Advanced Medical Surgical Nursing

Question

Question 1

A nursing student wants to know why clients with chronic obstructive pulmonary disease tend to be polycythemic. What response by the nurse instructor is best?

a. It is due to side effects of medications for bronchodilation.

b. It is from overactive bone marrow in response to chronic disease.

c. It combats the anemia caused by an increased metabolic rate.

d. It compensates for tissue hypoxia caused by lung disease.

Question 2

A nurse assesses a client who had a myocardial infarction and is hypotensive. Which additional assessment finding should the nurse expect?

a. Heart rate of 120 beats/min

b. Cool, clammy skin

c. Oxygen saturation of 90%

d. Respiratory rate of 8 breaths/min

Question 3

A nurse assesses a client in an outpatient clinic. Which statement alerts the nurse to the possibility of left-sided heart failure?

a.“I have been drinking more water than usual.”

b.“I am awakened by the need to urinate at night.”

c.“I must stop halfway up the stairs to catch my breath.”

d.“I have experienced blurred vision on several occasions.”

Question 4

A nurse assesses clients on a cardiac unit. Which client should the nurse identify as being at greatest risk for the development of left-sided heart failure?

a. A 36-year-old woman with aortic stenosis

b. A 42-year-old man with pulmonary hypertension

c. A 59-year-old woman who smokes cigarettes daily

d. A 70-year-old man who had a cerebral vascular accident

Question 5

A client is receiving rivaroxaban (Xarelto) and asks the nurse to explain how it works. What response by the nurse is best?

a. “It inhibits thrombin.”

b. “It inhibits fibrinogen.”

c. “It thins your blood.”

d. “It works against vitamin K.”

Question 6

A client undergoing hemodynamic monitoring after a myocardial infarction has a right atrial pressure of 0.5 mm Hg. What action by the nurse is most appropriate?

a. Level the transducer at the phlebostatic axis.

b. Lay the client in the supine position.

c. Prepare to administer diuretics.

d. Prepare to administer a fluid bolus.

Question 7

A nurse assesses a client with atrial fibrillation. Which manifestation should alert the nurse to the possibility of a serious complication from this condition?

a. Sinus tachycardia
b. Speech alterations
c. Fatigue
d. Dyspnea with activity

Question 8

A client has been diagnosed with hypertension but does not take the antihypertensive medications because of a lack of symptoms. What response by the nurse is best?

a.“Do you have trouble affording your medications?”

b.“Most people with hypertension do not have symptoms.”

c.“You are lucky; most people get severe morning headaches.”

d.“You need to take your medicine or you will get kidney failure.”

Question 9

A client received tissue plasminogen activator (t-PA) after a myocardial infarction and now is on an intravenous infusion of heparin. The client’s spouse asks why the client needs this medication. What response by the nurse is best?

a.“The t-PA didn’t dissolve the entire coronary clot.”

b.“The heparin keeps that artery from getting blocked again.”

c.“Heparin keeps the blood as thin as possible for a longer time.”

d.“The heparin prevents a stroke from occurring as the t-PA wears off.”

Question 10

The nurse is reviewing the lipid panel of a male client who has atherosclerosis. Which finding is most concerning?

a. Cholesterol: 126 mg/dL

b. High-density lipoprotein cholesterol (HDL-C): 48 mg/dL

c. Low-density lipoprotein cholesterol (LDL-C): 122 mg/dL

d. Triglycerides: 198 mg/dL

Question 11