480 Med-Surg

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Sample questions from 480 Med-Surg

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

1. 1.Which assessment finding in a client with acute pericarditis is most characteristic of the disorder?

   • A.Chest pressure that reliably occurs with exertion and resolves with rest
   • B.Sudden tearing pain radiating to the back with unequal arm pressures
   • C.Burning substernal discomfort relieved by antacids
   • D.Chest pain that worsens when lying flat and improves when leaning forward

   Rationale: Pericardial inflammation typically causes sharp chest pain that worsens when supine and improves when the client sits up and leans forward. Exertional pressure relieved by rest is more typical of stable angina. Tearing pain with unequal arm pressures suggests aortic dissection, while antacid relief suggests a gastrointestinal cause.

2. 2.Refer to the client's chart. Which actions should the nurse take first in response to the client's change in condition? Select all that apply.

   • A.Apply oxygen and assess respiratory effort
   • B.Place the client supine with the legs elevated
   • C.Obtain a 12-lead electrocardiogram
   • D.Activate the rapid response system
   • E.Encourage the client to walk to improve circulation

   Rationale: The chart shows new chest pressure, diaphoresis, falling blood pressure, tachycardia, and decreasing oxygen saturation, requiring urgent escalation, oxygenation assessment, and rapid ECG evaluation. Supine positioning with leg elevation may worsen breathing and is not the priority for suspected acute coronary syndrome. Ambulation is unsafe during active chest pain and hemodynamic instability.

3. 3.A client taking warfarin for atrial fibrillation reports black, tarry stools. Which instruction is most appropriate?

   • A.Take an over-the-counter aspirin for discomfort
   • B.Seek prompt evaluation because this may indicate gastrointestinal bleeding
   • C.Skip warfarin for one dose and restart when stools are normal
   • D.Increase dietary vitamin K today to reverse the medication

   Rationale: Black, tarry stools can indicate upper gastrointestinal bleeding, a serious complication for a client taking warfarin, and require prompt evaluation. The client should not independently change or stop the dose without clinical guidance. Increasing vitamin K or taking aspirin without direction can create additional risks and does not replace assessment.

4. 4.Which finding is most consistent with left-sided heart failure?

   • A.Dependent edema without respiratory symptoms
   • B.Ascites with an enlarged liver
   • C.Crackles and dyspnea when lying flat
   • D.Jugular venous distention that increases with inspiration

   Answer and rationale are in the full material.

5. 5.During a home visit, a client with hypertension asks how to reduce sodium intake. Which recommendation is best?

   • A.Choose fresh foods and compare labels for sodium content
   • B.Use a potassium-based salt substitute without discussing it with the provider
   • C.Avoid all fruits because they contain natural sodium
   • D.Use sea salt instead of table salt

   Answer and rationale are in the full material.