NR 324 Midterm Exam Study – ATI Test 4 Practice
Assessment
ATI - TEST 4 PRACTICE ASSESSMENT
A nurse is planning care for a client who has a suspected myocardial infarction. Which of the
following should the nurse administer first?
C. Oxygen
2
ATI - TEST 4 PRACTICE ASSESSMENT
While reading a client's ECG tracing, the nurse should understand that the P wave reflects which
of the following cardiac electrical activities?
C. Atrial deporlarization
3
ATI - TEST 4 PRACTICE ASSESSMENT
A client comes to the emergency department via ambulance to report severe radiating chest pain
and SOB. The client appears restless, frightened, and slightly cyanotic. The provider prescribes
oxygen by nasal cannula at 4 L/min stat, cardiac enzyme levels, IV fluids, and a 12-lead ECG.
Which of the following actions should the nurse assisting with this client client's care first?
C. Initiate oxygen therapy.
4
ATI - TEST 4 PRACTICE ASSESSMENT
A nurse is preparing a client for an echocardiogram the following day. Which of the following
instruction should the nurse include about this test?
C. It requires lying quietly on one side.
Rationale:
For a Transthoracic Echocardiogram (TTE), the client lies quietly on the left side with slight
,head elevation. There is no reason for the client to be NPO. The test takes up to 1 hour and there
is not discomfort as a transducer with conductive jelly is used on the chest.
5
ATI - TEST 4 PRACTICE ASSESSMENT
A nurse is reviewing the laboratory values on a client who has HTN. Blood tests are drawn and
reveal the following results. Which of the following results should the nurse identify as critical?
B. Potassium 2.3 mEq/L
6
ATI - TEST 4 PRACTICE ASSESSMENT
The nurse is completing a medication review of a client who has elevated cholesterol levels and
takes an anticoagulant. Which of the following should the nurse report to the provider?.
D. Uses garlic as a cholesterol lowering agent.
Rationale:
The nurse should be aware that the use of garlic to lower cholesterol may potentiate the action of
anticoagulant medication and should report the finding to the provider.
7
ATI - TEST 4 PRACTICE ASSESSMENT
A nurse is caring for a client who enters the emergency department complaining of severe chest
pain. Which of the following interventions should the nurse implement to determine if the client
is experiencing a myocardial infarction?
C. Perform a 12-lead ECG
,8
ATI - TEST 4 PRACTICE ASSESSMENT
While auscultating a client's heart sounds, the nurse hears turbulence between the S1 and S2
heart sounds. The nurse should document this finding as which of the following?
A. A cardiac murmur
Rationale:
Cardiac murmurs are relatively lout, turbulent sounds the nurse can hear between usual, expected
heart sounds. They create a whooshing or swishing sound.
9
ATI - TEST 4 PRACTICE ASSESSMENT
A nurse is reviewing the initial laboratory values for partial thromboplastin time, and
prothrombin time, and thrombin time on a client who has an acute episode of disseminated
intravascular coagulation (DIC). The nurse should expect the laboratory values to be
B. prolonged.
Rationale:
The nurse should expect the laboratory values to be prolonged because the anticoagulant
pathways are impaired and consume the key clotting factors, resulting in clotting dysfunction.
10
**ATI - TEST 4 PRACTICE ASSESSMENT**
A nurse is reinforcing discharge teaching for a client who has received an implantable
cardioverter/defribillator (ICD). Which of the following information should the nurse include?
, B. The client should hold his cell phone on the side opposite the ICD.
Rationale:
The client should keep his cellular phone on the side opposite of the ICD, as close proximity
could interfere with the ICD's function. The client should inform airport security of the device.
The client does not carry the ICD is in his pocket, this is an IMPLANTABLE device.
11
ATI - TEST 4 PRACTICE ASSESSMENT
A nurse is reinforcing teaching for a client who is postoperative following an insertion of a
permanent pacemaker. Which of the following instructions should the nurse include? (Select all
that apply.)
A. Count your pulse for 1 min each morning.
C. Do not wear tight clothing over the insertion area.
Rationale:
Avoid coming into contact with metal detectors is incorrect, there is not danger going through a
metal detector, but the client should inform airport security because the pacemaker will trigger
an alarm.
Do not operate microwave ovens is incorrect. It is save for clients with a pacemaker to operate
microwave ovens unless they are old and do not have the appropriate shielding or of they are
defective.
12
ATI - TEST 4 PRACTICE ASSESSMENT
A nurse is caring for a client with a ventricular pacemaker who is on ECG monitoring. The nurse
understands that the pacemaker is functioning properly when which of the following appears on
the monitor strip?
C. The pacemaker spikes before each QRS complex.
Assessment
ATI - TEST 4 PRACTICE ASSESSMENT
A nurse is planning care for a client who has a suspected myocardial infarction. Which of the
following should the nurse administer first?
C. Oxygen
2
ATI - TEST 4 PRACTICE ASSESSMENT
While reading a client's ECG tracing, the nurse should understand that the P wave reflects which
of the following cardiac electrical activities?
C. Atrial deporlarization
3
ATI - TEST 4 PRACTICE ASSESSMENT
A client comes to the emergency department via ambulance to report severe radiating chest pain
and SOB. The client appears restless, frightened, and slightly cyanotic. The provider prescribes
oxygen by nasal cannula at 4 L/min stat, cardiac enzyme levels, IV fluids, and a 12-lead ECG.
Which of the following actions should the nurse assisting with this client client's care first?
C. Initiate oxygen therapy.
4
ATI - TEST 4 PRACTICE ASSESSMENT
A nurse is preparing a client for an echocardiogram the following day. Which of the following
instruction should the nurse include about this test?
C. It requires lying quietly on one side.
Rationale:
For a Transthoracic Echocardiogram (TTE), the client lies quietly on the left side with slight
,head elevation. There is no reason for the client to be NPO. The test takes up to 1 hour and there
is not discomfort as a transducer with conductive jelly is used on the chest.
5
ATI - TEST 4 PRACTICE ASSESSMENT
A nurse is reviewing the laboratory values on a client who has HTN. Blood tests are drawn and
reveal the following results. Which of the following results should the nurse identify as critical?
B. Potassium 2.3 mEq/L
6
ATI - TEST 4 PRACTICE ASSESSMENT
The nurse is completing a medication review of a client who has elevated cholesterol levels and
takes an anticoagulant. Which of the following should the nurse report to the provider?.
D. Uses garlic as a cholesterol lowering agent.
Rationale:
The nurse should be aware that the use of garlic to lower cholesterol may potentiate the action of
anticoagulant medication and should report the finding to the provider.
7
ATI - TEST 4 PRACTICE ASSESSMENT
A nurse is caring for a client who enters the emergency department complaining of severe chest
pain. Which of the following interventions should the nurse implement to determine if the client
is experiencing a myocardial infarction?
C. Perform a 12-lead ECG
,8
ATI - TEST 4 PRACTICE ASSESSMENT
While auscultating a client's heart sounds, the nurse hears turbulence between the S1 and S2
heart sounds. The nurse should document this finding as which of the following?
A. A cardiac murmur
Rationale:
Cardiac murmurs are relatively lout, turbulent sounds the nurse can hear between usual, expected
heart sounds. They create a whooshing or swishing sound.
9
ATI - TEST 4 PRACTICE ASSESSMENT
A nurse is reviewing the initial laboratory values for partial thromboplastin time, and
prothrombin time, and thrombin time on a client who has an acute episode of disseminated
intravascular coagulation (DIC). The nurse should expect the laboratory values to be
B. prolonged.
Rationale:
The nurse should expect the laboratory values to be prolonged because the anticoagulant
pathways are impaired and consume the key clotting factors, resulting in clotting dysfunction.
10
**ATI - TEST 4 PRACTICE ASSESSMENT**
A nurse is reinforcing discharge teaching for a client who has received an implantable
cardioverter/defribillator (ICD). Which of the following information should the nurse include?
, B. The client should hold his cell phone on the side opposite the ICD.
Rationale:
The client should keep his cellular phone on the side opposite of the ICD, as close proximity
could interfere with the ICD's function. The client should inform airport security of the device.
The client does not carry the ICD is in his pocket, this is an IMPLANTABLE device.
11
ATI - TEST 4 PRACTICE ASSESSMENT
A nurse is reinforcing teaching for a client who is postoperative following an insertion of a
permanent pacemaker. Which of the following instructions should the nurse include? (Select all
that apply.)
A. Count your pulse for 1 min each morning.
C. Do not wear tight clothing over the insertion area.
Rationale:
Avoid coming into contact with metal detectors is incorrect, there is not danger going through a
metal detector, but the client should inform airport security because the pacemaker will trigger
an alarm.
Do not operate microwave ovens is incorrect. It is save for clients with a pacemaker to operate
microwave ovens unless they are old and do not have the appropriate shielding or of they are
defective.
12
ATI - TEST 4 PRACTICE ASSESSMENT
A nurse is caring for a client with a ventricular pacemaker who is on ECG monitoring. The nurse
understands that the pacemaker is functioning properly when which of the following appears on
the monitor strip?
C. The pacemaker spikes before each QRS complex.
