Med Surg 2 Final Exam Updated
The nurse is caring for a patient who has a history of heart disease. What factor should
the nurse identify as possibly contributing to a decrease in cardiac output? - ANS-A
heart rate of 54 bpm
The nurse is caring for an 82-year-old patient. The nurse knows that changes in cardiac
structure and function occur in older adults. What is a normal change expected in the
aging heart of an older adult? - ANS-Widening of the aorta
A critically ill patient is admitted to the ICU. The physician decides to use intra-arterial
pressure monitoring. After this intervention is performed, what assessment should the
nurse prioritize in the plan of care? - ANS-Perfusion distal to the insertion site
The physician has placed a central venous pressure (CVP) monitoring line in an acutely
ill patient so right ventricular function and venous blood return can be closely monitored.
The results show decreased CVP. What does this indicate? - ANS-Possible
hypovolemia
The critical care nurse is caring for a patient with a central venous pressure (CVP)
monitoring system. The nurse notes that the patient's CVP is increasing. Of what may
this indicate? - ANS-Hypervolemia
The nurse is caring for a patient who has central venous pressure (CVP) monitoring in
place. The nurse's most recent assessment reveals that CVP is 7 mm Hg. What is the
nurse's most appropriate action? - ANS-Assess the patient for fluid overload and inform
the physician.
The nurse working on a cardiac care unit is caring for a patient whose stroke volume
has increased. The nurse is aware that afterload influences a patient's stroke volume.
The nurse recognizes that afterload is increased when there is what? - ANS-Arterial
vasoconstriction
The nurse is caring for an acutely ill patient who has central venous pressure monitoring
in place. What intervention should be included in the care plan of a patient with CVP in
place? - ANS-Change the site dressing whenever it becomes visibly soiled.
The physician is about to perform carotid sinus massage on a client with
supraventricular tachycardia. What equipment is most important for the nurse to have
ready? - ANS-Resuscitation cart
A client is recovering after a coronary catheterization. What assessment findings in the
first few hours after the procedure require immediate action by the nurse? (Select all
that apply.) - ANS-Serum potassium of 2.9 mEq/L
Expanding groin hematoma
, Rhythm changes on the cardiac monitor
The critical care nurse is caring for a patient with a central venous pressure (CVP)
monitoring system. The nurse notes that the patient's CVP is increasing. Of what may
this indicate? - ANS-Hypervolemia
The nurse is monitoring a client undergoing an exercise electrocardiography (stress
test). Which assessment finding necessitates that the test be stopped? - ANS-
Significant ST-segment depression
The nurse working on a cardiac care unit is caring for a patient whose stroke volume
has increased. The nurse is aware that afterload influences a patient's stroke volume.
The nurse recognizes that afterload is increased when there is what? - ANS-Arterial
vasoconstriction
The nurse is caring for a patient who has had a dysrhythmic event. The nurse is aware
of the need to assess for signs of diminished cardiac output (CO). What change in
status may signal to the nurse a decrease in cardiac output? - ANS-Changes in level of
consciousness
An adult patient with third-degree AV block is admitted to the cardiac care unit and
placed on continuous cardiac monitoring. What rhythm characteristic will the ECG most
likely show? - ANS-Fewer QRS complexes than P waves
The nurse is planning discharge teaching for a patient with a newly inserted permanent
pacemaker. What is the priority teaching point for this patient? - ANS-Avoid exposure to
high-voltage electrical generators.
A patient is scheduled for catheter ablation therapy. When describing this procedure to
the patient's family, the nurse should address what aspect of the treatment? - ANS-
Destruction of specific cardiac cells
A nurse is providing health education to a patient scheduled for cryoablation therapy.
The nurse should describe what aspect of this treatment? - ANS-Using a cooled probe
to eliminate the source of dysrhythmia
During a CPR class, a participant asks about the difference between cardioversion and
defibrillation. What would be the instructor's best response? - ANS-The difference is the
timing of the delivery of the electric current.
The nurse is caring for an adult patient who has gone into ventricular fibrillation. When
assisting with defibrillating the patient, what must the nurse do? - ANS-Maintain firm
contact between paddles and patient skin.
A patient who is a candidate for an implantable cardioverter defibrillator (ICD) asks the
nurse about the purpose of this device. What would be the nurse's best response? -
The nurse is caring for a patient who has a history of heart disease. What factor should
the nurse identify as possibly contributing to a decrease in cardiac output? - ANS-A
heart rate of 54 bpm
The nurse is caring for an 82-year-old patient. The nurse knows that changes in cardiac
structure and function occur in older adults. What is a normal change expected in the
aging heart of an older adult? - ANS-Widening of the aorta
A critically ill patient is admitted to the ICU. The physician decides to use intra-arterial
pressure monitoring. After this intervention is performed, what assessment should the
nurse prioritize in the plan of care? - ANS-Perfusion distal to the insertion site
The physician has placed a central venous pressure (CVP) monitoring line in an acutely
ill patient so right ventricular function and venous blood return can be closely monitored.
The results show decreased CVP. What does this indicate? - ANS-Possible
hypovolemia
The critical care nurse is caring for a patient with a central venous pressure (CVP)
monitoring system. The nurse notes that the patient's CVP is increasing. Of what may
this indicate? - ANS-Hypervolemia
The nurse is caring for a patient who has central venous pressure (CVP) monitoring in
place. The nurse's most recent assessment reveals that CVP is 7 mm Hg. What is the
nurse's most appropriate action? - ANS-Assess the patient for fluid overload and inform
the physician.
The nurse working on a cardiac care unit is caring for a patient whose stroke volume
has increased. The nurse is aware that afterload influences a patient's stroke volume.
The nurse recognizes that afterload is increased when there is what? - ANS-Arterial
vasoconstriction
The nurse is caring for an acutely ill patient who has central venous pressure monitoring
in place. What intervention should be included in the care plan of a patient with CVP in
place? - ANS-Change the site dressing whenever it becomes visibly soiled.
The physician is about to perform carotid sinus massage on a client with
supraventricular tachycardia. What equipment is most important for the nurse to have
ready? - ANS-Resuscitation cart
A client is recovering after a coronary catheterization. What assessment findings in the
first few hours after the procedure require immediate action by the nurse? (Select all
that apply.) - ANS-Serum potassium of 2.9 mEq/L
Expanding groin hematoma
, Rhythm changes on the cardiac monitor
The critical care nurse is caring for a patient with a central venous pressure (CVP)
monitoring system. The nurse notes that the patient's CVP is increasing. Of what may
this indicate? - ANS-Hypervolemia
The nurse is monitoring a client undergoing an exercise electrocardiography (stress
test). Which assessment finding necessitates that the test be stopped? - ANS-
Significant ST-segment depression
The nurse working on a cardiac care unit is caring for a patient whose stroke volume
has increased. The nurse is aware that afterload influences a patient's stroke volume.
The nurse recognizes that afterload is increased when there is what? - ANS-Arterial
vasoconstriction
The nurse is caring for a patient who has had a dysrhythmic event. The nurse is aware
of the need to assess for signs of diminished cardiac output (CO). What change in
status may signal to the nurse a decrease in cardiac output? - ANS-Changes in level of
consciousness
An adult patient with third-degree AV block is admitted to the cardiac care unit and
placed on continuous cardiac monitoring. What rhythm characteristic will the ECG most
likely show? - ANS-Fewer QRS complexes than P waves
The nurse is planning discharge teaching for a patient with a newly inserted permanent
pacemaker. What is the priority teaching point for this patient? - ANS-Avoid exposure to
high-voltage electrical generators.
A patient is scheduled for catheter ablation therapy. When describing this procedure to
the patient's family, the nurse should address what aspect of the treatment? - ANS-
Destruction of specific cardiac cells
A nurse is providing health education to a patient scheduled for cryoablation therapy.
The nurse should describe what aspect of this treatment? - ANS-Using a cooled probe
to eliminate the source of dysrhythmia
During a CPR class, a participant asks about the difference between cardioversion and
defibrillation. What would be the instructor's best response? - ANS-The difference is the
timing of the delivery of the electric current.
The nurse is caring for an adult patient who has gone into ventricular fibrillation. When
assisting with defibrillating the patient, what must the nurse do? - ANS-Maintain firm
contact between paddles and patient skin.
A patient who is a candidate for an implantable cardioverter defibrillator (ICD) asks the
nurse about the purpose of this device. What would be the nurse's best response? -
