Medsurg 2 Exam 1
Medsurg 2 -> Exam 1 Questions and
Answers 2025 Graded A
A nurse is caring for a client who has heart failure and has been taking digoxin 0.25 mg
daily. The client refuses breakfast and reports nausea. Which of the following actions
should the nurse take first? -Correct Answer ✔Check the clients vt
A nurse is caring for a client receiving IV therapy in the left forearm and notices that the
site is red, swollen, and warm. Which of the following actions should the nurse perform
first? -Correct Answer ✔Discontinue the existing IV infusion
A nurse is contributing to the plan of care for a client who is 24 hr postoperative
following an aortic valve replacement with a biologic valve. Which of the following
interventions should the nurse include in the plan? -Correct Answer ✔Monitor daily
weight
A nurse is reinforcing discharge teaching with a client prescribed verapamil to treat
angina. Which of the following instructions should the nurse include? -Correct Answer
✔Monitor for increased Heart Rate while taking this medication
A nurse in a provider's office is collecting data from a client who takes furosemide daily
for heart failure. Which of the following findings is a manifestation of hypokalemia? -
Correct Answer ✔Reports of fatigue
A nurse is assisting with the care of a client in the emergency department and reports
severe radiating chest pain and shortness of breath. The client appears restless,
frightened, and slightly cyanotic. The provider prescribes oxygen by nasal cannula at 4
L/min stat, cardiac enzyme levels, IV fluids, and a 12-lead ECG. Which of the following
actions should the nurse take first? -Correct Answer ✔Initiate oxygen therapy
A nurse is reinforcing teaching with a client who uses a nitroglycerine patch to treat
angina. The client now has a new prescription for nitroglycerin sublingual tablets. Which
of the following instructions should the nurse include? -Correct Answer ✔Take the
medication at the first indication of chest pain.
A nurse assisting in the collection of data for a client who is in the early compensatory
stage of hypovolemic shock. Which of the following findings should the nurse expect? -
Correct Answer ✔Tachycardia
A nurse is reinforcing teaching with a client who has hypertension and a new
prescription for verapamil. The nurse should instruct the client to avoid taking this
medication with which of the following foods? -Correct Answer ✔Grapefruit juice
Medsurg 2 Exam 1
, Medsurg 2 Exam 1
A nurse is caring for a client who is postoperative following vascular surgery. Which of
the following manifestations should indicate to the nurse that the client has developed a
thrombus? -Correct Answer ✔Dull, aching calf pain
A nurse is collecting data from a client who has left-sided heart failure. Which of the
following findings should the nurse expect? -Correct Answer ✔Shortness of breath while
lying down
A nurse is caring for a client who has thrombophlebitis and is receiving a continuous
heparin infusion. Which of the following medications should the nurse have available to
reverse heparin's effects? -Correct Answer ✔Protamine sulfate
A nurse is collecting data from a client who reports a sudden onset of shortness of
breath, fatigue, and dizziness. Electrocardiography indicates the client is experiencing
atrial fibrillation. Which of the following medications should the nurse expect to
administer? -Correct Answer ✔Digoxin
A nurse is assisting in the plan of care for a client who has a suspected myocardial
infarction. Which of the following medications should the nurse plan to administer first? -
Correct Answer ✔Oxygen
A nurse is reviewing the laboratory findings of a client who experienced an acute
myocardial infarction 6 days ago. Which of the following laboratory values should the
nurse expect to remain elevated at this time? -Correct Answer ✔Troponin T
A nurse is collecting data on a client who has infective endocarditis. The nurse should
recognize which of the following findings is the priority to report to the provider? -Correct
Answer ✔Dyspnea
A nurse is assisting with the care of a client who has infective endocarditis. Which of the
following manifestations should the nurse identify as a complication of this disorder? -
Correct Answer ✔Dyspnea
A nurse is reinforcing discharge teaching with an older adult client who has peripheral
artery disease (PAD). Which of the following instructions should the nurse include in the
teaching? -Correct Answer ✔Adjust the thermostat so that the environment is warm.
A nurse is administering morning medications and realizes that nifedipine was
administered to the wrong client. Which of the following is the priority nursing action? -
Correct Answer ✔Check the client's vital signs.
A nurse is administering nicardipine to a client who has a BP of 180/120 mm Hg. Which
of the following actions should the nurse take first? -Correct Answer ✔Monitor the
client's BP every 5 minutes
Medsurg 2 Exam 1
Medsurg 2 -> Exam 1 Questions and
Answers 2025 Graded A
A nurse is caring for a client who has heart failure and has been taking digoxin 0.25 mg
daily. The client refuses breakfast and reports nausea. Which of the following actions
should the nurse take first? -Correct Answer ✔Check the clients vt
A nurse is caring for a client receiving IV therapy in the left forearm and notices that the
site is red, swollen, and warm. Which of the following actions should the nurse perform
first? -Correct Answer ✔Discontinue the existing IV infusion
A nurse is contributing to the plan of care for a client who is 24 hr postoperative
following an aortic valve replacement with a biologic valve. Which of the following
interventions should the nurse include in the plan? -Correct Answer ✔Monitor daily
weight
A nurse is reinforcing discharge teaching with a client prescribed verapamil to treat
angina. Which of the following instructions should the nurse include? -Correct Answer
✔Monitor for increased Heart Rate while taking this medication
A nurse in a provider's office is collecting data from a client who takes furosemide daily
for heart failure. Which of the following findings is a manifestation of hypokalemia? -
Correct Answer ✔Reports of fatigue
A nurse is assisting with the care of a client in the emergency department and reports
severe radiating chest pain and shortness of breath. The client appears restless,
frightened, and slightly cyanotic. The provider prescribes oxygen by nasal cannula at 4
L/min stat, cardiac enzyme levels, IV fluids, and a 12-lead ECG. Which of the following
actions should the nurse take first? -Correct Answer ✔Initiate oxygen therapy
A nurse is reinforcing teaching with a client who uses a nitroglycerine patch to treat
angina. The client now has a new prescription for nitroglycerin sublingual tablets. Which
of the following instructions should the nurse include? -Correct Answer ✔Take the
medication at the first indication of chest pain.
A nurse assisting in the collection of data for a client who is in the early compensatory
stage of hypovolemic shock. Which of the following findings should the nurse expect? -
Correct Answer ✔Tachycardia
A nurse is reinforcing teaching with a client who has hypertension and a new
prescription for verapamil. The nurse should instruct the client to avoid taking this
medication with which of the following foods? -Correct Answer ✔Grapefruit juice
Medsurg 2 Exam 1
, Medsurg 2 Exam 1
A nurse is caring for a client who is postoperative following vascular surgery. Which of
the following manifestations should indicate to the nurse that the client has developed a
thrombus? -Correct Answer ✔Dull, aching calf pain
A nurse is collecting data from a client who has left-sided heart failure. Which of the
following findings should the nurse expect? -Correct Answer ✔Shortness of breath while
lying down
A nurse is caring for a client who has thrombophlebitis and is receiving a continuous
heparin infusion. Which of the following medications should the nurse have available to
reverse heparin's effects? -Correct Answer ✔Protamine sulfate
A nurse is collecting data from a client who reports a sudden onset of shortness of
breath, fatigue, and dizziness. Electrocardiography indicates the client is experiencing
atrial fibrillation. Which of the following medications should the nurse expect to
administer? -Correct Answer ✔Digoxin
A nurse is assisting in the plan of care for a client who has a suspected myocardial
infarction. Which of the following medications should the nurse plan to administer first? -
Correct Answer ✔Oxygen
A nurse is reviewing the laboratory findings of a client who experienced an acute
myocardial infarction 6 days ago. Which of the following laboratory values should the
nurse expect to remain elevated at this time? -Correct Answer ✔Troponin T
A nurse is collecting data on a client who has infective endocarditis. The nurse should
recognize which of the following findings is the priority to report to the provider? -Correct
Answer ✔Dyspnea
A nurse is assisting with the care of a client who has infective endocarditis. Which of the
following manifestations should the nurse identify as a complication of this disorder? -
Correct Answer ✔Dyspnea
A nurse is reinforcing discharge teaching with an older adult client who has peripheral
artery disease (PAD). Which of the following instructions should the nurse include in the
teaching? -Correct Answer ✔Adjust the thermostat so that the environment is warm.
A nurse is administering morning medications and realizes that nifedipine was
administered to the wrong client. Which of the following is the priority nursing action? -
Correct Answer ✔Check the client's vital signs.
A nurse is administering nicardipine to a client who has a BP of 180/120 mm Hg. Which
of the following actions should the nurse take first? -Correct Answer ✔Monitor the
client's BP every 5 minutes
Medsurg 2 Exam 1
