ADVANCED MED SURG UPDATED EVALUATION EXAM
QUESTIONS AND SOLUTIONS GUARANTEE A+
✔✔The nurse administers IV nitroglycerin to a patient with an MI. In evaluating the
effect of this intervention, the nurse should monitor for
a. a decreased heart rate
b. relief of chest discomfort
c. an increase in BP
d. fewer cardiac dysrhythmias - ✔✔b. relief in chest discomfort
✔✔A patient has received instruction on the management of a new permanent
pacemaker before discharge from the hospital. The nurse recognizes that teaching has
been effective when the patient tells the nurse
a. I must avoid cooking with a microwave oven or being near a microwave in use
b. It will be 6 weeks before I can take a bath or return to my usual activities
c. I won't lift the arm on the pacemaker side up very high until I see the doctor
d. I will notify the airlines when I make a reservation that I have a pacemaker - ✔✔c. I
won't lift the arm on the pacemaker side up very high until I see the doctor
✔✔A client sustains an MI. Alteplase (tPA) is administered. The nurse is aware that
when a thrombolytic is administered, the thrombus should disintegrate within
a. 6 hours
b. 2 hours
c. 24 hours
d. 12 hours - ✔✔a. 6 hours
✔✔A patient with a dilated cardiomyopathy has an atrial fibrillation that has been
unresponsive to drug therapy for several days. THe nurse anticipates that further
treatment of the patient will require
a. insertion of an implantable cardioverter-defribillator (ICD)
b. electrical cardioversion
c, anticoagulant therapy with warfarin
d. IV adenosine (Adenocard) - ✔✔c. anticoagulant therapy with warfarin
✔✔During postoperative teaching with a patient who had a mitral valve replacement
with a mechanical valve, the nurse instructs the patient regarding
a. the need to avoid high voltage electrical fields
b. how to check the radial pulse
c. the need for valve replacement in 7 to 10 years
, d. how to monitor anticoagualtion therapy - ✔✔d. How to manage anticoagulation
therapy
✔✔A patient who is being admitted to the ED with sever chest pain gives the following
list of mediations taken at home to the nurse. Which of the medications has the most
immediare implications for the patient's care
a. sildenafil (Viagra)
b. diazepam (Valium)
c. furosemide ( Lasix)
d. captopril (Captoten) - ✔✔a. sildenafil (Viagra)
✔✔While caring for a patient with aortic stenosis, the nurse establishes a nursing
diagnosis of pain r/t decreased coronary blood flow. An appropriate intervention by the
nurse is to
a. promote rest to decrease myocardial oxygen demand
b. elevate the head of the bed 40 degrees to decrease venous return
c. educate the patient about the need for anticoagulant therapy
d. teach the patient to use sublingial nitroglycerin for chest pain - ✔✔a. promote rest to
decrease myocardial oxygen demand
✔✔A patient who has had recent cardiac surgery develops pericarditis and complains
od severe chest pain with deep breathing. Which of these ordered PRN medications
should the nurse administer
a. Fentanyl 2mg IV
b. PO acetaminophen 650 mg
c. PO ibuprofen 800 mg
d. IV morphine sulfate 6 mg - ✔✔d. IV morphine sulfate 6 mg
✔✔A patient with ST-segment elevation in several ECG leads is admitted to the ED and
diagnosed as having an AMI. WHich question should the nurse ask to determine
whether the patient is a candidate for fibrinolytic therapy
a. What time did your chest pain begin?
b. DO you take aspirin on a daily basis
c. Can you describe the quality of your chest pain
d. Is there any family history of heart disease - ✔✔a. WHat time did you chest pain
begin
✔✔Cardiac tamponade is suspected in a patient who has acute pericaditis. To assess
for the presence of pulsus paradouxus, the nurse should
a. Subtract the DBP from the SBP
QUESTIONS AND SOLUTIONS GUARANTEE A+
✔✔The nurse administers IV nitroglycerin to a patient with an MI. In evaluating the
effect of this intervention, the nurse should monitor for
a. a decreased heart rate
b. relief of chest discomfort
c. an increase in BP
d. fewer cardiac dysrhythmias - ✔✔b. relief in chest discomfort
✔✔A patient has received instruction on the management of a new permanent
pacemaker before discharge from the hospital. The nurse recognizes that teaching has
been effective when the patient tells the nurse
a. I must avoid cooking with a microwave oven or being near a microwave in use
b. It will be 6 weeks before I can take a bath or return to my usual activities
c. I won't lift the arm on the pacemaker side up very high until I see the doctor
d. I will notify the airlines when I make a reservation that I have a pacemaker - ✔✔c. I
won't lift the arm on the pacemaker side up very high until I see the doctor
✔✔A client sustains an MI. Alteplase (tPA) is administered. The nurse is aware that
when a thrombolytic is administered, the thrombus should disintegrate within
a. 6 hours
b. 2 hours
c. 24 hours
d. 12 hours - ✔✔a. 6 hours
✔✔A patient with a dilated cardiomyopathy has an atrial fibrillation that has been
unresponsive to drug therapy for several days. THe nurse anticipates that further
treatment of the patient will require
a. insertion of an implantable cardioverter-defribillator (ICD)
b. electrical cardioversion
c, anticoagulant therapy with warfarin
d. IV adenosine (Adenocard) - ✔✔c. anticoagulant therapy with warfarin
✔✔During postoperative teaching with a patient who had a mitral valve replacement
with a mechanical valve, the nurse instructs the patient regarding
a. the need to avoid high voltage electrical fields
b. how to check the radial pulse
c. the need for valve replacement in 7 to 10 years
, d. how to monitor anticoagualtion therapy - ✔✔d. How to manage anticoagulation
therapy
✔✔A patient who is being admitted to the ED with sever chest pain gives the following
list of mediations taken at home to the nurse. Which of the medications has the most
immediare implications for the patient's care
a. sildenafil (Viagra)
b. diazepam (Valium)
c. furosemide ( Lasix)
d. captopril (Captoten) - ✔✔a. sildenafil (Viagra)
✔✔While caring for a patient with aortic stenosis, the nurse establishes a nursing
diagnosis of pain r/t decreased coronary blood flow. An appropriate intervention by the
nurse is to
a. promote rest to decrease myocardial oxygen demand
b. elevate the head of the bed 40 degrees to decrease venous return
c. educate the patient about the need for anticoagulant therapy
d. teach the patient to use sublingial nitroglycerin for chest pain - ✔✔a. promote rest to
decrease myocardial oxygen demand
✔✔A patient who has had recent cardiac surgery develops pericarditis and complains
od severe chest pain with deep breathing. Which of these ordered PRN medications
should the nurse administer
a. Fentanyl 2mg IV
b. PO acetaminophen 650 mg
c. PO ibuprofen 800 mg
d. IV morphine sulfate 6 mg - ✔✔d. IV morphine sulfate 6 mg
✔✔A patient with ST-segment elevation in several ECG leads is admitted to the ED and
diagnosed as having an AMI. WHich question should the nurse ask to determine
whether the patient is a candidate for fibrinolytic therapy
a. What time did your chest pain begin?
b. DO you take aspirin on a daily basis
c. Can you describe the quality of your chest pain
d. Is there any family history of heart disease - ✔✔a. WHat time did you chest pain
begin
✔✔Cardiac tamponade is suspected in a patient who has acute pericaditis. To assess
for the presence of pulsus paradouxus, the nurse should
a. Subtract the DBP from the SBP
