FINAL STUDY Med Surg III - Exam #2
Question 1
Normal Junctional Rhythm (AV NODE)
60-100
30-60
40-60
50-70
Question 2
Which medication causes bradycardia in low doses, and tachycardia in high doses?
Atropine
Adenosine
Epinephrine
Lidocaine
Question 3
Which medication below is used to treat digitalis dysrhythmias?
Verapamil
Lidocaine
Amiodarone
Atropione
Question 4
Which medications below have a BLACK BOX WARNING that they should not be used in pregnancy as they can cause injury or death to the fetus? Select all that apply
Losartan
Captopril
Epinephrine
Enalapril
Question 5
What is the priority adverse effect of amlodipine
Ototoxicity
Dizziness
Decreased LOC
Pulmonary Toxicity
Question 6
Which medication is a potassium channel blocker, typically used to treat ventricular tachycardia & ventricular fibrillation
Amiodarone
Adenosine
Lidocaine
Verapamil
Question 7
Which medication is a sodium channel blocker, typically used to treat V. Fib and V Tach
Amiodarone
Propranolol
Lidocaine
Atropine
Question 8
Which medication is a calcium channel blocker typically used to treat atrial fibrillation & atrial flutter?
Atropine
Adenosine
Digoxin
Verapamil
Question 9
LFTs, Serum Electrolytes (K+) must be monitored with my use. My side effects are dizziness, muscle cramps, diarrhea, decreased sensitivity to touch, and angioedema. I have a BLACK BOX WARNING that I should not be used in pregnancy due to the risk of fetus injury or death. I have many interactions with food/herbs such as Alfalfa, California poppy, celery, garlic, ginger, hawthorn, marshmallow, mistletoe, quinine, shepherd's purse, St. John's Wort. Ginseng, Grapefruit Juice, Kola, Licorice.
Losartan
Captopril
Epinephrine
Amlodipine
Verapamil
Question 10
Food reduces my absorption. Side effects include headache, drowsiness, fatigue, dizziness, edema of the hands, ankles, and feet, flushing, palpitations, nausea & abdominal pain
Losartan
Captopril
Epinephrine
Amlodipine
Verapamil
Question 11
The client with a head injury is experiencing signs of increased intracranial pressure (ICP), and mannitol is prescribed. The nurse administering this medication expects which as intended effects of this medication? Select all that apply.
Reduced ICP
Increased diuresis
Increased osmotic pressure of glomerular filtrate
Reduced tubular reabsorption of water and solutes
Reabsorption of sodium and water in the loop of Henle
Question 12
My first dose, and any increased dosages should be taken at bedtime to prevent dizziness, and possible fainting
Prazosin
Atropine
Propranolol
Sotalol
Lidocaine
Question 13
Impulse starts in AV node before next sinus impulse
Abnormal or Absent P Wave
Rhythm is 40-60
Monitor
TREAT: If symptomatic = BBs, CCBs Antiarrhythmics (amiodarone)
Premature Junctional Complexes
Premature Ventricular Complexes
Ventricular Fibrillation
Idioventricular Rhythm
Question 14
The nurse is assigned to care for clients with SCI on a rehabilitation unit. Which signs does the nurse recognize as clinical manifestations of autonomic dysreflexia? Select all that apply.
Nasal congestion
Diaphoresis
Fever
Tachycardia
Hypertension
Question 15
the nurse is caring for a patient with a recent spinal cord injury. Which intervention does the nurse use to target and prevent potential spinal cord injury complications such as autonomic dysreflexia ?
frequently performed passive range of motion exercises
loosen or remove any tight clothing
monitor stool output and maintain a bowel program
keep the patient immobilized with the neck or back braces
monitor urinary output and check for bladder distention
Question 16
what does stimulation of the sympathetic nervous system produce
delayed electrical impulse that causes hypotension and Brady pnea
contractility and dilation of coronary vessels and increased heart rate
virtually no effect on the ventricles of the heart or vital signs
a slowed atrial ventricular conduction time that results in slow heart rate
Question 17
Cortana assessment of a patient with a lower spinal cord injury confirms that the patient has paralysis of the bilateral lower extremities. How does the nurse document this finding?
Paraparesis
Paraplegia
Quadriparesis
Quadriplegia
Question 18
because the patient is at risk for spinal shock, what does the nurse monitor for?
decrease blood pressure, Brady cardia, and decrease bowel sounds
tachycardia and a change in the level of consciousness
Decrease respiratory rate and a loss of sensation to pain and touch
it's called paralytic ileus and loss of bowel and bladder function
Question 19
The nurse who is providing care for a postoperative patient after a craniotomy, immediately notifies the surgeon of which assessment finding?
Drainage in the Jackson-Pratt Container of mL/8 hr
Intracranial pressure of 15 mm Hg
PCO2 level of 35 mm Hg
Serum sodium of 117 mEq/L
Question 20
Which statements about spinal shock are accurate? (Select all that apply)
It lasts for from less than 48 hours up to a few weeks
there is a temporary loss of motor and sensory function
there is a permanent loss of motor and sensory function
there is a temporary loss of reflex and autonomic function
there is a permanent loss of reflex and automatic function
Question 21
the nurse is reviewing an ECG of a patient admitted for fluid and electrolyte imbalances. The T waves are tall and peaked. The nurse reports his findings to the provider and obtains an order for which serum level test?
Sodium
glucose
potassium
phosphorus
Question 22
cardiac dysrhythmias are abnormal rhythms of the heart's electrical system. How does this affect the hearts function?
It cannot oxygenate the blood throughout the body
it cannot remove carbon dioxide from the body
it cannot effectively pump oxygenated blood throughout the body
it cannot effectively conduct impulses with increased activity
Question 23
The nurse is reviewing a patient's ECG and interprets a wide distorted QRS complex of 0.14 seconds followed by a P wave. What does this finding indicate?
Wide but normal complex, and no cause for concern
premature ventricular contractions
problem with the speed set on the ECG machine
delayed time of the electrical impulse through the ventricles
Question 24
The bedside cardiac monitor of a postoperative patient who becomes confused shows a sinus rhythm, but there is no palpable pulse. How does the nurse interpret these findings?
ECG monitor artifact or dysfunction
Pulseless electrical activity with inadequate perfusion
a pace rhythm with hypotension
idioventricular rhythm as seen in the dying heart
Question 25
Which of the following pathways does the normal cardiac electrical conduction follow?
Purkinje fibers - bundle branches - bundle of His - AV node - SA node
SA node - AV node - bundle of His - bundle branches - Purkinje Fibers
AV node - bundle of His - SA node - bundle branches - Purkinje Fibers
AV node - SA node - bundle of His - bundle branches - Purkinje Fibers
Question 26
Which aneurysm results in bleeding into the layers of the arterial wall?
Anastomotic
Dissecting
Thoracic
Abdominal
Question 27
Which of the following is the drug of choice for a stable patient with ventricular tachycardia?
Procainamide
Amiodarone
Atropine
Lidocaine
Question 28
Cerebral Edema peaks at which time point after intracranial surgery?
48 hours
24 hours
12 hours
72 hours
Question 29
A clients family member asks the nurse why DIC occurs. Which statement by the nurse correctly explains the cause?
It is caused by abnormal activation of the clotting pathway, causing excessive amounts of tiny clots to from inside organs
It is a complication of an autoimmune disease, that attacks the body's own cells
It occurs when the immune system attacks platelets and causes massive bleeding
It is caused when hemolytic processes destroy erythrocytes
Question 30
The nurse is caring for a client with a ventriculostomy. Which assessment finding demonstrates effectiveness of the ventriculostomy?
MAP is equal to ICP
Pupils are fixed and dilated
Increased ICP is 12 mm Hg
CPP is 21 mm Hg
Question 31
A client is treated for increased ICP. It is important for the client to avoid hypothermia because
Hypothermia can cause death
Shivering and hypothermia can increase ICP
Hypothermia is indicative of severe meningitis
Hypothermia is indicative of malaria
Question 32
The nurse is giving discharge instructions to the mother of a child who bumped her head on a table. Which statement by the mother indicates an understanding of the instructions?
I should not let her fall asleep
she may have nausea or headache for the first 24 hours
she should gently blow her nose and I'll observe her bleeding
she can run and play as she usually does
Question 33
Which Glasgow coma scale (GCS) data set indicates the most severe injury for a patient with traumatic brain injury and loss of consciousness?
GCS of 13 with loss of consciousness of 15 minutes
GCS of 9 with loss of consciousness of 30 minutes
GCS of 12 with loss of consciousness of 3 hours
GCS of 8 with loss of consciousness of 6.5 hours.
Question 34
Which description best defines a basilar skull fracture?
A simple, clean break in the skull
A direct opening to brain tissue
Fragments of bone are in brain tissue
Cerebrospinal fluid leaks from the nose or ears
Question 35
Which statement is true about respiratory problems in a patient with a major head injury?
Atelectasis and pneumonia can be prevented by proper pulmonary hygiene
Suctioning should be avoided because of the increase in ICP
Neurologic pulmonary edema occurs frequently
The patient should avoid breathing deeply because of increased ICP
Question 36
The nurse is caring for an intubated patient with increased ICP. If the patient needs to be suctioned, which nursing action does the nurse take to avoid further aggravating the increased ICP?
Manually hyperventilate with 100% oxygen before passing the catheter
maintain strict sterile technique when performing endotracheal suctioning
perform oral suctioning frequently, but do not perform endotracheal suctioning
obtain an order for an arterial blood gas before suctioning the patient
Question 37
what is the primary significance of ventricular tachycardia in a cardiac patient ?
it increases the ventricular filling time, therefore increasing cardiac output
it signals that the patient needs potassium supplement for replacement
it warns immediate initiation of cardio pulmonary resuscitation
it is commonly the initial rhythm before deterioration into ventricular fibrillation