meds
Med-Surg Exam 2
2. Patients with mitral stenosis may be placed on anticoagulant therapy. The nurse knows that
this type of therapy may be instituted to decrease the risk of which of the following?
A) Ventricular hypertrophy
B) Pulmonary embolism
C) Deep vein thrombosis
D) Atrial thrombus
Ans: D
Chapter: 29
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 1
Patient Needs: D-3
Feedback: Patients with mitral stenosis may
medbenefit from anticoagulants to decrease the risk for
developing atrial thrombus. Anticoagulant therapy may be instituted in patient with pulmonary
emboli and deep vein thrombosis.
11. When assessing a patient with mitral regurgitation, the nurse would expect which of
the following heart sounds to occur?
A) Diastolic murmur
B) Systolic murmur
C) Systolic click
D) Ventricular dysrhythmias
Ans: B
Chapter: 29
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 1
Patient Needs: A-1
Feedback: A systolic murmur is heard as a high-pitched, blowing sound at the apex in
patients with mitral regurgitation. Ventricular dysrhythmia and a systolic click may be
noted in a patient with mitral valve prolapse.
12. A patient is undergoing a valvuloplasty to repair a defective heart valve. Patient
education is aimed at which of the following priority areas of teaching?
A) Patient-controlled analgesia
B) Long-term anticoagulant therapy
,C) Long-term steroid therapy
D) Exercise program
Ans: B
Chapter: 29
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Teaching/Learning
Objective: 2
Patient Needs: A-1
Feedback: The nurse educates the patient about long-term anticoagulant therapy,
explaining the need for frequent follow-up appointments and blood laboratory studies.
20. The nurse is caring for a newly admitted patient on the telemetry unit. The patient is
experiencing progressive fatigue, hemoptysis, and dyspnea as a result of pulmonary venous
hypertension due to which of the following valvular disorders?
A) Aortic regurgitation
B) Mitral stenosis
C) Mitral valve prolapse
D) Aortic stenosis
Ans: B
Chapter: 29
Cognitive Level: Application
Difficulty: Difficult
Integrated Process: Nursing Process
Objective: 1
Patient Needs: D-4
Feedback: The left atrium has difficulty moving blood into the left ventricle due to the mitral
stenosis. The pulmonary veins are subject to a backward flow of blood. Pulmonary venous
hypertension results, and the patient experiences hemoptysis, dyspnea, progressive fatigue, and
repeated respiratory infections.
22. The nurse caring for a patient with aortic stenosis assesses for which common symptom?
A) Angina pectoris
B) Palpable arterial pulsations in the temporal arteries
C) Repeated respiratory infections
D) Orthopnea
Ans: A
Chapter: 29
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 1
, Patient Needs: D-4
Feedback: When symptoms develop in aortic stenosis, they include angina pectoris, exertional
dyspnea, dizziness, and fainting.
32. A community health nurse is providing information to a group of parents on rheumatic heart
disease. Which of the following is the most effective prevention of rheumatic heart disease?
A) Recognizing and prompting treatment of streptococcal infections
B) Adhering to antihypertensive medication treatment
C) Lowering blood cholesterol
D) Smoking cessation
Ans: A
Chapter: 29
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Teaching/Learning
Objective: 4
Patient Needs: B-2
Feedback: Group A Streptococcus can cause rheumatic heart fever, resulting in rheumatic
endocarditis. Being aware of signs and symptoms of streptococcal infections, identifying them
quickly, and treating them promptly is the best prevention of rheumatic endocarditis.
30.The client is scheduled to have a bronchoscopy. Which nursing intervention is most
appropriate in preparation for this procedure?
A. Ensure that the client does not smoke for 6 to 8 hours before the procedure.
B. Allow the client nothing by mouth for 4 hours before the procedure.
C. Discontinue all inhalant medications 6 to 8 hours before the procedure.
D. Shave the suprasternal area of the chest.
ANS: B
Aspiration is possible if vomiting occurs.
24.You observe that the 60-year-old client's anteroposterior (AP) chest diameter is the same as her
lateral chest diameter. What is your best next question in regard to this finding?
A. No questions are needed regarding this normal finding.
B. “Do you have any chronic breathing problems?”
C. “How often do you perform aerobic exercise?”
D. “What are your hobbies?”
ANS: B
9.A client being treated for emphysema has a chronic productive cough. The nurse would assess a
characteristic feature of clients with long-term emphysema, which is
Med-Surg Exam 2
2. Patients with mitral stenosis may be placed on anticoagulant therapy. The nurse knows that
this type of therapy may be instituted to decrease the risk of which of the following?
A) Ventricular hypertrophy
B) Pulmonary embolism
C) Deep vein thrombosis
D) Atrial thrombus
Ans: D
Chapter: 29
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 1
Patient Needs: D-3
Feedback: Patients with mitral stenosis may
medbenefit from anticoagulants to decrease the risk for
developing atrial thrombus. Anticoagulant therapy may be instituted in patient with pulmonary
emboli and deep vein thrombosis.
11. When assessing a patient with mitral regurgitation, the nurse would expect which of
the following heart sounds to occur?
A) Diastolic murmur
B) Systolic murmur
C) Systolic click
D) Ventricular dysrhythmias
Ans: B
Chapter: 29
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 1
Patient Needs: A-1
Feedback: A systolic murmur is heard as a high-pitched, blowing sound at the apex in
patients with mitral regurgitation. Ventricular dysrhythmia and a systolic click may be
noted in a patient with mitral valve prolapse.
12. A patient is undergoing a valvuloplasty to repair a defective heart valve. Patient
education is aimed at which of the following priority areas of teaching?
A) Patient-controlled analgesia
B) Long-term anticoagulant therapy
,C) Long-term steroid therapy
D) Exercise program
Ans: B
Chapter: 29
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Teaching/Learning
Objective: 2
Patient Needs: A-1
Feedback: The nurse educates the patient about long-term anticoagulant therapy,
explaining the need for frequent follow-up appointments and blood laboratory studies.
20. The nurse is caring for a newly admitted patient on the telemetry unit. The patient is
experiencing progressive fatigue, hemoptysis, and dyspnea as a result of pulmonary venous
hypertension due to which of the following valvular disorders?
A) Aortic regurgitation
B) Mitral stenosis
C) Mitral valve prolapse
D) Aortic stenosis
Ans: B
Chapter: 29
Cognitive Level: Application
Difficulty: Difficult
Integrated Process: Nursing Process
Objective: 1
Patient Needs: D-4
Feedback: The left atrium has difficulty moving blood into the left ventricle due to the mitral
stenosis. The pulmonary veins are subject to a backward flow of blood. Pulmonary venous
hypertension results, and the patient experiences hemoptysis, dyspnea, progressive fatigue, and
repeated respiratory infections.
22. The nurse caring for a patient with aortic stenosis assesses for which common symptom?
A) Angina pectoris
B) Palpable arterial pulsations in the temporal arteries
C) Repeated respiratory infections
D) Orthopnea
Ans: A
Chapter: 29
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 1
, Patient Needs: D-4
Feedback: When symptoms develop in aortic stenosis, they include angina pectoris, exertional
dyspnea, dizziness, and fainting.
32. A community health nurse is providing information to a group of parents on rheumatic heart
disease. Which of the following is the most effective prevention of rheumatic heart disease?
A) Recognizing and prompting treatment of streptococcal infections
B) Adhering to antihypertensive medication treatment
C) Lowering blood cholesterol
D) Smoking cessation
Ans: A
Chapter: 29
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Teaching/Learning
Objective: 4
Patient Needs: B-2
Feedback: Group A Streptococcus can cause rheumatic heart fever, resulting in rheumatic
endocarditis. Being aware of signs and symptoms of streptococcal infections, identifying them
quickly, and treating them promptly is the best prevention of rheumatic endocarditis.
30.The client is scheduled to have a bronchoscopy. Which nursing intervention is most
appropriate in preparation for this procedure?
A. Ensure that the client does not smoke for 6 to 8 hours before the procedure.
B. Allow the client nothing by mouth for 4 hours before the procedure.
C. Discontinue all inhalant medications 6 to 8 hours before the procedure.
D. Shave the suprasternal area of the chest.
ANS: B
Aspiration is possible if vomiting occurs.
24.You observe that the 60-year-old client's anteroposterior (AP) chest diameter is the same as her
lateral chest diameter. What is your best next question in regard to this finding?
A. No questions are needed regarding this normal finding.
B. “Do you have any chronic breathing problems?”
C. “How often do you perform aerobic exercise?”
D. “What are your hobbies?”
ANS: B
9.A client being treated for emphysema has a chronic productive cough. The nurse would assess a
characteristic feature of clients with long-term emphysema, which is
