Med-Surg 2 Final

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Sample questions from Med-Surg 2 Final

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A client with acute chest pain has a 12-lead ECG showing ST-segment elevation in leads II, III, and aVF. Which action is the priority while preparing for reperfusion therapy?

   • A.Obtain a right-sided ECG and assess for hypotension before administering nitroglycerin
   • B.Administer sublingual nitroglycerin immediately, regardless of blood pressure
   • C.Encourage the client to cough and deep breathe to reduce myocardial workload
   • D.Wait for serial troponin results before notifying the provider

   Rationale: Inferior-wall infarctions can involve the right ventricle, making cardiac output preload-dependent; a right-sided ECG and blood pressure assessment help identify risk before nitrates. Nitrates can cause severe hypotension in right-ventricular infarction, coughing does not treat acute coronary occlusion, and reperfusion decisions should not wait for serial troponins when the ECG is diagnostic. The exam takeaway is to assess for right-ventricular involvement and hypotension before giving nitrates.

2. 2.A client with heart failure reports increasing dyspnea and has crackles, an oxygen saturation of 88%, and pink frothy sputum. Which intervention should the nurse implement first?

   • A.Place the client in high-Fowler position and apply oxygen
   • B.Encourage oral fluids to thin secretions
   • C.Place the client supine and elevate the legs
   • D.Obtain a daily weight before initiating other care

   Rationale: The findings indicate acute pulmonary edema, so upright positioning and supplemental oxygen support ventilation and oxygenation immediately. Fluids can worsen congestion, a supine position increases venous return and respiratory distress, and daily weight is useful for ongoing management but does not address the immediate threat. Prioritize airway and breathing before routine assessment tasks.

3. 3.A client taking digoxin has nausea, yellow-green visual halos, and a heart rate of 52/min. Which action should the nurse take?

   • A.Hold the dose and notify the provider
   • B.Give the dose with food to reduce nausea
   • C.Administer an extra dose because the heart rate is slow
   • D.Reassure the client that visual changes are expected

   Rationale: Nausea, visual disturbances, and bradycardia suggest digoxin toxicity; the medication should be held and the provider notified. Food may not resolve toxicity, an extra dose could worsen bradyarrhythmia, and these visual changes are not an expected harmless effect. Check the apical pulse and assess potassium and renal function because hypokalemia and impaired clearance increase toxicity risk.

4. 4.A client with atrial fibrillation is prescribed warfarin. Which statement indicates correct understanding of teaching?

   • A.I will use a soft toothbrush and report unusual bleeding
   • B.I should stop eating all foods that contain vitamin K
   • C.I can take ibuprofen for pain without checking first
   • D.If I miss a dose, I will double the next dose

   Answer and rationale are in the full material.

5. 5.A client with suspected pulmonary embolism suddenly develops dyspnea, pleuritic chest pain, and an oxygen saturation of 84%. What is the nurse's priority action?

   • A.Apply oxygen and activate the rapid response system
   • B.Encourage ambulation to improve venous return
   • C.Massage the affected calf
   • D.Offer oral fluids and reassess in 30 minutes

   Answer and rationale are in the full material.