Medical Surgical Question: A 60-year-old female with a history of hypertension and atrial fibrillation is scheduled for elective surgery. She takes daily metoprolol for heart rate control. What is the most appropriate action regarding her beta-blocker therapy before surgery?
A) Continue metoprolol therapy as usual
B) Discontinue metoprolol 24 hours before surgery
C) Switch to a different beta-blocker before surgery
D) Administer an additional dose of metoprolol before surgery
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Explanation: In patients with hypertension and atrial fibrillation scheduled for surgery who are taking metoprolol, it is generally recommended to continue metoprolol therapy as usual (Option A) to maintain heart rate control and prevent exacerbation of cardiovascular symptoms. Abruptly discontinuing metoprolol (Option B) can lead to rebound hypertension and tachycardia. Switching to a different beta-blocker (Option C) is not typically necessary unless there are specific concerns or indications. Administering an additional dose of metoprolol (Option D) before surgery is not routinely required for patients on stable beta-blocker therapy. Cardiac, Cardiovascular
POP QUIZ Medical Surgical Question
@qbankproacademy 4000+ Free NCLEX QUESTIONS. Go to QBankProAcademy.com FREE Qbank questions for NCLEX RN, PN, HESI Exit, Med Surg, AANP, ANCC, and HesiA2. Practice questions, quizzes, and listen to the Free Podcast. In this video, we review a question on a LOOP DIURETIC, FUROSEMIDE in Nursing Care. At QbankproAcademy.com our mission is to provide free QBanks, videos, and the most up to date test prep information for nurses. If you find our website helpful, please tell other aspiring nurses, nursing students, and professors. Please link to our site from your blogs, videos, and college websites, or share us on your favorite social media sites. Thank you for your support! Free nursing NCLEX 60-DAY CHALLENGE https://qbankpro.thinkific.com/courses/qbankpro-academy nclex Nurses Nursing aanp qbank ancc hesi medsurg qbank
Medical Surgical Question: A 45-year-old male with a history of heart failure is scheduled for elective surgery. He takes daily digoxin for heart rate control. What is the most appropriate action regarding his digoxin therapy before surgery?
A) Continue digoxin therapy as usual
B) Discontinue digoxin 24 hours before surgery
C) Switch to a different heart rate control medication before surgery
D) Administer an additional dose of digoxin before surgery
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Explanation: In patients with heart failure scheduled for surgery who are taking digoxin, it is generally recommended to continue digoxin therapy as usual (Option A) to maintain heart rate control and prevent exacerbation of cardiovascular symptoms. Abruptly discontinuing digoxin (Option B) can lead to worsening heart failure and arrhythmias. Switching to a different heart rate control medication (Option C) may not be necessary unless there are specific concerns or indications. Administering an additional dose of digoxin (Option D) before surgery is not typically required for patients on stable digoxin therapy. Cardiac, Cardiovascular
Medical Surgical Nursing Questions: Cardiovascular Questions
Medical Surgical Question: A 65-year-old male with a history of heart failure presents with fatigue and generalized muscle weakness. His serum potassium level is 3.0 mEq/L. Which intravenous (IV) medication is the initial treatment of choice to acutely raise his potassium levels?
A) Calcium gluconate
B) Sodium bicarbonate
C) Potassium chloride
D) Magnesium sulfate
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Explanation: This patient presents with severe hypokalemia (low serum potassium levels) with symptoms of muscle weakness. The initial treatment of choice to acutely raise potassium levels is Potassium chloride (Option C). Potassium replacement is essential in hypokalemia to prevent cardiac and muscular complications. Calcium gluconate (Option A) is used for hyperkalemia, not hypokalemia. Sodium bicarbonate (Option B) is not the primary treatment for potassium replacement. Magnesium sulfate (Option D) may be indicated if there is concurrent magnesium deficiency, but potassium replacement should be prioritized. Electrolytes, Intravenous fluids, Cardiac, Cardiovascular
Medical Surgical Question: A 50-year-old male with a history of chronic kidney disease presents with muscle weakness and ECG changes indicative of hyperkalemia. His serum potassium level is 7.2 mEq/L. Which intravenous (IV) medication is the initial treatment of choice to acutely lower his potassium levels and stabilize his cardiac rhythm?
A) Calcium gluconate
B) Sodium bicarbonate
C) Furosemide (Lasix)
D) Sodium polystyrene sulfonate (Kayexalate)
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Explanation: Hyperkalemia, characterized by elevated serum potassium levels, can have serious cardiac consequences, including arrhythmias. The initial treatment for severe hyperkalemia is to stabilize the cardiac membrane potential. Calcium gluconate is the appropriate choice as it counteracts the effects of elevated potassium on the heart and stabilizes cardiac rhythm. Sodium bicarbonate may be used in some cases to shift potassium into cells temporarily but does not provide immediate cardiac stabilization. Furosemide (Lasix) can increase potassium excretion but is not the primary treatment for acute hyperkalemia. Sodium polystyrene sulfonate (Kayexalate) is used for non-urgent management of hyperkalemia but is not effective for acute correction of high potassium levels. Electrolytes, Cardiac, Cardiovascular
Cardiovascular System: Medical Surgical Nursing Questions
Medical Surgical Question: A 60-year-old female with a history of heart failure is scheduled for elective surgery. She takes a daily dose of furosemide (Lasix) for fluid management. What is the most appropriate action regarding her diuretic therapy before surgery?
A) Continue furosemide therapy as usual
B) Discontinue furosemide 24 hours before surgery
C) Switch to a thiazide diuretic before surgery
D) Administer a potassium-sparing diuretic before surgery
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Explanation: In patients with heart failure scheduled for surgery, it is generally recommended to continue furosemide (Lasix) therapy as usual (Option A) to maintain fluid balance and prevent exacerbation of heart failure symptoms. Discontinuing furosemide (Option B) can lead to fluid retention and worsening heart failure. Switching to a thiazide diuretic (Option C) or administering a potassium-sparing diuretic (Option D) is not typically necessary before surgery unless there are specific indications based on the patient’s clinical status. Cardiac, Cardiovascular
Medical Surgical Nursing Practice Questions: Cardiovascular Review
Medical Surgical Question: A 55-year-old female is undergoing a total knee replacement surgery. The surgeon has just made an incision and is preparing to dissect through the tissue layers. Suddenly, the patient experiences a significant drop in blood pressure and heart rate. What is the most likely cause of this intraoperative hemodynamic instability?
A) Anesthesia-induced hypotension
B) Surgical site infection
C) Allergic reaction to surgical drapes
D) Hemorrhage into the surgical site
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Explanation: Intraoperative hemodynamic instability with a sudden drop in blood pressure and heart rate is most likely due to hemorrhage into the surgical site (Option D). This can occur when a blood vessel is inadvertently injured during the surgical dissection. Anesthesia-induced hypotension (Option A) is less likely to cause a sudden drop in both blood pressure and heart rate. Surgical site infection (Option B) and allergic reactions to surgical drapes (Option C) typically do not manifest as sudden hemodynamic instability during surgery. Cardiac, Cardiovascular
Medical Surgical Nursing Questions: Heart Failure Review
Medical Surgical Question: A 55-year-old male underwent open-heart surgery. On the third postoperative day, he develops a fever, productive cough, and increased sputum production. What is the most likely postoperative complication, and what should the nurse do?
A) Atelectasis; encourage deep breathing exercises
B) Surgical site infection; administer antibiotics
C) Pneumonia; notify the healthcare provider
D) Wound dehiscence; apply sterile dressings
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Explanation: The fever, productive cough, and increased sputum production are indicative of pneumonia, a common postoperative complication, especially after open-heart surgery. The nurse’s immediate action should be to notify the healthcare provider (Option C) for further evaluation and treatment. While deep breathing exercises (Option A) are important for preventing atelectasis, they are not the primary intervention for pneumonia. Administering antibiotics (Option B) without a proper evaluation and diagnosis could delay appropriate treatment. Wound dehiscence (Option D) is unrelated to the respiratory symptoms described. Cardiac, Cardiovascular
Medical Surgical Nursing Questions: Heart Disorders
A) Pneumonia; notify the healthcare provider
B) Surgical site infection; administer antibiotics
C) Atelectasis; encourage deep breathing exercises
D) Hemorrhage; apply pressure to the surgical site
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Explanation: The combination of fever, productive cough, and increased sputum production is suggestive of pneumonia, a common postoperative complication, especially after open-heart surgery. The nurse’s immediate action should be to notify the healthcare provider (Option A) for further evaluation and treatment, which may include chest imaging and antibiotics. While deep breathing exercises (Option C) are important for preventing atelectasis, they are not the primary intervention for pneumonia. Surgical site infection (Option B) and hemorrhage (Option D) do not align with the symptoms described. Cardiac, Cardiovascular
Medical Surgical Nursing Exam Questions: Preoperative Nursing Care
Medical Surgical Question 10: A 70-year-old male patient with a history of heart valve replacement presents with fever, chills, and sudden-onset severe back pain. A transesophageal echocardiogram reveals an aortic root abscess. What is the most appropriate initial treatment for this patient’s infective endocarditis?
A) Intravenous ceftriaxone and oral doxycycline
B) Intravenous vancomycin and gentamicin
C) Oral amoxicillin
D) Intravenous fluconazole
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Explanation: The presence of an aortic root abscess in a patient with a prosthetic heart valve indicates infective endocarditis. The initial treatment includes a combination of intravenous vancomycin and gentamicin to cover common pathogens associated with prosthetic valve endocarditis. Cardiac, Cardiovascular
Medical Surgical Nursing Practice Questions: Study Guide for Cardiovascular
Medical Surgical Question: An 80-year-old female patient is being discharged home after a recent hospitalization for heart failure exacerbation. She has a history of medication non-compliance and frequent readmissions. What is a crucial component of her home care plan to prevent readmissions?
A) Increasing the number of prescribed medications
B) Scheduling frequent in-person follow-up appointments
C) Providing written instructions in complex medical terminology
D) Medication reconciliation and education on proper medication management
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Correct Answer: D) Medication reconciliation and education on proper medication management
Explanation: Medication reconciliation and education on proper medication management are crucial components of the home care plan for preventing readmissions, particularly in patients with a history of medication non-compliance. Ensuring that the patient understands their medications, how to take them, and the importance of adherence can help reduce the risk of exacerbations and readmissions. Cardiac, Cardiovascular
Medical Surgical Nursing Questions: NCLEX Cardiovascular Review
Medical Surgical Question: A 70-year-old male patient with end-stage heart failure is discharged home with palliative care. He experiences severe shortness of breath and anxiety. What is the primary goal of palliative care in this patient?
A) Aggressive disease management
B) Prolonging life at all costs
C) Symptom management and improving quality of life
D) Curative treatments and interventions
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Explanation: The primary goal of palliative care for a patient with end-stage heart failure is to provide symptom management and improve the patient’s quality of life. Palliative care focuses on addressing symptoms, such as shortness of breath and anxiety, and providing emotional and psychosocial support to enhance comfort and overall well-being. It does not pursue aggressive disease management, curative treatments, or the goal of prolonging life at all costs, as hospice and palliative care prioritize comfort and dignity at the end of life. Cardiac, Cardiovascular
Medical Surgical Nursing Test Bank: Cardiovascular Questions
Medical Surgical Question: A 60-year-old male patient in hospice care due to end-stage heart failure is experiencing profound fatigue and shortness of breath. What nursing intervention is essential to improve the patient’s comfort and quality of life?
A) Initiating cardiopulmonary resuscitation (CPR) in case of respiratory distress
B) Administering high-dose diuretics to reduce fluid retention
C) Providing oxygen therapy at a high flow rate
D) Offering emotional support and assistance with symptom management
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Explanation: In hospice care for a patient with end-stage heart failure, the essential nursing intervention is to offer emotional support and assistance with symptom management. Initiating CPR, administering high-dose diuretics, or providing high-flow oxygen therapy may not align with the goals of hospice care, which prioritize comfort, dignity, and quality of life at the end of life. The focus should be on alleviating symptoms, addressing emotional and psychosocial needs, and ensuring a peaceful and comfortable transition. Cardiac, Cardiovascular
Medical Surgical Nursing Quiz: Cardiovascular
Medical Surgical Question: A 60-year-old male patient with a history of heart failure presents with sudden-onset dyspnea, chest pain, and hemoptysis (coughing up blood). His vital signs show tachycardia and hypotension. What is the most likely diagnosis in this critical situation?
A) Acute bronchitis
B) Pneumothorax
C) Pulmonary embolism
D) Pleural effusion
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Explanation: The patient’s sudden-onset dyspnea, chest pain, hemoptysis, tachycardia, hypotension, and history of heart failure raise concern for a pulmonary embolism. Pulmonary embolism occurs when a blood clot (typically from deep vein thrombosis) travels to the pulmonary arteries, obstructing blood flow to the lungs. This is a life-threatening condition requiring immediate medical attention. Cardiac, Cardiovascular
Cardiovascular Medications: Medical Surgical Nursing
Medical Surgical Question: A 60-year-old male patient with a history of congestive heart failure presents with paroxysmal nocturnal dyspnea, orthopnea, and increased peripheral edema. Which medication is commonly used in the management of acute exacerbations of congestive heart failure?
A) Proton pump inhibitor (PPI)
B) Intravenous (IV) diuretics
C) Inhaled corticosteroids
D) Antihypertensive medication
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Explanation: In the management of acute exacerbations of congestive heart failure (CHF), intravenous diuretics are commonly used to reduce fluid overload, alleviate symptoms like paroxysmal nocturnal dyspnea, orthopnea, and peripheral edema, and improve cardiac function by reducing preload. Proton pump inhibitors (PPIs), inhaled corticosteroids, and antihypertensive medications are not the primary treatment modalities for acute CHF exacerbations. Cardiac, Cardiovascular
NCLEX Cardiovascular Medications
Medical-Surgical Question: A 55-year-old patient who smokes is interested in quitting but is concerned about nicotine withdrawal symptoms. What is a common nicotine withdrawal symptom that this patient may experience?
Explanation: Nicotine withdrawal symptoms are common when individuals quit smoking. One of the common symptoms is elevated blood pressure. Nicotine is a vasoconstrictor, and when a person quits smoking, their body experiences a sudden absence of nicotine, leading to increased blood pressure as the blood vessels begin to dilate. Other withdrawal symptoms can include increased appetite, irritability, anxiety, and difficulty concentrating. It’s important for healthcare providers to educate patients about these symptoms and offer support and pharmacotherapy options to manage them during the quitting process. Cardiac, Cardiovascular
Which vital sign abnormality is commonly associated with sepsis?
Correct Answer:
Explanation: Tachycardia (fast heart rate) is commonly associated with sepsis. Sepsis often leads to an increased heart rate as the body tries to compensate for the infection and maintain perfusion to vital organs.
Which of the following is a common complication associated with tracheostomy care and suctioning?
Correct Answer:
Explanation: A common complication associated with tracheostomy care and suctioning is bradycardia. Stimulation of the vagus nerve during suctioning can lead to a decrease in heart rate. Nurses should monitor vital signs and intervene promptly if bradycardia occurs.
Cardiovascular Assessment: Medical Surgical Nursing Practice Questions
A 72-year-old patient is being discharged after a hospitalization for heart failure exacerbation. The patient lives alone and has difficulty managing medications. What should the nurse prioritize during discharge planning to ensure the patient’s safety and adherence to medication regimens?
Correct Answer:
Explanation: To ensure the safety and medication adherence of a patient with difficulty managing medications and living alone, the nurse should prioritize arranging for home health care services. Home health nurses can assist with medication management and provide necessary care.
An 80-year-old patient with heart failure is being discharged. The patient lives with a caregiver who assists with daily activities. What aspect of discharge planning should the nurse prioritize to support both the patient and the caregiver in managing the patient’s care at home?
Correct Answer:
Explanation: To support both the patient and the caregiver in managing care at home, the nurse should prioritize recommending respite care services. Respite care provides temporary relief to caregivers, allowing them to rest and recharge while ensuring the patient’s well-being.
Medical-Surgical Question 1: A 58-year-old patient presents with consistently high blood pressure readings. The patient reports occasional headaches and shortness of breath. What is the most likely diagnosis?
Correct Answer:
Explanation: The most likely diagnosis for this patient is hypertension, as indicated by consistently high blood pressure readings. Hypertension, or high blood pressure, is a common medical condition that is often asymptomatic but can lead to serious complications such as heart disease, stroke, and kidney problems. The occasional headaches and shortness of breath reported by the patient are potential symptoms of hypertension-related issues. Early diagnosis, lifestyle modifications, and medication management are essential for controlling hypertension and reducing the risk of complications.
Patient Case: A 60-year-old male with a history of ACS is scheduled for cardiac rehabilitation. The nurse should emphasize the importance of cardiac rehab for:
Explanation: Cardiac rehabilitation is essential for improving cardiovascular health, functional capacity, and reducing the risk of future cardiac events in patients with ACS.
Correct Answer:
Patient Case: A 60-year-old male with a history of infective endocarditis develops heart failure symptoms. Echocardiography reveals severe valve damage. What is the most appropriate treatment for this patient’s endocarditis-related heart failure?
Explanation: Severe valve damage in endocarditis may require surgical intervention, such as valve replacement surgery, to address the underlying cause of heart failure.
Correct Answer:
Patient Case: A 50-year-old male with pericarditis develops worsening shortness of breath and hypotension. What procedure may be indicated in this patient for both diagnosis and treatment?
Explanation: In a patient with pericarditis who develops hemodynamic instability, pericardiocentesis may be indicated for both diagnosis (to rule out cardiac tamponade) and treatment (to relieve cardiac compression).
Correct Answer:
Patient Case: A 45-year-old male in the intensive care unit (ICU) has developed severe hypotension. His central venous pressure (CVP) is low, and he has muffled heart sounds. What is the most likely cause of his condition?
Explanation: The combination of severe hypotension, muffled heart sounds, and low CVP is indicative of cardiac tamponade, a medical emergency that requires immediate intervention.
Correct Answer:
A 35-year-old male experiences severe bleeding following a car accident, leading to hemorrhagic shock. What is the primary goal of treatment in the management of hemorrhagic shock?
Explanation: The primary goal in the management of hemorrhagic shock is to control bleeding and replace lost fluids to restore perfusion and prevent further complications.
Correct Answer:
Patient Case: A 45-year-old female with hemorrhagic shock requires blood transfusion. Which blood component is typically transfused to restore oxygen-carrying capacity in this condition?
Explanation: Packed red blood cells (PRBCs) are typically transfused in hemorrhagic shock to restore oxygen-carrying capacity and improve tissue oxygenation.
Correct Answer:
Patient Case: A 50-year-old male with hemorrhagic shock is receiving crystalloid fluids. What is the primary purpose of administering crystalloid fluids in this situation?
Explanation: The primary purpose of administering crystalloid fluids in hemorrhagic shock is to expand intravascular volume and improve perfusion.
Correct Answer:
Patient Case: A 35-year-old male experiences severe bleeding following a car accident, leading to hemorrhagic shock. What is the primary goal of treatment in the management of hemorrhagic shock?
Explanation: The primary goal in the management of hemorrhagic shock is to control bleeding and replace lost fluids to restore perfusion and prevent further complications.
Correct Answer:
Patient Case: A 55-year-old female with peripheral vascular disease (PVD) develops an open ulcer on her lower leg. Which of the following interventions is essential for promoting wound healing in PVD patients?
Explanation: Ensuring adequate blood flow to the wound is essential for promoting wound healing in PVD patients. Elevation and revascularization may be necessary interventions.
Correct Answer:
Patient Case: A 60-year-old patient with coronary artery disease (CAD) presents with angina. The physician recommends a revascularization procedure. What is the primary difference between stenting and CABG in the treatment of CAD?
Explanation: The primary difference is that stenting is a minimally invasive procedure that uses a mesh-like device to keep arteries open, while CABG is open-heart surgery that creates new bypasses using vessels from elsewhere in the body.
Correct Answer:
A 70-year-old patient with heart failure presents with abdominal distension. Which type of fluid is typically removed during a paracentesis in patients with ascites due to heart failure?
A. Blood
B. Urine
C. Ascitic fluid
D. Mucus
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During a paracentesis in patients with ascites due to heart failure, the goal is to remove ascitic fluid, which is the fluid that accumulates in the abdominal cavity.
A 50-year-old patient with a history of heart disease is concerned about weight gain while taking medications. Which cardiovascular medication class is least likely to contribute to weight gain?
Diuretics are the cardiovascular medication class least likely to contribute to weight gain. In fact, diuretics are often used to reduce fluid retention and promote weight loss.
A 60-year-old patient with a history of hypertension and heart failure is admitted to the hospital. The patient is on a low-sodium diet. Which food item should the nurse encourage the patient to avoid?
For a patient on a low-sodium diet due to hypertension and heart failure, canned soups are often high in sodium and should be avoided to manage blood pressure and fluid retention.
A 50-year-old patient with heart failure is receiving diuretic therapy. The nurse is monitoring for signs of hypokalemia. What clinical manifestations should the nurse assess for?
Hypokalemia can lead to muscle weakness and ECG changes, including potentially life-threatening cardiac arrhythmias. Monitoring for these manifestations is essential in patients receiving diuretic therapy.