Med Surg

Question 1

A nurse is caring for a client who has heart failure and is experiencing Atrial fibrillation. Which of the following findings should the nurse plan to monitor for an report to the provider immediately?

Answer 1

Slurred speech

greatest risk to a client is injury from an embolus caused by pooling of blood that can occur with a fib

-What is speech can indicate an adequate circulation to the brain because of an embolus

Question 2

A nurse is teaching a client who has a new prescription for an ace inhibitor to treat hypertension. The nurse should instruct the client to notify their provider if they experience which of the following adverse effects of this medication?

Answer 2

persistent cough

A persistent cough is an adverse effect of ace inhibitors 

Question 3

A nurse is caring for a client who is admitted for treatment of left sided heart failure and is receiving IV loop diuretic and digitalis therapy. Client is experiencing Weakness and irregular heart rate which of the following action should the nurse take first?

Answer 3

review serum electrolyte values

Weakness an irregular heart rate indicate that the client is a gait greatest risk for electrolyte imbalance

An adverse effect of loop diuretics

First action the nurse should take us to review the client electrolyte values particularly the potassium level because of the risk for dysrhythmias from hypokalemia.

Question 4

A nurse is preparing a client for a coronary angiography which of the following findings should the nurse report to the provider prior to the procedure?

Answer 4

previous allergic reaction to iodine

the contrast medium used for this procedure is iodine-based

Question 5

nurse in an emergency department is caring for a client who had an anterior myocardial infarction the clients history reveals they are one week Post-OP following an openCholecystectomy the nurse should identify which of the following interventions is contraindicated?

Answer 5

assisting with thrombolytic therapy

Major surgery within three weeks is contraindication for thrombolytic therapy.

Question 6

nurse is providing teaching to a client who is two days Post-OP following a heart transplant which of the following statements should the nurse include in her teaching?

Answer 6

-you may no longer be able to feel chest pain.
due to the deviation of the heart

-Activity tolerance should gradually improve as a healing process progresses
-you will need to permanently maintain a diet that is restricted in sodium and fat
-You will remain on immunosuppressants for the remainder of your life to help prevent rejection of a heart

Question 7

Patient has a PP of 254/139 the nurse recognizes that the client is in hypertensive crisis which of the following action should the nurse take first

Answer 7

elevate to head to bed

The greatest risk to the client is organ injury due to severe hypertension: elevate the head of the bed reduce blood pressure and promote oxygenation

Question 8

A nurse is providing health teaching to a group of clients which of the following client is at risk for developing peripheral artery disease?

Answer 8

A client with diabetes

Question 9

A nurse is caring for a client who has endocarditis which of the following findings should the nurse recognize as a potential complication

Answer 9

valvular disease

Often occurs as a result of inflammation or infection of the endocardium

Question 10

Nurse is caring for a client who had an onset of chest pain 24 hours ago the nurse should identify that an increase in which of the following values is a diagnostic of a myocardial infarction

Answer 10

creatinine kinase-MB

Is specific to the myocardium when elevated indicates myocardial muscle injury such as an MI

Question 11

C- reactive protein

Answer 11

when increased it indicates the beginning of an inflammatory process such as rheumatoid arthritis and is not specific to cardiac muscle

Question 12

Myoglobin

Answer 12

is elevated following and MI, and with skeletal muscle injury

Question 13

Hemocysteine

Answer 13

Always present in the blood, when increased in amount Might indicate a risk factor for the development of cardiovascular disease

Question 14

A nurse is caring for a client who is receiving heparin therapy and develops hematuria which of the following action should the nurse take if the client APTT is 96 seconds

Answer 14

stop the heparin infusion

the client a PTT is above critical value and the client is displaying manifestations of bleeding therefore the nurse should DC to heparin infusion immediately and notify the provider to reduce the risk of client injury

Question 15

A nurse is monitoring a client ECG monitor and notes the clients rhythm has changed from normal sinus to SVT the nurse should prepare to assist with which of the following interventions

Answer 15

vagal stimulation

might temporarily convert the clients heart rate to normal sinus rhythm

the nurse should have a defibrillator and resuscitation equipment at the clients bedside because vagal stimulation can cause Bradi dysrhythmias, ventricular dysrhythmias, or asystole

Question 16

A nurse is caring for a client who is scheduled for coronary artery bypass graft in two hours which of the following statements indicates a need for further Clarification by the nurse

Answer 16

I took my warfarin last night according to my usual schedule

Contour is scheduled for a CABG should not take anticoagulants such as warfarin for several days prior to the surgery to prevent excessive bleeding

Question 17

Nurse is assisting a client who has dilated cardiomyopathy which of the following findings should the nurse expect

Answer 17

dyspnea on exertion

due to ventricular compromise and reduced cardiac output

Question 18

A nurse is caring for a client who has a history of angina and is scheduled for exercise electrocardiography at 1100 which of the following statements by the client requires the nurse to contact the provider for possible rescheduling

Answer 18

 I smoked a cigarette some morning to call my nerves about having this procedure

smoking prior to this test can change the outcome and place the client at additional risk the procedure should be rescheduled if the client has smoke before the test

Question 19

Where should a nurse inspect when evaluating the point of maximal impulse of the heart

Answer 19

The nurse should assess the Apex area of the heart which is considered the apical pulse or point of maximal impulse. It is located at the left fifth intercostal space in the midclavicular line

Question 20

A nurse is admitting a client who has a leg ulcer in the history of diabetes which of the following focused assessment should the nurse use to help differentiate between arterial ulcer and venous ulcer

Answer 20

Inquire about the presence or absence of claudication clients who have arterial ulcers X variance claudication but those who have the newest ulcers do not

Question 21

A nurse is assessing a client who has a history of DVT and is receiving warfarin which of the following findings should indicate to the nurse that the medication is effective

Answer 21

INR within the desired range of 2 to 3 for a client who has DVT and is receiving warfarin therapy

Question 22

A nurse an emergency department is assessing a client who has Bradydysrhythmia which of the following findings should the nurse monitor for

Answer 22

infusion Bradydysrhythmia can cause decreasing somatic perfusion which can lead to confusion

Question 23

A nurse is providing teaching to a client who has heart failure the nurse should instruct the client to report which of the following findings immediately to the provider

Answer 23

Weight gain of 1 to 2 pounds per day

Question 24

A nurse is caring for a client who is eight hours postoperative following a coronary artery bypass graft which of the following findings should the nurse report

Answer 24

elevated blood pressure following a CABG because increased vascular pressure can cause bleeding at the incision sites

Question 25

A nurse is caring for a client who is being treated for heart failure and has a prescription for furosemide the nurse should plan to monitor for which of the following adverse effects of the medication

Answer 25

Lightheadedness Perez and I can cause substantial drop in blood pressure resulting in lightheadedness or dizziness

Question 26

A nurse is providing discharge teaching to a client who has a prescription for transdermal nitroglycerin patches which of the following instruction should the nurse include in the teaching

Answer 26

rotate patch sides to help prevent skin irritation

place the patch on an area of skin away from skin folds and joints

a patch free interval of 10 to 12 hours each day to prevent tolerance to the medication

patches do not treat angina attack because they do not take affect immediately

Question 27

A nurse is assessing a client who has left sided heart failure which of the following manifestations should the nurse expect to find

Answer 27

Weak peripheral pulses

Question 28

A nurse is assessing a client who has pulmonary edema related to R-value which of the following findings indicates effective treatment of the clients condition

Answer 28

Absence of advantageous breath sounds which indicate pulmonary edema when present

Question 29

A nurse is reviewing the laboratory results of several Mel clients who have peripheral artery disease the nurse should plan to provide dietary teaching for which of the following laboratory values

Answer 29

cholesterol 190/HDL 25/LDL 160

Expected reference range for cholesterol is less than 200 for HDL above 45 for males and above 55 for females and LDL is less than 130

Question 30

A nurse is caring for a client following insertion of a permanent pacemaker which of the following client statement indicates a potential complication of the insertion procedure

Answer 30

I can’t get rid of these hiccups

Hiccups can indicate that the pacemaker is stimulating the chest wall or diaphragm which can occur as a result of a lead wire perforation 

Question 31

A nurse is reviewing the ECG rhythm strip of a client who is receiving telemetry which of the following areas of the strip should the nurse examine to observe for atrial depolarization

Answer 31

The P-wave of the rhythm strip is used to evaluate for atrial depolarization

Question 32

 Ventricular depolarization

Answer 32

You are as complex

Question 33

Ventricular repolarization

Answer 33

T-wave

Question 34

A nurse is planning a presentation for a group of clients who have hypertension which of the following lifestyle modification should the nurse include

Answer 34

Limited alcohol intake, regular exercise program, tobacco cessation 

Question 35

A nurse is caring for a client who has won our postoperative following an aortic aneurysm repair which of the following findings can indicate shock and should be reported to the provider

Answer 35

Your an output of 20 ML/HR