Medical surg midterm Exam (Chamberlain)

Med Surg midterm questions 1. The nurse is caring for a client on the cardiac unit. Which change of condition may indicate potential increasing of right-side heart failure? Select all that apply. a) Increased weakness on ambulation b) Jugular vein distention c) Edema changed from a 3 to a 1 d) One-pound weight loss e) Increased palpitations f) Increased dyspnea 2. A patient has undergone a cardiac catheterization. He is to be discharged today. What information should the nurse emphasize during discharge teaching? a) Avoid heavy lifting for the next 24 hours. b) Take a tub bath, rather than a shower. c) Bend only at the waist. d) New bruising at the puncture site is normal. 3. The nurse is caring for a patient diagnosed with pericarditis. What serious complication should this patient be monitored for? a) Left ventricular hypertrophy b) Cardiac tamponade c) Decreased venous pressure d) Hypertension 4. A client in the emergency department complains of squeezing substernal pain that radiates to the left shoulder and jaw. He also complains of nausea, diaphoresis, and shortness of breath. What should the nurse do? a) Complete the client's registration information, perform an electrocardiogram, gain I.V. access, and take vital signs. b) Alert the cardiac catheterization team, administer oxygen, attach a cardiac monitor, and notify the physician. c) Gain I.V. access, give sublingual nitroglycerin, and alert the cardiac catheterization team. d) Administer oxygen, attach a cardiac monitor, take vital signs, and administer sublingual nitroglycerin. 5. The nurse is reviewing the medication administration record of a patient diagnosed with systolic HF. What medication should the nurse anticipate administering to this patient? A) A beta-adrenergic blocker B) An antiplatelet aggregator C) A calcium channel blocker D) A nonsteroidal anti-inflammatory drug (NSAID) 6. The nurse is assessing a patient who is known to have right-sided HF. What assessment finding is most consistent with this patient's diagnosis? A) Pulmonary edema B) Distended neck veins C) Dry cough D) Orthopnea 7. The nurse is performing a physical assessment on a patient suspected of having HF. The presence of what sound would signal the possibility of impending HF? A) An S3 heart sound B) Pleural friction rub C) Faint breath sounds D) A heart murmur 8. Diagnostic imaging reveals that the quantity of fluid in a client's pericardial sac is dangerously increased. The nurse should collaborate with the other members of the care team to prevent the development of what complication? A) Pulmonary edema B) Pericardiocentesis C) Cardiac tamponade D) Pericarditis 9. A patient admitted to the medical unit with HF is exhibiting signs and symptoms of pulmonary edema. The nurse is aware that positioning will promote circulation. How should the nurse best position the patient? A) In a high Fowler's position B) On the left side-lying position C) In a flat, supine position D) In the Trendelenburg position 10. The nurse is providing discharge education to a patient diagnosed with HF. What should the nurse teach this patient to do to assess her fluid balance in the home setting? A) Monitor her blood pressure daily B) Assess her radial pulses daily C) Monitor her weight daily D) Monitor her bowel movements 11. The nurse is providing patient education prior to a patient's discharge home after treatment for HF. The nurse gives the patient a home care checklist as part of the discharge teaching. What should be included on this checklist? A) Know how to recognize and prevent orthostatic hypotension. B) Weigh yourself weekly at a consistent time of day. C) Measure everything you eat and drink until otherwise instructed. D) Limit physical activity to only those tasks that are necessary. 12. A patient is brought to the ED and determined to be experiencing symptomatic sinus bradycardia. The nurse caring for this patient is aware the medication of choice for treatment of this dysrhythmia is the administration of atropine. What guidelines will the nurse follow when administering atropine? A) Administer atropine 0.5 mg as an IV bolus every 3 to 5 minutes to a maximum of 3.0 mg. B) Administer atropine as a continuous infusion until symptoms resolve. C) Administer atropine as a continuous infusion to a maximum of 30 mg in 24 hours. D) Administer atropine 1.0 mg sublingually. 13. A patient has undergone diagnostic testing and received a diagnosis of sinus bradycardia attributable to sinus node dysfunction. When planning this patient's care, what nursing diagnosis is most appropriate? A) Acute pain B) Risk for unilateral neglect C) Risk for activity intolerance D) Risk for fluid volume excess 14. During a CPR class, a participant asks about the difference between cardioversion and defibrillation. What would be the instructor's best response? A) "Cardioversion is done on a beating heart; defibrillation is not." B) "The difference is the timing of the delivery of the electric current." C) "Defibrillation is synchronized with the electrical activity of the heart, but cardioversion is not." D) "Cardioversion is always attempted before defibrillation because it has fewer risks." 15. Which of the following is the treatment of choice for ventricular fibrillation? a) Implanted defibrillator b) Pacemaker c) Immediate bystander CPR d) Atropine 16. A patient with mitral valve stenosis and coronary artery disease (CAD) is in the telemetry unit with pneumonia. The nurse assesses a 6-second rhythm strip and determines that the ventricular rhythm is highly irregular at 88, with no discernible P waves. What does the nurse determine this rhythm to be? a) Sinus tachycardia b) Ventricular flutter c) Atrial flutter d) Nonparoxysmal junctional tachycardia 17. An 83-year-old resident in the long-term care facility where you practice nursing has an irregular heart rate of around 100 beats/minute. He also has a significant pulse deficit. What component of his history would produce such symptoms? a) Bundle branch block b) Heart block c) Atrial flutter d) Atrial fibrillation 18. When the nurse observes an electrocardiogram (ECG) tracing on a cardiac monitor with a pattern in lead II and observes a bizarre, abnormal shape to the QRS complex, the nurse has likely observed which of the following ventricular dysrhythmias? a) Ventricular tachycardia b) Ventricular bigeminy c) Premature ventricular contraction (PVC) d) Ventricular fibrillation 19. A Nurse is completing a shift assessment on a patient admitted to the telemetry unit with a diagnosis of syncope. The patient’s heart rate is 55 bpm with a blood pressure of 90/66 mm Hg. The patient is also experiencing dizziness and shortness of breath. Which of the following medication will the nurse anticipate administering t the patient based on these clinical findings? A) Cardizem B) Atropine C) Lidocaine D) Pronestyl 20. The nursing instructor is talking about hepatitis with her clinical group. What would the instructor teach the students is the best method to prevent the transmission of the hepatitis E virus? A) Following proper hand-washing techniques B) Avoiding chemicals that are toxic to the liver C) Wearing a condom during sexual relations D) Isolating yourself from your family members 21. How is hepatitis C transmitted? A) Unintentional needlesticks B) Fecal-oral route C) Contaminated food D) Airborne route 22. A client is admitted to the hospital with acute hemorrhage from esophageal varices. What medication should the nurse anticipate administering that will reduce pressure in the portal venous system and control esophageal bleeding? a) Vasopressin (Pitressin) b) Vitamin K c) Epinephrine d) Octreotide (Sandostatin) 23. Which of the following is the most effective strategy to prevent hepatitis B infection? a) Vaccine b) Barrier protection during intercourse c) Covering open sores d) Avoid sharing toothbrushes 24. A client is admitted for suspected GI disease. Assessment data reveal muscle wasting, a decrease in chest and axillary hair, and increased bleeding tendency. The nurse suspects the client has: a) peptic ulcer disease. b) appendicitis. c) cholelithiasis. d) cirrhosis. .25. A patient with gallstones has been prescribed ursodeoxycholic acid (UDCA). The nurse understands that additional teaching is needed regarding this medication when the patient states: A) "It is important that I see my physician for scheduled follow-up appointments while taking this medication." B) "I will take this medication for 2 weeks and then gradually stop taking it." C) "If I lose weight, the dose of the medication may need to be changed." D) "This medication will help dissolve small gallstones made of cholesterol." 25. . A nurse is assisting with serving dinner trays on the unit. Upon receiving the dinner tray for a patient admitted with acute gallbladder inflammation, the nurse will question which of the following foods on the tray? A) Fried chicken B) Mashed potatoes C) Dinner roll D) Tapioca pudding 27. A patient with pancreatic cancer has been scheduled for a pancreaticoduodenectomy (Whipple procedure). During health education, the patient should be informed that this procedure will involve the removal of which of the following? Select all that apply. A) Gallbladder B) Part of the stomach C) Duodenum D) Part of the common bile duct E) Part of the rectum