MDC3 -3 MAKE SURE TO ANSWER ALL THE FOLLOW CAREFULLY AND CORRECTLY WITH CAREFUL UNDERSTANDING 1. Which of the following assessment findings are consistent with aortic regurgitation? Atrial fibrillation Systolic click Pitting edema Blowing decrescendo diastolic murmur 2. The nurse receives an order to infuse heparin 1000 units/hr IV. The IV bag contains 25.000 units heparin in 500ml. D5W. Calculate the IV rate in ml/hr___ ( record as a whole number) 3. The nurse is assessing a client with severe anemia. Which clinical manifestation does the nurse expect to see in this clients? Dyspnea with activity Hypertension Bradycardia Warm flushed skin 4. A nurse is caring for a 19 year old male recently diagnosed with leukemia. Which of the following nursing interventions is appropriate for the client? Strict hand hygiene to prevent infection Fluid restriction Low residual diet Therapeutic phlebotomy 5. The nurse assesses a client and documents the following findings edema 2+ bilateral ankles brown pigmentation of lower extremity skin aching pain of lower extremities when standing that resolves with elevation and 2+pedal pulses. What condition does the client likely have? Deep vein thrombosis Venous insufficiency Peripheral arterial disease Raynaud disease 6. The nurse is caring for a 65 year old female who presented to the emergency department with shortness of breath and chest discomfort. The client has not been feeling well for the past few days and complains of a productive cough of blood tinged sputum. Laboratory an elevated brain natriuretic peptide (BNP) and chest x-ray reveals pulmonary congestion , Based on the assessment findings which of the following diagnosis are consistent with these findings? Heart failure(left- sided) Pulmonary embolism Heart failure(right-sided) Lung cancer 7. A nurse is performing discharge teaching for a client who was recently diagnosed with heart failure. Which of the following should be included in the client and family teaching? (SATA) Medication teaching Low sodium diet Fluid restriction Weekly weight Symptoms to report to the provider 8. A 65 year old female presented to the emergency room with complaints of progressively worsening fatigue shortness of breath, and palpitations. Upon assessment heart rate is 150 beats per minute and irregular, and there is positive jugular vein distention heart tones reveal a high pitched holosystolic murmur. Which of the following disorders are consistent with these findings? Mitral regurgitation Mitral stenosis Aortic regurgitation Mitral valve prolapse 9. Which of the following assessment findings is consistent with mitral valve prolapse? Systolic click Urinary frequency Atrial fibrillation Claudication 10. The nurse is caring for four clients on a post surgical unit . The nurse understands that monitoring the client for which post operative complication takes priority? Constipation Nausea Urinary retention Pneumonia 11. A nurse is caring for a client who was recently diagno ...

1. MDC3 -3
MAKE SURE TO ANSWER ALL THE FOLLOW CAREFULLY
AND CORRECTLY WITH CAREFUL UNDERSTANDING
1. Which of the following assessment findings are consistent
with aortic regurgitation?
Atrial fibrillation
Systolic click
Pitting edema
Blowing decrescendo diastolic murmur
2. The nurse receives an order to infuse heparin 1000 units/hr
IV. The IV bag contains 25.000 units heparin in 500ml. D5W.
Calculate the IV rate in ml/hr___ ( record as a whole number)
3. The nurse is assessing a client with severe anemia. Which
clinical manifestation does the nurse expect to see in this
clients?
Dyspnea with activity
Hypertension
Bradycardia
Warm flushed skin
4. A nurse is caring for a 19 year old male recently diagnosed
with leukemia. Which of the following nursing interventions is
appropriate for the client?
Strict hand hygiene to prevent infection
Fluid restriction
Low residual diet
Therapeutic phlebotomy
5. The nurse assesses a client and documents the following
findings edema 2+ bilateral ankles brown pigmentation of l ower
extremity skin aching pain of lower extremities when standing
that resolves with elevation and 2+pedal pulses. What condition
does the client likely have?
Deep vein thrombosis
Venous insufficiency
Peripheral arterial disease

2. Raynaud disease
6. The nurse is caring for a 65 year old female who presented to
the emergency department with shortness of breath and chest
discomfort. The client has not been feeling well for the past few
days and complains of a productive cough of blood tinged
sputum. Laboratory an elevated brain natriuretic peptide (BNP)
and chest x-ray reveals pulmonary congestion , Based on the
assessment findings which of the following diagnosis are
consistent with these findings?
Heart failure(left- sided)
Pulmonary embolism
Heart failure(right-sided)
Lung cancer
7. A nurse is performing discharge teaching for a client who
was recently diagnosed with heart failure. Which of the
following should be included in the client and family teaching?
(SATA)
Medication teaching
Low sodium diet
Fluid restriction
Weekly weight
Symptoms to report to the provider
8. A 65 year old female presented to the emergency room with
complaints of progressively worsening fatigue shortness of
breath, and palpitations. Upon assessment heart rate is 150
beats per minute and irregular, and there is positive jugular vein
distention heart tones reveal a high pitched holosystolic
murmur. Which of the following disorders are consistent with
these findings?
Mitral regurgitation
Mitral stenosis
Aortic regurgitation
Mitral valve prolapse
9. Which of the following assessment findings is consistent with
mitral valve prolapse?
Systolic click

3. Urinary frequency
Atrial fibrillation
Claudication
10. The nurse is caring for four clients on a post surgical unit .
The nurse understands that monitoring the client for which post
operative complication takes priority?
Constipation
Nausea
Urinary retention
Pneumonia
11. A nurse is caring for a client who was recently diagnosed
with hemophilia. Which of the following laboratory tests is
consistent with that diagnosis?
Decreased bleeding time
Prolonged activated partial thromboplastin time
Prolonged prothrombin time
Decreased platelet count
12. A 78 year old female presented to the emergency department
with shortness of breath. Her daughter is at the bedside and
shares that the client has a history of heart failure. You place
the client on the cardiac monitor and find that the client is in
atrial fibrillation at rate of 180 beats per minute. Which of the
following are your concerns regarding this rhythm?(SATA)
Potential for embolic event
Hypotension due to elevated heart rate
Worsening heart failure
Dizziness and light headedness
Cerebral edema
13. Which of the following is the most common assessment
finding related to autoimmune thrombocytopenic purpura?
Bruising
Fatigue
Confusion
Fever
14. A client is receiving treatment for the diagnosis of
hemophilia A. Which of the following is most appropriate to

4. include in the assessment of the client?
Appetite
Urine output
Joint pain and bruising
Respiratory rate
15. A nurse is caring for a client who recently underwent a heart
transplant. Which of the following post operative nursing
interventions is the priority?
Assess for signs and symptoms of rejection
Advanced diet as tolerated
Auscultated bowel sounds
Maintain strict bedrest
16. A nurse is caring for a client diagnosed with polycythemia
vera. Which of the following should the nurse include in the
client and family education?
Decrease fluid intake to no more than 1 liter per day
Wear support hose while awake
Diet high in vitamin K intake
Resume normal activity
17. The nurse knows that hemolytic reaction to blood
transfusion occur most often within the ----first minutes of the
infusion?
100
15
45
60
18. The family of a neutropenic client reports that the client
confused and is not acting right, What action by the nurse is
the priority?
Ask the client about pain
Assess the client for infection
Delegate taking a set of vital signs
Look at todays laboratory results
19. During hourly rounding the nurse enters a room where the
client is unresponsive without a pulse. What is the nurses
priority action?

5. Call the family
Begin ventilation at 1 breath every 6-8 seconds
Start chest compressions at a rate of 100-120 compression per
minutes
Wait for the emergency response team for direction
20. Which of the following assessment findings is a priority
during a blood transfusion?
Chest pain
Headache
Joint pain
Fatigue
21. A nurse is caring for a client with a history of an abdominal
aortic aneurism. Which of the following assessment findings
request immediate intervention?
Decreased urine output
Back pain
Nausea and vomiting
Absent peripheral pulses
22. A nurse is caring for a client who has heart failure and a
prescription for digoxin 125mcg PO daily . Available is digoxin
PO 0.25mg/tablet. How many tablets should the nurse
administer per dose? (round nearest tenth)
23. A client admitted for sickle cell crisis is distraught after
learning her child also has the disease. What response by the
nurse is best?
Both you and the father are equally responsible for passing it on
I can see you are upset . I can stay here with you a while if you
like
Its not your fault there is no way to know who will have this
disease
There are many good treatments for sickle call disease these
days
24. A female client is being treated for a deep vein thrombus
she developed post operatively about one week ago and was
treated with unfractionated heparin, Today she presents to the
clinic with petechiae on bilateral hands and feet. Laboratory

6. results show a platelet count of 42, 000/mm3(42* 109/L). The
nurse is concerned about a drug reaction and anticipates the
client has which of the following?
Heparin induced thrombocytopenia(HIT)
Hemophilia A (classic hemophilia)
Thrombotic thrombocytopenic purpura(TTP)
Sickle call crisis
25. The nurse educates the client on which of the following
tests as the best tool for diagnosing heart failure?
Echocardiography
Pulmonary artery catheter
Radionuclide studies
Mitigated angiographic (MUGA) scan
26. Which of the following nursing interventions would be
appropriate for a client with sickle cell disease? (SATA)
Administer IV morphine
Keep the client strictly NPO
Remove restrictive clothing
Prepare the client for surgery
Provide a cool environment
27. A nurse is caring for a client who was received in the
emergency department with a heart rate of 220 beats per
minute. The clients cardiac monitor displays supraventricular
tachycardia(SVT) . Which of the following interventions should
the nurse anticipate?
Apply compression stockings
Check blood glucose
Draw labs
Vagal maneuver
28. A nurse is caring for a client diagnosed with peripheral
artery disease. Which of the following is a common assessment
finding?
3+ pedal pulses
1+ pedal pulses
4+pedal pulses
Bounding pulses in all 4 extremities

7. 29. A nurse is planning a client for a client who is iron
deficient. Which of the following foods high in iron should the
nurse include in the plan?
Oranges
Cashews
Red meat
Yogurt
30. A client states that their legs have pain with walking that
decreases with rest. The nurse observes absence of hair on the
clients lower extremities and the client has a thready weakened
posterior tibial pulse. What would be the best position to have
the clients legs?
Elevated on pillows
Crossed at the knee
Slightly bent with a pillow under the knees
Dependent position
31. A client diagnosed with stable angina is complaining of
substernal chest pain, rating the pain 5 out of 10 what would be
the priority action by the nurse?
Administer nitroglycerin 1 table sublingual immediately
Administer 81 mg of aspirin immediately
Administer the clients prescribed beta blocker
Administer morphine
32. A male client is presenting with radiating chest pain. Which
of the following would the nurse recognize as indicators that an
acute myocardial infarction may be occurring?(SATA)
Positive troponin markers
ST elevation on EKG on two contiguous leads
History of atherosclerosis
Pain radiating in jaw back shoulder or abdomen
Pain relieved with rest
33. Which of the following is a common early assessment
finding consistent with a diagnosis of hereditary
hemochromatosis?
Flank pain
Fever

8. Hypoglycemia
Liver dysfunction
34. Which of the following is a treatment option for a client
with sickle cell disease?
Pain management with NSAIDs only
Arthrocentesis
NPO diet
IV fluid bolus
35. Which of the following medications are appropriate for the
treatment of heart failure?(SATA)
Antibitics
Diuretics
Digoxin
Bronchodilators
Angiotensin- converting enzyme(ACE) inhibitors
36. Which of the following is a possible treatment plan for a
client diagnosed with leukemia?
Therapeutic phlebotomy
Stem cell transplant
Splenectomy
Dialysis
37. You are caring for a client who presented to the emergency
department with pulmonary edema. The clients is hypotensive
with a pulse oximeter reading of 85% on room air. Which of the
following is a nursing priority?
Administer diuretics
Administer IV fluids
Administer oxygen
Obtain a chest X-ray
38. The nurse is arriving at the beginning of her shift and taken
report on four clients on a medical surgical unit. Which client
should the nurse see first?
A client with pyelonephritis with nausea and vomiting
A client post total abdominal hysterectomy with 9/10 abdominal
pain
A client with chronic obstructive pulmonary disease with an

9. oxygen saturation of 89% on room air.
A client post prostatectomy with bright red blood and clots in
his catheter
39. Which of the following interventions should be included in
the nutrition care plan of the client with atherosclerosis?
Increase saturated fats
Increase daily intake of vegetables fruits and whole grains
Limit sodium intake to 6 g per day
Increase full fat dairy products
40. Which of the following is a treatment option for a client
with infective endocarditis?
Antimicrobials
Antihypertensives
Diet modification
Bedrest
41. A nurse is caring for a client recently diagnosed with
pericarditis which of the following is a common assessment
finding with this disorders?
ST segment depression
Pericardial friction rub
Elevated troponin
Heart failure
42. A nurse in a hematology clinic is working with four clients
who have polycythemia vera. Which client should the nurse see
first?
Client with a blood pressure of 180/98mm Hg
Client who reports shortness of breath
Client who reports calf tenderness and swelling
Client with a swollen and painful left great toe
43. A nurse sets an infusion pump to infuse 1 L of D5NS at the
rate of 100 ml/hr.
How many hours will it take to complete the infusion? __ hours
(record whole number)
44. Which of the following is the priority nursing intervention
for a client experiencing a transfusion reaction?
Stop transfusion immediately

10. Notify the provider
Flush the IV Line
Check vital signs
45. The nurse knows which of the following is the most
common problem for a client with valvular heart disease?
Decreased cardiac output
Difficulty coping
Bradycardia
Altered body image
46. A nurse is caring for a 65 year old male who recently
underwent an aortic valve replacement. Which of the following
is a post operative nursing care priority?
Temperature monitoring
Advance diet as tolerated
Assess for bleeding
Dressing change
47. A nurse is caring for a client recently diagnosed with
hypertension. Which of the following should be included in the
discharge teaching?
Only check your blood pressure at a clinic or pharmacy
Diet changes are not recommended
Decrease physical activity to avoid spikes in blood pressure
Adhere to prescribed medications
48. The nurse is discharging home a client at risk for venous
thromboembolism on enoxaparin sodium. What instruction is a
priority for the nurse to provide to this client?
Notify your health care provider if your stools appear dark or
tarry
Massage the injection site after the heparin is injected
You must have your PT/INR checked every 2 weeks
You must have you’re a PTT checked every 72 hours
49. A nurse is caring for a client who presented to the
emergency department with complaints of fatigue. Palpitations
and chest pain . Upon assessment the provider notes an S3 and
S4 gallop. Weak peripheral pulses and tachycardia. The
provider orders a chest x-ray and echocardiogram. Which

11. reveals left ventricular dilation. Which of the following
disorders is consistent with these findings?
Dilated cardiomyopathy
Restrictive cardiomyopathy
Pericarditis
Cardiac tamponade
50. A nurse is providing discharge teaching to a client who
recently underwent a mechanical valve replacement which of
the following statement by the client indicates the clients
correct understanding of the discharge teaching regarding
warfarin anticoagulant therapy?
I do not need to take my prescribed medication for the rest of
my life
Additional monitoring is not required while on the
anticoagulant
I can lead a normal life while on anticoagulants no restrictions
are required
I may need to modify my diet while on this medication
51. Which of the following procedures are performed for a
client with a pericardial effusion?
Coronary artery bypass graft
Thoracotomy
Pericardiocentesis
Thoracentesis
52. Which of the following is the treatment of choice for end
stage heart failure?
Heart transplant
Coronary artery bypass grafting
Percutaneous angiogram
Medications
53. A nurse are caring for a client diagnosed with
atherosclerosis. Which of the following is considered a risk
factor for the development of the disorder?
High HDL-C/ Low LDL- C
Vegan diet
Low HDL C/High LDL-C

12. Diet high in vitamin K
54. Which of the following medications are utilized to treat
peripheral artery disease(PAD)?
Antiplatelet drugs
Antibiotics
Nitroglycerin
Diuretics
55. Which of the following client is most at risk for developing
endocarditis?
A client who recently underwent a valve replacement
A client with Marfans syndrome
A client recently diagnosed with mitral stenosis
A client who recently had a valve replacement and had dental
work recently performed
56. A nurse is caring for a client who was recently diagnosed
with left ventricular heart failure what is an early sign the
client is most likely to report?
Abdominal distention
Weight gain
Swollen legs
Nocturnal coughing
57. A nurse reviews the arterial blood gas (ABG) values of a
client admitted with pneumonia PH 7;51 PaCO2 28mm Hg PaO2
70 mmHg and HCO2 24 mEq/L. What do these values indicates?
Metabolic acidosis
Respiratory alkalosis
Respiratory acidosis
Metabolic alkalosis
58. You are providing care to a client with pericarditis. If left
untreated which of the following is the client at risk of
developing?
Cardiac tamponade
Pneumonia
Pulmonary embolism
Deep vein thrombosis
59. A nurse is caring for a client recently diagnosed with

13. leukemia. Which of the following signs and symptoms are
consistent with this diagnosis?(SATA)
Bleeding gums
Bone pain
Weight gain
Increased urination
Fatigue
60. A 65 year old male client is brought via EMS to the
emergency department with chest pain , He rates the pain as a
10 on a scale from 0-10 the pain is located mid-sternum and
radiates to his left arm, His heart rate is 126 bpm and blood
pressure is 96/60 mm Hg A 12 lead electrocardiogram is
performed and reveals ST segment elevation. Which of the
following interventions does the nurse anticipate performing
immediately?(SATA)
Administer oxygen
Administer nitroglycerin
Administer a beta blocker
Administer morphine
Administer a statin
61. The client is admitted for heart failure and has edema neck
vein distension and ascites. What is the most accurate way to
monitor fluid gain or loss in this client?
Check for pitting edema in the dependent body parts
Auscultate the lungs for crackles or wheezing
Assess skin turgor and the condition of mucus membranes
Weigh the client daily at the same time with the same scale
62. When educating a female client on the signs and symptoms
of myocardial infarction the nurse recognizes that which of the
following should be included in the teaching?
Pain usually resolves with rest and relaxation
Women often present with a typical sign and symptoms
Substernal chest pain is the most common symptom in women
Women experience intermittent claudication
63. The nurse questions which order for a client with
thrombocytopenia?

14. Avoid IM injections
Administer enemas
Apply ice to areas of trauma
Test all urine and stool for the presence of occult blood
64. The nurse is caring for a 55 year old male who presented to
his primary physicians office for his yearly check up. Upon the
physical assessment the provider noted enlarged lymph nodes in
the groin and neck region. The provider questioned joe
regarding the possible causes of the findings. Which of the
following diagnosis are consistent with this finding?
Lymphoma
Sickle cell anemia
Leukemia
Polycythemia vera
65. A nurse cares for a client who has a nasogastric tube
attached to low suction because of a suspected bowel
obstruction. Which of the following arterial blood gas results
might be expected in this client?
pH 7.52 PCO2 54 mmHg
pH 7.42 PCO2 40 mmHg
pH &.25 PCO2 25 mm Hg
pH 7.38 PCO2 36 mm Hg
66. Which of the following is a pharmacologic treatment option
for a client with dilated cardiomyopathy? (SATA)
Diuretics
Sodium tablets
Digoxin
Phentermine
Anticholinergic
67. The nurse is reviewing laboratory values for a client which
of the following lab values should the nurse address
immediately?
Creatinine 6.2mg/dl
Phosphorus 5.1mg/dl
Potassium 5.9mmo/L
Sodium 147 mEq/L

15. 68. The nurse is caring for a client with mitral regurgita tion
which of the following would you anticipate the client to
develop if left untreated?
Myocardial ischemia
Left sided heart failure
Right sided heart failure
Renal failure
69. A nurse is caring for four clients with leukemia after hand
off report which client should the nurse see first?
Client who had two bloody diarrhea stools this morning
Client who has been premedicated for nausea prior to
chemotherapy
Client with a respiratory rate change from 15 to 20 breaths /min
Client with an unchanged lesion to the lower right lateral
malleolus
70. The nurse is arriving at the beginning of her shift and has
taken report on four clients on a medical surgical unit. Which
client should the nurse see first?
A client with hypertension with blood pressure of 172/92mm Hg
A client with a history of asthma complaining of increased
dyspnea
A client ready for discharge education after treatment of an
acute kidney injury
A client with pain that is two days post operative from a
prostatectomy
71. A hospitalized client has a platelet count of 58, 00/mm3
(58*109/L) what action by the nurse is best?
Encourage high protein foods
Institute neutropenic precautions
Limit visitors to healthy adults
Apply ice to bruises or sites of injury
72. Which of the following clients would not be a candidate for
thrombolytic therapy?
Client with a blood pressure of 100. 60 mm Hg
Client with a pulse of 102 beats/minute
Client with a history of hemorrhage stroke one month ago

16. Client age 65
73. Which of the following would predispose a client to mitr al
stenosis?
Obesity
Rheumatic fever
Diabetes
IV drug use
74. Missing
75. Which of the following is a priority nursing intervention for
a client in atrial fibrillation with a rate of 180 beats per minute?
Apply compression stockings
Administer anticoagulants
Administer medication to slow that rate
Monitor urine output
Explain how the economic and ecological situations from the
late 1920s-late 1930s shaped the experiences of the people
living in and leaving the Great Plains.
Students will integrate information from a total of three primary
and secondary sources and communicate a coherent
understanding of the Great Depression and the Dust Bowl.
Cite your sources by simply referring to the person, activity,
resource, or historian from videos or reading excerpts. Be clear
in your writing as you reference information.