Exam 2 Practice Questions- Med Surg 3 Questions And Correct Verified Answers

EXAM 2 PRACTICE QUESTIONS- MED
SURG 3 QUESTIONS AND CORRECT
VERIFIED ANSWERS
WhenA2assessingA2aA2patientA2withA2sepsis,A2whichA2findingA2wouldA2alertA2theA2nurseA2to
A2theA2onsetA2ofA2acuteA2respiratoryA2distressA2syndromeA2(ARDS)?


a.SpO2A2ofA280%
b.UseA2ofA2accessoryA2musclesA2ofA2respiration
c.Fine,A2scatteredA2cracklesA2onA2auscultationA2ofA2theA2chest
d.ABGsA2ofA2pHA27.33,A2Paco2A248A2mmA2Hg,A2andA2Pao2A280A2mmA2HgA2-A2Ans--
c.Fine,A2scatteredA2cracklesA2onA2auscultationA2ofA2theA2chest

TheA2initialA2presentationA2ofA2acuteA2respiratoryA2distressA2syndromeA2isA2oftenA2subtle.A
2AtA2theA2timeA2ofA2theA2initialA2injury,A2andA2forA2severalA2hoursA2toA21A2toA22A2daysA2after
ward,A2theA2patientA2mayA2notA2experienceA2respiratoryA2symptoms,A2orA2theA2patientA2m
ayA2exhibitA2onlyA2dyspnea,A2tachypnea,A2cough,A2andA2restlessness.A2ChestA2auscultati
onA2mayA2beA2normalA2orA2mayA2revealA2fine,A2scatteredA2crackles.

AA2nurseA2isA2watchingA2theA2cardiacA2monitorA2andA2noticesA2thatA2theA2rhythmA2suddenl
yA2changes.A2ThereA2areA2noA2PA2waves.A2TheA2QRSA2complexesA2areA2wideA2andA2theA2
ventricularA2rateA2isA2regularA2butA2overA2100.A2TheA2nurseA2determinesA2thatA2theA2clientA
2isA2experiencing:


A.A2PrematureA2ventricularA2contraction
B.A2VentricularA2tachycardia
C.A2VentricularA2fibrillation
D.A2SinusA2tachycardiaA2-A2Ans--B.A2VentricularA2tachycardia

WithA2ventricularA2tachycardiaA2theA2ventriclesA2areA2responsibleA2forA2stimulatingA2theA2i
mpulses.A2WhenA2theA2ventriclesA2stimulateA2anA2impulseA2thereA2willA2beA2noA2PA2wave,A
2theA2QRSA2complexesA2areA2wide,A2andA2theA2ventricularA2rateA2isA2usuallyA2fast.


AA2patientA2isA2admittedA2withA2chestA2painA2toA2theA2ER.A2TheA2patientA2hasA2beenA2inA2t
heA2ERA2forA25A2hoursA2andA2isA2beingA2admittedA2toA2yourA2unitA2forA2overnightA2observat
ion.A2FromA2theA2optionsA2below,A2whatA2isA2theA2mostA2IMPORTANTA2informationA2toA2k
nowA2aboutA2thisA2patientA2atA2thisA2time?

A.A2TroponinA2resultA2andA2whenA2theA2nextA2troponinA2levelA2isA2dueA2toA2beA2collected
B.A2DietA2status
C.A2LastA2consumptionA2ofA2caffeine
D.A2CKA2resultA2andA2whenA2theA2nextA2CKA2levelA2isA2dueA2toA2beA2collectedA2-A2Ans--
A.A2TroponinA2resultA2andA2whenA2theA2nextA2troponinA2levelA2isA2dueA2toA2beA2collected

,TroponinA2isA2specificA2toA2cardiacA2muscle.A2WhenA2aA2patientA2complainsA2ofA2chestA2p
ainA2and/
orA2otherA2symptomsA2thatA2couldA2potentiallyA2indicateA2theA2patientA2mayA2beA2havingA2
aA2MI,A2aA212A2leadA2ECGA2willA2beA2doneA2andA2bloodA2specimensA2willA2beA2collectedA2a
ndA2tested.A2IfA2theA2ECGA2doesA2notA2showA2STA2segmentA2changesA2andA2theA2bloodA2
workA2isA2negativeA2theA2patientA2mayA2beA2admittedA2forA224A2hoursA2observation.A2Duri
ngA2theA224A2hoursA2periodA2patientsA2willA2haveA2bloodworkA2(TroponinA2andA2CK/
MB)A2doneA2everyA26A2toA28A2hoursA2toA2determineA2ifA2theA2patientA2didA2orA2didA2notA2ha
veA2aA2MI.A2Therefore,A2itA2isA2importantA2toA2knowA2whenA2theA2firstA2setA2ofA2TroponinA2a
ndA2CK/MBA2wasA2collected.A2TheA2secondA2setA2ofA2TroponinA2andA2CK/
MBA2shouldA2beA2collectedA26A2toA28A2hoursA2afterA2theA2firstA2setA2thenA2againA26A2toA28A2
hoursA2afterA2theA2second.A2AlsoA2keepA2inA2mindA2TroponinA2andA2CK/
MBA2isA2specificA2toA2cardiacA2muscle;A2however,A2CKA2withoutA2MBA2isA2not.

AA2patient'sA2cardiacA2rhythmA2isA2sinusA2bradycardiaA2withA2aA2heartA2rateA2ofA234A2beats
/
min.A2IfA2theA2bradycardiaA2isA2symptomatic,A2theA2nurseA2wouldA2expectA2theA2patientA2to
A2exhibit:


a.Palpitations.
b.Hypertension.
c.Warm,A2flushedA2skin.
d.ShortnessA2ofA2breath.A2-A2Ans--d.ShortnessA2ofA2breath.

SignsA2ofA2symptomaticA2bradycardiaA2includeA2pale,A2coolA2skin;A2hypotension;A2weakne
ss;A2angina;A2dizzinessA2orA2syncope;A2confusionA2orA2disorientation;A2andA2shortnessA2of
A2breath.


AA2patientA2hasA2aA2diagnosisA2ofA2acuteA2myocardialA2infarction,A2andA2hisA2cardiacA2rhyt
hmA2isA2sinusA2bradycardiaA2withA26A2toA28A2prematureA2ventricularA2contractionsA2(PVCs
)A2perA2minute.A2TheA2patternA2thatA2theA2nurseA2recognizesA2asA2theA2mostA2characteristi
cA2ofA2PVCsA2is:

a.AnA2irregularA2rhythm.
b.AnA2invertedA2TA2wave.
c.AA2wide,A2distortedA2QRSA2complex.
d.AnA2increasinglyA2longA2PRA2interval.A2-A2Ans--c.AA2wide,A2distortedA2QRSA2complex.

PrematureA2ventricularA2contractionsA2haveA2wideA2andA2distortedA2QRSA2complexes.

AA2patientA2inA2theA2coronaryA2careA2unitA2developsA2ventricularA2fibrillation.A2TheA2firstA2a
ctionA2theA2nurseA2shouldA2takeA2isA2to:

a.PerformA2defibrillation.
b.InitiateA2cardiopulmonaryA2resuscitation.
c.PrepareA2forA2synchronizedA2cardioversion.

, d.AdministerA2IVA2antidysrhythmicA2drugsA2perA2protocol.A2-A2Ans--
b.InitiateA2cardiopulmonaryA2resuscitation.

ImmediateA2treatmentA2forA2ventricularA2fibrillationA2isA2theA2initiationA2ofA2cardiopulmonar
yA2resuscitation,A2followedA2byA2theA2useA2ofA2defibrillationA2andA2definitiveA2drugA2therap
yA2accordingA2toA2advancedA2cardiacA2lifeA2supportA2guidelines.

ToA2determineA2whetherA2thereA2isA2aA2delayA2inA2impulseA2conductionA2throughA2theA2ve
ntricles,A2theA2nurseA2willA2measureA2theA2durationA2ofA2theA2patient's
a.A2PA2wave.
c.A2PRA2interval.
b.A2QA2wave.
d.A2QRSA2complex.A2-A2Ans--d.A2QRSA2complex.

TheA2nurseA2obtainsA2aA2rhythmA2stripA2onA2aA2patientA2whoA2hasA2hadA2aA2myocardialA2in
farctionA2andA2makesA2theA2followingA2analysis:A2noA2visibleA2PA2waves,A2PRA2intervalA2n
otA2measurable,A2ventricularA2rateA2ofA2162,A2R-
RA2intervalA2regular,A2andA2QRSA2complexA2wideA2andA2distorted,A2andA2QRSA2durationA2
ofA20.18A2second.A2TheA2nurseA2interpretsA2theA2patient'sA2cardiacA2rhythmA2as

a.A2atrialA2flutter.
c.A2ventricularA2fibrillation.
b.A2sinusA2tachycardia.
d.A2ventricularA2tachycardia.A2-A2Ans--d.A2ventricularA2tachycardia.

*wideA2+A2distortedA2QRS,A2rateA2greaterA2thanA2150A2beats/
min,A2andA2theA2regularityA2ofA2theA2rhythmA2indicateA2ventricularA2tachycardia.

TheA2nurseA2notesA2thatA2aA2patient'sA2heartA2monitorA2showsA2thatA2everyA2otherA2beatA2i
sA2earlierA2thanA2expected,A2hasA2noA2visibleA2PA2wave,A2andA2hasA2aA2QRSA2complexA2th
atA2isA2wideA2andA2bizarreA2inA2shape.A2HowA2willA2theA2nurseA2documentA2theA2rhythm?

a.A2VentricularA2couplets
b.A2VentricularA2bigeminy
c.A2VentricularA2R-on-TA2phenomenon
d.A2MultifocalA2prematureA2ventricularA2contractionsA2-A2Ans--b.A2VentricularA2bigeminy

VentricularA2bigeminyA2describesA2aA2rhythmA2inA2whichA2everyA2otherA2QRSA2complexA2i
sA2wideA2andA2bizarreA2looking.

AfterA2theA2nurseA2givesA2IVA2atropineA2toA2aA2patientA2withA2symptomaticA2typeA21,A2seco
nd-
degreeA2atrioventricularA2(AV)A2block,A2whichA2findingA2indicatesA2thatA2theA2drugA2hasA2b
eenA2effective?

a.A2IncreaseA2inA2theA2patient'sA2heartA2rate