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NUR242 / NUR 242 Exam 2
Medical-Surgical Nursing Concepts
100% Guarantee passing score of 90% or higher
Consist of 50 Questions with Answers
- The client asks the nurse to explain the difference between arteriosclerosis and atherosclerosis. Which is the best explanation provided by the nurse?
Answer> A. Arteriosclerosis is a condition that produces structural changes in the
arteries, and atherosclerosis is a specific type of arteriosclerosis."
- When assessing a client who reports recent chest pain, the nurse obtains a thorough history. Which client statement most strongly suggests angina pectoris?
A. The pain lasted about 45 minutes." B. The pain resolved after I ate a sandwich." C. The pain got worse when I took a deep breath." D. The pain occurred while I was mowing the lawn."
Answer> D. The pain occurred while I was moving the lawn.
- Which is the analgesic of choice for acute myocardial infarction (MI)? A. Morphine B. Aspirin C. Meperidine D. Ibuprofen
Answer> A. Morphine
- In the treatment of coronary artery disease (CAD), medications are often ordered to control blood pressure in the client. Which of the following is a pri- mary purpose of using beta-adrenergic blockers in the nursing management of CAD?
A. To dilate coronary arteries B. To decrease workload of the heart C. To decrease homocysteine levels D. To prevent angiotensin II conversion
Answer> B. To decrease workload of the heart
- As part of health education for a patient with an abnormal fasting lipid profile, the nurse explains that an excess of this lipid leads to the formation of plaque in the arteries. Identify the lipid.
a) Triglycerides b) High-density lipoproteins (HDL) c) Low-density lipoproteins (LDL) d) Total cholesterol
D. Felodipine (Plendil
Answer> A. Clopidogrel (Plavix)
- A patient with coronary artery disease (CAD) is having a cardiac catheteriza- tion. What indicator is present for the patient to have a coronary artery bypass graft (CABG)?
A.The patient has had angina longer than 3 years. B.The patient has an ejection fraction of 65%. C.The patient has at least a 70% occlusion of a major coronary artery. D.The patient has compromised left ventricular function.
Answer> C.The patient has at least a 70% occlusion of a major coronary artery.
- The nurse is administering a calcium channel blocker to a patient who has symptomatic sinus tachycardia at a rate of 132 bpm. What is the anticipated action of the drug for this patient?
a) Decreases the sinoatrial node automaticity
b) Increases the atrioventricular node conduction
c) Increases the heart rate
d) Creates a positive inotropic effect
Answer> a) Decreases the sinoatrial node automaticity
- A nurse is reevaluating a client receiving IV fibrinolytic therapy. Which finding requires immediate intervention by the nurse? a. Minimal oozing of blood from the IV site b. Altered level of consciousness c. Presence of reperfusion dysrhythmias d. Chest pain 2 of 10 (on a 1- c. Presence of reperfusion dysrhythmias
Answer> b. Altered level of consciousness
- In order to be effective, percutaneous transluminal coronary angioplasty (PTCA) must be performed within what time frame, beginning with arrival at the emergency department after diagnosis of myocardial infarction (MI)?
a) 6 to 12 months b) 60 minutes c) 30 minutes d) 9 days
Answer> b) 60 minutes
- Which of the following would be inconsistent as criterion of extubating in the patient who has undergone a coronary artery bypass graft (CABG)?
A.high LDL level. B.low LDL level. C.normal LDL level. D.fasting LDL level
Answer> A.high LDL level
- A nurse who works in a busy emergency department provides care for numerous patients who present with complaints of chest pain. Which of the following questions is most likely to help the nurse differentiate between chest pain that is attributable to angina and chest pain due to myocardial infarction (MI)?
A. Have you ever been diagnosed with high blood pressure or diabetes?" B. Does your chest pain make it difficult to move around like you normally would?" C. When was the first time that you recall having chest pain?" D. Does resting and remaining still help your chest pain to decrease?"
Answer> D. Does resting and remaining still help your chest pain to
decrease?"
- A physician treating a client in the cardiac care unit for atrial arrhythmia orders metoprolol (Lopressor), 25 mg P.O. two times per day. Metoprolol inhibits the action of sympathomimetics at beta1-receptor sites. Where are these sites mainly located? A Heart
B Blood vessels C Bronchi D terus
Answer> A Heart
- A nurse is caring for a client in the cardiovascular intensive care unit following a coronary artery bypass graft. Which clinical finding requires im- mediate intervention by the nurse?
A. Central venous pressure reading of 1 B. Pain score 5/ C. Blood pressure 110/68 mm Hg D. Heart rate 66 bpm
Answer> A. Central venous pressure reading of 1
- A client with CAD thinks diltiazem (Cardizem) has been causing nausea. Diltiazem (Cardizem) is categorized as which type of drug?
a) nitrate b) calcium-channel blocker
1.025), the nurse suspects which condition?
a) Anuria b) Over-hydration c) Inadequate fluid volume d) Normal glomerular filtration
Answer> c) Inadequate fluid volume
- The nurse preceptor is evaluating the nurse who is preparing to administer digoxin intravenously (IV) to a client. Which intervention by the nurse would require the preceptor to stop the nurse?
Answer> Piggybacking the digoxin in an existing
infusion
- A nurse is caring for a client after cardiac surgery. Upon assessment, the client appears restless and reports nausea and weakness. The client's ECG reveals peaked T waves. The nurse reviews the client's serum electrolytes, anticipating which abnormality?
a) Hypercalcemia b) Hypomagnesemia c) Hyperkalemia d) Hyponatremia c) Hyperkalemia
Answer> c) Hyperkalemia
- Patients who are taking beta-adrenergic blocking agents should be cau- tioned not to stop taking their medications abruptly because which of the following may occur?
A. Formation of blood clots B. Worsening angina C. Internal bleeding D. Thrombocytopenia
Answer> B. Worsening angina
- A client with known coronary artery disease reports intermittent chest pain, usually on exertion.The physician diagnoses angina pectoris and orders sublingual nitroglycerin to treat acute angina episodes. When teaching the client about nitroglycerin administration, which instruction should the nurse provide?
A. "You may take a sublingual nitroglycerin tablet every 30 minutes, if needed. You may take as many as four doses." B. "Be sure to take safety precautions because nitroglycerin may cause dizziness when you stand up." C. "A burning sensation after administration indicates that the nitroglycerin tablets are potent." D. "Replace leftover sublingual nitroglycerin tablets every 9 months to make sure your pills are fresh."
Answer> B. "Be sure to take safety precautions because nitro- glycerin may cause
dizziness when you stand up."
B. anticonvulsant. C. antihypertensive. D. anticoagulant.
Answer> D. anticoagulant.
- The analgesic of choice for a hospitalized patient with an MI is morphine sulfate. An important nursing responsibility, prior to administering morphine, is to do which of the following?
A. Measure urinary output for dehydration. B. Count the respiratory rate for bradypnea. C. Check the radial pulse for arrhythmias. D. Measure the blood pressure for hypertension
Answer> B. Count the respiratory rate for bradypnea.
- Which nursing interventions are important when caring for clients receiv- ing intravenous (IV) digoxin? Select all that apply. One, some, or all responses may be correct.
Answer> Monitor the heart rate closely
Check the blood levels of digoxin Monitor the serum potassium level.
- A patient is given a prescription for Lopressor, a beta-blocker, after being examined by his health care provider. Select the most important information the nurse should provide.
A. If dizziness occurs, adjust the medication. B. Don't suddenly stop taking the medication without calling your health care provider. C. Dress warmly. Blood circulation may be reduced in the extremities. D. Take the medication at the same time each day.
Answer> B. Don't suddenly stop taking the medication without calling your health
care provider.
- The nurse is part of a triage team that is assessing a patient to determine if his chest pain is a manifestation of angina pectoris or an MI. The nurse knows that a primary distinction is that the pain of angina is
A. Relieved by rest and nitroglycerin B. Accompanied by diaphoresis and dyspnea C. Described as crushing and substernal D. Associated with nausea and vomiting
Answer> A. Relieved by rest and nitroglycerin
- A patient in the recovery room after cardiac surgery begins to have ex- tremity paresthesia, peaked T waves, and mental confusion. What type of electrolyte imbalance does the nurse suspect this patient is having?
A. Magnesium B. Sodium C. Calcium D. Potassium
Answer> D. Potassium
B. the client's pupils to become dilated. C. a decrease in the client's gastric secretions. D. a drop in the client's heart rate.
Answer> D. a drop in the client's heart rate.
- A client is receiving nitroglycerin ointment (Nitro-Dur) to treat angina pectoris. The nurse evaluates the therapeutic effectiveness of this drug by assessing the client's response and checking for adverse effects. Which vital sign is most likely to reflect an adverse effect of nitroglycerin?
A. Blood pressure 84/52 mm Hg B. Pulse rate of 84 beats/minute C. Respiration 26 breaths/minute D. Temperature of 100.2° F (37.9° C)
Answer> A. Blood pressure 84/52 mm Hg
- A nurse is teaching a client how to take nitroglycerin to treat angina pectoris.The client verbalizes an understanding of the need to take up to three
sublingual nitroglycerin (Nitrostat) tablets at 5-minute intervals, if necessary, and to notify the physician immediately if chest pain doesn't subside within 15 minutes. The nurse tells the client that, after taking the nitroglycerin, he may experience
A. nausea, vomiting, depression, fatigue, and impotence. B. flushing, dizziness, headache, and pedal edema. C. headache, hypotension, dizziness, and flushing. D. sedation, nausea, vomiting, constipation, and respiratory depression.
Answer> C. headache, hypotension, dizziness, and flushing.
- A nurse is caring for a client who is exhibiting signs and symptoms char- acteristic of a myocardial infarction (MI). Which statement describes priorities the nurse should establish while performing the physical assessment?
A. Ensure that the client's family is kept informed of his status. B. Prepare the client for pulmonary artery catheterization. C. Assess the client's level of anxiety and provide emotional support. D. Assess the client's level of pain and administer prescribed analgesics.
Answer> D. Assess the client's level of pain and administer prescribed analgesics.
- The nurse is caring for a client with coronary artery disease (CAD). What is an appropriate nursing action when evaluating a client with CAD?
A. Assess the client's mental and emotional status. B. Assess the skin of the client. C. Assess the characteristics of chest pain.
- A client with a family history of coronary artery disease reports experienc- ing chest pain and palpitations during and after morning jogs. What would reduce the client's cardiac risk?
A. smoking cessation B. a protein-rich diet C. exercise avoidance D. antioxidant supplements
Answer> A. smoking cessation
- Which is a diagnostic marker for inflammation of vascular endothelium?
A. C-reactive protein (CRP) B. Low-density lipoprotein (LDL) C. High-density lipoprotein (HDL) D. Triglyceride
Answer> A. C-reactive protein (CRP)
- Which condition most commonly results in coronary artery disease (CAD)?
A. Atherosclerosis B. Diabetes mellitus C. Myocardial infarction D. Renal failure
Answer> A. Atherosclerosis
- Digoxin is prescribed for a client with heart failure. The nurse will assess for which signs and symptoms that indicate digoxin toxicity? Select all that apply. One, some, or all responses may be correct.
Answer> Nausea
Yellow vision Irregular pulse
- A client is to receive 0.25 mg of digoxin intramuscularly. The ampule is labeled 0.5 mg = 2 mL. How many milliliters will the nurse administer? mL
Answer> 1 ml
- A client who takes furosemide and digoxin reports to the nurse that every- thing looks yellow. Which response by the nurse is most appropriate?
Answer> I will hold the medication until I consult with your health care provider."
- A preterm infant is started on digoxin and furosemide for persistent patent ductus arteriosus. Which nursing assessment provides the best indication of the effectiveness of the furosemide?
Answer> Urine output exceeds fluid intake
- Which topics would be included when teaching a client with heart failure who will be discharged with a new prescription for digoxin? Select all that
