GALEN NUR 242 EXAM 2- LATEST
MED SURG
A client with heart block who requires implantation of a permanent
pacemaker expresses concern about having an increased risk of
accidental electrocution. How would the nurse respond? - ANSWERS-
"The voltage emitted is not strong enough to electrocute."
Which activity would the nurse teach clients to avoid after having
implantation of a permanent cardiac pacemaker? - ANSWERS-Touring
a power plant
Which object would the nurse teach the client with a newly implanted
pacemaker to avoid? - ANSWERS-Strong magnet (can change setting
and function of the pm)
Microwave is not a concern
remote control devices are not contraindicated
Mobile phones should be used in the ear opposite the pacemaker.
After a client has had a permanent demand pacemaker implanted, which
finding by the nurse would be of most concern? - ANSWERS-Pulse rate
40 beats/minute
END OF
PAGE
1
, GALEN NUR 242 EXAM 2- LATEST
MED SURG
When a client who is admitted for coronary artery bypass graft (CABG)
surgery asks the nurse about the purpose of pacemaker wires inserted
during surgery, which explanation will the nurse give? - ANSWERS-
Prevention of slow heart rate after surgery
When a client has a newly implanted demand pacemaker and the nurse
observes spikes on the cardiac monitor at a regular rate but no QRS
following the spikes, how will the finding be documented? -
ANSWERS-Failure to capture
Which information would be included in the discharge planning for a
client who has had a new permanent pacemaker implanted above the left
clavicle? Select all that apply. One, some, or all responses may be
correct. - ANSWERS-Take your pulse daily and report changes to the
health care provider.
Notify the health care provider about swelling or drainage at the
incision.
Inform airport security about the presence of a pacemaker if you are
traveling.
END OF
PAGE
2
, GALEN NUR 242 EXAM 2- LATEST
MED SURG
Which finding in a client who has just been admitted indicates that the
nurse will anticipate assisting with insertion of a temporary pacemaker?
- ANSWERS-Third degree heart block
Which is the priority nursing intervention immediately after a client has
a ventricular demand pacemaker inserted? - ANSWERS-Monitor the
heart rate and rhythm
The spouse of a client who had coronary artery bypass graft (CABG)
surgery asks why there is a dressing on the client's left leg. Which
explanation would the nurse give? - ANSWERS-A vein in the leg was
used to bypass the coronary artery
When planning discharge teaching for a client who had coronary artery
bypass graft (CABG) surgery using a vein graft, which information will
the nurse include? - ANSWERS-Elevate the leg that provided the vein
graft whenever you are sitting.
Which finding in a client who had coronary artery bypass graft (CABG)
surgery 1 day previously is most important for the nurse to communicate
to the health care provider? - ANSWERS-Temperature of 102°F
(38.9°C)
END OF
PAGE
3
, GALEN NUR 242 EXAM 2- LATEST
MED SURG
Which finding in a client who has just arrived in the cardiac intensive
care unit after having coronary artery bypass grafting (CABG) requires
the most rapid action by the nurse? - ANSWERS-The serum potassium
level is 3.1 mEq/L (3.1 mmol/L).
The nurse is providing postoperative care to a client on the second day
after the client had a coronary artery bypass surgery. When assessing the
water-seal chamber of the chest drainage device, the nurse observes that
the fluid no longer fluctuates. Which action would the nurse take? -
ANSWERS-Assess for obstructions in the chest tube
Which information would the nurse include when teaching a client with
coronary artery disease about aspirin therapy? Select all that apply. One,
some, or all responses may be correct. - ANSWERS-Take aspirin with
food.
Report ringing in the ears.
Monitor and report excessive bleeding and bruising.
Avoid over-the-counter pain medications that contain aspirin.
When caring for an older adult with coronary artery disease, which
modification in the plan of care would the nurse make because of the
END OF
PAGE
4
MED SURG
A client with heart block who requires implantation of a permanent
pacemaker expresses concern about having an increased risk of
accidental electrocution. How would the nurse respond? - ANSWERS-
"The voltage emitted is not strong enough to electrocute."
Which activity would the nurse teach clients to avoid after having
implantation of a permanent cardiac pacemaker? - ANSWERS-Touring
a power plant
Which object would the nurse teach the client with a newly implanted
pacemaker to avoid? - ANSWERS-Strong magnet (can change setting
and function of the pm)
Microwave is not a concern
remote control devices are not contraindicated
Mobile phones should be used in the ear opposite the pacemaker.
After a client has had a permanent demand pacemaker implanted, which
finding by the nurse would be of most concern? - ANSWERS-Pulse rate
40 beats/minute
END OF
PAGE
1
, GALEN NUR 242 EXAM 2- LATEST
MED SURG
When a client who is admitted for coronary artery bypass graft (CABG)
surgery asks the nurse about the purpose of pacemaker wires inserted
during surgery, which explanation will the nurse give? - ANSWERS-
Prevention of slow heart rate after surgery
When a client has a newly implanted demand pacemaker and the nurse
observes spikes on the cardiac monitor at a regular rate but no QRS
following the spikes, how will the finding be documented? -
ANSWERS-Failure to capture
Which information would be included in the discharge planning for a
client who has had a new permanent pacemaker implanted above the left
clavicle? Select all that apply. One, some, or all responses may be
correct. - ANSWERS-Take your pulse daily and report changes to the
health care provider.
Notify the health care provider about swelling or drainage at the
incision.
Inform airport security about the presence of a pacemaker if you are
traveling.
END OF
PAGE
2
, GALEN NUR 242 EXAM 2- LATEST
MED SURG
Which finding in a client who has just been admitted indicates that the
nurse will anticipate assisting with insertion of a temporary pacemaker?
- ANSWERS-Third degree heart block
Which is the priority nursing intervention immediately after a client has
a ventricular demand pacemaker inserted? - ANSWERS-Monitor the
heart rate and rhythm
The spouse of a client who had coronary artery bypass graft (CABG)
surgery asks why there is a dressing on the client's left leg. Which
explanation would the nurse give? - ANSWERS-A vein in the leg was
used to bypass the coronary artery
When planning discharge teaching for a client who had coronary artery
bypass graft (CABG) surgery using a vein graft, which information will
the nurse include? - ANSWERS-Elevate the leg that provided the vein
graft whenever you are sitting.
Which finding in a client who had coronary artery bypass graft (CABG)
surgery 1 day previously is most important for the nurse to communicate
to the health care provider? - ANSWERS-Temperature of 102°F
(38.9°C)
END OF
PAGE
3
, GALEN NUR 242 EXAM 2- LATEST
MED SURG
Which finding in a client who has just arrived in the cardiac intensive
care unit after having coronary artery bypass grafting (CABG) requires
the most rapid action by the nurse? - ANSWERS-The serum potassium
level is 3.1 mEq/L (3.1 mmol/L).
The nurse is providing postoperative care to a client on the second day
after the client had a coronary artery bypass surgery. When assessing the
water-seal chamber of the chest drainage device, the nurse observes that
the fluid no longer fluctuates. Which action would the nurse take? -
ANSWERS-Assess for obstructions in the chest tube
Which information would the nurse include when teaching a client with
coronary artery disease about aspirin therapy? Select all that apply. One,
some, or all responses may be correct. - ANSWERS-Take aspirin with
food.
Report ringing in the ears.
Monitor and report excessive bleeding and bruising.
Avoid over-the-counter pain medications that contain aspirin.
When caring for an older adult with coronary artery disease, which
modification in the plan of care would the nurse make because of the
END OF
PAGE
4
