260 CHAPTER 14 Medical-Surgical Nursing
Medical-Surgical Nursing
14 Review Questions with Answers
CHAPTER
and Rationales
QUESTIONS
Note: Thousands of additional practice questions are available
on the enclosed companion CD.
Growth and Development 7. A nurse is caring for an older adult with a hearing loss sec-
u ondary to aging. What can the nurse expect to identify when
1. When planning discharge teaching for a young adult, the assessing this client? Select all that apply.
nurse should include the potential health problems common 1. Dry cerumen
in this age group. What should the nurse include in this 2. Tears in the tympanic membrane
teaching plan? 3. Difficulty hearing women’s voices
1. Kidney dysfunction 4. Decrease of hair in the auditory canal
2. Cardiovascular diseases 5. Overgrowth of the epithelial auditory lining
3. Eye problems, such as glaucoma 8. A 93-year-old client in a nursing home has been eating
4. Accidents, including their prevention less food during mealtimes. What is the priority nursing
2. What principle of teaching specific to an older adult should intervention?
the nurse consider when providing instruction to such a 1. Substitute a supplemental drink for the meal.
client recently diagnosed with diabetes mellitus? 2. Spoon-feed the client until the food is completely eaten.
1. Knowledge reduces general anxiety. 3. Allow the client a longer period of time to complete the
2. Capacity to learn decreases with age. meal.
3. Continued reinforcement is advantageous. 4. Arrange a consultation for the placement of a gastros-
4. Readiness of the learner precedes instruction. tomy tube.
3. A 76-year-old male client asks the nurse about the chances 9. A 78-year-old client who has hypertension is beginning
of getting osteoporosis like his wife. Which is the best treatment with furosemide (Lasix). Considering the client’s
response by the nurse? age, what should the nurse teach the client to do?
1. “This is only a problem for women.” 1. Limit fluids at bedtime.
2. “Exercise is a good way to prevent this problem.” 2. Change positions slowly.
3. “You are not at risk because of your small frame.” 3. Take the medication between meals.
4. “You might think about having a bone density test.” 4. Assess the skin for breakdown daily.
4. What is the priority when working with a group of middle-
aged adult clients?
1. Cessation of smoking Circulatory System (Cardiovascular,
2. Prevention of infection Blood, and Lymphatic Systems)
3. Abstinence from alcohol
4. Decreasing high-density lipoproteins levels 10. A nurse must obtain a client’s apical pulse. Place an X over
5. Which factor does the nurse consider most likely contributes u the site where the nurse should place the stethoscope.
to the increased incidence of hip fractures in older adults?
1. Carelessness
2. Fragility of bone
3. Sedentary existence
4. Rheumatoid diseases
6. Which age-related change should the nurse consider when
u formulating a plan of care for an older adult? Select all that
apply.
1. Difficulty in swallowing
2. Increased sensitivity to heat
3. Increased sensitivity to glare
4. Diminished sensation of pain
5. Heightened response to stimuli
260 u Denotes alternate format question.
, Review Questions 261
11. Which client statement indicates an understanding of the 3. Determine the mean blood pressure by averaging the
nurse’s instructions concerning a Holter monitor? two.
1. “The only times the monitor should be taken off is for 4. Calculate the difference between the apical and radial
showering and sleep.” rate.
2. “The monitor will record my activities and symptoms if 17. After surgery for insertion of a coronary artery bypass graft
an abnormal rhythm occurs.” (CABG), a client develops a temperature of 102° F (38.8°
3. “The results from the monitor will be used to determine C). What priority concern related to elevated temperatures
the size and shape of my heart.” does a nurse consider when notifying the health care pro-
4. “The monitor will record any abnormal heart rhythms vider about the client’s temperature?
while I go about my usual activities.” 1. A fever may lead to diaphoresis.
12. A client with a history of dysrhythmias is to wear a 2. A fever increases the cardiac output.
Holter monitor for 24 hours on an outpatient basis. What 3. An increased temperature indicates cerebral edema.
should the nurse teach the client to do while wearing 4. An increased temperature may be a sign of hemorrhage.
the monitor? 18. A nurse is teaching a group of clients with peripheral vascu-
1. Discontinue medications. lar disease about a smoking cessation program. Which phys-
2. Avoid using a microwave oven. iologic effect of nicotine should the nurse explain to the
3. Keep a written account of activities. group?
4. Record the blood pressure periodically. 1. Constriction of the superficial vessels dilates the deep
13. A client with a dysrhythmia is admitted to telemetry for vessels.
observation. In the morning the client asks for a cup of 2. Constriction of the peripheral vessels increases the force
coffee. What is the nurse’s best response? of flow.
1. “Hot drinks such as coffee are not good for your 3. Dilation of the superficial vessels causes constriction of
heart.” collateral circulation.
2. “Coffee is not permitted on the diet that was ordered for 4. Dilation of the peripheral vessels causes reflex constric-
you.” tion of visceral vessels.
3. “You cannot have coffee. I can bring you a cup of tea if 19. During an interview, the nurse discovers that the spouse of
you like.” a debilitated, chronically constipated client digitally removes
4. “Coffee has caffeine that can affect your heart. It should stool from the client’s rectum. What response to disimpac-
be avoided.” tion is the nurse attempting to prevent by presenting other
14. A client who had several episodes of chest pain is scheduled strategies to regulate the client’s bowel movements?
for an exercise electrocardiogram. Which explanation should 1. Increased pulse rate
the nurse include when teaching the client about this 2. Slowing of the heart
procedure? 3. Dilation of the bronchioles
1. “This is a noninvasive test to check your heart’s response 4. Coronary artery vasodilation
to physical activity.” 20. A nurse is assessing the legs of a client with a history
2. “This test is the definitive method to identify the actual u of chronic venous insufficiency. What physiologic changes
cause of your chest pain.” should the nurse conclude are the result of this disease
3. “The findings of this test will be of minimal assistance in process? Select all that apply.
the treatment of angina.” 1. Stasis ulcer
4. “The findings from this minimally invasive test will show 2. Necrotic tissue
how your body reacts to exercise.” 3. Ecchymotic areas
15. A client is admitted with chest pain unrelieved by nitroglyc- 4. Diminished pulses
erin, an elevated temperature, decreased blood pressure, and 5. Brown discoloration
diaphoresis. A myocardial infarction is diagnosed. Which 21. A nurse is caring for a client with chronic occlusive arterial
should the nurse consider as a valid reason for one of this disease. What precipitating cause is the nurse most likely to
client’s physiologic responses? identify for the development of ulceration and gangrenous
1. Parasympathetic reflexes from the infarcted myocardium lesions?
cause diaphoresis. 1. Emotional stress, which is short-lived
2. Inflammation in the myocardium causes a rise in the 2. Poor hygiene and limited protein intake
systemic body temperature. 3. Stimulants such as coffee, tea, or cola drinks
3. Catecholamines released at the site of the infarction cause 4. Trauma from mechanical, chemical, or thermal sources
intermittent localized pain. 22. A client is prescribed prolonged bed rest after surgery. Which
4. Constriction of central and peripheral blood vessels complication does the nurse expect to prevent by teaching
causes a decrease in blood pressure. this client to avoid pressure on the popliteal space?
16. What must the nurse do to determine a client’s pulse 1. Cerebral embolism
pressure? 2. Pulmonary embolism
1. Multiply the heart rate by the stroke volume. 3. Dry gangrene of a limb
2. Subtract the diastolic from the systolic reading. 4. Coronary vessel occlusion
,262 CHAPTER 14 Medical-Surgical Nursing
23. A nurse in the postanesthesia care unit is caring for a client
who received a general anesthetic. Which finding should the
nurse report to the health care provider?
1. Client pushes the airway out.
2. Client has snoring respirations.
3. Respirations of 16 breaths/min are shallow.
4. Systolic blood pressure drops from 130 to 90 mm Hg.
24. After abdominal surgery a client suddenly reports numbness
in the right leg and a “funny feeling” in the toes. What
should the nurse do first?
1. Elevate the legs and tell the client to drink more
fluids.
2. Instruct the client to remain in bed and notify the health
care provider.
3. Rub the client’s legs to stimulate circulation and cover
the client with a blanket.
4. Tell the client about the dangers of prolonged bed rest
and encourage ambulation.
25. After a bilateral lumbar sympathectomy a client has a sudden
drop in blood pressure, but there is no evidence of bleeding.
What should the nurse identify as the most likely cause of
the change in blood pressure?
1. Inadequate fluid intake
2. Consequence of anesthesia
3. Increased level of epinephrine
4. Reallocation of the blood supply
26. A nurse inspects a two-day-old intravenous site and identi-
fies erythema, warmth, and mild edema. The client reports 1. Keep the stockings on two hours and off two hours.
tenderness when the area is palpated. What should the nurse 2. Wear the stockings only at bedtime when activity
do first? lessens.
1. Irrigate the IV tubing. 3. Put the stockings on before getting out of bed in the
2. Discontinue the infusion. morning.
3. Slow the rate of the infusion. 4. Leave the stockings in place until the health care provider
4. Obtain a prescription for an analgesic. advises otherwise.
27. While convalescing from abdominal surgery a client devel- 31. A health care provider orders thigh-high antiembolism
u ops thrombophlebitis. Which clinical indicators of this com- stockings for a client with varicose veins. The client’s thighs
plication should the nurse expect to identify when assessing are heavier than the lower legs, and the stockings fit on the
the client? Select all that apply. lower leg but are causing discomfort and indentations on
1. Pain in the calf the upper thighs. What should the nurse do?
2. Intermittent claudication 1. Replace the thigh-high stockings with knee-high
3. Redness in the affected area stockings.
4. Pitting edema of the lower leg 2. Leave the antiembolism stockings off to prevent
5. Ecchymotic areas around the ankle tissue damage.
6. Localized warmth in the lower extremity 3. Roll the top of the stockings to below the knees to limit
28. A client who had surgery 24 hours ago reports pain in the popliteal pressure.
calf. Assessment reveals redness and swelling at the site of 4. Ask the health care provider if an elastic bandage can be
discomfort. What should the nurse do? used in place of the stockings.
1. Keep both legs dependent. 32. What should the nurse teach a client who is taking antihy-
2. Notify the health care provider. pertensives to do to minimize orthostatic hypotension?
3. Apply a warm soak to the left calf. 1. Wear support hose continuously.
4. Administer the prescribed analgesic. 2. Lie down for 30 minutes after taking medication.
29. A nurse is assessing arterial perfusion in a client who had 3. Avoid tasks that require high-energy expenditure.
u surgery with placement of a graft for an aneurysm in the left 4. Sit on the edge of the bed for 5 minutes before
femoral artery. Place an X over the site of the pulse that standing.
should be assessed to determine maximum arterial perfusion 33. A client being treated for hypertension reports having a
distal to the operative site. persistent hacking cough. What class of antihypertensive
30. A nurse is teaching a client about the use of antiembolism should the nurse identify as a possible cause of this response
stockings. What instruction should the nurse include? when reviewing a list of this client’s medications?
, Review Questions 263
1. ACE inhibitors 41. Which topic should the nurse determine is most appropriate
2. Thiazide diuretics when presenting health-related instruction to clients from
3. Calcium channel blockers an African-American community?
4. Angiotensin receptor blockers 1. Osteoporosis
34. What client response indicates to the nurse that a vasodilator 2. Hypertension
medication is effective? 3. Uterine cancer
1. Pulse rate decreases from 110 to 75 4. Thyroid disorders
2. Absence of adventitious breath sounds 42. Amlodipine (Norvasc) is prescribed for a client with hyper-
3. Increase in the daily amount of urine produced tension. Which response to the medication should the nurse
4. Blood pressure changes from 154/90 to 126/72 instruct the client to report to the health care provider?
35. What should the nurse assess to determine if a client is 1. Blurred vision
experiencing the therapeutic effect of valsartan (Diovan)? 2. Dizziness on rising
1. Lipid profile 3. Excessive urination
2. Apical pulse 4. Difficulty breathing
3. Urinary output 43. Atenolol (Tenormin) 150 mg by mouth is prescribed for a
4. Blood pressure u client with hypertension. Each tablet contains 50 mg. How
36. What information should the nurse include when teaching many tablets should the nurse administer? Record your
a client with heart disease about cholesterol? answer using a whole number.
1. Can be found in both plant and animal sources Answer: _____ tablets
2. Causes an increase in serum high-density lipoprotein 44. What should the nurse identify as the primary cause of the
3. Should be eliminated because it causes the disease process pain experienced by a client with a coronary occlusion?
4. Decreases when unsaturated fats are substituted for satu- 1. Arterial spasm
rated fats 2. Heart muscle ischemia
37. Which instructions should the nurse include in the teaching 3. Blocking of the coronary veins
plan for a client with hyperlipidemia who is being dis- 4. Irritation of nerve endings in the cardiac plexus
charged with a prescription for cholestyramine (Questran)? 45. What instructions about the use of nitroglycerin should the
1. “Increase your intake of fiber and fluid.” nurse provide to a client with angina?
2. “Take the medication before you go to bed.” 1. “Identify when pain occurs, and place 2 tablets under the
3. “Check your pulse before taking the medication.” tongue.”
4. “Contact your health care provider if your skin or sclera 2. “Place 1 tablet under the tongue, and swallow another
turn yellow.” when pain is intense.”
38. A nurse is providing dietary instruction to a client with 3. “Before physical activity place 1 tablet under the tongue,
cardiovascular disease. Which dietary selection by the client and repeat the dose in 5 minutes if pain occurs.”
indicates the need for further instruction? 4. “Place 1 tablet under the tongue when pain occurs, and
1. Whole milk with oatmeal use an additional tablet after the attack to prevent
2. Garden salad with olive oil recurrence.”
3. Tuna fish with a small apple 46. Which nursing action is most important when caring for a
4. Soluble fiber cereal with skim milk client after a cardiac catheterization?
39. A nurse asks a client with ischemic heart disease to identify 1. Provide for rest.
u the foods that are most important to restrict. The nurse 2. Administer oxygen.
determines that the client understands the dietary instruc- 3. Check a pulse distal to the insertion site.
tions when the client identifies the following foods. Select 4. Assess the electrocardiogram every fifteen minutes.
all that apply. 47. For which common complication of myocardial infarction
1. Olive oil should the nurse monitor clients in the coronary care unit?
2. Chicken broth 1. Dysrhythmia
3. Enriched whole milk 2. Hypokalemia
4. Red meats, such as beef 3. Anaphylactic shock
5. Vegetables and whole grains 4. Cardiac enlargement
6. Liver and other glandular organ meats 48. A nurse prepares a client for insertion of a pulmonary artery
40. Which instructions should the nurse include in the teaching catheter. What information can be obtained from monitor-
u plan for a client who will be taking simvastatin (Zocor) ing the pulmonary artery pressure?
when discharged? Select all that apply. 1. Stroke volume
1. Increase dietary intake of potassium. 2. Venous pressure
2. Avoid prolonged exposure to the sun. 3. Coronary artery patency
3. Schedule regular ophthalmic examinations. 4. Left ventricular functioning
4. Take the medication at least a half hour before meals. 49. A client with a thromboembolic disorder is receiving a con-
5. Contact your health care provider if skin becomes u tinuous intravenous infusion of heparin 1000 units per
gray-bronze. hour. There are 25,000 units of heparin in 500 mL of 5%
Medical-Surgical Nursing
14 Review Questions with Answers
CHAPTER
and Rationales
QUESTIONS
Note: Thousands of additional practice questions are available
on the enclosed companion CD.
Growth and Development 7. A nurse is caring for an older adult with a hearing loss sec-
u ondary to aging. What can the nurse expect to identify when
1. When planning discharge teaching for a young adult, the assessing this client? Select all that apply.
nurse should include the potential health problems common 1. Dry cerumen
in this age group. What should the nurse include in this 2. Tears in the tympanic membrane
teaching plan? 3. Difficulty hearing women’s voices
1. Kidney dysfunction 4. Decrease of hair in the auditory canal
2. Cardiovascular diseases 5. Overgrowth of the epithelial auditory lining
3. Eye problems, such as glaucoma 8. A 93-year-old client in a nursing home has been eating
4. Accidents, including their prevention less food during mealtimes. What is the priority nursing
2. What principle of teaching specific to an older adult should intervention?
the nurse consider when providing instruction to such a 1. Substitute a supplemental drink for the meal.
client recently diagnosed with diabetes mellitus? 2. Spoon-feed the client until the food is completely eaten.
1. Knowledge reduces general anxiety. 3. Allow the client a longer period of time to complete the
2. Capacity to learn decreases with age. meal.
3. Continued reinforcement is advantageous. 4. Arrange a consultation for the placement of a gastros-
4. Readiness of the learner precedes instruction. tomy tube.
3. A 76-year-old male client asks the nurse about the chances 9. A 78-year-old client who has hypertension is beginning
of getting osteoporosis like his wife. Which is the best treatment with furosemide (Lasix). Considering the client’s
response by the nurse? age, what should the nurse teach the client to do?
1. “This is only a problem for women.” 1. Limit fluids at bedtime.
2. “Exercise is a good way to prevent this problem.” 2. Change positions slowly.
3. “You are not at risk because of your small frame.” 3. Take the medication between meals.
4. “You might think about having a bone density test.” 4. Assess the skin for breakdown daily.
4. What is the priority when working with a group of middle-
aged adult clients?
1. Cessation of smoking Circulatory System (Cardiovascular,
2. Prevention of infection Blood, and Lymphatic Systems)
3. Abstinence from alcohol
4. Decreasing high-density lipoproteins levels 10. A nurse must obtain a client’s apical pulse. Place an X over
5. Which factor does the nurse consider most likely contributes u the site where the nurse should place the stethoscope.
to the increased incidence of hip fractures in older adults?
1. Carelessness
2. Fragility of bone
3. Sedentary existence
4. Rheumatoid diseases
6. Which age-related change should the nurse consider when
u formulating a plan of care for an older adult? Select all that
apply.
1. Difficulty in swallowing
2. Increased sensitivity to heat
3. Increased sensitivity to glare
4. Diminished sensation of pain
5. Heightened response to stimuli
260 u Denotes alternate format question.
, Review Questions 261
11. Which client statement indicates an understanding of the 3. Determine the mean blood pressure by averaging the
nurse’s instructions concerning a Holter monitor? two.
1. “The only times the monitor should be taken off is for 4. Calculate the difference between the apical and radial
showering and sleep.” rate.
2. “The monitor will record my activities and symptoms if 17. After surgery for insertion of a coronary artery bypass graft
an abnormal rhythm occurs.” (CABG), a client develops a temperature of 102° F (38.8°
3. “The results from the monitor will be used to determine C). What priority concern related to elevated temperatures
the size and shape of my heart.” does a nurse consider when notifying the health care pro-
4. “The monitor will record any abnormal heart rhythms vider about the client’s temperature?
while I go about my usual activities.” 1. A fever may lead to diaphoresis.
12. A client with a history of dysrhythmias is to wear a 2. A fever increases the cardiac output.
Holter monitor for 24 hours on an outpatient basis. What 3. An increased temperature indicates cerebral edema.
should the nurse teach the client to do while wearing 4. An increased temperature may be a sign of hemorrhage.
the monitor? 18. A nurse is teaching a group of clients with peripheral vascu-
1. Discontinue medications. lar disease about a smoking cessation program. Which phys-
2. Avoid using a microwave oven. iologic effect of nicotine should the nurse explain to the
3. Keep a written account of activities. group?
4. Record the blood pressure periodically. 1. Constriction of the superficial vessels dilates the deep
13. A client with a dysrhythmia is admitted to telemetry for vessels.
observation. In the morning the client asks for a cup of 2. Constriction of the peripheral vessels increases the force
coffee. What is the nurse’s best response? of flow.
1. “Hot drinks such as coffee are not good for your 3. Dilation of the superficial vessels causes constriction of
heart.” collateral circulation.
2. “Coffee is not permitted on the diet that was ordered for 4. Dilation of the peripheral vessels causes reflex constric-
you.” tion of visceral vessels.
3. “You cannot have coffee. I can bring you a cup of tea if 19. During an interview, the nurse discovers that the spouse of
you like.” a debilitated, chronically constipated client digitally removes
4. “Coffee has caffeine that can affect your heart. It should stool from the client’s rectum. What response to disimpac-
be avoided.” tion is the nurse attempting to prevent by presenting other
14. A client who had several episodes of chest pain is scheduled strategies to regulate the client’s bowel movements?
for an exercise electrocardiogram. Which explanation should 1. Increased pulse rate
the nurse include when teaching the client about this 2. Slowing of the heart
procedure? 3. Dilation of the bronchioles
1. “This is a noninvasive test to check your heart’s response 4. Coronary artery vasodilation
to physical activity.” 20. A nurse is assessing the legs of a client with a history
2. “This test is the definitive method to identify the actual u of chronic venous insufficiency. What physiologic changes
cause of your chest pain.” should the nurse conclude are the result of this disease
3. “The findings of this test will be of minimal assistance in process? Select all that apply.
the treatment of angina.” 1. Stasis ulcer
4. “The findings from this minimally invasive test will show 2. Necrotic tissue
how your body reacts to exercise.” 3. Ecchymotic areas
15. A client is admitted with chest pain unrelieved by nitroglyc- 4. Diminished pulses
erin, an elevated temperature, decreased blood pressure, and 5. Brown discoloration
diaphoresis. A myocardial infarction is diagnosed. Which 21. A nurse is caring for a client with chronic occlusive arterial
should the nurse consider as a valid reason for one of this disease. What precipitating cause is the nurse most likely to
client’s physiologic responses? identify for the development of ulceration and gangrenous
1. Parasympathetic reflexes from the infarcted myocardium lesions?
cause diaphoresis. 1. Emotional stress, which is short-lived
2. Inflammation in the myocardium causes a rise in the 2. Poor hygiene and limited protein intake
systemic body temperature. 3. Stimulants such as coffee, tea, or cola drinks
3. Catecholamines released at the site of the infarction cause 4. Trauma from mechanical, chemical, or thermal sources
intermittent localized pain. 22. A client is prescribed prolonged bed rest after surgery. Which
4. Constriction of central and peripheral blood vessels complication does the nurse expect to prevent by teaching
causes a decrease in blood pressure. this client to avoid pressure on the popliteal space?
16. What must the nurse do to determine a client’s pulse 1. Cerebral embolism
pressure? 2. Pulmonary embolism
1. Multiply the heart rate by the stroke volume. 3. Dry gangrene of a limb
2. Subtract the diastolic from the systolic reading. 4. Coronary vessel occlusion
,262 CHAPTER 14 Medical-Surgical Nursing
23. A nurse in the postanesthesia care unit is caring for a client
who received a general anesthetic. Which finding should the
nurse report to the health care provider?
1. Client pushes the airway out.
2. Client has snoring respirations.
3. Respirations of 16 breaths/min are shallow.
4. Systolic blood pressure drops from 130 to 90 mm Hg.
24. After abdominal surgery a client suddenly reports numbness
in the right leg and a “funny feeling” in the toes. What
should the nurse do first?
1. Elevate the legs and tell the client to drink more
fluids.
2. Instruct the client to remain in bed and notify the health
care provider.
3. Rub the client’s legs to stimulate circulation and cover
the client with a blanket.
4. Tell the client about the dangers of prolonged bed rest
and encourage ambulation.
25. After a bilateral lumbar sympathectomy a client has a sudden
drop in blood pressure, but there is no evidence of bleeding.
What should the nurse identify as the most likely cause of
the change in blood pressure?
1. Inadequate fluid intake
2. Consequence of anesthesia
3. Increased level of epinephrine
4. Reallocation of the blood supply
26. A nurse inspects a two-day-old intravenous site and identi-
fies erythema, warmth, and mild edema. The client reports 1. Keep the stockings on two hours and off two hours.
tenderness when the area is palpated. What should the nurse 2. Wear the stockings only at bedtime when activity
do first? lessens.
1. Irrigate the IV tubing. 3. Put the stockings on before getting out of bed in the
2. Discontinue the infusion. morning.
3. Slow the rate of the infusion. 4. Leave the stockings in place until the health care provider
4. Obtain a prescription for an analgesic. advises otherwise.
27. While convalescing from abdominal surgery a client devel- 31. A health care provider orders thigh-high antiembolism
u ops thrombophlebitis. Which clinical indicators of this com- stockings for a client with varicose veins. The client’s thighs
plication should the nurse expect to identify when assessing are heavier than the lower legs, and the stockings fit on the
the client? Select all that apply. lower leg but are causing discomfort and indentations on
1. Pain in the calf the upper thighs. What should the nurse do?
2. Intermittent claudication 1. Replace the thigh-high stockings with knee-high
3. Redness in the affected area stockings.
4. Pitting edema of the lower leg 2. Leave the antiembolism stockings off to prevent
5. Ecchymotic areas around the ankle tissue damage.
6. Localized warmth in the lower extremity 3. Roll the top of the stockings to below the knees to limit
28. A client who had surgery 24 hours ago reports pain in the popliteal pressure.
calf. Assessment reveals redness and swelling at the site of 4. Ask the health care provider if an elastic bandage can be
discomfort. What should the nurse do? used in place of the stockings.
1. Keep both legs dependent. 32. What should the nurse teach a client who is taking antihy-
2. Notify the health care provider. pertensives to do to minimize orthostatic hypotension?
3. Apply a warm soak to the left calf. 1. Wear support hose continuously.
4. Administer the prescribed analgesic. 2. Lie down for 30 minutes after taking medication.
29. A nurse is assessing arterial perfusion in a client who had 3. Avoid tasks that require high-energy expenditure.
u surgery with placement of a graft for an aneurysm in the left 4. Sit on the edge of the bed for 5 minutes before
femoral artery. Place an X over the site of the pulse that standing.
should be assessed to determine maximum arterial perfusion 33. A client being treated for hypertension reports having a
distal to the operative site. persistent hacking cough. What class of antihypertensive
30. A nurse is teaching a client about the use of antiembolism should the nurse identify as a possible cause of this response
stockings. What instruction should the nurse include? when reviewing a list of this client’s medications?
, Review Questions 263
1. ACE inhibitors 41. Which topic should the nurse determine is most appropriate
2. Thiazide diuretics when presenting health-related instruction to clients from
3. Calcium channel blockers an African-American community?
4. Angiotensin receptor blockers 1. Osteoporosis
34. What client response indicates to the nurse that a vasodilator 2. Hypertension
medication is effective? 3. Uterine cancer
1. Pulse rate decreases from 110 to 75 4. Thyroid disorders
2. Absence of adventitious breath sounds 42. Amlodipine (Norvasc) is prescribed for a client with hyper-
3. Increase in the daily amount of urine produced tension. Which response to the medication should the nurse
4. Blood pressure changes from 154/90 to 126/72 instruct the client to report to the health care provider?
35. What should the nurse assess to determine if a client is 1. Blurred vision
experiencing the therapeutic effect of valsartan (Diovan)? 2. Dizziness on rising
1. Lipid profile 3. Excessive urination
2. Apical pulse 4. Difficulty breathing
3. Urinary output 43. Atenolol (Tenormin) 150 mg by mouth is prescribed for a
4. Blood pressure u client with hypertension. Each tablet contains 50 mg. How
36. What information should the nurse include when teaching many tablets should the nurse administer? Record your
a client with heart disease about cholesterol? answer using a whole number.
1. Can be found in both plant and animal sources Answer: _____ tablets
2. Causes an increase in serum high-density lipoprotein 44. What should the nurse identify as the primary cause of the
3. Should be eliminated because it causes the disease process pain experienced by a client with a coronary occlusion?
4. Decreases when unsaturated fats are substituted for satu- 1. Arterial spasm
rated fats 2. Heart muscle ischemia
37. Which instructions should the nurse include in the teaching 3. Blocking of the coronary veins
plan for a client with hyperlipidemia who is being dis- 4. Irritation of nerve endings in the cardiac plexus
charged with a prescription for cholestyramine (Questran)? 45. What instructions about the use of nitroglycerin should the
1. “Increase your intake of fiber and fluid.” nurse provide to a client with angina?
2. “Take the medication before you go to bed.” 1. “Identify when pain occurs, and place 2 tablets under the
3. “Check your pulse before taking the medication.” tongue.”
4. “Contact your health care provider if your skin or sclera 2. “Place 1 tablet under the tongue, and swallow another
turn yellow.” when pain is intense.”
38. A nurse is providing dietary instruction to a client with 3. “Before physical activity place 1 tablet under the tongue,
cardiovascular disease. Which dietary selection by the client and repeat the dose in 5 minutes if pain occurs.”
indicates the need for further instruction? 4. “Place 1 tablet under the tongue when pain occurs, and
1. Whole milk with oatmeal use an additional tablet after the attack to prevent
2. Garden salad with olive oil recurrence.”
3. Tuna fish with a small apple 46. Which nursing action is most important when caring for a
4. Soluble fiber cereal with skim milk client after a cardiac catheterization?
39. A nurse asks a client with ischemic heart disease to identify 1. Provide for rest.
u the foods that are most important to restrict. The nurse 2. Administer oxygen.
determines that the client understands the dietary instruc- 3. Check a pulse distal to the insertion site.
tions when the client identifies the following foods. Select 4. Assess the electrocardiogram every fifteen minutes.
all that apply. 47. For which common complication of myocardial infarction
1. Olive oil should the nurse monitor clients in the coronary care unit?
2. Chicken broth 1. Dysrhythmia
3. Enriched whole milk 2. Hypokalemia
4. Red meats, such as beef 3. Anaphylactic shock
5. Vegetables and whole grains 4. Cardiac enlargement
6. Liver and other glandular organ meats 48. A nurse prepares a client for insertion of a pulmonary artery
40. Which instructions should the nurse include in the teaching catheter. What information can be obtained from monitor-
u plan for a client who will be taking simvastatin (Zocor) ing the pulmonary artery pressure?
when discharged? Select all that apply. 1. Stroke volume
1. Increase dietary intake of potassium. 2. Venous pressure
2. Avoid prolonged exposure to the sun. 3. Coronary artery patency
3. Schedule regular ophthalmic examinations. 4. Left ventricular functioning
4. Take the medication at least a half hour before meals. 49. A client with a thromboembolic disorder is receiving a con-
5. Contact your health care provider if skin becomes u tinuous intravenous infusion of heparin 1000 units per
gray-bronze. hour. There are 25,000 units of heparin in 500 mL of 5%
