Med surg 1 DQ

A nurse is providing discharge teaching to a client who has a new permanent pacemaker . Which of the following statements by the client indicates an understanding of the teaching ? A " I should check my heart rate at the same time each day . " B. " I don't have to take my antihypertensive medications now that I have a pacemaker . " C. " I should keep a pressure dressing over the generator until the incision is healed . " D. " I cannot stand in front of our new microwave oven when it is on . "

A " I should check my heart rate at the same time each day . "

A nurse is providing teaching for a client who has a prescription for a low - sodium diet to manage hypertension . Which of the following statements by the client indicates an understanding of the teaching ? A. " I can snack on fresh fruit . " B. " I can continue to eat lunchmeat sandwiches . " C. " I can have cottage cheese with my meals . " D. " Canned soup is a good lunch option . "

A. " I can snack on fresh fruit . "

A nurse is providing information to a client who is scheduled for an exercise electrocardiography test . Which of the following client statements indicates an understanding of the teaching ? A. " I will not drink coffee 4 hr prior to my test . " B. " I can eat a light meal 1 hr prior to the test . " C. " I can have a cigarette up to 30 min prior to the test . " D. " I will take my heart medication on the day of the test . "

A. " I will not drink coffee 4 hr prior to my test . "

A nurse is caring for a client who is undergoing treatment for hypertension . Which of the following statements indicates that the client is adhering to the treatment plan ? A. " I would never have believed I could get used to enjoying my food without salt . " B. " My blood pressure device at home usually shows about 156 over 98 or so . " C. " I make sure I take my blood pressure medicine when I have headaches . " D. " My blood pressure pills are very expensive . Could I take a cheaper medication ? "

A. " I would never have believed I could get used to enjoying my food without salt . "

A nurse is preparing a client for cardiac catheterization . Which of the following pieces of information should the nurse give the client before the procedure ? ( Select all that apply . ) A. " You'll have to lie flat for several hours after the procedure . " B. " You'll receive medication to relax you before the procedure . " C. " You'll feel a cool sensation after the injection of the dye . " D. " You'll have to keep your leg straight after the procedure . " E. " You'll have to limit the amount of fluid you drink for the first 24 hr . "

A. " You'll have to lie flat for several hours after the procedure . B. " You'll receive medication to relax you before the procedure . " D. " You'll have to keep your leg straight after the procedure . "

A nurse is caring for a client who is undergoing conservative treatment for deep - vein thrombosis . The client asks the nurse what will happen to the clot . Which of the following responses should the nurse make ? A. " Your body has a process called fibrinolysis that will eventually dissolve the clot . " B. " Your body has a mechanism that will keep the clot stable in its present location . " c . " The clot will break into tiny fragments and float harmlessly in your bloodstream . " D. " Treatment with heparin will dissolve the clot and keep other clots from forming . "

A. " Your body has a process called fibrinolysis that will eventually dissolve the clot . "

A nurse is rewarming a client following coronary artery bypass graft ( CABG ) surgery . For which of the following complications of the rewarming process should the nurse monitor the client ? A. Acidosis B. Infection C. Hypertension D . Cardiac tamponade

A. Acidosis

A nurse is caring for a client who has an abdominal aortic aneurysm and is scheduled for surgery . The client's vital signs are blood pressure 160/98 mmHg . heart rate 102 / min , respirations 22 / min , and Sp02 95 % . Which of the following actions should the nurse take ? A. Administer antihypertensive medication for blood pressure B. Monitor to ensure the client's urinary output is 20 mL / hr C. Withhold pain medication to prepare the client for surgery D. Take the client's vital signs every 2 hr

A. Administer antihypertensive medication for blood pressure

A nurse is teaching about a low - cholesterol diet to a client who had a myocardial infarction . Which of the following meal selections by the client indicates an understanding of the teaching ? A. Chicken breast and corn on the cob B. Shrimp and rice C. Cheese omelet and turkey bacon D. Liver and onions

A. Chicken breast and corn on the cob

A nurse is caring for a client who had a myocardial infarction 5 days ago . The client has a sudden onset of shortness of breath and begins coughing frothy , pink sputum . The nurse auscultates loud , bubbly sounds on inspiration . Which of the following adventitious breath sounds should the nurse document ? A. Coarse crackles B. Wheezes C. Rhonchi D. Friction rub

A. Coarse crackles

A nurse is examining the ECG of a client who has hyperkalemia . Which of the following ECG changes should the nurse expect ? A. Elevated ST segments B. Absent P waves C. Depressed ST segments D. Varying PP intervals

A. Elevated ST segments

While participating in a community health fair , a nurse is providing information to a client who has a blood pressure of 150/90 mmHg during screening . Which of the following actions should the nurse take ? A. Give the client a written record of his BP to bring to his provider B. Encourage the client to go to the nearest emergency department C. Instruct the client to follow - up with a provider within 6 months D. Explain to the client that he is not at risk unless he has manifestations of hypertension

A. Give the client a written record of his BP to bring to his provider

A nurse is assessing a client who has deep - vein thrombosis in her left calf . Which of the following manifestations should the nurse expect to find ? ( Select all that apply . ) A. Hardening along the blood vessel B. Absence of a peripheral pulse C. Tenderness in the calf D. Cool skin on the leg E. Increased leg circumference

A. Hardening along the blood vessel C. Tenderness in the calf E. Increased leg circumference Deep - vein thrombosis can cause hardening along the affected blood vessel and prominence of superficial veins , pain or tenderness in the calf , and an increase in the circumference of the leg due to swelling .

A nurse is assessing a client who has heart failure and is taking daily furosemide . The client's apical pulse is weak and irregular . The nurse should identify these findings as manifestations of which of the following electrolyte imbalances ? A. Hypokalemia B. Hypophosphatemia C. Hypercalcemia D. Hypermagnesemia

A. Hypokalemia

A nurse is teaching a client who has coronary artery disease about the difference between angina pectoris and myocardial infarction ( MI ) . Which of the following manifestations should the nurse identify as indications of MI ? ( Select all that apply . ) A. Nausea and vomiting B. Diaphoresis and dizziness c . Chest and left arm pain that subsides with rest D. Anxiety and feelings of doom E. Bounding pulse and bradypnea

A. Nausea and vomiting B. Diaphoresis and dizziness D. Anxiety and feelings of doom

A nurse is examining the ECG of a client who is having an acute myocardial infarction . The nurse should identify that the elevated ST segments on the ECG indicate which of the following alterations ? A. Necrosis B. Hypokalemia C. Hypomagnesemia D. Insufficiency

A. Necrosis

A nurse is caring for an older adult client who had an acute myocardial infarction ( MI ) . When assessing this client , the nurse should identify that older adults are prone to complications of MI from poor tissue perfusion because of which of the following age - related factors ? A. Peripheral vascular resistance increases . B. The sensitivity of blood pressure - adjusting baroreceptors increases . C. Blood is hypercoagulable and clots more quickly . D. Cardiac medications are less effective .

A. Peripheral vascular resistance increases .

A nurse is caring for a client who is postoperative following vein ligation and stripping for varicose veins . Which of the following actions should the nurse take ? A. Position the client supine with his legs elevated when in bed B. Encourage the client to ambulate for 15 min every hour while awake for the first 24 hr C. Tell the client to sit with his legs dependent after ambulating D. Instruct the client to wear knee - length socks for 2 weeks after surgery

A. Position the client supine with his legs elevated when in bed

A nurse is caring for a client with heart failure whose telemetry reading displays a flattening of the T wave . Which of the following laboratory results should the nurse anticipate as the cause of this ECG change ? A. Potassium 2.8 mEq / L B. Digoxin level 0.7 ng / mL C. Hemoglobin 9.8 g / dL D. Calcium 8.0 mg

A. Potassium 2.8 mEq / L

A nurse is caring for a client who has a demand pacemaker inserted with a set rate of 72 / min . Which of the following findings should the nurse expect ? A. Telemetry monitoring showing QRS complexes occurring at a rate of 74 / min with no pacing spikes B. Premature ventricular complexes at 12 / min C. Telemetry monitoring showing pacing spikes with no QRS complexes D. Hiccups

A. Telemetry monitoring showing QRS complexes occurring at a rate of 74 / min with no pacing spikes

A nurse is monitoring a client for reperfusion following thrombolytic therapy to treat acute myocardial infarction ( MI ) . Which of the following indicators should the nurse identify to confirm reperfusion ? A. Ventricular dysrhythmias B. Appearance of Q waves C. Elevated ST segments D. Recurrence of chest pain

A. Ventricular dysrhythmias

A nurse is assessing a client who has late - stage heart failure and is experiencing fluid volume overload . Which of the following findings should the nurse expect ? A. Weight gain of 1 kg ( 2.2 lb ) in 1 day B. Pitting edema +1 C. Client report of a nocturnal cough D. B - type natriuretic peptide ( BNP ) level of 100 pg / ml .

A. Weight gain of 1 kg ( 2.2 lb ) in 1 day

A nurse is providing teaching about lifestyle changes to a client who experienced a myocardial infarction and has a new prescription for a beta blocker . Which of the following client statements indicates an understanding of the teaching ? A. " I should eat foods that are high in saturated fat . " B. " Before taking my medication , I will count my radial pulse rate . " C. " I will exercise once a week for an hour at the health club . " D. " I will stop taking my medication when my blood pressure is within a normal range . "

B. " Before taking my medication , I will count my radial pulse rate .

A nurse is providing discharge teaching to an adult female client who has infective endocarditis about how to prevent recurrence . Which of the following statements by the client indicates an understanding of the teaching ? A. " I will ask my provider to change my contraception to an intrauterine device . " B. " I will notify my doctor before I have dental procedures . " C. " I will avoid using antiseptic mouthwash for oral care . " D. " I will wear a mask when I go out in public . "

B. " I will notify my doctor before I have dental procedures . "

A nurse is assessing a client who has peripheral vascular disease and a venous ulcer on the right ankle . Which of the following findings should the nurse expect in the client's affected extremity ? A. Absent pedal pulses B. Ankle swelling C. Hair loss D. Skin atrophy

B. Ankle swelling

A nurse on a telemetry unit is caring for a client who has an irregular radial pulse . Which of the following ECG abnormalities should the nurse recognize as atrial flutter ? A. P waves occurring at 0.16 seconds before each QRS complex B. Atrial rate of 300 / min with QRS complex of 80 / min C. Ventricular rate of 82 / min with an atrial rate of 80 / min D. Irregular ventricular rate of 125 / min with a wide QRS pattern

B. Atrial rate of 300 / min with QRS complex of 80 / min

A nurse is assessing a client who has left - sided heart failure . Which of the following findings should the nurse expect ? A. Pitting peripheral edema B. Crackles in the lung bases C. Jugular vein distention D. Hepatomegaly

B. Crackles in the lung bases

A nurse is preparing an in - service presentation about the management of myocardial infarction ( MI ) . Death following MI is often a result of which of the following complications ? A. Cardiogenic shock B. Dysrhythmias C. Heart failure D . Pulmonary edema

B. Dysrhythmias

A nurse is caring for a client who has severely elevated blood pressure . Which of the following findings should the nurse identify as a manifestation of hypertension ? A. Vertigo B. Epistaxis C. Exophthalmos D. Spondylolisthesis

B. Epistaxis

A nurse completing an assessment on a client . Which of the following findings should the nurse identify as a risk factor for coronary artery disease ? ( Select all that apply . ) A. Hypothyroidism B. Hypertension C. Diabetes mellitus D. Hyperlipidemia E. Tobacco smoking

B. Hypertension C. Diabetes mellitus D. Hyperlipidemia E. Tobacco smoking

A nurse is monitoring a client who has heart failure related to mitral stenosis . The client reports shortness of breath on exertion . Which of the following conditions should the nurse expect ? A. Increased cardiac output B. Increased pulmonary congestion C. Decreased left atrial pressure D. Decreased pulmonary artery pressure

B. Increased pulmonary congestion

A nurse is examining the ECG of a client who has frequent premature ventricular contractions ( PVCs ) . Which of the following QRS changes should the nurse expect to see on the client's ECG ? A. Narrower than usual QRS complexes B. Much greater amplitude than the usual QRS complexes C. Same polarity as the usual QRS complexes D. Immediate resumption of the usual rhythm

B. Much greater amplitude than the usual QRS complexes

A nurse is monitoring the electrocardiogram of a client who has hypocalcemia . Which of the following findings should the nurse expect ? A. Flattened T waves B. Prolonged QT intervals C. Shortened QT intervals D. Widened QRS complexes

B. Prolonged QT intervals

A nurse is providing discharge teaching for a client who has a newly inserted permanent pacemaker . Which of the following instructions should the nurse include in the teaching ? A. " Request a provider's prescription when traveling to alert airport security . B. " Stand at least 3 feet away while using a microwave . " C. " Keep your cell phone 6 inches away from your pacemaker when making a call . " D. " Avoid showering for the first 2 weeks following surgery . "

C. " Keep your cell phone 6 inches away from your pacemaker when making a call . "

A client who just learned that he has variant ( Prinzmetal's ) angina asks the nurse how this type of angina compares with stable angina . Which of the following replies should the nurse make ? A. " Exertion often brings on pain . " B. " Variant angina occurs randomly at various times . " C. " Variant angina can cause changes on your electrocardiogram . " D. " Reducing your cholesterol can help you experience less pain . "

C. " Variant angina can cause changes on your electrocardiogram . "

A nurse is assessing a client who had coronary artery bypass grafts for cardiac tamponade . Which of the following actions should the nurse take ? A. Check for hypertension B. Auscultate for loud , bounding heart sounds C. Auscultate blood pressure for pulsus paradoxus D. Check for a pulse deficit

C. Auscultate blood pressure for pulsus paradoxus

A nurse is caring for a client who reports calf pain . What is the first action the nurse should take ? A. Notify the provider B. Elevate the affected extremity C. Check the affected extremity for warmth and redness D. Prepare to administer unfractionated heparin

C. Check the affected extremity for warmth and redness

A nurse in a clinic is assessing the lower extremities and ankles of a client who has a history of peripheral arterial disease . Which of the following findings should the nurse expect ? A. Pitting edema B. Areas of reddish - brown pigmentation C. Dry , pale skin with minimal body hair D . Sunburned appearance with desquamation

C. Dry , pale skin with minimal body hair .

A nurse is assessing a client who has pericarditis . Which of the following manifestations should the nurse expect ? A. Bradycardia with ST - segment depression B. Relief of chest pain with deep inspiration C. Dyspnea with hiccups D . Chest pain that increases when sitting upright

C. Dyspnea with hiccups

A nurse is caring for an adult male client who is undergoing screening tests for atherosclerosis . Which of the following laboratory findings should the nurse identify as an increased risk for this disorder ? A. Cholesterol level 195 mg / dL B. Elevated HDL levels C. Elevated LDL levels D. Triglyceride level 135 mg

C. Elevated LDL levels

A nurse is caring for a client who has a peripherally inserted central catheter ( PICC ) in place . Which of the following actions should the nurse take when handling this central venous access device ? ( Select all that apply . ) A. Use a 5 mL syringe to flush the line B. Cleanse the insertion site with half - strength hydrogen peroxide C. Flush the line with sterile 0.9 % sodium chloride before and after medication administration D. Access the PICC for blood sampling E. Perform a heparin flush of the line at least daily when not in use

C. Flush the line with sterile 0.9 % sodium chloride before and after medication administration D. Access the PICC for blood sampling E. Perform a heparin flush of the line at least daily when not in use

A nurse is caring for a client who is having a possible myocardial infarction ( MI ) . Which of the following findings should the nurse identify as an associated manifestation of an MI ? A. Headache B. Hemoptysis C. Nausea D. Diarrhea

C. Nausea

A nurse is preparing an in - service presentation about assessing clients who are having an acute myocardial infarction ( MI ) . What is the most common assessment finding with acute MI ? A. Dyspnea B. Pain in the shoulder and left arm C. Substernal chest pain D. Palpitations

C. Substernal chest pain

A nurse is monitoring a client who had a myocardial infarction . For which of the following complications should the nurse monitor in the first 24 hr ? A. Infective endocarditis B. Pericarditis C. Ventricular dysrhythmias D. Pulmonary emboli

C. Ventricular dysrhythmias

A nurse is teaching a 70 - year - old client about risk factors for heart failure . The client has mild asthma , diabetes mellitus , and coronary artery disease . Which of the following statements by the client indicates an understanding of the teaching ? A. " My diabetes will not increase my risk of heart failure . " B. " My asthma makes it more likely for me to have heart failure . " C. " My age does not increase my risk of heart failure . " D. " My coronary artery disease is a risk factor for heart failure . "

D. " My coronary artery disease is a risk factor for heart failure . "

A nurse is assessing a client who is 85 years old . Which of the following findings should the nurse identify as a manifestation of myocardial infarction ? A. Sudden hemoptysis B. Acute diarrhea C. Frontal headache D. Acute confusion

D. Acute confusion

A nurse is preparing an automated external defibrillator ( AED ) for a client receiving CPR after a cardiac arrest . Which of the following actions should the nurse perform first ? A. Press the analyze button on the machine B. Stop CPR and move away from the client C. Push the charge button to prepare to shock . D. Apply the defibrillator pads to the client's chest

D. Apply the defibrillator pads to the client's chest

A nurse is completing an assessment for a client who has a history of unstable angina . Which of the following findings should the nurse expect ? A. Chest pain is relieved soon after resting . B. Nitroglycerin relieves chest pain . C. Physical exertion does not precipitate chest pain . D. Chest pain lasts for longer than 15 min .

D. Chest pain lasts for longer than 15 min .

A nurse is assessing a client who has right - sided heart failure . Which of the following findings should the nurse expect ? A. Decreased capillary refill B. Dyspnea C. Orthopnea D. Dependent edema

D. Dependent edema

A nurse is caring for a client who has peripheral vascular disease ( PVD ) and ulcers on the toes . Which of the following findings of PVD is a risk factor for ulceration of the extremities ? A. Insufficient skin care B. Dehydration C. Immobility D. Impaired circulation

D. Impaired circulation

A nurse is assessing a client who has an abdominal aortic aneurysm . Which of the following manifestations should the nurse expect ? A. Midsternal chest pain B. Thrill C. Pitting edema in lower extremities D. Lower back discomfort

D. Lower back discomfort

A nurse is planning care for a client who is having a percutaneous transluminal coronary angioplasty ( PTCA ) with stent placement . Which of the following actions should the nurse anticipate in the post - procedure plan of care ? A. Instruct the client about a long - term cardiac conditioning program B. Administer scheduled doses of acetaminophen C. Check for peak laboratory markers of myocardial damage D. Monitor for bleeding

D. Monitor for bleeding

A nurse is showing a client who has right - sided heart failure an illustration of the heart . Which of the following blood vessels carry deoxygenated blood to the right atrium ? A. Right coronary artery B. Left carotid artery C. Aorta D. Superior vena cava

D. Superior vena cava

A nurse is reviewing the progress notes for a client who has heart failure . The provider noted some improvement in the client's cardiac output . The nurse should understand that cardiac output reflects which of the following physiologic parameters? A. The percentage of blood the ventricles pump during each beat B. The amount of blood the left ventricle pumps during each beat C. The amount of blood in the left ventricle at the end of diastole D. The heart rate times the stroke volume

D. The heart rate times the stroke volume