A 42-year-old female highway construction worker is concerned about he

NCLEX RN Medical Surgical Questions

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Question 1 of 5.

A 42-year-old female highway construction worker is concerned about her cancer risks. She reveals that she has been married for 18 years, has two children, smokes one pack of cigarettes per day, and drinks one to two beers with her husband after work almost every day. She is 30 lb overweight, eats fast food often, and rarely eats fresh fruits and vegetables. Her mother was diagnosed with breast cancer 2 years ago. Her father and an aunt both died of lung cancer. She had a basal cell carcinoma removed from her cheek 3 years earlier. What combination of behavioral changes should the nurse instruct this client to make first?

A. Decrease fat in the diet, decrease alcohol consumption, and use sunscreen every day.

B. Decrease intake of salt-cured food, lose weight, and stop smoking.

C. Stop drinking beer, decrease fiber in the diet, and use sun protection.

D. Stop smoking, use sun protection, and lose weight.

Explanation: Stopping smoking, using sun protection, and losing weight address the most critical modifiable risk factors for this client, given her smoking history, prior skin cancer, and obesity, which are linked to multiple cancers.

Question 2 of 5.

The nurse notices that a client's heart rate decreases from 63 to 50 beats per minute on the monitor. The nurse should first:

A. Administer Atropine 0.5 mg I.V. push.

B. Auscultate for abnormal heart sounds.

C. Prepare for transcutaneous pacing.

D. Take the client's blood pressure.

Explanation: A heart rate of 50 bpm may indicate bradycardia. Taking the blood pressure first assesses hemodynamic stability, guiding whether immediate intervention (e.g., atropine or pacing) is needed.

Question 3 of 5.

The nurse is assessing clients at a health fair. Which client is at greatest risk for coronary artery disease?

A. A 32-year-old female with mitral valve prolapse who quit smoking 10 years ago.

B. A 43-year-old male with a family history of CAD and cholesterol level of 158.

C. A 56-year-old male with an HDL of 60 who takes atorvastatin (Lipitor).

D. A 65-year-old female who is obese with an LDL of 188.

Explanation: Obesity and elevated LDL (188) are significant risk factors for coronary artery disease. The other clients have lower-risk profiles due to younger age, smoking cessation, or controlled lipids.

Question 4 of 5.

The physician refers the client with unstable angina for a cardiac catheterization. The nurse explains to the client that this procedure is being used in this specific case to:

A. Open and dilate blocked coronary arteries.

B. Assess the extent of arterial blockage.

C. Bypass obstructed vessels.

D. Assess the functional adequacy of the valves and heart muscle.

Explanation: Cardiac catheterization in unstable angina assesses the extent of coronary artery blockage to guide interventions like angioplasty or bypass surgery.

Question 5 of 5.

The nurse finds the apical impulse below the fifth intercostal space. The nurse suspects:

A. Left atrial enlargement.

B. Left ventricular enlargement.

C. Right atrial enlargement.

D. Right ventricular enlargement.

Explanation: An apical impulse below the fifth intercostal space suggests left ventricular enlargement, common in heart failure due to ventricular dilation.