Med-Surg 480

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Sample questions from Med-Surg 480

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

1. 1.Refer to the client's chart. Which actions should the nurse take first in response to the client's current findings? Select all that apply.

   • A.Administer prescribed chewable aspirin if no contraindication is present.
   • B.Place the client on continuous cardiac monitoring.
   • C.Reassess the client in 30 minutes before intervening.
   • D.Encourage the client to walk to reduce anxiety.
   • E.Establish IV access and notify the rapid response team.

   Rationale: The client's new chest pressure, diaphoresis, and rising heart rate require immediate monitoring, rapid escalation, and prompt treatment for suspected acute coronary syndrome; aspirin reduces platelet aggregation when not contraindicated. Walking increases myocardial oxygen demand, and delaying reassessment risks missing deterioration. The chart's evolving symptoms and vital signs make waiting inappropriate.

2. 2.Which assessment finding is most characteristic of left-sided heart failure?

   • A.Bounding peripheral pulses
   • B.Jugular venous distention with dependent edema
   • C.Ascites with hepatomegaly
   • D.Crackles and orthopnea

   Rationale: Left ventricular failure causes pulmonary congestion, commonly producing crackles, dyspnea, and orthopnea. Jugular venous distention, ascites, and dependent edema are more typical of systemic venous congestion associated with right-sided failure. Bounding pulses are not a defining finding of heart failure.

3. 3.At a community clinic, an adult taking warfarin asks which food pattern is safest. Which response is appropriate?

   • A.Keep intake of vitamin K-containing foods consistent from week to week.
   • B.Double the next dose after eating a large serving of spinach.
   • C.Stop warfarin whenever a leafy vegetable is eaten.
   • D.Avoid all foods containing vitamin K.

   Rationale: Consistency in vitamin K intake helps maintain a stable warfarin effect; sudden increases or decreases can alter the INR. Avoiding all vitamin K foods is unnecessary and may make the diet nutritionally limited. Warfarin doses should not be doubled or stopped without prescriber direction.

4. 4.Which instructions should the nurse include when teaching a client with chronic stable angina about sublingual nitroglycerin? Select all that apply.

   • A.Store tablets in their original tightly closed container.
   • B.Call emergency services if pain persists 5 minutes after the first dose.
   • C.Sit or lie down before taking a dose.
   • D.Expect a mild headache as a possible medication effect.
   • E.Take one tablet every 5 minutes for up to three doses while waiting to call for help.

   Answer and rationale are in the full material.

5. 5.A client with atrial fibrillation is prescribed apixaban. Which finding should the client report promptly?

   • A.A brief episode of hiccups
   • B.Mild thirst after exercise
   • C.Black, tarry stools
   • D.A small bruise at an old venipuncture site

   Answer and rationale are in the full material.