Final Exam: NUR2502/ NUR 2502 (New 2023/ 2024 Update) Multidimensional Care III/ MDC 3 Exam| Questions and Verified Answers| 100% Correct| Graded A- Rasmussen
Final Exam: NUR2502/ NUR 2502 (New
2023/ 2024 Update) Multidimensional Care
III/ MDC 3 Exam| Questions and Verified
Answers| 100% Correct| Graded ARasmussen
QUESTION
The nurse is caring for a 55-year-old male who presented to his primary physician’s office
for his yearly check-up. Upon the physical assessment the provider noted enlarged lymph
nodes in the groin and neck region. The provider questioned joe regarding the possible causes
of the finding. Which of the following diagnosis are consistent with this finding?
Answer:
Lymphoma
QUESTION
Which of the following is a priority nursing intervention for a client in atrial fibrillation with a
rate of 180 beats per minute?
Answer:
Administer medications to slow the rate
QUESTION
The nurse is caring for a 65-year-old client female who presented to the emergency
department with shortness of breath and chest discomfort. The client has not been feeling well
for the past few days and complaints of a productive cough of blood -tinged sputum. Laboratory
tests reveal an elevated brain natriuretic peptide (BNP), and chest X ray reveals pulmonary
congestion. Based on the assessment findings. Which of the following diagnosis are consistent
with these findings?
Answer:
Heart failure (left sided)
QUESTION
You are providing care to a client with pericarditis. If left untreated which of the following is
the client at risk of developing?
Answer:
Cardiac tamponade
QUESTION
A nurse is caring for a client who has heart failure and a prescription for digoxin 125 mcg po
daily. Available is digoxin 0.25 mg/tablets. How many tablets should the nurse administer per
dose (round to the nearest tenth, one decimal places) use a trailing zero. Answer numerically
only.do not label
Answer:
0.5
QUESTION
A nurse is caring for a client who presented to the emergency department with complaints of
fatigue, palpitations, and chest pain, upon assessment the provider notes ab s3 and s4 gallop,
weak peripheral pulses, and tachycardia. The provider orders a chest x ray and
echocardiogram. Which reveals left ventricular dilation. which of the following disorders is
consistent with these findings?
Answer:
Dilated cardiomyopathy
QUESTION
Which of the following medications are utilized to treat peripheral artery disease (PAD)?
Answer:
Antiplatelet drugs
QUESTION
The nurse receives an order to infuse heparin 1000 units/hr. IV. the IV bag contains 25000
units heparin in 500 ml D5W.calculate the IV rate in ml/hr. (record the answer as a whole
number)
Answer:
20
QUESTION
A hospitalized client has a platelet count of 58,000 /mm3 (58 times 109/L). what action by
the nurse is best?
Answer:
Institute neutropenic precautions
QUESTION
Which of the following client is most at risk for developing endocarditis?
Answer:
A client who recently had a valve replacement and had dental work recently
performed.
QUESTION
A NURSE IS planning a diet for a client who is iron deficient. Which of the following foods
high in iron should the nurse include in the plan?
Answer:
Red meat (this was not an option) instead it says Leafy greens, which is the answer.
Leafy green is high in iron.
QUESTION
A nurse sets an infusion pump to infuse 1 L of D5NS at the rate of 100 ml/hr.
How many hours will it take to complete the infusion? Hours. (Record as a whole number)
Answer:
10
QUESTION
Which of the following assessment findings is consistent with mitral valve prolapse?
Answer:
Systolic click
QUESTION
A nurse is caring for a client who was received in the emergency department with a heart rate of
220 beats per minute. The clients cardiac monitoring displays supraventricular tachycardia
(SVT). which of the following interventions should the nurse anticipate?
Answer:
Vagal maneuver.
QUESTION
Which of the following is a treatment option for a client with infective endocarditis?
Answer:
Antimicrobials
QUESTION
During hourly rounding, the nurse enters a room where the client is unresponsive without a
pulse. His is the priority action? (Asystole)
Answer:
Start chest compression at a rate of 100-120 compressions per minute.
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Which of the following assessment findings are consistent with aortic regurgitation
a. Atrial fibrillation
b. Systolic click
c. Pitting edema
d. Blowing,decrescendo diastolic murmur
a. Blowing,decrescendo diastolic murmur
- The nurse knows which of the following is the most common problem for a client with valvular heart disease
Decreased cardiac output
Difficulty coping
Bradycardia
Altered body image.
Decreased cardiac output - The nurse is assessing a client with severe anemia.which clinical manifestation does the nurse expect to see in this client
Dyspnea with activity
Hypertension
Bradycardia
Warm,flushed skin
Dyspnea with activity - A client diagnosed with stable angina is complaining of substernal chterm-4est pain, rating the pain 5 out of 10. What would be the priority action by the nurse?
Administer nitroglycerin,1 tablet sublingual immediately
Administer 81 mg of aspirin immediately
Administer the client’s prescribed beta blocker.
Administer morphine
Administer nitroglycerin,1 tablet sublingual immediately - A nurse is caring for a client diagnosed with polycythemia vera. Which of the following should the nurse include in the client and family education
Decreased fluid intake to no more than 1 little per day
Wear support hose while awake
Diet high in vitamin k
Resume normal activity
Wear support hose while awake - A nurse is performing discharge teaching for a client who was recently diagnosed with heart failure.which of the following should be included in the client and family teaching ( select all that apply)
Medication teaching
Low sodium diet
Fluid restriction
Weekly weights
Symptoms to report to the provider
Medication teaching
Low sodium diet
Fluid restriction
Symptoms to report to the provider - The family of a neutropenic client reports that the client confused and is not acting right what action by the nurse is the priority
Ask the client about pain
Assess the client for infection
Delegate taking a set of vital signs
Look at today’s laboratory results.
Assess the client for infection - A nurse is caring for a client with a history of an abdominal aortic aneurysm. Which of the following assessment requires immediate intervention
Decreased urine output
Back pain
Nausea and vomiting
Absent peripheral pulses.
Absent peripheral pulses. - Which of the following assessment is a priority findings during a blood transfusion
Chest pain
Headache
Joint pain
Fatigue
Chest pain - The nurse questions which order for a client with thrombocytopenia
Avoid IM injection
Administer enemas
Apply ice to areas of trauma
Test all urine and stool for the presence of occult blood.
Administer enemas - Which of the following clients would not be a candidate for thrombolytic therapy
Client with a blood pressure of 100/60 mm HG
Client with a pulse of 102 beats/minute
Client with a history of hemorrhage stroke one month ago
Client age 65
Client with a history of hemorrhage stroke one month ago - Which of the following procedures are performed for a client with a pericardial effusion
Coronary artery bypass graft
Thoracotomy
Pericardiocentesis
Thoracentesis
Pericardiocentesis - Which of the following is the treatment of choice for end stage heart failure
Heart transplant
Coronary artery bypass
Percutaneous angiogram
Medications
Heart transplant - A nurse is caring for a client who recently underwent a heart transplant.which of the following nursing interventions is the priority
Assess for signs and symptoms of rejection
Advance diet as tolerated
Auscultate bowel sounds
Maintain strict bedrest
Assess for signs and symptoms of rejection - A nurse is caring for a client recently diagnosed with pericarditis which of the following is a common assessment finding with this disorder
ST- segment depression
Elevated troponin
Heart failure
ST- segment depression - A 65 year old male client is brought via EMS to the emergency department with chest pain.he rates the pain as a 10 on a scale from 0 to 10 .the pain is located mid-sternum and radiates to his left arm.his heart rate is 126 bpm,and blood pressure is 96/60 mm.Hg.A 12-lead electrocardiogram is perform and reveals ST-segment elevation.which of the following interventions does the nurse anticipate performing immediately.
Administer oxygen
Administer a beta blocker
Administer morphine
Administer a statin.
Administer morphine - Which of the following nursing interventions would be appropriate for a client with sickle cell disease.( select all that apply)
Administer IV morphine
Keep the client strictly NPO
Remove restrictive clothing
Prepare the client for surgery
Provide a cool environment
Administer IV morphine
Remove restrictive clothing - A nurse is caring for a client diagnosed with atherosclerosis. Which of the risk factors for the development of this disorder.
High HDL-C/low LDL-C
Vegan diet
Low HDL-C/High LDL-C
Diet high in vitamin K
Low HDL-C/High LDL-C - A nurse is caring for a client diagnosed with peripheral artery disease.which of the following is a common assessment finding
3+ pedal pulses
1+ pedal pulses
4+ pedal pulses
1+ pedal pulses - The nurse knows that hemolytic reactions to blood transfusions occur most often within the first —— minutes of the infusions
100
15
45
60
15 - A client admitted sickle crisis is distraught after learning her child also has the disease. What response by the is best
Both you and the father are equally responsible for passing it on
I can see you are upset. I can stay here with you a while if you like
It’s not your fault there is no way to know who will have this disease.
There are many good treatments for sickle cell disease these days.
I can see you are upset. I can stay here with you a while if you like - A NURSE IS caring for four clients with leukemia. After a hand-off report,which client should the nurse see first?
Client who had two bloody diarrhea stools this morning
Client who has been premedicated for nausea prior to chemotherapy
Client with a respiratory rate change from 15 to 20 breaths/min
Client with an unchanged lesions to the lower right lateral malleolus
Client who had two bloody diarrhea stools this morning - The nurse is working in the emergency department and has four clients arrive at the same time.which client should the nurse see first.
A client who states she has not urinated in 8 hours
A client with a history of chronic obstructive pulmonary disease reporting increased dyspnea
A client requesting antibiotics
A client who has a facial fracture with severe swelling.
A client who has a facial fracture with severe swelling. - A 65 year old female presented to the emergency room complaints of progressively worsening fatigue,,shortness of breath,and palpitations.upon assessment,heart rate is 130 beats per minute and irregular,and there is positive jugular vein distention.heart tones a high-pitched holosystolic murmur.which of the following disorders are consistent with these findings
.
Mitral regurgitation
Mitral stenosis
Aortic regurgitation
Mitral valve prolapse.
Mitral regurgitation - A client is receiving treatment for the diagnosis of hemophilia A.WHICH OF THE FOLLOWING IS MOST APPROPRIATE TO INCLUDE IN THE ASSESSMENT OF THIS CLIENT
a. Appetite
b. Urine output
c. Joint pain and bruising
d. Respiratory rate.
a. Joint pain and bruising - A nurse is caring for a 65 year old male who recently underwent an aortic valve replacement.which of the following is post-operative nursing care priority
Temperature monitoring
Advance diet as tolerated
Assess for bleeding
Dressing for bleeding
Assess for bleeding - The nurse educates the client on which of the following tests as the best tool for diagnosis heart failure.
echocardiography
Pulmonary artery catheter
Radionuclide studies
Multigated angiographic ( MUGA) scan
echocardiography - A nurse is caring for a client with leukemia.which of the following sign and symptoms are consistent with this diagnosis( select all that apply)
Bleeding gums
Bone pain ‘
Weight gain
Increased urination
Fatigue
Bleeding gums
Bone pain ‘
Fatigue - A nurse in a hematology clinic is working with four clients who have polycythemia vera.which client should the nurse see first?
Client with a blood pressure 180/98 mm HG
Client who reports shortness of breath
Client who reports calf tenderness and swelling
Client with a swollen and painful left great toe.
Client who reports shortness of breath - A nurse is providing discharge teaching to a client who recently underwent a mechanical valve replacement.which of the following statements by the client indicates the client’s correct understanding of the discharge teaching regarding warfarin anticoagulant therapy.
I do not need to take my prescribed medication for the rest of my life
Additional monitoring is not required while on the anticoagulant
I can lead a normal life while on anticoagulants , no restrictions are required
I may need to modify my diet while on this medication
I may need to modify my diet while on this medication - Which of the following medications are appropriate for the treatment of heart failure ( select all that apply)
Antibiotics
Diuretics
Digoxin
Bronchodilators
angiotensin -converting enzyme ( ace ) inhibitors.
Diuretics
Digoxin
angiotensin -converting enzyme ( ace ) inhibitors. - When educating a female client on the signs and symptoms of myocardial infarction , the nurse recognizes that which of the following should be included in the teaching
Pain usually resolves with rest and relaxation
Women often present with atypical signs and symptoms
Substernal chest pain is the most common symptoms in women
Women experience intermittent claudication
Women often present with atypical signs and symptoms - Which of the following would predispose a client mitral stenosis
Obesity
Rheumatic fever
Diabetes
IV drug use.
Rheumatic fever - A NURSE IS CARING FOR A CLIENt who has a nasogastric tube attached to low suction because of a suspected bowel obstruction.which of the following arterial blood gas results might be expected in this client?
PH 7.52,PCO2 54 MM HG
PH 7.42,PCO2 40 MM HG
PH 7.25 , PC02 25 MM HG
PH 7.38,PCO2 36 MM HG
PH 7.52,PCO2 54 MM HG - A 78 year old female presented to the emergency department with shortness of breath.Her daughter is at the bedside and shares that the client has a history of heart failure. You place the client on the cardiac monitor and find that the client is in atrial fibrillation at a rate of 180 beats per minute.which of the following are you concerns regarding this rhythm( select all that apply)
Potential for embolic event
Hypotension due to elevated heart rate
Worsening heart failure
Dizziness and light-headness
Cerebral edema
Potential for embolic event
Hypotension due to elevated heart rate
Worsening heart failure
Dizziness and light-headness - The nurse is caring for a 55 year old male who presented to his primary physician’s office for his yearly check-up.Upon the physical assessment the provider noted enlarged lymph nodes in the groin and neck region. The provider questioned joe regarding the possible causes of the finding.which of the following diagnosis are consistent with this finding.
Lymphoma
Sickle cell anemia
Leukemia
Polycythemia vera.
Lymphoma - Which of the following is a priority nursing intervention for a client in atrial fibrillation with a rate of 180 beats per minute?
Apply compression stockings
Administer anticoagulants
Administer medications to slow the rate
Monitor urine output
Administer anticoagulants - The nurse is caring for a 65 year old client female who presented to the emergency department with shortness of breath and chest discomfort.the client has not been feeling well for the past few days and complaints of a productive cough of blood -tinged sputum.laboratory tests reveal an elevated brain natriuretic peptide ( BNP) , and chest X ray reveals pulmonary congestion.Based on the assessment findings.which of the following diagnosis are consistent with these findings.
Heart failure ( left sided)
Pulmonary embolism
Heart failure ( right sided)
Lung cancer.
Heart failure ( left sided) - You are providing care to a client with pericarditis.if left untreated which of the following is the client at risk of developing
Cardiac tamponade
Pneumonia
Pulmonary embolism
Deep vein thrombosis
Cardiac tamponade - A nurse is caring for a client who has heart failure and a prescription for digoxin 125 mcg po daily.available is digoxin 0.25 t=mg/tablets.how many tablets should the nurse administer per dose( round to the nearest tenth , one decimal places) use a trailing zero.Anser numerically only.do notlabel
0.5 - A nurse is caring for a client who presented to the emergency department with complaints of fatigue,palpitations,and chest pain, upon assessment the provider notes ab s3 and s4 gallop,weak peripheral pulses , and tachycardia.the provider orders a chest x ray and echocardiogram.which reveals left ventricular dilation .which of the following disorders is consistent with these findings.
Dilated cardiomyopathy
Restrictive cardiomyopathy
Pericarditis
Cardiac tamponade
Dilated cardiomyopathy - Which of the following medications are utilized to treat peripheral artery disease(PAD)
Antiplatelet drugs
Antibiotics
Nitroglycerin
Diuretics,
Antiplatelet drugs - The nurse receives an order to infuse heparin 1000 units/hr IV. the IV bag contains 25000 units heparin in 500 ml D5W.calculate the IV rate in ml/hr ( record the answer as a whole number)
20 - A hospitalized client has a platelet count of 58,000 /mm3 ( 58 times 109/L).what action by the nurse is best
Encourage high protein
Institute neutropenic precautions
Limit visitors to healthy adults
Apply ice to bruises or sites of injury.
Apply ice to bruises or sites of injury. - Which of the following client is most at risk for developing endocarditis
A client who recently underwent a valve replacement
A client with marfan’s syndrome
A client recently diagnosed with mitral stenosis
A client who recently had a valve replacement and had dental work recently performed.
A client who recently had a valve replacement and had dental work recently performed. - A NURSE IS planning a diet for a client who is iron deficient.which of the following foods high in iron should the nurse include in the plan.
Oranges
Cashews
Red meat
Yogurt.
Red meat - A nurse sets an infusion pump to infuse 1 L of D5NS at the rate of 100 ml/hr
How many hours will it take to complete the infusion? Hours. ( record as a whole number)
10 - Which of the following assessment findings is consistent with mitral valve prolapse.
Systolic click
Urinary frequency
Atrial fibrillation
Claudication
Systolic click - A nurse is caring for a client who was received in the emergency department with a heart of 220 beats per minute.the client’s cardiac monitoring displays supraventricular tachycardia ( SVT).which of the following interventions should the nurse anticipate.
Apply compression stockings
Check blood glucose
Draw labs
Vagal maneuver.
Vagal maneuver. - Which of the following is a treatment option for a client with infective endocarditis
Antimicrobials
antihypertensive s
Diet modifications
Bedrest.
Antimicrobials
51.during hourly rounding ,the nurse enters a room where the client is unresponsive without a pulse.whis is the priority action
Call the family
Begin ventilation at 1 breath every 6 to 8 seconds
Start chest compression at a rate of 100-120 compressions per minute.
Wait for the emergency response team for direction
Start chest compression at a rate of 100-120 compressions per minute.
- The nurse is caring for a client with mitral regurgitation. Which of the following would you anticipate the client to develop if left untreated?
Myocardial ischemia
Left-sided heart failure
Right-sided heart failure
Renal failure
Right-sided heart failure
. Which of the following is a possible treatment plan for a client with leukemia
Therapeutic phlebotomy
Stem cell transplant
Splenectomy
Dialysis
Stem cell transplant
- The nurse is arriving at the beginning of her shift and has taken report on four clients on a medical -surgical unit.which client should the nurse see first
A client with pyelonephritis with nausea and vomiting
A client with post-total abdominal hysterectomy with 9/10 abdominal pain
A client with chronic obstructive pulmonary disease with an oxygen saturation of 89% on room air
A client with post-prostatectomy with bright red blood and clots in his catheter.
A client with post-prostatectomy with bright red blood and clots in his catheter. - Which of the following interventions should be included in the nutrition care plan of the client with atherosclerosis ?
Increase saturated fat
Increase daily intake of vegetables ,fruits , and whole grains
Limit sodium intake to 6 g per day
Increase full-fat dairy products.
Increase daily intake of vegetables ,fruits , and whole grains - You are caring for a client who presented to the emergency department with pulmonary edema.the client is hypotensive with a pulse oximeter regarding 85% on room air.which of the following is a nursing priority
Administer diuretics
Administer iv fluids
Administer oxygen
Obtain a chest x-ray.
Administer oxygen - A client states that their legs have pain with walking that decreases with rest.the nurse observes absence of hair on the client’s lower extremities and the client has a thready, walker posterior tibial pulse.what should be the best position to have the client’s legs.
Elevated on pillows
Crossed at the knee
Slightly bent with a pillow under the knees
Dependent position
Dependent position
58.A nurse is caring for a client recently diagnosed with hypertension which of the following should be included in the discharge teaching
Only check your blood pressure at a clinic or pharmacy
Diet changes are not recommended
Decrease physical activity to avoid spikes in blood pressure
Adhere to prescribed medications
Adhere to prescribed medications
- Which of the following is a priority nursing intervention for a client experiencing a transfusion reaction
Stop transfusion immediately
Notify the provider
Flush the IV line
Check vital signs
Stop transfusion immediately - Which of the following is a treatment option for a client with sickle cell disease
Pain management with NSaids only
Arthrocentesis
NPO diet
IV fluid bolus
IV fluid bolus - The nurse is discharging at home a client at risk for venous thromboembolism on enoxaparin sodium. What instruction is a priority for the nurse to provide to this client.
Notify your health provider if your stools appear dark or tarry
Massage the injection site after the heparin is injected
You must have your PT/INR checked every 2 weeks.
You must have your aPTT checked every 72 hours.
Notify your health provider if your stools appear dark or tarry
62.. Which of the following is a common early assessment finding consistent with a diagnosis of hereditary hemochromatosis
Flank pain
Fever
Hypoglycemia
Liver dysfunction
Liver dysfunction
- A nurse is caring for a 19 year old male client diagnosed with leukemia.which of the following interventions is appropriate for the care of this client?
Strict hand hygiene to prevent infection
Fluid restriction
Low residue diet
Therapeutic phlebotomy
Strict hand hygiene to prevent infection - A female client is being treated for a deep vein thrombosis she developed post-operatively about one week ago and was treated with unfractionated heparin.today she presents to the clinic with petechiae on bilateral hands and feet. Laboratory results show a platelet count of 42,000 /mm3( 42 times 109/L).the nurse is concerned about a drug reaction and anticipates the client has which of the following
Heparin-induced thrombocytopenia
Hemophilia A ( classic hemophilia)
Thrombotic thrombocytopenic purpura
Sickle cell crisis
Heparin-induced thrombocytopenia - Which of the following is a pharmacologic treatment option for a client with dilated cardiomyopathy( select all that apply)
.diuretic
Sodium tablets
Digoxin
Phentermine
Anticholinergic
diuretic
digoxin - Which of the following is the most common assessment related to autoimmune thrombocytopenic purpura
Bruising
Fatigue
Confusion
Bruising - A male client is presenting with radiating chest pain.which of the following would the nurse recognize as indicators that an acute myocardial infarction may be occurring. ( select all that apply)
Positioning troponin markers
ST-elevation on EKG on two contiguous leads
History of atherosclerosis
Pain radiating in jaw,back,shoulder or abdomen.
Pain relieved with rest.
Positioning troponin markers
ST-elevation on EKG on two contiguous leads
History of atherosclerosis
Pain radiating in jaw,back,shoulder or abdomen. - The client is admitted for heart failure and has edema neck vein distension and ascites .what is the most accurate way to monitor fluid gain or loss in this client.
Check for pitting edema in the dependent body parts
Auscultate the lungs for crackles or wheezing
Assess skin turgor and the condition of mucus membranes
Weight the client daily at the same time with the same scale.
Weight the client daily at the same time with the same scale. - A nurse is caring for a client who was recently diagnosed with left ventricular heart failure.what is an early sign the client is most likely to report
Abdominal distention
Weight gain
Swollen legs
Nocturnal coughing
Nocturnal coughing - A nurse is caring for a client who was recently diagnosed with Hemophilia .which of the following laboratory tests is consistent with that diagnosis.
Decreased bleeding
Prolonged activated partial thromboplastin time
Prolonged prothrombin time
Decreased platelet count
Prolonged activated partial thromboplastin time - The nurse is reviewing the laboratory values for a client.which of the following lab values the nurse address immediately
Creatine 6.2 mg/dl
Phosphorus 5.1 mg/dl
Potassium 5.9 mmol/L
Sodium 147 mEq/L
K - The nurse is caring for four clients on a post-surgical unit.the nurse understands that monitoring the client for which post-operative complication takes priority
Constipation
Nausea
Urinary retention
Pneumonia
Pneumonia - A nurse reviews the arterial blood gas ( ABG) values of a client admitted with pneumonia.PH ,7.51 , pac02 28 mm HG, pa02 70 mm HG ,and HC03 ,25 mEq/L .what do these values indicate
Metabolic acidosis
Respiratory alkalosis
Respiratory acidosis
Metabolic alkalosis
Respiratory acidosis - A nurse is arriving at the beginning of her shift and has taken report on four clients on a medical-surgical unit.which client should the nurse see first
A client with hypertension with a blood pressure of 172/92 mm HG
A client with a history of asthma complaining of increased dyspnea
A client ready for discharge education after treatment of an acute kidney injury
A client with pain that is two days postoperative from a prostatectomy
A client with a history of asthma complaining of increased dyspnea
75.the nurse assesses a client and documents findings edema 2+ bilateral ankles,brown pigmentation of lower extremity skin,acting pain of lower extremities when standing that resolves with elevation and 2+pedal pulses what condition does the client likely have?
Deep vein thrombosis
Venous insufficiency
Peripheral arterial disease
Raynaud’s disease.
Deep vein thrombosis
Venous insufficiency
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