ATI TARGETED MEDICAL-SURGICAL 2019:
CARDIOVASCULAR 2024 -2025 NEWEST
ACTUAL EXAM VERIFIED QUESTIONS AND
CORRECT ANSWERS WITH RATIONALES TOP
RAKED BY EXPERTS ALREADY RAKED A+.
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. Serosanguinous drainage on dressing
B. Severe pain with coughing
C. Urine output of 20 ml/hr
D. Increase in temp from 36.C (98.2F)- 37.5C (99.5F) - ANSWER- C. Urine output
of 20
ml/hr
Rationale: Urine output less than 30 mL/hr is a manifestation of shock. Urine
output is
decreased due to a compensatory decreased blood flow to the kidneys,
hypovolemia, or
graft thrombosis or rupture.
A nurse is admitting a client who has a leg ulcer and a history of DM. The nurse
should
use which of the following focused assessments to help differentiate between
an arterial
ulcer and a venous stasis ulcer?
A. Explore the clients family history of peripheral vascular disease
,B. Note the presence or absence of pain at the ulcer site
C. Inquire about the presence or absence of claudication
, D. Ask if the client has had a recent infection - ANSWER- C. Inquire about the
presence
or absence of claudication
Rationale: Knowing if the client is experiencing claudication helps differentiate
venous
from arterial ulcers. Clients who have arterial ulcers experience claudication,
but those
who have venous ulcers do not.
A nurse is caring for a client who presents to the ER with a BP of 254/138
mmhg. The
nurse recognizes that the client is in a hypertensive crisis. Which of the
following actions
should the nurse take first?
A. Initiate seizure precautions.
B. Tell the client to report vision changes
C. Elevate the head of the clients bed
D. Start a peripheral IV - ANSWER- C. Elevate the head of the clients bed
Rationale: 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 is reviewing the ECG rhythm strip of a client who is receiving telemetry.
Identify
the area of the strip the nurse should examine to observe for atrial
depolarization. (You
CARDIOVASCULAR 2024 -2025 NEWEST
ACTUAL EXAM VERIFIED QUESTIONS AND
CORRECT ANSWERS WITH RATIONALES TOP
RAKED BY EXPERTS ALREADY RAKED A+.
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. Serosanguinous drainage on dressing
B. Severe pain with coughing
C. Urine output of 20 ml/hr
D. Increase in temp from 36.C (98.2F)- 37.5C (99.5F) - ANSWER- C. Urine output
of 20
ml/hr
Rationale: Urine output less than 30 mL/hr is a manifestation of shock. Urine
output is
decreased due to a compensatory decreased blood flow to the kidneys,
hypovolemia, or
graft thrombosis or rupture.
A nurse is admitting a client who has a leg ulcer and a history of DM. The nurse
should
use which of the following focused assessments to help differentiate between
an arterial
ulcer and a venous stasis ulcer?
A. Explore the clients family history of peripheral vascular disease
,B. Note the presence or absence of pain at the ulcer site
C. Inquire about the presence or absence of claudication
, D. Ask if the client has had a recent infection - ANSWER- C. Inquire about the
presence
or absence of claudication
Rationale: Knowing if the client is experiencing claudication helps differentiate
venous
from arterial ulcers. Clients who have arterial ulcers experience claudication,
but those
who have venous ulcers do not.
A nurse is caring for a client who presents to the ER with a BP of 254/138
mmhg. The
nurse recognizes that the client is in a hypertensive crisis. Which of the
following actions
should the nurse take first?
A. Initiate seizure precautions.
B. Tell the client to report vision changes
C. Elevate the head of the clients bed
D. Start a peripheral IV - ANSWER- C. Elevate the head of the clients bed
Rationale: 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 is reviewing the ECG rhythm strip of a client who is receiving telemetry.
Identify
the area of the strip the nurse should examine to observe for atrial
depolarization. (You
