Med-Surg 2 Exam 1

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Sample questions from Med-Surg 2 Exam 1

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

1. 1.A 68-year-old client with a history of heart failure reports sudden shortness of breath and must sit upright to breathe. The nurse hears crackles bilaterally and notes an oxygen saturation of 86% on room air. Which action should the nurse take first?

   • A.Obtain a daily weight before intervening.
   • B.Administer the scheduled oral diuretic and reassess in 1 hour.
   • C.Place the client in high-Fowler position and apply oxygen as prescribed.
   • D.Encourage the client to drink water to thin secretions.

   Rationale: High-Fowler positioning and oxygen support address the immediate problem of impaired oxygenation while the nurse continues assessment and obtains additional help. A daily weight is useful for trending fluid status but does not treat acute hypoxemia. Oral fluids may worsen congestion, and waiting for an oral diuretic to work delays urgent respiratory support.

2. 2.A nurse is teaching a client newly prescribed warfarin for atrial fibrillation. Which instructions should the nurse include? Select all that apply.

   • A.Keep intake of vitamin K-containing foods consistent from week to week.
   • B.Report black, tarry stools or blood in the urine promptly.
   • C.Check with the prescriber before starting over-the-counter medicines or supplements.
   • D.Stop taking warfarin when bruising appears, without contacting the prescriber.
   • E.Use an electric razor and a soft-bristled toothbrush.

   Rationale: Consistent vitamin K intake helps keep anticoagulation stable; clients generally do not need to avoid vitamin K foods entirely. Black stools or blood in urine can indicate bleeding, and an electric razor and soft toothbrush reduce injury risk. Warfarin should not be stopped without clinical direction, and over-the-counter drugs or supplements may alter bleeding risk or INR.

3. 3.A client with stable angina asks how to use prescribed sublingual nitroglycerin during an episode of chest pain. Which instruction is correct?

   • A.Stop activity, sit down, and take one dose; call emergency services if pain is not relieved after 5 minutes.
   • B.Take three tablets at once and then resume activity if pain lessens.
   • C.Store the tablets in a weekly pill organizer to make them easier to access.
   • D.Swallow the tablet with water and wait 30 minutes before seeking help.

   Rationale: The client should stop activity, sit or lie down, take one sublingual dose, and seek emergency help if pain persists after 5 minutes; additional doses may be taken at 5-minute intervals as directed while awaiting help. Taking three tablets at once is unsafe and resuming activity risks worsening ischemia. Nitroglycerin is absorbed under the tongue, and it should remain in its original container to protect potency.

4. 4.A client with heart failure is prescribed furosemide. Which laboratory result is most important for the nurse to monitor for a medication-related complication?

   • A.Serum bilirubin.
   • B.Serum potassium.
   • C.Serum amylase.
   • D.Platelet count.

   Answer and rationale are in the full material.

5. 5.A nurse is teaching a client with peripheral arterial disease about foot care and symptom management. Which instructions should the nurse include? Select all that apply.

   • A.Use a heating pad on cold feet to improve circulation.
   • B.Stop smoking and seek help with smoking cessation if needed.
   • C.Wear well-fitting shoes and avoid walking barefoot.
   • D.Inspect the feet daily for blisters, cracks, or color changes.
   • E.Avoid crossing the legs for prolonged periods.

   Answer and rationale are in the full material.