Med Surg. Exam 3 __ Practice Questions 2025
A 50-year-old woman weighs 95 kg and has a history of tobacco use, high blood pressure, high
sodium intake, and sedentary lifestyle. When developing an individualized care plan for her, the
nurse determines that the most important risk factors for peripheral artery disease (PAD) that must
be modified are
a. weight and diet.
b. activity level and salt intake.
c. tobacco use and high blood pressure.
d. sedentary lifestyle and exercise training. - ansc
Rationale: Significant risk factors for peripheral artery disease include tobacco use, hyperlipidemia,
elevated levels of high-sensitivity C-reactive protein, diabetes mellitus, and uncontrolled
hypertension; the most important is tobacco use. Other risk factors include family history,
hypertriglyceridemia, hyperuricemia, increasing age, obesity, sedentary lifestyle, and stress.
A 70-year-old male patient has multiple myeloma. His wife calls to report that he sleeps most of the
day, is confused when awake, and complains of nausea and constipation. Which complication of
cancer is this most likely caused by?
a. Hypercalcemia
b. Tumor lysis syndrome
c. Spinal cord compression
d. Superior vena cava syndrome - ansa
Rationale: Hypercalcemia can occur with multiple myeloma. Immobility and dehydration can
contribute to or exacerbate hypercalcemia. The primary manifestations of hypercalcemia include
,apathy, depression, fatigue, muscle weakness, electrocardiographic changes, polyuria and nocturia,
anorexia, nausea, and vomiting.
A characteristic of the stage of progression in the development of cancer is
a. oncogenic viral transformation of target cells.
b. a reversible steady growth facilitated by carcinogens.
c. a period of latency before clinical detection of cancer.
d. proliferation of cancer cells despite host control mechanisms. - ansd
Rationale: Progression is the final stage of cancer. This stage is characterized by increased growth
rate of the tumor, increased invasiveness, and spread of the cancer to a distant site (i.e.,
metastasis). Progression occurs as a result of the following characteristics of cancer cells: rapid
proliferation and decreased cell adhesion.
A compensatory mechanism involved in HF that leads to inappropriate fluid retention and
additional workload of the heart is
a. ventricular dilation.
b. ventricular hypertrophy.
c. neurohormonal response.
d. sympathetic nervous system activation. - ansc
Rationale: The following mechanisms in heart failure lead to inappropriate fluid retention and
additional workload of the heart: activation of the renin-angiotensin-aldosterone system (RAAS)
cascade and release of antidiuretic hormone from the posterior pituitary gland in response to low
cerebral perfusion pressure that results from low cardiac output.
,A complication of the hyperviscosity of polycythemia is
a. thrombosis.
b. cardiomyopathy.
c. pulmonary edema.
d. disseminated intravascular coagulation (DIC). - ansa
Rationale: The patient with polycythemia may experience angina, heart failure, intermittent
claudication, and thrombophlebitis, which may be complicated by embolization. These
manifestations are caused by blood vessel distention, impaired blood flow, circulatory stasis,
thrombosis, and tissue hypoxia, which is caused by the hypervolemia and hyperviscosity. The most
common serious acute complication is stroke, caused by thrombosis.
A key aspect of teaching for the patient on anticoagulant therapy includes which instructions?
a. Monitor for and report any signs of bleeding.
b. Do not take acetaminophen (Tylenol) for a headache.
c. Decrease your dietary intake of foods containing vitamin K.
d. Arrange to have blood drawn twice a week to check drug effects. - ansa
Rationale: Patients taking anticoagulants should be taught to monitor and report any signs of
bleeding, which can be a serious complication. Other important patient teaching includes
maintenance of a consistent intake of foods containing vitamin K and avoidance of supplements
that contain vitamin K. If a patient is taking warfarin, routine coagulation laboratory studies are
necessary, although frequency is patient dependent, not necessarily twice a week.
, A P wave on an ECG represents an impulse arising at the
a. SA node and repolarizing the atria.
b. SA node and depolarizing the atria.
c. AV node and depolarizing the atria.
d. AV node and spreading to the bundle of His. - ansb
Rationale: The first wave, P, begins with the firing of the sinoatrial (SA) node and represents
depolarization of the fibers of the atria.
A patient has a severe blockage in his right coronary artery. Which heart structures are most likely
to be affected by this blockage (select all that apply)?
a. AV node
b. Left ventricle
c. Coronary sinus
d. Right ventricle
e. Pulmonic valve - ansa, b, d
Rationale: The right coronary artery (RCA) supplies blood to the right atrium, the right ventricle,
and a portion of the posterior wall of the left ventricle. In 90% of people, the RCA supplies blood to
the atrioventricular (AV) node, bundle of His, and part of the cardiac conduction system.
A patient has recently been diagnosed with early stages of breast cancer. What is most appropriate
for the nurse to focus on?
