ATI CARDIO EXAM 2020
A nurse is caring for a client who has dilated cardiomyopathy. The client reports increasing difficulty completing her daily
... [Show More] 1-mile walks. The nurse should recognize that this is a finding of which of the following?
a. Left ventricular failure
b. Peripheral vasodilation
c. Pericardial effusion
d. Decreased vascular volume
a. Activity intolerance is a finding of left ventricular failure and is associated with dilated cardiomyopathy.
A nurse is caring for a client who presents to the emergency department with a blood pressure of 254/139 mm Hg. The nurse recognizes that the client is in a hypertensive crisis. Which of the following actions should the nurse take first?
a. Obtain blood samples for laboratory testing
b. Tell the client to report vision changes
c. Place the head of the bed at 45 degrees
d. Initiate an IV
c. The first action the nurse should take when using the airway, breathing, circulation approach to client care is to place the head of the client’s bed at 45 degrees. This improves respiratory status and promotes venous return to reduce workload on the heart.
A nurse is assessing a client who has left-sided heart failure. Which of the following manifestations should the nurse expect to find?
a. Increased abdominal girth
b. Weak peripheral pulses
c. Jugular venous neck distention
d. Dependent edema
b. Weak peripheral pulses are related to decreased cardiac output resulting from left-sided heart failure.
A nurse is caring for a client in the first hour following an aortic aneurysm repair. Which of the following findings can indicate shock and should be reported to the provider?
a. Serosanguineous drainage on dressing
b. Severe pain with coughing
c. Urine output of 20 mL/hr
d. Increase in temperature from 36.8 degrees C (98.2 F) to 37.5 degrees C (99.5 F)
c. Urine output less than 30 mL/hr can indicate shock because it reflects decreased blood flow to the kidneys, possibly from graft rupture and hemorrhage.
A nurse is caring for a client who has a history of deep-vein thrombosis and is receiving warfarin. Which of the following client findings provides the nurse with the best evidence regarding the effectiveness of the warfarin therapy?
a. Hemoglobin 14 g/dL
b. Minimal bruising of extremities
c. Reduced circumference of affected extremity
d. INR 2.5
d. The nurse should determine that an INR of 2,5 is within the desired therapeutic range and is the best evidence of effective warfarin therapy.
A nurse is reviewing the laboratory results of several clients who have peripheral arterial disease. The nurse should plan to provide dietary teaching for the client who has which of the following laboratory values?
a. Cholesterol 180 mg/dL, HDL 70 mg/dL, LDL 90 mg/dL
b. Cholesterol of 185 mg/dL, HDL 50 mg/dL, LDL 120 mg/dL
c. Cholesterol 190 mg/dL, HDL 25 mg/ dL, LDL 160 mg/dL
d. Cholesterol 195 mg/dL, HDL 55 mg/dL, LDL 125 mg/dL
c. The expected reference range of cholesterol is less than 200 mg/dL, HDL above 40 mg/dL, and LDL less than 100 mg/dL.
A nurse is caring for a client in the first 8 hr following coronary artery bypass graft (CABG) surgery. Which of the following client findings should the nurse report to the provider?
a. Mediastinal drainage 100 mL/hr
b. Blood pressure 160/80 mm Hg
c. Temperature 37.1 degrees C (98.8 F) [Show Less]