Medical Surgical Nursing 2 Exam 1 - Questions and Answers

Medical Surgical Nursing 2 Exam 1 - Questions and Answers A patient who is scheduled for a coronary arteriogram is admitted to the hospital on the day of the procedure. Which patient information is most important for the nurse to communicate to the health care provider (HCP) before the procedure? Patient took metformin 500mg this morning The nurse is participating as a team member in the resuscitation of a patient who has experienced a cardiac arrest. The health care provider who is directing the resuscitation asks the nurse to administer epinephrine 1 mg IV. After giving the medication, which action should the nurse take next? State "Epinephrine 1mg IV has been given" The clinic nurse is evaluating a patient who had coronary artery stenting through the right femoral artery a week previously and is taking metoprolol, clopidogrel, and aspirin. Which information reported by the patient is most important to report to the health care provider? Patient is experiencing shortness of breath and fatigue. The nurse has just received a change-of-shift report about these patients on the coronary step-down unit. Which one will the nurse assess first? A 45-year-old patient with constrictive cardiomyopathy who developed acute dyspnea and agitation about 1 hour before the shift change The nurse is ambulating a cardiac surgery patient whose heart rate suddenly increases to 146 beats/min. In which order will the nurse take the following actions? Have patient sit down, administer oxygen by nasal cannula as needed, check the patient's blood pressure, call health care provider A patient whose systolic blood pressure is always higher than 140 mm Hg in the clinic tells the nurse, "My blood pressure at home is always fine!" What action should the nurse take next? Ask the patient to obtain blood pressures twice daily with an automatic blood pressure cuff at home and bring the results to the clinic in a week. A patient who has endocarditis with vegetation on the mitral valve suddenly reports severe left foot pain. The nurse notes that no pulse is palpable in the left foot and that it is cold and pale. Which action should the nurse take next? Notify the health care provider about the change in status Two weeks ago, a patient with heart failure received a new prescription for carvedilol 12.5 mg orally. Which finding by the nurse who is evaluating the patient in the cardiology clinic is of most concern? Sinus Bradycardia at a rate of 48 beats per minute The nurse is caring for a hospitalized patient with heart failure who is receiving captopril and spironolactone. Which laboratory value will be most important to monitor? Potassium An 80-year-old patient on the coronary step-down unit tells the nurse, "I do not need to take that docusate. I never get constipated!" Which action by the nurse is most appropriate? Explain that his decreased activity level may cause constipation. A patient with stable angina has a prescription for ranolazine 500 mg twice a day. Which patient finding is most important for the nurse to discuss with the health care provider (HCP)? Patient reports having chronic constipation (adverse effect of the medication, does not impact heart rate or BP and can be taken with beta blockers or nitrates) Which patient is best for the coronary care charge nurse to assign to a float RN who has come for the day from the general medical-surgical unit? Patient receiving IV furosemide to treat acute left ventricular failure. (the nurse would be familiar with LVF and the administration of IV medications) Which topics will the nurse plan to include in dis-charge teaching for a patient who has been admitted with heart failure? Select all that apply. o How to monitor and record daily weight o Date and time for follow-up appointments o Symptoms of worsening heart failure o How to read food labels for sodium content A patient who has just arrived in the emergency department reports substernal and left arm discomfort that has been going on for about 3 hours. Which laboratory test will be most useful in determining whether the nurse should anticipate implementing the acute coronary syndrome standard protocol? Troponin I A patient seen in the clinic with shortness of breath and fatigue is being evaluated for a possible diagnosis of heart failure. Which laboratory result will be most useful to monitor? B-type Natriuretic Peptide The emergency department nurse is caring for a patient who was just admitted with left anterior chest pain, suggesting possible acute myocardial infarction (MI). Which action will the nurse take first? Administer sublingual nitroglycerin The health care provider prescribes these actions for a patient who was admitted with acute substernal chest pain. Which actions are appropriate to assign to an experienced LPN/LVN who is working in the emergency department? Select all that apply