ATI Cardiovascular Targeted Exam
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 - questions and answers-Assisting with thrombolytic therapy
The nurse should recognize that major surgery within the previous 3 weeks is a contraindication
for thrombolytic therapy.
A nurse in an emergency department is caring for a client who has a blood pressure of 254/139
mmHg. The nurses recognizes that the client is in a hypertensive crisis. Which of the following
actions should the nurse take first?
-Initiate seizure precautions
-Tell the client to report vision changes
-Elevate the head of the client's bed
-Start a peripheral IV - questions and answers-Elevate the head of the client's bed.
The greatest risk to this client is organ injury due to severe hypertension. Therefore, the first
action the nurse should take is to elevate the head of the client's bed to reduce blood pressure
and promote oxygenation.
A nurse in an emergency room is assessing a client who has a bradydysrhythmia. Which of the
following findings should the nurse monitor for?
-Confusion
-Friction rub
-Hypertension
-Dry skin - questions and answers-Confusion
Bradydysrhythmia can cause decreased systemic perfusion, which can lead to confusion.
A nurse is admitting a client who has a leg ulcer and a history of diabetes mellitus. The nurse
should use which of the following focused assessments to help differentiate between an arterial
ulcer and a venous stasis ulcer?
, -Explore the client's family history of peripheral vascular disease
-Note the presence or absence of pain at the ulcer site
-Inquire about the presence or absence of claudication
-Ask if the client has had a recent infection - questions and answers-Inquire about the presence
or absence of claudication
Clients who have arterial ulcers experience claudication, but those who have venous ulcers do
not.
A nurse is assessing a client who has a history of deep-vein thrombosis and is receiving
warfarin. The nurse should identify that which of the following findings indicates the medication
is effective?
-Hemoglobin 14 g/dL
-Minimal bruising of extremities
-Decreased blood pressure
-INR 2.0 - questions and answers-INR 2.0
The nurse should identify that an INR of 2.0 is within the desired reference range of 2.0 to 3.0
for a client who has a deep-vein thrombosis and is receiving warfarin to reduce the risk of new
clot formation and a stroke.
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 - questions and answers-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 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 - questions and answers-Weak peripheral pulses.
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 - questions and answers-Assisting with thrombolytic therapy
The nurse should recognize that major surgery within the previous 3 weeks is a contraindication
for thrombolytic therapy.
A nurse in an emergency department is caring for a client who has a blood pressure of 254/139
mmHg. The nurses recognizes that the client is in a hypertensive crisis. Which of the following
actions should the nurse take first?
-Initiate seizure precautions
-Tell the client to report vision changes
-Elevate the head of the client's bed
-Start a peripheral IV - questions and answers-Elevate the head of the client's bed.
The greatest risk to this client is organ injury due to severe hypertension. Therefore, the first
action the nurse should take is to elevate the head of the client's bed to reduce blood pressure
and promote oxygenation.
A nurse in an emergency room is assessing a client who has a bradydysrhythmia. Which of the
following findings should the nurse monitor for?
-Confusion
-Friction rub
-Hypertension
-Dry skin - questions and answers-Confusion
Bradydysrhythmia can cause decreased systemic perfusion, which can lead to confusion.
A nurse is admitting a client who has a leg ulcer and a history of diabetes mellitus. The nurse
should use which of the following focused assessments to help differentiate between an arterial
ulcer and a venous stasis ulcer?
, -Explore the client's family history of peripheral vascular disease
-Note the presence or absence of pain at the ulcer site
-Inquire about the presence or absence of claudication
-Ask if the client has had a recent infection - questions and answers-Inquire about the presence
or absence of claudication
Clients who have arterial ulcers experience claudication, but those who have venous ulcers do
not.
A nurse is assessing a client who has a history of deep-vein thrombosis and is receiving
warfarin. The nurse should identify that which of the following findings indicates the medication
is effective?
-Hemoglobin 14 g/dL
-Minimal bruising of extremities
-Decreased blood pressure
-INR 2.0 - questions and answers-INR 2.0
The nurse should identify that an INR of 2.0 is within the desired reference range of 2.0 to 3.0
for a client who has a deep-vein thrombosis and is receiving warfarin to reduce the risk of new
clot formation and a stroke.
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 - questions and answers-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 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 - questions and answers-Weak peripheral pulses.
