Med Surg 3 Exam 2 Practice Questions with Answers Rated A
c.Fine, scattered crackles on auscultation of the chest
When assessing a patient with sepsis, which finding
would alert the nurse to the onset of acute respiratory The initial presentation of acute respiratory distress syn-
distress syndrome (ARDS)? drome is often subtle. At the time of the initial injury, and
for several hours to 1 to 2 days afterward, the patient may
a. SpO2 of 80%
not experience respiratory symptoms, or the patient may
b. Use of accessory muscles of respiration
exhibit only dyspnea, tachypnea, cough, and restlessness.
c. Fine, scattered crackles on auscultation of the chest
Chest auscultation may be normal or may reveal fine,
d.ABGs of pH 7.33, Paco2 48 mm Hg, and Pao2 80 mm Hg
scattered crackles.
A nurse is watching the cardiac monitor and notices that
the rhythm suddenly changes. There are no P waves. The
QRS complexes are wide and the ventricular rate is regular B. Ventricular tachycardia
but over 100. The nurse determines that the client is
experiencing: With ventricular tachycardia the ventricles are responsible
for stimulating the impulses. When the ventricles stimu-
A. Premature ventricular contraction late an impulse there will be no P wave, the QRS complexes
B. Ventricular tachycardia are wide, and the ventricular rate is usually fast.
C. Ventricular fibrillation
D. Sinus tachycardia
A. Troponin result and when the next troponin level is due
to be collected
A patient is admitted with chest pain to the ER. The patient
has been in the ER for 5 hours and is being admitted Troponin is specific to cardiac muscle. When a patient
to your unit for overnight observation. From the options complains of chest pain and/or other symptoms that could
below, what is the most IMPORTANT information to know potentially indicate the patient may be having a MI, a
about this patient at this time? 12 lead ECG will be done and blood specimens will be
collected and tested. If the ECG does not show ST seg-
A. Troponin result and when the next troponin level is due
ment changes and the blood work is negative the patient
to be collected
may be admitted for 24 hours observation. During the
B. Diet status
24 hours period patients will have bloodwork (Troponin
and CK/MB) done every 6 to 8 hours to determine if the
,Med Surg 3 Exam 2 Practice Questions with Answers Rated A
patient did or did not have a MI. Therefore, it is important
to know when the first set of Troponin and CK/MB was
C. Last consumption of catteine collected. The second set of Troponin and CK/MB should
D. CK result and when the next CK level is due to be be collected 6 to 8 hours after the first set then again 6 to
collected 8 hours after the second. Also keep in mind Troponin and
CK/MB is specific to cardiac muscle; however, CK without
MB is not.
A patient's cardiac rhythm is sinus bradycardia with a heart
rate of 34 beats/min. If the bradycardia is symptomatic,
d. Shortness of breath.
the nurse would expect the patient to exhibit:
Signs of symptomatic bradycardia include pale, cool skin;
a.Palpitations.
hypotension; weakness; angina; dizziness or syncope;
b.Hypertension.
confusion or disorientation; and shortness of breath.
c.Warm, flushed skin.
d.Shortness of breath.
A patient has a diagnosis of acute myocardial infarction,
and his cardiac rhythm is sinus bradycardia with 6 to 8
premature ventricular contractions (PVCs) per minute. The
pattern that the nurse recognizes as the most character- c.A wide, distorted QRS complex.
istic of PVCs is:
Premature ventricular contractions have wide and distort-
a. An irregular rhythm. ed QRS complexes.
b. An inverted T wave.
c. A wide, distorted QRS complex.
d.An increasingly long PR interval.
b.Initiate cardiopulmonary resuscitation.
A patient in the coronary care unit develops ventricular
fibrillation. The first action the nurse should take is to: Immediate treatment for ventricular fibrillation is the ini-
tiation of cardiopulmonary resuscitation, followed by the
a. Perform defibrillation.
use of defibrillation and definitive drug therapy according
b. Initiate cardiopulmonary resuscitation.
to advanced cardiac life support guidelines.
, Med Surg 3 Exam 2 Practice Questions with Answers Rated A
c.Prepare for synchronized cardioversion.
d.Administer IV antidysrhythmic drugs per protocol.
To determine whether there is a delay in impulse con-
duction through the ventricles, the nurse will measure the
duration of the patient's
a. P wave. d. QRS complex.
c. PR interval.
b. Q wave.
d. QRS complex.
The nurse obtains a rhythm strip on a patient who has had
a myocardial infarction and makes the following analysis:
no visible P waves, PR interval not measurable, ventricular
rate of 162, R-R interval regular, and QRS complex wide d. ventricular tachycardia.
and distorted, and QRS duration of 0.18 second. The
nurse interprets the patient's cardiac rhythm as *wide + distorted QRS, rate greater than 150 beats/min,
and the regularity of the rhythm indicate ventricular tachy-
a. atrial flutter. cardia.
c. ventricular fibrillation.
b. sinus tachycardia.
d. ventricular tachycardia.
The nurse notes that a patient's heart monitor shows that
every other beat is earlier than expected, has no visible P
wave, and has a QRS complex that is wide and bizarre in
b. Ventricular bigeminy
shape. How will the nurse document the rhythm?
Ventricular bigeminy describes a rhythm in which every
a. Ventricular couplets
other QRS complex is wide and bizarre looking.
b. Ventricular bigeminy
c. Ventricular R-on-T phenomenon
d. Multifocal premature ventricular contractions
After the nurse gives IV atropine to a patient with symp-
tomatic type 1, second-degree atrioventricular (AV) block,
c.Fine, scattered crackles on auscultation of the chest
When assessing a patient with sepsis, which finding
would alert the nurse to the onset of acute respiratory The initial presentation of acute respiratory distress syn-
distress syndrome (ARDS)? drome is often subtle. At the time of the initial injury, and
for several hours to 1 to 2 days afterward, the patient may
a. SpO2 of 80%
not experience respiratory symptoms, or the patient may
b. Use of accessory muscles of respiration
exhibit only dyspnea, tachypnea, cough, and restlessness.
c. Fine, scattered crackles on auscultation of the chest
Chest auscultation may be normal or may reveal fine,
d.ABGs of pH 7.33, Paco2 48 mm Hg, and Pao2 80 mm Hg
scattered crackles.
A nurse is watching the cardiac monitor and notices that
the rhythm suddenly changes. There are no P waves. The
QRS complexes are wide and the ventricular rate is regular B. Ventricular tachycardia
but over 100. The nurse determines that the client is
experiencing: With ventricular tachycardia the ventricles are responsible
for stimulating the impulses. When the ventricles stimu-
A. Premature ventricular contraction late an impulse there will be no P wave, the QRS complexes
B. Ventricular tachycardia are wide, and the ventricular rate is usually fast.
C. Ventricular fibrillation
D. Sinus tachycardia
A. Troponin result and when the next troponin level is due
to be collected
A patient is admitted with chest pain to the ER. The patient
has been in the ER for 5 hours and is being admitted Troponin is specific to cardiac muscle. When a patient
to your unit for overnight observation. From the options complains of chest pain and/or other symptoms that could
below, what is the most IMPORTANT information to know potentially indicate the patient may be having a MI, a
about this patient at this time? 12 lead ECG will be done and blood specimens will be
collected and tested. If the ECG does not show ST seg-
A. Troponin result and when the next troponin level is due
ment changes and the blood work is negative the patient
to be collected
may be admitted for 24 hours observation. During the
B. Diet status
24 hours period patients will have bloodwork (Troponin
and CK/MB) done every 6 to 8 hours to determine if the
,Med Surg 3 Exam 2 Practice Questions with Answers Rated A
patient did or did not have a MI. Therefore, it is important
to know when the first set of Troponin and CK/MB was
C. Last consumption of catteine collected. The second set of Troponin and CK/MB should
D. CK result and when the next CK level is due to be be collected 6 to 8 hours after the first set then again 6 to
collected 8 hours after the second. Also keep in mind Troponin and
CK/MB is specific to cardiac muscle; however, CK without
MB is not.
A patient's cardiac rhythm is sinus bradycardia with a heart
rate of 34 beats/min. If the bradycardia is symptomatic,
d. Shortness of breath.
the nurse would expect the patient to exhibit:
Signs of symptomatic bradycardia include pale, cool skin;
a.Palpitations.
hypotension; weakness; angina; dizziness or syncope;
b.Hypertension.
confusion or disorientation; and shortness of breath.
c.Warm, flushed skin.
d.Shortness of breath.
A patient has a diagnosis of acute myocardial infarction,
and his cardiac rhythm is sinus bradycardia with 6 to 8
premature ventricular contractions (PVCs) per minute. The
pattern that the nurse recognizes as the most character- c.A wide, distorted QRS complex.
istic of PVCs is:
Premature ventricular contractions have wide and distort-
a. An irregular rhythm. ed QRS complexes.
b. An inverted T wave.
c. A wide, distorted QRS complex.
d.An increasingly long PR interval.
b.Initiate cardiopulmonary resuscitation.
A patient in the coronary care unit develops ventricular
fibrillation. The first action the nurse should take is to: Immediate treatment for ventricular fibrillation is the ini-
tiation of cardiopulmonary resuscitation, followed by the
a. Perform defibrillation.
use of defibrillation and definitive drug therapy according
b. Initiate cardiopulmonary resuscitation.
to advanced cardiac life support guidelines.
, Med Surg 3 Exam 2 Practice Questions with Answers Rated A
c.Prepare for synchronized cardioversion.
d.Administer IV antidysrhythmic drugs per protocol.
To determine whether there is a delay in impulse con-
duction through the ventricles, the nurse will measure the
duration of the patient's
a. P wave. d. QRS complex.
c. PR interval.
b. Q wave.
d. QRS complex.
The nurse obtains a rhythm strip on a patient who has had
a myocardial infarction and makes the following analysis:
no visible P waves, PR interval not measurable, ventricular
rate of 162, R-R interval regular, and QRS complex wide d. ventricular tachycardia.
and distorted, and QRS duration of 0.18 second. The
nurse interprets the patient's cardiac rhythm as *wide + distorted QRS, rate greater than 150 beats/min,
and the regularity of the rhythm indicate ventricular tachy-
a. atrial flutter. cardia.
c. ventricular fibrillation.
b. sinus tachycardia.
d. ventricular tachycardia.
The nurse notes that a patient's heart monitor shows that
every other beat is earlier than expected, has no visible P
wave, and has a QRS complex that is wide and bizarre in
b. Ventricular bigeminy
shape. How will the nurse document the rhythm?
Ventricular bigeminy describes a rhythm in which every
a. Ventricular couplets
other QRS complex is wide and bizarre looking.
b. Ventricular bigeminy
c. Ventricular R-on-T phenomenon
d. Multifocal premature ventricular contractions
After the nurse gives IV atropine to a patient with symp-
tomatic type 1, second-degree atrioventricular (AV) block,
