Final Med surg 2 Exam 1 NSG223 Test
Questions 100% Well Answered 2025
Updated.
Cardiomyopathy -Assessment NSG223 03.02.03 - Answer -begins with a detailed history of the
presenting signs and symptoms
● nurse identifies possible cause factors (heavy alcohol intake, recent illness or pregnancy, or
history of the disease in immediate family members)
● If the patient reports chest pain, a thorough review of the pain, including its precipitating
factors, is
warranted
● review of systems includes the presence of orthopnea, PND, and syncope or dyspnea with
exertion
● number of pillows needed to sleep, usual weight, any weight change, and limitations on
activities of
daily living are assessed
● patient's usual diet is evaluated to determine the need to reduce sodium intake, optimize
nutrition, or
supplement with vitamin
Physical assessment focuses on signs and symptoms of heart failure - Answer baseline
assessment includes key components
■ Vital signs
■ Calculation of pulse pressure and identification of pulsus paradoxus
■ Current weight and any weight gain or loss
■ Detection by palpation of the point of maximal impulse, often shifted to the left
■ Cardiac auscultation for a systolic murmur and S3 and S4 heart sounds
■ Pulmonary auscultation for crackles
■ Measurement of jugular vein distention
■ Assessment of edema and its severity
Cardiomyopathy - Diagnostics NSG223 03.02.0 - Answer ● Diagnosis is usually made from
findings disclosed by the patient's history and by ruling out other
,● ECG demonstrates dysrhythmias (atrial fibrillation, ventricular dysrhythmias) and changes
consistent
with left ventricular hypertrophy (left axis deviation, wide QRS, ST changes, inverted T waves)
○ ARVC/D, there often is a small deflection, an epsilon wave, at the end of the QRS
● chest x-ray reveals heart enlargement and possibly pulmonary congestion
● Cardiac catheterization is sometimes used to rule out coronary artery disease as a causative
factor
● Endomyocardial biopsy may be performed to analyze myocardial cell
Cardiomyopathy - Pharmacological mgt NSG223 03.02.04 - Answer ● directed at controlling
symptoms
Mitral Valve Prolapse manifestations - Answer -Most never have symptoms
-fatigue
-may occur regardless of activity level and amount of rest or sleep
-shortness of breath
-not correlated with activity levels or pulmonary function
- lightheadedness
-dizziness
- syncope
-palpitations
-Atrial or ventricular dysrhythmias may produce the sensation of palpitations
-have been reported while the heart has been beating normally
-chest pain
- not correlated with activity and may last for days ○ anxiety
-may be a response to symptoms
-some report anxiety as the only symptoms
mitral regurgitation - Answer ○ Chronic is often asymptomatic
○ acute (resulting from a myocardial infarction) usually manifests as severe congestive heart
failure
■ Dyspnea
, ■ cough from pulmonary congesti
Mitral Stenosis - Answer ○ first symptom is often dyspnea on exertion (DOE) as a result of
pulmonary venous hypertension
○ Symptoms usually develop after the valve opening is reduced by one third to one half its usual
size
○ may experience progressive fatigue and decreased exercise tolerance as a result of low cardiac
output
○ enlarged left atrium may create pressure on the left bronchial tree, resulting in a dry cough or
wheezing
○ may expectorate blood (hemoptysis) or experience palpitations, orthopnea, paroxysmal
nocturnal dyspnea (PND), and repeated respiratory infections
■ result of increased blood volume and pressure, the atrium dilates, hypertrophies, and
becomes electrically unstable (patients experience atrial dysrhythmi
Aortic Regurgitation - Answer ○ develops without symptoms in most
○ Some patients are aware of a forceful heartbeat, especially in the head or neck
○ Marked arterial pulsations visible or palpable at carotid or temporal arteries may be present
due
to increased force and volume of blood ejected from a hypertrophied left ventricle
○ Exertional dyspnea and fatigue follow
○ Signs and symptoms of progressive left ventricular failure include breathing difficulties
(orthopnea and paroxysmal nocturnal dyspnea (PND
Aortic Stenosis - Answer ○ Many are asymptomatic
○ When symptoms develop, patients usually first have exertional dyspnea
■ caused by increased pulmonary venous pressure due to left ventricular failure
○ Orthopnea
○ paroxysmal nocturnal dyspnea (PND)
○ pulmonary edema
○ Reduced blood flow to the brain may cause dizziness and syncope
○ Angina pectoris is a frequent symptom
Questions 100% Well Answered 2025
Updated.
Cardiomyopathy -Assessment NSG223 03.02.03 - Answer -begins with a detailed history of the
presenting signs and symptoms
● nurse identifies possible cause factors (heavy alcohol intake, recent illness or pregnancy, or
history of the disease in immediate family members)
● If the patient reports chest pain, a thorough review of the pain, including its precipitating
factors, is
warranted
● review of systems includes the presence of orthopnea, PND, and syncope or dyspnea with
exertion
● number of pillows needed to sleep, usual weight, any weight change, and limitations on
activities of
daily living are assessed
● patient's usual diet is evaluated to determine the need to reduce sodium intake, optimize
nutrition, or
supplement with vitamin
Physical assessment focuses on signs and symptoms of heart failure - Answer baseline
assessment includes key components
■ Vital signs
■ Calculation of pulse pressure and identification of pulsus paradoxus
■ Current weight and any weight gain or loss
■ Detection by palpation of the point of maximal impulse, often shifted to the left
■ Cardiac auscultation for a systolic murmur and S3 and S4 heart sounds
■ Pulmonary auscultation for crackles
■ Measurement of jugular vein distention
■ Assessment of edema and its severity
Cardiomyopathy - Diagnostics NSG223 03.02.0 - Answer ● Diagnosis is usually made from
findings disclosed by the patient's history and by ruling out other
,● ECG demonstrates dysrhythmias (atrial fibrillation, ventricular dysrhythmias) and changes
consistent
with left ventricular hypertrophy (left axis deviation, wide QRS, ST changes, inverted T waves)
○ ARVC/D, there often is a small deflection, an epsilon wave, at the end of the QRS
● chest x-ray reveals heart enlargement and possibly pulmonary congestion
● Cardiac catheterization is sometimes used to rule out coronary artery disease as a causative
factor
● Endomyocardial biopsy may be performed to analyze myocardial cell
Cardiomyopathy - Pharmacological mgt NSG223 03.02.04 - Answer ● directed at controlling
symptoms
Mitral Valve Prolapse manifestations - Answer -Most never have symptoms
-fatigue
-may occur regardless of activity level and amount of rest or sleep
-shortness of breath
-not correlated with activity levels or pulmonary function
- lightheadedness
-dizziness
- syncope
-palpitations
-Atrial or ventricular dysrhythmias may produce the sensation of palpitations
-have been reported while the heart has been beating normally
-chest pain
- not correlated with activity and may last for days ○ anxiety
-may be a response to symptoms
-some report anxiety as the only symptoms
mitral regurgitation - Answer ○ Chronic is often asymptomatic
○ acute (resulting from a myocardial infarction) usually manifests as severe congestive heart
failure
■ Dyspnea
, ■ cough from pulmonary congesti
Mitral Stenosis - Answer ○ first symptom is often dyspnea on exertion (DOE) as a result of
pulmonary venous hypertension
○ Symptoms usually develop after the valve opening is reduced by one third to one half its usual
size
○ may experience progressive fatigue and decreased exercise tolerance as a result of low cardiac
output
○ enlarged left atrium may create pressure on the left bronchial tree, resulting in a dry cough or
wheezing
○ may expectorate blood (hemoptysis) or experience palpitations, orthopnea, paroxysmal
nocturnal dyspnea (PND), and repeated respiratory infections
■ result of increased blood volume and pressure, the atrium dilates, hypertrophies, and
becomes electrically unstable (patients experience atrial dysrhythmi
Aortic Regurgitation - Answer ○ develops without symptoms in most
○ Some patients are aware of a forceful heartbeat, especially in the head or neck
○ Marked arterial pulsations visible or palpable at carotid or temporal arteries may be present
due
to increased force and volume of blood ejected from a hypertrophied left ventricle
○ Exertional dyspnea and fatigue follow
○ Signs and symptoms of progressive left ventricular failure include breathing difficulties
(orthopnea and paroxysmal nocturnal dyspnea (PND
Aortic Stenosis - Answer ○ Many are asymptomatic
○ When symptoms develop, patients usually first have exertional dyspnea
■ caused by increased pulmonary venous pressure due to left ventricular failure
○ Orthopnea
○ paroxysmal nocturnal dyspnea (PND)
○ pulmonary edema
○ Reduced blood flow to the brain may cause dizziness and syncope
○ Angina pectoris is a frequent symptom
