Med Surg 2 All Exam Questions And Answers Updated 2023/2024
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Course
Med Surg
Institution
Med Surg
Med Surg 2 All Exam Questions And Answers Updated 2023/2024
Med Surg 2 All Exam Questions And Answers Updated 2023/2024
Exam 1, 2 & 3
1. A client is sent home with a Holter monitor. The most import...
Med Surg 2 All Exam Questions And
Answers Updated 2023/2024
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Med Surg 2 All Exam Questions And Answers
Updated 2023/2024
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 severe arterial disease has difficulty falling asleep due to pain in her legs.
The 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
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?
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a. Bleeding (P. 751, 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 failure.
For which sign 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
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
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