NUR 114 Test 3 Actual Test Questions with verified answers

NUR 114 Test 3 Actual Test Questions with verified answers A nurse assesses a client after administering a prescribed beta blocker. Which assessment should the nurseexpect to find? a. Blood pressure increased from 98/42 mm Hg to 132/60 mm Hg b. Respiratory rate decreased from 25 breaths/min to 14 breaths/min c. Oxygen saturation increased from 88% to 96% d. Pulse decreased from 100 beats/min to 80 beats/min ANS: D Beta blockers block the stimulation of beta1-adrenergic receptors. They block the sympathetic (fight-or-flight)response and decrease the heart rate (HR). The beta blocker will decrease HR and blood pressure, increasingventricular filling time. It usually does not have effects on beta2-adrenergic receptor sites. Cardiac output willdrop because of decreased HR. An emergency room nurse obtains the health history of a client. Which statement by the client should alert the nurse to the occurrence of left-sided heart failure? a. I get short of breath when I climb stairs. b. I see halos floating around my head. c. I have trouble remembering things. d. I have lost weight over the past month. ANS: A Dyspnea on exertion is an early manifestation of heart failure and is associated with an activity such as stairclimbing. The other findings are not specific to early occurrence of heart failure. A nurse obtains the health history of a client who is newly admitted to the medical unit. Which statement by the client should alert the nurse to the presence of edema with right-sided heart failure? a. I wake up to go to the bathroom at night. b. My shoes fit tighter by the end of the day. c. I seem to be feeling more anxious lately. d. I drink at least eight glasses of water a day. ANS: B Weight gain can result from fluid accumulation in the interstitial spaces. This is known as edema. The nurseshould note whether the client feels that his or her shoes or rings are tight, and should observe, when present,an indentation around the leg where the socks end. The other answers do not describe edema. A nurse assesses a client 2 hours after a cardiac angiography via the left femoral artery. The nurse notes that the left pedal pulse is weak. Which action should the nurse take? a. Elevate the leg and apply a sandbag to the entrance site. b. Increase the flow rate of intravenous fluids. c. Assess the color and temperature of the left leg. d. Document the finding as left pedal pulse of +1/4. ANS: C Loss of a pulse distal to an angiography entry site is serious, indicating a possible arterial obstruction. Thepulse may be faint because of edema. The left pulse should be compared with the right, and pulses should becompared with previous assessments, especially before the procedure. Assessing color (pale, cyanosis) andtemperature (cool, cold)