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Med surg 2 all exam questions latest 2025
Exam 1, 2 & 3
1. A client is sent home with a holter monitor. The most important information the client should
receive from the nurse
A. Keep a record of daily activities
2. A client is scheduled for a cardiac catheterization using a radiopaque dye. Which of the following
assessments is most critical before the procedure?
A. Allergy to iodine or shellfish.
3. In developing a standard teaching plan for the outpatient unit where stress testing is performed,
the nurse should include information that:
A. The test may cause the client to experience chest pain
4. the diagnostic study that should provide the nurse with the most relevant information related to
cardiac perfusion is
A. Thallium 201 scintigoraphy
5. In advising a client with higher levels of hdl in proportion to ldl, an appropriate outcome is that
this client:
A. Is less likely to develop cad
6. Nursing care of a client immediately after a ptca should include:
A. Encouraging oral fluids for the client
7. A nurse is caring for a client who has had angiography with the entrance site in the left femoral
artery. 2 hours after the procedure, the nurse is unable to palpate the left pedal pulse. The priority
action at this time would be to:
A. Attempt to locate pulse using a doppler
8. the client participates in a thallium imaging during exercise. The nuclear camera results obtained
10 minutes later show diffuse uptake of the thallium in all areas of the heart. What does this mean
for the nurse?
A. The test shows no myocardial scarring or impairment of myocardial perfusion
9. The ck-mb level is markedly elevated in a client with chest pain 12 hours after admission. The
nurse interprets this finding as evidence of:
A. Cellular tissue necrosis
10. Ck-mb and troponin levels are ordered for a client. The client asks the nurse for the test. The
nurse bases the response on the knowledge that:
A. The presence of myocardial damage occurring several days earlier can be validated best by the
troponin level. (p.743 text: often as long as 3 weeks, and it therefore can be used to detect recent
myocardial damage)
11. The nurse is about to perform a physical assessment of the distal extremities for a client with
Buerger’s disease. What clinical manifestations should the nurse expect to see in this client?
A. Extremities are reddened and distal pulses are diminished
12. a nurse caring for a client who is overweight, htn, and smokes is newly diagnosed with
thromboangitis obliterans (buerger’s disease). The priority for teaching should focus on: a.
Smoking cessation
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13. After walking one block the client complains of muscular, cramp-like pain to his lower extremities
that is relieved by rest. Based on the clinical findings, the nurse should further assess the patient
for possible:
a. Peripheral arterial disease
14. a client comes to the health care provider with complaints of pain after walking five blocks is
experiencing intermittent claudication, the nurse should ask:
a. Does pain always occur when you walk that distance?
15. A female client with falling asleep due to pain in her legs. The severe
arterial disease has
difficulty first action by the nurse would be to:
a. Assist the client to dangle her legs
16. A nurse is educating a client who has raynaud’s disease. Which intervention is aimed at
preventing complications?
a. Wear warm clothing when exposed to cool temperature
17. A client who has returned to the unit after arterial revascularization states, “the pain is similar to
the pain felt before the procedure.” What would be the nurse’s priority action?
a. Assess peripheral pulses of the extremities
18. a client recovering from aortofemoral bypass surgery has developed swelling, pain, and complains
of tightness of the operative limb. What complication of the procedure is most likely the cause of
the client’s symptoms?
a. Compartment syndrome
19. A nurse is assessing the neurovascular status of a client who returned to the surgical nursing unit
4 hours ago after undergoing aortoiliac bypass
graft. The affected leg is warm, and the nurse
notes
Redness and edema. The nurse interprets that the neurovascular status is:
a. normal because of increased blood flow through the leg
20. A nurse is caring for a client who has early peripheral vascular disease. While inspecting the lower
extremities the nurse should expect to find:
a. Decreased peripheral pulse
21. A nurse is caring for a young client who is brought to the ed after experiencing a rapid heart rate
and chest discomfort. The client reports using cocaine adding that “everybody always tells me
coke is bad for your heart. What does cocaine do?” The nurse should respond:
a. “a fight or flight reaction occurs when cocaine is used, stressing the heart, often beyond its
capacity.
22. A nurse is caring for a client who has an mi. The client reports chest pain and ekg shows
Intermittent premature ventricular contractions. The nurse’s first priority for this client would
be to:
a. relief of pain and pain management
23. A client is admitted to the tele unit with a diagnosis of mi within the last 24 hours. The immediate
care plan for this client should include which of the following measure:
a. Use a bedpan commode for bowel movement
24. The client is undergoing progressive ambulation on the third day after an mi. Which clinical
manifestation should indicate to the nurse that the client should not be advanced yet to the next level?
A. Onset of chest pain
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25. the nurse is caring for a client who had ptca 1 hour ago. Which of the following is a priority
assessment at this time?
A.(p. 751, Bleeding complication after the procedure may include abrupt closure of the coronary artery.
And variety of vascular complication such as bleeding at the insertion site, retroperitoneal bleeding,
hematoma, and arterial occlusion).
26. a nurse has just received a client from the cardiac cath lab. Nursing care of a client immediately after
a ptca should include:
A. Encouraging oral fluids for the client
27. A nurse is monitoring a client with chf. Which of the following would require further evaluation
by the nurse?
A. Weight gain of 1.5 pounds in 24 hours
28. a nurse in a cardiac step down unit is preparing discharge instruction, which includes dietary
information. Which breakfast food recommendations should be most appropriate for a client
with coronary heart disease?
A. Skim milk, whole wheat toast, decaf coffee
29. While caring for a client with angina, the nurse plans interventions that decrease myocardial
oxygen demand and promote coronary blood flow. Appropriate interventions are those that
primarily prevent:
A. An increase in heart rate 30.
A client who has experienced a myocardial infarction develops left ventricular heart Which
sign failure. For of
poor organ
perfusion should the nurse monitor this client?
a. Urine output of <30ml/hr
31. A nurse is assessing a client who has a diagnosis of left ventricular heart failure. Which of the
following statements if made by the client would be of concern to the nurse?
a. I cannot climb the stair in my house without becoming short of breath.
32. A nurse should determine that teaching regarding a 2 gram na diet for a client who has a history
of cardiac disease, is effective if the client states: “i can eat most foods as long as i do not add salt
when cooking or at the table.”
33. when the client with left sided heart failure develops bilateral 2+ pitting edema of the ankles, the
nurse should assess that this could be early manifestation of:
a. Right sided failure
A client with chf has tachypnea, severe dyspnea, and a sao2 of 84%. The nurse identifies a nursing
diagnosis of impaired gas exchange r/t increased preload & mechanical failure. An appropriate nursing
intervention for this diagnosis is to:
Place the client in a high-fowlers position with the feet
dangling.
the nurse has written an outcome goal “demonstrates tolerance for increased activity” for a client
diagnosed with chf. Which intervention should the nurse implement to assist the client to achieve this
outcome?
Plan for frequent rest
periods
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34. A nurse is developing a teaching plan for a client with congestive heart failure, which of the
following outcomes indicates to the nurse that the treatment is effective? All that apply
a. Clients weight today is 79.5 kg and yesterday’s weight was 80.2 kg
b. Urinary output of 480cc over the previous 24 hours
c. Auscultated clear lung sounds bilaterally
d. Able to walk to the bathroom without dyspnea
35. the nurse assesses 2+ pitting edema on the left lower extremities and 3+ pitting edema on the right
lower extremity of a client admitted 2 days ago with acute mi. Following this assessment, which is
the nurse’s best next action?
a. Review the daily weight since admission
36. During the initial home visit, the nurse is teaching a client with heart failure how to prevent
complications and future hospitalizations. Which of the following statements if made by the client
indicates the client’s understanding? I will call my health care provider if:
a. I become increasingly sob at rest
b. I gain 2 pounds in one day
c. I have to sleep sitting up in a reclining chair
37. Which of the following statements is an indication that the client needs more teaching regarding a
treatment regimen for heart failure?
a. I should only weigh myself once a month and watch for fluid retention
38. A client diagnosed with essential htn asks the nurse to explain how this type of htn develops.
What is the nurse’s best response?
a. There is no known cause for this type of htn
39. A nurse is performing a physical assessment on a client who has htn. Which of the following
assessment should the nurse plan to include in the assessment?
a. fundoscopic examination for changes in retinal vessels (the retinas are examined and laboratory
studies are performed to assess possible target organ damage).
40. For a client complaining of leg pain at rest after transluminal angioplasty, the nurse initially
should:
a. Assess the limb for temperature and perfusion
41. a nurse is providing care to a client who is being treated for htn crisis. A priority for the nurse
would be to monitor the bp carefully during the first 2 hours to prevent:
a. Renal ischemia (p.864)
42. A client in htn crisis has a sustained bp of 180/120 and is being treated with htn protocol. The
nurse recognizes that the optimum pressure target for the client in the first 2 hours of reduction
therapy is:
a. 150/95
43. An otherwise healthy 28 yo woman has just been diagnosed with stage i htn. She says she has a
Glass of wine once or twice a week and eats “fast food” frequently because of her busy schedule.
Which topic should the nurse plans on including in the client-teaching plan?
a. Low-sodium food choices when eating out
44. Which of the following bp findings for an adult client with no other medical problems should be
evaluated further for htn? All that apply
a. 138-78
b. 140/96
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Med surg 2 all exam questions latest 2025
Exam 1, 2 & 3
1. A client is sent home with a holter monitor. The most important information the client should
receive from the nurse
A. Keep a record of daily activities
2. A client is scheduled for a cardiac catheterization using a radiopaque dye. Which of the following
assessments is most critical before the procedure?
A. Allergy to iodine or shellfish.
3. In developing a standard teaching plan for the outpatient unit where stress testing is performed,
the nurse should include information that:
A. The test may cause the client to experience chest pain
4. the diagnostic study that should provide the nurse with the most relevant information related to
cardiac perfusion is
A. Thallium 201 scintigoraphy
5. In advising a client with higher levels of hdl in proportion to ldl, an appropriate outcome is that
this client:
A. Is less likely to develop cad
6. Nursing care of a client immediately after a ptca should include:
A. Encouraging oral fluids for the client
7. A nurse is caring for a client who has had angiography with the entrance site in the left femoral
artery. 2 hours after the procedure, the nurse is unable to palpate the left pedal pulse. The priority
action at this time would be to:
A. Attempt to locate pulse using a doppler
8. the client participates in a thallium imaging during exercise. The nuclear camera results obtained
10 minutes later show diffuse uptake of the thallium in all areas of the heart. What does this mean
for the nurse?
A. The test shows no myocardial scarring or impairment of myocardial perfusion
9. The ck-mb level is markedly elevated in a client with chest pain 12 hours after admission. The
nurse interprets this finding as evidence of:
A. Cellular tissue necrosis
10. Ck-mb and troponin levels are ordered for a client. The client asks the nurse for the test. The
nurse bases the response on the knowledge that:
A. The presence of myocardial damage occurring several days earlier can be validated best by the
troponin level. (p.743 text: often as long as 3 weeks, and it therefore can be used to detect recent
myocardial damage)
11. The nurse is about to perform a physical assessment of the distal extremities for a client with
Buerger’s disease. What clinical manifestations should the nurse expect to see in this client?
A. Extremities are reddened and distal pulses are diminished
12. a nurse caring for a client who is overweight, htn, and smokes is newly diagnosed with
thromboangitis obliterans (buerger’s disease). The priority for teaching should focus on: a.
Smoking cessation
Downloaded by NELSON KIIRU ()
, lOMoARcPSD|26582732
13. After walking one block the client complains of muscular, cramp-like pain to his lower extremities
that is relieved by rest. Based on the clinical findings, the nurse should further assess the patient
for possible:
a. Peripheral arterial disease
14. a client comes to the health care provider with complaints of pain after walking five blocks is
experiencing intermittent claudication, the nurse should ask:
a. Does pain always occur when you walk that distance?
15. A female client with falling asleep due to pain in her legs. The severe
arterial disease has
difficulty first action by the nurse would be to:
a. Assist the client to dangle her legs
16. A nurse is educating a client who has raynaud’s disease. Which intervention is aimed at
preventing complications?
a. Wear warm clothing when exposed to cool temperature
17. A client who has returned to the unit after arterial revascularization states, “the pain is similar to
the pain felt before the procedure.” What would be the nurse’s priority action?
a. Assess peripheral pulses of the extremities
18. a client recovering from aortofemoral bypass surgery has developed swelling, pain, and complains
of tightness of the operative limb. What complication of the procedure is most likely the cause of
the client’s symptoms?
a. Compartment syndrome
19. A nurse is assessing the neurovascular status of a client who returned to the surgical nursing unit
4 hours ago after undergoing aortoiliac bypass
graft. The affected leg is warm, and the nurse
notes
Redness and edema. The nurse interprets that the neurovascular status is:
a. normal because of increased blood flow through the leg
20. A nurse is caring for a client who has early peripheral vascular disease. While inspecting the lower
extremities the nurse should expect to find:
a. Decreased peripheral pulse
21. A nurse is caring for a young client who is brought to the ed after experiencing a rapid heart rate
and chest discomfort. The client reports using cocaine adding that “everybody always tells me
coke is bad for your heart. What does cocaine do?” The nurse should respond:
a. “a fight or flight reaction occurs when cocaine is used, stressing the heart, often beyond its
capacity.
22. A nurse is caring for a client who has an mi. The client reports chest pain and ekg shows
Intermittent premature ventricular contractions. The nurse’s first priority for this client would
be to:
a. relief of pain and pain management
23. A client is admitted to the tele unit with a diagnosis of mi within the last 24 hours. The immediate
care plan for this client should include which of the following measure:
a. Use a bedpan commode for bowel movement
24. The client is undergoing progressive ambulation on the third day after an mi. Which clinical
manifestation should indicate to the nurse that the client should not be advanced yet to the next level?
A. Onset of chest pain
Downloaded by NELSON KIIRU ()
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25. the nurse is caring for a client who had ptca 1 hour ago. Which of the following is a priority
assessment at this time?
A.(p. 751, Bleeding complication after the procedure may include abrupt closure of the coronary artery.
And variety of vascular complication such as bleeding at the insertion site, retroperitoneal bleeding,
hematoma, and arterial occlusion).
26. a nurse has just received a client from the cardiac cath lab. Nursing care of a client immediately after
a ptca should include:
A. Encouraging oral fluids for the client
27. A nurse is monitoring a client with chf. Which of the following would require further evaluation
by the nurse?
A. Weight gain of 1.5 pounds in 24 hours
28. a nurse in a cardiac step down unit is preparing discharge instruction, which includes dietary
information. Which breakfast food recommendations should be most appropriate for a client
with coronary heart disease?
A. Skim milk, whole wheat toast, decaf coffee
29. While caring for a client with angina, the nurse plans interventions that decrease myocardial
oxygen demand and promote coronary blood flow. Appropriate interventions are those that
primarily prevent:
A. An increase in heart rate 30.
A client who has experienced a myocardial infarction develops left ventricular heart Which
sign failure. For of
poor organ
perfusion should the nurse monitor this client?
a. Urine output of <30ml/hr
31. A nurse is assessing a client who has a diagnosis of left ventricular heart failure. Which of the
following statements if made by the client would be of concern to the nurse?
a. I cannot climb the stair in my house without becoming short of breath.
32. A nurse should determine that teaching regarding a 2 gram na diet for a client who has a history
of cardiac disease, is effective if the client states: “i can eat most foods as long as i do not add salt
when cooking or at the table.”
33. when the client with left sided heart failure develops bilateral 2+ pitting edema of the ankles, the
nurse should assess that this could be early manifestation of:
a. Right sided failure
A client with chf has tachypnea, severe dyspnea, and a sao2 of 84%. The nurse identifies a nursing
diagnosis of impaired gas exchange r/t increased preload & mechanical failure. An appropriate nursing
intervention for this diagnosis is to:
Place the client in a high-fowlers position with the feet
dangling.
the nurse has written an outcome goal “demonstrates tolerance for increased activity” for a client
diagnosed with chf. Which intervention should the nurse implement to assist the client to achieve this
outcome?
Plan for frequent rest
periods
Downloaded by NELSON KIIRU ()
, lOMoARcPSD|26582732
34. A nurse is developing a teaching plan for a client with congestive heart failure, which of the
following outcomes indicates to the nurse that the treatment is effective? All that apply
a. Clients weight today is 79.5 kg and yesterday’s weight was 80.2 kg
b. Urinary output of 480cc over the previous 24 hours
c. Auscultated clear lung sounds bilaterally
d. Able to walk to the bathroom without dyspnea
35. the nurse assesses 2+ pitting edema on the left lower extremities and 3+ pitting edema on the right
lower extremity of a client admitted 2 days ago with acute mi. Following this assessment, which is
the nurse’s best next action?
a. Review the daily weight since admission
36. During the initial home visit, the nurse is teaching a client with heart failure how to prevent
complications and future hospitalizations. Which of the following statements if made by the client
indicates the client’s understanding? I will call my health care provider if:
a. I become increasingly sob at rest
b. I gain 2 pounds in one day
c. I have to sleep sitting up in a reclining chair
37. Which of the following statements is an indication that the client needs more teaching regarding a
treatment regimen for heart failure?
a. I should only weigh myself once a month and watch for fluid retention
38. A client diagnosed with essential htn asks the nurse to explain how this type of htn develops.
What is the nurse’s best response?
a. There is no known cause for this type of htn
39. A nurse is performing a physical assessment on a client who has htn. Which of the following
assessment should the nurse plan to include in the assessment?
a. fundoscopic examination for changes in retinal vessels (the retinas are examined and laboratory
studies are performed to assess possible target organ damage).
40. For a client complaining of leg pain at rest after transluminal angioplasty, the nurse initially
should:
a. Assess the limb for temperature and perfusion
41. a nurse is providing care to a client who is being treated for htn crisis. A priority for the nurse
would be to monitor the bp carefully during the first 2 hours to prevent:
a. Renal ischemia (p.864)
42. A client in htn crisis has a sustained bp of 180/120 and is being treated with htn protocol. The
nurse recognizes that the optimum pressure target for the client in the first 2 hours of reduction
therapy is:
a. 150/95
43. An otherwise healthy 28 yo woman has just been diagnosed with stage i htn. She says she has a
Glass of wine once or twice a week and eats “fast food” frequently because of her busy schedule.
Which topic should the nurse plans on including in the client-teaching plan?
a. Low-sodium food choices when eating out
44. Which of the following bp findings for an adult client with no other medical problems should be
evaluated further for htn? All that apply
a. 138-78
b. 140/96
Downloaded by NELSON KIIRU ()
