Exam 2 Practice Questions- Med Surg 3
Questions and answers With complete
solution Latest 100% PASS
When assessing a patient with sepsis, which finding would alert the nurse to the onset of acute
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
respiratory distress syndrome (ARDS)? II! II! II!
a.SpO2 of 80% II! II!
b.Use of accessory muscles of respiration
II! II! II! II! II!
c.Fine, scattered crackles on auscultation of the chest
II! II! II! II! II! II! II!
d.ABGs of pH 7.33, Paco2 48 mm Hg, and Pao2 80 mm Hg - Correct Answers c.Fine, scattered crackles
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
on auscultation of the chest
II! II! II! II!
The initial presentation of acute respiratory distress syndrome is often subtle. At the time of the initial
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
injury, and for several hours to 1 to 2 days afterward, the patient may not experience respiratory
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
symptoms, or the patient may exhibit only dyspnea, tachypnea, cough, and restlessness. Chest
II! II! II! II! II! II! II! II! II! II! II! II! II!
auscultation may be normal or may reveal fine, scattered crackles. II! II! II! II! II! II! II! II! II!
A nurse is watching the cardiac monitor and notices that the rhythm suddenly changes. There are no P
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
waves. The QRS complexes are wide and the ventricular rate is regular but over 100. The nurse
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
determines that the client is experiencing: II! II! II! II! II!
A. Premature ventricular contraction
II! II! II!
B. Ventricular tachycardia
II! II!
C. Ventricular fibrillation
II! II!
D. Sinus tachycardia - Correct Answers B. Ventricular tachycardia
II! II! II! II! II! II! II! II! II!
With ventricular tachycardia the ventricles are responsible for stimulating the impulses. When the
II! II! II! II! II! II! II! II! II! II! II! II! II!
ventricles stimulate an impulse there will be no P wave, the QRS complexes are wide, and the ventricular
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
rate is usually fast.
II! II! II! II!
, A patient is admitted with chest pain to the ER. The patient has been in the ER for 5 hours and is being
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
admitted to your unit for overnight observation. From the options below, what is the most IMPORTANT
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
information to know about this patient at this time? II! II! II! II! II! II! II! II!
A. Troponin result and when the next troponin level is due to be collected
II! II! II! II! II! II! II! II! II! II! II! II! II!
B. Diet status
II! II!
C. Last consumption of caffeine
II! II! II! II!
D. CK result and when the next CK level is due to be collected - Correct Answers A. Troponin result and
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
when the next troponin level is due to be collected
II! II! II! II! II! II! II! II! II!
Troponin is specific to cardiac muscle. When a patient complains of chest pain and/or other symptoms
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
that could potentially indicate the patient may be having a MI, a 12 lead ECG will be done and blood
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
specimens will be collected and tested. If the ECG does not show ST segment changes and the blood
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
work is negative the patient may be admitted for 24 hours observation. During the 24 hours period
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
patients will have bloodwork (Troponin and CK/MB) done every 6 to 8 hours to determine if the patient
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
did or did not have a MI. Therefore, it is important to know when the first set of Troponin and CK/MB
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
was collected. The second set of Troponin and CK/MB should be collected 6 to 8 hours after the first set
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
then again 6 to 8 hours after the second. Also keep in mind Troponin and CK/MB is specific to cardiac
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
muscle; however, CK without MB is not. II! II! II! II! II! II!
A patient's cardiac rhythm is sinus bradycardia with a heart rate of 34 beats/min. If the bradycardia is
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
symptomatic, the nurse would expect the patient to exhibit: II! II! II! II! II! II! II! II!
a.Palpitations.
b.Hypertension.
c.Warm, flushed skin. II! II!
d.Shortness of breath. - Correct Answers d.Shortness of breath. II! II! II! II! II! II! II! II! II!
Signs of symptomatic bradycardia include pale, cool skin; hypotension; weakness; angina; dizziness or
II! II! II! II! II! II! II! II! II! II! II! II! II!
syncope; confusion or disorientation; and shortness of breath. II! II! II! II! II! II! II!
, A patient has a diagnosis of acute myocardial infarction, and his cardiac rhythm is sinus bradycardia with
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
6 to 8 premature ventricular contractions (PVCs) per minute. The pattern that the nurse recognizes as
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
the most characteristic of PVCs is:
II! II! II! II! II!
a.An irregular rhythm. II! II!
b.An inverted T wave. II! II! II!
c.A wide, distorted QRS complex.
II! II! II! II!
d.An increasingly long PR interval. - Correct Answers c.A wide, distorted QRS complex.
II! II! II! II! II! II! II! II! II! II! II! II! II!
Premature ventricular contractions have wide and distorted QRS complexes. II! II! II! II! II! II! II! II!
A patient in the coronary care unit develops ventricular fibrillation. The first action the nurse should
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
take is to: II! II!
a.Perform defibrillation. II!
b.Initiate cardiopulmonary resuscitation. II! II!
c.Prepare for synchronized cardioversion. II! II! II!
d.Administer IV antidysrhythmic drugs per protocol. - Correct Answers b.Initiate cardiopulmonary II! II! II! II! II! II! II! II! II! II! II! II!
resuscitation.
Immediate treatment for ventricular fibrillation is the initiation of cardiopulmonary resuscitation,
II! II! II! II! II! II! II! II! II! II! II!
followed by the use of defibrillation and definitive drug therapy according to advanced cardiac life
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
support guidelines. II!
To determine whether there is a delay in impulse conduction through the ventricles, the nurse will
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
measure the duration of the patient's II! II! II! II! II!
a. P wave.
II! II!
c. PR interval.
II! II!
b. Q wave.
II! II!
d. QRS complex. - Correct Answers d. QRS complex.
II! II! II! II! II! II! II! II! II!
Questions and answers With complete
solution Latest 100% PASS
When assessing a patient with sepsis, which finding would alert the nurse to the onset of acute
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
respiratory distress syndrome (ARDS)? II! II! II!
a.SpO2 of 80% II! II!
b.Use of accessory muscles of respiration
II! II! II! II! II!
c.Fine, scattered crackles on auscultation of the chest
II! II! II! II! II! II! II!
d.ABGs of pH 7.33, Paco2 48 mm Hg, and Pao2 80 mm Hg - Correct Answers c.Fine, scattered crackles
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
on auscultation of the chest
II! II! II! II!
The initial presentation of acute respiratory distress syndrome is often subtle. At the time of the initial
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
injury, and for several hours to 1 to 2 days afterward, the patient may not experience respiratory
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
symptoms, or the patient may exhibit only dyspnea, tachypnea, cough, and restlessness. Chest
II! II! II! II! II! II! II! II! II! II! II! II! II!
auscultation may be normal or may reveal fine, scattered crackles. II! II! II! II! II! II! II! II! II!
A nurse is watching the cardiac monitor and notices that the rhythm suddenly changes. There are no P
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
waves. The QRS complexes are wide and the ventricular rate is regular but over 100. The nurse
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
determines that the client is experiencing: II! II! II! II! II!
A. Premature ventricular contraction
II! II! II!
B. Ventricular tachycardia
II! II!
C. Ventricular fibrillation
II! II!
D. Sinus tachycardia - Correct Answers B. Ventricular tachycardia
II! II! II! II! II! II! II! II! II!
With ventricular tachycardia the ventricles are responsible for stimulating the impulses. When the
II! II! II! II! II! II! II! II! II! II! II! II! II!
ventricles stimulate an impulse there will be no P wave, the QRS complexes are wide, and the ventricular
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
rate is usually fast.
II! II! II! II!
, A patient is admitted with chest pain to the ER. The patient has been in the ER for 5 hours and is being
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
admitted to your unit for overnight observation. From the options below, what is the most IMPORTANT
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
information to know about this patient at this time? II! II! II! II! II! II! II! II!
A. Troponin result and when the next troponin level is due to be collected
II! II! II! II! II! II! II! II! II! II! II! II! II!
B. Diet status
II! II!
C. Last consumption of caffeine
II! II! II! II!
D. CK result and when the next CK level is due to be collected - Correct Answers A. Troponin result and
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
when the next troponin level is due to be collected
II! II! II! II! II! II! II! II! II!
Troponin is specific to cardiac muscle. When a patient complains of chest pain and/or other symptoms
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
that could potentially indicate the patient may be having a MI, a 12 lead ECG will be done and blood
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
specimens will be collected and tested. If the ECG does not show ST segment changes and the blood
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
work is negative the patient may be admitted for 24 hours observation. During the 24 hours period
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
patients will have bloodwork (Troponin and CK/MB) done every 6 to 8 hours to determine if the patient
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
did or did not have a MI. Therefore, it is important to know when the first set of Troponin and CK/MB
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
was collected. The second set of Troponin and CK/MB should be collected 6 to 8 hours after the first set
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
then again 6 to 8 hours after the second. Also keep in mind Troponin and CK/MB is specific to cardiac
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
muscle; however, CK without MB is not. II! II! II! II! II! II!
A patient's cardiac rhythm is sinus bradycardia with a heart rate of 34 beats/min. If the bradycardia is
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
symptomatic, the nurse would expect the patient to exhibit: II! II! II! II! II! II! II! II!
a.Palpitations.
b.Hypertension.
c.Warm, flushed skin. II! II!
d.Shortness of breath. - Correct Answers d.Shortness of breath. II! II! II! II! II! II! II! II! II!
Signs of symptomatic bradycardia include pale, cool skin; hypotension; weakness; angina; dizziness or
II! II! II! II! II! II! II! II! II! II! II! II! II!
syncope; confusion or disorientation; and shortness of breath. II! II! II! II! II! II! II!
, A patient has a diagnosis of acute myocardial infarction, and his cardiac rhythm is sinus bradycardia with
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
6 to 8 premature ventricular contractions (PVCs) per minute. The pattern that the nurse recognizes as
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
the most characteristic of PVCs is:
II! II! II! II! II!
a.An irregular rhythm. II! II!
b.An inverted T wave. II! II! II!
c.A wide, distorted QRS complex.
II! II! II! II!
d.An increasingly long PR interval. - Correct Answers c.A wide, distorted QRS complex.
II! II! II! II! II! II! II! II! II! II! II! II! II!
Premature ventricular contractions have wide and distorted QRS complexes. II! II! II! II! II! II! II! II!
A patient in the coronary care unit develops ventricular fibrillation. The first action the nurse should
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
take is to: II! II!
a.Perform defibrillation. II!
b.Initiate cardiopulmonary resuscitation. II! II!
c.Prepare for synchronized cardioversion. II! II! II!
d.Administer IV antidysrhythmic drugs per protocol. - Correct Answers b.Initiate cardiopulmonary II! II! II! II! II! II! II! II! II! II! II! II!
resuscitation.
Immediate treatment for ventricular fibrillation is the initiation of cardiopulmonary resuscitation,
II! II! II! II! II! II! II! II! II! II! II!
followed by the use of defibrillation and definitive drug therapy according to advanced cardiac life
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
support guidelines. II!
To determine whether there is a delay in impulse conduction through the ventricles, the nurse will
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
measure the duration of the patient's II! II! II! II! II!
a. P wave.
II! II!
c. PR interval.
II! II!
b. Q wave.
II! II!
d. QRS complex. - Correct Answers d. QRS complex.
II! II! II! II! II! II! II! II! II!
