Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank Complete All Chapters ()

An adult patient with third-degree AV block is admitted to the cardiac care unit and placed on continuous cardiac monitoring. What rhythm characteristic will the ECG most likely show? A) PP interval and RR interval are irregular. B) PP interval is equal to RR interval. C) Fewer QRS complexes than P waves D) PR interval is constant. 5. The nurse is writing a plan of care for a patient with a cardiac dysrhythmia. What would be the most appropriate goal for the patient? A) Maintain a resting heart rate below 70 bpm. B) Maintain adequate control of chest pain. C) Maintain adequate cardiac output. D) Maintain normal cardiac structure. Page 1 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 6. A patient has returned to the cardiac care unit after having a permanent pacemaker implantation. For which potential complication should the nurse most closely assess this patient? A) Chest pain B) Bleeding at the implantation site C) Malignant hyperthermia D) Bradycardia 7. The nurse is caring for an adult patient who has gone into ventricular fibrillation. When assisting with defibrillating the patient, what must the ?/test A) Maintain firm contact between paddles and patient skin. B) Apply a layer of water as a conducting agent. C) Call “all clear” once before discharging the D) Ensure the defibrillator is in the sync mode. 8. A patient who is a candidate for an implantable f/itbesrtillator (ICD) asks the nurse about the purpose of this device. What would be the nurse's best response? A) “To detect and treat dysrhythmias such as ventricular fibrillation and ventricular tachycardia” B) “To detect and treat bradycardia, which is an excessively slow heart rate” C) “To detect and treat atrial fibrillation, in which your heart beats too quickly and inefficiently” D) “To shock your heart if you have a heart attack at hoabmirbe.c”om/test 9. A nurse is providing health education to a patient schedualbeirdb.f co omr/ctersyt oablation therapy. The nurse should describe what aspect of this treatment? A) Peeling away the area of endocardium responsible for the dysrhythmia B) Using electrical shocks directly to the endocarduim to eliminate the source of dysrhythmia C) Using high-frequency sound waves to eliminate the source of dysrhythmia D) Using a cooled probe to eliminate the source of dysrhythmia 10. During a patient's care conference, the team is discussing whether the patient is a candidate for cardiac conduction surgery. What would be the most important criterion for a patient to have this surgery? A) Angina pectoris not responsive to other treatments B) Decreased activity tolerance related to decreased cardiac output C) Atrial and ventricular tachycardias not responsive D) Ventricular fibrillation not responsive to other treatments Page 2 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 11. A nurse is caring for a patient who is exhibiting ventricular tachycardia (VT). Because the patient is pulseless, the nurse should prepare for what intervention? A) Defibrillation B) ECG monitoring C) Implantation of a cardioverter defibrillator D) Angioplasty 12. A patient converts from normal sinus rhythm at 80 bpm to atrial fibrillation with a ventricular response at 166 bpm. Blood pressure is 162/74 mm Hg. Respiratory rate is 20 breaths per minute with normal chest expansion and n/tgesst bilaterally. IV heparin and Cardizem are given. The nurse caring for the patient understands that the main goal of treatment is what? A) Decrease SA node conduction B) Control ventricular heart rate C) Improve oxygenation D) Maintain anticoagulation 13. The nurse and the other members of the team are caring for a patient who converted to ventricular fibrillation (VF). The patient was c/cteesst sfully and the patient remains in VF. According to national standards, the nurse should anticipate the administration of what medication? A) Epinephrine 1 mg IV push B) Lidocaine 100 mg IV push C) Amiodarone 300 mg IV push D) Sodium bicarbonate 1 amp IV push 14. The nurse is caring for a patient who has just undergone catheter ablation therapy. The nurse in the step-down unit should prioritize what assessment? A) Cardiac monitoring B) Monitoring the implanted device signal C) Pain assessment D) Monitoring the patient's level of consciousness (LOaCbi) 15. The ED nurse is caring for a patient who has gone into cardiac arrest. During external defibrillation, what action should the nurse perform? A) Place gel pads over the apex and posterior chest for better conduction. B) Ensure no one is touching the patient at the time shock is delivered. C) Continue to ventilate the patient via endotracheal i/ntegstthe procedure. D) Allow at least 3 minutes between shocks. Page 3 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 16. The nurse is providing care to a patient who has just undergone an electrophysiologic (EP) study. The patient states that she is nervous about “things going wrong” during the procedure. What is the nurse's best response? A) “This is basically a risk-free procedure.” B) “Thousands of patients undergo EP every year.” C) “Remember that this is a step that will bring you closer to enjoying good health.” D) “The whole team will be monitoring you very h/teestentire procedure.” 17. The nurse is caring for a patient with refractory atrial fibrillation who underwent the maze procedure several months ago. The nurse reviews t u/lttesotf the patient's most recent cardiac imaging, which notes the presence of scarring on the atria. How should the nurse best respond to this finding? A) Recognize that the procedure was unsuccessful. B) Recognize this as a therapeutic goal of the procedure. C) Liaise with the care team in preparation for repeating the maze procedure. D) Prepare the patient for pacemaker implantation. 18. A patient is undergoing preoperative teaching before his cardiac surgery and the nurse is aware that a temporary pacemaker will be placed later thaabtird . /Wtesht at is the nurse's responsibility in the care of the patient's pacemaker? A) Monitoring for pacemaker malfunction or battery failure B) Determining when it is appropriate to remove the pacemaker C) Making necessary changes to the pacemaker D) Selecting alternatives to future pacemaker use 19. The nurse is caring for a patient who has had a dysrhythmic event. The nurse is aware of the need to assess for signs of diminished cardiac output (CO). What change in status may signal to the nurse a decrease in cardiac output? A) Increased blood pressure B) Bounding peripheral pulses C) Changes in level of consciousness D) Skin flushing 20. The nurse is caring for a patient who has had a biventricular pacemaker implanted. When planning the patient's care, the nurse should intervention? A) Resynchronization B) Defibrillation C) Angioplasty D) Ablation Page 4 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 21. When planning the care of a patient with an implanted pacemaker, what assessment should the nurse prioritize? A) Core body temperature B) Heart rate and rhythm C) Blood pressure D) Oxygen saturation level 22. The staff educator is teaching a CPR class. Which of the following aspects of defibrillation should the educator stress to the class? A) Apply the paddles directly to the patient's skin. B) Use a conducting medium between the paddles and the skin. C) Always use a petroleum-based gel between the paddles and the skin. D) Any available liquid can be used between the t/hteestskin. 23. During a CPR class, a participant asks about the difference between cardioversion and defibrillation. What would be the instructor's best responasbeir? A) “Cardioversion is done on a beating heart; defibrillation is not.” B) “The difference is the timing of the delivery of the electric current.” C) “Defibrillation is synchronized with the electrical acab omo/tfestthe heart, but cardioversion is not.” D) “Cardioversion is always attempted before defibrillation because it has fewer risks.” 24. A patient is admitted to the cardiac care unit for an electrophysiology (EP) study. What goal should guide the planning and execution of the patieanbitrb'r/tee?st A) Ablate the area causing the dysrhythmia. B) Freeze hypersensitive cells. C) Diagnose the dysrhythmia. D) Determine the nursing plan of care. 25. A patient calls his cardiologist's office and talks to the nuarbsireb..coHme/teisstconcerned because he feels he is being defibrillated too often. The nurse tells the patient to come to the office to be evaluated because the nurse knows that the most frequent complication of ICD therapy is what? A) Infection B) Failure to capture C) Premature battery depletion D) Oversensing of dysrhythmias Page 5 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank Answer Key 1. A 2. B 3. C 4. C 5. C 6. B 7. A 8. A 9. D 10. C 11. A 12. B 13. A 14. A 15. B 16. D 17. B 18. A 19. C 20. A 21. B 22. B 23. B 24. C 25. D Page 6 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 1. The nurse is taking a health history of a new patient. The patient reports experiencing pain in his left lower leg and foot when walking. This pain is relieved with rest. The nurse notes that the left lower leg is slightly edematous and is hairless. When planning this patient's subsequent care, the nurse should most dmre/ts esst what health problem? A) Coronary artery disease (CAD) B) Intermittent claudication C) Arterial embolus D) Raynaud's disease 2. While assessing a patient the nurse notes that the patient's ankle-brachial index (ABI) of the right leg is 0.40. How should the nurse best respond to this assessment finding? A) Assess the patient's use of over-the-counter dietary m/teesnt ts. B) Implement interventions relevant to arterial narrowing. C) Encourage the patient to increase intake of foods high in vitamin K. D) Adjust the patient's activity level to accommodate decreased coronary output. 3. The nurse is admitting a 32-year-old woman to the presurgical unit. The nurse learns during the admission assessment that the patient takes tr/taecsteptives. Consequently, the nurse's postoperative plan of care should include what intervention? A) Early ambulation and leg exercises B) Cessation of the oral contraceptives until 3 weeks postoperative C) Doppler ultrasound of peripheral circulation twice D) Dependent positioning of the patient's extremities when at rest 4. A nurse is creating an education plan for a patient with venous insufficiency. What measure should the nurse include in the plan? A) Avoiding tight-fitting socks. B) Limit activity whenever possible. C) Sleep with legs in a dependent position. D) Avoid the use of pressure stockings. 5. The nurse is caring for a patient who returned from the tropics a few weeks ago and who sought care with signs and symptoms of lymphedema. The nurse's plan of care should prioritize what nursing diagnosis? A) Risk for infection related to lymphedema B) Disturbed body image related to lymphedema C) Ineffective health maintenance related to D) Risk for deficient fluid volume related to lymphedema Page 1 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 6. An occupational health nurse is providing an educational event and has been asked by an administrative worker about the risk of varicose veins. What should the nurse suggest as a proactive preventative measure for varicose veins? A) Sit with crossed legs for a few minutes each hour B) Walk for several minutes every hour to promote circulation. C) Elevate the legs when tired. D) Wear snug-fitting ankle socks to decrease edema. 7. A patient comes to the walk-in clinic with complaints of pain in his foot following stepping on a roofing nail 4 days ago. The patient has a r/etedststreak running up his foot and ankle. What health problem should the nurse suspect? A) Cellulitis B) Local inflammation C) Elephantiasis D) Lymphangitis 8. A nurse has written a plan of care for a man diagnosed with peripheral arterial insufficiency. One of the nursing diagnoses in the care plan is altered peripheral tissue perfusion related to compromised circulation. What is thaebm t /atepspt ropriate intervention for this diagnosis? A) Elevate his legs and arms above his heart when resting. B) Encourage the patient to engage in a moderate amount of exercise. C) Encourage extended periods of sitting or standing. D) Discourage walking in order to limit pain. 9. The nurse is caring for a 72-year-old patient who is in cardiac rehabilitation following heart surgery. The patient has been walking on a regular basis for about a week and walks for 15 minutes 3 times a day. The patient states that he is having a cramp-like pain in the legs every time he walks and that the pain getasbi“te/treswt hen I rest.” The patient's care plan should address what problem? A) Decreased mobility related to VTE B) Acute pain related to intermittent claudication C) Decreased mobility related to venous insufficiency D) Acute pain related to vasculitis Page 2 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 10. A nurse in the rehabilitation unit is caring for an older adult patient who is in cardiac rehabilitation following an MI. The nurse's plan of care calls for the patient to walk for 10 minutes 3 times a day. The patient questions the relationship between walking and heart function. How should the nurse best reply? A) “The arteries in your legs constrict when you walk and allow the blood to move faster and with more pressure on the tissue.” B) Walking increases your heart rate and blood T.choemr/etefsot re your heart is under less stress.” C) “Walking helps your heart adjust to your new arteries and helps build your self-esteem.” D) “When you walk, the muscles in your legs contract m/tepst the blood in your veins back toward your heart, which allows more blood to return to your heart.” 11. The nurse is preparing to administer warfarin (Coumadin) to a client with deep vein thrombophlebitis (DVT). Which laboratory value would most clearly indicate that the patient's warfarin is at therapeutic levels? A) Partial thromboplastin time (PTT) within normal refaebirre e/treasnt ge B) Prothrombin time (PT) eight to ten times the control C) International normalized ratio (INR) between 2 and 3 D) Hematocrit of 32% 12. A patient who has undergone a femoral to popliteal bypass graft surgery returns to the surgical unit. Which assessments should the nurse in/tg estthe first postoperative day? A) Assess pulse of affected extremity every 15 minutes at first. B) Palpate the affected leg for pain during every .m/test C) Assess the patient for signs and symptoms of compartment syndrome every 2 hours. D) Perform Doppler evaluation once daily. 13. You are caring for a patient who is diagnosed with Raynaud's phenomenon. The nurse should plan interventions to address what nursing diagnoasbiirsb?.com/test A) Chronic pain B) Ineffective tissue perfusion C) Impaired skin integrity D) Risk for injury Page 3 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 14. A patient presents to the clinic complaining of the inability to grasp objects with her right hand. The patient's right arm is cool and has a difference in blood pressure of more than 20 mm Hg compared with her left arm. The nurse should expect that the primary care provider may diagnose the woman with what em/tes?t A) Lymphedema B) Raynaud's phenomenon C) Upper extremity arterial occlusive disease D) Upper extremity VTE 15. A nurse working in a long-term care facility is d/temstission assessment of a newly admitted, 85-year-old resident. During inspection of the resident's feet, the nurse notes that she appears to have early evidence of gangrene on one of her great toes.The nurse knows that gangrene in the elderly is often theabfi i/gtenstof what? A) Chronic venous insufficiency B) Raynaud's phenomenon C) VTE D) PAD 16. The prevention of VTE is an important part of the o/tefsht igh-risk patients. When providing patient teaching for these high-risk patients, the nurse should advise lifestyle changes, including which of the following? Select all that apply. A) High-protein diet B) Weight loss C) Regular exercise D) Smoking cessation E) Calcium and vitamin D supplementation 17. The nurse is assessing a woman who is pregnant at 27 weeks' gestation. The patient is concerned about the recent emergence of varicose veins b/taesctks of her calves. What is the nurse's best response? A) Facilitate a referral to a vascular surgeon. B) Assess the patient's ankle-brachial index (ABI) andapbeirbrf .coormm/teD st oppler ultrasound testing. C) Encourage the patient to increase her activity level. D) Teach the patient that circulatory changes during pregnancy frequently cause varicose veins. Page 4 Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank 18. Graduated compression stockings have been prescribed to treat a patient's venous insufficiency. What education should the nurse prioritize when introducing this intervention to the patient? A) The need to take anticoagulants concurrent with B) The need to wear the stockings on a “one day on, one day off” schedule C) The importance of wearing the stockings around the clock to ensure maximum benefit D) The importance of ensuring the stockings are applied evenly with no pressure points 19. How should the nurse best position a patient who has leg ulcers that are venous in origin? A) Keep the patient's legs flat and straight. B) Keep the patient's knees bent to 45-degree angle and supported with pillows. C) Elevate the patient's lower extremities. D) Dangle the patient's legs over the side of the bed. 20. A patient with advanced venous insufficiency is confined following orthopedic surgery. How can the nurse best prevent skin breakdown in the 'sml /toeswt er extremities? A) Ensure that the patient's heels are protected and supported. B) Closely monitor the patient's serum albumin and prealbumin levels. C) Perform gentle massage of the patient's lower legs, as tolerated. D) Perform passive range-of-motion exercises once .m/test 21. The nurse has performed a thorough nursing emc/taerset of a patient with chronic leg ulcers. The nurse's assessment should include which of the following components? Select all that apply. A) Location and type of pain B) Apical heart rate C) Bilateral comparison of peripheral pulses D) Comparison of temperature in the patient's legs