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Med-Surg 2 Exam 1 Practice Questions
Latest 2025 Update!!! Graded A+
A patient who has received a maximum dose of nitroglycerin continues to report chest pain. What is the next medication that the nurse should administer to the patient? A. Ticagrelor B. Morphine sulfate C. Docusate D. Esmolol - B. Morphine Sulfate When planning emergent care for a patient with a suspected myocardial infarction (MI), what should the nurse anticipate administrating? A. Oxygen, nitroglycerin, aspirin, morphine B. Nitroglycerin, lorazepam, oxygen, warfarin C. Aspirin, nitroprusside, dopamine, oxygen D. Oxygen, furosemide, nitroglycerin, meperidine - A. Oxygen, nitroglycerin, aspirin, morphine A patient is classified as having stage 2 hypertension on the basis of the blood pressure recorded. The nurse notes that the primary goal of therapy for the patient is to normalize the blood pressure. What should be the patient's target blood pressure? A. 130/ B. less than 120/ C. 140/ D. 150/90 - B. less than 120/ The nurse assesses a patient with papillary muscle dysfunction. Which observation supports the patient's diagnosis?
A. Crackles B. S3 heart sound C. Murmur at the cardiac apex D. Deep sound noted when auscultating at the lower sternal border - C. Murmur at the cardiac apex Which is a characteristic of a complicated lesion? A. Platelet aggregation and adhesion B. Lipid-filled smooth muscle cells C. Fibrous plaque formation D. Transport of lipids into arterial intima - A. Platelet aggregation and adhesion Which statement by an 84-year-old patient with coronary artery disease (CAD) indicates understanding of discharge teaching about physical activity? A. I can stop exercising as soon as my cardiac symptoms disappear B. I have to exercise for longer periods of time and more vigorously compared with younger people C. I should exercise outside all the time to achieve better results D. I will use longer rest periods between exercise sessions - D. I will use longer rest periods between exercise sessions The nurse is providing teaching to a patient recovering from a myocardial infarction (MI). How should resumption of sexual activity be discussed? A. Delegated to the HCP B. Discussed along with other physical activities C. Avoided because it is embarrassing to the patient D. Accomplished by providing the patient with written material - B. Discussed along with other physical activities
D. Encourage the patient to do isometric exercises - C. Position the patient upright and administer oxygen A patient with chronic stable angina has received a prescription for sublingual (SL) nitroglycerin. The nurse tells the patient that orthostatic hypotension is a side effect of the drug. What should the nurse include in the patient's teaching about preventing complications associated with the side effect? A. Take your BP daily and record the measurement B. Take the medication with each meal while you are seated C. Avoid sudden changes in position after taking nitroglycerin to prevent falls D. If the medication causes a tingling sensation, this indicates that hypotension will be more severe - C. Avoid sudden changes in position after taking nitroglycerin to prevent falls The nurse provides medication teaching to a patient who has been prescribed sublingual nitroglycerin tablets. Which statement made by the patient indicates the need for further education? A. When I put the tablet under my tongue, I should feel a tingling sensation B. I can take as many tablets as needed until the pain goes away, each five minutes apart C. I will need to be careful when I stand up because nitroglycerin can cause dizziness D. If chest pain occurs, I will stop what I'm doing and put a tablet under my tongue - B. I can take as many tablets as needed until the pain goes away, each five minutes apart A patient that is being discharged from the hospital after acute coronary syndrome will be participating in cardiac rehabilitation. What information should the nurse provide about the early recovery phase of rehabilitation? A. Therapeutic lifestyle changes should become lifelong habits B. Physical activity always begins in the hospital and continued at home C. Activity is increased gradually with supervision by the rehab team and with ECG monitoring D. The focus of rehab will be on management of chest pain, anxiety, dysrhythmias, and other complications - C. Activity is increased gradually with supervision by the rehab team and with ECG monitoring
Which type of angina increases in frequency, duration, and severity as the time progresses? A. Unstable B. Prinzmetal's C. Chronic stable D. Microvascular - A. Unstable angina The nurse provides discharge teaching to a patient who is newly diagnosed with coronary artery disease (CAD). Which statement made by the patient indicates understanding of the dietary modifications that need to be implemented after discharge home? A. I will not eat any bacon or pork products B. I will only eat fried eggs instead of boiled eggs C. I may continue to enjoy french fries with hot dogs D. I will drink no more than one glass of whole milk per day - A. I will not eat any bacon or pork products After teaching a patient with chronic stable angina about nitroglycerin, the nurse recognizes the need for further teaching when the patient makes which statement? A. I will replace my nitroglycerin supply every six months B. I can take up to five tablets every three minutes for relief of my chest pain C. I will take Tylenol to treat the headache caused my nitroglycerin D. I will take the nitroglycerin 10 minutes before a planned activity that usually causes chest pain - B. I can take up to five tablets every three minutes for relief of my chest pain The nurse is reviewing a plan of care for emergency treatment of a patient with chest pain. The nurse should question which item listed on the plan? A. Give a high-dose statin B. Give 162-325 mg aspirin chewable
The nurse provides information to a patient about preventing coronary artery disease (CAD) by maintaining healthy serum low-density lipoproteins (LDL) and high-density lipoprotein (HDL) levels. The nurse should include what goals? A. Decreased LDLs; decreased HDLs B. Decreased LDLs; increased HDLs C. Increased LDLs; decreased HDLs D. Increased LDLs; increased HDLs - B. Decreased LDLs; increased HDLs Which statement made by the student nurse indicates effective learning regarding the instructions to be given to a patient that receives a prescription for nitroglycerin? A. I should direct to inhale the spray containing medication B. I should ask the patient to change positions rapidly after medication use C. I should instruct the patient to report changes in the pattern of their pain to the HCP D. I should encourage the patient to administer the medication every 30 min sublingually if symptoms persist - C. I should instruct the patient to report changes in the pattern of their pain to the HCP The nurse teaches a student nurse about diagnostic studies used for acute coronary syndrome. Which statement made by the student nurse indicates effective learning? A. A nitroprusside stress echocardiogram is used for patients with acute pericarditis B. A pathogenic Q wave is always present in the ECG of patients with unstable angina C. Serum cardiac markers are proteins released from necrotic heart muscle D. Coronary angiography is the only way to confirm the diagnosis of unstable angina - C. Serum cardiac markers are proteins released from necrotic heart muscle Which symptoms should the nurse recognize as unstable angina in a perimenopausal client? A. Dyspnea, hyperglycemia, polyuria B. Fatigue, indigestion, SOB C. Peripheral edema with decreased urinary output
D. Altered mentation with difficulty breathing - B. Fatigue, indigestion, SOB A patient in teh coronary care unit develops Vfib. The first action the nurse should take is to A. Perform defibrillation B. Initiate CPR C. Prepare for synchronized cardioversion D. Administer IV antidysrhythmic drugs per protocol - B. Initiate CPR A patient has a diagnosis of acute MI, and his cardiac rhythm is sinus bradycardia with 6-8 PVCs per minute. The pattern that the nurse recognizes as the most characteristic of PVCs is A. An irregular rhythm B. An inverted T wave C. A wide, distorted QRS complex D. An increasingly long PR interval - C. A wide, distorted QRS complex A patient's cardiac rhythm is sinus bradycardia with a HR of 34 bpm. If the bradycardia is symptomatic, the nurse would expect the patient to exhibit A. Palpitations B. HTN C. Warm, flushed skin D. SOB - D. SOB A patient is admitted to the coronary care unit following a cardiac arrest and successful CPR. When reviewing the HCP's admission orders, which order should the nurse question? A. Oxygen at 4 L/min via NC B. Morphine sulfate 2 mg IV every 10 min until pain is relieved C. t-PA 100 mg IV infused over 3 hr
B. I should avoid standing near antitheft devices C. I should avoid direct blows to the pacemaker site D. I should avoid close proximity to high-output electric generators - A. I should avoid using microwave ovens A patient has sought care following a syncopal episode of unknown etiology. The nurse anticipates that what will be included in the patient's treatment plan? A. IV beta blocker B. Head-up tilt-test C. Pacemaker insertion D. Antiplatelet therapy - B. Head-up tilt-test The nurse assesses a patient and notes a temperature of 101.6° F. Which type of dysrhythmia is associated with a fever? A. Fibrillation B. Sinus tachycardia C. Sinus bradycardia D. Junctional tachycardia - B. Sinus tachycardia Which ECG characteristic is consistent with a diagnosis of ventricular tachycardia (VT)? A. Unmeasurable rate and rhythm B. Rate 150 bpm; inverted P wave C. Rate 200 bpm; P wave not visible D. Rate 125 bpm; normal QRS complex - C. Rate 200 bpm; P wave not visible A patient develops symptomatic sinus tachycardia. The nurse recognizes that which drug will likely be included in the patient's treatment plan?
A. Atropine B. Dopamine C. Adenosine D. Epinephrine - C. Adenosine What does the T wave in an electrocardiogram (ECG) represent? A. Time for ventricular repolarization B. Time for depolarization of both ventricles C. Time for the passage of electrical impulse through the atrium D. Time between ventricular depolarization and repolarization - A. Time for ventricular repolarization Which statement is true regarding the role of the autonomic nervous system in impulse formation? A. Stimulation of the parasympathetic nerves increases cardiac contractility B. Stimulation of the vagus nerve causes a decreased rate of firing of the SA node C. Stimulation of the sympathetic nerves decreases AV node impulse conduction D. Stimulation of the vagus nerve causes increased impulse conduction of the AV node - B. Stimulation of the vagus nerve causes a decreased rate of firing of the SA node A patient's electrocardiogram (ECG) shows a heart rate of 150 beats/minute and a normal P wave preceding each QRS complex. How should the nurse interpret the finding? A. A fib B. Sinus tachycardia C. V fib D. PAC - B. Sinus tachycardia Defibrillation is indicated for which dysrhythmia?
The nurse is monitoring a patient on a wireless electrocardiogram (ECG) monitor. Which observation is a cause for concern? A. Upright P wave B. Flat ST segment C. Prolonged QT interval D. Upright T wave - C. Prolonged QT interval The nurse recognizes that which cardiac dysrhythmia is life-threatening and necessitates immediate intervention? A. Sinus tachycardia B. A fib C. Junctional tachycardia D. V fib - D. V fib The nurse analyzes a patient's electrocardiogram (ECG) and determines that there are 8 R-R intervals in a span of six seconds. What should the nurse document as the patient's heart rate? Record the answer using a whole number. _______ bpm - 80 bpm The ECG monitor of a patient in the cardiac care unit after myocardial infarction (MI) indicates ventricular fibrillation. What should be the nurse's immediate action? A. Perform CPR B. Administer IV amiodarone C. Perform synchronized cardioversion D. Prepare for insertion of temporary transvenous pacemaker - A. Perform CPR
Which property of the cardiac cell aids in responding mechanically to an impulse? A. Excitability B. Contractility C. Conductivity D. Automaticity - B. Contractility A patient's electrocardiogram (ECG) has changed from a normal sinus rhythm to the following rhythm. The nurse assesses the patient who was sleeping. The patient's respirations are 16 and unlabored, and the blood pressure has dropped from 110/70 to 104/68. What action should the nurse take? A. Continue monitoring the patient B. Notify HCP C. Check medical record for hyperkalemia D. Perform an in-depth assessment ____^/_^____________^/_^______________^/_^_________________^/_^_______________ - A. Continue monitoring the patient The rhythm was sinus bradycardia which is sometimes normal when sleeping A patient reports a new onset of jaw pain. The nurse obtains the following electrocardiogram (ECG) tracing (looks like a weird fireman's hat). What action should the nurse take? A. Administer hydrocodone B. Contact the HCP C. Place patient in Trendelenburg position D. Recognize ECG changes as indicative of digitalis toxicity - B. Contact the HCP A patient develops atrial flutter with a rapid ventricular response. The nurse anticipates that what treatment will be prescribed? A. Defibrillation
C. Atrial flutter D. A fib - C. Atrial flutter Which type of arrhythmia is associated with the absence of P waves on an electrocardiogram (ECG)? A. Sinus tachycardia B. Sinus bradycardia C. V fib D. Type II 2nd degree AV block - C. V fib What is a disadvantage of a centralized monitoring system? A. It can't diagnose dysrhythmias B. It measures the patient's HR remotely C. It can't rapidly detect myocardial ischemia D. It requires continuous observation of the patient's ECGs - D. It requires continuous observation of the patient's ECGs The nurse is caring for a patient with aortic stenosis. What should the nurse assess the patient for? A. Systolic murmur B. Pericardial friction rub C. Diminished or absent S D. Low-pitched diastolic murmur - A. Systolic murmur A 19 yo patient with rheumatic heart disease is admitted to the hospital with a recurrence of rheumatic fever. In planning care for the patient, which nursing diagnosis should the nurse include? A. Ineffective coping r/t refusal to carry out health promotion activities B. Risk for infection r/t recent exposure to group A beta-hemolytic streptococci
C. Impaired adjustment r/t unsuccessful lifestyle modifications, goal setting, and problem solving D. Ineffective health management r/t lack of knowledge about long-term prophylactic antibiotic therapy
- D. Ineffective health management r/t lack of knowledge about long-term prophylactic antibiotic therapy A patient has been in the hospital for 1 wk and is being discharged with a diagnosis of sub-acute infective endocarditis (IE), afebrile, and no signs of heart damage. The patient will go home on antibiotics. What is most important for the nurse to consider in discharge planning? A. Plan how his needs will be met while he is on bed rest B. Teach the patient to avoid outdoor activities to relieve restlessness and boredom C. Assess the patient's home environment in terms of family assistance and hospital access D. Encourage use of diversional activities to relieve restlessness and boredom - C. Assess the patient's home environment in terms of family assistance and hospital access A patient is admitted to the hospital with a suspected acute pericarditis. To establish the presence of a pericardial friction rub, the nurse listens to the patient's chest... A. While timing the sound with the respiratory pattern B. With the diaphragm of the stethoscope at the left sternal border of the chest C. With the bell of the stethoscope at the apex of the heart D. With the stethoscope diaphragm to auscultate a high-pitched continuous rumbling sound - B. With the diaphragm of the stethoscope at the left sternal border of the chest A patient with acute pericarditis has a nursing diagnosis of pain r/t pericardial inflammation. An appropriate nursing intervention for the patient is: A. Administer opioids as prescribed around-the-clock B. Promote progressive relaxation exercises using deep slow breathing techniques C. Position the patient on the right side with the HOB elevated 15 degrees D. Position the patient in Fowler's position and pad the over-the-bed table for the patient to lean on - D. Position the patient in Fowler's position and pad the over-the-bed table for the patient to lean on
C. Lungs D. Liver - C. Lungs While performing an admission assessment, the nurse notes Janeway's lesions on a patient's fingertips, palms, soles of feet, and toes. The nurse suspects what diagnosis? A. Acute kidney injury B. MI C. Infective endocarditis D. Chronic thrombophlebitis - C. Infective endocarditis Which category of medication helps reduce afterload in patients with heart failure? A. Morphine B. Antidysrhythmia drugs C. Beta blockers D. ACE inhibitors - D. ACE inhibitors Which statement made by the nurse to a patient with cardiomyopathy regarding home care instructions needs correction? A. Avoid diet pills B. Eat a low-sodium diet C. Increase your caffeine consumption D. Report increased fatigue to your primary HCP - C. Increase your caffeine consumption The nurse finds diastolic murmurs in a patient who says, "I'm finding it hard to breathe, and sometimes I cough up blood." What condition does the nurse suspect? A. Mitral valve stenosis B. Mitral valve prolapse
C. Aortic valve stenosis D. Aortic valve regurgitation - A. Mitral valve stenosis The nurse is caring for a patient with valvular heart disease who experiences atrial dysrhythmias. The nurse anticipates a prescription for which type of medication? A. Nitrate B. Positive inotrope C. Calcium channel blocker D. ACE inhibitor - C. Calcium channel blocker The nurse provides education to a patient with infective endocarditis related to home care management. Which statement made by the patient indicates the need for further teaching? A. I should wear elastic compression stockings B. I should cough and deep breathe every 2 hours C. I should perform ROM exercises daily D. I should be aware that fever and fatigue are normal - D. I should be aware that fever and fatigue are normal The nurse is assessing a patient with a pacemaker during a follow-up visit. The patient has red, painful, tender, pea-sized lesions on the fingertips and toes. How should the nurse document this finding? A. Roth's spots B. Osler's nodes C. Janeway's lesions D. Splinter hemorrhages - B. Osler's nodes The nurse is measuring a patient's pulsus paradoxus. The first Korotkoff sound during expiration is noted at 115 mm Hg, and the reading at which sounds are heard throughout the respiratory cycle is noted at 84 mm Hg. What is the amount of paradoxus? Record the answer using a whole number.
