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NUR 242 MEDICAL-SURGICAL EXAM 3|2025-
2026|ACTUAL 150 QUESTIONS WITH CORRECT
DETAILED AND VERIFIED ANSWERS|GRADED A+
Terms in this set (152) Original An older client with a history of congestive heart failure expresses concerns about potential exposure to tuberculosis (TB) from his or her roommate at the extended care facility. The roommate coughs a great deal and sometimes spits up blood. Which is the primary reason that the nurse pursues more information about the roommate? TB adversely affects older adults with chronic illness When the clinic nurse is teaching a group of clients with heart failure (HF) about dietary interventions to prevent fluid overload, which topic will be included? Use of fresh or frozen vegetables instead of canned ones / low sodium Which action would the nurse take first when a client with heart failure has an episode of paroxysmal nocturnal dyspnea (PND)? Assist the client to sit on the edge of the bed When caring for a client with a diagnosis of right ventricular heart failure, the nurse expects which assessment findings? Select all that apply.. Dependent edema Swollen hands and fingers
Right upper quadrant discomfort The nurse's physical assessment of a client with heart failure reveals tachypnea and bilateral crackles. Which is the priority nursing intervention? Place client in a high-Fowler position. Which treatment would the nurse anticipate when caring for an infant with heart failure? Medications that are prescribed for both children and adults Which feeding education would the nurse provide the parent of a 2-month-old infant with the diagnosis of heart failure? Feed slowly while allowing time for adequate periods of rest Which assessment finding would indicate improvement in a 4 - month-old infant admitted to the pediatric unit with a diagnosis of congestive heart failure? Weight loss during next 2 days The parent of an infant with heart failure questions the necessity of weighing the baby every morning. Which would the nurse say that this daily information is important in determining? Fluid retention
Calibrated syringe An infant with a diagnosis of heart failure is being given furosemide twice a day. Which laboratory value would the nurse report to the health care provider? Potassium of 3.0 mEq/L (3.0 mmol/L) A client with congestive heart failure is receiving intravenous digoxin (Cardoxin) therapy. The registered nurse identifies that which items on the client's care plan are appropriate for a licensed practical nurse (LPN) to perform? Select all that apply.. Help the client ambulate when required. Monitor the client's vitals every 30 minutes Administer adequate oral fluids to the client The nurse taught a client with heart failure who is scheduled for discharge about how medications, diet, and exercise improve activity tolerance. During a follow-up visit, the nurse finds that the client has learned how to adapt his or her exercise prescription to increase activity tolerance. Which theory did the nurse follow to achieve this positive outcome? Roy's theory Which intervention would the nurse use after observing that a 6-month-old child lies quietly, rarely smiles or babbles, and has his basic needs barely met by the primary caregiver, who is a grandparent with chronic heart failure?
Initiate a referral for assessment of home health and schedule a family conference. A client with heart failure weighed 175 lb (79.4 kg) yesterday, and today's weight is 181 lb (82.1 kg). How many milliliters of fluid has the client retained?. ___mL 2700 ml An infant with a congenital heart defect is in heart failure and is receiving daily weight measurements. Which complication of heart failure would daily weights help monitor? Fluid retention Which intervention would the nurse implement for a 4-month-old infant with tetralogy of Fallot and heart failure? Providing small, frequent feedings The nurse provides teaching to a client who is being discharged after an acute exacerbation of chronic obstructive pulmonary disease (COPD). The nurse would instruct the client to monitor for which indication of right-sided heart failure? Weight gain When a client with heart failure reports frequent sudden waking during the night with shortness of breath, how will the nurse document this finding? Paroxysmal nocturnal dyspnea
A client with left ventricular heart failure and supraventricular tachycardia is prescribed digoxin 0.25 mg daily. Which changes would the nurse expect to find if this medication is therapeutically effective? Select all that apply.. Diuresis Decreased edema Decreased pulse rate A client with hypertensive heart disease who had an acute episode of heart failure is to be discharged on a regimen of metoprolol and digoxin. Which outcome would the nurse anticipate when metoprolol is administered with digoxin? Bradycardia A health care provider prescribes milrinone for a client with congestive heart failure. Which action would the nurse perform first? Have the prescription, dosage calculations, and pump settings checked by a second nurse Which care plan would the nurse implement for an infant admitted to the pediatric unit with the diagnosis of heart failure? Offer the infant small, frequent feedings
Which parent education would the nurse provide as rationale for gavage feedings in an infant with congestive heart failure? The energy that would have been expended on suckling is conserved Which assessment finding for a client with heart failure who is taking digoxin will be most important to communicate to the health care provider? Premature ventricular contractions Which statement made by the nursing student requires correction regarding the effect of applying the Roy adaptation model on improved functional status in clients with heart failure? Use of literature resources supports practical-based nursing interventions." The nurse assesses bilateral +4 peripheral edema while assessing a client with heart failure and peripheral vascular disease. Which is the pathophysiological reason for the excessive edema? Shift of fluid into the interstitial spaces A client with heart failure is to receive digoxin. Which therapeutic effect is associated with this medication? Slows and strengthens cardiac contractions
Tell the client that it might be helpful to talk with family members during the initial visit. Which finding for a client who has just arrived in the emergency department and has a history of heart failure requires the most rapid action by the nurse? Oxygen saturation 86% When a client is diagnosed with left-sided congestive heart failure, which assessment findings would the nurse expect? Select all that apply.. Dyspnea Crackles Frequent cough When assessing a client with chronic heart failure, which clinical finding would the nurse expect to find? Dependent edema in the evening When a client with heart failure reports sudden dyspnea and has bilateral crackles throughout the lungs with a respiratory rate of 32 breaths/minute, which action would the nurse take first? Elevate the head of the bed to 75 degrees.
When taking the health history for a client admitted with heart failure, which assessment finding will the nurse expect the client to report? Using several pillows at night to sleep When a client with heart failure is seen in the clinic with new onset ankle edema, the nurse would question the client about which lifestyle factors that may have contributed to the ankle swelling? Select all that apply.. Intake of salty foods Medication compliance Recent travel How would anxiety affect outcomes for a client with heart failure? Increases the cardiac workload When a client with heart failure reports a 9-pound (4-kilogram) weight gain in the past 2 weeks, which assessment is the priority? Auscultate breath sounds. Which statement by a client who is seen for follow-up in the heart failure clinic is most important for the nurse to communicate to the health care provider?
When caring for a client with heart failure, which type of lung sounds would the nurse expect to hear? Crackles When reviewing laboratory results for a client with heart failure who has been receiving furosemide daily, the nurse notes a blood urea nitrogen (BUN) of 42 mg/dL (15.2 mmol/L) and a creatinine of 1.1 mg/dL (97 mcmol/L). Which action by the nurse is a priority? Notifying the health care provider about the results Which topics would be included when teaching a client with heart failure who will be discharged with a new prescription for digoxin? Select all that apply.. Take your radial pulse daily and write it down. Notify the health care provider if you develop any vision changes Call the health care provider if your pulse is irregular or less than 60 beats/minute When an older client with heart failure is transferred from the emergency department to the medical service, which would the nurse on the unit do first? Assess the client's heart and lung sounds
When teaching a client with heart failure about signs and symptoms that indicate a need to contact the primary health care provider, which clinical manifestations would the nurse include? Select all that apply.. Extreme fatigue Coughing at night Difficulty breathing Which medication prescribed for a client with an acute episode of heart failure would the nurse question? Beta blocker When caring for a client who was admitted with heart failure, which action by the nurse will be most effective in determining whether the client's fluid overload is improving? Weighing the client Which statement by a client is consistent with a diagnosis of heart failure? "I have trouble breathing when I climb a flight of stairs. Which finding would the nurse expect when caring for a client with right-sided heart failure?
Which suggestion would the nurse make for a client with heart failure? Avoid emotionally stressful situations Which would the nurse do to help alleviate the distress of a client with heart failure and pulmonary edema? Place the client in the orthopneic position The nurse is caring for a client who is admitted to the hospital for medical management of heart failure and severe peripheral edema. Which clinical indicator associated with unresolved severe peripheral edema would the nurse initially assess? Tissue ischemia The heartbeat assessment of four clients is given below. Which client is at an increased risk for right-sided heart failure? Bilateral pressures higher than 2.5 cm are considered elevated and are a sign of right-sided heart failure. Client A has both right and left jugular venous pressure above 2.5 cm. This client is at risk for right-sided heart failure. One-sided pressure elevation is caused by obstruction, as observed in clients B, C, and D.
A neonate with heart failure is prescribed furosemide. Which changes to the dosage or time intervals between doses would the nurse make? The time between doses should be lengthened Which nursing interventions promote safe administration of digoxin in a child diagnosed with heart failure? Select all that apply.. Checking for compliance with the client's medication regimen Monitoring the client's serum potassium and magnesium levels regularly Calculating the correct dosage form, prescribed amounts, and the prescriber's prescription Monitoring and recording the client's intake and output, heart rate, blood pressure, daily weight, and respiration rate regularly Which education would the nurse teach the parents of an infant with a cardiac defect about an early sign of heart failure? Increased heart rate When assessing a client with heart failure for activity tolerance, which activity would the nurse expect to cause the most distress for the client? Climbing a flight of stairs to the bedroom
How can the nurse describe heart failure to a client? an inability of the heart to pump blood in proportion to metabolic needs Which action would the nurse manager employ during implementation and evaluation of a quality improvement project to decrease hospital readmissions for heart failure clients? Select all that apply.. Meeting regularly with staff throughout project implementation Using readmission data for heart failure clients to evaluate project effectiveness Collaborating with staff to address continuing high readmission rates post-project implementation Ensuring that staff are provided time to participate in development and implementation of the new project Coaching staff on effective implementation of the transition of care for heart failure clients being discharged Which action would the nurse include in the plan of care for a client admitted with heart failure who has gained 20 pounds in 3 weeks? Select all that apply.. Diuretics Low-salt diet Daily weight checks Fluid restriction
Intake and output Oxygen administration Which parameter would the nurse assess in a client with right-sided heart failure? Select all that apply.. Fluid volume The client with congestive heart failure is receiving furosemide 80 mg once daily. Which data collection assessment would be performed to evaluate medication effectiveness? Select all that apply.. Daily weight Intake and output Monitor for edema Daily pulse oximetry Auscultate breath sounds Which assessment finding of a client with heart failure would prompt the nurse to contact the health care provider? Select all that apply.. Fatigue Orthopnea Pitting edema Dry hacking cough
