MED SURG 3 EXAM 1 QUESTIONS AND ANSWERS
An ICU patient is on arterial pressure monitoring. The nurse noticed the physiologic monitor alarm
sounds. Which of the following indicate correct nursing actions? Select all that apply - CORRECT
ANSWER✅✅-check to see whether the catheter is kinked
-make sure that there is sufficient pressure in the pressure bag
-check the patency of the catheter
-check to see whether the stopcocks are turned the wrong way
A patient requires the insertion of an arterial catheter. Which nursing action is indicated? - CORRECT
ANSWER✅✅Obtain sterile gowns, gloves, caps, and masks for all persons who will be present during
the insertion
A patient who was stabbed multiple times in the chest and abdomen has just returned from emergency
surgery. Hemodynamic monitoring was initiated during surgery and now reveals that the patient's
central venous pressure has dropped to 2 mmHg. The nurse would assess for findings of which
conditions? Select all that apply. - CORRECT ANSWER✅✅-internal hemorrhage
-vasodilation from drugs administered during surgery
-fluid loss during surgery
The nurse is assessing a patient's arterial waveform and notes a notch on the descending portion of the
waveform. The nurse associates this notch with which physiological events? - CORRECT
ANSWER✅✅closure of the aortic valve
Which of the following was prescribed to decrease cardiac preload and afterload and to increase the
blood flow to the myocardium?
Mr. Ethan Gruppman, a 55-year-old businessman on a business trip, has been brought to the ED by a
colleague with SOB and chest pain. One hour ago, Mr. Gruppman began to experience "indigestion,"
which was unrelieved by antacid, after a heavy meal. Mr. Gruppman is 5'6" tall and weighs 175 pounds.
He has a history of hypertension and high cholesterol for which he takes captopril 50 mg twice a day and
simvastatin 20 mg once daily. His father, 74, has had two MIs; his mother recently died of a CVA at age
72. Mr. Gruppman takes frequent business trips, eats fast food and "banquet meals," and works out
sporadically. His BP is 178/90, P 104, R 26, and T 98.8°C. His 12-lead ECG is unremarkable. Orders are
, given for CXR, continuous ECG monitoring, serial CK-MB, Troponin & Myoglobin as well as a C - CORRECT
ANSWER✅✅Nitroglycerin
One hour later, Mr. Gruppman's 12-lead ECG shows an elevated ST-segment in leads V2-V4with a T
wave inversion. His CK-MB, troponin I, and myoglobin levels are elevated. His troponin T is normal. Mr.
Gruppman is given a diagnosis of anterior wall MI. He is told he has had "a mild heart attack" and will be
given a "clot buster" to help restore circulation to his heart. He is started on a 3-hour infusion of
alteplase. He is stabilized and transferred to CCU with an hour remaining on his alteplase IV, a heparin
drip, and a Foley catheter in place.
An anterior wall MI indicates occlusion of which of the following coronary arteries? - CORRECT
ANSWER✅✅Left anterior defending artery
Administration of the fibrolytic agent alteplase includes certain tasks such as ECG and heart and lung
assessments. Which of the following are the other expected tasks in nursing assessments and
interventions during the administration of the fibrolytic agent alteplase? Select all that apply. - CORRECT
ANSWER✅✅-expect reperfusion dysrhythmias
-assess neuro signs every 15-30 minutes
-monitor for evidence of internal or external bleeding
The following day, Mr. Gruppman's vital signs are as follows: T 38.2°C, BP 138/72,SpO 96% on 2 L/m,
pain 0. His troponin continues to rise, his FBS is 140, and his remaining metabolic lab findings are WNL.
His continuous ECG monitoring shows occasional Premature Ventricular contractions (PVCs) and the
nurse reviews standing orders for this dysrhythmia. Mr. Gruppman has new orders to get up in a chair,
his captopril is increased to three times per day to help prevent Ventricular Remodeling, and he is to
start atenolol 50 mg twice a day.
Mr. Gruppman asks why his "heart labs" keep increasing and wonders if he is having another heart
attack. What is the ideal response that the nurse should provide? - CORRECT ANSWER✅✅"Cardiac
marker labs continue to rise for 24 to 48 hours after your heart attack. They should start to fall
tomorrow.
The nurse writes a nursing diagnosis for Mr. Gruppman of Ineffective Cardiac Tissue Perfusion related to
decreased coronary blood flow with a goal to decrease chest pain. Which of the following are
appropriate interventions for this goal? (Select All That Apply). - CORRECT ANSWER✅✅-monitor ECG
-administer medications as ordered
-Assess pain, including location, intensity, radiation, duration, factors affecting pain as well as associated
symptoms such as nausea, etc.
An ICU patient is on arterial pressure monitoring. The nurse noticed the physiologic monitor alarm
sounds. Which of the following indicate correct nursing actions? Select all that apply - CORRECT
ANSWER✅✅-check to see whether the catheter is kinked
-make sure that there is sufficient pressure in the pressure bag
-check the patency of the catheter
-check to see whether the stopcocks are turned the wrong way
A patient requires the insertion of an arterial catheter. Which nursing action is indicated? - CORRECT
ANSWER✅✅Obtain sterile gowns, gloves, caps, and masks for all persons who will be present during
the insertion
A patient who was stabbed multiple times in the chest and abdomen has just returned from emergency
surgery. Hemodynamic monitoring was initiated during surgery and now reveals that the patient's
central venous pressure has dropped to 2 mmHg. The nurse would assess for findings of which
conditions? Select all that apply. - CORRECT ANSWER✅✅-internal hemorrhage
-vasodilation from drugs administered during surgery
-fluid loss during surgery
The nurse is assessing a patient's arterial waveform and notes a notch on the descending portion of the
waveform. The nurse associates this notch with which physiological events? - CORRECT
ANSWER✅✅closure of the aortic valve
Which of the following was prescribed to decrease cardiac preload and afterload and to increase the
blood flow to the myocardium?
Mr. Ethan Gruppman, a 55-year-old businessman on a business trip, has been brought to the ED by a
colleague with SOB and chest pain. One hour ago, Mr. Gruppman began to experience "indigestion,"
which was unrelieved by antacid, after a heavy meal. Mr. Gruppman is 5'6" tall and weighs 175 pounds.
He has a history of hypertension and high cholesterol for which he takes captopril 50 mg twice a day and
simvastatin 20 mg once daily. His father, 74, has had two MIs; his mother recently died of a CVA at age
72. Mr. Gruppman takes frequent business trips, eats fast food and "banquet meals," and works out
sporadically. His BP is 178/90, P 104, R 26, and T 98.8°C. His 12-lead ECG is unremarkable. Orders are
, given for CXR, continuous ECG monitoring, serial CK-MB, Troponin & Myoglobin as well as a C - CORRECT
ANSWER✅✅Nitroglycerin
One hour later, Mr. Gruppman's 12-lead ECG shows an elevated ST-segment in leads V2-V4with a T
wave inversion. His CK-MB, troponin I, and myoglobin levels are elevated. His troponin T is normal. Mr.
Gruppman is given a diagnosis of anterior wall MI. He is told he has had "a mild heart attack" and will be
given a "clot buster" to help restore circulation to his heart. He is started on a 3-hour infusion of
alteplase. He is stabilized and transferred to CCU with an hour remaining on his alteplase IV, a heparin
drip, and a Foley catheter in place.
An anterior wall MI indicates occlusion of which of the following coronary arteries? - CORRECT
ANSWER✅✅Left anterior defending artery
Administration of the fibrolytic agent alteplase includes certain tasks such as ECG and heart and lung
assessments. Which of the following are the other expected tasks in nursing assessments and
interventions during the administration of the fibrolytic agent alteplase? Select all that apply. - CORRECT
ANSWER✅✅-expect reperfusion dysrhythmias
-assess neuro signs every 15-30 minutes
-monitor for evidence of internal or external bleeding
The following day, Mr. Gruppman's vital signs are as follows: T 38.2°C, BP 138/72,SpO 96% on 2 L/m,
pain 0. His troponin continues to rise, his FBS is 140, and his remaining metabolic lab findings are WNL.
His continuous ECG monitoring shows occasional Premature Ventricular contractions (PVCs) and the
nurse reviews standing orders for this dysrhythmia. Mr. Gruppman has new orders to get up in a chair,
his captopril is increased to three times per day to help prevent Ventricular Remodeling, and he is to
start atenolol 50 mg twice a day.
Mr. Gruppman asks why his "heart labs" keep increasing and wonders if he is having another heart
attack. What is the ideal response that the nurse should provide? - CORRECT ANSWER✅✅"Cardiac
marker labs continue to rise for 24 to 48 hours after your heart attack. They should start to fall
tomorrow.
The nurse writes a nursing diagnosis for Mr. Gruppman of Ineffective Cardiac Tissue Perfusion related to
decreased coronary blood flow with a goal to decrease chest pain. Which of the following are
appropriate interventions for this goal? (Select All That Apply). - CORRECT ANSWER✅✅-monitor ECG
-administer medications as ordered
-Assess pain, including location, intensity, radiation, duration, factors affecting pain as well as associated
symptoms such as nausea, etc.
