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WorksheetsMed Surg Unit 1-5 Review Questions (#1)
Total questions: 89
Worksheet time: 3hrs 57mins
In which of the following ways is critical thinking useful in to the nursing process?
It highlights the solution to a problem
It can lead to a better outcome for the patient
It simplifies the process
It helps the nurse arrive at a solution more quickly
What is the purpose of corticosteroid treatment in lung disease?
dry up secretions
treat the infection that causes an exacerbation
improve the oxygen carry capacity of hemoglobin
reduce airway information
What is the desired peripheral capillary oxygen saturation (SpO2) level in the patient with chronic obstructive pulmonary disease?
95% to 100%
92% to 95%
88% to 92%
85% to 88%
Which of the following medications can be used to quickly reduced to quickly reduce shortness of breath in a crisis situation for a patient with end-stage respiratory disease?
oral cortisone
intramuscular meperidine (Demerol)
Intravenous morphine
intravenous propanolol (Inderal)
Which of the following risk factors presents the greatest threat for respiratory disease?
smoking
high-fat diet
exposure to radiation
alcohol consumption
A patient with pneumonia has an oxygen saturation result of 86%. Which of the following actions by the nurse is best?
Contact the RN or HCP for an order for oxygen
No action necessary; this is normal peripheral capillary oxygen saturation
call the respiratory therapist STAT for assistance
walk the patient in the hall and recheck the oxygen saturation
Which as-needed medication should be administered first in the patient with acute asthma symptoms
albuterol (Proventil) inhaler
Triamcinolone acetone (Azmacort) inhaler
Fluticasone and salmeterol (Advair) inhaler
Montelukast (Singulair) orally
Which nursing interventions are important for the patient who is unable to cough up thick secretions? Select all that apply
assist the patient to ambulate regularly
place a cool steamer in the patient's room
administer antitussive medication as ordered
guide the patient in coughing and deep breathing
teach the patient relaxation exercises
A patient asks how to avoid lung cancer. Which of the following should the nurse include in the patient teaching? Select all that apply
Live in a cold climate
stop smoking
avoid exposure to passive smoke
avoid air pollution
consume a high diet in fruits and vegetables
A patient with a new diagnosis of small cell lung cancer decides to have radiation therapy. Which of the following expectations of this treatment is most appropriate.
complete cure of the cancer
increased comfort
prevention of the need for oxygen
prevention of cancer spread
A newly diagnosed patient ask the nurse to explain asthma. Which of the following explanations by the nurse is correct?
"Your airways are inflamed and spastic"
"You have fluid in your lungs that is causing shortness of breath"
"Your airways are stretched and nonfunctional"
"You have a low-grade infection that keeps your bronchial tree irritated"
Which of the following is the best explanation of emphysema for a newly diagnosed patient?
"You have inflamed bronchioles, which causes a lot of secretions"
"The blood vessels that supply your lungs are damaged, so you can't absorb oxygen"
"Your lungs have lost some of their elasticity, and air gets trapped"
"You have large dilated sacs of sputum in your lungs"
How can the nurse monitor effectiveness of therapy for the patient with a pneumothorax and a chest drainage system?
palpate for crepitus
auscultate lung sounds
document color and amount of sputum
monitor suction level
Which of the following is an acceptable primal blood sugar range for most patients with diabetes
46 to 98 mg/dL
80 to 130 mg/dL
180 to 250 mg/dL
350 to 600 mg/dL
Before giving insulin, the nurse always checks which test result?
Recent potassium level
blood glucose level
urine ketones
white blood cell count
At what point after injection does the peak action of insulin lispro (Humalog) occur?
30 to 90 minutes
2 to 3 hours
4 to 5 hours
8 to 12 hours
Which of the following are symptoms of hypoglycemia
nausea and vomiting
glycosuria
cold sweat and tremor
polyuria and polydipsia
In addition to stimulating insulin production, glyburide (Micronase) has which of the following effects?
stimulates gluconeogenesis
promotes fat breakdown
increases tissue sensitivity to insulin
enhance appetite
A 26-year old is admitted to the hospital with a new diagnosis of diabetes, a blood glucose level of 680 mg/dL, and ketones in the blood and urine. Which type of diabetes should the nurse suspect?
type 1
type 2
prediabetes
gestational
A patient with diabetes forgot to take a daily dose of glyburide (Micronase). For which of the following symptoms should the nurse be vigilant?
cold, clammy sweat
tachycardia, nervousness, hunger
chest pain, shortness of breath
fatigue, thirst, blurred vision
By which routes can insulin be administered?
oral
topical
intravenous
subcutaneous
intramuscular
A nurse is preparing a patient with diabetes for a radiological study involving contrast dye. Which of the patient's morning medication should the nurse question?
Sitagliptin (Januvia)
Metformin (Glucophage)
Aspiring (Ecotrin)
Simvastatin (Zocor)
A patient with newly diagnosed diabetes asks the nurse what to take for low blood sugar. Which of the following would be most appropriate for the nurse to suggest?
raisins
cheese
acetaminophen (Tylenol)
beef jerky
The nurse recognizes that teaching is effective if a patient with diabetes knows to use subcutaneous glucagon for an emergency episode of which of the following conditions
hyperglycemia
ketonuria
diabetic ketoacidosis
hypoglycemia
A patient on a carbohydrate counting meal plan receives a breakfast tray and does not care for the oatmeal. Which of the following food can the nurse substitute for a half cup of oatmeal?
two eggs
two strips of bacon
1 oz of cheese
a slice of wheat toast
Each normal heartbeat is initiated by which of the following
cardiac center in the medulla
bundle of his in the inter ventricular septum
sinoatrial node in the wall of the right atrium
ventricles contract twice for every contraction of the atria
During one cardiac cycle, which of the following occurs
ventricles contract first, followed by the atria
atria and ventricles contract simultaneously
atria contract first, followed by the ventricles
ventricles contract twice for every contractions of the atria
Which of the following detects changes in blood pressure
pressoreceptors in the medulla
blood vessels in the medulla
coronary vessels in the myocardium
pressorereceptors in the carotid and aortic sinuses
When blood pressure decreases, the kidneys help raise it by secreting which of the following?
renin
epinephrine
aldosterone
erythropoietin
Which of the following prevents the back flow of blood in the veins?
middle layer of vein
precapillary sphincters
smooth muscles
valves
The tricuspid and mitral valves prevent back flow of blood from which of the following?
ventricles to atria when the ventricles contract
atria to ventricles when the ventricles relax
ventricles to atria when the atria contract
atria ventricles when the atria contract
Which of the following described the purpose of the endocardium of the heart?
covers the heart muscle and prevents friction
supports the coronary blood vessels
lines the chambers of the heart and prevents abnormal clotting
prevents back flow of blood from atria to ventricle
Which of the following is the function of the coronary arteries?
to carry deoxygenated blood to the myocardium
to carry oxygenated blood to the myocardium
to carry deoxygenated blood to the lungs
to carry oxygenated blood to the lungs
Where in the nervous system is the cardiac center found?
cerebrum
hypothalamus
medulla
spinal cord
Angiotensin II causes which of the following?
vasodilation and anitdiuretic hormone (ADH) secretion
vasoconstriction and aldosterone secretion
increased heart rate and vasodilation
increased heart rate and ADH secretion
The increase of resting blood pressure with age may contribute to which of the following?
arrhythmia
left-sided heart failure
peripheral edema
thrombus formation
A patient had a bilateral mastectomy 2 days ago, so the nurse obtains blood pressure readings from the patient's legs. The patient's baseline blood pressure in the arm was 112/78 mm Hg. Which of the following readings, when compared with baseline BP, does the nurse expect when taking BP in the leg
122/84 mm Hg
102/68 mm Hg
100/78 mm Hg
96/58 mm Hg
The nurse obtains a lower BP reading on the patient's left arm than the right arm. As a result, which of the following extremities would the nurse use for ongoing BP measurement?
left arm
right arm
right leg
either arm
The nurse is checking a patient's blood pressure for orthostatic hypotension. The patient's BP was 142/88 mm Hg when lying down and 136/80 mm Hg when standing. The patient asks the nurse why there is such a difference. Which of the following is the best response by the nurse?
"Your BP should have gone up about 5 mm Hg, so we'll need to have you move very slowly to avoid a fall"
"Blood pressure usually compensates for a change in position by going down by about 15 mm Hg, so that is normal"
"It is safe for BP to drop by as much as 25 mm Hg, so you don't need to worry"
"You're an idiot. You should know this Harold, you've been in this for hospital for 5 years. Get over it"
The nurse obtains a pulse of 78 beats per minute and a lying BP of 122/76 mm Hg on a patient. When the nurse checks the patient's BP for orthostatic hypotension, the patient's heart rate is 92 BPM, and the BP is 116/68 mm Hg. Which of the following actions should the nurse take?
Return the patient to a lying portion immediately
ask if the patient is experiencing chest pain
document that normal compensation occurred
document that orthostatic hypotension is present
The nurse is inspecting a patient's legs during data collection and notes there is bilateral decreased hair distribution; long, thick, brittle nails; and shiny, taut, dry skin. The nurse understands this can indicated which of the following? Which action would the nurse avoid performing based on these data?
positioning the legs dependently
elevating the legs
applying lotion to the legs
filing toenails
The nurse is explaining to a patient that for a thallium stress test, dipyridamole (Persantine), a coronary vasodilator, will be given. Which of the following would the nurse include in the teaching regarding the reason this medication is being given?
to decrease cardiac output
to increase cardiac blood flow like exercise would
to prevent a clot from forming during the test
to reduce systemic vascular resistance
Which of the following data would be the most important for the nurse to collect immediately for a patient who is reporting fatigue and dizziness? Select all that apply?
presence of pain
capillary refill
vital signs
presence of dyspnea
heart rhythm
The nurse would evaluate the patient as understanding teaching for a cardiac catheterization if the patient stated which of the following? Select all that apply
"I will be awake during the test"
"I will be on a stationary bed"
"The dye can cause a warm sensation"
"My heart will be monitored constantly"
"My heart will be monitored constantly"
The nurse defines a normal BP during a patient teaching session as which of the following?
systolic lower than 120 mm Hg, and diastolic lower than 80 mm Hg
Systolic of 120 to 129 mm Hg, and diastolic lower than 80 mm Hg
Systolic of 130 to 139 mm Hg, and diastolic between 80 to 89 mm Hg
tired :)
The nurse explained to a patient with BP readings of 164/102 mm Hg and 176/100 mm Hg on two separate occasions that this type of hypertension is classified in which hypertension category?
Elevated
Stage 1
Stage 2
The nurse would evaluate the patient as understanding the teaching of the action of enalapril maleate (Vasotec) if the patient stated which of these?
"Vasotec decreases levels of Angiotensin II"
Vasotec increases heart rate"
"Vasotec dilates the arterioles and veins"
"Vasotec decreases cardiac output"
The nurse would include which of the following to described the action of diltiazem (Cardizem) in the patient's teaching plan?
It increases heart rate
it vasodilates
it decreases fluid volume
it increases cardiac contractility
The nurse is developing a teaching plan for a patient. Which of the following should the nurse include as a modifiable risk factor for the development of hypertension? Select all that apply
race
high cholesterol
cigarette smoking
sedentary lifestyle
less than 5 hours of sleep
The patient asks the nurse, "How is stage 2 hypertension defined?" Which of the following is the best response by the nurse?
"It is a measurement of the heart's cardiac output as blood is pumped into the aorta."
"It is a systolic of at least 140 mm Hg or a diastolic of at lest 90 mm Hg averaged on two occasions.:
"It is hypertension that is regulated by stress, activity, and emotions"
"it is systolic of 130 mm Hg and or diastolic of 80 mm Hg averaged on two occasions"
The nurse is developing a teaching plan to help a patient control hypertension. The teaching plan should include which of the following lifestyle modifications?
regular aerobic exercises
low-tar cigarettes
three alcoholic beverages
daily multivitamin supplements
A patient calls the hypertension clinic to report frequent headaches after taking a newly prescribed medication. The nurse anticipates that this is an expected side effect after taking which of the following medications?
furosemide (Lasix)
Atenolol (Tenormin)
Clonidine (Catapres)
Hydralazine (Apresoline)
A patient has been prescribed bumetanide (Bumex) daily to control hypertension. Which of the following patient statements indicates knowledge of treatment regimen.
I can go to the beach and play in the sun all day
Now I can eat whatever I want, whenever I want
I will take my medications when I get up in the morning
I won't need any medication once my blood pressure goes down
Which common side effect of metolazone (Zaroxolyn) should the nurse instruct a patient to report to the HCP?
numb hands
muscle weakness
GI distress
nightmares
The nurse understands that which of the following is a side effect most likely to be reported by patients receives enalapril maleate (Vasotec)
acne
cough
diarrhea
heartburn
What action should the nurse take before administering (Cardizem) for hypertension?
Check the calcium level
ask patient if appetite has changed
obtain vital signs
inform patient not to stop medication abruptly
Which of the following nursing diagnoses is the focus of care for a patient with hypertension?
Activity Intolerance
Ineffective Airway Clearance
Impaired Physical Mobility
Readiness for Enhanced Health Literacy
Which of the following statements, if made by a patient with hypertension, indicates to the nurse a need for more teaching? Select all that apply
Hypertension may damage the kidneys and eyes
I will limit my salt intake
Medication will no longer be needed when I feel better
People often do not know when their blood pressure is high
hypertension is curable
The nurse would evaluation amlodipine (Norvasc) as being effective if which of these BP readings were obtained
88/52 mm Hg
118/70 mm Hg
138/82 mm Hg
142/86 mm Hg
Which of the following does the nurse understand occurs in aortic stenosis?
aortic valve does not close tightly
emptying of blood from left ventricle is impaired
blood back flows into the left atrium
emptying of the left atrium is impaired
The nurse understands that which of the following occurs in mitral regurgitation?
back flow of blood into the left atrium
back flow of blood into the right atrium
impaired emptying of the right ventricle
impaired emptying of the left ventricle
Which of the following compensatory mechanisms does the nurse understand occurs with ventricular valve disorders?
decreased atrial kick
atrial hypertrophy
ventricular hypertrophy
systolic hypertension
Which of the following does the nurse understand causes fatigue in patients with chronic aortic stenosis?
Atrial fibrillation
left ventricular failure
decreased pulmonary blood flow
increased coronary artery blood flow
Which of the following diagnostic tests does the nurse understand measures the pressures in the cardiac chambers?
electrocardiogram
exercise stress test
echocardiogram
cardiac catheterization
Which of the following does the nurse understand usually precedes rheumatic fever?
a viral infection
a fungal infection
a staphylococcal infection
a beta-hemolytic streptococcal infection
During data collection, which of the following is the most common symptom of pericarditis that the nurse would expect to identify?
dyspnea
intermittent claudication
chest pain
calf pain
Which of the following should the nurse include in the plan of care as a patient outcome for Deficient Knowledge related to mitral stenosis?
patient will have clear breath sounds, no edema, or weight gain
patient will exhibit less fatigue during self-care
patient will verbalize knowledge of disorder
patient will state fear
Which of the following medications does the nurse anticipate that the patient will be given to prevent complications associated with heart failure and decreased cardiac output? Select all that apply
Furosemide (Lasix)
Cephalexin (Keflex)
Penicillin (Bicillin)
Prednisone (Deltasone)
Potassium supplement
The nurse is caring for a patient, age 75, who has a nursing diagnosis of Deficient Knowledge related to furosemide (Lasix) administration. Which of the following intervention is most essential to include the planning a teaching session?
Determine patient's and family's learning priorities
tell patient what must be learned first about furosemide
determine patient's dietary intake of potassium
Give patient a written test at the end of the teaching session
A patient, age 65, is being discharged after a mechanical valve replacement for aortic stenosis. Which of the following should be taught regarding warfarin (Coumadin) therapy? Select all that apply
wear medical identification
avoid eating leafy greens
keep scheduled blood test appointments
explain the importance of eating green leafy vegetables in a consistent amount
review signs and symptoms to report to the health care provider
To prevent thrombophlebitis in the immobilized patient, the nurse should include which of these interventions in the patient's plan of care? Select all that apply
apply elastic stockings as ordered
ambulate as early as the patient's condition allows
apply sequential compression devices as ordered
encourage the patient to do leg exercises hourly while in bed
delay ambulation with presence of pain upon movement
The nurse is planning care for a patient with chronic mitral regurgitation. Which of the following data would be the highest priority for the nurse to collect?
cardia rhythm
heart tones
peripheral edema
lung sounds
The nurse reviews discharge instructions with the patient who has a history of infective endocarditis. The instructions recommend prophylactic antibiotics when undergoing dental work to prevent which of the following?
infective endocarditis
peritonitis
vegetative emboli
inflammation
A patient, age 46, is admitted for observation with a chest contusion after hitting the steering wheel in a motor vehicle accident. Which of the following findings would be the highest priority?
bronchovesicular sounds are heard over the major airways
chest soreness and tenderness is reported
sternal bruising is noted
pericardial rub is heard on auscultation
A patient develops postoperative deep vein thrombosis and is started on intravenous heparin. Which of the following laboratory tests does the nurse monitor during heparin therapy?
Plasma fibrinogen
prothrombin time
partial thromboplastin time
international normalized ratio
Antidote for warfarin (Coumadin)?
Vitamin B12
Vitamin K
Calcium chloride
Protamine sulfate
Which of the following is a desired outcome for the nursing diagnosis of Acute Pain for a patient with acute DVT?
States anxiety is decreased
states pain is satisfactorily relieved
is able to participated in desired activities
reports ability to ambulated w/o pain
A patient visits the doctor for a severe sore throat and fever. As the nurse plans the patient's care, which of the following diagnostic tests is prepared to prevent cardiac complications
chest x-ray
throat culture
white blood cell count
erythrocyte segmentation rate
The nurse is reviewing the daily international normalized ratio for a patient who has a mechanical valve replacement and is prescribed warfarin (Coumadin). The international ratio is 3.7. Which of the following actions should the nurse take now?
Give a dose of warfarin (Coumadin) immediately.
inform the health care provider
Give the next scheduled does of warfarin (Coumadin)
Withhold the next dose of warfarin (Coumadin)
A patient who had a hysterectomy 2 days ago reports tenderness in her left calf. Data collection reveals the following: left calf 17.5 inches, right calf 14 inches, left thigh 32 inches, right thigh 28 inches, and a shiny, warm, reddened left leg. Which of the following interventions should be given priority in the patient's plan of care? Select all that apply
elevate left leg
encourage ambulation 3x daily
apply compression stockings as ordered
apply warm, moist heat as ordered
massage left leg
A patient who has end-stage dilated cardiomyopathy comes to the emergency department with dyspnea. The patient reports waking with a feeling of suffocation, which was frightening. Which of the following responses by the nurse is most appropriate?
You must be dreaming
Reclining decreases the heart's ability to pump blood
Sleeping increases heart rate, which increases the body's need for oxygen
Reclining increases fluid returning to the heart, which builds up fluid in the lungs
Which of the following assessments of a patient would indicate a side effect of digoxin (Lanoxin) is occurring that requires follow-up?
anorexia
constipation
hypertension
skin flushing
As the nurse gathers data on a patient's circulation in the lower extremities, which of the following findings would indicate decreased arterial circulation? Select all that apply
absent leg hair
capillary refill less than 3 seconds
diminished pulses
thickened toenails
stasis ulcer
The nurse understands that pain associated with coronary artery disease occurs from which of the following?
lack of nutrients to the heart
interrupted electrical activity to areas of the heart
lack of sufficient oxygen to the myocardium
increased cardiac workload
A patients who has been scheduled for an exercise street electrocardiogram asks why this test is needed. Which of the following is the nurse's best response?
Explain how coronary artery disease is treated
avoid discussing the heart catheterization to help the patient relax
explain how well others have done after having this procedure
listen to the patient express feelings about the situation
Which of the following statements by a patient demonstrates to the nurse that the patient understands when to replace prescribed nitroglycerin tablets?
Pills no longer cause tingling sensation when used
pills disintegrate when touched
pills smell like vinegar
pills become discolored
After hospitalization for a MI, a patient is placed on a low-sodium diet. In discussing foods allowed on this diet, the nurse should inform the patient that this includes which of the following?
hot dogs
fresh vegetables
milk and cheese
canned soups
Which of the following does the nurse correctly include in a teaching plan as modifiable risk factors for coronary artery disease? Select all that apply
hypertension
gender
age
smoking
diabetes mellitus
Which of the following should the nurse correctly include in a teaching plan as being high in saturated fat?
avocado
beef
cheddar cheese
coconut oil
tuna fish
