©SIRJOEL EXAM SOLUTIONS
10/14/2024 11:14 PM
Med Surg Exam Questions And Correct
Answers
A client is admitted to the hospital with atrial fibrillation. A diagnosis of mitral valve stenosis is
suspected. The nurse concludes that it is most significant if the client presents with what history?
- answer✔*Streptococcal infections occurring in childhood* may result in damage to heart
valves, particularly the mitral valve. Group A streptococcal antigens bind to receptors on heart
cells, where an autoimmune response is triggered damaging the heart.
A client is in profound (late) hypovolemic shock. The nurse assesses the client's laboratory
values. What does the nurse know that clients in late shock develop? - answer✔Decreased
oxygen increases the conversion of pyruvic acid to lactic acid, resulting in *metabolic acidosis*.
Hyperkalemia will occur because of renal shutdown. In late shock metabolic or respiratory
acidosis occurs. The Pco2 level will increase in profound shock.
An older client who lives alone was found unconscious on the floor at home. The client was
admitted to the hospital with the diagnoses of a fractured hip, kidney failure, and dehydration. In
the 24 hours since admission, the client received 1500 mL of intravenous fluid, and the serum
electrolyte value demonstrates hyponatremia. What would the nurse concludes was the element
that most likely contributed to the hyponatremia? - answer✔*Fluid intake*
Hemodilution has occurred because the 1500 mL of intravenous fluid has lowered the serum
sodium level.
A client develops internal bleeding after abdominal surgery. Which signs and symptoms of
hemorrhage should the nurse expect the client to exhibit? - answer✔*Pallor* occurs with
hemorrhage as the peripheral blood vessels constrict in an effort to shunt blood to the vital
organs in the center of the body. *Heart rate accelerates* in hemorrhage as the body attempts to
increase blood flow and oxygen to body tissues. *Urinary output decreases* with hemorrhage
because of a lowered glomerular filtration rate secondary to hypovolemia. *Respirations
increase* and become shallow with hemorrhage as the body attempts to take in more oxygen.
*Hypotension* occurs in response to hemorrhage as the person experiences hypovolemia.
A nurse is taking blood pressures at a health fair. Which finding should cause the nurse to advise
the client to have the blood pressure checked by a primary healthcare provider? - answer✔A
sustained diastolic pressure exceeding 90 mm Hg reflects pathology and could indicate
hypertension.
, ©SIRJOEL EXAM SOLUTIONS
10/14/2024 11:14 PM
The nurse notes that the client's cardiac rhythm strips show more P waves than QRS complexes.
There is no relationship between the atria and the ventricles. How should the nurse interpret this
rhythm strip? - answer✔Third degree block often is called complete heart block because no atrial
impulses are conducted through the AV node to the ventricles. In complete heart block, the atria
and ventricles beat independently of each other because the AV node is completely blocked to
the sinus impulse and is not conducted to the ventricles. One hallmark of third degree heart block
is that the P waves have no association with the QRS complexes and appear throughout the QRS
waveform.
During chest physiotherapy (CPT) a client reports fatigue, and the client's heart rate increases
from 90 to 140 beats per minute. What should the nurse do next? - answer✔The client's response
indicates lack of physiologic tolerance to the procedure, and it must be interrupted.
A child with a congenital heart defect has a cardiac catheterization. What is an essential element
of nursing care after this procedure? - answer✔Monitoring the extremity distal to the insertion
site for changes in temperature and color should indicate the presence or absence of a clot;
comparing pedal pulses of both extremities may reveal clot formation that disrupts circulation.
A client with squamous cell carcinoma of the tongue is to be treated with interstitially implanted
radon seeds. Which consideration is priority when the nurse is planning room placement? -
answer✔Radon seeds emit radiation; the client should be isolated in a private room to decrease
radiation to others.
The nurse is caring for a client after the client's open heart surgery (coronary artery bypass
grafting [CABG]). Serosanguineous fluid drains from the client's chest tube. The nurse expects
what volume of drainage from the tube during the first 24 hours after the surgery? -
answer✔During the first 24 hours after CABG surgery, 500 mL of fluid will accumulate in the
intrapleural space because of trauma and the inflammatory response; gradually, this amount will
decrease.
A client arrives at the emergency room complaining of chest pain and dizziness. The client has a
history of angina. The primary healthcare provider prescribes an electrocardiogram (ECG) and
lab tests. A change in which component of the ECG tracing should the nurse recognize as the
client actively having a myocardial infarction (MI)? - answer✔In ECG tracing, the displacement
of the S-T segment is caused by an active ischemic injury in the myocardium.
A nurse is caring for a client who has a prescription for a 2-gram sodium diet and an oral fluid
restriction of 1200 mL daily. The most recent laboratory results are blood urea nitrogen (BUN)
42 mg/dL (15.2 mmol/L) and creatinine 1.1 mg/dL (97 mcmol/L). Considering the assessment
findings, what is the most appropriate intervention by the nurse? - answer✔Diuretics cause
dehydration, increasing the BUN; increasing fluid intake will result in a decrease in the BUN
level.
10/14/2024 11:14 PM
Med Surg Exam Questions And Correct
Answers
A client is admitted to the hospital with atrial fibrillation. A diagnosis of mitral valve stenosis is
suspected. The nurse concludes that it is most significant if the client presents with what history?
- answer✔*Streptococcal infections occurring in childhood* may result in damage to heart
valves, particularly the mitral valve. Group A streptococcal antigens bind to receptors on heart
cells, where an autoimmune response is triggered damaging the heart.
A client is in profound (late) hypovolemic shock. The nurse assesses the client's laboratory
values. What does the nurse know that clients in late shock develop? - answer✔Decreased
oxygen increases the conversion of pyruvic acid to lactic acid, resulting in *metabolic acidosis*.
Hyperkalemia will occur because of renal shutdown. In late shock metabolic or respiratory
acidosis occurs. The Pco2 level will increase in profound shock.
An older client who lives alone was found unconscious on the floor at home. The client was
admitted to the hospital with the diagnoses of a fractured hip, kidney failure, and dehydration. In
the 24 hours since admission, the client received 1500 mL of intravenous fluid, and the serum
electrolyte value demonstrates hyponatremia. What would the nurse concludes was the element
that most likely contributed to the hyponatremia? - answer✔*Fluid intake*
Hemodilution has occurred because the 1500 mL of intravenous fluid has lowered the serum
sodium level.
A client develops internal bleeding after abdominal surgery. Which signs and symptoms of
hemorrhage should the nurse expect the client to exhibit? - answer✔*Pallor* occurs with
hemorrhage as the peripheral blood vessels constrict in an effort to shunt blood to the vital
organs in the center of the body. *Heart rate accelerates* in hemorrhage as the body attempts to
increase blood flow and oxygen to body tissues. *Urinary output decreases* with hemorrhage
because of a lowered glomerular filtration rate secondary to hypovolemia. *Respirations
increase* and become shallow with hemorrhage as the body attempts to take in more oxygen.
*Hypotension* occurs in response to hemorrhage as the person experiences hypovolemia.
A nurse is taking blood pressures at a health fair. Which finding should cause the nurse to advise
the client to have the blood pressure checked by a primary healthcare provider? - answer✔A
sustained diastolic pressure exceeding 90 mm Hg reflects pathology and could indicate
hypertension.
, ©SIRJOEL EXAM SOLUTIONS
10/14/2024 11:14 PM
The nurse notes that the client's cardiac rhythm strips show more P waves than QRS complexes.
There is no relationship between the atria and the ventricles. How should the nurse interpret this
rhythm strip? - answer✔Third degree block often is called complete heart block because no atrial
impulses are conducted through the AV node to the ventricles. In complete heart block, the atria
and ventricles beat independently of each other because the AV node is completely blocked to
the sinus impulse and is not conducted to the ventricles. One hallmark of third degree heart block
is that the P waves have no association with the QRS complexes and appear throughout the QRS
waveform.
During chest physiotherapy (CPT) a client reports fatigue, and the client's heart rate increases
from 90 to 140 beats per minute. What should the nurse do next? - answer✔The client's response
indicates lack of physiologic tolerance to the procedure, and it must be interrupted.
A child with a congenital heart defect has a cardiac catheterization. What is an essential element
of nursing care after this procedure? - answer✔Monitoring the extremity distal to the insertion
site for changes in temperature and color should indicate the presence or absence of a clot;
comparing pedal pulses of both extremities may reveal clot formation that disrupts circulation.
A client with squamous cell carcinoma of the tongue is to be treated with interstitially implanted
radon seeds. Which consideration is priority when the nurse is planning room placement? -
answer✔Radon seeds emit radiation; the client should be isolated in a private room to decrease
radiation to others.
The nurse is caring for a client after the client's open heart surgery (coronary artery bypass
grafting [CABG]). Serosanguineous fluid drains from the client's chest tube. The nurse expects
what volume of drainage from the tube during the first 24 hours after the surgery? -
answer✔During the first 24 hours after CABG surgery, 500 mL of fluid will accumulate in the
intrapleural space because of trauma and the inflammatory response; gradually, this amount will
decrease.
A client arrives at the emergency room complaining of chest pain and dizziness. The client has a
history of angina. The primary healthcare provider prescribes an electrocardiogram (ECG) and
lab tests. A change in which component of the ECG tracing should the nurse recognize as the
client actively having a myocardial infarction (MI)? - answer✔In ECG tracing, the displacement
of the S-T segment is caused by an active ischemic injury in the myocardium.
A nurse is caring for a client who has a prescription for a 2-gram sodium diet and an oral fluid
restriction of 1200 mL daily. The most recent laboratory results are blood urea nitrogen (BUN)
42 mg/dL (15.2 mmol/L) and creatinine 1.1 mg/dL (97 mcmol/L). Considering the assessment
findings, what is the most appropriate intervention by the nurse? - answer✔Diuretics cause
dehydration, increasing the BUN; increasing fluid intake will result in a decrease in the BUN
level.
