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NSG223/ NSG 223 Exam 1: (New 2024/ 2025 Update) Med Surg II Review| Questions and Verified, Exams of Medical Sciences

QUESTION INR ranges Answer: normal therapeutic range: 2.0 - 3.0 mitral valve replacement range: 2.0 - 3.5 aortic valve replacement range: 1.8 - 2.2 QUESTION aPTT therapeutic range Answer: 45 - 70 seconds QUESTION paroxysmal supraventricular tachycardia (PSVT) Answer: - bursts of ventricular ac- tivity (multiple QRS complexes) - rate: 150-200 - regular rhythm QUESTION causes for PSVT Answer: - hypoxia - nicotine

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Available from 09/13/2024

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NSG223/ NSG 223 Exam 1: (New 2024/ 2025
Update) Med Surg II Review| Questions and
Verified Answers| 100% Correct| A Grade
Herzing
QUESTION
INR ranges
Answer:
normal therapeutic range: 2.0 - 3.0 mitral valve replacement range: 2.0 - 3.5
aortic valve replacement range: 1.8 - 2.2
QUESTION
aPTT therapeutic range
Answer:
45 - 70 seconds
QUESTION
paroxysmal supraventricular tachycardia (PSVT)
Answer:
- bursts of ventricular ac- tivity (multiple QRS complexes)
- rate: 150-200
- regular rhythm
QUESTION
causes for PSVT
Answer:
- hypoxia
- nicotine
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Partial preview of the text

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NSG223/ NSG 223 Exam 1: (New 2024/ 2025

Update) Med Surg II Review| Questions and

Verified Answers| 100% Correct| A Grade –

Herzing

QUESTION

INR ranges Answer: normal therapeutic range: 2.0 - 3.0 mitral valve replacement range: 2.0 - 3. aortic valve replacement range: 1.8 - 2.

QUESTION

aPTT therapeutic range Answer: 45 - 70 seconds

QUESTION

paroxysmal supraventricular tachycardia (PSVT) Answer:

  • bursts of ventricular ac- tivity (multiple QRS complexes)
  • rate: 150 - 200
  • regular rhythm

QUESTION

causes for PSVT Answer:

  • hypoxia
  • nicotine
  • caffeine
  • stress

QUESTION

treatment for PSVT Answer:

  • valsalva maneuvers (carotid massage, bear down)
  • betablockers
  • adenosine
  • calcium channel blockers
  • cardiac ablation (destruction of cells causing irregularity)

QUESTION

premature ventricular contraction (PVC) Answer:

  • early contraction of the ventricles
  • only affects QRS complex

QUESTION

causes for PVC Answer:

  • stimulants
  • nicotine
  • alcohol
  • hypoxia
  • Digoxin toxicity
  • hypokalemia

QUESTION

treatments for PVC

QUESTION

medications to treat high cholesterol Answer:

  • Atorvastatin (Lipitor)
  • Ezetimibe (Zetia)
  • Gemfibrozil (Lopid)
  • Cholestyramine (Questran)

QUESTION

Lipitor (Atorvastatin) Answer:

  • decreases LDL
  • increases HDL
  • take at the same time every day
  • avoid grapefruit juice
  • monitor liver function

QUESTION

Ezetimibe (Zetia) Answer:

  • often used with other statins
  • can cause abdominal pain
  • monitor liver function

QUESTION

types of angina Answer:

  • stable
  • unstable
  • intractable
  • variant
  • silent ischemia

QUESTION

stable angina Answer:

  • chronic
  • predictable
  • associated with activity
  • reversible ischemia
  • short duration (5- 15 min)
  • pain decreases with rest
  • stable cardiac enzymes
  • treated with Nitroglycerin and lifestyle modifications

QUESTION

unstable angina Answer:

  • unpredictable
  • pain can occur at rest
  • increases in frequency
  • reversible ischemia
  • stable cardiac enzymes
  • treated with lifestyle changes and MONA (morphine, oxygen, nitro, aspirin)

QUESTION

cardiac labs Answer:

  • troponin
  • CK-MB
  • BNP
  • pain not relieved with Nitroglycerin

QUESTION

STEMI (ST elevation myocardial infarction) Answer:

  • complete occlusion
  • irreversible damage
  • elevated cardiac enzymes
  • ECG changes (ST elevation)

QUESTION

signs and symptoms of MI Answer:

  • sudden crushing chest pain
  • unrelieved by rest and nitroglycerin
  • SOB
  • nausea
  • anxiety/restlessness
  • increased HR
  • cool, pale, moist skin

QUESTION

medical management of MI Answer:

  • MONA (morphine, oxygen, nitroglycerin, aspirin)
  • EKG
  • labs (cardiac enzymes)
  • anticoagulation
  • bedrest 12 - 24 hours

QUESTION

indications for management of STEMIs Answer:

  • thrombolytic therapy (Alteplase) - dissolve thrombus
  • administer within 30 minutes of presenting to hospital
  • chest pain > 20 minutes
  • < 6 hours from onset of chest pain

QUESTION

sinus rhythm Answer:

  • considered to be a normal heart rhythm
  • rate 60 - 100 bpm
  • regular rhythm
  • consistent P wave
  • P wave prior to every QRS complex
  • PR interval 0.12 - 0.20 seconds (SATA question)

QUESTION

sinus bradycardia characteristics Answer:

  • rate <60 bpm
  • regular rhythm
  • consistent P wave
  • P wave prior to every QRS complex
  • PR interval 0.12 - 0.20 seconds

QUESTION

patient symptoms with sinus bradycardia Answer:

  • tiredness
  • do not want pause to be more than 3 seconds
  • caused by low potassium or digoxin toxicity

QUESTION

premature atrial contraction (PAC) Answer:

  • extra contraction or ectopic beat before normal P wave
  • caused by stimulants, anxiety, hypoxia

QUESTION

atrial flutter Answer:

  • multiple atrial contractions (many P waves)
  • AV node protects the heart and does not allow extra P waves to affect rhythm
  • sawtooth appearance on ECG
  • REGULAR RHYTHM

QUESTION

atrial fibrillation Answer:

  • multiple atrial vibrations (no real P waves)
  • IRREGULAR RHYTHM

QUESTION

For what dysrhythmia can the telemetry alarm be turned off? Answer: atrial fibrilla- tion

QUESTION

risk factors for atrial fibrillation Answer:

  • hypertension
  • diabetes
  • obesity
  • heart failure
  • advanced age

QUESTION

Patient with atrial fibrillation and another risk factor are most at risk for what? Answer: stroke

QUESTION

management of atrial fibrillation Answer:

  • coumadin (oral) - check INR
  • Lovenox (Sub-Q)
  • Heparin (IV) - check aPTT
  • Amiodarone - check pulmonary function and renal tests

QUESTION

Amiodarone considerations Answer:

  • highly toxic to lungs and kidneys
  • obtain pulmonary function test
  • check renal tests
  • cannot take if allergic to iodine

Answer: valve replacement with metal or tissue valves

QUESTION

mitral valve stenosis Answer:

  • narrowing of the mitral valve
  • blood flow through the valve is reduced
  • usually caused by rheumatic endocarditis (strep throat)

QUESTION

symptoms of mitral valve stenosis Answer:

  • hemoptysis
  • wheezing
  • shortness of breath on exertion
  • possibly atrial fibrillation
  • risk for stroke

QUESTION

treatment of mitral valve stenosis Answer: balloon angioplasty

QUESTION

symptoms of aortic valve stenosis Answer:

  • dyspnea
  • dizziness
  • angina
  • fatigue
  • hypertrophy of left ventricle
  • high mortality rate
  • systolic murmur

QUESTION

symptoms of aortic valve regurgitation Answer:

  • water-hammer pulse
  • dyspnea on exertion
  • fatigue
  • diastolic murmur

QUESTION

What is the most common cause of cardiac valve disorders? Answer: rheumatic heart disease (develops from strep throat)

QUESTION

medical management of valve disorders Answer:

  • prophylactic antibiotics prior to invasive procedures or dental work
  • treat the symptoms (vasodilators, ACE, betablockers, diuretics)
  • daily weights*** (no more than 2.5-3lbs in 1 day or 5lbs in 1 week)
  • sodium restriction

QUESTION

mechanical valve replacement patient education Answer:

  • long-lasting

Answer:

  • rigid ventricular walls
  • impaired ventricular filling and stretch

QUESTION

symptoms of cardiomyopathy Answer:

  • slow progression of symptoms
  • dyspnea on exertion
  • dysrhythmias***
  • cough
  • orthopnea
  • palpitations
  • fatigue
  • peripheral edema
  • dizziness

QUESTION

diagnostic tests for cardiomyopathy Answer:

  • echocardiogram***
  • cardiac MRI
  • ECG
  • chest x-ray

QUESTION

medical management of cardiomyopathy Answer:

  • low sodium diet
  • exercise/rest regimen
  • anticoagulants
  • betablockers
  • diuretics
  • anti-dysrhythmics (Amiodarone)

QUESTION

What will nurse do if patient has weight loss of more than 2 pounds in 1 day, increased HR, and decreased BP? Answer: do not give diuretic, concern for dehydration

QUESTION

pulses paradoxus Answer: systolic BP drop of >10 during inspiration

QUESTION

treatment for rheumatic heart disease Answer:

  • antibiotics
  • bed rest
  • NSAIDs
  • steroids

QUESTION

treatment for infective endocarditis Answer:

  • IV antibiotics for 2 - 6 weeks
  • Amphotericin B (fungal infection)

QUESTION

normal PR interval on ECG Answer: 0.12 - 0.20 seconds

QUESTION

normal QRS complex on ECG Answer: 0.06 - 0.12 seconds

QUESTION

1 small box on ECG Answer: 0.04 seconds

QUESTION

ECG nursing considerations Answer:

  • clip hair if needed (no shaving)
  • change electrodes every 24 hours
  • do not place electrodes over pacemakers, incisions, or planned incision sites
  • remove ECG prior to MRI or other procedure
  • educate patient about ECG box's purpose

QUESTION

cardiac stress test contraindications Answer:

  • within 48 hours of MI***
  • unstable angina
  • uncontrolled dysrhythmias

QUESTION

cardiac stress test information Answer:

  • patient walks on treadmill to stress the heart
  • if unable to walk, meds are given to stress the heart (Dobutamine)
  • test is stopped if target heartrate is reached or patient becomes unstable (dizzi- ness, chest pain, discomfort)

QUESTION

patient education prior to cardiac stress test Answer:

  • fast for 3 hours
  • avoid stimulants (caffeine, tobacco)
  • meds may be taken but beta blocker may be held
  • wear comfortable clothing
  • report chest pain to technician

QUESTION

cardiac catheterization information Answer:

  • patient remains awake
  • patient is NPO
  • catheter inserted into a great vessel
  • contrast used for left-sided procedure
  • monitor renal function
  • bedrest 2 - 8 hours post-procedure
  • observe access site for bleeding
  • monitor for chest pain post-procedure

QUESTION

blood flow through the heart