Med Surg Exam 4
A nurse assesses clients on a medical-surgical unit. Which client should the nurse identify as
having the greatest risk for cardiovascular disease
A An 86-year-old man with a history of asthma
B A 32-year-old Asian-American man with colorectal cancer
C A 45-year-old American Indian woman with diabetes mellitus
D A 53-year-old postmenopausal woman who is on hormone therapy - ANS-C
A nurse assesses an older adult client who is experiencing a myocardial infarction. Which
clinical manifestation should the nurse expect
A Excruciating pain on inspiration
B Left lateral chest wall pain
C Disorientation and confusion
D Numbness and tingling of the arm - ANS-C
A nurse assesses a client who is scheduled for a cardiac catheterization. Which assessment
should the nurse complete prior to this procedure
A Client's level of anxiety
B Ability to turn self in bed
C Cardiac rhythm and heart rate
D Allergies to iodine-based agents - ANS-D
A nurse cares for a client who has an 80% blockage of the right coronary artery (RCA) and is
scheduled for bypass surgery. Which intervention should the nurse be prepared to implement
while this client waits for surgery
A Administration of IV furosemide (Lasix)
B Initiation of an external pacemaker
C Assistance with endotracheal intubation
D Placement of central venous access - ANS-C
A nurse teaches a client with diabetes mellitus and a body mass index of 42 who is at high risk
for coronary artery disease. Which statement related to nutrition should the nurse include in this
client's teaching
A "The best way to lose weight is a high-protein, low-carbohydrate diet."
B "You should balance weight loss with consuming necessary nutrients."
,C "A nutritionist will provide you with information about your new diet."
D "If you exercise more frequently, you won't need to change your diet." - ANS-B
A nurse cares for a client who has advanced cardiac disease and states, "I am having trouble
sleeping at night." How should the nurse respond
A "I will consult the provider to prescribe a sleep study to determine the problem."
B "You become hypoxic while sleeping; oxygen therapy via nasal cannula will help."
C "A continuous positive airway pressure, or CPAP, breathing mask will help you breathe at
night."
D "Use pillows to elevate your head and chest while you are sleeping." - ANS-D
A nurse cares for a client who is recovering from a myocardial infarction. The client states, "I will
need to stop eating so much chili to keep that indigestion pain from returning." How should the
nurse respond
A "Chili is high in fat and calories; it would be a good idea to stop eating it."
B "The provider has prescribed an antacid for you to take every morning."
C "What do you understand about what happened to you"
D "When did you start experiencing this indigestion" - ANS-C
An emergency department nurse triages clients who present with chest discomfort. Which client
should the nurse plan to assess first
A A 42-year-old female who describes her pain as a dull ache with numbness in her fingers
B A 49-year-old male who reports moderate pain that is worse on inspiration
C A 53-year-old female who reports substernal pain that radiates to her abdomen
D A 58-year-old male who describes his pain as intense stabbing that spreads across his chest -
ANS-D
A nurse is caring for a client with a history of renal insufficiency who is scheduled for a cardiac
catheterization. Which actions should the nurse take prior to the catheterization (Select all that
apply.)
A Assess for allergies to iodine.
B Administer intravenous fluids.
C Assess blood urea nitrogen (BUN) and creatinine results.
D Insert a Foley catheter.
E Administer a prophylactic antibiotic.
F Insert a central venous catheter. - ANS-A B C
An emergency room nurse assesses a female client. Which assessment findings should alert
the nurse to request a prescription for an electrocardiogram (Select all that apply.)
, A Hypertension
B Fatigue despite adequate rest
C Indigestion
D Abdominal pain
E Shortness of breath - ANS-B C E
A nurse assesses a client who is recovering after a coronary catheterization. Which assessment
findings in the first few hours after the procedure require immediate action by the nurse (Select
all that apply.)
A Blood pressure of 140/88 mm Hg
B Serum potassium of 2.9 mEq/L
C Warmth and redness at the site
D Expanding groin hematoma
E Rhythm changes on the cardiac monitor - ANS-B D E
A nurse reviews a client's laboratory results. Which findings should alert the nurse to the
possibility of atherosclerosis (Select all that apply.)
A Total cholesterol: 280 mg/dL
B High-density lipoprotein cholesterol: 50 mg/dL
C Triglycerides: 200 mg/dL
D Serum albumin: 4 g/dL
E Low-density lipoprotein cholesterol: 160 mg/dL - ANS-A C E
A nurse prepares a client for a pharmacologic stress echocardiogram. Which actions should the
nurse take when preparing this client for the procedure (Select all that apply.)
A Assist the provider to place a central venous access device.
B Prepare for continuous blood pressure and pulse monitoring.
C Administer the client's prescribed beta blocker.
D Give the client nothing by mouth 3 to 6 hours before the procedure.
E Explain to the client that dobutamine will simulate exercise for this examination. - ANS-B D E
A nurse cares for a client who is recovering from a right-sided heart catheterization. For which
complications of this procedure should the nurse assess (Select all that apply.)
A Thrombophlebitis
B Stroke
C Pulmonary embolism
D Myocardial infarction
E Cardiac tamponade - ANS-A C E
A nurse assesses clients on a medical-surgical unit. Which client should the nurse identify as
having the greatest risk for cardiovascular disease
A An 86-year-old man with a history of asthma
B A 32-year-old Asian-American man with colorectal cancer
C A 45-year-old American Indian woman with diabetes mellitus
D A 53-year-old postmenopausal woman who is on hormone therapy - ANS-C
A nurse assesses an older adult client who is experiencing a myocardial infarction. Which
clinical manifestation should the nurse expect
A Excruciating pain on inspiration
B Left lateral chest wall pain
C Disorientation and confusion
D Numbness and tingling of the arm - ANS-C
A nurse assesses a client who is scheduled for a cardiac catheterization. Which assessment
should the nurse complete prior to this procedure
A Client's level of anxiety
B Ability to turn self in bed
C Cardiac rhythm and heart rate
D Allergies to iodine-based agents - ANS-D
A nurse cares for a client who has an 80% blockage of the right coronary artery (RCA) and is
scheduled for bypass surgery. Which intervention should the nurse be prepared to implement
while this client waits for surgery
A Administration of IV furosemide (Lasix)
B Initiation of an external pacemaker
C Assistance with endotracheal intubation
D Placement of central venous access - ANS-C
A nurse teaches a client with diabetes mellitus and a body mass index of 42 who is at high risk
for coronary artery disease. Which statement related to nutrition should the nurse include in this
client's teaching
A "The best way to lose weight is a high-protein, low-carbohydrate diet."
B "You should balance weight loss with consuming necessary nutrients."
,C "A nutritionist will provide you with information about your new diet."
D "If you exercise more frequently, you won't need to change your diet." - ANS-B
A nurse cares for a client who has advanced cardiac disease and states, "I am having trouble
sleeping at night." How should the nurse respond
A "I will consult the provider to prescribe a sleep study to determine the problem."
B "You become hypoxic while sleeping; oxygen therapy via nasal cannula will help."
C "A continuous positive airway pressure, or CPAP, breathing mask will help you breathe at
night."
D "Use pillows to elevate your head and chest while you are sleeping." - ANS-D
A nurse cares for a client who is recovering from a myocardial infarction. The client states, "I will
need to stop eating so much chili to keep that indigestion pain from returning." How should the
nurse respond
A "Chili is high in fat and calories; it would be a good idea to stop eating it."
B "The provider has prescribed an antacid for you to take every morning."
C "What do you understand about what happened to you"
D "When did you start experiencing this indigestion" - ANS-C
An emergency department nurse triages clients who present with chest discomfort. Which client
should the nurse plan to assess first
A A 42-year-old female who describes her pain as a dull ache with numbness in her fingers
B A 49-year-old male who reports moderate pain that is worse on inspiration
C A 53-year-old female who reports substernal pain that radiates to her abdomen
D A 58-year-old male who describes his pain as intense stabbing that spreads across his chest -
ANS-D
A nurse is caring for a client with a history of renal insufficiency who is scheduled for a cardiac
catheterization. Which actions should the nurse take prior to the catheterization (Select all that
apply.)
A Assess for allergies to iodine.
B Administer intravenous fluids.
C Assess blood urea nitrogen (BUN) and creatinine results.
D Insert a Foley catheter.
E Administer a prophylactic antibiotic.
F Insert a central venous catheter. - ANS-A B C
An emergency room nurse assesses a female client. Which assessment findings should alert
the nurse to request a prescription for an electrocardiogram (Select all that apply.)
, A Hypertension
B Fatigue despite adequate rest
C Indigestion
D Abdominal pain
E Shortness of breath - ANS-B C E
A nurse assesses a client who is recovering after a coronary catheterization. Which assessment
findings in the first few hours after the procedure require immediate action by the nurse (Select
all that apply.)
A Blood pressure of 140/88 mm Hg
B Serum potassium of 2.9 mEq/L
C Warmth and redness at the site
D Expanding groin hematoma
E Rhythm changes on the cardiac monitor - ANS-B D E
A nurse reviews a client's laboratory results. Which findings should alert the nurse to the
possibility of atherosclerosis (Select all that apply.)
A Total cholesterol: 280 mg/dL
B High-density lipoprotein cholesterol: 50 mg/dL
C Triglycerides: 200 mg/dL
D Serum albumin: 4 g/dL
E Low-density lipoprotein cholesterol: 160 mg/dL - ANS-A C E
A nurse prepares a client for a pharmacologic stress echocardiogram. Which actions should the
nurse take when preparing this client for the procedure (Select all that apply.)
A Assist the provider to place a central venous access device.
B Prepare for continuous blood pressure and pulse monitoring.
C Administer the client's prescribed beta blocker.
D Give the client nothing by mouth 3 to 6 hours before the procedure.
E Explain to the client that dobutamine will simulate exercise for this examination. - ANS-B D E
A nurse cares for a client who is recovering from a right-sided heart catheterization. For which
complications of this procedure should the nurse assess (Select all that apply.)
A Thrombophlebitis
B Stroke
C Pulmonary embolism
D Myocardial infarction
E Cardiac tamponade - ANS-A C E
