Med-Surg Exam Study Guide

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1- Question:
A client arrives in the emergency room complaining of chest pain that began 4 hours ago . A troponin T blood specimen is obtained , and the results indicate a level of 0.6 ng/mL . The nurse interprets that this result indicates a: Options:

1 . Normal level
2 . Low value that indicates possible gastritis
3 . Level that indicates a myocardial infarction
4 . Level that indicates the presence of possible angina
Answer:
3 .

2- Question:
A 22-year- old adult has a cholesterol blood test done at a screening clinic sponsored by a local health club. The nurse volunteering at the screening teaches the client that diet and exercise should be used as health measures to keep the total cholesterol level below: Options:

1 . 80 mg/dL
2 . 200 mg/dL
3 . 250 mg/dL
4 . 300 mg/dL
Answer:
2 .

Rationale:
The nurse should counsel the client to keep the total cholesterol level under 200 mg/dL . This will aid in the prevention of atherosclerosis, which can lead to a number of cardiovascular disorders later in life. Options 3 and 4 are elevated values and place the client at risk for cardiovascular disease . Although option 1 is a low cholesterol level , option 2 identifies the realistic value to assist in preventing cardiovascular disease.

3- Question:
A client is suspected of having a myocardial infarction. The nurse assesses for elevations in which of the following isoenzyme values reported with the creatine kinase level? Options:
1 . MM
2 . MB
3 . BB
4 . MK
Answer:
2 .
Rationale:
Creatine kinase (CK) is a cellular enzyme that can be fractionated into three isoenzymes. The MB band reflects CK from cardiac muscle. This is the level that elevates with myocardial infarction. The MM band reflects CK from skeletal muscle. The BB band reflects CK from the brain. There is no MK band. Question: A client is suspected of having a myocardial infarction. The nurse assesses for elevations in which of the following isoenzyme values reported with the creatine kinase level? Options:

1 . MM
2 . MB
3 . BB
4 . MK
Answer:2 .
Rationale:
Creatine kinase (CK) is a cellular enzyme that can be fractionated into three isoenzymes. The MB band reflects CK from cardiac muscle. This is the level that elevates with myocardial infarction. The MM band reflects CK from skeletal muscle. The BB band reflects CK from the brain. There is no MK band.

4- Question:
A client with atrial fibrillation who is receiving maintenance therapy of warfarin sodium (Coumadin) has a prothrombin time of 35 seconds . Based on the prothrombin time , the nurse anticipates which of the following orders? Options:

1 . Adding a dose of heparin sodium
2 . Holding the next dose of warfarin
3 . Increasing the next dose of warfarin
4 . Administering the next dose of warfarin
Answer:
2 .
Rationale:
The normal prothrombin time (PT) is 9.6 to 11.8 seconds (male adult) or 9.5 to 11.3 seconds (female adult). A therapeutic PT level is 1.5 to 2.0 times higher than the normal level . Because the value of 35 seconds is high (and perhaps near the critical range), the nurse should anticipate that the client would not receive further doses at this time. 5-Question:

The nurse checks the laboratory result for a serum digoxin level that was determined for a client earlier in the day and notes that the result is 2.4 ng/mL . Which of the following is the most important action on the part of the nurse? Options:

1 . Notify the physician.
2 . Check the client ’s last pulse rate.
3 . Record the normal value on the client ’s flow sheet.
4 . Administer the next dose of the medication as scheduled. Answer:
1 .
Rationale:
The normal therapeutic range for digoxin is 0.5 to 2.0 ng/mL . A level of 2.4 ng/mL exceeds the therapeutic range and indicates toxicity. The most important action is to notify the physician, who may give further orders about holding further doses of digoxin . Option 3 is incorrect because the level is not normal. The next dose should not be...
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