Med Surg I Exam 4 ACTUAL UPDATED
QUESTIONS AND CORRECT ANSWERS
A nurse is assessing a client who has pericarditis. Which of the following manifestations
should the nurse expect?
1. Bradycardia with ST-segment depression
2. Relief of chest pain with deep inspiration
3. Dyspnea with hiccups
4. Chest pain that increases when sitting upright - CORRECT ANSWERS✅✅3
Rationale: A client who has pericarditis will experience dyspnea, hiccups, and a
nonproductive cough. These manifestations can indicate heart failure from pericardial
compression due to constrictive pericarditis or cardiac tamponade.
A nurse completing an assessment on a client. Which of the following findings should the
nurse identify as a risk factor for coronary artery disease? Select all that apply.
1. Hypothyroidism
2. Hypertension
3. Diabetes Mellitus
4. Hyperlipidemia
5. Tobacco smoking - CORRECT ANSWERS✅✅2, 3, 4, 5
Rationale: A client who has hypertension, diabetes mellitus, hyperlipidemia, or a history of
smoking tobacco is at risk for coronary artery disease (CAD). Hypertension and
hyperlipidemia can be controlled by diet and exercise, along with medication if needed.
Diabetes can cause damage to large and small blood vessels, which leads to poor perfusion,
cell death, and organ damage. Diabetes mellitus can be managed by monitoring glucose
levels and implementing diet and exercise recommendations. Cholesterol levels, such as total
HDL and LDL levels, should be monitored since elevated total serum cholesterol levels
increase the risk of a myocardial infarction.
A nurse is assessing a client who has late-stage heart failure and is experiencing fluid volume
overload. Which of the following findings should the nurse expect?
1. Weight gain of 1 kg (2.2 lb) in 1 day
2. Pitting edema +1
3. Client report of a nocturnal cough
,4. B-type natriuretic peptide (BNP) level of 100 pg/mL - CORRECT ANSWERS✅✅1
Rationale: A weight gain of 1 kg (2.2 lb) in 1 day indicates that the client is retaining fluid
and is at risk for fluid volume overload. This suggests the client's heart failure is worsening.
A nurse is providing teaching about lifestyle changes to a client who experienced a
myocardial infarction and has a new prescription for a beat blocker. Which of the following
client statements indicates an understanding of the teaching?
1. "I should eat foods that are high in saturated fat."
2. "Before taking my medication, I will count my radial pulse rate."
3. "I will exercise once a week for an hour at the health club."
4. "I will stop taking my medication when my blood pressure is within a normal range." -
CORRECT ANSWERS✅✅2
Rationale: A beta blocker will induce bradycardia. The client should take the pulse rate for 1
minute before self-administration.
A nurse is caring for a client who is undergoing treatment for hypertension. Which of the
following statements indicates that the client is adhering to the treatment plan?
1. "I would never have believed I could get used to enjoying my food without salt."
2. "My blood pressure device at home usually shows about 156/98 or so."
3. "I make sure I take my blood pressure medicine when I have headaches."
4. My blood pressure pills are very expensive. Could I take a cheaper medication?" -
CORRECT ANSWERS✅✅1
Rationale: This statement implies that the client has stopped adding salt to food. Sodium
restriction is a single aspect of the treatment plan, but it does indicate dietary adherence by
the client.
A nurse is caring for an adult male client who is undergoing screening tests for
atherosclerosis. Which of the following laboratory findings should the nurse identify as an
increased risk for this disorder?
1. Cholesterol level 195 mg/dL
2. Elevated HDL levels
3. Elevated LDL levels
4. Triglyceride level 135mg - CORRECT ANSWERS✅✅3
, Rationale: AN elevated LDL level increases a client's risk of atherosclerosis. The client's
desirable LDL level is <100 mg/dL.
A nurse is assessing a client who has fluid volume overload from a cardiovascular disorder.
Which of the following manifestations should the nurse expect? Select all that apply.
1. Jugular vein distension
2. Moist crackles
3. Postural hypotension
4. Increased heart rate
5. Fever - CORRECT ANSWERS✅✅1, 2, 4
Rationale: The increased venous pressure due to excessive circulating blood volume results in
neck vein distension. Moist crackles are an indicator of pulmonary edema that can quickly
lead to death. Fluid volume excess (hypervolemia) is an expansion of fluid volume in the
extracellular fluid compartment, which results in an increased heart rate and bounding pulses.
A nurse is completing dietary teaching with a client who has heart failure and is prescribed a
2g sodium diet. Which of the following statements by the client indicates an understanding of
the teaching?
1. "I should use salt sparingly while cooking."
2. "I can have yogurt as a dessert."
3. "I should use baking soda when I bake."
4. "I should use canned vegetables instead of frozen." - CORRECT ANSWERS✅✅2
Rationale: The client understands the teaching when he selects yogurt as a dessert. Yogurt is
low in fat and sodium and is a good source of calcium and protein.
A nurse is caring for a client with heart failure whose telemetry reading displays a flattening
of the T wave. Which of the following laboratory results should the nurse anticipate as the
cause of this ECG change?
1. Potassium 2.8 mEq/L
2. Digoxin level 0.7 mg/mL
3. Hemoglobin 9.8 g/dL
4. Calcium 8.0 mg - CORRECT ANSWERS✅✅1
Rationale: A flattened T wave or the development of U waves is indicative of a low
potassium level.
QUESTIONS AND CORRECT ANSWERS
A nurse is assessing a client who has pericarditis. Which of the following manifestations
should the nurse expect?
1. Bradycardia with ST-segment depression
2. Relief of chest pain with deep inspiration
3. Dyspnea with hiccups
4. Chest pain that increases when sitting upright - CORRECT ANSWERS✅✅3
Rationale: A client who has pericarditis will experience dyspnea, hiccups, and a
nonproductive cough. These manifestations can indicate heart failure from pericardial
compression due to constrictive pericarditis or cardiac tamponade.
A nurse completing an assessment on a client. Which of the following findings should the
nurse identify as a risk factor for coronary artery disease? Select all that apply.
1. Hypothyroidism
2. Hypertension
3. Diabetes Mellitus
4. Hyperlipidemia
5. Tobacco smoking - CORRECT ANSWERS✅✅2, 3, 4, 5
Rationale: A client who has hypertension, diabetes mellitus, hyperlipidemia, or a history of
smoking tobacco is at risk for coronary artery disease (CAD). Hypertension and
hyperlipidemia can be controlled by diet and exercise, along with medication if needed.
Diabetes can cause damage to large and small blood vessels, which leads to poor perfusion,
cell death, and organ damage. Diabetes mellitus can be managed by monitoring glucose
levels and implementing diet and exercise recommendations. Cholesterol levels, such as total
HDL and LDL levels, should be monitored since elevated total serum cholesterol levels
increase the risk of a myocardial infarction.
A nurse is assessing a client who has late-stage heart failure and is experiencing fluid volume
overload. Which of the following findings should the nurse expect?
1. Weight gain of 1 kg (2.2 lb) in 1 day
2. Pitting edema +1
3. Client report of a nocturnal cough
,4. B-type natriuretic peptide (BNP) level of 100 pg/mL - CORRECT ANSWERS✅✅1
Rationale: A weight gain of 1 kg (2.2 lb) in 1 day indicates that the client is retaining fluid
and is at risk for fluid volume overload. This suggests the client's heart failure is worsening.
A nurse is providing teaching about lifestyle changes to a client who experienced a
myocardial infarction and has a new prescription for a beat blocker. Which of the following
client statements indicates an understanding of the teaching?
1. "I should eat foods that are high in saturated fat."
2. "Before taking my medication, I will count my radial pulse rate."
3. "I will exercise once a week for an hour at the health club."
4. "I will stop taking my medication when my blood pressure is within a normal range." -
CORRECT ANSWERS✅✅2
Rationale: A beta blocker will induce bradycardia. The client should take the pulse rate for 1
minute before self-administration.
A nurse is caring for a client who is undergoing treatment for hypertension. Which of the
following statements indicates that the client is adhering to the treatment plan?
1. "I would never have believed I could get used to enjoying my food without salt."
2. "My blood pressure device at home usually shows about 156/98 or so."
3. "I make sure I take my blood pressure medicine when I have headaches."
4. My blood pressure pills are very expensive. Could I take a cheaper medication?" -
CORRECT ANSWERS✅✅1
Rationale: This statement implies that the client has stopped adding salt to food. Sodium
restriction is a single aspect of the treatment plan, but it does indicate dietary adherence by
the client.
A nurse is caring for an adult male client who is undergoing screening tests for
atherosclerosis. Which of the following laboratory findings should the nurse identify as an
increased risk for this disorder?
1. Cholesterol level 195 mg/dL
2. Elevated HDL levels
3. Elevated LDL levels
4. Triglyceride level 135mg - CORRECT ANSWERS✅✅3
, Rationale: AN elevated LDL level increases a client's risk of atherosclerosis. The client's
desirable LDL level is <100 mg/dL.
A nurse is assessing a client who has fluid volume overload from a cardiovascular disorder.
Which of the following manifestations should the nurse expect? Select all that apply.
1. Jugular vein distension
2. Moist crackles
3. Postural hypotension
4. Increased heart rate
5. Fever - CORRECT ANSWERS✅✅1, 2, 4
Rationale: The increased venous pressure due to excessive circulating blood volume results in
neck vein distension. Moist crackles are an indicator of pulmonary edema that can quickly
lead to death. Fluid volume excess (hypervolemia) is an expansion of fluid volume in the
extracellular fluid compartment, which results in an increased heart rate and bounding pulses.
A nurse is completing dietary teaching with a client who has heart failure and is prescribed a
2g sodium diet. Which of the following statements by the client indicates an understanding of
the teaching?
1. "I should use salt sparingly while cooking."
2. "I can have yogurt as a dessert."
3. "I should use baking soda when I bake."
4. "I should use canned vegetables instead of frozen." - CORRECT ANSWERS✅✅2
Rationale: The client understands the teaching when he selects yogurt as a dessert. Yogurt is
low in fat and sodium and is a good source of calcium and protein.
A nurse is caring for a client with heart failure whose telemetry reading displays a flattening
of the T wave. Which of the following laboratory results should the nurse anticipate as the
cause of this ECG change?
1. Potassium 2.8 mEq/L
2. Digoxin level 0.7 mg/mL
3. Hemoglobin 9.8 g/dL
4. Calcium 8.0 mg - CORRECT ANSWERS✅✅1
Rationale: A flattened T wave or the development of U waves is indicative of a low
potassium level.
