Medsurg Exam 2 33, 34, 35, 36, 37 + ATI
Questions 2025 with Correct Answers
A nurse assesses a client who had a myocardial infarction and is hypotensive.
Which additional assessment finding should the nurse expect?
a.Heart rate of 120 beats/min
b.Cool, clammy skin
c.Oxygen saturation of 90%
d. Respiratory rate of 8 breaths/min - ....ANSWER ...-ANS: A
When a client experiences hypotension, baroreceptors in the aortic arch sense a
pressure decrease in the vessels. The parasympathetic system responds by lessening
the inhibitory effect on the sinoatrial node. This results in an increase in heart rate
and respiratory rate. This tachycardia is an early response and is seen even when
blood pressure is not critically low. An increased heart rate and respiratory rate will
compensate for the low blood pressure and maintain oxygen saturations and
perfusion. The client may not be able to compensate for long, and decreased
oxygenation and cool, clammy skin will occur later.
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 1
,A nurse assesses a client after administering a prescribed beta blocker. Which
assessment should the nurse expect to find?
a.Blood pressure increased from 98/42 mm Hg to 132/60 mm Hg
b.Respiratory rate decreased from 25 breaths/min to 14 breaths/min
c.Oxygen saturation increased from 88% to 96%
d.Pulse decreased from 100 beats/min to 80 beats/min - ....ANSWER ...-
ANS: D
Beta blockers block the stimulation of beta1-adrenergic receptors. They block the
sympathetic (fight-or-flight) response and decrease the heart rate (HR). The beta
blocker will decrease HR and blood pressure, increasing ventricular filling time. It
usually does not have effects on beta2-adrenergic receptor sites. Cardiac output
will drop because of decreased HR.
A nurse assesses clients on a medical-surgical unit. Which client should the nurse
identify as having the greatest risk for cardiovascular disease?
a.An 86-year-old man with a history of asthma
b.A 32-year-old Asian-American man with colorectal cancer
c.A 45-year-old American Indian woman with diabetes mellitus
d.A 53-year-old postmenopausal woman who is on hormone therapy -
....ANSWER ...-ANS: C
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 2
,The incidence of coronary artery disease and hypertension is higher in American
Indians than in whites or Asian Americans. Diabetes mellitus increases the risk for
hypertension and coronary artery disease in people of any race or ethnicity.
Asthma, colorectal cancer, and hormone therapy do not increase risk for
cardiovascular disease.
A nurse assesses an older adult client who has multiple chronic diseases. The
client's heart rate is 48 beats/min. Which action should the nurse take first?
a.Document the finding in the chart.
b.Initiate external pacing.
c.Assess the client's medications.
d.Administer 1 mg of atropine. - ....ANSWER ...-ANS: C
Pacemaker cells in the conduction system decrease in number as a person ages,
resulting in bradycardia. The nurse should check the medication reconciliation for
medications that might cause such a drop in heart rate, then should inform the
health care provider. Documentation is important, but it is not the priority action.
The heart rate is not low enough for atropine or an external pacemaker to be
needed.
An emergency room nurse obtains the health history of a client. Which statement
by the client should alert the nurse to the occurrence of heart failure?
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 3
, a." I get short of breath when I climb stairs."
b." I see halos floating around my head."
c." I have trouble remembering things."
d." I have lost weight over the past month." - ....ANSWER ...-ANS: A
Dyspnea on exertion is an early manifestation of heart failure and is associated with
an activity such as stair climbing. The other findings are not specific to early
occurrence of heart failure.
A nurse obtains the health history of a client who is newly admitted to the medical
unit. Which statement by the client should alert the nurse to the presence of
edema?
a." I wake up to go to the bathroom at night."
b." My shoes fit tighter by the end of the day."
c." I seem to be feeling more anxious lately."
d." I drink at least eight glasses of water a day." - ....ANSWER ...-ANS: B
Weight gain can result from fluid accumulation in the interstitial spaces. This is
known as edema. The nurse should note whether the client feels that his or her
shoes or rings are tight, and should observe, when present, an indentation around
the leg where the socks end. The other answers do not describe edema.
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 4
Questions 2025 with Correct Answers
A nurse assesses a client who had a myocardial infarction and is hypotensive.
Which additional assessment finding should the nurse expect?
a.Heart rate of 120 beats/min
b.Cool, clammy skin
c.Oxygen saturation of 90%
d. Respiratory rate of 8 breaths/min - ....ANSWER ...-ANS: A
When a client experiences hypotension, baroreceptors in the aortic arch sense a
pressure decrease in the vessels. The parasympathetic system responds by lessening
the inhibitory effect on the sinoatrial node. This results in an increase in heart rate
and respiratory rate. This tachycardia is an early response and is seen even when
blood pressure is not critically low. An increased heart rate and respiratory rate will
compensate for the low blood pressure and maintain oxygen saturations and
perfusion. The client may not be able to compensate for long, and decreased
oxygenation and cool, clammy skin will occur later.
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 1
,A nurse assesses a client after administering a prescribed beta blocker. Which
assessment should the nurse expect to find?
a.Blood pressure increased from 98/42 mm Hg to 132/60 mm Hg
b.Respiratory rate decreased from 25 breaths/min to 14 breaths/min
c.Oxygen saturation increased from 88% to 96%
d.Pulse decreased from 100 beats/min to 80 beats/min - ....ANSWER ...-
ANS: D
Beta blockers block the stimulation of beta1-adrenergic receptors. They block the
sympathetic (fight-or-flight) response and decrease the heart rate (HR). The beta
blocker will decrease HR and blood pressure, increasing ventricular filling time. It
usually does not have effects on beta2-adrenergic receptor sites. Cardiac output
will drop because of decreased HR.
A nurse assesses clients on a medical-surgical unit. Which client should the nurse
identify as having the greatest risk for cardiovascular disease?
a.An 86-year-old man with a history of asthma
b.A 32-year-old Asian-American man with colorectal cancer
c.A 45-year-old American Indian woman with diabetes mellitus
d.A 53-year-old postmenopausal woman who is on hormone therapy -
....ANSWER ...-ANS: C
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 2
,The incidence of coronary artery disease and hypertension is higher in American
Indians than in whites or Asian Americans. Diabetes mellitus increases the risk for
hypertension and coronary artery disease in people of any race or ethnicity.
Asthma, colorectal cancer, and hormone therapy do not increase risk for
cardiovascular disease.
A nurse assesses an older adult client who has multiple chronic diseases. The
client's heart rate is 48 beats/min. Which action should the nurse take first?
a.Document the finding in the chart.
b.Initiate external pacing.
c.Assess the client's medications.
d.Administer 1 mg of atropine. - ....ANSWER ...-ANS: C
Pacemaker cells in the conduction system decrease in number as a person ages,
resulting in bradycardia. The nurse should check the medication reconciliation for
medications that might cause such a drop in heart rate, then should inform the
health care provider. Documentation is important, but it is not the priority action.
The heart rate is not low enough for atropine or an external pacemaker to be
needed.
An emergency room nurse obtains the health history of a client. Which statement
by the client should alert the nurse to the occurrence of heart failure?
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 3
, a." I get short of breath when I climb stairs."
b." I see halos floating around my head."
c." I have trouble remembering things."
d." I have lost weight over the past month." - ....ANSWER ...-ANS: A
Dyspnea on exertion is an early manifestation of heart failure and is associated with
an activity such as stair climbing. The other findings are not specific to early
occurrence of heart failure.
A nurse obtains the health history of a client who is newly admitted to the medical
unit. Which statement by the client should alert the nurse to the presence of
edema?
a." I wake up to go to the bathroom at night."
b." My shoes fit tighter by the end of the day."
c." I seem to be feeling more anxious lately."
d." I drink at least eight glasses of water a day." - ....ANSWER ...-ANS: B
Weight gain can result from fluid accumulation in the interstitial spaces. This is
known as edema. The nurse should note whether the client feels that his or her
shoes or rings are tight, and should observe, when present, an indentation around
the leg where the socks end. The other answers do not describe edema.
....COPYRIGHT ©️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 4
