Medsurg Exam 2 100% Correctly Verified Updated Questions with Answers, Exams of Nursing

Download Medsurg Exam 2 100% Correctly Verified Updated Questions with Answers and more Exams Nursing in PDF only on Docsity! 1 / 19 Medsurg Exam 2 100% Correctly Verified Updated Questions with Answers 1. A triage nurse in the emergency department assesses It may have devel- an adult patient who presents with reports of midster- nal chest pain that has lasted for the last 5 hours. If the patients symptoms are due to an MI, what will have happened to the myocardium? 2. Family members bring Dan Smith to the emergency department with pale cool skin, sudden midsternal oped an increased area of infarction during the time without treatment. The symptoms in- dicate an acute chest pain unrelieved with rest, and a history of CAD. coronary episode How should the nurse best interpret these initial data? 3. An operating nurse is preparing to assist with a coro- nary artery bypass graft (CABG). The nurse knows that what vessel is most commonly used as a source for a CABG? 4. Billy James had an occluded artery and has been ad- mitted for an emergency percutaneous transluminal coronary angioplasty (PTCA). He is admitted to the cardiac critical care unit after the PTCA. The compli- cations from which the nurse should monitor him for include which of the following? 5. Eric Johnson has type 2 diabetes and hypertension (HTN) and is having a routine follow up appointment after a cardiac stent placement. The nurse notes the client weighs 113.4kg with a waist circumference of 40 inches, BP 162/84 mm Hg, and fasting blood glu- cose is 220mg/dL. Based on these findings, which syndrome should the nurse best suspect? and should be treated as such. Greater Saphe- nous vein Bleeding at the in- sertion site Metabolic syn- drome 2 / 19 Medsurg Exam 2 100% Correctly Verified Updated Questions with Answers 6. The nurse has just admitted Jesse James for a cardiac Explore the facts surgery. He is tearfully describing the feeling of being afraid of dying while undergoing the surgery. What is the nurse's best response? 7. George Jones presents to the ED reporting severe substernal chest pain radiating down the left arm. He underlying the pa- tient's anxiety. Begin EKG moni- toring 5 / 19 Medsurg Exam 2 100% Correctly Verified Updated Questions with Answers 13. In preparation for cardiac surgery, Blanc Steven- son was taught about measures to prevent venous I will make sure I don't cross my thromboembolism. What statement indicates that Ms. legs when I am Stevenson clearly understands this education? 14. The emergency department nurse is caring for a pa- tient with a suspected MI. What drug should the nurse anticipate administering to this patient? 15. When assessing a patient, what signs and symptoms are suggestive of acute coronary syndrome? SATA 16. A care conference is taking place for a patient with acute coronary syndrome (ACS). What goal should guide the care team's selection of assessments, inter- ventions and treatments? 17. The nurse working on a coronary care unit is caring for Jack Black who has been diagnosed with acute coronary syndrome (ACS). How can the nurse best meet his psychosocial needs? 18. An emergency nurse is assessing a 63 year old fe- male patient for a suspected myocardial infarction (MI). When planning assessment, the nurse should be aware of what signs and symptoms of a myocardial infarction that are particularly common in female pa- tients? SATA 19. While the preferred method used for an acute ST elevated myocardial infarction is a percutaneous transluminal coronary angioplasty, thrombolytics can be used. The medications Alteplase, reteplase and tenecteplase work best when given within 30 minutes of the onset of symptoms. What are the contraindica- tions of these therapies? SATA resting in bed. Aspirin Dyspnea Unusual fatigue Syncope Chest pain Balancing myocar- dial oxygen supply with demand. Directly address the client's anxi- eties and fears. Indigestion Nausea Active bleeding History of intracra- nial vessel malfor- 6 / 19 Medsurg Exam 2 100% Correctly Verified Updated Questions with Answers mation Pregnancy History of hemor- rhagic stroke 20. 7 / 19 Medsurg Exam 2 100% Correctly Verified Updated Questions with Answers Ben Wilson reports pain in the left lower leg and foot when walking. This pain is relieved with rest and the nurse observes that the left lower leg is slightly ede- matous and hairless. The nurse should suspect which health problem? 21. A nurse is closely monitoring a patient who has recently been diagnosed with an abdominal aortic aneurysm. What assessment finding would signal an impending rupture of the patient's aneurysm? 22. Leonard Bond has a diagnosis of arterial insufficien- cy. Adequate blood flow depends on which of the following physiological variables? SATA 23. A nurse is caring for a patient who has just been diagnosed with peptic ulcer disease. When teaching the patient about the new diagnosis, how should the nurse best describe a peptic ulcer? 24. Betty White who has a diagnostic of peptic ulcer disease requests more information about the typical causes of Helicobacter pylori infection. Which of the following responses would be most appropriate for the nurse to give Ms. White? 25. A patient who experienced a large upper GI bleed due to gastritis has had the bleeding controlled and is now stable. For the next several hours, the nurse caring for this patient should assess for what signs and symptoms? 26. Diagnostic imaging and physical assessment have revealed that a patient with peptic. ulcer disease has suffered a perforated ulcer. The nurse recognizes that 10 / 19 Medsurg Exam 2 100% Correctly Verified Updated Questions with Answers patient who is experiencing ventricular tachycardia (VT). Because the patient is pulse less, the nurse should prepare for what inter- vention? lation and ventric- ular tachycardia Defibrillation 11 / 19 Medsurg Exam 2 100% Correctly Verified Updated Questions with Answers 34. A patient converts from a normal sinus rhythm at 80 bpm to atrial fibrilation with a ventricular response at 166 bpm. Blood pressure is 162/74 mm Hg. Diltiazem is ordered. The nurse prepared to administer diltiazem for its ability to do which action? 35. Sally Lou is normally in a normal sinus rhythm but converts to atrial fibrilation while on the cardiac unit. Intravenous Heparin Is given .Why does the nurse ad- minister IV heparin to a patient who has just converted from a normal sinus rhythm (NSR) to atrial fibrilation (A-fib) 36. A nurse and the other member of the team caring for a patient who converted to pulse-less ventricular fibrila- tion (V-fib). The patient was defibrillated successfully and remains in VF. The nurse should anticipate the administration of what medication to be given first? 37. The nurse is planning discharge teaching for a Grace Control ventricular heart rate Preventive antico- agulation Epinephrine 1 mg IV push Avoid exposure Kane who has a newly inserted permanent pacemaker. to strong electro- What is the priority teaching point for this patient? 38. Mike Miller is brought to the emergency department it is determined that he is experiencing symptomatic sinus bradycardia. The nurse is aware that the med- ication of choice for treatment of this dysrhythmia is the administration of atropine. What guidelines will the nurse follow when administering atropine? 39. An emergency department nurse is caring for a pa- tient who has gone into cardiac arrest. What action should the nurse perform during external defibrilla- tion? 40. The nurse is caring for a client who has had a dys- rhythmic event.The nurse is aware of the need to assess for signs of diminished cardiac output. What change in 12 / 19 Medsurg Exam 2 100% Correctly Verified Updated Questions with Answers state may signal to the nurse a decrease in cardiac output? magnetic Fields Administer At- ropine 0.5 mg as an IV bolus every 3-5 minutes to a maximum of 3mg Ensure no one is touching the client at the time shock is delivered Changes in level of consciousness 15 / 19 Medsurg Exam 2 100% Correctly Verified Updated Questions with Answers 49. The nurse is admitting a patient with a diagnosis of the left ventricular hypertrophy. The client reports dys- pnea on exertion as well as fatigue. Which diagnostic tool will be the most helpful in diagnosing this type of myopathy? 50. The staff educator is presenting a workshop on valvu- lar disorders and is discussing the pathophysiology of aortic regurgitation. The educator describes what consequence of this disorder? streptococcal in- fections. Echocardiogram Left ventricular hy- pertrophy 51. The nurse notes that a client has developed dyspnea, Pulmonary edema a productive mucoid cough, peripheral cyanosis and noisy moist sounding rapid breathing. The nurse best cares on the belief that these signs and symptoms are indicative of which health problem? 52. The triage nurse in the emergency department is as- sessing a patient with chronic heart failure who has presented with worsening symptoms. The nurse pro- vides care based on knowing which action is the pri- mary cause of heart failure? 53. The nurse is providing care for a patient who is receiv- ing loop diuretics for the treatment of heart failure. What assessment should the nurse prioritize before administering this medication? 54. The nurse is assessing a patient who is known to have right sided heart failure. What assessment is most consistent with this patient's diagnosis? 55. Freddy Krueger presents to the ED reporting in- creased shortness of breath. The nurse assessing him notes a history of left sided heart failure. He is agi- tated and occasionally coughs up pink tinged foamy 16 / 19 Medsurg Exam 2 100% Correctly Verified Updated Questions with Answers Atherosclerosis Blood pressure Distended neck veins Acute Pulmonary edema 17 / 19 sputum. The nurse should recognize the signs and symptoms of what health problems? 56. The nurse is providing discharge instructions to a client diagnosed with heart failure. What should the nurse teach this client on how to check their fluid balance in the home setting? 57. A patient's health history is suggestive of inflamma- tory bowel disease. Which of the following would sug- gest Crohn's disease rather than ulcerative colitis as the cause of the patient's signs and symptoms? 58. The nurse is providing care for a patient whose in- flammatory bowel disease has necessitated hospital treatment. The nurse would most likely include which actions in the care for this patient ? 59. A nurse is planning discharge teaching for a 31 year old patient with a new diagnosis of ulcerative colitis. The nurse plans care based on knowing that the great- est impact on the patient's ability to cope with the diagnosis comes from the family's ability to perform which action? 60. A nurse is caring for a patient who has been admitted for the treatment of advanced cirrhosis. The nurse pro- vides care based on knowing that the priority assess- ment for this patient involves which of the following? 61. A patient with esophageal varices being cared for in the ICU. The varices have began to bleed. The patient has RL at 150 mL/hr infusing. The nurse should antic- ipate performing which action? 62. A nurse is caring for a patient with cirrhosis sec- ondary to heavy alcohol use. The nurse's most recent assessment reveals subtle changes in the patient's cognition and behavior. What is the nurse's most ap- propriate response?