ATI Learning System RN 3.0 Actual Dynamic
Practice Quiz: Medical-Surgical Nursing
Cardiovascular & Hematology with Complete
Solutions
SECTION I: CARDIOVASCULAR DISORDERS
Questions 1-30
Question 1 (Multiple Choice)
A nurse is caring for a client with heart failure who is receiving intravenous furosemide
40 mg. Which assessment finding indicates the medication is producing the desired
therapeutic effect?
A) Weight increase of 0.5 kg from previous day
B) Decreased dyspnea and improved oxygen saturation
C) Heart rate increase from 88 to 102 beats/min
D) Blood pressure increase from 110/70 to 130/84 mmHg
Correct Answer: B
Complete Rationale:
,Furosemide is a loop diuretic that reduces fluid overload in heart failure by inhibiting
sodium and water reabsorption in the loop of Henle. The therapeutic goal is reduction of
pulmonary congestion and peripheral edema. Decreased dyspnea indicates reduced
pulmonary vascular congestion and improved gas exchange. Oxygen saturation
improvement confirms better respiratory status.
● A is incorrect: Weight gain suggests continued fluid retention or worsening heart
failure, not therapeutic response. Expected outcome is 0.5-1 kg weight loss per
day.
● C is incorrect: Tachycardia may indicate hypovolemia, worsening heart failure, or
compensatory response to reduced preload—not a therapeutic effect.
● D is incorrect: Blood pressure elevation suggests inadequate afterload reduction
or possible fluid overload; furosemide typically causes mild hypotension due to
volume reduction.
ATI Cognitive Level: Evaluating effectiveness of interventions
Nursing Process: Evaluation
Client Need: Physiological Integrity: Pharmacological Therapies
Question 2 (Multiple Choice)
A client with atrial fibrillation has been taking warfarin 5 mg daily. Today's laboratory
result shows INR 2.8. What action should the nurse take?
A) Administer the prescribed dose as scheduled
B) Hold the dose and notify the provider immediately
C) Administer vitamin K 5 mg orally
D) Increase the dose to 7.5 mg for the next dose
Correct Answer: A
,Complete Rationale:
For atrial fibrillation, the therapeutic INR range is 2.0-3.0. An INR of 2.8 falls within this
therapeutic window, indicating adequate anticoagulation without excessive bleeding
risk. The nurse should administer the scheduled dose to maintain therapeutic levels.
● B is incorrect: Holding the dose is appropriate for INR >4.0 or signs of bleeding.
An INR of 2.8 does not require interruption of therapy.
● C is incorrect: Vitamin K is administered for INR >4.0-5.0 with bleeding, or INR
>9.0 without bleeding, to reverse anticoagulation. It is not indicated for
therapeutic levels.
● D is incorrect: Increasing the dose would risk supratherapeutic anticoagulation
and bleeding complications.
ATI Cognitive Level: Medication management and monitoring
Nursing Process: Implementation
Client Need: Physiological Integrity: Reduction of Risk Potential
Question 3 (Multiple Choice)
A client with acute myocardial infarction suddenly develops ventricular fibrillation. The
nurse delivers one defibrillation at 200 joules. The rhythm persists. What is the priority
action?
A) Administer epinephrine 1 mg IV push
B) Resume high-quality CPR immediately for 2 minutes
C) Administer amiodarone 300 mg IV push
D) Deliver a second defibrillation at 300 joules
Correct Answer: B
, Complete Rationale:
Per 2020 AHA ACLS guidelines for cardiac arrest, after any shock delivery (defibrillation
or cardioversion), CPR should resume immediately for 2 minutes (5 cycles of 30:2
compressions-to-ventilations) before the next rhythm check. This ensures adequate
coronary and cerebral perfusion between assessments.
● A is incorrect: Epinephrine is administered every 3-5 minutes during CPR, but not
immediately after the first shock. Rhythm check and continued CPR take
precedence.
● C is incorrect: Amiodarone is considered after the second shock if ventricular
fibrillation/pulseless ventricular tachycardia persists.
● D is incorrect: Repeat defibrillation occurs after 2 minutes of CPR and rhythm
reassessment, not immediately.
ATI Cognitive Level: Emergency protocol application
Nursing Process: Implementation
Client Need: Physiological Integrity: Physiological Adaptation
Question 4 (Select-All-That-Apply)
Which clients are at increased risk for developing infective endocarditis? (Select all that
apply)
☐ A) Client with prosthetic mechanical heart valve
☐ B) Client with mitral valve prolapse without regurgitation
☐ C) Client with previous history of infective endocarditis
☐ D) Client with hypertrophic cardiomyopathy
☐ E) Client with atrial septal defect repaired via device closure 3 months ago
Practice Quiz: Medical-Surgical Nursing
Cardiovascular & Hematology with Complete
Solutions
SECTION I: CARDIOVASCULAR DISORDERS
Questions 1-30
Question 1 (Multiple Choice)
A nurse is caring for a client with heart failure who is receiving intravenous furosemide
40 mg. Which assessment finding indicates the medication is producing the desired
therapeutic effect?
A) Weight increase of 0.5 kg from previous day
B) Decreased dyspnea and improved oxygen saturation
C) Heart rate increase from 88 to 102 beats/min
D) Blood pressure increase from 110/70 to 130/84 mmHg
Correct Answer: B
Complete Rationale:
,Furosemide is a loop diuretic that reduces fluid overload in heart failure by inhibiting
sodium and water reabsorption in the loop of Henle. The therapeutic goal is reduction of
pulmonary congestion and peripheral edema. Decreased dyspnea indicates reduced
pulmonary vascular congestion and improved gas exchange. Oxygen saturation
improvement confirms better respiratory status.
● A is incorrect: Weight gain suggests continued fluid retention or worsening heart
failure, not therapeutic response. Expected outcome is 0.5-1 kg weight loss per
day.
● C is incorrect: Tachycardia may indicate hypovolemia, worsening heart failure, or
compensatory response to reduced preload—not a therapeutic effect.
● D is incorrect: Blood pressure elevation suggests inadequate afterload reduction
or possible fluid overload; furosemide typically causes mild hypotension due to
volume reduction.
ATI Cognitive Level: Evaluating effectiveness of interventions
Nursing Process: Evaluation
Client Need: Physiological Integrity: Pharmacological Therapies
Question 2 (Multiple Choice)
A client with atrial fibrillation has been taking warfarin 5 mg daily. Today's laboratory
result shows INR 2.8. What action should the nurse take?
A) Administer the prescribed dose as scheduled
B) Hold the dose and notify the provider immediately
C) Administer vitamin K 5 mg orally
D) Increase the dose to 7.5 mg for the next dose
Correct Answer: A
,Complete Rationale:
For atrial fibrillation, the therapeutic INR range is 2.0-3.0. An INR of 2.8 falls within this
therapeutic window, indicating adequate anticoagulation without excessive bleeding
risk. The nurse should administer the scheduled dose to maintain therapeutic levels.
● B is incorrect: Holding the dose is appropriate for INR >4.0 or signs of bleeding.
An INR of 2.8 does not require interruption of therapy.
● C is incorrect: Vitamin K is administered for INR >4.0-5.0 with bleeding, or INR
>9.0 without bleeding, to reverse anticoagulation. It is not indicated for
therapeutic levels.
● D is incorrect: Increasing the dose would risk supratherapeutic anticoagulation
and bleeding complications.
ATI Cognitive Level: Medication management and monitoring
Nursing Process: Implementation
Client Need: Physiological Integrity: Reduction of Risk Potential
Question 3 (Multiple Choice)
A client with acute myocardial infarction suddenly develops ventricular fibrillation. The
nurse delivers one defibrillation at 200 joules. The rhythm persists. What is the priority
action?
A) Administer epinephrine 1 mg IV push
B) Resume high-quality CPR immediately for 2 minutes
C) Administer amiodarone 300 mg IV push
D) Deliver a second defibrillation at 300 joules
Correct Answer: B
, Complete Rationale:
Per 2020 AHA ACLS guidelines for cardiac arrest, after any shock delivery (defibrillation
or cardioversion), CPR should resume immediately for 2 minutes (5 cycles of 30:2
compressions-to-ventilations) before the next rhythm check. This ensures adequate
coronary and cerebral perfusion between assessments.
● A is incorrect: Epinephrine is administered every 3-5 minutes during CPR, but not
immediately after the first shock. Rhythm check and continued CPR take
precedence.
● C is incorrect: Amiodarone is considered after the second shock if ventricular
fibrillation/pulseless ventricular tachycardia persists.
● D is incorrect: Repeat defibrillation occurs after 2 minutes of CPR and rhythm
reassessment, not immediately.
ATI Cognitive Level: Emergency protocol application
Nursing Process: Implementation
Client Need: Physiological Integrity: Physiological Adaptation
Question 4 (Select-All-That-Apply)
Which clients are at increased risk for developing infective endocarditis? (Select all that
apply)
☐ A) Client with prosthetic mechanical heart valve
☐ B) Client with mitral valve prolapse without regurgitation
☐ C) Client with previous history of infective endocarditis
☐ D) Client with hypertrophic cardiomyopathy
☐ E) Client with atrial septal defect repaired via device closure 3 months ago
