Med Surg 2 All Exam Questions Exam 1, 2 & 3.

(Answered) Med Surg 2 All Exam Questions 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 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 R ayn au d ’s d is eas e . 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? 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