Med Surg 2 Exam 1 Practice Questions and Answers with verified solutions

Med Surg 2 Exam 1 Practice Questions and Answers with verified solutions A 19 yo patient with rheumatic heart disease is admitted to the hospital with a recurrence of rheumatic fever. In planning care for the patient, which nursing diagnosis should the nurse include? A. Ineffective coping r/t refusal to carry out health promotion activities B. Risk for infection r/t recent exposure to group A beta-hemolytic streptococci C. Impaired adjustment r/t unsuccessful lifestyle modifications, goal setting, and problem solving D. Ineffective health management r/t lack of knowledge about long-term prophylactic antibiotic therapy - ANS -D. Ineffective health management r/t lack of knowledge about long-term prophylactic antibiotic therapy A multiple gated acquisition (MUGA) scan has been prescribed to a patient with cardiac problems to determine what? A. The patient's ejection fraction B. The presence of conduction disturbances C. The effectiveness of dilated cardiomyopathy D. The presence of infectious organisms in the heart tissue - ANS -A. The patient's ejection fraction A patient develops atrial flutter with a rapid ventricular response. The nurse anticipates that what treatment will be prescribed? A. Defibrillation B. ICD C. AED D. Synchronized cardioversion - ANS -D. Synchronized cardioversion A patient develops symptomatic sinus tachycardia. The nurse recognizes that which drug will likely be included in the patient's treatment plan? A. Atropine B. Dopamine C. Adenosine D. Epinephrine - ANS -C. Adenosine A patient experiences anginal pain. What is an appropriate nursing intervention? A. Place the patient in the recumbent position during the attack B. Encourage a salt-rich diet to prevent orthostatic hypotension C. Position the patient upright and administer oxygen D. Encourage the patient to do isometric exercises - ANS -C. Position the patient upright and administer oxygen A patient has a diagnosis of acute MI, and his cardiac rhythm is sinus bradycardia with 6-8 PVCs per minute. The pattern that the nurse recognizes as the most characteristic of PVCs is A. An irregular rhythm B. An inverted T wave C. A wide, distorted QRS complex D. An increasingly long PR interval - ANS -C. A wide, distorted QRS complex A patient has been in the hospital for 1 wk and is being discharged with a diagnosis of sub-acute infective endocarditis (IE), afebrile, and no signs of heart damage. The patient will go home on antibiotics. What is most important for the nurse to consider in discharge planning? A. Plan how his needs will be met while he is on bed rest B. Teach the patient to avoid outdoor activities to relieve restlessness and boredom C. Assess the patient's home environment in terms of family assistance and hospital access D. Encourage use of diversional activities to relieve restlessness and boredom - ANS -C. Assess the patient's home environment in terms of family assistance and hospital access A patient has sought care following a syncopal episode of unknown etiology. The nurse anticipates that what will be included in the patient's treatment plan? A. IV beta blocker B. Head-up tilt-test C. Pacemaker insertion D. Antiplatelet therapy - ANS -B. Head-up tilt-test A patient in asystole is likely to receive which drug treatment? A. Epi and vasopressin B. Lidocaine and amiodarone C. Digoxin and procainamide D. Beta blockers and dopamine - ANS -A. Epi and vasopressin A patient in teh coronary care unit develops Vfib. The first action the nurse should take is to A. Perform defibrillation B. Initiate CPR C. Prepare for synchronized cardioversion D. Administer IV antidysrhythmic drugs per protocol - ANS -B. Initiate CPR A patient is admitted to the coronary care unit following a cardiac arrest and successful CPR. When reviewing the HCP's admission orders, which order should the nurse question? A. Oxygen at 4 L/min via NC B. Morphine sulfate 2 mg IV every 10 min until pain is relieved C. t-PA 100 mg IV infused over 3 hr D. IV nitroglycerin at 5 mcg/min and increase 5 mcg/min every 3-5 min - ANS -C. t-PA 100 mg IV infused over 3 hr A patient is admitted to the hospital with a suspected acute pericarditis. To establish the presence of a pericardial friction rub, the nurse listens to the patient's chest... A. While timing the sound with the respiratory pattern B. With the diaphragm of the stethoscope at the left sternal border of the chest C. With the bell of the stethoscope at the apex of the heart D. With the stethoscope diaphragm to auscultate a high-pitched continuous rumbling sound - ANS -B. With the diaphragm of the stethoscope at the left sternal border of the chest A patient is classified as having stage 2 hypertension on the basis of the blood pressure recorded. The nurse notes that the primary goal of therapy for the patient is to normalize the blood pressure. What should be the patient's target blood pressure? A. 130/80 B. less than 120/80 C. 140/90 D. 150/90 - ANS -B. less than 120/80 A patient reports a new onset of jaw pain. The nurse obtains the following electrocardiogram (ECG) tracing (looks like a weird fireman's hat). What action should the nurse take? A. Administer hydrocodone B. Contact the HCP C. Place patient in Trendelenburg position D. Recognize ECG changes as indicative of digitalis toxicity - ANS -B. Contact the HCP A patient that is being discharged from the hospital after acute coronary syndrome will be participating in cardiac rehabilitation. What information should the nurse provide about the early recovery phase of rehabilitation? A. Therapeutic lifestyle changes should become lifelong habits B. Physical activity always begins in the hospital and continued at home C. Activity is increased gradually with supervision by the rehab team and with ECG monitoring D. The focus of rehab will be on management of chest pain, anxiety, dysrhythmias, and other complications - ANS -C. Activity is increased gradually with supervision by the rehab team and with ECG monitoring A patient that is hospitalized with acute pericarditis reports severe, sharp chest pain. To increase patient comfort, the nurse should encourage the patient to assume which position? A. Flat on back B. Semi-Fowlers C. Sit up and lean forward D. Lie down and bend knees - ANS -C. Sit up and lean forward A patient who has received a maximum dose of nitroglycerin continues to report chest pain. What is the next medication that the nurse should administer to the patient? A. Ticagrelor B. Morphine sulfate C. Docusate D. Esmolol - ANS -B. Morphine Sulfate A patient with a newly inserted pacemaker receives discharge instructions from the nurse. Which patient statement indicates that further teaching is required? A. I should avoid using microwave ovens B. I should avoid standing near antitheft devices C. I should avoid direct blows to the pacemaker site D. I should avoid close proximity to high-output electric generators - ANS -A. I should avoid using microwave ovens A patient with acute pericarditis has a nursing diagnosis of pain r/t pericardial inflammation. An appropriate nursing intervention for the patient is: A. Administer opioids as prescribed around-the-clock B. Promote progressive relaxation exercises using deep slow breathing techniques C. Position the patient on the right side with the HOB elevated 15 degrees D. Position the patient in Fowler's position and pad the over-the-bed table for the patient to lean on - ANS -D. Position the patient in Fowler's position and pad the over-the-bed table for the patient to lean on A patient with chronic stable angina has received a prescription for sublingual (SL) nitroglycerin. The nurse tells the patient that orthostatic hypotension is a side effect of the drug. What should the nurse include in the patient's teaching about preventing complications associated with the side effect? A. Take your BP daily and record the measurement B. Take the medication with each meal while you are seated C. Avoid sudden changes in position after taking nitroglycerin to prevent falls D. If the medication causes a tingling sensation, this indicates that hypotension will be more severe - ANS -C. Avoid sudden changes in position after taking nitroglycerin to prevent falls A patient with group A streptococcal pharyngitis states, "I do not want to take the antibiotics that have been prescribed." How should the nurse respond? A. You will not feel well if you don't take this medicine and get over this infection B. You may not want to take the antibiotics for this infection, but you'll be sorry if you don't C. Without treatment, you can get rheumatic fever, which can lead to rheumatic heart disease