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SAUNDERS HESI MED SURG PT 2 Questions and Correct Answers | Latest Update
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A client is admitted to the emergency department with chest pain that is consistent with myocardial infarction based on elevated troponin levels. Heart sounds are normal and vital signs are noted on the client's chart. The nurse should alert the health care provider because these changes are ...

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  • September 28, 2024
  • 122
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

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  • saunders hesi med surg pt 2 questions and correct
  • a client is admitted to the emergency department w

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Best Grades | Must Pass | Latest Update | Correct Answers | 2024/ 2025


SAUNDERS HESI MED SURG PT 2 Questions
and Correct Answers | Latest Update
A client is admitted to the emergency department


with chest pain that is consistent with myocardial


infarction based on elevated troponin levels.


Heart sounds are normal and vital signs are noted


on the client's chart. The nurse should alert the


health care provider because these changes are


most consistent with which complication? Refer


to chart.




1. Cardiogenic shock


2. Cardiac tamponade


3. Pulmonary embolism


4. Dissecting thoracic aortic aneurysm


 1




Cardiogenic shock occurs with severe damage (more than 40%) to the left ventricle. Classic

signs include hypotension; a rapid pulse that becomes weaker; decreased urine output; and

cool, clammy skin. Respiratory rate increases as the body develops metabolic acidosis from



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, Best Grades | Must Pass | Latest Update | Correct Answers | 2024/ 2025

shock. Cardiac tamponade is accompanied by distant, muffled heart sounds and prominent

neck vessels. Pulmonary embolism presents suddenly with severe dyspnea accompanying the

chest pain. Dissecting aortic aneurysms usually are accompanied by back pain.




A client admitted to the hospital with chest pain and a history of type 2 diabetes mellitus is

scheduled for cardiac catheterization. Which medication would need to be withheld for 24

hours before the procedure and for 48 hours after the procedure?




1. Glipizide


2. Metformin


3. Repaglinide


4. Regular insulin


 2




Metformin needs to be withheld 24 hours before and for 48 hours after cardiac

catheterization because of the injection of contrast medium during the procedure. If the

contrast medium affects kidney function, with metformin in the system the client would be at

increased risk for lactic acidosis. The medications in the remaining options do not need to be

withheld 24 hours before and 48 hours after cardiac catheterization.




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, Best Grades | Must Pass | Latest Update | Correct Answers | 2024/ 2025

A client in sinus bradycardia, with a heart rate of 45 beats/minute, complains of dizziness and

has a blood pressure of 82/60 mm Hg. Which prescription should the nurse anticipate will be

prescribed?




1. Administer digoxin.


2. Defibrillate the client.


3. Continue to monitor the client.


4. Prepare for transcutaneous pacing


 4




Sinus bradycardia is noted with a heart rate less than 60 beats per minute. This rhythm

becomes a concern when the client becomes symptomatic. Hypotension and dizziness are signs

of decreased cardiac output. Transcutaneous pacing provides a temporary measure to

increase the heart rate and thus perfusion in the symptomatic client. Defibrillation is used for

treatment of pulseless ventricular tachycardia and ventricular fibrillation. Digoxin will further

decrease the client's heart rate. Continuing to monitor the client delays necessary intervention.




The nurse in a medical unit is caring for a client with heart failure. The client suddenly develops

extreme dyspnea, tachycardia, and lung crackles and the nurse suspects pulmonary edema.

The nurse immediately asks another nurse to contact the health care provider and prepares to

implement which priority interventions? (SELECT ALL THAT APPLY.)




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, Best Grades | Must Pass | Latest Update | Correct Answers | 2024/ 2025

1. Administering oxygen


2. Inserting a Foley catheter


3. Administering furosemide


4. Administering morphine sulfate intravenously


5. Transporting the client to the coronary care unit


6. Placing the client in a low Fowler's side-lying position


 1, 2, 3, 4




Pulmonary edema is a life-threatening event that can result from severe heart failure. In

pulmonary edema, the left ventricle fails to eject sufficient blood, and pressure increases in the

lungs because of the accumulated blood. Oxygen is always prescribed, and the client is

placed in a high Fowler's position to ease the work of breathing. Furosemide, a rapid-acting

diuretic, will eliminate accumulated fluid. A Foley catheter is inserted to measure output

accurately. Intravenously administered morphine sulfate reduces venous return (preload),

decreases anxiety, and also reduces the work of breathing. Transporting the client to the

coronary care unit is not a priority intervention. In fact, this may not be necessary at all if the

client's response to treatment is successful.




A client with myocardial infarction suddenly becomes tachycardic, shows signs of air hunger,

and begins coughing frothy, pink-tinged sputum. Which finding would the nurse anticipate

when auscultating the client's breath sounds?




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