ATI CARDIAC QUESTIONS
You are reviewing the chart of a PT who is receiving heparin therapy for a DVT. Which
intervention should the RN anticipate taking if the PTs aPTT is 96 seconds?
1. Increase heparin infusion rate by 2mL/hr
2. Continue monitor the heparin infusion as prescribed
3. Request a prothrombin time PT
4. Stop the heparin infusion - Answer 4. Stop the heparin infusion- pt is above the
therapeutic range of 1-5-2 times the control. should discontinue to prevent harm
You are providing teaching to a PT who is 2 days post op following a heart transplant.
Which following statements should the nurse include in the teaching?
1. You may no longer be able to feel chest pain
2. Your level of activity intolerance will not change
3. after 6 months you will no longer need to restrict you Na
4. You will be able to stop taking immunosuppressants after 12 months - Answer 1. You
may no longer be able to feel chest pain- transplant PTs no longer feel chest pain due
to denervation of the heart
ER nurse is assessing PT with bradydysrhythmia. Which finding should he expect?
1. Confusion
2. Friction Rub
3. HTN
4. Dry skin - Answer 1. Confusion- as a result of decreased tissue perfusion
You are caring for a PT who had an anterior MI. PTs hx shows she is 1 wk post op open
cholecystectomy the RN knows that which intervention is contraindicated?
1. Administering IV morphine
2. giving O2 at 2L NC
3. Helping client to BSC
4. Assisting in thrombolytic therapy - Answer 4. Assisting in thrombolytic therapy- having
surgery within 3 wks is a contraindication for thrombolytic therapy
You are caring for a PT who has endocarditis. Which finding should you recognize as a
complication?
1. Ventricular depolarization
2. Guillain Barre Syndrome
3. Myelodysplastic syndrome
4. Valvular disease - Answer 4. Valvular disease- damage will occur as a result of
inflammation or infection of the endocardium
,You are caring for PT with BP of 254/139, you recognize the PT is in a hypertensive
crisis. Which action should you take first?
1. Obtain blood samples for testing
2. Tell the PT to report vision changes
3. Place HOB at 45 degrees
4. Initiate IV access - Answer 3. Place HOB at 45 degrees-ABC's this will promote
respiratory status and promote venous return reducing workload on heart
**Initiate IV access- not first action
When performing a cardiac assessment what is the point of maximal impulse?
1. 2nd intercostal space right to the sternum
2. 2nd intercostal space left to the sternum
3. 5th intercostal space to the left of thermal border
4. Left 5th intercostal space in the midclavicular line - Answer 4. Left 5th intercostal
space in the midclavicular line-this is best to hear the apex of the heart which is
considered maximal impulse
You are caring for a PT who is experiencing Afib. You should report what finding to the
provider?
1. Slurred speech
2. Irregular pulse
3. Dependent edema
4. Persistant fatigue - Answer 1. Slurred speech- greatest risk is an embolus and this
can indicate embolus
You are assessing a PT with Left sided heart failure. What manifestation should you
expect to find?
1. Increased abdominal girth
2. Weak peripheral pulses
3. Jugular venous neck distention
4. Dependent edema - Answer 2. Weak peripheral pulses- r/t decreased CO from LSHF
You are caring for a PT who is being treated for HF and has prescriptions for digoxin
and furosemide. You plan to monitor for which of the following as an adverse effect of
these meds?
1. SOB
2. Lightheadedness
3. Dry cough
, 4. Metallic taste - Answer 2. Lightheadedness- can cause a sudden drop in BP=
lightheadedness
You are monitoring a PT following coronary bypass graft surgery (CABG). Which finding
indicates cardiac tamponade?
1. Sternal instability
2. Increased WBC count
3. BP of 140/82 on inspiration and 154/90 on expiration
4. Sinus rhythm with occasional premature atrial contractions and HR 88 - Answer 3. BP
of 140/82 on inspiration and 154/90 on expiration= pulses paradoxus
What is Pulsus Paradoxus? - Answer When the systolic BP is 10 points higher on
expiration than on inspiration
**This is indicative of cardiac tamponade
You are preparing PT for coronary angiography. You should report what finding to the
provider prior to procedure?
1. Hgb 14.4
2. HX: PAD peripheral arterial disease
3. UOP of 200ml in 4 hr
4. Previous allergic reaction to shell fish - Answer 4. Previous allergic reaction to shell
fish- shellfish reaction will often react to iodine
You are caring for a PT following insertion of a permanent pacemaker. Which PT
statement indicates a potential complication of the insertion procedure?
1. I can't get rid of these hiccups
2. I feel dizzy when i stand
3. My incision stings
4. i have a headache - Answer 1. I can't get rid of these hiccups-can indicate the
pacemaker is stimulating the chest wall or diaphragm indicating wire lead perforation
You are providing discharge teaching to a PT who has a prescription for the transdermal
nitroglycerin patch. Which instruction would you include?
1. Apply new patch to the same site as the previous patch.
2. Place the new patch on an area skin away from skin folds and joints
3. Keep the patch on 24 hr per day
4. Replace the patch at the onset of angina - Answer 2. Place the new patch on an area
skin away from skin folds and joints- should apply to skin that is prone not to move or
wrinkle
You are reviewing the chart of a PT who is receiving heparin therapy for a DVT. Which
intervention should the RN anticipate taking if the PTs aPTT is 96 seconds?
1. Increase heparin infusion rate by 2mL/hr
2. Continue monitor the heparin infusion as prescribed
3. Request a prothrombin time PT
4. Stop the heparin infusion - Answer 4. Stop the heparin infusion- pt is above the
therapeutic range of 1-5-2 times the control. should discontinue to prevent harm
You are providing teaching to a PT who is 2 days post op following a heart transplant.
Which following statements should the nurse include in the teaching?
1. You may no longer be able to feel chest pain
2. Your level of activity intolerance will not change
3. after 6 months you will no longer need to restrict you Na
4. You will be able to stop taking immunosuppressants after 12 months - Answer 1. You
may no longer be able to feel chest pain- transplant PTs no longer feel chest pain due
to denervation of the heart
ER nurse is assessing PT with bradydysrhythmia. Which finding should he expect?
1. Confusion
2. Friction Rub
3. HTN
4. Dry skin - Answer 1. Confusion- as a result of decreased tissue perfusion
You are caring for a PT who had an anterior MI. PTs hx shows she is 1 wk post op open
cholecystectomy the RN knows that which intervention is contraindicated?
1. Administering IV morphine
2. giving O2 at 2L NC
3. Helping client to BSC
4. Assisting in thrombolytic therapy - Answer 4. Assisting in thrombolytic therapy- having
surgery within 3 wks is a contraindication for thrombolytic therapy
You are caring for a PT who has endocarditis. Which finding should you recognize as a
complication?
1. Ventricular depolarization
2. Guillain Barre Syndrome
3. Myelodysplastic syndrome
4. Valvular disease - Answer 4. Valvular disease- damage will occur as a result of
inflammation or infection of the endocardium
,You are caring for PT with BP of 254/139, you recognize the PT is in a hypertensive
crisis. Which action should you take first?
1. Obtain blood samples for testing
2. Tell the PT to report vision changes
3. Place HOB at 45 degrees
4. Initiate IV access - Answer 3. Place HOB at 45 degrees-ABC's this will promote
respiratory status and promote venous return reducing workload on heart
**Initiate IV access- not first action
When performing a cardiac assessment what is the point of maximal impulse?
1. 2nd intercostal space right to the sternum
2. 2nd intercostal space left to the sternum
3. 5th intercostal space to the left of thermal border
4. Left 5th intercostal space in the midclavicular line - Answer 4. Left 5th intercostal
space in the midclavicular line-this is best to hear the apex of the heart which is
considered maximal impulse
You are caring for a PT who is experiencing Afib. You should report what finding to the
provider?
1. Slurred speech
2. Irregular pulse
3. Dependent edema
4. Persistant fatigue - Answer 1. Slurred speech- greatest risk is an embolus and this
can indicate embolus
You are assessing a PT with Left sided heart failure. What manifestation should you
expect to find?
1. Increased abdominal girth
2. Weak peripheral pulses
3. Jugular venous neck distention
4. Dependent edema - Answer 2. Weak peripheral pulses- r/t decreased CO from LSHF
You are caring for a PT who is being treated for HF and has prescriptions for digoxin
and furosemide. You plan to monitor for which of the following as an adverse effect of
these meds?
1. SOB
2. Lightheadedness
3. Dry cough
, 4. Metallic taste - Answer 2. Lightheadedness- can cause a sudden drop in BP=
lightheadedness
You are monitoring a PT following coronary bypass graft surgery (CABG). Which finding
indicates cardiac tamponade?
1. Sternal instability
2. Increased WBC count
3. BP of 140/82 on inspiration and 154/90 on expiration
4. Sinus rhythm with occasional premature atrial contractions and HR 88 - Answer 3. BP
of 140/82 on inspiration and 154/90 on expiration= pulses paradoxus
What is Pulsus Paradoxus? - Answer When the systolic BP is 10 points higher on
expiration than on inspiration
**This is indicative of cardiac tamponade
You are preparing PT for coronary angiography. You should report what finding to the
provider prior to procedure?
1. Hgb 14.4
2. HX: PAD peripheral arterial disease
3. UOP of 200ml in 4 hr
4. Previous allergic reaction to shell fish - Answer 4. Previous allergic reaction to shell
fish- shellfish reaction will often react to iodine
You are caring for a PT following insertion of a permanent pacemaker. Which PT
statement indicates a potential complication of the insertion procedure?
1. I can't get rid of these hiccups
2. I feel dizzy when i stand
3. My incision stings
4. i have a headache - Answer 1. I can't get rid of these hiccups-can indicate the
pacemaker is stimulating the chest wall or diaphragm indicating wire lead perforation
You are providing discharge teaching to a PT who has a prescription for the transdermal
nitroglycerin patch. Which instruction would you include?
1. Apply new patch to the same site as the previous patch.
2. Place the new patch on an area skin away from skin folds and joints
3. Keep the patch on 24 hr per day
4. Replace the patch at the onset of angina - Answer 2. Place the new patch on an area
skin away from skin folds and joints- should apply to skin that is prone not to move or
wrinkle
