NSG 223 - Medical-Surgical Nursing II
Exam 1
Question:
A patient who has endocarditis with vegetation on the mitral valve suddenly reports severe left foot pain. The nurse notes that no pulse is palpable in the left foot and that it is cold and pale. Which action should the nurse take next?
Answer:
Notify the health care provider about the change in status
Question:
Two weeks ago, a patient with heart failure received a new prescription for carvedilol 12.5 mg orally. Which finding by the nurse who is evaluating the patient in the cardiology clinic is of most concern?
Answer:
Sinus Bradycardia at a rate of 48 beats per minute
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Question:
The nurse is caring for a hospitalized patient with heart failure who is receiving captopril and spironolactone. Which laboratory value will be most important to monitor?
Answer:
Potassium
Question:
An 80-year-old patient on the coronary step-down unit tells the nurse, "I do not need to take that docusate. I never get constipated!" Which action by the nurse is most appropriate?
Answer:
Explain that his decreased activity level may cause constipation.
Question:
A patient with stable angina has a prescription for ranolazine 500 mg twice a day. Which patient finding is most important for the nurse to discuss with the health care provider (HCP)?
Answer:
Patient reports having chronic constipation (adverse effect of the medication, does not impact heart rate or BP and can be taken with beta blockers or nitrates)
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Question:
Which patient is best for the coronary care charge nurse to assign to a float RN who has come for the day from the general medical-surgical unit?
Answer:
Patient receiving IV furosemide to treat acute left ventricular failure. (the nurse would be familiar with LVF and the administration of IV medications)
Question:
Which topics will the nurse plan to include in dis-charge teaching for a patient who has been admitted with heart failure? Select all that apply.
Answer:
- How to monitor and record daily weight
- Date and time for follow-up appointments
- Symptoms of worsening heart failure
- How to read food labels for sodium content
Question:
A patient who has just arrived in the emergency department reports substernal and left arm discomfort that has been going on for about 3 hours.Which laboratory test will be most useful in determining whether the nurse should anticipate implementing the acute coronary syndrome standard protocol?
Answer:
Troponin I 3 / 4
Question:
A patient seen in the clinic with shortness of breath and fatigue is being evaluated for a possible diagnosis of heart failure. Which laboratory result will be most useful to monitor?
Answer:
B-type Natriuretic Peptide
Question:
The emergency department nurse is caring for a patient who was just admitted with left anterior chest pain, suggesting possible acute myocardial infarction (MI). Which action will the nurse take first?
Answer:
Administer sublingual nitroglycerin
Question:
The health care provider prescribes these actions for a patient who was admitted with acute substernal chest pain. Which actions are appropriate to assign to an experienced LPN/LVN who is working in the emergency department? Select all that apply
Answer:
- Obtaining a 12-lead electrocardiogram (ECG)
- Attaching cardiac monitor leads
- Having patient chew and swallow aspirin 162mg
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