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Med Surg Unit 1-5 Review Questions (#1)

Total questions: 89

Worksheet time: 3hrs 57mins

Name
Class
Date
1.

In which of the following ways is critical thinking useful in to the nursing process?

a)

It highlights the solution to a problem

b)

It can lead to a better outcome for the patient

c)

It simplifies the process

d)

It helps the nurse arrive at a solution more quickly

2.

What is the purpose of corticosteroid treatment in lung disease?

a)

dry up secretions

b)

treat the infection that causes an exacerbation

c)

improve the oxygen carry capacity of hemoglobin

d)

reduce airway information

3.

What is the desired peripheral capillary oxygen saturation (SpO2) level in the patient with chronic obstructive pulmonary disease?

a)

95% to 100%

b)

92% to 95%

c)

88% to 92%

d)

85% to 88%

4.

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?

a)

oral cortisone

b)

intramuscular meperidine (Demerol)

c)

Intravenous morphine

d)

intravenous propanolol (Inderal)

5.

Which of the following risk factors presents the greatest threat for respiratory disease?

a)

smoking

b)

high-fat diet

c)

exposure to radiation

d)

alcohol consumption

6.

A patient with pneumonia has an oxygen saturation result of 86%. Which of the following actions by the nurse is best?

a)

Contact the RN or HCP for an order for oxygen

b)

No action necessary; this is normal peripheral capillary oxygen saturation

c)

call the respiratory therapist STAT for assistance

d)

walk the patient in the hall and recheck the oxygen saturation

7.

Which as-needed medication should be administered first in the patient with acute asthma symptoms

a)

albuterol (Proventil) inhaler

b)

Triamcinolone acetone (Azmacort) inhaler

c)

Fluticasone and salmeterol (Advair) inhaler

d)

Montelukast (Singulair) orally

8.

Which nursing interventions are important for the patient who is unable to cough up thick secretions? Select all that apply

a)

assist the patient to ambulate regularly

b)

place a cool steamer in the patient's room

c)

administer antitussive medication as ordered

d)

guide the patient in coughing and deep breathing

e)

teach the patient relaxation exercises

9.

A patient asks how to avoid lung cancer. Which of the following should the nurse include in the patient teaching? Select all that apply

a)

Live in a cold climate

b)

stop smoking

c)

avoid exposure to passive smoke

d)

avoid air pollution

e)

consume a high diet in fruits and vegetables

10.

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.

a)

complete cure of the cancer

b)

increased comfort

c)

prevention of the need for oxygen

d)

prevention of cancer spread

11.

A newly diagnosed patient ask the nurse to explain asthma. Which of the following explanations by the nurse is correct?

a)

"Your airways are inflamed and spastic"

b)

"You have fluid in your lungs that is causing shortness of breath"

c)

"Your airways are stretched and nonfunctional"

d)

"You have a low-grade infection that keeps your bronchial tree irritated"

12.

Which of the following is the best explanation of emphysema for a newly diagnosed patient?

a)

"You have inflamed bronchioles, which causes a lot of secretions"

b)

"The blood vessels that supply your lungs are damaged, so you can't absorb oxygen"

c)

"Your lungs have lost some of their elasticity, and air gets trapped"

d)

"You have large dilated sacs of sputum in your lungs"

13.

How can the nurse monitor effectiveness of therapy for the patient with a pneumothorax and a chest drainage system?

a)

palpate for crepitus

b)

auscultate lung sounds

c)

document color and amount of sputum

d)

monitor suction level

14.

Which of the following is an acceptable primal blood sugar range for most patients with diabetes

a)

46 to 98 mg/dL

b)

80 to 130 mg/dL

c)

180 to 250 mg/dL

d)

350 to 600 mg/dL

15.

Before giving insulin, the nurse always checks which test result?

a)

Recent potassium level

b)

blood glucose level

c)

urine ketones

d)

white blood cell count

16.

At what point after injection does the peak action of insulin lispro (Humalog) occur?

a)

30 to 90 minutes

b)

2 to 3 hours

c)

4 to 5 hours

d)

8 to 12 hours

17.

Which of the following are symptoms of hypoglycemia

a)

nausea and vomiting

b)

glycosuria

c)

cold sweat and tremor

d)

polyuria and polydipsia

18.

In addition to stimulating insulin production, glyburide (Micronase) has which of the following effects?

a)

stimulates gluconeogenesis

b)

promotes fat breakdown

c)

increases tissue sensitivity to insulin

d)

enhance appetite

19.

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?

a)

type 1

b)

type 2

c)

prediabetes

d)

gestational

20.

A patient with diabetes forgot to take a daily dose of glyburide (Micronase). For which of the following symptoms should the nurse be vigilant?

a)

cold, clammy sweat

b)

tachycardia, nervousness, hunger

c)

chest pain, shortness of breath

d)

fatigue, thirst, blurred vision

21.

By which routes can insulin be administered?

a)

oral

b)

topical

c)

intravenous

d)

subcutaneous

e)

intramuscular

22.

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?

a)

Sitagliptin (Januvia)

b)

Metformin (Glucophage)

c)

Aspiring (Ecotrin)

d)

Simvastatin (Zocor)

23.

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?

a)

raisins

b)

cheese

c)

acetaminophen (Tylenol)

d)

beef jerky

24.

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

a)

hyperglycemia

b)

ketonuria

c)

diabetic ketoacidosis

d)

hypoglycemia

25.

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?

a)

two eggs

b)

two strips of bacon

c)

1 oz of cheese

d)

a slice of wheat toast

26.

Each normal heartbeat is initiated by which of the following

a)

cardiac center in the medulla

b)

bundle of his in the inter ventricular septum

c)

sinoatrial node in the wall of the right atrium

d)

ventricles contract twice for every contraction of the atria

27.

During one cardiac cycle, which of the following occurs

a)

ventricles contract first, followed by the atria

b)

atria and ventricles contract simultaneously

c)

atria contract first, followed by the ventricles

d)

ventricles contract twice for every contractions of the atria

28.

Which of the following detects changes in blood pressure

a)

pressoreceptors in the medulla

b)

blood vessels in the medulla

c)

coronary vessels in the myocardium

d)

pressorereceptors in the carotid and aortic sinuses

29.

When blood pressure decreases, the kidneys help raise it by secreting which of the following?

a)

renin

b)

epinephrine

c)

aldosterone

d)

erythropoietin

30.

Which of the following prevents the back flow of blood in the veins?

a)

middle layer of vein

b)

precapillary sphincters

c)

smooth muscles

d)

valves

31.

The tricuspid and mitral valves prevent back flow of blood from which of the following?

a)

ventricles to atria when the ventricles contract

b)

atria to ventricles when the ventricles relax

c)

ventricles to atria when the atria contract

d)

atria ventricles when the atria contract

32.

Which of the following described the purpose of the endocardium of the heart?

a)

covers the heart muscle and prevents friction

b)

supports the coronary blood vessels

c)

lines the chambers of the heart and prevents abnormal clotting

d)

prevents back flow of blood from atria to ventricle

33.

Which of the following is the function of the coronary arteries?

a)

to carry deoxygenated blood to the myocardium

b)

to carry oxygenated blood to the myocardium

c)

to carry deoxygenated blood to the lungs

d)

to carry oxygenated blood to the lungs

34.

Where in the nervous system is the cardiac center found?

a)

cerebrum

b)

hypothalamus

c)

medulla

d)

spinal cord

35.

Angiotensin II causes which of the following?

a)

vasodilation and anitdiuretic hormone (ADH) secretion

b)

vasoconstriction and aldosterone secretion

c)

increased heart rate and vasodilation

d)

increased heart rate and ADH secretion

36.

The increase of resting blood pressure with age may contribute to which of the following?

a)

arrhythmia

b)

left-sided heart failure

c)

peripheral edema

d)

thrombus formation

37.

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

a)

122/84 mm Hg

b)

102/68 mm Hg

c)

100/78 mm Hg

d)

96/58 mm Hg

38.

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?

a)

left arm

b)

right arm

c)

right leg

d)

either arm

39.

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?

a)

"Your BP should have gone up about 5 mm Hg, so we'll need to have you move very slowly to avoid a fall"

b)

"Blood pressure usually compensates for a change in position by going down by about 15 mm Hg, so that is normal"

c)

"It is safe for BP to drop by as much as 25 mm Hg, so you don't need to worry"

d)

"You're an idiot. You should know this Harold, you've been in this for hospital for 5 years. Get over it"

40.

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?

a)

Return the patient to a lying portion immediately

b)

ask if the patient is experiencing chest pain

c)

document that normal compensation occurred

d)

document that orthostatic hypotension is present

41.

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?

a)

positioning the legs dependently

b)

elevating the legs

c)

applying lotion to the legs

d)

filing toenails

42.

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?

a)

to decrease cardiac output

b)

to increase cardiac blood flow like exercise would

c)

to prevent a clot from forming during the test

d)

to reduce systemic vascular resistance

43.

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?

a)

presence of pain

b)

capillary refill

c)

vital signs

d)

presence of dyspnea

e)

heart rhythm

44.

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

a)

"I will be awake during the test"

b)

"I will be on a stationary bed"

c)

"The dye can cause a warm sensation"

d)

"My heart will be monitored constantly"

e)

"My heart will be monitored constantly"

45.

The nurse defines a normal BP during a patient teaching session as which of the following?

a)

systolic lower than 120 mm Hg, and diastolic lower than 80 mm Hg

b)

Systolic of 120 to 129 mm Hg, and diastolic lower than 80 mm Hg

c)

Systolic of 130 to 139 mm Hg, and diastolic between 80 to 89 mm Hg

d)

tired :)

46.

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?

a)

Elevated

b)

Stage 1

c)

Stage 2

47.

The nurse would evaluate the patient as understanding the teaching of the action of enalapril maleate (Vasotec) if the patient stated which of these?

a)

"Vasotec decreases levels of Angiotensin II"

b)

Vasotec increases heart rate"

c)

"Vasotec dilates the arterioles and veins"

d)

"Vasotec decreases cardiac output"

48.

The nurse would include which of the following to described the action of diltiazem (Cardizem) in the patient's teaching plan?

a)

It increases heart rate

b)

it vasodilates

c)

it decreases fluid volume

d)

it increases cardiac contractility

49.

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

a)

race

b)

high cholesterol

c)

cigarette smoking

d)

sedentary lifestyle

e)

less than 5 hours of sleep

50.

The patient asks the nurse, "How is stage 2 hypertension defined?" Which of the following is the best response by the nurse?

a)

"It is a measurement of the heart's cardiac output as blood is pumped into the aorta."

b)

"It is a systolic of at least 140 mm Hg or a diastolic of at lest 90 mm Hg averaged on two occasions.:

c)

"It is hypertension that is regulated by stress, activity, and emotions"

d)

"it is systolic of 130 mm Hg and or diastolic of 80 mm Hg averaged on two occasions"

51.

The nurse is developing a teaching plan to help a patient control hypertension. The teaching plan should include which of the following lifestyle modifications?

a)

regular aerobic exercises

b)

low-tar cigarettes

c)

three alcoholic beverages

d)

daily multivitamin supplements

52.

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?

a)

furosemide (Lasix)

b)

Atenolol (Tenormin)

c)

Clonidine (Catapres)

d)

Hydralazine (Apresoline)

53.

A patient has been prescribed bumetanide (Bumex) daily to control hypertension. Which of the following patient statements indicates knowledge of treatment regimen.

a)

I can go to the beach and play in the sun all day

b)

Now I can eat whatever I want, whenever I want

c)

I will take my medications when I get up in the morning

d)

I won't need any medication once my blood pressure goes down

54.

Which common side effect of metolazone (Zaroxolyn) should the nurse instruct a patient to report to the HCP?

a)

numb hands

b)

muscle weakness

c)

GI distress

d)

nightmares

55.

The nurse understands that which of the following is a side effect most likely to be reported by patients receives enalapril maleate (Vasotec)

a)

acne

b)

cough

c)

diarrhea

d)

heartburn

56.

What action should the nurse take before administering (Cardizem) for hypertension?

a)

Check the calcium level

b)

ask patient if appetite has changed

c)

obtain vital signs

d)

inform patient not to stop medication abruptly

57.

Which of the following nursing diagnoses is the focus of care for a patient with hypertension?

a)

Activity Intolerance

b)

Ineffective Airway Clearance

c)

Impaired Physical Mobility

d)

Readiness for Enhanced Health Literacy

58.

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

a)

Hypertension may damage the kidneys and eyes

b)

I will limit my salt intake

c)

Medication will no longer be needed when I feel better

d)

People often do not know when their blood pressure is high

e)

hypertension is curable

59.

The nurse would evaluation amlodipine (Norvasc) as being effective if which of these BP readings were obtained

a)

88/52 mm Hg

b)

118/70 mm Hg

c)

138/82 mm Hg

d)

142/86 mm Hg

60.

Which of the following does the nurse understand occurs in aortic stenosis?

a)

aortic valve does not close tightly

b)

emptying of blood from left ventricle is impaired

c)

blood back flows into the left atrium

d)

emptying of the left atrium is impaired

61.

The nurse understands that which of the following occurs in mitral regurgitation?

a)

back flow of blood into the left atrium

b)

back flow of blood into the right atrium

c)

impaired emptying of the right ventricle

d)

impaired emptying of the left ventricle

62.

Which of the following compensatory mechanisms does the nurse understand occurs with ventricular valve disorders?

a)

decreased atrial kick

b)

atrial hypertrophy

c)

ventricular hypertrophy

d)

systolic hypertension

63.

Which of the following does the nurse understand causes fatigue in patients with chronic aortic stenosis?

a)

Atrial fibrillation

b)

left ventricular failure

c)

decreased pulmonary blood flow

d)

increased coronary artery blood flow

64.

Which of the following diagnostic tests does the nurse understand measures the pressures in the cardiac chambers?

a)

electrocardiogram

b)

exercise stress test

c)

echocardiogram

d)

cardiac catheterization

65.

Which of the following does the nurse understand usually precedes rheumatic fever?

a)

a viral infection

b)

a fungal infection

c)

a staphylococcal infection

d)

a beta-hemolytic streptococcal infection

66.

During data collection, which of the following is the most common symptom of pericarditis that the nurse would expect to identify?

a)

dyspnea

b)

intermittent claudication

c)

chest pain

d)

calf pain

67.

Which of the following should the nurse include in the plan of care as a patient outcome for Deficient Knowledge related to mitral stenosis?

a)

patient will have clear breath sounds, no edema, or weight gain

b)

patient will exhibit less fatigue during self-care

c)

patient will verbalize knowledge of disorder

d)

patient will state fear

68.

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

a)

Furosemide (Lasix)

b)

Cephalexin (Keflex)

c)

Penicillin (Bicillin)

d)

Prednisone (Deltasone)

e)

Potassium supplement

69.

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?

a)

Determine patient's and family's learning priorities

b)

tell patient what must be learned first about furosemide

c)

determine patient's dietary intake of potassium

d)

Give patient a written test at the end of the teaching session

70.

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

a)

wear medical identification

b)

avoid eating leafy greens

c)

keep scheduled blood test appointments

d)

explain the importance of eating green leafy vegetables in a consistent amount

e)

review signs and symptoms to report to the health care provider

71.

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

a)

apply elastic stockings as ordered

b)

ambulate as early as the patient's condition allows

c)

apply sequential compression devices as ordered

d)

encourage the patient to do leg exercises hourly while in bed

e)

delay ambulation with presence of pain upon movement

72.

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?

a)

cardia rhythm

b)

heart tones

c)

peripheral edema

d)

lung sounds

73.

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?

a)

infective endocarditis

b)

peritonitis

c)

vegetative emboli

d)

inflammation

74.

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?

a)

bronchovesicular sounds are heard over the major airways

b)

chest soreness and tenderness is reported

c)

sternal bruising is noted

d)

pericardial rub is heard on auscultation

75.

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?

a)

Plasma fibrinogen

b)

prothrombin time

c)

partial thromboplastin time

d)

international normalized ratio

76.

Antidote for warfarin (Coumadin)?

a)

Vitamin B12

b)

Vitamin K

c)

Calcium chloride

d)

Protamine sulfate

77.

Which of the following is a desired outcome for the nursing diagnosis of Acute Pain for a patient with acute DVT?

a)

States anxiety is decreased

b)

states pain is satisfactorily relieved

c)

is able to participated in desired activities

d)

reports ability to ambulated w/o pain

78.

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

a)

chest x-ray

b)

throat culture

c)

white blood cell count

d)

erythrocyte segmentation rate

79.

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?

a)

Give a dose of warfarin (Coumadin) immediately.

b)

inform the health care provider

c)

Give the next scheduled does of warfarin (Coumadin)

d)

Withhold the next dose of warfarin (Coumadin)

80.

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

a)

elevate left leg

b)

encourage ambulation 3x daily

c)

apply compression stockings as ordered

d)

apply warm, moist heat as ordered

e)

massage left leg

81.

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?

a)

You must be dreaming

b)

Reclining decreases the heart's ability to pump blood

c)

Sleeping increases heart rate, which increases the body's need for oxygen

d)

Reclining increases fluid returning to the heart, which builds up fluid in the lungs

82.

Which of the following assessments of a patient would indicate a side effect of digoxin (Lanoxin) is occurring that requires follow-up?

a)

anorexia

b)

constipation

c)

hypertension

d)

skin flushing

83.

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

a)

absent leg hair

b)

capillary refill less than 3 seconds

c)

diminished pulses

d)

thickened toenails

e)

stasis ulcer

84.

The nurse understands that pain associated with coronary artery disease occurs from which of the following?

a)

lack of nutrients to the heart

b)

interrupted electrical activity to areas of the heart

c)

lack of sufficient oxygen to the myocardium

d)

increased cardiac workload

85.

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?

a)

Explain how coronary artery disease is treated

b)

avoid discussing the heart catheterization to help the patient relax

c)

explain how well others have done after having this procedure

d)

listen to the patient express feelings about the situation

86.

Which of the following statements by a patient demonstrates to the nurse that the patient understands when to replace prescribed nitroglycerin tablets?

a)

Pills no longer cause tingling sensation when used

b)

pills disintegrate when touched

c)

pills smell like vinegar

d)

pills become discolored

87.

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?

a)

hot dogs

b)

fresh vegetables

c)

milk and cheese

d)

canned soups

88.

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

a)

hypertension

b)

gender

c)

age

d)

smoking

e)

diabetes mellitus

89.

Which of the following should the nurse correctly include in a teaching plan as being high in saturated fat?

a)

avocado

b)

beef

c)

cheddar cheese

d)

coconut oil

e)

tuna fish