(Complete 140 Q&A) Med Surg II: Quiz Questions 2023 All with Correct Answers and Rationale |Garde A+

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A patient diagnosed with heart failure is started on the nitrate, isosorbide. After the initial dose, the patient reports a headache. Which action by the nurse is most appropriate? {{Ans:- Obtain an... order for acetaminophen and administer it to the patient or Inform the patient not to worry, headaches are common with this medication Rationale: It is not uncommon for patients to initially report H/A when beginning a nitrate medication The nurse is providing care to an elderly patient being admitted to the acute care facility to rule out mitral valve stenosis. The nurse is aware which information would be most significant? {{Ans:- The patient has a history of rheumatic fever Rationale: Most cases of adult mitral valve stenosis result from rheumatic carditis, with rheumatic fever being the most common cause of the problem Rationale: Most cases of adult mitral valve stenosis result from rheumatic carditis, with rheumatic fever being the most common cause of the problem Impaired cardiac function from left-sided (ventricular) failure results in: {{Ans:- Decreased cardiac output Rationale: Heart failure develop when the heart cannot effectively fill or contract with adequate strength to function as a pump to meet the needs of the body; and as a result, cardiac output falls The nurse is taking an admission history of a patient with right-sided heart failure. The nurse would expect the patient to report which of the following? {{Ans:- Anorexia, dependent edema, polyuria at night Rationale: Manifestations of right heart failure include: fatigue, dependent edema, JVD, murmurs, weight gain, night polyuria/ diuresis, anorexia, bloating, nausea, early saity, RUQ pain & hepatomegaly The nurse is providing discharge teaching for a patient being treated for hypertrophic cardiomyopathy. During discharge teaching, what is the most important information to include? {{Ans:- Make an appointment for genetic screening and counselling Rationale: Patient with HCM are encouraged to seek genetic counselling. First degree relatives should be screened for the presence of HCM, and an echocardiography should be offered starting at age 12 years The nurse is caring for a patient diagnosed with acute pericarditis. Which sound would the nurse expect to hear upon auscultation? {{Ans:- Pericardial friction rub Rationale: This is a characteristic sign & is produced by the inflamed pericardial layers rubbing against the chest wall or pleura The nurse would expect to note which signs/symptoms in a patient who has mitral stenosis? SELECT ALL THAT APPLY. {{Ans:- Dry cough, orthopnea, paroxysmal noctural dyspnea Rationale: Dry cough occurs when patient with long term valvular disease has difficulty breathing when walking or performing any type of activity; Orthopnea is an abnormal condition in which the patient must sit or stand to breathe comfortably and occurs in valvular disorders; Paroxysmal nocturnal dyspnea is a sudden attach of respiratory distress usually occurring at night b/c of the reclining position and occurs in valvular disorders The patient asks, "How did I get rheumatic carditis?" The most appropriate response by the nurse is that rheumatic heart disease is frequently a result of which of the following? {{Ans:- Streptococcal infection Rationale: Rheumatic fever is caused by an abnormal immune response to a pharyngeal group A beta-hemolytic streptococcal infection. About 10% of people with rheumatic fever develop RHD The three major determinants of left ventricular stroke volume are: {{Ans:- Preload, afterload, and myocardial contractility Rationale: Cardiac output depends on preload, afterload, myocardial contractility, and heart rate. Current treatment of HF includes meds to reduce fluid volume, decreased preload, decreased afterload, and augment contractility [Show More]

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