Med Surg 2 - NCLEX Questions

Med Surg 2 - NCLEX Questions Leave the first rating Students also studied Terms in this set (105) Save Nclex Style EKG Practice 16 terms amandahendrick91 Preview Blood Transfusion NCLEX 39 terms llundeen17Preview EKG JUST RHYTHM STRIPS nclex 24 terms sedatress123Preview Saunde 147 term Mo

• A patient admitted with ACS has continuous ECG

monitoring. An examination of the rhythm strip reveals

the following characteristics: atrial rate 74 beats/min and

regular; ventricular rate 62 beats/min and irregular; P wave normal shape; PR interval lengthens progressively until a P wave is not conducted; QRS normal shape. The priority nursing intervention would be to

• perform synchronized cardioversion.
• administer epinephrine 1 mg IV push.
• observe for symptoms of hypotension or angina.
• apply transcutaneous pacemaker pads on the patient.
• observe for symptoms of hypotension or angina.
• The nurse is monitoring the ECG of a patient admitted

with ACS. Which ECG characteristics would be most suggestive of myocardial ischemia?

• Sinus rhythm with a pathologic Q wave
• Sinus rhythm with an elevated ST segment
• Sinus rhythm with a depressed ST segment
• Sinus rhythm with premature atrial contractions
• Sinus rhythm with a depressed ST segment
• The ECG monitor of a patient in the cardiac care unit

after an MI indicates ventricular bigeminy with a rate of 50 beats/min. The nurse would anticipate

• performing defibrillation.
• treating with IV amiodarone.
• inserting a temporary transvenous pacemaker.
• assessing the patient's response to the dysrhythmia.
• assessing the patient's response to the dysrhythmia.

• The nurse prepares a patient for synchronized

cardioversion knowing that cardioversion differs from defibrillation in that

• defibrillation requires a lower dose of electrical energy.
• cardioversion is indicated to treat atrial

bradydysrhythmias.

• defibrillation is synchronized to deliver a shock during

the QRS complex.

• patients should be sedated if cardioversion is done on

a nonemergency basis.

• patients should be sedated if cardioversion is done on a nonemergency basis.
• Which patient teaching points should the nurse include

when providing discharge instructions to a patient with a new permanent pacemaker and the caregiver (select all that apply)?

• Avoid or limit air travel.
• Take and record a daily pulse rate.
• Obtain and wear a Medic Alert ID device at all times.
• Avoid lifting arm on the side of the pacemaker above

shoulder.

• Avoid microwave ovens because they interfere with

pacemaker function.

• Take and record a daily pulse rate.
• Obtain and wear a Medic Alert ID device at all times.
• Avoid lifting arm on the side of the pacemaker above shoulder.
• Important teaching for the patient scheduled for a

radiofrequency catheter ablation procedure includes explaining that

• ventricular bradycardia may be induced and treated

during the procedure.

• a catheter will be placed in both femoral arteries to

allow double-catheter use.

• the procedure will destroy areas of the conduction

system that are causing rapid heart rhythms.

• a general anesthetic will be given to prevent the

awareness of any "sudden cardiac death" experiences.

• the procedure will destroy areas of the conduction system that are causing

rapid heart rhythms.

• When teaching a patient about the long-term

consequences of rheumatic fever, the nurse should discuss the possibility of

• valvular heart disease.
• pulmonary hypertension.
• superior vena cava syndrome.
• hypertrophy of the right ventricle.
• valvular heart disease.

• Which clinical finding would most likely indicate

decreased cardiac output in a patient with aortic valve regurgitation?

• Reduction in peripheral edema and weight
• Carotid venous distention and new-onset atrial

fibrillation

• Significant pulsus paradoxus and diminished peripheral

pulses

• Shortness of breath on minimal exertion and a diastolic

murmur

• Shortness of breath on minimal exertion and a diastolic murmur
• A patient is diagnosed with mitral stenosis and new-

onset atrial fibrillation. Which interventions could the nurse delegate to unlicensed assistive personnel (UAP) (select all that apply)?

• Obtain and record daily weight.
• Determine apical-radial pulse rate.
• Observe for overt signs of bleeding.
• Obtain and record vital signs, including pulse oximetry.
• Teach the patient how to purchase a Medic Alert

device.

• Obtain and record daily weight.
• Observe for overt signs of bleeding.
• Obtain and record vital signs, including pulse oximetry
• Which diagnostic study best differentiates the various

types of cardiomyopathy?

• Echocardiography
• Arterial blood gases
• Heart catheterization
• Endomyocardial biopsy
• Echocardiography
• The nurse is caring for a patient newly admitted with

heart failure secondary to dilated cardiomyopathy. Which intervention would be a priority?

• Encourage caregivers to learn CPR.
• Consider a consultation with hospice for palliative care.
• Monitor the patient's response to prescribed

medications.

• Arrange for the patient to enter a cardiac rehabilitation

program.

• Monitor the patient's response to prescribed medications.

• In teaching a patient about coronary artery disease, the

nurse explains that the changes that occur in this disorder include (select all that apply)

• diffuse involvement of plaque formation in coronary

veins.

• abnormal levels of cholesterol, especially low-density

lipoproteins.

• accumulation of lipid and fibrous tissue within the

coronary arteries.

• development of angina due to a decreased blood

supply to the heart muscle.

• chronic vasoconstriction of coronary arteries leading

to permanent vasospasm.

• abnormal levels of cholesterol, especially low-density lipoproteins.
• accumulation of lipid and fibrous tissue within the coronary arteries.
• development of angina due to a decreased blood supply to the heart muscle.
• After teaching about ways to decrease risk factors for

CAD, the nurse recognizes that additional instruction is needed when the patient says'

• "I would like to add weight lifting to my exercise

program."

• "I can only keep my blood pressure normal with

medication."

• "I can change my diet to decrease my intake of

saturated fats."

• "I will change my lifestyle to reduce activities that

increase my stress."

• "I would like to add weight lifting to my exercise program."
• A hospitalized patient with a history of chronic stable

angina tells the nurse that she is having chest pain. The nurse bases his actions on the knowledge that ischemia

• will always progress to myocardial infarction.
• will be relieved by rest, nitroglycerin, or both.
• indicates that irreversible myocardial damage is

occurring.

• is frequently associated with vomiting and extreme

fatigue.

• will be relieved by rest, nitroglycerin, or both.
• The nurse is caring for a patient who is 2 days post MI.

The patient reports that she is experiencing chest pain.She states, "It hurts when I take a deep breath." Which action would be a priority?

• Notify the physician STAT and obtain a 12-lead ECG.
• Obtain vital signs and auscultate for a pericardial

friction rub.

• Apply high-flow O2 by face mask and auscultate breath

sounds.

• Medicate the patient with PRN analgesic and

reevaluate in 30 minutes.

• Obtain vital signs and auscultate for a pericardial friction rub.