Med-Surg Final Exam 2024
A client is admitted for treatment of hypoparathyroidism. Based on the client's diagnosis,
the nurse would anticipate an order for:
Potassium
Magnesium
Calcium
Iron - Calcium
The client is admitted with left-sided CHF. In assessing the client for edema, the nurse
should check
Feet
Neck
Hands
Sacrum - Neck
A client with polyuria, polydipsia, and polyphagia is diagnosed with Diabetes Mellitus.
The nurse would expect that these symptoms are related to:
Hypoglycemia
Hyperglycemia
Hyperparathyroidism
Hyperthyroidism - Hyperglycemia
he client admitted with angina is given a prescription for nitroglycerine. The client should
be instructed to:
Replenish her supply every 3 months
Take one every 15 minutes if pain occurs
Leave the medication in the brown bottle
Crush the medication and take it with water. - Leave the medication in the brown bottle
Which of the following is not a risk factor for the development of atherosclerosis?
Family history of early heart attack
Late onset of puberty
Total blood cholesterol level greater than 220mg/dL.
Elevated fasting blood glucose concentration. - Late onset of puberty
A client with heart failure is receiving digoxin intravenously. The nurse should determine
the effectiveness of the drug by assessing which of the following?
Dilated coronary arteries
Increased myocardial contractility
,Decreased cardiac arrhythmias
Decreased electrical conductivity in the heart - Increased myocardial contractility
When assessing an ECG, the nurse knows that the P-R interval represents the time it
takes for the:
Impulse to begin atrial contraction
Impulse to transverse the atria to the AV node
SA node to discharge the impulse to begin atrial depolarization
Impulse to travel to the ventricles - Impulse to travel to the ventricles
The nurse is assessing the lower extremities of the client with peripheral vascular
disease (PVD). During the assessment, the nurse should expect to find which of the
follow clinical manifestations of PVD?
Hairy legs
Mottled skin
Pink, cool skin
Warm, moist skin - Mottled skin
A client has returned to the medical-surgical unit after a cardiac catheterization. Which
is the MOST important initial postprocedure nursing assessment for this client?
Monitor the laboratory values
Observe neurologic function every 15 minutes
Observe the puncture site for swelling and bleeding
Monitor skin warmth and turgor - Observe the puncture site for swelling and bleeding
A priority nursing diagnosis for a client with burns during the emergent period would be:
Excess fluid volume
Imbalanced nutrition: less than body requirements
Risk for injury (falling)
Risk for infection - Risk for infection
The nurse assesses the respiratory status of a client who is experiencing an
exacerbation of chronic obstructive pulmonary disease (COPD) secondary to an upper
respiratory tract infection. Which of the following findings would be expected?
Normal breath sounds
Prolonged inspiration
Normal chest movement
Coarse crackles and rhonchi - Coarse crackles and rhonchi
,A client admitted to the hospital with chest pain and history of type 2 diabetes mellitus is
scheduled for cardiac catheterization. Which of the following medications would need to
be withheld for 48 hours before and after the procedure?
Regular insulin
Glipizide (Glucotrol)
Repaglinide (Prandin)
Metformin (Glucophage) - Metformin (Glucophage)
A client with myocardial infarction suddenly becomes tachycardic, shows signs of air
hunger, and begins coughing frothy, pink tinged sputum. Which of the following would
the nurse anticipate when auscultating the client's breath sounds?
Stridor
Crackles
Scattered rhonchi
Diminished breath sounds - Crackles
A nurse is caring for a client with an ileostomy understands that the client is most at risk
for developing which acid-base disorder?
Metabolic acidosis
Metabolic alkalosis
Respiratory acidosis
Respiratory alkalosis - Metabolic acidosis
A nurse notes that a client with sinus rhythm has a premature ventricular contraction
that falls on the T wave of the preceding beat. The client's rhythm suddenly changes to
the one with no P waves, no definable QRS complexes, and coarse wavy lines of
varying amplitude. How would the nurse correctly interpret this rhythm?
Asystole
Atrial fibrillation
Ventricular fibrillation
Ventricular tachycardia - Ventricular fibrillation
A client is admitted to an emergency department with chest pain that is being ruled out
for myocardial infarction. Vital signs are as follows: at 11am → P - 92, RR - 24, BP -
140/88; at 11:15am → P - 96, RR - 26, BP - 128/82; at 11:30am → P - 104, RR - 28, BP
- 104/68; at 11:45am → P - 118, RR - 32, BP - 88/58. The nurse should alert the
physician because these changes are most consistent with which of the following
complications?
Cardiogenic shock
Cardiac tamponade
Pulmonary embolism
, Dissecting thoracic aortic aneurysm - Cardiogenic shock
A nurse is watching the cardiac monitor and notices that the rhythm suddenly changes.
There are no P waves, the QRS complexes are wide, and the ventricular rate is regular
but more than 100 bpm. The nurse determines that the client is experiencing which of
the following dysrhythmias?
Sinus tachycardia
Ventricular fibrillation
Ventricular tachycardia
Premature ventricular contractions - Ventricular tachycardia
A client has frequent bursts of ventricular tachycardia on the cardiac monitor. What
should the nurse be most concerned about with this dysrhythmia?
It can develop into ventricular fibrillation at any time
It is almost impossible to convert to a normal rhythm
It is uncomfortable for the client, giving a sense of impending doom
It produces a high cardiac output that quickly leads to cerebral and myocardial
ischemia - It can develop into ventricular fibrillation at any time
A client is having frequent premature ventricular contractions. A nurse would place
priority on assessment of which of the following?
Sensation of palpitations
Causative factors, such as caffeine
Precipitating factors, such as infection
Blood pressure and oxygen saturation - Blood pressure and oxygen saturation
A nurse is watching the cardiac monitor, and a client's rhythm suddenly changes. There
are no P waves; instead, there are fibrillatory waves before each QRS complex. How
should the nurse correctly interpret the client's heart rhythm?
Atrial fibrillation
Sinus tachycardia
Ventricular fibrillation
Ventricular tachycardia - Atrial fibrillation
A nurse is evaluating a client's response to cardioversion. Which of the following would
be of highest priority to the nurse?
Blood pressure
Status of airway
Oxygen flow rate
Level of consciousness (LOC) - Status of airway
A client is admitted for treatment of hypoparathyroidism. Based on the client's diagnosis,
the nurse would anticipate an order for:
Potassium
Magnesium
Calcium
Iron - Calcium
The client is admitted with left-sided CHF. In assessing the client for edema, the nurse
should check
Feet
Neck
Hands
Sacrum - Neck
A client with polyuria, polydipsia, and polyphagia is diagnosed with Diabetes Mellitus.
The nurse would expect that these symptoms are related to:
Hypoglycemia
Hyperglycemia
Hyperparathyroidism
Hyperthyroidism - Hyperglycemia
he client admitted with angina is given a prescription for nitroglycerine. The client should
be instructed to:
Replenish her supply every 3 months
Take one every 15 minutes if pain occurs
Leave the medication in the brown bottle
Crush the medication and take it with water. - Leave the medication in the brown bottle
Which of the following is not a risk factor for the development of atherosclerosis?
Family history of early heart attack
Late onset of puberty
Total blood cholesterol level greater than 220mg/dL.
Elevated fasting blood glucose concentration. - Late onset of puberty
A client with heart failure is receiving digoxin intravenously. The nurse should determine
the effectiveness of the drug by assessing which of the following?
Dilated coronary arteries
Increased myocardial contractility
,Decreased cardiac arrhythmias
Decreased electrical conductivity in the heart - Increased myocardial contractility
When assessing an ECG, the nurse knows that the P-R interval represents the time it
takes for the:
Impulse to begin atrial contraction
Impulse to transverse the atria to the AV node
SA node to discharge the impulse to begin atrial depolarization
Impulse to travel to the ventricles - Impulse to travel to the ventricles
The nurse is assessing the lower extremities of the client with peripheral vascular
disease (PVD). During the assessment, the nurse should expect to find which of the
follow clinical manifestations of PVD?
Hairy legs
Mottled skin
Pink, cool skin
Warm, moist skin - Mottled skin
A client has returned to the medical-surgical unit after a cardiac catheterization. Which
is the MOST important initial postprocedure nursing assessment for this client?
Monitor the laboratory values
Observe neurologic function every 15 minutes
Observe the puncture site for swelling and bleeding
Monitor skin warmth and turgor - Observe the puncture site for swelling and bleeding
A priority nursing diagnosis for a client with burns during the emergent period would be:
Excess fluid volume
Imbalanced nutrition: less than body requirements
Risk for injury (falling)
Risk for infection - Risk for infection
The nurse assesses the respiratory status of a client who is experiencing an
exacerbation of chronic obstructive pulmonary disease (COPD) secondary to an upper
respiratory tract infection. Which of the following findings would be expected?
Normal breath sounds
Prolonged inspiration
Normal chest movement
Coarse crackles and rhonchi - Coarse crackles and rhonchi
,A client admitted to the hospital with chest pain and history of type 2 diabetes mellitus is
scheduled for cardiac catheterization. Which of the following medications would need to
be withheld for 48 hours before and after the procedure?
Regular insulin
Glipizide (Glucotrol)
Repaglinide (Prandin)
Metformin (Glucophage) - Metformin (Glucophage)
A client with myocardial infarction suddenly becomes tachycardic, shows signs of air
hunger, and begins coughing frothy, pink tinged sputum. Which of the following would
the nurse anticipate when auscultating the client's breath sounds?
Stridor
Crackles
Scattered rhonchi
Diminished breath sounds - Crackles
A nurse is caring for a client with an ileostomy understands that the client is most at risk
for developing which acid-base disorder?
Metabolic acidosis
Metabolic alkalosis
Respiratory acidosis
Respiratory alkalosis - Metabolic acidosis
A nurse notes that a client with sinus rhythm has a premature ventricular contraction
that falls on the T wave of the preceding beat. The client's rhythm suddenly changes to
the one with no P waves, no definable QRS complexes, and coarse wavy lines of
varying amplitude. How would the nurse correctly interpret this rhythm?
Asystole
Atrial fibrillation
Ventricular fibrillation
Ventricular tachycardia - Ventricular fibrillation
A client is admitted to an emergency department with chest pain that is being ruled out
for myocardial infarction. Vital signs are as follows: at 11am → P - 92, RR - 24, BP -
140/88; at 11:15am → P - 96, RR - 26, BP - 128/82; at 11:30am → P - 104, RR - 28, BP
- 104/68; at 11:45am → P - 118, RR - 32, BP - 88/58. The nurse should alert the
physician because these changes are most consistent with which of the following
complications?
Cardiogenic shock
Cardiac tamponade
Pulmonary embolism
, Dissecting thoracic aortic aneurysm - Cardiogenic shock
A nurse is watching the cardiac monitor and notices that the rhythm suddenly changes.
There are no P waves, the QRS complexes are wide, and the ventricular rate is regular
but more than 100 bpm. The nurse determines that the client is experiencing which of
the following dysrhythmias?
Sinus tachycardia
Ventricular fibrillation
Ventricular tachycardia
Premature ventricular contractions - Ventricular tachycardia
A client has frequent bursts of ventricular tachycardia on the cardiac monitor. What
should the nurse be most concerned about with this dysrhythmia?
It can develop into ventricular fibrillation at any time
It is almost impossible to convert to a normal rhythm
It is uncomfortable for the client, giving a sense of impending doom
It produces a high cardiac output that quickly leads to cerebral and myocardial
ischemia - It can develop into ventricular fibrillation at any time
A client is having frequent premature ventricular contractions. A nurse would place
priority on assessment of which of the following?
Sensation of palpitations
Causative factors, such as caffeine
Precipitating factors, such as infection
Blood pressure and oxygen saturation - Blood pressure and oxygen saturation
A nurse is watching the cardiac monitor, and a client's rhythm suddenly changes. There
are no P waves; instead, there are fibrillatory waves before each QRS complex. How
should the nurse correctly interpret the client's heart rhythm?
Atrial fibrillation
Sinus tachycardia
Ventricular fibrillation
Ventricular tachycardia - Atrial fibrillation
A nurse is evaluating a client's response to cardioversion. Which of the following would
be of highest priority to the nurse?
Blood pressure
Status of airway
Oxygen flow rate
Level of consciousness (LOC) - Status of airway
