NURSING 120 Advanced Med Surg Final Exam Test Bank | Questions and Answers 2023 | Score 100% | West Coast University

NURSING 120 Advanced Med Surg Final Exam Test Bank | Questions and Answers 2023 | Score 100% | West Coast University. A nurse in a cardiac care unit is caring for a client with acute heart failure. Which of the following findings should the nurse expect? a. Decreased brian natriuretic peptide (BNP) b. Elevated central venous pressure (CVP) c. Decreased pulmonary pressure d. Increases urinary output 10. A client comes into the ED reporting nausea and vomiting that worsens when lying down and without relief from antacids. The provider suspects’ acute pancreatitis. Which of the following lab test results should the nurse expect to see if the client has acute pancreatitis? a. Decreased WBC b. Increased serum amylase c. Decreased serum lipase d. Increased serum calcium 11. A nurse in the ICU is caring for a client who has acute respiratory distress syndrome (ARDS) and is receiving mechanical via an endotracheal tube. The provider plans to exubate her within the next 24 hour. Which of the following is an important criterion for exubating the client? a. Ability to cough effectively b. Adequate tidal volume without manually assisted breaths c. No indication of infection d. No need for supplemental oxygen 12. A nurse is caring for a client following a CT scan with dye who suffered from an anaphylactic reaction. Which of the following conditions requires a priority nursing response? a. urticaria b. stridor c. tachypnea d. angioedema 13. A nurse is caring for a female client who came in to the ED reporting SOB and pain in the lung area. Her heart rate is 110/min, resp. rate 40/min, and blood pressure 140/80 mmHg. Her arterial blood gases are: pH 7.5, PaCO2 29 mmHg, PaO2 60 mm Hg, HCO3 20 mEq/L, and SaO2 86%. Which of the following is the priority intervention? a. Prepare for mechanical ventilation b. Administer oxygen via facemask c. Prepare to administer a sedative d. Monitor for pulmonary embolism 14. A nurse is monitoring a client who has just had a thoracentesis to remove pleural fluid. Which of the following clinical manifestations indicate a complication that requires notifying the immediately? a. Serosanguineous drainage from the puncture site b. Discomfort at the puncture site c. Increased heart rate d. Decreased temperature 15. A group of college students was attending a weekend football rally when one of the students stumbled and fell into the bonfire. Although several friends quickly intervened, the client sustained partial-thickness burns to lower legs, chest, and both forearms. Which of the following is priority nursing action when the client is brought to the ED? a. cover the burned area with sterile gauze b. inspect mouth for signs of inhalation c. administer intravenous pain medication d. draw blood for a CBC 16. A triage nurse in an emergency dept is caring for a client who has gunshot wound to the right side of chest. The nurse notices thick dressing on the chest and sucking noise coming from the wound. The client has a pressure of 100/60 mm Hg, a weak pulse rate of 118/min, and a respiratory rate of 40/min. Which of the following actions should the nurse take initially? a. Raise the foot of the bed to a 90 degree angle b. Remove the dressing to inspect the wound c. Prepare to insert a central line d. Administer oxygen via nasal cannula 17. A nurse is suctioning the endotracheal tube of a client who is on a ventilator. The client’s heart rate increases from 86/min to 110/min and becomes irregular. The nurse should know that the requires which of the following? a. A cardiology consult b. Less frequent suctioning c. An antidysrhythmic medication d. Pre-oxygenation prior to suctioning 18. The nurse is caring for a client who is receiving a blood transfusion. The transfusion started minutes ago at a rate of 100 mL/hr. The client begins to complain of low back pain and headache increasingly restless. What is the first nursing action? a. Stop the transfusion, disconnect the blood tubing, and begin a primary infusion of normal saline solution b. Slow the infusion and evaluate the vital signs and the client’s history of transfusion reactions c. Slow the infusion of blood and begin infusion of normal saline solution from the Y connector. d. Recheck the unit of blood for correct identification numbers and crossmatch information 19. A client with a diagnosis of disseminated intravascular coagulation (DIC) has the assessment findings: blood pressure of 76/56, temperature 102.6 degrees, resp. 24 breath/min., with complaints of severe neck and back pain. Which nursing action should the nurse implement first? a. Administer acetaminophen (Tylenol) PO. b. Administer ibuprofen (Motrin) PO. c. Draw coagulation study blood work in the AM d. Give morphine sulfate IV 20. The nurse administering albuterol (Proventil) via a metered-dose inhaler (MDI) to a client who has a history of coronary artery disease is now in congestive heart failure. What side effects will be particularly important to observe for when the client takes the medication? a. Tremors and central nervous system stimulation b. Tachycardia and chest discomfort c. Development of oral candidiasis d. An increase in blood pressure 21. The nurse is assessing a client who is on a ventilator and has an endotracheal tube in place. What data confirms that the tube has migrated too far into the trachea? a. Decreased breath sounds are heard over the left side of the chest b. Increased rhonchi are present at the lung bases bilaterally c. Ventilator pressure alarm continues to sound d. Client is able to speak and coughs excessively 22. What is the desired action of dopamine (Intropin) when administered in the treatment of shock? a. It increases myocardial contractility b. It is associated with fewer severe allergic reactions c. It causes rapid vasodilation of the vascular bed d. It supports renal perfusion by dilation of the renal arteries 23. The nurse is monitoring an IV infusion of sodium nitroprusside (Nirpride). Fifteen minutes after the infusion is started, the client’s BP goes from 190/120 mm Hg to 120/90 mm Hg. What is the priority nursing action? a. Recheck the BP and call the doctor b. Decrease the infusion rate and recheck the blood pressure in 5 minutes c. Stop the medication and keep the IV open with D5W. d. Assess the client’s tolerance of the current level of BP 24. Norepinephrine (Levophed) has been ordered for a client in hypovolemic shock. Before administering the drug, the nurse should make sure that the client has: a. A heart rate of less than 120 beats/min b. Urine output of at least 30 mL/hr. c. Received adequate anticoagulation d. Been receiving adequate IV fluid replacement 25. The client returns to his room after a thoracotomy. What will the nursing assessment reveal if hypovolemia from excessive blood loss is present? a. CVP of 3 cm H20 and urine output of 20 mL/hr b. Jugular vein distention with the head elevated 45 degrees c. Chest tube drainage of 50 mL/hr in the first 2 hours d. Persistent increased BP and increased pulse pressure 26. The nurse is performing an assessment and finds the client has cold, clammy skin, pulse of 130 beats/min and weak, blood pressure of 84/56 mm Hg, and urinary of 20 mL for the past hour. The nurse would interpret these findings as suggestive of which pathophysiology? a. Reduction of circulation to the coronary arteries, this increasing the preload b. Decreased glomeruli filtration rate, resulting in volume overload c. Stimulation of the sympathetic nervous system, causing severe vasoconstriction d. Decrease in the cardiac output and inadequate tissue perfusion 27. The nurse applies a Nitro-Dur patch on a client who has undergone cardiac surgery. What nursing observation indicates that a Nitro-Dur patch is achieving the desired effect? a. Chest pain is completely relieved b. Client performs activities of daily living without chest pain c. Pain is controlled with frequent changes of patch d. Client tolerates increased activity without pain 28) The V/S of a client with Cardiac disease are as follows: BP 102/76 mm/hg, Pulse 52, RR 16. Atropine is administered IV push. What nursing assessment indicates a therapeutic response to the medication? a. Pulse rate has increased to 70 beats/min b. systolic BP has increased by 20 c. pupils are dilated d. oral secretions have decreased 29) An older adult client comes into ER stating that he has no appetite, is nauseated, his heart feels funny and has noticed haziness in his vision. The client states that he has been taking an antihypertensive drug and digitalis for more than a year. Based on the presenting symptoms, what would be the priority nursing action? A. Obtain an order for an EKG and serum potassium and digitalis levels B. Perform a neurological assessment to determine whether he has one side weakness. C. Assess lungs for decreased breath sounds and/or adventitious breath sounds. d. Obtain an order for an EKG 30) The nurse is administering alteplase to a client who has been diagnosed with acute coronary syndrome. What are important nursing implications for this medication? A. Monitor the ECG for dysrthymias B. Place the client on bleeding precautions C. Monitor urine output hourly D. Monitor for activity tolerance 31) The nurse is caring for a client who underwent cardiac catheterization 1 hour ago. What is an important nursing measure at this time? A. Measure urinary output hourly and maintain continuous cardiac monitoring B. Encourage client to perform slow pressure exercise of the affected side to promote circulation. C. Maintain pressure over catheter insertion site and determine distal circulation status. D. Evaluate apical pulse and determine presence of pulse deficit. 32. The nurse in a cardiac stepdown unit has received a hand-off shift report for these clients. Which client should be assessing first? A. a client who has just returned from a coronary arteriogram with placement of an intracoronary stent. B. A client who is in heart failure an has gained 2 pnds in the last 24 hours. C. a client with endocarditis who has temperature elevation of 100F and P 100 beats/min D. A client who was cardioverted from atrial fib 24 hours ago and has had 3 atrial premature 33) What ECG changes would reflect myocardial ischemia in a client who has been admitted for observation after experiencing an episode of chest pain? A. Prolonged PR interval B. Wide QRS complex C. ST- Segment elevation or depression D. Tall, peak T-waves 34) A new employee at a facility needs a hepatitis vaccine. Which statement reflects accurate understanding of the immunization? A. I need to get 6 shots of hep C B. Once I receive the Hep vaccine I will always been immune C. I will receive 3 injections over a period of months, which should protect me from hep B D. Hep vaccine is an oral vaccine with live attenuated Virus 35) While talking with a client with a diagnosis of end stage liver disease. The nurse notices the client is unable to stay awake and seems to fall asleep in the middle of a sentence. The nurse recognizes these symptoms to be indicative of what condition? A. Hyperglycemia B. Increased Bile production C. Increased blood ammonia levels