07-07-2024 MS Exam

As prepared and rationalized by Dr. Ferrer, MD, PhD

A 65-year-old patient underwent an annual medical checkup. Which of the following is a risk factor for the development of coronary artery disease?

Low levels of HDL cholesterol
Low levels of LDL cholesterol
Low concentration of triglycerides

A nurse receives emergency laboratory results for a client with chest pain and immediately informs the physician. An increased brain natriuretic peptide (BNP) suggests which of the following?

Pericarditis
Endocarditis
Heart failure
Myocardial damage

For a 72-year-old client with edema in the leg and periorbital area, the most important nursing diagnosis is:

Pain related to deteriorating health status
Decreased fluid volume related to fluid retention and altered compensatory mechanisms
Decreased ejection fraction related to reduced myocardial contractility
Impaired airway clearance related to accumulation of secretions

A patient who is receiving digitalis preparations should be observed for symptoms of toxicity, which include:

Edema
Bleeding
Vomiting
Tinnitus

Which of the following will appear abnormal in the ECG when there is hypokalemia?

Prolonged PR interval
ST segment changes
Peaked T wave
Prolonged QT interval

What is the drug of choice in a patient with symptomatic 2 degree Mobitz 2 AV block?

Epinephrine
Atropine
Adenosine
Amiodarone

A 54-year-old patient was admitted with MI, the nurse remembers that the blood test most indicative of cardiac damage is:

Leukocytosis
Troponin I
CKMM
CBC

A client with pericarditis should be monitored for:

Hypovolemic shock
Myocardial infarction
Tamponade signs
Pneumonia

From an ECG reading, P waves represent:

Ventricular depolarization
End of ventricular depolarization
Ventricular repolarization
Atrial depolarization

Which of the following statements by Mr. Z to the nurse indicates a risk factor for CAD?

“My sister had history of endocarditis.”
My total cholesterol is 187 mg/dL
My HDL level is 12 mg/dL
I exercise thrice a week only

Which of the following represents myocardial ischemia?

ST depression
ST segment elevation
Prolonged PR interval
Absent P wave

Which of the following presentations of angina mimics MI?

Anginal pain that does not produce clenching of the fists over the chest
Anginal pain radiates to the left arm
Anginal pain that usually lasts only 3 to 5 minutes
Anginal pain that is usually relieved by rest

You have given streptokinase for a patient as prescribed by the physician. The reason for this is related to?

To dissolve blood clot
To prevent blood clot
Prevent bleeding
To reduce heart work

Atherosclerosis may produce:

Inflammation of the endocardium
Plaque that obstructs the artery
May increase the risk of VHD
Plaque that obstructs the artery

Which of the following hemodynamic monitoring methods would you expect to be placed to monitor pressure at the right side of the heart?

Central Venous Pressure Catheter
Swan Ganz Catheter
Pulmonary Artery Catheter
Coronary Stent

The Swan Ganz catheter:

Evaluates intra-arterial BP
Evaluates myocardial ischemia
Provides information about pulmonary resistance
Monitors ejection fraction of the heart

Which of the following nursing assessments indicates right ventricular failure in a client?

Paroxysmal nocturnal dyspnea
Pink, frothy sputum
Icteresia
Decrease oliguria

A low fat, low salt diet is prescribed upon discharge to the client who had heart failure. Which is a good food selection for this diet?

Fruit slices
Yogurt with meat
Cheese and macaroni salad
Half chicken salad sandwich

A client with heart failure is receiving digoxin. Which parameter should be checked prior to administering digoxin?

Respiratory rate
Blood pressure
Apical pulse
Heart rate

A client with heart failure starts to complain of seeing green halos around lights. You review his medications and determines this is mostly caused by a high level of:

Furosemide
Metoprolol
Captopril
Digoxin

Which of the following nursing assessments is associated with left-sided heart failure?

Paroxysmal nocturnal dyspnea
Hepatomegaly
Jaundice
Crackles

Which of the following is true for thrombolytics?

A piece of internal mammary artery is used to bypass the blocked section of artery
A clot dissolving drug is administered through IV
A catheter is placed next to the plaque blocking artery, then a balloon is inflated to crush the plaque.
A tiny rotating blade is used to scrape off plaque that is blocking an artery.

The nurse is aware that the treatment for supraventricular tachycardia includes:

Epinephrine
Adenosine
Dopamine
Atropine

The nurse is aware that asking the patient to cough may be done in patients with:

Ventricular fibrillation
Atrial fibrillation
Ventricular tachycardia
Supraventricular tachycardia

Which of the following medication below will the nurse expect to be given for a patient with wide QRS ECG, with pulse?

Atropine
Amiodarone
Digoxin
Adenosine

The client has experienced cardiac arrest and the nurse is performing CPR. The correct position of the nurse hand on the client’s chest is?

Over the xiphoid process and upper half of the sternum
Over lower half of the sternum
Three finger-widths below the sternal notch
Two finger-widths above the sternal angle

During a cardioversion attempt, which strategy improves safety?

Checking the RR of the patient
Blood pressure monitoring
A verbal and visual check of “All Clear”
Stand in alignment with the bed while administering shock

Based on the knowledge of the nurse about coronary blood flow, the coronary arteries receive blood flow during:

Inspiration
Expiration
Systole
Diastole

On an ECG tracing of a patient with ischemia, which would most likely initially present?

Wide QRS complex: PVC, V-Tach
ST depression: Ischemia
Absent P wave: Atrial Fibrillation
Peaked T wave: Hyperkalemia Rationalization:

As the client being assessed, the nurse is aware that the earliest sign of shock is:

Decreased urine output
Presence of S4
Cyanosis
Altered level of consciousness

The nurse plans the care of the client with cardiac tamponade, knowing that the initial goal for it is:

Correct hypertension
Improve ventricular filling
Correct arrhythmia
Prevent infarction of the tissue

Which of the following conditions may result in endocarditis?

Recurrent dental abscess
Alcoholism
Smoking
Low HDL levels Rationalization:

Which of the following medications will the nurse anticipate to be given to a cilent with symptomatic bradycardia? - Adenosine - Amiodarone - Atropine - Metoprolol Rationalization:

The client with chronic kidney disease was discharged after three days of admission from pyelonephritis. He was prescribed with Epogen and Bicarbonate. Which of the following would be expected as their lab values when the admitted?

pH 7.32, pCO₂ 19, HCO₃ 19
pH 7.43, pCO₂ 31, K⁺ 4.4
WBC 5.0, K⁺ 5.3, Hgb 19
pH 7.16, paCO₂ 54, Na⁺ 135

The nurse has the following patients for triage; who is placed on a yellow tag?

A 54-year-old client with ST elevation
A 32-year-old client with cystitis for 2 days admitted with WBC of 12,000
A 67-year-old elderly client with a history of 2 days loose bowel movement
A 46-year-old obese client admitted for supraventricular tachycardia 48 hours ago

Which of the following nursing diagnoses would you select as being appropriate for an obese patient with reduced exercise tolerance?

Fluid volume deficit
Ineffective airway clearance
Impaired gas exchange
Altered cardiac output: decreased

Friction rub assessment in clients with pericarditis involves:

Auscultation of the chest
Percussion
Palpation of the point of maximal impulse
Auscultation of the heart

The nurse has noted a serum sodium level of 112 mEq/L for a patient with a head injury. They are planning to institute seizure precautions for a client who is being admitted from the emergency department. Which of the following measures would the nurse not include in planning for the client’s safety?

Padding the side rails of the bed
Storing a padded tongue blade at the head of the bed
Placing an airway, oxygen, and suction equipment at bedside
Having intravenous equipment ready for insertion of an intravenous catheter

Which of the following should be at the bedside when the ECG of a 62-year-old male admitted at the coronary care unit displays a heart rate of 43?

Adenosine
Atropine
Epinephrine
Levophed

Which of the following is an appropriate nursing diagnosis for a client with cholelithiasis?

Potential for fluid excess
Pain
Ineffective breathing pattern
Imbalanced nutrition: less than body requirements

A patient with ascites from chronic hepatitis B is scheduled for a paracentesis. What is the best patient preparation instruction before the procedure?

Avoid high residue diet prior to the procedure.
Empty bladder prior to the procedure.
Do not eat anything for 12 hours before the test.
Avoid stimulants and alcohol for 24 to 48 hours before the test.

Which priority nursing diagnosis is appropriate for a 32-year-old client with a random blood sugar reading of 400 mg/dL?

Risk for social isolation
Fluid volume deficit
Imbalanced nutrition more than body requirements
Altered bowel movement

A 54-year-old male with portal hypertension that developed coffee ground vomitus has been placed on NGT for:

Provision of enteral feeding
Decompression
Monitor bleeding episodes
Establishing an enteric medicine route

Mr. A with diabetes mellitus was admitted due to a 50% TBSA 2nd degree burn wound. Which of these signs and symptoms is specifically observed in the client?

Red, dry, blanching skin
White, painless wound
Blistered, weeping wound
Erythema around the burn area

To guide you in your assessment of the client’s corneal reflex, which item will you utilize?

Penlight
Snellen’s chart
Cotton
All of the above

The Trigeminal nerve (CN V) affects which of the following?

Eye movement
Pupil response
Sight
Corneal reflex

A client is using a sealed source of radiation therapy for cancer. Which of the following is an important measure?

Limiting the visitor’s time with the client to less than 60 minutes in a day.
Keeping a lead-line container and long forceps in the client’s room.
Instructing visitors to maintain a distance of about 4 feet from the client.
Reminding the client to flush the toilet several times after each use.

A client on chemotherapy had a tumor lysis syndrome. The nurse understands that appropriate nursing care for this client would include:

Reducing the intake of vitamin A for oral replacement.
Handling the client gently to prevent pathologic fractures.
Limiting fluid intake.
Administering an antiemetic as ordered to reduce the syndrome.

A client has a WBC count of 6, and a platelet count of 120. Which measure is appropriate?

Advise the client avoid flossing their teeth before and after meals.
Encourage the client to rinse their mouth with saline every 1 to 2 hours while awake.
Keep the client on a low-fiber diet.
Limiting visitors every day.

An LF on chemotherapy should have which of the following measures implemented?

Place the client on enteric isolation
Advise to have low fiber diet
Limit hydration
Encourage eating fresh fruits and vegetables

If the client finds a reading of 9 mg/dL during chemotherapy, the appropriate nursing diagnosis is:

Risk of infection
Risk of aspiration
Risk of bleeding
Risk of falls

Which of the following symptoms usually occurs in early multiple sclerosis?

Diplopia
Tremor and shuffling gait
Ascending paralysis
Recent memory loss

Which of the following measures would be avoided in teaching for Kurt with multiple sclerosis to avoid an exacerbation of the disease?

Patching the affected eye
Providing a diet as tolerated
Taking hot baths for relaxation
All of the above

Which of the following statements is true of myasthenia gravis?

A myasthenic crisis is caused by overmedication of anticholinesterases
A cholinergic crisis is caused by under medication of anticholinesterases
Atropine is the antidote for Tensilon Test
An electromyographic confirmation of the diagnosis of myasthenia gravis

Which of the following nursing actions is initial in caring for an acute asthma attack?

Place him on orthopneic position
Stay with him at the bedside
Anticipate an ABG order
Administer albuterol nebulization

Which of these drugs are a bronchodilator?

Montelukast
Hydrocortisone
Albuterol
Prednisone

A nurse assesses the water seal camber of a closed chest drainage system and notes fluctuations in the chamber. This indicates that:

An air leak is present.
The tubing is kinked.
The lung has re-expanded.
The system is functioning as expected.

Four hours ago, a chest tube connected to a closed water seal system was placed on a patient with tension pneumothorax. Which assessment finding should be reported immediately?

There is intermittent bubbling in the water seal chamber
There is continuous bubbling in the water seal chamber
There is serosanguinous drainage in the collection chamber
There is no subcutaneous emphysema in the affected lung

The nurse understands that DPT immunization will provide:

Natural immunity
Acquired immunity
Innate immunity
Passive immunity

A 67-year-old client with left ventricular failure has been taking furosemide (Lasix) and was just started on digoxin (Lanoxin). The nurse must check the client’s most recent:

Digoxin level
Sodium level
Potassium level
Creatinine level

A nurse is teaching a client how to mix regular insulin and NPH insulin in the same syringe. Which of the following actions, if performed by the client, indicates the need for further teaching?

Reads the NPH insulin vial
Withdraws the NPH insulin first
Gently rolls the vial between their palms
Withdraws the regular insulin first

A nurse has given a client taking ethambutol information about the medication. The client understands the instructions if the client states to immediately report:

Tingling sensations
Difficulty in differentiating red and green colors
Impaired sense of hearing
Orange-red discoloration of body secretions

A client on Digoxin has a serum potassium level of 2.7 mEq/L and is complaining of anorexia. What is the therapeutic serum level of digitalis?

0.5 to 2.0 ng/mL
1.2 to 2.8 ng/mL
3.0 ng/mL
3.5 ng/mL

Which clinical findings would the nurse most likely note during an Addisonian crisis?

Serum potassium level of 3.2 mEq/L, BP of 150/80
Serum potassium level of 5.9 mEq/L, BP of 70/50
Serum sodium level of 150 mEq/L, BP of 160/70
Serum sodium level of 135 mEq/L, BP of 60/40

The nurse’s immediate action for a client with a COPD exacerbation would be?

Suctioning the client’s secretions
Place the client in a high fowler’s position
Begin assembling medications that will be given
Call the respiratory therapy department for a ventilator

What early symptom would the nurse ask for a male client with UTI?

Dysuria
Nocturia
Decreased force in the urine stream
Flank pain

A client with chronic kidney disease secondary to diabetic nephropathy is on dialysis. Which indicators would the nurse use to evaluate the client’s status post-dialysis?

Potassium level and sodium
BUN and creatinine level
Vital signs and urine output
Vital signs and weight

Tonometry is used for a client with glaucoma. The nurse remembers that the normal intraocular pressure is:

2 to 7 mm Hg
8 to 21 mm Hg
22 to 30 mm Hg
31 to 35 mm Hg

A client is scheduled for enoxaparin therapy. Based on the client history, which would be an absolute indication for this medication?

Hypertension
Peripheral arterial disease
Heart failure
Prosthetic valve replacement

A 28-year-old female had a lumbar puncture for CSF analysis. The nurse would place the client in which position for the procedure?

Side-lying with legs pulled up and head bent down onto chest
Side-lying with a pillow under the hip
Elevated at 30 degrees
Flat on bed

A client has just undergone intravenous pyelography. Which would be an appropriate post-procedure care instruction?

Eat lightly during the day
Rest and keep your feet dangling
Hold medications for at least 4 hours
Force fluids for the day

The nurse assesses a client with a tentative diagnosis of emphysema. Which of the following distinguishes emphysema from asthma?

Copious sputum with an increased anteroposterior diameter of the chest
Distended neck vein with crackles
Minimal weight loss
Cough lasing 2 months for 3 years

Which nursing action is the most appropriate when planning to obtain a sputum specimen?

Provide the client with generous fluid intake
Encourage the client to change positions regularly
Ask the dietitian to send the client a clear liquid diet
Administer an antitussive prior to collecting the specimen

Which drug is used when there is symptomatic bradycardia?

Atropine
Epinephrine
Adenosine
Amiodarone

Which diagnostic examination is most appropriate for dengue fever?

Peripheral blood smear
RT-PCR
Bone marrow biopsy
Epogen injection

What is the nursing management for a client with azotemia?

Dietary management
Recreation therapy
Blood transfusion
Epogen injection

With which of these should you keenly observer in a client on anticoagulants?

Developing rashes
Developing systemic fungal infection
Developing petechiae
Developing fever blister

A client who underwent modified radical mastectomy on the right is brough to the recovery room. Which is an essential nursing action?

Wrapping the right arm with the blood pressure cuff
Allowing the patient to stay on bed rest for 48 hours
Elevating the right arm
Allowing the affected leg to dangle

Which of the following arterial blood gas results would be found in vomiting?

pH 7.32, pCO₂ 45, HCO₃ 17, pO₂ 90
pH 7.46, pCO₂ 30, HCO₃ 29, pO₂ 80
pH 7.31, pCO₂ 55, HCO₃ 22, pO₂ 50
pH 7.47, pCO₂ 40, HCO₃ 36, pO₂ 78

The nurse ensures this medication is ready for a client on warfarin:

Vitamin K (Aquamephyton)
Digibind
Enoxaparin
Protamine Sulfate

Several patients are admitted from a vehicular accident. Which of the following is assessed in a patient with an increased ICP?

Increasing temperature, pulse, respirations, and decreasing blood pressure
Increasing temperature, blood pressure, and decreasing pulse and respiration
Decreasing temperature, pulse, blood pressure, and increasing respirations
Decreasing temperature, respirations, and increasing pulse and blood pressure

A 30-year-old is treated in the emergency room for a fractures left ankle. Which instructing the client for ambulating with crutches, the nurse most appropriate teaches the client to:

Place the crutches under the arms, bear weight on the axilla, and position both crutches 8 to 10 inches in front of the body
Move the right foot and left crutch together, then the left foot and right crutch
Move crutches and feet in the following sequence: right crutch, left foot, left crutch, right foot
Move both crutches and the left foot forward simultaneously, followed by the right foot

Basic principles in the management of patients with osteoarthritis include:

Activity with joint splinting
Rest and pain relief
Antiinflammatory drugs with dietary modifications
Alternating heat and cold treatments

A patient with rheumatoid arthritis is taking NSAIDs. They should be observed for:

Gastritis
Inflammatory Bowel Disease
Urinary Tract Infection
Hearing Loss

The pathophysiology of osteoarthritis is characterized by:

Degeneration of the articular cartilage
Spur formation at the joint surfaces
Infection of the endosteal bone
Inflammation of the synovium

What would be the primary goal for a client with Endocarditis?

Improve respiratory rate
Decrease exercise tolerance
Prevent heart failure
Decrease peripheral edema

Hypertension is defined as persistently elevated systolic and diastolic pressure above:

170/100
200/80
140/90
170/90

A 56-year-old client is receiving digoxin (Lanoxin) following discharge. The nurse should be primarily concerned with:

Assessing the client for changes in urine output and planning activity at home based on tolerance
Observing the client for the return of and for adverse effects of the drug
Monitoring appetite and encouraging gradual increase in activities of daily living
Taking the apical pulse before drug administration and teaching the client how to count the pulse rate

All of the following present changes in an ECG, except:

Liver failure
Kidney failure
Electrolyte imbalance
Hypoparathyroidism

Which ECG aspect would be altered in a heart block?

T wave
PR interval
QRS complex
P wave

The nurse identifies which medication to be a vasodilator to have an adverse effect of coughing:

ACE Inhibitors
Morphine sulfate
Nitroglycerin
Beta blockers

During a life-threatening arrythmia such as ventricular tachycardia, the nurse keeps which of the following in mind:

Checking the patient’s pulse
Time when the client loses consciousness
To ask the client’s medication chart
To check the latest urine output of the client

In reducing the risk of endocarditis, good dental care is an important measure. To promote good dental care in clients with tricuspid regurgitation, the teaching plan includes the proper use of:

Firm toothbrush
Electric toothbrush
Dental floss
Alcohol-based mouthwash

During the first several hours of chest tube thoracostomy insertion, it would be most essential for the nurse to:

Frequently monitor the client’s apical pulse and blood pressure
Monitor the client’s respiratory rate every hour
Elevate the client’s bed at forty-five degrees
Instruct the client to cough and perform deep breathing exercises every 2 hours

A 22-year-old client with dry oral mucosa is admitted to the emergency room. She has tachycardia and pale skin. Which step in the nursing process is demonstrated in this scenario?

Planning
Analysis
Implementation
Evaluation

A client with endocarditis should be closely monitored for which complication of valve replacement?

Hypertension
Cardiomyopathy
Cardiac tamponade
Thrombophlebitis

A client has been diagnosed with stage 2 hypertension. The priority nursing diagnosis would be:

Pain
Impaired skin integrity
Deficient fluid volume
Ineffective health maintenance

A patient is hospitalized following myocardial infarction. He inquires about why Atorvastatin is prescribed. The nurse explains that the medication:

Helps prevent arrythmias of the heart
Dilates coronary blood vessels
Encourages bed rest and passive ROM
Encourages deep breathing and coughing exercises

A nurse teaches the client with angina about the common expected side effects of nitroglycerin including:

Hypertension
Headache
Rashes
Increased urine output

NNN

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07-07-2024 MS Exam

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