NUR 372 124745332-Medical-Surgical-QandA 100% GRADED.
1.A 60-year-old male client comes into the emergency department with complaints of crushing
substernal chest pain that radiates to his shoulder and left arm. The admitting diagnosis is acute
myocardial infraction (MI). Immediate admission orders include oxygen by nasal cannula at 4
L/minute, blood work, a chest radiograph, a 12-lead electrocardiogram (ECG), and 2 mg of
morphine sulfate given intravenously. The nurse should first:
a. Administer the morphine
b. Obtain a 12-lead ECG
c. Obtain the blood work
d. Order the chest radiograph
Ans: A – although obtaining the ECG, chest radiograph, and blood work are all important, the
nurse’s priority action should be to relieve the crushing chest pain. Therefore, administering
morphine sulfate is priority action.
2. When administering a thrombolytic drug to the client experiencing an MI, the nurse explains
to him that the purpose of the drug is to:
a. Help keep him well hydrated
b. Dissolve clots that he may have
c. Prevent kidney failure
d. Treat potential cardiac dysrhythmias
Ans: B – thrombolytic drugs are administered within the first 6 hours after of myocardial
infarction to lyse clots and reduce the extent of myocardial damage.
3. If the client who has admitted for MI develops cardiogenic shock, which characteristic signs
should the nurse expect to observe?
a. Oliguria
b. Bradycardia
c. Elevated blood pressure
d. Fever
Ans: A – oliguria occurs during cardiogenic shock because there is reduced blood flow to the
kidneys. Typically signs of cardiogenic shock include low blood pressure, rapid and weak pulse,
decrease urine output, and signs of diminished blood flow to the brain, such as confusion and
restlessness. Cardiogenic shock is a serious complication of MI, with a mortality rate approaching
90%. Fever is not a typical sign of cardiogenic shock.
4. The physician orders continuous intravenous nitroglycerin infusion for the client with MI.
essential nursing action include which of the following?
a. Obtaining an infusion pump for the medication
b. Monitoring blood pressure every 4 hours
c. Monitoring urine output hourly
d. Obtaining serum potassium levels daily
Ans: A – intravenous nitroglycerin infusion requires an infusion pump for precise control of the
medication. Blood pressure monitoring would be done with a continuous system, and more
frequently than every 4 hours. Hourly urine outputs are not always required. Obtaining serum
potassium levels is not associated with nitroglycerin infusion.
5. When teaching the client with MI, the nurse explains that the pain associated with MI is caused by:
a. Left ventricular overload
b. Impending circulatory collapse
c. Extracellular electrolyte imbalances
d. Insufficient oxygen reaching the heart muscle
Ans: D – an MI interferes with or blocks circulation to the heart muscle. Decreased blood supply
to the heart muscle causes ischemia, or poor myocardial oxygenation. Diminished oxygenation
or lack of oxygen to the cardiac muscle results in ischemic pain or angina.
6. Aspirin is administered to the client experiencing an MI because of its:
a. Antipyretic action
b. Antithrombotic action
c. Antiplatelet action
d. Analgesic action
Ans: B – aspirin does have antipyretic, antiplatelet, and analgesic actions, but the primary reason
aspirin is administered to the client experiencing an MI is its antithrombotic action. In clinical trials,
the antithrombotic action of aspirin has been thought to account for improved outcomes in clients
with MI.
7. While caring for a client who has sustained an MI, the nurse notes eight PVCs in 1 minute on
the cardiac monitor. The client is receiving an intravenous infusion of 5% dextrose in water and
oxygen at 2 L/minute. The nurse’s first course of action should be to:
, NUR 372 124745332-Medical-Surgical-QandA 100% GRADED.
oxygen concentration should not be the nurse’s first course of action; rather, the nurse should
notify the physician promptly. Administering a prescribed analgesic would not decrease ventricular
irritability.
8. Which of the following is an expected outcome for a client on the second day of
hospitalization after an MI? The client:
, NUR 372 124745332-Medical-Surgical-QandA 100% GRADED.
a. Has minimal chest pain
b. Can identify risk factors for MI
c. Agrees to participate in a cardiac rehabilitation program
d. Can perform personal self-care activities without pain
Ans: D – by day 2 of hospitalization after an MI, clients are expected to be able to perform personal
care without chest pain. Day 2 of hospitalization may be too soon for clients to be able to identify
risk factors for MI or to be able to agree to participate in a cardiac rehabilitation program.
9. When teaching a client about the expected outcomes after intravenous administration of
furosemide, the nurse would include which outcome?
a. Increased blood pressure
b. Increased urine output
c. Decreased pain
d. Decreased PVCs
Ans: B – furosemide is a loop diuretic acts to increase urine output. Furosemide does not increase
blood pressure, decrease pain, or decrease dysrhythmias.
10. After an MI, the hospitalized client is taught to move the legs about while resting in bed. This
type of exercise is recommended primarily to help:
a. Prepare the client for ambulation
b. Promote urinary and intestinal elimination
c. Prevent thrombophlebitis and blood clot formation
d. Decrease the likelihood of decubitus ulcer formation
Ans: C – although this type of exercise may decrease the likelihood of heel decubitus ulcer form
formation, it is taught to the MI client to prevent thrombophlebitis and blood clot formation.
Movement of the lower extremities provides muscular action and aids venous return. As a result,
the activity helps prevent stasis of blood, which predisposes the client to thrombophlebitis and
blood clot formation. This type of exercise is not associated with promoting urinary and intestinal
elimination.
11. Which of the following reflects the principle on which a client’s diet will most likely be based
during the acute phase of MI?
a. Liquids as desired
b. Small, easily digested meals
c. Three regular meals per day
d. Nothing by mouth
Ans: B – recommended dietary principles in the acute phase of MI include avoiding large meals
because small, easily digested foods are better tolerated. Fluids are given according to the client’s
needs, and sodium restrictions may be prescribed, especially for clients with manifestations of
heart failure. Cholesterol restrictions may be ordered as well. Clients are not prescribed diets of
liquids only or restricted to nothing by mouth unless their condition is very unstable.
12. Of the following controllable risk factors for coronary artery disease (CAD) appears most
closely linked to the development of the disease?
a. Age
b. Medication usage
c. High cholesterol levels
d. Gender
Ans: C – high cholesterol levels are considered a controllable risk factor for CAD and appear most
clearly linked to the development of the disease. High cholesterol levels can be modified through
diet, exercise, and medication. Age and gender are uncontrollable risk factors for CAD. Medication
usage is not considered a risk factor for CAD.
13. Which of the following is an uncontrollable risk factor that has been linked to the development of
CAD?
a. Exercise
b. Obesity
c. Stress
d. Heredity
Ans: D – heredity has been linked to CAD and is an uncontrollable risk factor. Exercise, obesity,
and stress are controllable risk factor for CAD.
14. If a client displays risk factors for CAD such as smoking cigarettes, eating a diet high in
saturated fat, or leading a sedentary lifestyle, technique of behavior modification may be used to
help the client change behavior. The nurse can best reinforce new adaptive behaviors by:
a. Explaining how the old behavior leads to poor health
b. Withholding praise until the new behavior is well established
, NUR 372 124745332-Medical-Surgical-QandA 100% GRADED.
c. Control the dysrhythmias associated with MI
d. Revascularize the blocked coronary artery
Ans: D – the thrombolytic agent t-PA, administered intravenously, lyses the clot blocking the
coronary artery. The drug is most effective when administered within the first 6 hours after onset.
1.A 60-year-old male client comes into the emergency department with complaints of crushing
substernal chest pain that radiates to his shoulder and left arm. The admitting diagnosis is acute
myocardial infraction (MI). Immediate admission orders include oxygen by nasal cannula at 4
L/minute, blood work, a chest radiograph, a 12-lead electrocardiogram (ECG), and 2 mg of
morphine sulfate given intravenously. The nurse should first:
a. Administer the morphine
b. Obtain a 12-lead ECG
c. Obtain the blood work
d. Order the chest radiograph
Ans: A – although obtaining the ECG, chest radiograph, and blood work are all important, the
nurse’s priority action should be to relieve the crushing chest pain. Therefore, administering
morphine sulfate is priority action.
2. When administering a thrombolytic drug to the client experiencing an MI, the nurse explains
to him that the purpose of the drug is to:
a. Help keep him well hydrated
b. Dissolve clots that he may have
c. Prevent kidney failure
d. Treat potential cardiac dysrhythmias
Ans: B – thrombolytic drugs are administered within the first 6 hours after of myocardial
infarction to lyse clots and reduce the extent of myocardial damage.
3. If the client who has admitted for MI develops cardiogenic shock, which characteristic signs
should the nurse expect to observe?
a. Oliguria
b. Bradycardia
c. Elevated blood pressure
d. Fever
Ans: A – oliguria occurs during cardiogenic shock because there is reduced blood flow to the
kidneys. Typically signs of cardiogenic shock include low blood pressure, rapid and weak pulse,
decrease urine output, and signs of diminished blood flow to the brain, such as confusion and
restlessness. Cardiogenic shock is a serious complication of MI, with a mortality rate approaching
90%. Fever is not a typical sign of cardiogenic shock.
4. The physician orders continuous intravenous nitroglycerin infusion for the client with MI.
essential nursing action include which of the following?
a. Obtaining an infusion pump for the medication
b. Monitoring blood pressure every 4 hours
c. Monitoring urine output hourly
d. Obtaining serum potassium levels daily
Ans: A – intravenous nitroglycerin infusion requires an infusion pump for precise control of the
medication. Blood pressure monitoring would be done with a continuous system, and more
frequently than every 4 hours. Hourly urine outputs are not always required. Obtaining serum
potassium levels is not associated with nitroglycerin infusion.
5. When teaching the client with MI, the nurse explains that the pain associated with MI is caused by:
a. Left ventricular overload
b. Impending circulatory collapse
c. Extracellular electrolyte imbalances
d. Insufficient oxygen reaching the heart muscle
Ans: D – an MI interferes with or blocks circulation to the heart muscle. Decreased blood supply
to the heart muscle causes ischemia, or poor myocardial oxygenation. Diminished oxygenation
or lack of oxygen to the cardiac muscle results in ischemic pain or angina.
6. Aspirin is administered to the client experiencing an MI because of its:
a. Antipyretic action
b. Antithrombotic action
c. Antiplatelet action
d. Analgesic action
Ans: B – aspirin does have antipyretic, antiplatelet, and analgesic actions, but the primary reason
aspirin is administered to the client experiencing an MI is its antithrombotic action. In clinical trials,
the antithrombotic action of aspirin has been thought to account for improved outcomes in clients
with MI.
7. While caring for a client who has sustained an MI, the nurse notes eight PVCs in 1 minute on
the cardiac monitor. The client is receiving an intravenous infusion of 5% dextrose in water and
oxygen at 2 L/minute. The nurse’s first course of action should be to:
, NUR 372 124745332-Medical-Surgical-QandA 100% GRADED.
oxygen concentration should not be the nurse’s first course of action; rather, the nurse should
notify the physician promptly. Administering a prescribed analgesic would not decrease ventricular
irritability.
8. Which of the following is an expected outcome for a client on the second day of
hospitalization after an MI? The client:
, NUR 372 124745332-Medical-Surgical-QandA 100% GRADED.
a. Has minimal chest pain
b. Can identify risk factors for MI
c. Agrees to participate in a cardiac rehabilitation program
d. Can perform personal self-care activities without pain
Ans: D – by day 2 of hospitalization after an MI, clients are expected to be able to perform personal
care without chest pain. Day 2 of hospitalization may be too soon for clients to be able to identify
risk factors for MI or to be able to agree to participate in a cardiac rehabilitation program.
9. When teaching a client about the expected outcomes after intravenous administration of
furosemide, the nurse would include which outcome?
a. Increased blood pressure
b. Increased urine output
c. Decreased pain
d. Decreased PVCs
Ans: B – furosemide is a loop diuretic acts to increase urine output. Furosemide does not increase
blood pressure, decrease pain, or decrease dysrhythmias.
10. After an MI, the hospitalized client is taught to move the legs about while resting in bed. This
type of exercise is recommended primarily to help:
a. Prepare the client for ambulation
b. Promote urinary and intestinal elimination
c. Prevent thrombophlebitis and blood clot formation
d. Decrease the likelihood of decubitus ulcer formation
Ans: C – although this type of exercise may decrease the likelihood of heel decubitus ulcer form
formation, it is taught to the MI client to prevent thrombophlebitis and blood clot formation.
Movement of the lower extremities provides muscular action and aids venous return. As a result,
the activity helps prevent stasis of blood, which predisposes the client to thrombophlebitis and
blood clot formation. This type of exercise is not associated with promoting urinary and intestinal
elimination.
11. Which of the following reflects the principle on which a client’s diet will most likely be based
during the acute phase of MI?
a. Liquids as desired
b. Small, easily digested meals
c. Three regular meals per day
d. Nothing by mouth
Ans: B – recommended dietary principles in the acute phase of MI include avoiding large meals
because small, easily digested foods are better tolerated. Fluids are given according to the client’s
needs, and sodium restrictions may be prescribed, especially for clients with manifestations of
heart failure. Cholesterol restrictions may be ordered as well. Clients are not prescribed diets of
liquids only or restricted to nothing by mouth unless their condition is very unstable.
12. Of the following controllable risk factors for coronary artery disease (CAD) appears most
closely linked to the development of the disease?
a. Age
b. Medication usage
c. High cholesterol levels
d. Gender
Ans: C – high cholesterol levels are considered a controllable risk factor for CAD and appear most
clearly linked to the development of the disease. High cholesterol levels can be modified through
diet, exercise, and medication. Age and gender are uncontrollable risk factors for CAD. Medication
usage is not considered a risk factor for CAD.
13. Which of the following is an uncontrollable risk factor that has been linked to the development of
CAD?
a. Exercise
b. Obesity
c. Stress
d. Heredity
Ans: D – heredity has been linked to CAD and is an uncontrollable risk factor. Exercise, obesity,
and stress are controllable risk factor for CAD.
14. If a client displays risk factors for CAD such as smoking cigarettes, eating a diet high in
saturated fat, or leading a sedentary lifestyle, technique of behavior modification may be used to
help the client change behavior. The nurse can best reinforce new adaptive behaviors by:
a. Explaining how the old behavior leads to poor health
b. Withholding praise until the new behavior is well established
, NUR 372 124745332-Medical-Surgical-QandA 100% GRADED.
c. Control the dysrhythmias associated with MI
d. Revascularize the blocked coronary artery
Ans: D – the thrombolytic agent t-PA, administered intravenously, lyses the clot blocking the
coronary artery. The drug is most effective when administered within the first 6 hours after onset.
