent urination, causing interruption of sleep, should be
reported immediately.
A nurse is assessing a patient with congestive heart failure for jugular vein
distension (JVD). Which of the following observations is important to report to the
physician?
,a) JVD is noted 3 cm above the sternal angle.
b) JVD is noted at the level of the sternal angle.
c) No JVD is present.
d) JVD is noted 1 cm above the sternal angle. a) JVD is noted 3 cm above the
sternal angle.
Explanation:
JVD is assessed with the patient sitting at a 45° angle. Jugular vein distention
greater than 3 cm above the sternal angle is considered abnormal and is
indicative of right ventricular failure.
Which is a potassium-sparing diuretic used in the treatment of heart failure (HF)?
a) Spironolactone (Aldactone)
b) Bumetanide (Bumex)
c) Chlorothiazide (Diuril)
d) Ethacrynic acid (Edecrin) a) Spironolactone (Aldactone)
Explanation:
Aldactone is a potassium-sparing diuretic. A thiazide diuretic is Diuril. Bumex
and Edecrin are loop diuretics
The nurse recognizes which of the following symptoms as a classic sign of
cardiogenic shock?
a) High blood pressure
b) Increased urinary output
, c) Hyperactive bowel sounds
d) Restlessness and confusion d) Restlessness and confusion
Explanation:
Cardiogenic shock occurs when decreased cardiac output leads to inadequate
tissue perfusion and initiation of the shock syndrome. Inadequate tissue
perfusion is manifested as cerebral hypoxia (restlessness, confusion, agitation).
The nurse identifies which of the following symptoms as a manifestation of right-
sided heart failure (HF)?
a) Reduction in cardiac output
b) Reduction in forward flow
c) Accumulation of blood in the lungs
d) Congestion in the peripheral tissues d) Congestion in the peripheral
tissues
Explanation:
Right-sided HF, failure of the right ventricle, results in congestion in the
peripheral tissues and the viscera and causes systemic venous congestion and a
reduction in forward flow. Left-sided HF refers to failure of the left ventricle; it
results in pulmonary congestion and causes an accumulation of blood in the
lungs and a reduction in forward flow or cardiac output that results in
inadequate arterial blood flow to the tissues.
Which of the following medications is categorized as a loop diuretic?
a) Furosemide (Lasix)
SET OF QUESTIONS WITH CORRECT DETAILED ANSWERS
AND EXPLANATION – A+ RATED
A patient is prescribed digitalis preparations. Which of the following conditions
should the nurse closely monitor when caring for the patient?
a) Enlargement of joints
b) Vasculitis
c) Potassium levels
d) Flexion contractures c) Potassium levels
Explanation:
A key concern associated with digoxin therapy is digitalis toxicity. Clinical
manifestations of toxicity include anorexia, nausea, visual disturbances,
confusion, and bradycardia. The serum potassium level is monitored because
the effect of digoxin is enhanced in the presence of hypokalemia and digoxin
toxicity may occur.
When the nurse observes that the patient has increased difficulty breathing when
lying flat, the nurse records that the patient is demonstrating which of the
following?
a) Hyperpnea
b) Dyspnea on exertion
,c) Paroxysmal nocturnal dyspnea
d) Orthopnea d) Orthopnea
Explanation:
Patients with orthopnea prefer not to lie flat and will need to maintain their
beds in a semi- to high Fowler's position. Dyspnea on exertion refers to difficulty
breathing with activity. Hyperpnea refers to increased rate and depth of
respiration. Paroxysmal nocturnal dyspnea refers to orthopnea that occurs only
at night.
The patient with cardiac failure is taught to report which of the following
symptoms to the physician or clinic immediately?
a) Persistent cough
b) Weight loss
c) Ability to sleep through the night
d) Increased appetite a) Persistent cough
Explanation:
Persistent cough may indicate an onset of left-sided heart failure. Loss of
appetite should be reported immediately. Weight gain should be reported
immediately. Frequent urination, causing interruption of sleep, should be
reported immediately.
A nurse is assessing a patient with congestive heart failure for jugular vein
distension (JVD). Which of the following observations is important to report to the
physician?
,a) JVD is noted 3 cm above the sternal angle.
b) JVD is noted at the level of the sternal angle.
c) No JVD is present.
d) JVD is noted 1 cm above the sternal angle. a) JVD is noted 3 cm above the
sternal angle.
Explanation:
JVD is assessed with the patient sitting at a 45° angle. Jugular vein distention
greater than 3 cm above the sternal angle is considered abnormal and is
indicative of right ventricular failure.
Which is a potassium-sparing diuretic used in the treatment of heart failure (HF)?
a) Spironolactone (Aldactone)
b) Bumetanide (Bumex)
c) Chlorothiazide (Diuril)
d) Ethacrynic acid (Edecrin) a) Spironolactone (Aldactone)
Explanation:
Aldactone is a potassium-sparing diuretic. A thiazide diuretic is Diuril. Bumex
and Edecrin are loop diuretics
The nurse recognizes which of the following symptoms as a classic sign of
cardiogenic shock?
a) High blood pressure
b) Increased urinary output
, c) Hyperactive bowel sounds
d) Restlessness and confusion d) Restlessness and confusion
Explanation:
Cardiogenic shock occurs when decreased cardiac output leads to inadequate
tissue perfusion and initiation of the shock syndrome. Inadequate tissue
perfusion is manifested as cerebral hypoxia (restlessness, confusion, agitation).
The nurse identifies which of the following symptoms as a manifestation of right-
sided heart failure (HF)?
a) Reduction in cardiac output
b) Reduction in forward flow
c) Accumulation of blood in the lungs
d) Congestion in the peripheral tissues d) Congestion in the peripheral
tissues
Explanation:
Right-sided HF, failure of the right ventricle, results in congestion in the
peripheral tissues and the viscera and causes systemic venous congestion and a
reduction in forward flow. Left-sided HF refers to failure of the left ventricle; it
results in pulmonary congestion and causes an accumulation of blood in the
lungs and a reduction in forward flow or cardiac output that results in
inadequate arterial blood flow to the tissues.
Which of the following medications is categorized as a loop diuretic?
a) Furosemide (Lasix)
