Cardiac Disorders LVN ATI

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Sample questions from Cardiac Disorders LVN ATI

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.At change of shift in a cardiac step-down unit, which client should the practical nurse report to the RN first?

   • A.A client with stable angina who requests the prescribed nitroglycerin before walking
   • B.A client 1 day after cardiac catheterization whose groin dressing has a 1-cm area of dried blood
   • C.A client receiving digoxin who reports nausea and has a new apical pulse of 54/min
   • D.A client with chronic heart failure who gained 0.5 kg (1.1 lb) overnight and has mild ankle edema

   Rationale: New nausea with a pulse of 54/min in a client receiving digoxin may indicate toxicity and warrants prompt reporting before the next dose. The small weight increase and ankle edema need follow-up but are less urgent than possible medication-related bradycardia. A small amount of dried blood can be monitored if it is not expanding, and the client with stable angina can receive prescribed nitroglycerin according to the established plan.

2. 2.During a home visit, a client with heart failure says, "I feel fine, so I stopped weighing myself." Which response by the practical nurse best supports the established plan of care?

   • A."Restart your diuretic whenever your weight is higher than usual."
   • B."Weigh yourself each morning after urinating, and report the gain specified in your plan."
   • C."Check your weight once a week, because daily changes are usually fluid shifts."
   • D."Limit fluids further whenever your ankles look swollen."

   Rationale: Daily weights taken under consistent conditions help identify fluid retention early, and the client should follow the reporting threshold in the established plan. Weekly weights can miss clinically important changes. Independently changing a diuretic dose or fluid restriction is not appropriate; those changes require direction from the RN or provider.

3. 3.A client's potassium is 6.1 mEq/L (reference range 3.5 to 5.0 mEq/L), and the client takes lisinopril for heart failure. Which actions should the practical nurse take? Select all that apply.

   • A.Offer a potassium-rich snack to prevent weakness.
   • B.Review the medication administration record for potassium supplements or salt substitutes documented in the plan.
   • C.Report the potassium result promptly to the RN or provider.
   • D.Assess for palpitations, weakness, or new muscle tingling and report findings.
   • E.Give the next lisinopril dose as scheduled because it is prescribed for heart failure.

   Rationale: A potassium of 6.1 mEq/L is critically elevated and should be promptly reported; assessment for symptoms such as palpitations or weakness provides important data for the RN. Reviewing the medication record for potassium sources can help identify relevant contributors without independently changing therapy. Giving lisinopril without clarifying the plan or offering a potassium-rich snack could worsen hyperkalemia.

4. 4.In a long-term care facility, an older adult with atrial fibrillation takes warfarin. Which finding should the practical nurse report to the RN immediately?

   • A.A new severe headache and difficulty finding words
   • B.A small bruise at a venipuncture site from yesterday
   • C.An INR of 2.4 with no visible bleeding
   • D.A request to replace a leafy vegetable at lunch

   Answer and rationale are in the full material.

5. 5.The provider prescribes digoxin for a 12-year-old with a congenital heart disorder. Before administering the scheduled dose, which finding should prompt the practical nurse to hold the dose and contact the RN?

   • A.The child ate half of the breakfast tray.
   • B.The child's blood pressure is 104/66 mm Hg, consistent with the documented baseline.
   • C.The child reports a mild headache after school.
   • D.The apical pulse is 58/min, below the hold parameter in the medication instructions.

   Answer and rationale are in the full material.