Page |1
TEST BANK
Medical-Surgical Nursing Concepts for Clinical Judgment and Collaborative,
11TH EDITION
, Page |2
Which of the following medications can be used in the treatment of hemodynamically stable atrial fibrillation
with concomitant Wolff-Parkinson-White syndrome?
AAdenosine
B Diltiazem
C Ibutilide
DMetoprolol - Correct Ans✓✓ C
all of the other options are all AV nodal blocking agents and should be avoided in patients with preexcited atrial
fibrillation. Blocking the AV node can promote and enhance conduction down the accessory pathway, which can
deteriorate into an unstable rhythm such as ventricular tachycardia or ventricular fibrillation.
Triad for Wolff-parkinson white syndrome (EKG characteristics) –
Correct Ans✓✓
1. Slurred upstroke of QRS (delta wave)
2. shortened PR interval
3. Wide QRS
A 45-year-old man with a past medical history significant for obesity, status post partial gastrectomy, returns to
the clinic following a recent barium swallow study for complaints of abdominal pressure and fullness. Results
from the study show displacement of the gastroesophageal junction and herniation of a portion of the gastric
fundus into the thoracic cavity. Which of the following is the most likely diagnosis?
A. Esophageal motility disorder
B. Esophagitis
C. Paraesophageal hiatus hernia
, Page |3
D. Sliding hiatus hernia - Correct Ans✓✓ C
Paraesophageal hiatal hernias can be asymptomatic, but may also be associated with epigastric or postprandial
fullness, nausea, and vomiting. Less commonly, they can be associated with gastroesophageal reflux disease
(GERD) symptoms
Tx: Fundoplication (Necessary if volvulus of stomach occurs)
An elderly man with a history of atrial fibrillation presents with sudden onset of severe periumbilical pain that is
out of proportion to physical examination. A CT scan will most likely show lack of flow in which visceral
vessel?
A. Celiac trunk
B. Inferior mesenteric artery
C. Superior mesenteric artery
D. Superior mesenteric vein - Correct Ans✓✓ C
A 65-year-old man with hypertension presents to the clinic complaining of worsening shortness of breath with
physical exertion for the past two weeks. He has no history of chronic lung disease. He denies chest discomfort
and palpitations. Vital signs include heart rate 78 beats per minute, blood pressure 134/84 mm Hg, temperature
98.8°F, pulse oxygenation 93%, and 20 respirations per minute. Exam reveals an obese man, bibasilar lung
crackles, normal heart sounds, and 1+ pitting edema in both ankles. Which of the following is the best next step?
a. Duplex ultrasonography of the lower extremities
b. Echocardiogram
c. Helical chest computed tomography
d. Thoracentesis - Correct Ans✓✓ B
Aside from infection, what is a serious complication of chronic venous ulcers? - Correct Ans✓✓ Malignancy
such as squamous cell carcinoma.
An 84-year-old man presents to the clinic with an ulcer on his left medial malleolus. The 1.5 cm ulcer has an
irregular shape and well-defined borders, and no purulence is noted. The skin surrounding the ulcer is firm, dry,
and pruritic. He has bilateral peripheral edema and hyperpigmentation at his ankles and feet. The
, Page |4
hyperpigmentation does not change with leg elevation. Aside from venous duplex ultrasonography, which of the
following tests is also recommended before initiating the treatment for this patient's most likely condition?
A. Ankle-brachial index
B. Microcirculation assessment
C. Venous plethysmographyYour Answer
D. Wound biopsy - Correct Ans✓✓ A.
wound care for venous ulcers involves a zinc impregnated gauze wrapped around the lower extremity and then
wrapped with coband to provide compression. this compression can be detrimental to those with arterial disease,
so ABI is recommended before tx
56-year-old woman with stage IV breast cancer presents to the emergency department complaining of dyspnea
and cough that started one hour ago. She was first diagnosed with breast cancer five years ago and had a
lumpectomy with adjuvant radiation. She was diagnosed with metastatic disease six months ago. She also has a
history of hypertension, hypothyroidism, and gastroesophageal reflux disease. Her pulse is 102, blood pressure
is 115/76 mm Hg, respiratory rate is 16, and temperature is 98.3°F. Which of the following is the most likely
diagnosis?
a. Community-acquired pneumonia
b. Congestive heart failure
c. Pulmonary embolism
d. Radiation pneumonitis - Correct Ans✓✓ C
Which of the following is appropriate initial treatment for uncomplicated symptomatic Crohn's disease?
A. Antibiotic treatment
B. Chemotherapy
C. Immunosuppressant therapy
D. Watchful waiting
A 65-year-old woman presents for her annual physical to her primary care physician. She has a history of
recurrent urinary tract infections and has a 30 pack-year smoking history. She has worked in a textile factory for
TEST BANK
Medical-Surgical Nursing Concepts for Clinical Judgment and Collaborative,
11TH EDITION
, Page |2
Which of the following medications can be used in the treatment of hemodynamically stable atrial fibrillation
with concomitant Wolff-Parkinson-White syndrome?
AAdenosine
B Diltiazem
C Ibutilide
DMetoprolol - Correct Ans✓✓ C
all of the other options are all AV nodal blocking agents and should be avoided in patients with preexcited atrial
fibrillation. Blocking the AV node can promote and enhance conduction down the accessory pathway, which can
deteriorate into an unstable rhythm such as ventricular tachycardia or ventricular fibrillation.
Triad for Wolff-parkinson white syndrome (EKG characteristics) –
Correct Ans✓✓
1. Slurred upstroke of QRS (delta wave)
2. shortened PR interval
3. Wide QRS
A 45-year-old man with a past medical history significant for obesity, status post partial gastrectomy, returns to
the clinic following a recent barium swallow study for complaints of abdominal pressure and fullness. Results
from the study show displacement of the gastroesophageal junction and herniation of a portion of the gastric
fundus into the thoracic cavity. Which of the following is the most likely diagnosis?
A. Esophageal motility disorder
B. Esophagitis
C. Paraesophageal hiatus hernia
, Page |3
D. Sliding hiatus hernia - Correct Ans✓✓ C
Paraesophageal hiatal hernias can be asymptomatic, but may also be associated with epigastric or postprandial
fullness, nausea, and vomiting. Less commonly, they can be associated with gastroesophageal reflux disease
(GERD) symptoms
Tx: Fundoplication (Necessary if volvulus of stomach occurs)
An elderly man with a history of atrial fibrillation presents with sudden onset of severe periumbilical pain that is
out of proportion to physical examination. A CT scan will most likely show lack of flow in which visceral
vessel?
A. Celiac trunk
B. Inferior mesenteric artery
C. Superior mesenteric artery
D. Superior mesenteric vein - Correct Ans✓✓ C
A 65-year-old man with hypertension presents to the clinic complaining of worsening shortness of breath with
physical exertion for the past two weeks. He has no history of chronic lung disease. He denies chest discomfort
and palpitations. Vital signs include heart rate 78 beats per minute, blood pressure 134/84 mm Hg, temperature
98.8°F, pulse oxygenation 93%, and 20 respirations per minute. Exam reveals an obese man, bibasilar lung
crackles, normal heart sounds, and 1+ pitting edema in both ankles. Which of the following is the best next step?
a. Duplex ultrasonography of the lower extremities
b. Echocardiogram
c. Helical chest computed tomography
d. Thoracentesis - Correct Ans✓✓ B
Aside from infection, what is a serious complication of chronic venous ulcers? - Correct Ans✓✓ Malignancy
such as squamous cell carcinoma.
An 84-year-old man presents to the clinic with an ulcer on his left medial malleolus. The 1.5 cm ulcer has an
irregular shape and well-defined borders, and no purulence is noted. The skin surrounding the ulcer is firm, dry,
and pruritic. He has bilateral peripheral edema and hyperpigmentation at his ankles and feet. The
, Page |4
hyperpigmentation does not change with leg elevation. Aside from venous duplex ultrasonography, which of the
following tests is also recommended before initiating the treatment for this patient's most likely condition?
A. Ankle-brachial index
B. Microcirculation assessment
C. Venous plethysmographyYour Answer
D. Wound biopsy - Correct Ans✓✓ A.
wound care for venous ulcers involves a zinc impregnated gauze wrapped around the lower extremity and then
wrapped with coband to provide compression. this compression can be detrimental to those with arterial disease,
so ABI is recommended before tx
56-year-old woman with stage IV breast cancer presents to the emergency department complaining of dyspnea
and cough that started one hour ago. She was first diagnosed with breast cancer five years ago and had a
lumpectomy with adjuvant radiation. She was diagnosed with metastatic disease six months ago. She also has a
history of hypertension, hypothyroidism, and gastroesophageal reflux disease. Her pulse is 102, blood pressure
is 115/76 mm Hg, respiratory rate is 16, and temperature is 98.3°F. Which of the following is the most likely
diagnosis?
a. Community-acquired pneumonia
b. Congestive heart failure
c. Pulmonary embolism
d. Radiation pneumonitis - Correct Ans✓✓ C
Which of the following is appropriate initial treatment for uncomplicated symptomatic Crohn's disease?
A. Antibiotic treatment
B. Chemotherapy
C. Immunosuppressant therapy
D. Watchful waiting
A 65-year-old woman presents for her annual physical to her primary care physician. She has a history of
recurrent urinary tract infections and has a 30 pack-year smoking history. She has worked in a textile factory for
