Care of the patient with various Cardiovascular Disorder

1. The nurse know that the characteristic of pain in a patient with acute coronary syndrome
(MI) is:
a. Sharp or stabbing pain localized in anterior chest
b. Pain radiate across the chest to the medial aspect of arms and hands, jaw, and
shoulder
c. Gnawing pain that radiates to arms and hands, jaw, shoulders, and upper back
d. Sharp, severe substernal or epigastric pain that can radiate to neck, arms, and back

2. The nurse is expected to watch closely for complications related to mechanical ventilation.
Which of the following will the nurse do to assess subcutaneous emphysema?
a. Observe for signs of unequal chest expansion
b. Auscultate the lungs and observe for crackles
c. Palpate neck for air bubble popping sensation
d. Percuss for a hyperresonant percussion tone

3. You admitted Teddy, male, 70 years old, because of pulmonary edema. He has a history of
Congestive Heart Failure, type 2 diabetes mellitus and hypertension. Based on Teddy’s health
history, you specifically noted that he regularly takes lanoxin (Digoxin). Which of the following is
the SPECIFIC action of this drug on the patient?
a. Improves myocardial contractility, decreases the heart rate and reduces oxygen
consumption
b. Causes vasoconstriction, increase preload and dilates the ventricles
c. Reduces peripheral vascular resistance and afterload, reducing myocardial work
d. Interfere with the production of angiostensin II resulting in improved cardiac output and
reducing pulmonary congestion

4. You observed for fibrillation on the cardiac monitor. Which of the following ECG
characteristics did you observe on the cardiac monitor?
a. “Sawtooth” appearance of P waves
b. P waves hidden in the QRS
c. P waves unidentifiable
d. P waves observed before, during and after QRS

5. Upon assessment, the nurse is listening for the characteristic of murmur in mitral valve
stenosis and it is a?
a. Systolic crescendo-decrescendo murmur
b. Diastolic murmur, high-pitched, blowing sound at the 3rd and 4th ICS.
c. Systolic murmur, high-pitched, blowing sound at the apex of the heart
d. Diastolic murmur, low-pitched, rumbling sound

ENDOCRINE SYSTEM DISORDERS

Situation: Nurse Crystal admitted Alahas for management of acromegaly.

6. Nurse Crystal is aware that acromegaly is a condition when growth hormone occurs in
excess in adulthood of after epiphyses of the long bone shave fused. The following are the
typical features of the disorder, except:
a. The soft tissues continue to grow
b. Hands and feet are enlarged
c. The client grows taller
d. Broad and bulbous nose
Answer: C. The client grows taller. Acromegaly occurs after the epiphyses close and is
characterized by an increase in connective tissue, soft tissue and cartilage giving the
characteristic growth of the hands, face and feet. It also includes increase in the size of the
nose, prominence of periorbital ridges and growth of mandible resulting in widely paced
teeth. Phipp’s Medical Surgical Nursing, 8th ed., 2007, p. 1061-64. Acromegaly is an excess
hormone in adult without an increase in height. Brunner and Suddarth’s Textbook in Medical
Surgical Nursing, 10th ed., vol. 2. p. 1209

7. The client was prescribed ocreotide acetate (Sandostatin). Nurse Crystal would monitor
for which of the following side effects?
a. Abdominal pain
b. Dysuria
c. Hypotension
d. Constipation
Answer: A. Abdominal pain. Ocreotide acetate (Sandostatin) can result in abdominal
discomfort, nausea, vomiting, diarrhea and increased or decreased glucose. Saunder’s
Comprehensive Review for the NCLEX-RN Exam, 3rd ed. 2005 p. 659

8. For effective dosing, ocreotide acetate must be administered by which appropriate route,
three times weekly?
a. Intravenously
b. Orally
c. Intramuscularly
d. Subcutaneously
Answer: D. Subcutaneously. Ocreotide acetate must be given subcutaneously. Focus on
nursing Pharmacology by Amy Karch. 3rd ed. P. 515

9. Priority discharge plans should include which of the following? Select all that apply.
1. Fasting blood sugar 3. Intake and output
2. Bone assessment 4. Urine output
a. 2 and 3
b. All except 1
c. 1, 2 and 3
d. 1 and 2
Answer: C. Blood sugar, bone assessment and intake and output must be monitored.
Saunders, NCLEX comprehensive review 4th edition.

10. Acromegaly often develops insidiously that nurses should understand that the client with
this disorder would seek medical care because of:
a. Alteration in fat and carbohydrate metabolism
b. Changes in blood sugar level
c. Changes in appearance
d. Alteration in their voice
Answer: C. patients with acromegaly seek medical care because of changes in appearance.
Saunders, NCLEX comprehensive review 4th edition.
SITUATION: Foot care among patients with peripheral vascular problems due to
diabetes mellitus is very important

11. When teaching a client with peripheral vascular disease about foot care, you should
include which instructions:
a. Avoid wearing canvass shoes
b. Avoid using a nail clipper to cut the nails
c. Avoid use of cornstarch on the foot
d. Avoid wearing cotton socks

12. What is the earliest manifestation of peripheral neuropathy?

a. Paresthesia
b. burning sensations specially in the morning
c. Prickling or heightened sensation with episodes of sharp pain
d. Numbness

13. Peripheral neuropathy can best be controlled by:

a. Good glucose control
b. Steroid therapy
c. Vitamin supplement
d. Nothing, there is no slowing the process

14. In addition to clients with DM you must be aware that acute hypoglycemia can also
develop in a client with:
a. Hypertension
b. Hyperthyroidism
c. Liver disease
d. Diabetes insipidus

Care of the patient with various Endocrine Disorders

15. Which of the following is the symptom of SIADH?

a. proteinuria
b. Hypertension
c. Oliguria
d. Specific gravity of 1.001

16. Which of the following is indicative of a thyroid crisis?

a. Falling blood pressure
b. Regular and noisy breathing
c. High fever
d. Spasm in the hand

17. Which of the following is the adverse effect of PTU?

a. Palpitations
b. Diarrhea
c. Bradycardia
d. Cold tolerance

18. What is the serious side effect of metformin?

a. Disulfiram-like effect
b. Lactic Acidosis
c. Hypoglycemia
d. Diarrhea
19. Which safety measure should the nurse use for a client who has Cushing's disease?
a. Pad the siderails of the client's bed.
b. Assist the client to change positions frequently.
c. Use a lift sheet to change the client's position.
d. Keep suctioning equipment at the client's bedside.

20. Which safety measure should the nurse use for a client who has adrenocortical
insufficiency?
a. Pad the siderails of the client's bed.
b. Assist the client to change positions slowly.
c. Use a lift sheet to change the client's position.
d. Keep suctioning equipment at the client's bedside.