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SAUNDERS HESI MED SURG PT 2 Questions
and Correct Answers | Latest Update
A client is admitted to the emergency department
with chest pain that is consistent with myocardial
infarction based on elevated troponin levels.
Heart sounds are normal and vital signs are noted
on the client's chart. The nurse should alert the
health care provider because these changes are
most consistent with which complication? Refer
to chart.
1. Cardiogenic shock
2. Cardiac tamponade
3. Pulmonary embolism
4. Dissecting thoracic aortic aneurysm
1
Cardiogenic shock occurs with severe damage (more than 40%) to the left ventricle. Classic
signs include hypotension; a rapid pulse that becomes weaker; decreased urine output; and
cool, clammy skin. Respiratory rate increases as the body develops metabolic acidosis from
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shock. Cardiac tamponade is accompanied by distant, muffled heart sounds and prominent
neck vessels. Pulmonary embolism presents suddenly with severe dyspnea accompanying the
chest pain. Dissecting aortic aneurysms usually are accompanied by back pain.
A client admitted to the hospital with chest pain and a history of type 2 diabetes mellitus is
scheduled for cardiac catheterization. Which medication would need to be withheld for 24
hours before the procedure and for 48 hours after the procedure?
1. Glipizide
2. Metformin
3. Repaglinide
4. Regular insulin
2
Metformin needs to be withheld 24 hours before and for 48 hours after cardiac
catheterization because of the injection of contrast medium during the procedure. If the
contrast medium affects kidney function, with metformin in the system the client would be at
increased risk for lactic acidosis. The medications in the remaining options do not need to be
withheld 24 hours before and 48 hours after cardiac catheterization.
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A client in sinus bradycardia, with a heart rate of 45 beats/minute, complains of dizziness and
has a blood pressure of 82/60 mm Hg. Which prescription should the nurse anticipate will be
prescribed?
1. Administer digoxin.
2. Defibrillate the client.
3. Continue to monitor the client.
4. Prepare for transcutaneous pacing
4
Sinus bradycardia is noted with a heart rate less than 60 beats per minute. This rhythm
becomes a concern when the client becomes symptomatic. Hypotension and dizziness are signs
of decreased cardiac output. Transcutaneous pacing provides a temporary measure to
increase the heart rate and thus perfusion in the symptomatic client. Defibrillation is used for
treatment of pulseless ventricular tachycardia and ventricular fibrillation. Digoxin will further
decrease the client's heart rate. Continuing to monitor the client delays necessary intervention.
The nurse in a medical unit is caring for a client with heart failure. The client suddenly develops
extreme dyspnea, tachycardia, and lung crackles and the nurse suspects pulmonary edema.
The nurse immediately asks another nurse to contact the health care provider and prepares to
implement which priority interventions? (SELECT ALL THAT APPLY.)
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1. Administering oxygen
2. Inserting a Foley catheter
3. Administering furosemide
4. Administering morphine sulfate intravenously
5. Transporting the client to the coronary care unit
6. Placing the client in a low Fowler's side-lying position
1, 2, 3, 4
Pulmonary edema is a life-threatening event that can result from severe heart failure. In
pulmonary edema, the left ventricle fails to eject sufficient blood, and pressure increases in the
lungs because of the accumulated blood. Oxygen is always prescribed, and the client is
placed in a high Fowler's position to ease the work of breathing. Furosemide, a rapid-acting
diuretic, will eliminate accumulated fluid. A Foley catheter is inserted to measure output
accurately. Intravenously administered morphine sulfate reduces venous return (preload),
decreases anxiety, and also reduces the work of breathing. Transporting the client to the
coronary care unit is not a priority intervention. In fact, this may not be necessary at all if the
client's response to treatment is successful.
A client with myocardial infarction suddenly becomes tachycardic, shows signs of air hunger,
and begins coughing frothy, pink-tinged sputum. Which finding would the nurse anticipate
when auscultating the client's breath sounds?
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SAUNDERS HESI MED SURG PT 2 Questions
and Correct Answers | Latest Update
A client is admitted to the emergency department
with chest pain that is consistent with myocardial
infarction based on elevated troponin levels.
Heart sounds are normal and vital signs are noted
on the client's chart. The nurse should alert the
health care provider because these changes are
most consistent with which complication? Refer
to chart.
1. Cardiogenic shock
2. Cardiac tamponade
3. Pulmonary embolism
4. Dissecting thoracic aortic aneurysm
1
Cardiogenic shock occurs with severe damage (more than 40%) to the left ventricle. Classic
signs include hypotension; a rapid pulse that becomes weaker; decreased urine output; and
cool, clammy skin. Respiratory rate increases as the body develops metabolic acidosis from
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, Best Grades | Must Pass | Latest Update | Correct Answers | 2024/ 2025
shock. Cardiac tamponade is accompanied by distant, muffled heart sounds and prominent
neck vessels. Pulmonary embolism presents suddenly with severe dyspnea accompanying the
chest pain. Dissecting aortic aneurysms usually are accompanied by back pain.
A client admitted to the hospital with chest pain and a history of type 2 diabetes mellitus is
scheduled for cardiac catheterization. Which medication would need to be withheld for 24
hours before the procedure and for 48 hours after the procedure?
1. Glipizide
2. Metformin
3. Repaglinide
4. Regular insulin
2
Metformin needs to be withheld 24 hours before and for 48 hours after cardiac
catheterization because of the injection of contrast medium during the procedure. If the
contrast medium affects kidney function, with metformin in the system the client would be at
increased risk for lactic acidosis. The medications in the remaining options do not need to be
withheld 24 hours before and 48 hours after cardiac catheterization.
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, Best Grades | Must Pass | Latest Update | Correct Answers | 2024/ 2025
A client in sinus bradycardia, with a heart rate of 45 beats/minute, complains of dizziness and
has a blood pressure of 82/60 mm Hg. Which prescription should the nurse anticipate will be
prescribed?
1. Administer digoxin.
2. Defibrillate the client.
3. Continue to monitor the client.
4. Prepare for transcutaneous pacing
4
Sinus bradycardia is noted with a heart rate less than 60 beats per minute. This rhythm
becomes a concern when the client becomes symptomatic. Hypotension and dizziness are signs
of decreased cardiac output. Transcutaneous pacing provides a temporary measure to
increase the heart rate and thus perfusion in the symptomatic client. Defibrillation is used for
treatment of pulseless ventricular tachycardia and ventricular fibrillation. Digoxin will further
decrease the client's heart rate. Continuing to monitor the client delays necessary intervention.
The nurse in a medical unit is caring for a client with heart failure. The client suddenly develops
extreme dyspnea, tachycardia, and lung crackles and the nurse suspects pulmonary edema.
The nurse immediately asks another nurse to contact the health care provider and prepares to
implement which priority interventions? (SELECT ALL THAT APPLY.)
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, Best Grades | Must Pass | Latest Update | Correct Answers | 2024/ 2025
1. Administering oxygen
2. Inserting a Foley catheter
3. Administering furosemide
4. Administering morphine sulfate intravenously
5. Transporting the client to the coronary care unit
6. Placing the client in a low Fowler's side-lying position
1, 2, 3, 4
Pulmonary edema is a life-threatening event that can result from severe heart failure. In
pulmonary edema, the left ventricle fails to eject sufficient blood, and pressure increases in the
lungs because of the accumulated blood. Oxygen is always prescribed, and the client is
placed in a high Fowler's position to ease the work of breathing. Furosemide, a rapid-acting
diuretic, will eliminate accumulated fluid. A Foley catheter is inserted to measure output
accurately. Intravenously administered morphine sulfate reduces venous return (preload),
decreases anxiety, and also reduces the work of breathing. Transporting the client to the
coronary care unit is not a priority intervention. In fact, this may not be necessary at all if the
client's response to treatment is successful.
A client with myocardial infarction suddenly becomes tachycardic, shows signs of air hunger,
and begins coughing frothy, pink-tinged sputum. Which finding would the nurse anticipate
when auscultating the client's breath sounds?
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